Friday, February 11, 2011

ADHD Meds and Therapies Update

I have mixed feelings about meds. Here is a little about the pros and cons, and an update on therapies.

The teachers who want to see a child with ADHD takes meds are right when they say it will help keep him from falling behind in school. Once behind he may have a hard time catching up.

However, meds do not cure , they only help with attention, etc. for the hours after the child takes the pill. And the side effects can sometimes be difficult. There is a new med out called Intuniv that works in a different way, lasts 24 hours and appears to have fewer side effects. This is an option for parents to consider and discuss with their doctor.

A lot of the experts these days are suggesting that you try to not go the meds route until you have tried other things for 6-12 months. Here are things to try:

1. Neuro-feedback, which is expensive but has the best results record around.

2. Interactive Metronome (IM) - usually found in a pediatric occupational therapy setting. I sometimes mix IM with sound therapy and get good results - but you'd have to find an OT who knows how to do that.

3. Cognitive therapy in which a psychologist or social worker helps the child to see what his challenges are and offers some approaches to meeting them.

4. Self Management techniques in the classroom in which the child scores himself for staying attentive and then is rewarded at the end of the day if he succeeded 75% of the time. (To get this started, another adult scores with him so that he understands what is expected).

5. There are also programs that help with working memory (another problem for kids with ADHD) - I do not have personal experience with this, but evidence is good.

6. Nutritional help - some children have food sensitivities that mimic ADHD symptoms. The best way to find out is to eliminate a variety of common allergens - milk (cheese, yogurt and whey), wheat, soy (soy oil is everywhere), and corn (don't forget corn syrup) are the usual culprits. Do them one at a time for 2 weeks and be religious about it - reading the labels of everything. And forget about eating out while you are doing it unless the restaurant you are going to has an allergy menu.

By the way, new research shows that a daily vitamin with minerals is very helpful. So is a high protein breakfast. And if he is a picky eater or has poor bowel movements, a visit to a DAN doctor (austim) may help to correct gastric issues.

The children who do best with getting rid of ADHD symptoms are those who have done multiple therapies. Which means that the parent has to shell out for lots of pricey therapy. How a parent with limited means accomplishes that is to browse the book store books, settle on an approach and go from there - working step by step through the book. And then on to another one.