The complex issues surrounding ADHD Diagnosis and Treatments
Identification of Signs, Symptoms, Types, and Treatments
Attention-Deficit Hyperactivity Disorder in ChildrenChildhood ADHD or attention-deficit with hyperactivity disorder is normally diagnosed after a child has shown 6 or more specific symptoms of hyperactivity on a consistent basis for more than six months. There is no single test for ADHD.
A doctor normally diagnoses ADHD using standard guidelines as outlined in the current edition of the Diagnostic and Statistical Manual of Mental Disorders. The diagnosis of ADHD usually involves the gathering of information from several sources, including school, caregivers, and parents. The healthcare provider will also consider how a child's behavior compares with that of other children the same age. The following is a link to a slideshow and descriptions about typical actions of the ADHD child.
Symptoms of Childhood ADHD
Children with ADHD usually show signs of lack of attention, they are hyperactive or hyperkenetic, and are impulsive in one or more of the ways listed below. Please note that not all symptoms need to be present for a diagnosis of ADHD or ADD.
- Are in constant motion.
- Squirm and fidget.
- Do not seem to listen.
- Have difficulty playing quietly.
- Often talk excessively.
- Interrupt or intrude on others.
- Are easily distracted.
- Do not finish tasks.
Some behaviors can sometimes appear to be ADHD-related, but are not. Some causes of ADHD-like behavior are:
- A sudden life change (such as divorce, a death in the family, or moving).
- Undetected seizures.
- Medical disorders affecting brain function.
How Is ADHD Diagnosed?
Your child's counselor, psychologist, or psychiatrist are usually the best equipped professionals to determine whether your child has ADHD using standard guidelines developed by the American Psychiatric Association. These diagnosis guidelines are for children 6 to 12 years of age.
Know that it is very difficult to diagnose ADHD in children younger than 5 years of age. That's because many preschool children have some ADHD symptoms in various situations. In addition, children change very rapidly during the preschool years. As well, It can also be difficult to diagnose ADHD once a child becomes a teenager.
The process of diagnosing ADHD requires several steps and involves gathering a lot of information from multiple sources. You, your child, your child's school, and other health care providers should all be involved in assessing your child's behavior.
A trained healthcare provider in this area can conduct a medical history to help put a child's behavior in context. They will ask what symptoms a child is showing, how long the symptoms have occurred, and how the behavior affects a child and his or her family.
Types of ADHD in Children
Healthcare providers may classify symptoms as the following types of ADHD:
- Combined Type (Inattentive/Hyperactive/Impulsive). Children with this type of ADHD show all three symptoms. This is the most common form of ADHD.
- Hyperactive/Impulsive Type. Children show both hyperactive and impulsive behavior, but are able to pay attention.
- Inattentive Type. Formerly known as attention deficit disorder (ADD), these children are not overly active. They do not disrupt the classroom or other activities, so their symptoms might not be noticed.
ADHD Treatment Overview
Education of the child and family is an essential component of any treatment plan, which may include specialized education programs, psychological intervention, and medication treatment. You should discuss all of these options with your child's health care provider to find the best treatment for him or her.
Studies show that long-term treatment with a combination of medications and behavioral therapy is far superior to simply medication treatment, or no specific treatments in managing hyperactivity, impulsivity, inattention, and symptoms of anxiety and depression. Those kids treated with both ADHD medication and or alternative medicines as well as therapy also had better social skills.
The controversy about medications for use with Childhood ADHD
A class of drugs called psychostimulants or stimulants have generally been seen as the most effective treatment for childhood with ADHD. These medicines, including Ritalin, Concerta, and Adderall XR, help children to focus their thoughts and ignore distractions. Stimulant medications have been shown to be effective in 70% to 80% of patients. However, there is growing concern with respect to the long term use of these medications as well as their short-term side effects. Many people have found comparable success in using non-addictive holistic medications that have little or no side effects.
