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 A research study conducted at Nottingham University in the UK found that immediate reward in the form of points in a video game had a similar effect on brain activity as stimulant medication. Based on EEG results, the team found that both the rewards and the child’s usual dose of stimulant medication resulted in the normalization of brain regions and improved task completion though the medication yielded a slightly higher effect.
The researchers cautioned that immediate consequences in this case, reward are associated with positive effects on behavior in ADHD children. They stated that it may be difficult for parents and teachers to provide rewards immediately. However, other research shows than children with attention deficit hyperactivity disorder actually respond as well or better to social reinforcement such as a smile as they do to tangible reinforcers like points, tokens or money. This means that a smile or a brief word of encouragement may achieve significant benefits and could reduce or eliminate the need for medication for some children.
Years of research and current professional guidelines indicate that behavioral interventions should be tried first before medication except of children with severe symptoms. However, many parents find it difficult to find an effective, affordable and user friendly option for behavioral interventions. Total Focus is a comprehensive behavioral program using evidence-based techniques to improve behavior, learning, self-esteem and social skills. Parents and children work together as a team to bring about real lasting change involving activities that are fun and require less than an hour per day. Total Focus costs less than one visit to a mental health professional.
Up until now, the prescribing of medication for children with attention deficit hyperactivity is often tedious for the physician and the family. Children who do not respond to the first stimulant prescribed may respond to the next one tried or the one after that.
 There are two types of stimulants found to be effective for treating ADHD: amphetamine and methamphetamine. A study involving 89 children between the ages of 7 and 11 conducted at Cincinnati Children’s Hospital found that subjects with at least one copy of the 7-repeat DRD4 gene had a positive response to methylphenidate (a methamphetamine) while children without this gene related to dopamine did not. Methylphenidate is the active drug in Ritalin and Concerta along with several other ADHD medications.
This is good news for physicians and parents. This may prove to become part of the prescribing process that could lead to finding the best medication on the first try. According to the lead researcher in Cincinnati, Dr. Froehlich, “with more information about genes that may be involved in ADHD medication response, we might be able to predict treatment course, tailor our approach to each child, and improve symptom response while decreasing health care costs.”
 A recent research study to be published in the August 2010 issue of Child Psychiatry and Human Development found that low blood levels for zinc and iron are associated with symptoms of attention deficit hyperactivity disorder based on scores on the Conner’s Parent Rating Scale through the low levels were not associated with higher scores on the Conner’s Teacher Rating Scale.
There were 118 with ADHD (ages 7-14 years). While Conduct Problems and Anxiety were associated with lower zinc levels, increased Hyperactivity scores were related to both lower zinc and iron levels. It is known that these two minerals as involved with dopamine metabolism, one of the two neurotransmitters related to ADHD.
Parents may want to ask their child’s physician to check these levels and recommend supplements if they are found to be out of the normal range. Parents should be cautioned however, to not rush to some the supplement products on the market containing zinc and/or iron. Unless a child’s level is low for either of these two minerals, there is no evidence that boosting normal levels would be beneficial and could be harmful.
It is known that a healthy diet and regular exercise is good for brain development for all children and certainly beneficial for children with attention deficit hyperactivity disorder. With the exception of fish oil with Omega 3 antioxidants, no other supplements containing mega doses of vitamins, minerals or other “natural” substances have been proven through rigorous scientific research to be beneficial for kids with ADHD.
Parents concerned about their child’s ADHD symptoms should rely on treatment recommended by professional organizations which are (1) behavioral interventions, (2) school interventions and (3) stimulant medication for severe symptoms that do not respond to the first two approaches.
Many parents find it difficult to find an effective, affordable and user friendly option for behavioral interventions. Total Focus is a comprehensive behavioral program using evidence-based techniques to improve behavior, learning, self-esteem and social skills. Parents and children work together as a team to bring about real lasting change involving activities that are fun and require less than an hour per day. Total Focus costs less than one visit to a mental health professional.
A recent study published in the June online edition of Pediatrics showed that children with higher levels of organophosphate pesticide metabolites in their urine were at higher risk of developing ADHD symptoms. For every 10 fold increase in organophosphate pesticide metabolites in the urine there is a 55-72% increase in the odds of developing ADHD. Organophosphate pesticides affect insects by disrupting their central nervous system; specifically it affects acetylcholine, a neurotransmitter that may be involved in ADHD. The major source of exposure for children is through their diet. CropLife, an industry group representing manufacturers and distributors of agriculture and pest management products released a statement that this study ”leads us to believe much more research is needed to ascertain if there is a direct link between exposure to organophosphate pesticides and the development of ADHD in children.
