Don’t withhold recess!!!

I’m amazed at the number of parents who tell me that their child misses recess to finish homework or as a consequence for inappropriate behavior. It seems counterintuitive to restrict play when kids are unfocused or behaving out of line. We now have a lot of research on how kids with ADHD don’t respond to typical behavioral modifications. It’s not really a choice for them to do the behaviors they’re doing, so trying to offer recess as a reward just doesn’t work. With all this accumulated research, it’s surprising that some schools and teachers continue to support restricting recess.

Today’s blog is from Chris Dendy, an expert on ADHD. She is an acclaimed author and speaker. Chris has worked as a classroom teacher, school psychologist and mental health counselor. She’s worked as local and state level mental health administrator, has been a lobbyist and has served as executive director of a statewide mental health advocacy organization and as a national mental health consultant on children’s issues. Her Facebook post below shows the importance of recess.

I have edited her original post to make headlines more visible, but I did not change the content at all. See her original post linked at the bottom of this page.

BOTH AAP & CDC STRESS THE IMPORTANCE OF PLAY

EVERYONE SUFFERS WHEN YOU WITHHOLD RECESS:

When recess is withheld as a punishment for misbehavior or incomplete academic work, both teachers and children suffer. Teachers who know their research never withhold recess and here’s one key reason why:
“misbehavior is higher on days when children with ADHD don’t have recess.”

CHILDREN’S BRAINS WORK BETTER AFTER EXERCISE:

After exercising, students show improved attention, retention of information, working memory, mood and social skills. School officials also report a reduction in school suspensions. Students with better fitness levels earn higher scores on academic achievement tests.

EXERCISE GROWS NEW BRAIN CELLS:

Interestingly, John Ratey, M.D. a well-known psychiatrist, describes exercise as “Miracle-gro” for the brain because it actually builds new neurotransmitters and increases blood flow to the brain. The author of How the Brain Learns, Dr. David Sousa, explains that “down time” is needed to allow the brain to recharge and process new information. Recess provides this much needed recharging time.

IF A STUDENT IS CONSTANTLY MISSING RECESS, LOOK FOR UNIDENTIFIED LEARNING PROBLEMS:

One of the most common reasons for keeping students in during recess is to complete unfinished work. Instead of withholding this important activity, educators must determine the underlying reason for the failure to finish the classwork and implement a preventive strategy: utilize positive interventions instead of punishment!

For example, the culprit may be deficits in executive skills including inattention, difficulty getting started, or slow processing speed. Secondly, many students with ADHD have trouble getting started on their work and must be given an external prompt to start working. Finally, twenty-eight percent of children with ADD inattentive have slow processing speed. Children who struggle with this slow processing should be provided shorter assignments and/or extended time.

Unfortunately, researchers report that many of our children are on doses of medication that are too low for peak academic performance. Even though they are on medication, students with low medication doses will have problems paying attention and working efficiently. Teacher rating scales of classroom performance are available that reflect how well medication is working.

INCREASE MOVEMENT THROUGH “IN-HOUSE FIELD TRIPS:

Veteran teacher Jackie Minniti, suggests giving “in-house field trips” to allow increased movement and subsequent increased blood flow to the brain: for instance, give out supplies, close the door, take a note to the teacher across the hall that simply says, “Hi”, and then the student returns to his class. Doing jumping jacks or dancing to music in the classroom can be very helpful. Minniti’s positive incentives include rewarding timely work completion with five minutes extra recess time or giving stars on a chart toward a class pizza party.

FIND VOICE OF REASON AT SCHOOL OR ASK YOUR DOCTOR OR PSYCHOLOGIST TO WRITE A STATEMENT SAYING RECESS SHOULD NOT BE WITHHELD.

If you have a reasonable teacher, talk with her about trying these positive intervention strategies first instead of punishment. If you think the teacher will not be receptive to your suggestions, then consider getting a note from your physician stating that your child must have recess each day. The next step will be to ask that deficits in executive skills and the need for recess be addressed in an IEP or Section 504 plan. If the teacher fails to comply with these requirements in the IEP, you will have to approach the guidance counselor, special education coordinator, or principal for assistance.

THE CENTER FOR DISEASE CONTROL (CDC) STATES THAT RECESS SHOULD NOT BE WITHHELD AS PUNISHMENT:

Because of growing concerns about obesity and other chronic diseases, Congress passed the “Healthy, Hunger-Free Kids Act” in 2010 that resulted in the Centers for Disease Control in Atlanta developing guidelines in several areas including recess.
Each local school system that has a National School Lunch Program must develop a school wellness policy to address Congressional concerns. The CDC expressly states, “Schools should not use physical activity as punishment or withhold opportunities for physical activity as a form of punishment.” Exclusion from recess for bad behavior in a classroom (including incomplete academic work) “deprives students of physical activity experiences that benefit health and can contribute toward improved behavior in the classroom.”

AMERICAN ACADEMY OF PEDIATRICS (AAP) STATES UNSTRUCTURED FREE PLAY IS CRITICAL:

Here are highlights adapted from their policy statement.

1. Eliminating recess may be counterproductive to academic achievement. Recess promotes not only physical health and social development but also cognitive performance.
2. Creative supporting free play as a fundamental component of a child’s
normal growth and development.
3. Recess is a necessary break in the day for optimizing a child’s social,
emotional, physical, and cognitive development.
4. Recess may help provide the recommended 60 minutes of moderate to vigorous activity per day to fight against obesity.
5. Recess offers the opportunity to build lifelong skills required for communication, negotiation, cooperation, sharing, problem solving.

Updated from Dr. Dendy’s original article published in ADDitude magazine.

For more information:

From the AAP: The Crucial Role of Recess in School

Homework Battle Plan: Prepare Now!

Any parent with school aged children knows that homework can be a battle. Even good students can procrastinate, prefer to play, or have practice after school, leaving little time for homework.  Then there are the kids who struggle…

Student Responsibility

We all know that kids need help with homework. Sometimes parents help too much. Kindergarten projects should not look professionally done. Even when kids hate doing the work, they need to do it. If they cannot, you need to talk to the teacher to get the work scaled to what they can accomplish. Don’t do it for them.

Step back, one step at a time.

As kids get older, parents should offer less and less help.

It makes sense that young elementary school students will need help learning to organize their things and plan the appropriate amount of time to complete homework and projects.

If they are not asked to assume more responsibility over the years, many will never take over the tasks that they can be capable of doing.

The goal is that by the later half of high school teens can organize their work, schedule their time efficiently, and get it done without reminders. I know that sounds impossible for many kids, but if your senior is still needing you to nudge daily for homework, they will not survive when they leave home. Mommy isn’t there to remind anymore.

I’ve written before about what kids need to know to leave the nest if you want to think about all the things they need to be responsible to do.

How can you help your kids with homework without letting it become your problem? 

I am a firm believer that kids are the students, not the parents.

Kids need to eventually take ownership of their homework and all other aspects of school. Of course, for many kids this is easier said than done, but I hear all too often of college kids who have Mommy call the Professor to question a grade.

That is totally unacceptable.

Kids need to practice ownership from early on. Parents need to guide always, but manage less and less as the kids grow.

Not every solution comes from a cookie cutter mold. Kids have different personalities and abilities.

You know your kids best. Think how they work and what makes them tick.

All kids need the basics

Many parents underestimate the problem with missing out on basics: sleep, nutrition, and exercise.

If kids don’t get the amount of sleep they need, healthy foods, and regular exercise, they will not be as successful academically.

After school have a set time for kids to eat a healthy snack and get a bit of exercise. Both help make homework time more productive!

I have blogged on this previously on this site and on a teen site about developing self confidence. I really feel that finding balance is important for everyone for mental and physical health and success.

Find the right solution

Kids have different problems with homework at different times, and they each deserve their own solutions. 

Not one of these “types” fits every child perfectly.

Most kids have more than one of these qualities, but tend to fit into one type best.

Procrastination:

There is always something more fun to do than work.  Kids will put off overwhelming tasks or big projects because, well, there’s a lot to do.

Don’t just ask what homework they have due tomorrow, but also if there are any big projects due in the near or later future. See if they can estimate how much time it will take to do the project and help them plan how much to do each night to get it done on time.

Breaking big assignments or long worksheets into small pieces with short breaks in between can help kids focus. Use a timer for breaks or do a fun quick activity, like silly dance to one song.

Allow kids to have some “down” time after school for a healthy snack (brain food) and to run off energy. Limit this time with a timer to 30 minutes or so. The timer helps kids know there is an end point to the fun, and then it’s time for work. Play can resume when work is done correctly.

For more procrastination avoidance tips, visit Finish Tasks. It was written for teens, but has tips anyone can use!

Poor Self Confidence:

Kids who are afraid they won’t understand their homework might fear even starting.

They might blame the teacher for not teaching it correctly.

Some might complain that they are stupid or everyone else is smarter.

They blame the class for being too loud, causing distraction and therefore more homework.

Or they might complain of chronic headaches or belly aches due to anxiety.

All of these are problems with a fixed mindset. Many kids suffer from the negativity of a fixed mindset, but you can help them learn to have a growth mindset.

Praise kids when they do things right and when they give a good try, even if they have an incorrect answer. Praising effort builds their resilience and growth mindset. If you focus on the outcome, they develop a fixed mindset, which is associated with less success overall.

Be honest, but try to think of something positive to tell them each day. When they don’t meet expectations, first see if they can see the mistake and find a solution themselves.  Guide without giving the solution. Then praise the effort!

Find their strengths and allow them to follow those. If they are poor in math but love art, keep art materials at home and display their projects with pride. Consider an art class.

Remember to budget time. Over scheduling can result in anxiety, contributing to the problems.