Another possible pharmaceutical consideration for treatment of ADHD in kids is the nonstimulant medication, Strattera. More studies will need to be done to contrast Strattera with the medications already available, but the evidence to date indicates that over 70% of children with ADHD given Strattera have significant improvement in their symptoms.
ADHD medicines are available in short-acting (immediate-release), intermediate-acting, and long-acting forms. It may take some time for a physician to find the best medication, dosage, and schedule for an individual with ADHD. ADHD medicines generally have side effects, and most of these are felt to end early in treatment because the patient either gets used to the medication and their body adjusts or they simply have better behavior and the side effects become secondary to the benefit. Either way the side effects are promoted as usually ending early in treatment and being mild and short-lived. Our belief at Accurate Assessments and Treatment is that when a medicine is used that we want to supply one that has the most benefit and the least "side effects" as possible. Are preference is to have no side effects. It is our belief that stimulant medicines should be used as the last consideration rather than the first, therefore alternatives that have little or no side effects need to be explored first. These alternatives, are the types of medications that our firm specializes in recommending. We supply testing for not only the patient in question but can also have the ability to test the medication being considered prior to use to see if it is compatible with the patient's physiology. One such medication that we have considered with respect to ADHD is Theanine. The film below talks about its use with two young men in which it had very positive effects.
Behavioral Treatments for Children With ADHD
Behavioral treatment for children with ADHD involves adjusting the environment to promote more successful social interactions. Such adjustments include creating more structure, encouraging routines, and clearly stating expectations of the child with ADHD.
Other forms of ADHD treatment that may benefit the child include:
- Social skills training. This can help a child with ADHD learn behaviors that will help them develop and maintain social relationships.
- Support groups and parenting skills training. Education and support for the parents can be an integral part of treating ADHD in children.
What Treatment Is Best for My Child?
For children with ADHD it is important to remember that no single treatment is the answer for every child. A child may have undesirable side effects to a medication, making a particular treatment unacceptable. If a child with ADHD also has anxiety or depression, treatments combining medication and behavioral therapy must be very carefully chosen by the healthcare provider. Each child's needs and personal history must be carefully considered for each major component of their physiology as well as their cognitive, behavioral, emotional, and spiritual aspects of their individuality. It is important to work with a physician to find the best solution for your child.
Adults with ADHD may have double the challenge of children with the same disorder! Firstly, they often go undiagnosed because attention deficit hyperactivity disorder treatment tends to focus mostly on children. Although it is a problem which an ADHD adult usually carries from childhood, it was not a widely recognized disorder in past generations so they often don't realize they have ADHD until their own child is diagnosed. Parents will recognize their own past or present behavior when they look through the list of symptoms for their child. Also, there are several fairly common adult conditions that can mimic ADHD , such as depression, anxiety, hormonal imbalances hypothyroidism, manic depression or obsessive compulsive disorder. It is very important that your healthcare provider consider these other possibilities and rule them out before they diagnose adult ADHD.
The ADHD adult may have the same challenges as the ADHD child with the main difference being that adults have more sophisticated coping mechanisms than children. Behaviors may include: difficulty staying organized, difficulty finishing a task, procrastination, trouble maintaining relationships or controlling their moods, very impulsive, poor financial management, etc. Once adult ADHD is diagnosed, health care providers often prescribe antidepressant medication, like Prozac, and if that is ineffective, stimulant drugs likely will be tried. It is also very important to understand that the symptoms of attention deficit hyperactivity disorder in adults can usually be successfully reduced or eliminated naturally by incorporating diet and dietary supplementation as well as exercise and other lifestyle modifications.
Attention Deficit Disorder Medication:
The Pharmaceutical Consideration
Attention Deficit Disorder is generally difficult to diagnose because the symptoms are mostly ‘behavioral' and could have a variety of causes; anxiety, depression, allergies, seizures, or problems with the home or school environment can mimic Attention Deficit Disorder. However, once an expert diagnosis has been made, one of the first treatments for ADD prescribed by mainstream psychiatrists are stimulant medications such as Ritalin, Adderall (banned in Canada) and Concerta. Dexedrine is typically prescribed to patients who do not respond well to Ritalin. Psychiatrists also at times prescribe the ADD medication Cylert although because it has sometimes been blamed for potentially life-threatening and fatal side effects it is the least favorite of ADD medication.
