Medications for ADHD can have serious side effects including growth retardation and heart problems. Many parents are looking for ways to help a child who has been diagnosed ADHD without resorting to medications. Here are some non-pharmaceutical ideas. These are by no means in order of importance. Each child is individual. The most important difference for one child might be step #8 while the most important intervention for another may be #1. Use your own judgement.
(Most of these ideas apply equally to adults with ADD or ADHD.)
1. Check the Diagnosis
No one knows your child as well as you. Look up the diagnosis for ADD or ADHD and see if you agree with it. Doctors are not gods and they are heavily influenced by the medical model and the pharmaceutical industry. Consider also whether your child has experienced any kind of event or situation which may have caused trauma or anxiety. Many children with whom I work are anxious due to situations in which they have lived or are living, but are diagnosed as "ADHD". What looks like "hyperactivity" may be anxiety. What looks like "inattentiveness" may be dissociation, a "spacing out" which is done by many people who have been traumatized. If you think trauma or anxiety is the problem look up the diagnostic criteria for PTSD and the diagnostic criteria for Generalized Anxiety Disorder and see what you think. If the true problem is trauma or anxiety, putting the child on medication for ADHD (which is basically a stimulant) will only make things worse. Imagine being very nervous or scared about something and downing several cups of coffee. Not a good idea.
I cannot emphasize this enough. Children were not made to sit and be quiet all day. They were made to run and explore in the fresh air and sunshine. I have one parent of an "ADHD" child who was actually struggling with PTSD symptoms. Instead of hustling him off to school during rush hour traffic every morning she got up extra early, ran through the Starbuck's drive through for a cup of java for herself and took him to the park for an hour. She sipped coffee and read the paper while he ran and played. He arrived at school tired but calm from playing. His school work and concentration improved greatly. He is now in the gifted program at his school and doing very well. This brings up point #3.
3. Be Sure You Aren't Dealing with a Gifted Child
Gifted children do not tolerate boredom well at all. Their minds are constantly busy and seeking stimulation. In regular classes they will finish their work early and then start getting into "trouble" in an attempt to keep their very active minds stimulated and engaged. If you suspect your child is gifted ask the school to have him tested. The problem may not be the child, it may be the classwork.
Another point of contention is constantly feeding children sugar then complaining when they ricochet off the walls. Check your child's diet, not only what they eat at home, but what they are eating at school. Many schools are now eliminating soda and candy machines for juice and healthier snacks. Fill them with complex carbs (whole grains, beans, vegetables), complex sugars (fruits with fructose instead of candy with sucrose), quality proteins (beans, lean meats) and good fats (olive oil, avocadoes). Simple sugars and carbs break down quickly in the body and give your child's energy and attention a big boost, followed by an even bigger crash. Complex carbs and sugars, quality proteins and fats break down more slowly and provide a more steady supply of energy throughout the day. You can read the article, "Eating for Mental Health" for more ideas about nutrition's effects on mental health.
5. Water, Water, Everywhere
Make sure that children are getting enough plain water, not sugary drinks. This is even more important during warm weather or in hot climates and when children are active outdoors. Adequate hydration is important for maintaining concentration and fighting fatigue.
6. Teach Your Child the Skills they Need
To ConcentrateMany parents don't realize that we have to teach our children how to tolerate frustrations and irritation. We also have to teach them how to concentrate and perservere when tasks are difficult. This requires a lot of time and effort from parents who are already over-burdened just making ends meet which is why we often see it falling by the wayside. But the gargatuan effort you put in now will pay off big in the future when your child moves to higher grades and harder tasks.
To Tolerate Frustration
Invest in inexpensive puzzles that your child has to struggle to complete. Be sure to check the level of difficulty. You want them to be a bit challenging, but not impossible. If they are too difficult it will only reinforce your child's tendency to give up. Work with your child and encourage them to perservere just a little bit further every time. Watch them carefully and when they have gone that extra distance take a break and play at something active or let them go outdoors or to a nearby park and run around.
Read to your child instead of sitting them in front of the TV or a video game. Encourage them to "help" you sound out the words or read the story. Increase the reading level as they master them. Encourage them to stick with it just a little past where they get tired or frustrated. This teaches them to tolerate frustration. Other areas in which they can practice tolerating frustration may be:
• Finishing homework without an extended break
• Being completely quiet while you are on the telephone
• Brushing teeth before hearing a bedtime story
• Cleaning dinner dishes before playing on the computer
• Finishing dinner before eating dessert
• Not eating breakfast until bed is made
• Not buying sneakers until they are on sale or they really need a new pair
To Delay Gratification
Research has shown that children who can wait for a reward score higher on SATs. They also do better in life. Psychologist Walter Mischel designed experiments that gave children a simple choice: one marshmallow immediately or two marshmallows after an unspecified waiting period. The child who was able to wait twenty minutes for the two marshmallows had a combined SAT score that was 210 points higher than the child who was unwilling to wait. Not only did the children who were able to delay gratification have higher SAT scores, they were also rated by their parents as better able to cope with stress, effectively pursue goals, and resist temptation. Develop a similar reward system for your child. A small reward immediately, a larger reward if they can wait an unspecified amount of time.