Perfectionist:

While the desire to do everything right has its benefits, it can cause a lot of anxiety in kids. These kids think through things so much that they can’t complete the task. See also the “poor self confidence” section above, because these kids are at risk for feeling they are failures if they don’t get a 100% on everything. They can have melt downs if the directions don’t make sense or if they have a lot of work to do.

Help with organization

Help your child learn organizational techniques, such as write down assignments and estimate time to do each project. Plan how much time to spend each day on big projects and limit to that time. Help them review their progress in the middle of big projects to see if they are on track. If not, have them establish another calendar and learn to review why they are behind.

Watch for self-blame

Watch for self-blame when things don’t go well. Is it because one step took longer than projected, they were invited to a movie and skipped a day, they got sick and were not able to work… This helps plan the next project and builds on planning skills. Use failures as growing experiences, not something to regret!

Build self confidence

Remember to give attention and praise for just being your kid. These kids feel pressure to succeed, but they need to remember that they are loved unconditionally.

If you notice they have an incorrect answer,  state “that isn’t quite right. Is there another way to approach the problem?”

Not everything is about the grade. Praise the effort they put into all they do, not the end point. Make positive comments on other attributes: a funny thing they said, how they helped a younger child, how they showed concern for someone who was hurt.

Leave the comfort zone

Encourage them to try something new that is outside their talent. Not only are they exploring life, but they are developing new skills, and learning to be humble if they aren’t the best at this activity. Help them praise others. Model this behavior in your own life.  

Co-dependence:

Helicopter parenting is a term often used to describe the parent hovering over the child in everything they do. This does not allow a child to learn from failing. It does not allow a child to grow into independence.

It involves the parent “owning” the homework. These kids call home when they leave the homework or lunch on the kitchen table for Mommy to bring it to school. They often grow up blaming everyone when things don’t go their way and Mommy can’t fix it. These kids don’t learn to stand up for themselves. They seem constantly immature with life situations.

Slowly give over ownership

Young children need more guidance, but gradually decrease this as they get older. Teachers can help guide you on age appropriate needs. There are kids who need more help than their peers. For example, kids with ADHD are often 3-5 years behind their peers in skills that involve executive functioning. Your 10 year old with ADHD might need the support typically given to 5-8 year olds, but that does not mean they should rely on you to the same degree year after year. They must also continue to grow.

Most parents must sign a planner of younger kids, but as kids get older the kids become more responsible for knowing what the homework is. Many schools now have websites that parents can check homework assignments, but be sure the kids own the task of knowing what is due too.

Have a place that children can work on homework without distraction (tv, kids playing, etc).

Advise, but don’t do it

Be available to answer questions, but don’t do the work for them. If they need help, find another way to ask the question that might help them see the solution. Get a piece of scrap paper that they can try to work through the problem. If they have problems with reading comprehension, have them read a few lines then summarize to you what they read.  They can take notes on their summary, then read the notes after the entire chapter to get a full summary.

Busy, busy, busy:

Some kids are really busy with after school activities, others just rush through homework to get it done so they can play.

Set limits on screen time

Set limits on how much screen time (tv, video games, computer time) kids can have each week day and week end.

If they know they can’t have more than 30 minutes of screen time, they are less likely to rush through homework to get to the tv or computer.

It used to be recommended no more than 10 hours a week for screen time, but newer guidelines are more flexible. This is because the quality of screen time can vary considerably and it is constantly changing. Many kids require screen time for homework.

The big thing is that kids need balance. They should still have the opportunity to play with friends in real life. Kids need exercise. They should learn to problem solve through interactions with friends. Too many hours on a screen diminish the time with real people and in active play.

Do it right

Ask kids to double check their work and then give to you to double check if you know they make careless mistakes.

Don’t correct the mistakes, but kindly point them out and ask if they can find a better answer.

Once they learn that they have to sit at the homework station until all the work is done correctly, they might not be so quick to rush.

Avoid overscheduling

If kids have after school activities the time allowed for home work and down time are affected. Avoid over scheduling, especially in elementary school.

Be sure they have time for homework, sleep, healthy meals, and free time in addition to their activities.  

Are the activities really so important that they should interfere with the basic needs of the child? Is the child mature enough to handle the work load?

It is generally recommended to allow kids to do up to their age in number of hours of extra curricular activities. A 10 year old can do up to 10 hours of extra curriculars per week. This means they really shouldn’t take dance class 3 hours a day 4 days a week. That’s too many hours. And remember it all adds up: sports, music lessons, scouts – don’t over schedule!

When they can’t sit still

Kids who are in constant motion can’t seem to sit still long enough to do homework. Be sure they have the proper balance of sleep, nutrition, and exercise or all else will fail.

Praise their efforts when they are successful.

Schedule breaks

Set a timer after school to let them play hard for 30 minutes, but then make them get work done.

Help little ones organize what needs to be done and break homework into several smaller jobs.

Set regular 5 minute breaks every 30 minutes so they can release energy. Set a timer to remind them to get back to work and compliment them when they get back on task.

For more organization tips, see this blog on finishing tasks..

Don’t require sitting still

Some kids do better staying focused if they can stand to work. If you have a table, counter or desk that fits their height when standing, let them use it. When standing helps, try to problem solve places that they can do it to help with productivity!

If your kids need movement, let them wiggle. Kicking the legs or constant wiggling helps some kids.

Fidget items can help, so let your child use them as long as they don’t become a play item that distracts.

If you have an exercise ball, let them sit on it. No ball? Try a pillow on a chair.

Time matters

If kids wait to do homework until evening hours, it might not be as productive and it can interfere with getting to sleep.

When we’re tired, we don’t stay as focused, so everything takes longer. We constantly need to refocus. We don’t learn as well, so studying is less effective.

If homework requires getting on a computer or tablet, the light exposure suppresses the melatonin level. Melatonin is needed to feel tired and go to sleep. If kids are on a screen too close to bedtime, they will struggle to fall asleep. Try to get them to do all work that requires a computer done first. Ideally all screens will be off at least 1-2 hours of bedtime.

I see far too many teens who stay up far to late studying. They need to find a way to start homework earlier if at all possible. I know this is difficult with work and extracurricular schedules, but that brings us back to avoiding over scheduling…

Kids with ADHD

Timing matters even more if kids need medicine to help them stay focused. Don’t let them try to do homework after medicine wears off.

They’re not focused and a little homework takes a long time, which is frustrating to the child. They also won’t retain as much information they’re studying and they’re more likely to make silly mistakes or have unreadable handwriting. If the medicine doesn’t last late enough in the day, talk to your child’s doctor.

Struggling despite help:

There are many reasons kids struggle academically.  Reasons vary, such as behavior problems, anxiety, illness, learning disabilities, bullying, and more.

Work with the teacher

If they are struggling academically, talk with the teacher to see if there are any areas that can be worked on in class or with extra help at school.

Can the teacher offer suggestions for what to work on at home?

Talk to your child’s physician

If kids have chronic pains or school avoidance, ask what is going on.

Depression and anxiety aren’t obvious and can have vague symptoms that are different than adult symptoms.

Bullying can lead to many consequences, and many kids suffer in silence.

If your child won’t talk to you, consider a trained counselor.

Talk with your pediatrician if your child is struggling academically despite resource help at school or if he suffers from chronic headaches or tummy aches. Treating the underlying illness and ruling out medical causes of pain is important. Depression, anxiety, ADHD, and other learning disorders can be difficult to identify, but with proper diagnosis and treatment, these kids can really succeed and improve their self confidence!

Can I talk to you privately?

Every once in a while a parent will tell the nurse that they want the child out of the room to discuss an issue with the doctor privately. This is usually something they perceive as a negative thing for the child to hear. Some of the most common concerns are about the child’s weight or behaviors. Sometimes it relates to a change in the family dynamics, such as divorce or a parent having a significant illness.

Secrets should never be kept…

While I understand the parent’s intentions, I find this to be disruptive and counter productive. As much as I try to find an excuse to have a child leave, it is usually obvious that the nurse keeps them out longer than needed.

If we have the child leave the room, he knows something is up. We are talking about him.

But not sharing with him.

What could possibly be so bad that we won’t talk to him about it?

How do you feel when you suspect people are talking about you?

When people talk secretively it hurts.
When people talk secretively it hurts.
And we should always live by example.

I teach kids from early on that there should be no secrets in families.

Why then should parents and doctors keep things from the child?

That doesn’t mean kids need to know everything.

We all know that as adults that we do shield our kids from things.

Kids do not need to know our financial worries. We can teach them financial responsibility without increasing their anxieties.

They do not need the burden of knowing about extramarital affairs. If there are problems in a relationship, they will know there are problems, but they do not need to know details.

I don’t think that kids need to know everything, but that doesn’t mean that we should make it obvious that we’re hiding something. Especially when it pertains to them.

What does the child know?

Any patient needs to know what the issues are so they can be addressed. This includes most kids.

My guess is most of these kids already know what the concerns are.

They may need help working on the concern or help adjusting to the home life situation.

If they are overweight, we need to talk about what they eat, how they exercise, and how they sleep.

When there are behavior problems, they need to give insight into how they feel and what leads to the behaviors.

Regardless of the issue, they need to be a part of the plan to fix the problems. If they aren’t on board, they won’t change their habits. I can talk about weight (or behavior, or drugs, or whatever the concern is) sensitively and in an age appropriate manner with the child. The kids at school are likely talking about it in a not-so-sensitive manner, so it’s best to not make it worse by secretly discussing it.

What if it really needs to be said?

If a parent really wants to let a physician know specific points without the child present, there are ways to do that without making the child feel left out.

