ADHD Treatments, Discipline, and Lifestyle

“We’re happy to provide you with a little monthly help,” the Denver Health and Human Services case worker told me as I signed some final paperwork just before our adoption hearing was scheduled. I glanced at my sleeping son. He was peacefully sucking his thumb in his car seat next to me, bundled up against a fierce Colorado spring storm raging outside. I wasn’t even sure why Denver County was agreeing to give us any adoption stipend at all. Josh was such a calm, happy baby. He’d been born addicted to meth, but aside from some admittedly severe constipation and other related gut issues, there had been no further medical complications—yet.

“He’ll be special needs for sure. He’ll have many behavioral problems like ADHD and probably bipolar disorder like his birth mother,” she assured me.

I glanced dubiously at Josh. Suck suck suck went his little mouth around his fat little thumb, his chubby cheeks bouncing up and down, his chest swelling and falling regularly with each breath, his white-blond hair a tiny bit sweaty from all the bundling up. Is he too hot? I wondered distractedly.

I was already a bit in denial. The truth was, Josh was even now at 18 months starting to show signs of his disorders. We had taken him to Disneyland to celebrate his first birthday and it had been a disaster. He had screamed his head off almost every second we were there. Not because he was frightened of the characters, but because he was confined to a stroller and wanted to be crawling on the ground. Problem was if we set him free, he was off like a shot without a care about where he was or where we were or who could step on him or anything. Situational or spatial awareness? He had none. Distraction? He had it in droves. Sensory processing disorder? Well I had no clue what that was yet but oh ya, you bet’cha. The truth was, Josh had severe ADHD and I still had no clue what I was in for.

 

Is ADHD even “real”

The whole subject of ADHD is not short on public controversy – some people, even some medical doctors,  insist that ADHD is a “manufactured disorder” intended as a ploy by the pharmaceutical industry to sell more Ritalin.  In this interview for PBS Frontline, child neurologist Dr. Fred Baughman says, “We’re talking about as many kids as you’ve got people in New York City, and to me, this is a catastrophe. These are all normal children. Psychiatry has never validated ADHD as a biologic entity, so their fraud and their misrepresentation is in saying to the parents of the patients in the office, saying to the public of the United States, that this and every other psychiatric diagnosis is, in fact, a brain disease.”

Other voices point out that ADHD is a real disorder with discernible brain wave activity that is correlative to symptoms. In that same story, Dr. Russel Barkley, Professor of Psychiatry and Neurology at the University of Massachusetts Medical Center in Worcester says, “There is no controversy among practicing scientists who have devoted their careers to this disorder. No scientific meetings mention any controversies about the disorder, about its validity as a disorder, about the usefulness of using stimulant medications like Ritalin for it. There simply is no controversy. The science speaks for itself. And the science is overwhelming that the answer to these questions is in the affirmative: it’s a real disorder; it’s valid; and it can be managed, in many cases, by using stimulant medication in combination with other treatments.”

Most medical professionals claim adamantly that ADHD is a true disorder, a chemical imbalance and true malfunction of the brain. Those in this camp do not necessarily focus on medicine, but instead tend to take a balanced treatment approach, not necessarily shunning medication, but advocate combining it with other forms of therapy to bring about symptom relief. This has been the case with my son Josh and his team of medical professionals. He sees a medical doctor, a psychiatric nurse practitioner, and a therapist. He is on a stimulant and a couple of antianxiety medications. So far my eldest son Arrow has been able to get away with treatment from our family doctor and a therapist on occasion. However, as he grows up and becomes more complicated, our doctor has indicated the need for a psychiatric specialist. Because ADHD and anxiety often go hand in hand (and they most certainly do for poor Arrow), he will probably be going up in dosage on his stimulant in the near future. He was just put on a new antianxiety medication which has already improved his life tremendously in only a week!

Because ADD and ADHD are brain disorders, it’s easy to label them as character defects or the result of poor discipline. It’s a lot like the frustrations that people with depression face as friends, family, and colleagues try to “cheer them up” only to be met with no success. Kids and adults such as my children and myself with symptoms do not exhibit them only at school or work, but to some degree in all situations. It defines our approach to life.