“All crop protection products are extensively reviewed by regulatory agencies before approval for market use. Many scientific factors are examined by government pesticide regulators, based on extensive laboratory testing, all of which are intended to guarantee safety for the environment and people, including children,” the statement reads. “The class of crop protection compound that is the subject of this study has been approved and registered by the US EPA, and when used according to the label, the EPA has determined it to be safe.”
In the meantime, what can parents do to minimize pesticide exposures? All fruits and vegetables should be washed thoroughly, consider buying certified organic vegetables, purchase baby foods that are prepared from certified organic sources and minimize the use of insecticides around the home.
A recent review of the literature on sleep-onset insomnia in children with ADHD published in the December issue of the Annals of Pharmacotherapy found that Melatonin may be helpful to children with ADHD who have difficulty falling asleep. This is good news as the problem is quite common in ADHD children and may be a symptom of the disorder and/or related to the use of stimulants for treatment of the disorder.
While their are few studies on this subject and the studies that exist have some research methodology limitations, the author of the study concluded that Melatonin along with behavior modification and good sleep hygiene can be beneficial to children and teens with this problem.
Melatonin, a hormone produced by the brain regulates circadian rhythm sleep disorders such as sleep-onset insomnia, is often prescribed for various sleep disorders. The article concluded, when given at doses ranging from 3 to 6 mg within a few hours of a scheduled bedtime, melatonin was associated with improvement in sleep onset and sleep latency in 4 studies in children aged 6-14 years with ADHD and insomnia. Adverse events were transient and mild in all studies.
Parents should discuss this solution to sleep with their child’s physician. For more tips see Healthy Sleep Tips from Akron Children’s Hospital
Summer is that time every kid looks forward to. It is the “light at end of the tunnel” of a long school year. It is a time to “let loose” and have a great time. For kids with ADHD this is a big change. The day to day structure goes away, the daily routine is gone.
In just a few days or weeks, this long anticipated break can become a potential nightmare for kids with ADHD. It becomes a time when these kids are going around whining and saying, “I’m bored.” They come in complaining about an argument with peers or they are tormenting their siblings.
With a little planning ahead these and many other events can be avoided. Kids with ADHD still need structure, although it can be more relaxed than during the school year. Use a calendar that shows upcoming activities. Make a collage of things they can do when there is no planned activity (like games, toys, books, etc) and tell them when they are bored they need to check it and select an activity and do it.
Plan intermittent structured activities such as day camp, vacation Bible school, various recreation programs (like tennis lessons, swimming lessons, computer workshop or drama club and summer sports leagues) provided by schools, churches, and community recreation departments.
Think about summer camp. If decide this is a good idea, make sure the camp can handle ADHD kids and are willing to administer medications if your child takes them during the summer. Check out the list of Summer Camp Programs from CHADD which provide structure, fun and skill building. For other possible camp suggestions please visit the American Camp Association website.
Make this family fun time. When parents get home from work, devote a half hour or so to play time. Play around your home; go to a park or some other fun spot. Have a family game night or movie night. Enjoy a hobby together. Check out the Family Activities page from our main website for more suggestions.
No matter what the situation, you can make it enjoyable and productive for your ADHD child by thinking ahead and providing a little guidance and structure to curb impulsivity and teach them how to create their own fun time.
The word “disorder” conjures up images of illness, disease and serious disabilities. All parents want to see their child as the smartest, most capable and best liked boy or girl on the block. So why would they want to have a label attached to them that often coveys just the opposite–such as slow learner, under-achiever or Attention Deficit Hyperactivity Disorder?
What a difference one word can make. Suppose we changed the last D in ADHD from “disorder” to “difference.” We could then say that a child with ADHD has some significant differences in his cognitive ability, emotional sensitivity and activity level when compared to other children. This difference is probably inherited. His “skill set” is different from 95% of the children in his class.
Unfortunately, the environment in which he spends most of his time is geared toward the other 95%. However, we then could look at helping him to adapt successfully to this environment, using his own set of strengths rather than helping him to with this environment due to his weaknesses. We then might say that this child may need psychostimulants and/or psychological intervention to enable him to concentrate on boring tasks and control spontaneity in a highly regimented environment.