  • Send in a letter or secure electronic message with your concerns before the appointment. Be sure it’s at least a few days before the appointment so the doctor has a chance to review it!
  • Schedule a consult appointment for just parents to come in without the child.
  • Call in advance to note your concerns so the physician can address it as needed during the visit.
  • Slip a note in with all the paperwork you’re turning in during check in so the physician can read it before coming into the room. Be sure whoever you give it to realizes it’s included with the standard paperwork so they can pass it on.
  • Don’t bring siblings to an appointment where you want to discuss a private matter with your child.
All of these help the physician know your concerns without blatantly kicking a child out to talk about something privately.

Your child will appreciate it.

Final Thoughts on ADHD Medicines

My last post was how to start and titrate ADHD medicines. Today I’d like to discuss more of the fine-tuning issues, such as what happens if medicine isn’t taken every day, how to remember it, what to do if parents disagree about medicine, and even how to plan for travel.

Time Off ADHD Medicines

starting ADHD medicinesOnce a good dose is found, parents often ask if medicines need to be taken every day. 

Stimulants work when they work, but they don’t build up in the body or require consistent use. (This is not true for the non-stimulants, which are often not safe to suddenly start and stop.)

Some kids fail to gain weight adequately due to appetite suppression on stimulants, so parents will take drug holidays to allow better eating.

Days off the medicine also seems help to slow down the need for repeated increases in dosing for people who are rapid metabolizers.

Drug holidays off stimulants were once universally recommended to help kids eat better and grow on days off school. Studies ultimately did not show a benefit to this, so it is not necessary. Some kids suffer if they are not on medications. Behavior issues, including safety issues while playing (or driving for older kids) can be a significant problem when not medicated. Self esteem can also suffer when kids are not medicated. 

Despite the fact that some kids need daily medicine, others don’t. When kids can manage their safety and behavior adequately, it isn’t wrong to take days off. Many kids want to gain better weight, and taking a drug holiday can help with appetite.

Talk to your child’s doctor if you plan on not giving your child the medicine daily to be sure that is the right choice for your child.

Remembering the medicine

It’s difficult to get into the habit of giving medicine to a child every day.  Tomorrow’s post will be about how to remember medicines

My favorite tip is to put the pills in a weekly pill sorter at the beginning of each week. This allows you to see if you’re running low before you run out and allows you to see if it was given today or not. These medicines should not be kept where kids who are too young to understand the responsibility of taking the medicine have access.

Controlled substances

Controlled substances, such as stimulants, cannot be called in or faxed to a pharmacy. Many physicians now have the ability to e-prescribe these.

Controlled substance prescriptions cannot have refills, but a prescriber can write for either three 30 day prescriptions or one 90 day prescription when they feel a patient is stable on a dose.

Stimulants are not controlled substances because of increased risks and side effects. Some of the more significant side effects of ADHD medicines are seen in non-stimulant medicines. 

They are controlled substances because they have a street value. Teens often buy them from other teens as study drugs. This can be very dangerous since it isn’t supervised by a physician and the dose might not be safe for the purchaser. It is of course illegal to sell these medicines.

The DEA does monitor these prescriptions more closely than others. If the prescription is over 90 days old, many pharmacists cannot fill it (this will vary by state), so do not attempt to hold prescriptions to use at a later time.


Acids and Stimulants

It has been recommended that you shouldn’t take ascorbic acid or vitamin C (such as with a glass of orange juice) an hour before and after you take medication.

The theory is that ADHD stimulants are strongly alkaline and cannot be absorbed into the bloodstream if these organic acids are present at the same time.

High doses of vitamin C (1000 mg) in pill or juice form, can also accelerate the excretion of amphetamine in the urine and act like an “off” switch on the med.

In reality  have never seen this to be an issue.

If anyone has noticed a difference in onset of action or effectiveness of their medicine if they take it with ascorbic acid or vitamin C, please post your comment below.

When Mom and Dad disagree

It is not uncommon that one parent wants to start a medication for their child, but the other parent does not.

It’s important to agree on a plan, whatever the plan is.

Have a time frame for each step of the plan before a scheduled re-evaluation.

If the plan isn’t working, then change directions.

Be cautious of how you talk about this with your child. If kids know it is a disagreement, they might fear the medicine or think that needing it makes them inferior or bad.

Do not talk about the diagnosis as if it’s something the child can control. They can’t.

Don’t make the child feel guilty for having this disorder. It isn’t fair to the child and it only makes the situation worse.

Having the medicine when you need it

Refills 

There is nothing more frustrating for a parent and child than to realize that there’s a big test tomorrow and you have no medicine left and you’re out of refills.

Technically none of the stimulant medicines can have refills, but a prescription covering 90 days at a time can be given. This can be done with a 90 day prescription or three 30 day prescriptions.

The technicality of this is sometimes difficult. You cannot call your pharmacy to request a refill. You must ask to have the next prescription filled if your physician provided 3 prescriptions for 3 months.

Be sure to know the procedure for refills at your doctor’s office.

Travel

It’s very important to plan ahead prior to travel if your travel involves the timeframe of needing new medication.

You must plan ahead so that if a refill will be needed during the trip you will either be able to fill a prescription you have on vacation or you will need to fill the prescription in advance.

Most people can get a prescription 7 days prior to the 30 day supply running out but not sooner, so you might need to fill a couple prescriptions a few days earlier in the month each to have enough on hand to make it through your vacation. It takes planning!

Sometimes you can work with your physician and pharmacist to get medicines early prior to travel. Talk to your pharmacist to see if they can help arrange this.

If you are out of town and you realize you forgot your child’s non-stimulant, call your doctor to see if they can e-prescribe it. Many of the non-stimulants are not safe to suddenly stop, so they are likely to send in a prescription. Insurance is not likely to pay for these extra pills if it was recently filled.

International travel will require that you find the laws in the other country to find out if you can bring controlled substances into the country. If you will need additional medicine while you are in that country, you will need to find a way to get the medicine.

 

Mail order

Some insurance companies will allow mail order 90 day prescriptions.

There are insurance companies that not only allow, but require them on daily medicines.

Others do not allow it.

In general I advise against a 90 day prescription if the dose is not established or if there are any concerns that it might not be the perfect dose. If there is any concern that it might need to be changed, a 30 day prescription is a better option.

If you will need to do a mail order, be sure you schedule your appointment to get the prescription early enough to account for the lost time mailing.

Looking for more?

Many parents benefit from support groups to learn from others who have gone through or are currently going through similar situations, fears, failures, and successes. Find one in your area that might help you go through the process with others who share your concerns. If you know of a support group that deserves mention, please share!

ADHD

CHADD is the nationwide support group that offers a lot online and has many local chapters, such as ADHDKC. I am a volunteer board member of ADHDKC and have been impressed with the impact they have made in our community in the short time they have existed (established in 2012). I encourage parents to attend their free informational meetings. The speakers have all been fantastic and there are many more great topics coming up!

Anxiety

Many parents are surprised to learn how much anxiety can affect behavior and learning. To look for local support groups, check out the tool on Psychology Today.

Autism

The Autism Society has an extensive list of resources.

Dyslexia 

Dyslexia Help is designed to help dyslexics, parents, and professionals find the resources they need, from scholarly articles and reviewed books to online forums and support groups.

Learning Disabilities 

Learning Disabilities Association of America offers support groups as well as information to help understand learning disabilities, negotiating the special education process, and helping your child and yourself.

Tourette’s Syndrome and Tic Disorders 

Tourette’s Syndrome Association is a great resource for people with tic disorders.

General Support Group List 

For a list of many support groups in Kansas: Support Groups in Kansas .

School information

Choosing schools for kids with ADHD and learning differences isn’t always possible, but look to the linked articles on ways to decide what might work best for your child. When choosing colleges, look specifically for programs they offer for students who learn differently and plan ahead to get your teen ready for this challenge.

Midwest ADHD Conference – April 2018

Check out the Midwest ADHD Conference coming to the KC area in April, 2018. I’m involved in the planning stages and it will be a FANTASTIC conference for parents, adults with ADHD, and educators/teachers.

Midwest ADHD Conference
The Midwest ADHD Conference will be held in April 2018, in Overland Park, Kansas.


Share Quest for Health

ADHD Medications: Types and side effects

I have spent several days on the diagnosis of learning and behavioral problems and non-medical, dietary and supplemental treatments that can be used for these issues. Today I will focus on the types of prescription medications used primarily for ADHD as well as their side effects. Tomorrow will cover how to get started on a medication for ADHD.

Approved vs not approved medicines

There are many treatments out there that are not approved for the purpose they are used. This sounds scary, but if done properly might be a good consideration.

Physicians sometimes use treatments that have not been approved for the purpose or an age group because they know from general experience that it works or they are at a loss from approved treatments failing and they need to try something else.

One example is using a shorter acting form of guanfacine (Tenex) that has not been approved to treat ADHD, but it has some advantages over the longer acting form (Intuniv) that is approved for ADHD. The short acting form can be broken, allowing slower titration of dose changes. The long acting form cannot be broken.

Another common example is the use of albuterol, a medicine that helps breathing with conditions that cause wheezing. It is not approved for use under 2 years of age, but it is commonly used for younger children with difficulty breathing — and it helps them breathe, which might keep them out of the hospital and off of supplemental oxygen.

I do not think that all non-approved medicines are good or bad. It is a very individual decision of what medicines to use. Discuss with your doctor if a treatment is approved or if they are using something that is not. Although this is relatively common among people who treat children because many drugs have not been tested in children and have been “grandfathered” into use through experiences that show benefit, be sure the provider is not picking something that has no basis or supporting evidence, especially if he or she profits from the treatment.

Be very wary of anyone who promises a cure – if one really existed everyone would use it.

Medications approved to treat ADHD


When a medication is needed to control symptoms of ADHD, the first line medications are the stimulants unless there are contraindications. Non-stimulant medications are not found to be as effective as stimulants in the majority of children, but they do have a place in the treatment plan for some children. They are sometimes used in addition to stimulants for optimal results.