Although these medications have been found to have some positive short term benefits in dealing with the symptoms of ADD & ADHD, ALL of them have potentially harmful side effects . Parents of children diagnosed with Attention Deficit Disorder (ADD & ADHD) often feel overwhelmed and trapped in a very bad situation. However, knowledge is power so if parents take some time to fully inform themselves about alternative treatments (including diet, nutritional supplements, more fresh air and exercise) before choosing the pharmaceutical route, perhaps they can avoid exposing their children to potentially harmful medications or at least find a healthier balance between drugs and other treatments. Below is a short clip that discusses the ADHD pharmaceutical medication options.
Possible ADHD Dietary modifications
ADHD in many cases has been linked to diet, which includes food allergies and nutritional deficiencies. Therefore in some cases simply eliminating certain foods or adding others can reduce symptoms or eliminate them altogether. However, in some cases eliminating certain foods is not always practical or desirable. Therefore testing to find the offending culprits and desensitizing the individual to these foods so that they can continue to be consumed without their previous behavioral side effects is the most desirable course of action. Hyperactive children are especially vulnerable as they are more ‘hyper' sensitive to sugar and other stimulants than adults. If you have noticed how your child's behavior changes very shortly after he or she consumes a soft drink, sugary cereals or chocolate then changes in diet should be considered. We believe it is worth attempting to address the ‘root' of the problem first. If the problem is indeed a nutritional problem, before ingesting the potentially toxin rich pharmaceutical alternatives that merely mask the symptoms changes in diet should be considered. Making healthy food choices for you and your child is NOT difficult. There is NO downside to adopting a healthy eating program and huge benefits for everyone, whether dealing with a current health issue or preventing future ones.
Another suggestion for a healthy diet may be to consider buying certified organic products...these are foods which are grown without the use of potentially harmful long-lasting pesticides, herbicides, and fungicides. Since organic foods are also grown without genetically modified seeds, sewage sludge or irradiation, some people feel that this is a more wholesome choice. If you choose to adopt the strategy to “cleanse” the body first to reduce symptoms of ADD, this may be an option you would like to consider. Imagine if we put dirty fuel in our cars and never changed the oil...how efficiently do you think they would run?
Below is a copy of a diet ADHD kids and adults. It is not a very strict program unless you are a regular at fast food restaurants. This is a “back to the basics” program and is recommended for every member of the family...not just someone with ADHD.
First, what NOT to eat for TWO WEEKS:
1) NO DAIRY PRODUCTS, especially cow's milk. This is the single most important restriction. Instead try Almond milk, Rice milk, or Better Than Milk. Drink water instead of milk. In fact, drink lots of water. The brain is about 80% water, and increasing your water intake to 7 to 10 glasses per day might be helpful all by itself. Sodas, Gatorade, teas, icees, etc., do not count as water. Water counts as water.
2) NO YELLOW FOODS. Especially Corn or Squash. Bananas are white. Don't eat the peel.
3) NO JUNK FOODS. If it comes in a cellophane wrapper, don't eat it.
4) NO FRUIT JUICES. Too much sugar content. One small glass of apple juice has the sugar content of eight apples. Later on you can have juice, but dilute it with water 50/50.
5) CUT SUGAR INTAKE BY 90%. If you can, cut it down to zero. Sugar is in just about everything, but give it a try. Do your best without going crazy.
6) CUT CHOCOLATE BY 90%. No more than a single piece, once a week.
7) NO NUTRASWEET. None. Period.
8) NO PROCESSED MEATS and NO MSG. Only get meats with labels that say, “Turkey and Water,” etc. If the meat has chemicals listed that you can't pronounce, don't buy it.
9) CUT FRIED FOODS BY 90%.