 

The Role of Discipline

So how do you discipline a kid with ADHD. My answer might surprise you. I never punish my kids. Nope. I never spank any more. I confess–we used to. A lot. We regret it. A lot. It only made things much, much worse. We don’t have time outs. We don’t ground. We don’t send to bed early or take things away. There are consequences. There are corrections. We do get angry. Sometimes we raise our voices. We’re only human. But then we ask for forgiveness.

Punishments. don’t. work. The only thing that does? Positive reinforcement. When I “catch” my kids doing something well? I praise them to the skies. When they’ve completed a chore, they get money. When they say thank you or do something nice, they hear about it from us. Maybe they get thanked publicly or they overhear me bragging to Mema or their dad. The point is, they know when they’ve done a good job. Heck, they know when they’ve done a meh job. Practice makes progress around here. I don’t expect perfection, I just expect them to try.

ADHD is NOT your fault Mama. You did not cause this. Your child’s teacher did not cause this. That weed you smoked before you knew you were pregnant did not cause this. An imbalance in your child’s brain has caused this. But you can help manage it. I urge you to take the first step and arrange a talk with your family doctor. He or she can set you on the path towards success.

A diagnosis of ADD/ADHD does not mean a life sentence of failure to succeed. People with ADD/ADHD can be successful, and parents and teachers can help these kids on their journeys toward a successful life. Here are some tips that may help.

 

Specific Directions

One of the things that can be challenging for kids with ADD/ADHD is not knowing how to make things happen. Children with this disorder are not acting willfully, experts assure us; rather, they simply don’t know how to do the things they’re asked to do.

They may also find it hard to remember directions. So when you’re asking a child with ADHD to do something, remember that he or she may need really specific advice on how to get that task done. For example, instead of saying, “Clean your room,” you could break it down into simple steps. Instead, you might say something like, “Let’s clean your room. First, let’s pick up the Legos off the floor, put them in the bin, and put the bin on the shelf.” This language also includes you as the overseer and helper, which can help motivate a child with ADHD to stick to the task.

 

It’s Okay to Help

While most experts agree that it’s not a good idea to do everything for a child, your active participation may go a long way in helping an ADD/ADHD child complete his or her tasks. As you’re breaking things down into manageable steps, follow through and encourage the child along the way. It may help to show him or her how it’s done (without taking over and doing it all yourself).

The other day, both of my kids had ADD/ADHD meltdowns because they were having trouble with their chores. I should mention, both kids also fall somewhere on the sensory spectrum. First it was Josh. He was crying because I had never asked him to fold shirts before and, though mine looked perfect when I folded them, his looked messy and “too small”. He wanted me to do them for him. Instead, I suggested we try a few different ways until he found a method he liked. I told him several times, in several ways, very patiently and kindly that I didn’t want perfection. I wanted him to practice until he got it. And he may not get it this time, but maybe he would get it next time, so let’s try together! Well, we persisted and he found a method he liked!

Then Arrow, left to his own devices, got overwhelmed by his chores and his school work and stormed off, locked himself in the bathroom, and got into a warm bath (his refuge in times of trouble.) What did this wise, sage, all-knowing mom do? I yelled at him through the door! Yup. I lost it because I didn’t take two seconds to find out what was going on his in his head. Turns out I had put too much of a burden on him that day without talking things out with him. Another kiddo in tears and another opportunity for me to turn things around and have a good mom moment AFTER I had blown it. When he got out, we had a heart-to-heart about how his semester was not going to hell, his chores were manageable, and it was not time to freak out. Mom was here for him and I was going to try to be a help, not a burden from now on. And by the way, as an apology, Dad was picking up a cheesecake and gourmet root beer as an after dinner treat that night. Yay!