Continue reading ADHD: Disorder or Difference?
I often joke that kids with ADHD would make great politicians or lawyers, because they never give up a fight! Trying to cope with a child who argues at the drop of a hat can test the patience of any sane person. Not surprisingly, over the years many parents have asked me what they can do to make the arguing stop. What you can do is help your children turn their ability to argue into a positive trait rather than a negative one.
Here’s a way to understand what’s happening in your ADHD child’s brain: Many experiences of kids with ADHD are amplified or more intense than those of average kids. So when the word “No” is heard by a child with ADHD, it registers a “10” on their emotional scale while it probably would be a “5” or less for the average kid. Quite a few of them also have a lower-than-average tolerance for any departure from what they consider to be fair, whether it’s rules for a game or requests for doing something around the house. Added to this is the fact that most of these kids are also not known for their patience or low-volume voices! Continue reading How to Stop Arguing and Start Talking with Your ADHD Child
 I fully understand the concerns of parents regarding medication for ADHD. My wife and I struggled with this when my son was 5. He had a great response to stimulant medication and remained on medication until he was 14. He suffered no observable side effects. He is a 6’4” guy who completed college with honors and has been employed for 5 years in the film industry and currently is an editor for a top rated cable network show. We were at our wits end and what we called “the small vitamin” was a miracle drug. At home we also used psychosocial interventions from time to time during his formative years.
During my years as a child psychologist, I have been able to help many children with mild to moderate symptoms of ADHD do well at home and school without medication using psychological interventions. However, children with more severe symptoms benefit greatly from medication. Current guidelines now state that behavioral interventions should be tried first for mild to moderate symptoms and also should be used for more severe manifestations along with medications which may reduce the dose needed to control symptoms and may reduce the length of time required to remain on medication.
Continue reading ADHD: To Medicate or Not to Medicate?
A recent exploratory study conducted at a private school reported in Current Issues in Education stated that the use of meditation can be beneficial to 11 to 14 year old students diagnosed with attention deficit hyperactivity disorder, or ADHD. According to the researchers, “the technique has potential to improve attention, behavior regulation, and executive function by naturally reducing stress and anxiety and improving brain functioning.”
It is encouraging to see the growing interest in and availability of funding for research dedicated to the investigation of non-medication interventions for ADHD. Actually, relaxation training has been known for some time to provide benefits, and I have been using this technique along with others since the ’80s to help kids with ADHD. When combined with parent training, behavior modification and several other evidence-based techniques, I have found that children with mild to moderate symptoms can achieve significant improvement at home and at school without medication.
Published professional guidelines recommend that children with mild to moderate symptoms receive behavioral interventions, ie, some kind of behavioral help, training or modification, prior to moving on to medication. In the MTA study conducted by the NIMH, 30% of the children in the behavioral-only group normalized after 14 months, which means they were able to function on a normal level without medication. After 3 years, all of the children in the behavioral-only group demonstrated the same improvement in symptoms as those receiving medication and those receiving a combination of medication and behavioral intervention.
Unfortunately, even with this information, the rate of inclusion of behavioral intervention has been limited due to financial and time constraints. After years of working with kids with ADD and ADHD, I developed The Total Focus Program to help parents and families learn how to manage the behaviors that come along with the disorder. It can be used with or without medication as part of a total treatment program. Whether you try Total Focus or another program, I encourage you to seek out some kind of behavioral training program for your child with ADHD.
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A research study conducted at Nottingham University in the UK found that immediate reward in the form of points in a video game had a similar effect on brain activity as stimulant medication. Based on EEG results, the team found that both the rewards and the child’s usual dose of stimulant medication resulted in the normalization of brain regions and improved task completion though the medication yielded a slightly higher effect.
Robert Myers, PhD is a child psychologist with 30 years of experience working with children and adolescents with Attention Deficit Hyperactivity Disorder and learning disabilities and is the creator of the Total Focus Program. Dr Myers is Assistant Clinical Professor of Psychiatry and Human Behavior at UC Irvine School of Medicine. He earned his Ph.D. from the University of Southern California. He is a member of the American Psychological Association, Learning Disabilities Association of America and CHADD (Children and Adults with Attention Deficit/Hyperactivity Disorder).