For information on these medicines, see A Guide to ADHD Medications. It reviews how stimulants act on dopamine and norepinephrine and various time release patterns of different medicines.

ADHD medication guide
ADHD Medication Guide

I love the ADHD Medication Guide (different from the similarly named post above) because it lists the medicines approved to treat ADHD in a colorful chart that groups the medicines in an easy-to-read format.

Categories of Medicines used for ADHD:

Stimulants
  • Methylphenidates (Aptensio©. Ritalin©, Focalin©, Concerta©, Daytrana©, Metadate©, Quillivant©)
  • Amphetamines (Adderall©, Vyvanse©, dexedrine)
Non-stimulants
  • Atomoxetine (Strattera©)
  • Guanfacine (Intuniv©)
  • Clonidine (Kapvay©)
  • Others are used off-label (no FDA approval for the purpose of ADHD treatment): Tenex, Catapres patch, antidepressants, and antipsychotics

Side Effects

Parents usually worry about medication side effects. This is a very legitimate concern, but must be balanced with the risks of not treating. Overall the medicines listed above are very well tolerated.

If a child has side effects to one stimulant, they can usually do well on a different class (methylphenidate vs amphetamine). When neither type is tolerated, a trial of a non-stimulant is indicated. If this isn’t tolerated, reconsider the ADHD diagnosis.

I often hear concerns that parents don’t want their kids changing their personalities or becoming “zombies”. If the right medicine is used at the appropriate dose, this is usually not a problem.

Finding that right medicine and right dose might take some trial and error. Work with your prescriber to get to the right one for your child.

Most commonly observed side effects of stimulants:

Decreased appetite

Appetite is often low in the middle of the day and more normal by supper time if kids take a long acting stimulant.

Good nutrition is a priority. Encourage kids to eat the healthy “main course” first and leave the dessert out of the lunchbox. They should have healthy snacks (think of mini-meals) after school when they get hungry.

Short acting meds improve mid day appetite since they wear off around lunch time. The downside is the child needs to take a dose around lunch time at school.

Kids are often very hungry in the evenings when medicines wear off, so encourage healthy foods at that time.

I have seen some kids who have a really hard time off medicine sitting down to eat. These kids actually gain weight better on medicine because they can finish the meal.

Some kids can improve their appetite with an appetite stimulant. I often use cyproheptadine if weight drops too much in a child. It works best if it is not used every day. I will have kids skip their cyproheptadine at least a couple days each week.

Insomnia

Trouble sleeping is common with ADHD — with or without medicines.

If it is due to the stimulant medicine still being active, trouble sleeping may be relieved by taking it earlier in the day.

If the child’s brain is too active in the evenings because the medicine wears off, learning relaxation exercises can help. Check out the Winding Down section of Sleep Tips for more details.

Increased irritability

Moodiness is especially common as the medication wears off in the afternoon or evening and in younger children.

It makes sense if you consider that all day they are able to focus and think before acting and speaking, but then suddenly their brain can’t focus and they act impulsively.

Typically kids learn to adjust to the medicine wearing off as they mature.

Sometimes just giving kids 30 minutes to themselves and offering a healthy snack can help.

Cognitive behavioral therapy can help.

Anxiety

Anxiety does occur with ADHD and might be under-appreciated before the ADHD symptoms are treated.

Symptoms of anxiety are often missed. They can include avoidance, irritability, moodiness, somatic complaints (headache, stomach ache), and more. HeySigmund has a great list of subtle anxiety symptoms.

When kids can focus better, they might focus more on things that bother them, increasing anxiety and making it more apparent.

It is also possible that anxiety is misdiagnosed as ADHD, which is one reason for stimulant medication failure.

If you notice signs of anxiety, talk to your child’s doctor and/or therapist.

Mild stomach aches or headaches

Stomach aches and headaches are occasionally noted with stimulant medications. It is my experience that they are most common with a new medication or a change in dose.

Because these have many causes, it can be hard to determine if they are really from the medicine or another cause.

If they persist with the medicine, changing to another medication might help.

Tics

Tics are related to treated and untreated ADHD.

People with ADHD are more likely to have tics than the general population.

It was once thought that tics were caused by the stimulant medicines, but it is now thought that they happen independent of the medicine, and medicines might even help treat the tics.

Growth

Weight gain can be difficult for some kids on stimulant medications due to the appetite suppression on the medicine.

Studies have shown a decreased final adult height of about 1-2 cm (1/2 – 1 inch). For most people this small height difference is not significant compared to the benefits in self esteem, academics and behavior children gain on stimulants.

 

Rare side effects of stimulants

Hallucinations

I have only seen two children who could not tolerate stimulants due to hallucinations, but it is very scary for the family when it happens.

Unless there is a significant family history of them, I don’t know a way to predict which child is at risk.

These are a contraindication for continuing that medication, but another type of stimulant or medication can be considered.

Heart issues

Cardiac (heart) problems are overall a rare complication of stimulants and often times are not a contraindication to continuing the stimulant medicine.

There is a small increase in blood pressure and heart rate, both of which should be monitored regularly while on treatment and if the treatment is stopped.

A cardiologist should be considered to further evaluate a patient prior to starting a stimulant if there is any of the following:

  • Shortness of breath with exercise not due to a known non-cardiac cause, such as asthma
  • Poor exercise tolerance compared to children of the same age and conditioning
  • Excessively rapid heart rate, dizziness, or fainting with exercise
  • Family history of sudden cardiac death or unexplained death (such as SIDS)
  • Family or personal history of prolonged QT syndrome, heart arrythmias, cardiomyopathy, pulmonary hypertension, implantable defibrillator or pacemaker

side effects for the non-stimulants:

Atomoxetine

Atomoxetine can cause initial gastroesophageal complaints (abdominal pain, decreased appetite), especially if the dose is started too high or if it is increased too rapidly.

It can also cause tiredness and fatigue when it is first started or if the dose is increased too quickly.

It can increase the blood pressure and heart rate, both of which should be monitored regularly during treatment with atomoxetine.

There is an increased incidence in suicidal thoughts, though uncommon, so children should be monitored for mood issues on this medication.

A rare complication of atomoxetine is hepatitis (inflammation of the liver with yellow jaundice and abnormal liver function labs). The hepatitis resolves with stopping the atomoxetine.

Guanfacine and clonidine

Guanfacine and clonidine both cause fatigue and tiredness, especially when first starting the medication or with increases in dose.

Both of these medications can lower the blood pressure and heart rate, and these should be monitored closely while on guanfacine or clonidine, especially when first starting and increasing dose.

Handouts for medicines

I absolutely love the handouts that Dr. Nerissa Bauer has made for ADHD medications. Click on the image’s caption to go to her website’s page for that handout. The two stimulant classes are first, followed by the non-stimulants.

amphetamine adderall vyvanse
Amphetamines

Amphetamines (Adderall, Adderall XR, Vyvanse, amphetamine mixed salts, Dexidrine, Zenzedi)

 

 

 

ritalin concerta apetnsio metadate
Methylphenidate

Methylphenidate (ritalin, Aptensio XR, Concerta, Metadate CD or ER, Focalin, Daytrana)

 

 

 

strattera, atomoxetine
Atomoxetine

Atomoxetine (Strattera)

 

 

 

clonidine
Clonidine

Clonidine (Catapres, Kapvay)

 

 

 

guanfacine intuniv tenex
Guanfacine

Guanfacine (Intuniv, tenex)

 

 

 

Next up:

Tomorrow’s blog will be about how to choose a medicine to start and how to titrate it to find the best dose.

Looking for more?

Many parents benefit from support groups to learn from others who have gone through or are currently going through similar situations, fears, failures, and successes. Find one in your area that might help you go through the process with others who share your concerns. If you know of a support group that deserves mention, please share!

ADHD

CHADD is the nationwide support group that offers a lot online and has many local chapters, such as ADHDKC. I am a volunteer board member of ADHDKC and have been impressed with the impact they have made in our community in the short time they have existed (established in 2012). I encourage parents to attend their free informational meetings. The speakers have all been fantastic and there are many more great topics coming up!

Anxiety

Many parents are surprised to learn how much anxiety can affect behavior and learning. To look for local support groups, check out the tool on Psychology Today.

Autism

The Autism Society has an extensive list of resources.

Dyslexia 

Dyslexia Help is designed to help dyslexics, parents, and professionals find the resources they need, from scholarly articles and reviewed books to online forums and support groups.

Learning Disabilities 

Learning Disabilities Association of America offers support groups as well as information to help understand learning disabilities, negotiating the special education process, and helping your child and yourself.

Tourette’s Syndrome and Tic Disorders 

Tourette’s Syndrome Association is a great resource for people with tic disorders.

General Support Group List 

For a list of many support groups in Kansas: Support Groups in Kansas .

School information

Choosing schools for kids with ADHD and learning differences isn’t always possible, but look to the linked articles on ways to decide what might work best for your child. When choosing colleges, look specifically for programs they offer for students who learn differently and plan ahead to get your teen ready for this challenge.

Midwest ADHD Conference – April 2018

Check out the Midwest ADHD Conference coming to the KC area in April, 2018. I’m involved in the planning stages and it will be a FANTASTIC conference for parents, adults with ADHD, and educators/teachers.

Midwest ADHD Conference
The Midwest ADHD Conference will be held in April 2018, in Overland Park, Kansas.


Share Quest for Health

Alternative Treatments for ADHD

I’ve covered why you should get your child evaluated for learning and behavior issues, who does the evaluations, and what the evaluation process involves in my previous posts. I’ve also covered specific diets and supplements. Today I want to talk about alternative treatments for ADHD. If parents aren’t ready to use medicines yet or if they want to supplement medications with additional treatments, there are many alternatives.