7. Structure, Structure, Structure
Most humans feel calmer with a structured routine in their lives. However, the amount of structure individuals needs can vary greatly. This may be genetically programmed at birth. It can definitely be affected by situations such as domestic violence or substance abuse. Children from more chaotic homes or who have experienced some form of trauma need more structure than children who have lived in relatively stable, safe environments their entire lives. Parents and children can have different structural needs. Children who have a need for a highly structured environment who have parents who value autonomy and freedom and see structure as inhibiting can look like ADHD kids when they're really just very anxious kids. One of my mothers refers to this as being a "Nazi mom". But she tried it and it worked. Her child is the one mentioned above who is now doing very well in school and getting the highest grades in his gifted class. Her introduction to a much more structured lifestyle calmed him down and made him feel safe after a very traumatic event. This calming effect was immediately reflected in his concentration and frustration tolerance at school (combined with a daily run in the park before school every morning).
Some very simple ways of introducing structure are to develop a morning "ritual" and a bedtime "ritual". Rituals are very calming to every human mind. That is why religions are often heavily loaded with rituals. Most people turn to religion when they are upset and lighting a candle, reciting a prayer or performing a mantra that is familiar can be very soothing. Rituals for Getting-Ready-For-School and Going-To-Bed can also be calming and familiar. Let your child participate in developing these rituals. Rituals for going to bed should move from more energetic activities (bathing, putting on your pajamas, brushing your teeth) to more calm activities (reading a goodnight story) in order to help the child change their energy levels slowly and gradually.
A family dinner together is a luxury many families can no longer manage. If you can, this is a wonderful "ritual" to practice. Dinner is at the same time every night and everyone is expected to be there. Turn off the television, the video games and the music and actually have a quiet conversation with each other.
Scheduling times to do homework everyday is also very helpful. If the child has been sitting in a classroom before you pick them up, let them come home or go to the park and play for awhile to burn off energy. If they've been playing at an after school program and have had a chance to run around you might have them sit down and do homework immediately upon arriving home, or while you cook dinner. If not, doing homework immediately after dinner might be more easily accomplished.
Be sure to develop a schedule that works for Mom and Dad as well as the child. If it doesn't work for you, you won't maintain it. If you don't maintain it, the whole purpose of developing the schedule, to have a regular routine, is lost.
I have found that a lot of children performing poorly in school are simply not getting enough sleep! Children who aren't getting enough rest can't possibly sit through a day of reading, lectures and study. Imagine a day of business meetings without enough rest. In his book, Healthy Sleep Habits, Happy Child, Dr. Marc Weissbluth gives the following guidelines:
3 - 6 years old: 10 3/4 - 12 hours per day
7 - 12 years old: 10 - 11 hours per day
12 - 18 years old: 8 1/4 - 9 1/2 hours per day
9. Sports or Martial Arts
Enrolling your child in a non-varsity sports program can give them the opportunity to develop the skills required to work within a team structure while also allowing them to burn off energy. Martial arts will teach them concentration and discipline. A weekend soccer team will teach them cooperation and how to work within a group. It's important to carefully screen the sports program or martial arts class. You want one that fosters self respect, self esteem and respect for others. One which teaches team spirit and cooperation. Classes should not focus on punishment, embarrassment or aggression. They should encourage self-regulation and commitment. The focus should be on mastery and having fun, not competition and aggression.
10. Censor the Adults
Last but certainly not least; censor your mouth and the mouths of other adults who work with your child. I worked with one 6 year old whose teacher would announce to his mother in the pick up line everyday that, "Mike had a bad day today". I worked with a 9 year old whose mentor would bring him into the computer lab and make the same kinds of announcements - to the entire room. He kept talking about how badly the boy had behaved despite my repeated requests that he stop. In his defense, he seemed totally oblivious to the effect it was having on the child, which was to shame him. Once he was aware of it, he did stop. But in the meantime, the other kids repeated the mentor's words back to the child during the computer lab and chided him for misbehaving. It was also interesting to watch their attitude toward the child. He became known as a "problem" kid and was ostracized by the others.
Don't allow your child to be labeled a "problem" child or a "difficult" boy or girl. Don't allow adults to talk about his or her behavior in front of others, or in front of the child. This is something the teacher should discuss in private with you. Don't allow the teacher to label them as a "bad" student or any other negative label. And if you don't believe your child is ADHD don't allow the teacher or doctor or others to label them as such. I had one parent who adamantly believed that her child had been misdiagnosed as ADHD. She fought heartedly with diagnosing psychiatrists, therapists and teachers to get them to see that her child was struggling with PTSD, not ADHD (he had been sexually abused). She won. The adults who are working with the child no longer ask if he took his medication this morning. They now realize that his behavior is the result of anxiety and fear and work for ways to calm him. They are also no longer labeling him a "problem" child. They now see him as an abused child who needs compassion and safety.
People who truly care about your child will listen and can change their attitudes.
If you have a child who has been traumatized as a result of abuse, especially sexual abuse, please keep that particular information very, very private. People don't need to know the details of the abuse or who abused them. This can be extremely embarrassing for children who are struggling to make sense of it already. I can't tell you how many parents I've met who announce this in the lobby with their child sitting their trying to crawl under the chair. Boundaries, boundaries, boundaries. Keep private information private. Don't apply negative labels to your child. Don't allow other adults to make negative comments or apply negative labels to your child.