 

Structure and Routine

Whether at home or in school, sources note that routines and structure are a tremendous help to those with ADD/ADHD. While it’s a good idea to be somewhat flexible and know when to compromise, a routine and structured activities can help a child with ADD/ADHD feel calmer and better able to focus. In this article from ADDittude Magazine, which includes sample ADD/ADHD routines and advice for how to implement them, Peter Jaksa, Ph.D. says, “Routines affect life positively on two levels. In terms of behavior, they help improve efficiency and daily functioning. It may not always be obvious, but children want and need routines. A predictable schedule offers structure that helps kids feel safe and secure. (Click on Jaksa’s link for info on ADHD and safety). By building one, you send a message that says, “This is how we do things.” Routines make daily activities manageable, allowing your child to focus on one thing at a time.

“In addition, your whole family will benefit psychologically from a structured regime. Both parents and children experience decreased stress when there’s less drama about what time you’ll eat dinner and where you’ll settle down to do homework.” (Click on this link for advice on ADHD and homework).

In our home, we have a good structure base. Because my kids attend an online school, we have a lot of flexibility. School starts at 11 am and goes until you’ve completed that day’s lessons (usually until about 4 or 5 pm). We do take frequent breaks. And the kids are allowed to choose which order they want to do their lessons in (some freedom and choice in life is good for the soul). If you have math work to do with Dad, that is done right after dinner or on Saturday afternoon.

 

Communication between Teachers and Parents

If you don’t homeschool, do remember that teachers are busy. But also remember that you are your child’s best advocate. Parents can help their ADD/ADHD child succeed by meeting with the teacher and accepting feedback from him or her frequently throughout the school year. It can help your child do better in school if you the parent are involved and actively working with the teacher and staff of the school. I looooooove email. Teachers have the freedom to respond when they are able and it gives me the flexibility to word what I have to say just so. That way I get all my questions down and don’t forget anything. I also love to talk on the phone with my kids’ homeroom teachers now and again as they are super friendly and helpful (MAN do I ever love Connections Academy. In all the years we’ve been with them, we have had ONE bad egg among many teachers. ALL of the rest have been super stars). Since my kids go to school online, it helps to hear a friendly voice from time to time and get that “human” connection.

 

Goals and Reinforcement

Children with ADD/ADHD need clear directions and daily goals, say experts. As you make a behavior plan with your child, make sure your expectations are clear and that you reward success with positive reinforcement (see above).

 

Common Treatment Options for ADHD

While ADHD is diagnosed according to common symptoms, how individuals and families cope with the disorder varies quite a bit. Some individuals use medication only; others use a combination of medication and therapy; still others shun medication altogether (Medication has changed my life, Arrow’s life, and Josh’s life. We are “us” only so much better for the meds). Here is a brief discussion of some of the common treatments for ADHD.

Medication

It may seem ironic, but the medications given to people with ADHD are stimulants. This is because the brains of those with ADHD tend to have slow brain wave patterns. The stimulants compensate for and “speed up” this slow activity, normalizing symptoms. Common medications include:

* Ritalin

* Adderall

* Concerta

Some medical professionals may also prescribe anti-depressants or anti-anxiety medication, which is the case for my children and myself. Josh is the one with severe ADHD and sensory spectrum disorder, I have ADD and bipolar, and Arrow has ADD and high functioning autism spectrum. We are all on several psychotropic medications and are so much better off for it.

Lifestyle

Lifestyle changes are a viable and growing means of treating ADHD. Here are some of the common adjustments families may choose to make in order to manage family members’ ADHD.

*Diet (to me, this is “woo woo” science. I do not employ this in our lives. I believe in a balanced diet of protein, lots of fruits and veggies, a healthy dose of fats, the occasional complex carb, and a few treats so you’re not deprived. However, I know families that swear by the ADHD diet, so I’m going to go ahead and include it here—I’ve done a ton of research into nutrition, and have even taken some college level courses in it and there’s nothing here that can harm you or your children.)