Natural treatments, psychological and occupational therapies, and complementary alternative therapy for the treatment of ADHD are available. Some of these are more effective than others.

Alternative Treatments

Nutritionalternative treatments for ADHD

Nutrition is very important for learning and behavior in all kids, not just those with a diagnosis of some sort. My next blog will be dedicated to more on components of nutrition and elimination diets, then the following blog will cover vitamins and supplements.

Behavioral Therapy

Behavioral therapy can be very effective to help manage the symptoms of ADHD. It is beneficial even for children who are medicated to help them learn to control behaviors over time.

Parent skills training provides parents with tools and techniques for managing their child’s behavior. Behavior therapy rewards appropriate behavior and discourages destructive behavior. This training has been shown to improve ADHD symptoms among children, but studies show it does not change academic performance when used alone.

Parent training teaches parents to interact differently with children to encourage desirable behavior. This is done by reinforcing good behavior and having set consequences for bad behavior.

There are several kinds of parent training that have been shown to be effective. These include Parent-Child Interaction Therapy (PCIT), Parent Management Training (PMT), Positive Parenting Program (Triple P).

Cognitive Behavioral Therapy (CBT) is a way to change thinking from negative to positive and focuses on finding solutions to current problems. It has been proven to be effective in the treatment of ADHD and other common issues, such as anxiety. CBT can help children learn techniques to control behaviors, screen thoughts before speaking, organize things, and more.

Initial treatment for ADHD in children under 5 years of age is behavioral therapy. Studies show that the best benefits for ADHD are a combination of medication and behavioral therapy for those over 5 years of age.

 

social skills group

Many kids with ADHD struggle socially. They tend to lag behind peers by a few years developmentally. Their impulsivity and inattention leads to poor behavior and trouble making good friends. They may also have trouble managing their emotions.

Joining a professionally run social skills group can help kids learn and practice important skills for interacting with others. Some school counselors can do this during school hours and many therapists offer groups outside of school.

School resources

Schools have various abilities in helping kids with unique needs. They can offer special seating (or standing desks), extra time for tests, fidget items, and other accommodations. To learn more about school resources, Understood.org has much needed information about what is available and what you can do to legally get accommodations with IEPs or 504Plans.

Exercise

Getting kids outside and moving has many benefits for all kids – including those with ADHD.

First, they are off all screens, which have been shown to increase aggressiveness and impulsivity.

Second, they are getting exercise. Studies show that when kids play outside their focus, attention, and behavior improve.

Exercise helps to elevate the same neurotransmitters that are increased with stimulant medications, which helps with executive functioning skills (sequencing, working memory, prioritizing, inhibiting, and sustaining attention).

Any exercise helps, but studies show the best are martial arts, ballet, ice skating, gymnastics, yoga, rock climbing, mountain biking, skateboarding, and whitewater paddling (I know not all of these are practical on a regular basis, but most are). These activities require sustaining attention, balance, timing, fine motor adjustments, sequencing, evaluating consequences, error correction, and inhibition.

Sleep

Sleep problems are common in many children, especially those with ADHD. Fixing the sleep cycle can have extreme benefits in learning and behavior.

Sometimes it’s as easy as getting a routine for sleep to ensure the proper number of hours for a child, but often they suffer from insomnia, nightmares, sleep apnea, restless leg, or other medical conditions that impair sleep time and/or quality.

Symptoms of chronic sleep deprivation in kids are hyperactivity, poor focus, and irritability. There are many kids who can have all of their ADHD symptoms relieved when they simply get better sleep. I see this in many teens who suddenly “develop ADHD”- only it’s really not ADHD at all. They are running on 4-5 hours of sleep a night. If your child has sleep troubles not improved with these Sleep Tips, talk to your child’s doctor.

Occupational Therapy and Sensory Training

There are many kids with ADHD who benefit from using techniques that occupational therapists use with sensory processing disorder (SPD). In some kids, SPD might be the real diagnosis causing symptoms of ADHD, but in others they may co-exist.

Treating SPD is usually fun for the kids, and there is no harm in doing their techniques even if a child doesn’t have the disorder.

Schools have started integrating these ideas into their classrooms as needed, such as having kids sit on stability balls or using tactile objects at their desks.

Therapy for SPD involves playing in ways that use sensory input (such as with sand or play doh, rolling down a hill, manipulating tactile objects, and more).

For a great list of ideas visit Sensory Integration Activities, but working with an occupational therapist is recommended.

Biofeedback and Neurofeedback

Biofeedback and neurofeedback are often not covered by insurance due to inconclusive evidence that they work. Children and adults with ADHD often have abnormal patterns of brain electrical activity on electroencephalographic (EEG) testing. EEG biofeedback is aimed at normalizing EEG activity by correcting the brain’s state of relative under-arousal and optimizing cognitive and behavioral functioning.

Neurofeedback trains kids to become more aware of their physiological responses and improve their executive functioning. Each neurofeedback session lasts 30-60 min and children usually need 10-20 sessions. Patients wear a cap that measures their brain activities, and it helps them train their brain to maintain focus during video games specific to this purpose.

The significance of most findings on neurofeedback and EEG biofeedback is limited by study design flaws that include small study sizes, heterogeneous populations, absence of a control group, inconsistent outcome measures, self-selection bias, and limited or no long-term follow-up. While this doesn’t mean they don’t work, I would like to see more studies showing their benefit. You might invest a lot of time and money only to find out it doesn’t work.

Working memory training

Working memory training has been shown in studies to help with symptoms of ADHD, though there are some conflicting studies out there.

Cogmed is the company that has studies showing benefit. It’s a computer program that kids play like a video game, but it reportedly trains their brain to remember things. Cogmed is intensive: 1 hour a day, 5 days a week for 5 weeks, but can be done at home. It can be expensive and is often not covered by insurance. About 70-80% of children show improvement immediately after the training, and of those who improved, 80% maintained the benefit over a 6 – 12 month window. Cogmed is designed to be used with medication, such as stimulants.

Herbs and other supplements

There are some studies supporting nutritional supplements or herbal medicines for ADHD, but many reported treatments have not been found effective. I will cover these in a separate blog.

ADHD Coaching

Just like anyone who needs help improving a skill, working with a coach with experience helping others in that area can be a big help.

Working with an ADHD coach can help many with certain aspects of their life. ADHD coaches can help with organization, motivate a person with ADHD to finish tasks, or help them learn techniques that makes them more effective at life skills.

Coaches do not do psychotherapy or counseling. This can be beneficial for people who are against therapy but need help to improve their skills.

It does not work if the parent makes the child go. The child must be motivated to make changes in his or her life and be willing to work on things, then coaching can be great.

Tips on finding an ADHD coach can be found on PsychCentral.

Mindfulness

I recommend mindfulness for many issues, especially anxiety (which often co-exists with ADHD). Mindfulness is thought to help with ADHD as well. It is a process of being focused on the present moment and is more fully explained on Understood.org’s Mindfulness page.

There are many free apps that can help kids (and adults) learn mindfulness.

No evidence exists for these treatments

There are many alternative treatments out there that do not have scientific proof that they help. Many parents try these treatment programs in hope that their child’s symptoms will go away.

In general, if it sounds too good to be true, it probably is.

Don’t be fooled into thinking “alternative” or “natural” treatments are without risk. There are always risks, including the lost time not being on a proven therapy, leading to a child falling further behind academically and suffering emotionally from symptoms related to ADHD.

“Train the brain” games 

There are claims that games designed to train the brain can improve memory, attention and other skills, but there is no research that supports this claim. Kids may get good at playing the game and seem to learn, but studies have found no improvements that generalize to their daily life or learning. For more, see what experts say about “train the brain games” for kids with ADHD.

Brain Balance has a center in our city, and I’ve seen more than a few parents who waste time and money on their program. I don’t know of any that noted significant and continued benefit. Although their website might look like there’s impressive evidence to use it, there really isn’t. Please see Science Based Medicine: Brain Balance for more information.

Caffeine

Caffeine is a stimulant but since it is available from grocery stores instead of pharmacies some parents feel more comfortable using it instead of a medication.

If you’re using it as a drug, it is a drug.

Whether it comes in a beverage or a pill, it is a chemical with properties that act like other drugs in our bodies.

Unfortunately studies don’t really support its use. It’s difficult to dose since it comes in so many forms, and most people develop a tolerance for it, requiring more and more, which can increase side effects.

For details, see Science Based Medicine: Caffeine for ADHD.

chiropractic medicine, Vision therapy, and Applied kinesiology

I have not been able to find any valid scientific studies for chiropractic medicine, vision training, and applied kinesiology for the treatment of ADHD.

Insurance usually does not cover these and they can be quite expensive. I do not recommend them.

Essential oils and aromatherapy

Essential oils are all the rage now. It seems they can cure everything if you do a quick online search. The problem is that research hasn’t shown that to be true. Dr. Chad Hayes does a good job of discussing what they are and why they aren’t recommended.