10) AVOID FOOD COLORINGS WHENEVER POSSIBLE. See if your child is sensitive to any particular colors, such as Reds, Yellows, etc. For now, though, avoid all if possible.
SUMMARY: Just eat foods that are non-man made made for a while. Generally this includes primarily organic meats, fruits and vegetables in their natural context. Dairy products and grains, because they have a great possibility for causing problems should be eleminated, at least early on, in the patient's diet. Eat like people did in the 1940's. Go to a used book store and get a Betty Crocker's Cook Book for recipe ideas. There really are about 10,000 meals that you CAN eat. Just not much in the way of “fast foods” or “convenience” foods.
AFTER TWO WEEKS begin adding these foods back into your diet, one food every other day. Eat A LOT of that food every day for four days. If you have a problem with one of the foods, you will see some kind of a “reaction” within four days. The reaction can vary from big red splotches on the body to ears turning bright red to behavioral changes such as an explosive temper. Generally, if there's a problem, you'll know. If there's no problem, you can normally go ahead and enjoy the food.
WHAT TO EAT TO FEED THE ADHD BRAIN:
1) FOR BREAKFAST SERVE HIGH PROTEIN, LOW CARBOHYDRATE MEALS. Say, “Good-bye,” to Breakfast cereals and milk. Serve 60% Protein and 40% Carbohydrates for Breakfast. Other meals should be 50% / 50% unless otherwise suggested by your healthcare provider.
2) PROTEIN SUPPLEMENTS might be needed to get the added protein for Breakfast. They are often very helpful in the afternoon as well. Here is our favorite recipe for a Protein Shake:
a) Make a cup of coffee, using one of General Mills' International Coffees, or something like that, with a flavor that you or your child will like (yes, I know I'm breaking my own rules here, as these coffees have dried milk and some sugar, but I'm trying to get your kid to actually drink the thing, and also get some caffeine mixed with the protein). Pour the hot coffee into a blender with about 6 oz of ice. Turn on the blender for a bit.
b) Add a good quality protein powder. There are many good ones available. If you can't find one that you like, ask at your local health food store or healthcare provider. Get protein powders that are mostly protein and very little carbohydrate. Add between 15 and 20 grams of protein to the cold coffee in the blender.
c) Turn on the blender again.
d) Drink it up.
This protein shake is helpful for a lot of people. For many small kids, and many adults, this recipe works about as well as a small dose of Ritalin (100 mg of caffeine is roughly the same as 5 mg of Ritalin). So many who might just take a small dose of Ritalin might get away with just doing this.
Don't forget, though, that even caffeine can have some side effects. Every once in a while we find someone that has problems with the caffeine in the coffee. Usually, though, the caffeine in the coffee helps the person to focus better. The protein helps to feed the brain. If you find this helpful, have one with Breakfast, and one around 3 pm. If it is not helpful, then don't bother with it.
3) MINERAL SUPPLEMENTS may be helpful. Colloidal Minerals or fully chelated minerals are the best. We like the MinPac from VAXA, but there are several good choices. Don't buy minerals in the grocery store. Get good minerals.
4) ATTEND, EXTRESS, or MEMORIN from VAXA. We recommend the "Attend" product for everyone. "Extress" is recommended in addition for those with problems with hyperactivity and temper, and "Memorin," in addition to the "Attend," for those with poor concentration or memory. These are strongly recommended. Here is more information on ATTEND, the amino acid based, homeopathic medicine that is a great alternative to ritalin.
5) FLAX SEED or PRIMROSE OIL. High sources of Omega oils. Borage oils and some fish oils are good as well. Very important. Mix about a spoonful a day into foods as you prepare them, or add to salad dressings, etc.
6) EAT LOTS OF FRUITS AND VEGETABLES. Avoid Aluminum exposure. Eat in a healthy manner.
Try it out and let us know what you think. Oh, before you email back and ask, “Well, what can we eat?” please look through your Betty Crocker Cook Book and you'll find hundreds of recipes that will fit. It's the convenience foods that are most of the problem. Re-discover the lost art of cooking!