  • Eating whole foods that are locally and/or organically grown
  • Including lots of fresh fruits and vegetables in the diet
  • Eating healthy fats (in supplement and/or food form)
  • Removing trans fats from the diet
  • Removing artificial colors, flavors, and preservatives from the diet
  • Using natural leavening in baked goods
  • Limiting white sugar

 

 

*Exercise is something I can really get behind. I have seen my kids on no exercise and I have seen them worn out and sleeping well after a full day of activity. I’ll choose a full day of activity over a day of video games any time. Like the popular drugs for ADHD, exercise is said to boost the production of “good” brain chemicals, chemicals that are often lacking or malfunctioning in ADHD individuals. Also, exercise burns off some of that restless energy. Regular exercise is an important aspect of health for everyone, so this is a good lifestyle change that the whole family can adopt.

 

There’s a great homeschool curriculum that I recommend for any ADD/ADHD family, homeschooled or not, called Activate which you can find by clicking here. Activate helps the ADD/ADHD child with memory and concentration using games, activities, and special exercises that “activate” and stimulate the brain in a positive way, much the same way medications will. Used in conjunction with your child’s medication and therapy, Activate can soothe symptoms and ease the discomfort and problems associated with ADHD.

 

 

*Routine

Families and individuals find that the implementation of a regular routine helps relieve ADHD symptoms. People with ADHD tend not to cope with change well, so a predictable routine may help them feel more secure and calmer (see above).

 

 

*Sleep

Both of my kids are insomniacs and always have been. Same goes for me. We all take sleep medications and I HIGHLY recommend them if you or your kids don’t sleep well. At the very least, try Melatonin. Children’s Hospital of Colorado Sleep Clinic recommended Natrol 1 mg melatonin for Josh when his insomnia was completely out of control. The sleep specialist I spoke with there said that was one of the few trustworthy brands. She also told me not to give him or even an adult more than 3 mg as that can make the problem even worse. Sleeping well is fundamental to treating any brain disorder. Establishing regular bedtimes that allow for adequate sleep will also help. Children with ADHD are notoriously difficult sleepers, but regularity and a bedtime routine will most certainly help. If your child is having difficulty getting to bed, I recommend starting the bedtime routine very early—even as early as 7:30 pm. Get them off electronics at this point, get them their medication, and have them start winding down right about now. Here’s a great article about bedtime from WebMD.

 

*Therapy

Therapy and counseling have benefitted both children and adults with ADHD. Depending on the type of therapy, patients are generally taught coping mechanisms, behavioral skills, and self-esteem. Biofeedback is another treatment option that teaches patients to recognize their own brain waves and anticipate (and curtail) upcoming behavior. I have heard it can be effective, but neither of my kids has ever participated in it.

 

*Back to Nature

Many studies have shown convincing evidence that time outdoors helps alleviate ADHD symptoms. Apparently, the greener the better, as these studies show that outdoor settings like parking lots do not seem to have the same positive effect as outdoor environments that included trees, grass, and other natural elements. Victoria L. Dunkley M.D., of Psychology Today, cites several scholarly studies in this article and says, “Green-time promotes long term gains in attention and impulse control—domains which largely shape how well our brain functions, and therefore how well we function in school, work, relationships, and health. Green-time is a truly solid investment in mental wealth.”

This has not worked for my kids. We go to the mountains frequently. In fact, we used to spend every Saturday hiking. But sadly, the effort was lost on both Arrow and Josh who both seem to have developed agoraphobia—especially Arrow who calls himself a “vampire” and doesn’t even like to go to the beach. (Who doesn’t like the beach??) Josh loves to swim and will hang out in the yard for a bit most days. But Arrow shrivels in the sun and spends his mountain time inside playing video games. It makes my nature-loving heart weep, but I can’t seem to do anything about it. But you give it a shot with your kiddos, Mama. Green them up for me! I personally can’t get enough nature and love to “escape” to the local reservoir once in a while all alone and just sit by the lake and watch the water fowl and the little wavelets lap at the rocks. I can’t think of a single thing that will sooth my ADD symptoms faster than an hour spent in nature.

 

Tell us what techniques you’ve used in your family, Mama. How do you discipline/reward your kids? What soothes your kids or gets them to sleep? What has worked in school or homeschool? Any other tips for us? Let’s get behind each other and help a Mama out! Tell us all about it in the comments below!

 

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