Remember…

There is no alternative medicine. There is only medicine that works and medicine that doesn’t work. ~ Richard Dawkins

If it stays alternative, that must say something. Once an alternative treatment is shown to work, it becomes a preferred treatment, no longer an alternative…

Things to consider when choosing treatment plans:

  • First, be sure your child is properly assessed to make the best diagnosis on which to base the treatment plan.
  • Natural isn’t necessarily safe. Evaluate all the risks and benefits known before making a decision. Even exercise (which is always recommended) comes with risks, such as injury and at times sleep problems due to scheduled activity times.
  • Talk with your doctor about any treatments you are doing with your child. Don’t forget to mention vitamins, supplements, herbs, brain training, therapies, etc.
  • Choosing one treatment doesn’t mean you are married to it. If response doesn’t prove to be beneficial, re-think your approach.
  • There is no cure for ADHD known at this time. If someone claims that they can cure your child, don’t buy into it.
  • Learn your costs. Does insurance cover it? Insurance companies often prefer certain treatments due to their cost and other factors. They also do not cover many treatments. Sometimes this is again due to cost, but other times it is because there is no evidence to show the treatment is effective. (Hint: This is a good clue to look at other treatments!)
  • Is the treatment something your child can do and is your family willing to put in the time? CBT is proven to help, but it doesn’t work if the child and parents don’t work on the techniques at home. Neurofeedback and Cogmed take many hours of treatment over weeks of time and are not guaranteed to work in all children.  Medications must be titrated to find the most effective dose that limits side effects. This requires frequent follow up with your doctor until the best dose is found.

Sources:

The ADDitude Guide to Alternative ADHD Treatment

WebMD: Attention Deficit and Hyperactivity Disorder: Alternative Treatments 

American Psychological Association: Easing ADHD Without Meds
Psych Central: Neurofeedback Therapy an Effective, Non-Drug Treatment for ADHD

Psychiatric Times: Integrative Management of ADHD: What the Evidence Suggests

Attention Deficit Hyperactivity Disorder: Diagnosis and Treatment in Children and Adolescents

Looking for more?

Many parents benefit from support groups to learn from others who have gone through or are currently going through similar situations, fears, failures, and successes. Find one in your area that might help you go through the process with others who share your concerns. If you know of a support group that deserves mention, please share!

ADHD

CHADD is the nationwide support group that offers a lot online and has many local chapters, such as ADHDKC. I am a volunteer board member of ADHDKC and have been impressed with the impact they have made in our community in the short time they have existed (established in 2012). I encourage parents to attend their free informational meetings. The speakers have all been fantastic and there are many more great topics coming up!

Anxiety

Many parents are surprised to learn how much anxiety can affect behavior and learning. To look for local support groups, check out the tool on Psychology Today.

Autism

The Autism Society has an extensive list of resources.

Dyslexia 

Dyslexia Help is designed to help dyslexics, parents, and professionals find the resources they need, from scholarly articles and reviewed books to online forums and support groups.

Learning Disabilities 

Learning Disabilities Association of America offers support groups as well as information to help understand learning disabilities, negotiating the special education process, and helping your child and yourself.

Tourette’s Syndrome and Tic Disorders 

Tourette’s Syndrome Association is a great resource for people with tic disorders.

General Support Group List 

For a list of many support groups in Kansas: Support Groups in Kansas .

School information

Choosing schools for kids with ADHD and learning differences isn’t always possible, but look to the linked articles on ways to decide what might work best for your child. When choosing colleges, look specifically for programs they offer for students who learn differently and plan ahead to get your teen ready for this challenge.

Midwest ADHD Conference – April 2018

Check out the Midwest ADHD Conference coming to the KC area in April, 2018. I’m involved in the planning stages and it will be a FANTASTIC conference for parents, adults with ADHD, and educators/teachers.

Midwest ADHD Conference
The Midwest ADHD Conference will be held in April 2018, in Overland Park, Kansas.

 

Supplements for ADHD: Do Vitamins, Herbs, and Fatty Acids Work?

Parents often ask if they can treat their child’s ADHD without prescription medication. There are many alternative treatments in addition to prescription medications – some of which are more effective than others.  I will cover ADHD treatment with supplements today.

Supplements for ADHD – general

If you’re giving your kids supplements for any reason, be sure to tell their physician and pharmacist to avoid any known complications or interactions with other treatments.

Supplement use in general is gaining popularity. All you have to do is visit a pharmacy or specialty store and you will see various products marketed to treat ADHD.

There are some studies that show people with ADHD have low levels of certain vitamins and minerals. More studies are being done to determine if supplementing helps symptoms. There is growing evidence for vitamin supplementation, but there are no standard recommendations yet.

Should you use high dose vitamins?

Clinical trials using various combinations of high dose vitamins such as vitamin C, pantothenic acid, and pyridoxine show no effect on ADHD.

I don’t recommend high dose vitamin supplements unless a specific deficiency is identified. I don’t routinely screen for deficiencies at this time because there are no standard recommendations for this. We still have a long way to go before we know enough to make recommendations.

For children without a known vitamin deficiency, a standard pediatric multivitamin can be used, but effectiveness is not proven. I have no problems with anyone taking a multivitamin daily. However, I cannot recommend any specific brand since none of them are regulated by the FDA and there are many reports that show the label often misrepresents levels of what is really in the bottle. There have been instances of higher or lower than listed amounts of ingredients as well as unlisted ingredients in supplements.

My advice is to buy a brand that allows independent lab testing of their products if you choose to buy any vitamin or supplement.

Vitamins & minerals

The following is adapted from the University of Maryland Medical Center with the help of ADDitude Magazine and Natural Medicines Comprehensive Database.

Magnesium

Symptoms of magnesium deficiency include irritability, decreased attention span, and mental confusion.

Some experts believe that children with ADHD may be showing the effects of mild magnesium deficiency. In one preliminary study of 75 magnesium-deficient children with ADHD, those who received magnesium supplements showed an improvement in behavior compared to those who did not receive the supplements.

Too much magnesium can be dangerous and magnesium can interfere with certain medications, including antibiotics and blood pressure medications.

Talk to your doctor before supplementing with magnesium.

Vitamin B6

Adequate levels of vitamin B6 are needed for the body to make and use brain chemicals called neurotransmitters. These include serotonin, dopamine, and norepinephrine, the chemicals affected in children with ADHD.

One preliminary study found that B6 pyridoxine was slightly more effective than Ritalin in improving behavior among hyperactive children – but other studies failed to show a benefit. The study that did show benefit used a high dose of B6, which could cause nerve damage, so more studies need to be done to confirm that it helps.

If B6 is found to help, we need to learn how to monitor levels and dose the vitamin before this can be used safely.

Because high doses can be dangerous, do not give your child B6 without your doctor’s supervision.

Vitamin C

Vitamin C can help modulate the dopamine levels in the brain. Dopamine is a neurotransmitter that helps control the reward and pleasure centers in the brain.

Vitamin C can affect the way your body absorbs medications (especially stimulants for ADHD) so it is suggested to avoid vitamin C supplements and citrus fruits that are high in vitamin C within the hour of taking medicines.

Preliminary evidence suggests that a low dose of vitamin C in combination with flaxseed oil twice per day might improve some measures of attention, impulsivity, restlessness, and self-control in some children with ADHD. More evidence is needed before this combination can be recommended.

Vitamin D

Vitamin D is the one vitamin that is recommended to take as a supplement by many experts.

As we have gotten smarter about sun exposure, our vitamin D levels have decreased. Vitamin D deficiency has been linked to many problems, including ADHD.

Zinc

Zinc regulates the activity of brain chemicals, fatty acids, and melatonin. All of these are related to behavior.

Several studies show that zinc may help improve behavior.

Higher doses of zinc can be dangerous, so talk to your doctor before giving zinc to a child or taking it yourself.

Iron

Iron deficiencies commonly occur in children due to inadequate dietary sources since kids are so picky. Other causes include blood loss or excessive milk intake.

Iron is needed for the synthesis of dopamine, norepinephrine, and serotonin- all neurotransmitters in the brain.

Low iron has been linked to learning and behavior problems.

Too much iron can be dangerous, so talk with your doctor if you want to start high dose supplements. (Regular multivitamins with iron should not cause overdose if used according to package directions.)

If you’re using high doses of iron, it is important to follow labs to be sure the iron dose is not too high.

Essential fatty acids

Fatty acids, such as those found in fish, fish oil, flax seed (omega-3 fatty acids) and evening primrose oil (omega-6 fatty acids) are “good fats” that play a key role in normal brain function.

In a large review, Omega-3/6 supplementation made no difference in ADHD symptoms, but there are other benefits to this supplement and it carries little risk.

If you want to try fish oil to see if it reduces ADHD symptoms, talk to your doctor about the best dose. Some experts recommend that young school aged kids take 1,000-1,500 mg a day, and kids over 8 years get 2,000-2,500 mg daily.

For ADHD symptom control it is often recommended to get twice the amount of EPA to DHA.

L-carnitine

L-carnitine is formed from an amino acid and helps cells in the body produce energy.

One study found that 54% of a group of boys with ADHD showed improvement in behavior when taking L-carnitine. More research is needed to confirm any benefit.

Because L-carnitine has not been studied for safety in children, talk to your doctor before giving a child L-carnitine.

L-carnitine may make symptoms of hypothyroid worse and may increase the risk of seizures in people who have had seizures before. It can also interact with some medications. L-carnitine should not be given until you talk to your child’s doctor.

 

Proteins

Proteins are great for maintaining a healthy blood sugar and for keeping the brain focused.

They are best eaten as foods: lean meats, eggs, dairy, nuts and seeds, legumes, and fish are high protein foods. Most people in our country eat more protein than is needed.

If your child does not eat these foods in good quantity, there are supplements available. Talk with your doctor to see if they are appropriate for your child. Many of the supplements are high in sugar and other additives. Some have too much protein for children to safely eat on a regular basis.

Herbs

There are some studies supporting nutritional supplements or herbal medicines for ADHD, but many reported treatments have not been found effective.

Pinus marinus (French maritime pine bark), and a Chinese herbal formula (Ningdong) showed some support.

Current data suggest that Ginkgo biloba (ginkgo) and Hypercium perforatum (St. John’s wort) are ineffective in treating ADHD.

Summary

In general I think we all should eat a healthy diet that is made up primarily of fruits, vegetables, lean proteins, and complex carbohydrates.

If children are on a restricted diet due to allergy or sensitivities to foods or additives (or extreme pickiness), discuss their diet with your doctor. Consider working with a nutritionist to be sure your child is getting all the nutrition needed for proper growth.

If supplements are being considered, they should be discussed with your doctor. Talking about risks and benefits can help decide which are right for your child.


Looking for more?

Many parents benefit from support groups to learn from others who have gone through or are currently going through similar situations, fears, failures, and successes. Find one in your area that might help you go through the process with others who share your concerns. If you know of a support group that deserves mention, please share!

ADHD

CHADD is the nationwide support group that offers a lot online and has many local chapters, such as ADHDKC. I am a volunteer board member of ADHDKC and have been impressed with the impact they have made in our community in the short time they have existed (established in 2012). I encourage parents to attend their free informational meetings. The speakers have all been fantastic and there are many more great topics coming up!

Anxiety

Many parents are surprised to learn how much anxiety can affect behavior and learning. To look for local support groups, check out the tool on Psychology Today.

Autism

The Autism Society has an extensive list of resources.

Dyslexia 

Dyslexia Help is designed to help dyslexics, parents, and professionals find the resources they need, from scholarly articles and reviewed books to online forums and support groups.

Learning Disabilities 

Learning Disabilities Association of America offers support groups as well as information to help understand learning disabilities, negotiating the special education process, and helping your child and yourself.

Tourette’s Syndrome and Tic Disorders 

Tourette’s Syndrome Association is a great resource for people with tic disorders.

General Support Group List 

For a list of many support groups in Kansas: Support Groups in Kansas .

School information

Choosing schools for kids with ADHD and learning differences isn’t always possible, but look to the linked articles on ways to decide what might work best for your child. When choosing colleges, look specifically for programs they offer for students who learn differently and plan ahead to get your teen ready for this challenge.

Midwest ADHD Conference – April 2018

Check out the Midwest ADHD Conference coming to the KC area in April, 2018. I’m involved in the planning stages and it will be a FANTASTIC conference for parents, adults with ADHD, and educators/teachers.

Midwest ADHD Conference
The Midwest ADHD Conference will be held in April 2018, in Overland Park, Kansas.


Share Quest for Health

 

Special Diets for ADHD

Most of us have heard of the claims of cures for all sorts of ills, including behavioral problems (especially ADHD and autism) with simple dietary changes (with and without supplements). This post covers some diets for ADHD that have been recommended as treatments. Supplements will be covered tomorrow.

Why talk about diets for ADHD?

ADHD elimination diet, vitaminsFears of side effects from long-term medication or a history of medication failures cause families to look for alternative treatment options for child behavior issues. Diet modification and restriction is intriguing for parents since it fits into the ideal of a healthy lifestyle without added medicines and their potential side effects. However, there is a lot of controversy as to whether these restrictions help except in a small subset of children who have true allergy to the substance.

In general if a simple solution through diet was found, everyone would be doing it.

That just isn’t happening.

I do think that we all benefit from eating real foods — the ones that look like they did when they were grown, not processed and packaged. Fruits, vegetables, protein sources, whole grains, and complex carbohydrates should be the basis for everyone’s diet. It’s just good nutrition. But the direct effect of special diets on learning, behavior, and conditions such as ADHD is limited.

Natural does not equal safe.

When my kids were young and picky eaters I never would have considered stimulating their appetite with organically grown marijuana. While it is all natural (even organic!) and it might increase their appetites, it would have risks, right? In this case I don’t think the risks would outweigh the benefits. But so often parents think that if it’s natural, it’s healthier than something made by man.

Drugs have been tested. They have risks too, but those risks are a known. Some natural therapies have not been as thoroughly tested and they are not regulated, so the label might not correctly identify the contents. For this reason, I think that healthy foods are a great option for everyone, but I hesitate to recommend a lot of supplements, especially by brand.

Elimination diets

Over the years there have been many foods or additives that have been blamed for causing learning and behavioral problems. Some of the proposed problematic foods:

  • food dyes
  • refined sugars
  • gluten
  • salicylate and additives
  • dairy products
  • wheat
  • corn
  • yeast
  • soy
  • citrus
  • eggs
  • chocolate
  • nuts

I’m sure the list goes on, but I’ve got to move on. I’ll discuss some of the specific elimination diets and what evidence about each says.

Food additives

Food additives have been blamed for learning and behavior problems for many years. In 1975, Dr. Ben Feingold hypothesized that food additives (artificial flavors and colors, and naturally occurring salicylates) were associated with learning disabilities and hyperactive behavior in some children.

Since then many case reports of similar claims have continued to surface, but those do not have the same weight as a double-blinded control study. Most studies done in a scientific manner have failed to show a benefit.

It never hurts to eliminate artificial dyes and additives in your child’s diet. If it helps, continue to avoid them. But if no change is noted, don’t continue to rely on dye avoidance as a treatment plan.

GAPS Diet

Another elimination diet is the GAPS (Gut and Psychology Syndrome) diet, designed by Dr. Natasha Campbell-McBride.

She asserts that a wide variety of health problems  (autism, ADHD, schizophrenia, depression, and more) are from an imbalance of gut microbes. Not only has it not been proven to work, I worry that it restricts healthy foods, such as fruits, and kids will develop other problems on this diet.

I cannot go into details in this space, but for more information visit Science Based Medicine: GAPS diet.

Gluten

Gluten is in the news to be the base of many problems. It seems to be recommended to go gluten free for just about any ailment you can think of.

There are a subset of people who are really sensitive to gluten, and they benefit greatly from a gluten free diet.

But the large majority of people gain no direct benefit from this expensive and restrictive diet. One indirect benefit of the diet previously was that it was nearly impossible to eat pre-packaged and processed foods, which leaves real fruits, vegetables, and other high quality foods. As more people are going gluten free there are more pre-package products made gluten free. I wonder if the benefits people have noticed previously will wane when they eat these foods.

Talk with your doctor before deciding if going gluten free will work for your child.

Sugar

Sugar is often blamed on hyperactivity. By all means, no child needs extra sugar, so cut out what you can.

Well controlled studies did not find a behavioral difference in kids after refined sugars.

Interestingly, parents still perceived a change (despite researchers finding none) in at least one study by Wolraich, Wilson, and White. 1995.

Food allergies

Food allergies are now commonly thought to be related to behavior and learning problems.

In some children with true allergies, foods can affect behavior. However, most children do not have food allergies and avoiding foods does not alter behavior. It can be challenging to determine if there is a food allergy since some of the tests offered are not reliable.

Elimination Diets Final Thoughts

In a small subset of kids food avoidance helps, but in the large majority studies do not support avoidance of foods.

If you think your child benefits from avoiding one or two foods, it probably isn’t a big deal to restrict those foods.

But if you suspect your child is allergic to everything under the sun, you will need to work with your doctor and possibly an allergist and a nutritionist to determine exactly what your child must avoid and how they can get all the nutrients they need to grow and develop normally.

Next up: Supplements for ADHD

Stay tuned for a summary of supplements on ADHD – what’s been proven to work and what hasn’t!

Evaluation Process to Diagnose Learning & Behavioral Issues

I have talked about why kids should be evaluated if they have learning or behavioral issues and who is involved in this evaluation in the past few posts. Today I want to talk about what to expect during an evaluation. Not all kids need every test available. It depends on what their specific concerns are as to what will be tested, but a proper diagnosis can’t be made without standardized testing and a complete evaluation.

What types of things are evaluated?

Evaluation Process to Diagnose Learning & Behavioral IssuesThe evaluation includes several types of assessments because there are many things that can cause learning or behavioral issues.

There are no specific laboratory or imaging tests available to determine a diagnosis on a routine basis. It’s important to do a thorough standardized evaluation to get the right diagnosis.

Contributing issues include but are not limited to: ADHD, anemia, anxiety, bullying or abuse, chronic illness, depression, hearing or vision problems, learning disabilities, malnutrition, oppositional defiant disorder, sensory integration disorder, and sleep deprivation.

Symptom overlap

Having one diagnosis does not mean you can’t have a second. Actually many of these issues go hand-in-hand and co-exist.

ADHD, anxiety, neurodiversity, learning disorders
There is a lot of overlap of symptoms of many similar conditions.

Standardized questions

A big part of the diagnosis lays in the symptoms noted at home and school, so there are a lot of questions about how your child fares at each.

Both parents and teachers and any other significant adults should fill out standardized questionnaires as recommended by the clinician doing the evaluation for many behavioral issues. Older kids (and adults) can do self assessments.

It’s important to answer each question as honestly as possible to avoid misrepresentation of symptoms, which can lead to an improper diagnosis.

History

Reviewing the child’s story can give clues. This includes the current concerns of parents and teachers in addition to historical facts and events.

If there were developmental delays in motor skills or language development, further evaluation in those areas might be insightful.

It’s important to review the family history, since many of these issues run in families.

Sleep patterns are often insightful since sleep deprivation can decrease executive functioning and mimic many conditions.

Other issues, like a history of anemia or elevated lead levels should be discussed.

Exam findings

A physical exam should be done to help identify any physical symptoms that can contribute to learning or behavioral problems, such as large tonsils leading to sleep apnea.

Behavior evaluation

Some clinicians will go to your child’s classroom to observe behaviors. This is sometimes provided through the school district but might also involve a private therapist.

Neuropsychological testing

Neuropsychological testing might be recommended. It can assess learning disorders and attention issues, identify strengths and weaknesses, and help determine what interventions will work best for your student. Understood.org has information about neuropsychological testing.

Vision and Hearing

If your child has not had a vision and hearing screen done previously or there are concerns, it is recommended to do those screens. When a child cannot see the white board or hear the instructions, learning and behavior are both impacted.

Evaluation Process

As you can see, there are many things to consider when evaluating learning and behavioral concerns. A proper diagnosis usually takes more than one visit. More than one person should be involved in the screenings in many cases. Do not attempt to shortchange this process. Without a proper assessment, the wrong treatment might be advised, leading to poor outcome.

The next few blogs will discuss treatment options for ADHD, including dietary changes, supplements, alternative and additional treatments and medications.


Looking for more?

Many parents benefit from support groups to learn from others who have gone through or are currently going through similar situations, fears, failures, and successes. Find one in your area that might help you go through the process with others who share your concerns. If you know of a support group that deserves mention, please share!

ADHD

CHADD is the nationwide support group that offers a lot online and has many local chapters, such as ADHDKC. I am a volunteer board member of ADHDKC and have been impressed with the impact they have made in our community in the short time they have existed (established in 2012). I encourage parents to attend their free informational meetings. The speakers have all been fantastic and there are many more great topics coming up!

Anxiety

Many parents are surprised to learn how much anxiety can affect behavior and learning. To look for local support groups, check out the tool on Psychology Today.

Autism

The Autism Society has an extensive list of resources.

Dyslexia 

Dyslexia Help is designed to help dyslexics, parents, and professionals find the resources they need, from scholarly articles and reviewed books to online forums and support groups.

Learning Disabilities 

Learning Disabilities Association of America offers support groups as well as information to help understand learning disabilities, negotiating the special education process, and helping your child and yourself.

Tourette’s Syndrome and Tic Disorders 

Tourette’s Syndrome Association is a great resource for people with tic disorders.

General Support Group List 

For a list of many support groups in Kansas: Support Groups in Kansas .

School information

Choosing schools for kids with ADHD and learning differences isn’t always possible, but look to the linked articles on ways to decide what might work best for your child. When choosing colleges, look specifically for programs they offer for students who learn differently and plan ahead to get your teen ready for this challenge.

Midwest ADHD Conference – April 2018

Check out the Midwest ADHD Conference coming to the KC area in April, 2018. I’m involved in the planning stages and it will be a FANTASTIC conference for parents, adults with ADHD, and educators/teachers.

Midwest ADHD Conference
The Midwest ADHD Conference will be held in April 2018, in Overland Park, Kansas.


Share Quest for Health

 


 

Who’s Who In Learning & Behavior Evaluation & Management?

I tried to convey why it’s so important to get a proper diagnosis of learning and behavioral problems in my last blog, Labels – Why should my child be diagnosed? Today I’d like to explain what is done during the evaluation and who’s involved in testing and treatment. Primary care physicians are a great place to start with questions about how to evaluate and treat various concerns. After that where should you go?

Start with the pediatrician

learning and behavior evaluation and managementParents are sometimes surprised to learn that I treat ADHD, anxiety, and many other behavioral disorders. I see many kids every day with these issues. I enjoy watching as they learn to manage their behaviors and improve their executive functioning over the years. Even kids who really struggle in the early years can grow into confident and accomplished adults.

I often say that kids with ADHD are talented, smart and can do wonderful things. They have unique gifts.

There are some pediatricians who don’t treat these issues, but I find there’s a huge need. In many cases since I’ve followed a child for years, I know them well and can help better than a specialist who doesn’t have that history.

Despite plenty of experience, I do use specialists often.

Many learning and behavior problems have similar symptoms, so it might take several professionals to help evaluate the situation.

Of course the professionals at school are imperative to being part of the team. And there are times when the diagnosis isn’t clear or a child doesn’t respond to the treatment well, other specialists are very helpful to assess the issues.

Cautions…

There are of course many tests and treatments available that have not been proven to help. Future blogs will cover testing and treatments, but until then, just a few cautions.

There are tests available, such as EEG for ADHD, that are not shown to be beneficial and can increase cost without adding to the diagnostic evaluation.

There are many treatments that haven’t been shown to be effective but still advertise good results for a fee.

If it sounds too good to be true, it probably is. Discuss tests you are considering with your child’s doctor, especially if there is a large price tag attached.

 

Who’s who?

The alphabet soup of credentials confuses many parents. I’ve tried to compile a list of experts in various fields who might need to be involved in your child’s assessment and care as well as explain what types of things they can do to help in the process of evaluating and treating learning and behavior issues.

Parents

Parents (or primary caregivers) are critical to giving insight into how children learn and behave. They should be interviewed and fill out standardized questionnaires to help with the diagnosis. Their feedback on how each treatment is working is helpful in fine tuning treatment plans.

Teachers & Other School Professionals

Teachers are imperative in helping assess the issues and concerns since they can compare any one child to a room of their peers and they know how your child handles various situations and what their typical behaviors are.

Many schools will have a school counselor or psychologist evaluate and help treat students.

Teachers with advanced background in learning disabilities are used to help address specific concerns.

It’s recommended that each teacher fill out standardized questionnaires to help with the initial evaluation of focus and behavior disorders and again to assess responses to treatments.

Schools may put students on IEP or 504 Plans to help with their education. For more on these see IEP & 504 Plan. 

Therapists (not mental health)

Physical Therapists, Occupational Therapists, Audiologists, and Speech Therapists can be school based or private, but they are helpful in addressing specific motor skills, sensory issues, hearing issues, or speech/language concerns.

They do not prescribe medication, but work within their area to improve certain skills that affect learning and behavior.

Check with your insurance to see what is covered in your plan. Ask the school if they offer any of these services.

Mental health specialists

Psychologists (clinical psychologists, cognitive psychologists, educational psychologists and neuropsychologists) and clinical social workers offer testing as well as therapy for many disorders.

Some therapists specialize in testing, others in treating. Some do both. You will have to ask what their qualifications are and what role they play in diagnosis and management.

Clinical therapists can do parent training to help parents manage behaviors at home, especially for younger children.

Therapists cannot prescribe medications, but some people find that the therapy provides enough benefit that medication is not needed or that the therapy in addition to medicine helps better than either treatment alone.

Cognitive behavioral therapy is the preferred first line treatment for certain disorders, such as ADHD in young children and anxiety.

Therapists often provide social skills training, which is needed for many children with behavioral and learning issues who don’t learn social skills as easily as their peers.

You should check your insurance list of providers to see who is covered. It also might be worth pricing some who do not take your insurance but will give you a bill to submit yourself. If a person is out of network your cost might be about the same as a person who is harder to get in to see but on your plan.

I find the searchable database from Psychology Today to be helpful. You start with your zip code, then you can choose insurance, issues needed, male or female providers, and more to limit your list of suggested therapists.

Physicians

Physicians (pediatrician, family physician, developmental pediatrician, neurologist, and psychiatrist) can make a diagnosis and prescribe medications for treatment of certain diagnoses, such as ADHD or anxiety.

Not all have experience with each of these issues so you must ask what their experience is.

It can take quite a while to get into specialists and they can be expensive, so starting with your primary care physician often is easier and very helpful to rule out medical issues and to do the evaluation and treatment if they are comfortable.

Many psychiatrists do not accept insurance and they are typically difficult to get in to see.

Physicians (including psychiatrists) generally do not do therapy. They focus on the medication benefits and side effects. Therapy along with medication often improves outcome, so multiple specialists working together can be beneficial.

Physician-extenders

Nurse practitioners and physician assistants can work with physicians to diagnose disorders and prescribe medications to treat them. In some states they can work independently.

They do not offer psychotherapy, so it is often beneficial to work with more than one person to get the best outcome.

Benefits include that they are generally easier to get in to see and they are relatively inexpensive compared to physicians. Not all are comfortable with treating these issues. Ask about training and experience.

Working as a team

The types of professionals who work with any given child to assist in diagnosis and treatment vary depending on the issues at hand. The most important thing is that they work as a team and communicate with one another.

This communication is often done through parents and written reports. It’s important that all members of the team have access to what the others are doing.

Looking for more?

Many parents benefit from support groups to learn from others who have gone through or are currently going through similar situations, fears, failures, and successes. Find one in your area that might help you go through the process with others who share your concerns. If you know of a support group that deserves mention, please share!

ADHD

CHADD is the nationwide support group that offers a lot online and has many local chapters, such as ADHDKC. I am a volunteer board member of ADHDKC and have been impressed with the impact they have made in our community in the short time they have existed (established in 2012). I encourage parents to attend their free informational meetings. The speakers have all been fantastic and there are many more great topics coming up!

New in Fall 2018: ADHDKCTeen – a group just for teens with ADHD (and anxiety, learning difference, and anyone else who thinks it will help them).

Anxiety

Many parents are surprised to learn how much anxiety can affect behavior and learning. To look for local support groups, check out the tool on Psychology Today.

Autism

The Autism Society has an extensive list of resources.

Dyslexia 

Dyslexia Help is designed to help dyslexics, parents, and professionals find the resources they need, from scholarly articles and reviewed books to online forums and support groups.

Learning Disabilities 

Learning Disabilities Association of America offers support groups as well as information to help understand learning disabilities, negotiating the special education process, and helping your child and yourself.

Tourette’s Syndrome and Tic Disorders 

Tourette’s Syndrome Association is a great resource for people with tic disorders.

General Support Group List 

For a list of many support groups in Kansas: Support Groups in Kansas .

School information

Choosing schools for kids with ADHD and learning differences isn’t always possible, but look to the linked articles on ways to decide what might work best for your child. When choosing colleges, look specifically for programs they offer for students who learn differently and plan ahead to get your teen ready for this challenge.

Midwest ADHD Conference – April 2018

Check out the Midwest ADHD Conference coming to the KC area in April, 2018. I’m involved in the planning stages and it will be a FANTASTIC conference for parents, adults with ADHD, and educators/teachers.

Midwest ADHD Conference
The Midwest ADHD Conference will be held in April 2018, in Overland Park, Kansas.

Share Quest for Health