Each year Kids to Parks Day is celebrated on the 3rd Saturday of May. It’s a day we can help kids and families connect with their local, state, and national parks and have fun! This year it’s Saturday, May 19th.
Why should we have a national day to celebrate taking kids to a park?
Because anything that encourages families and friends to explore the outdoors together is a great thing!
Where should you go?
If you’re wondering where to go, check out this great page from the National Park Trust called Explore Parks Near You. You can click on the state you want to explore to find parks.
Of course if there’s no national park near you, you can visit any nearby park or trail. The point is to get outside and enjoy nature.
What can you do?
Parks may offer a number of activities. You can investigate if they have hiking or biking trails, water activities such as swimming or fishing, camping, or more.
Always make sure you’re prepared when you’re going into nature.
Sunscreen and sun protection from hats and clothing is a must when outdoors. Use at least an SPF of 25 and reapply sunscreen every 2 hours until evening hours.
Sunglasses might also be appreciated and help protect the eyes from damaging rays. Be sure your sunglasses provide 100% UV protection from both UVA and UVB rays. Don’t forget the kids! We get 75-80% of our UV exposure before we turn 18.
Be sure to bring water bottles for everyone. Dehydration is a risk when you’re active, especially if it’s warm outside. Caffeinated (and for adults, alcoholic) beverages don’t rehydrate as well as water.
Wear appropriate shoes. Many kids want to wear their favorite sandals, but if you’ll be outdoors walking, they will need a more sturdy shoe. If you’ll be around water you might even pack a second pair in case they get wet. Walking in wet shoes is begging for blisters.
Bring a camera to take memories, but don’t spend the day trying to get the perfect picture. Snap a few pictures, but make the day about enjoying the outdoors, not about taking pictures.
If you’ll be hiking, bird watching, or looking for wildlife, it might be helpful to have binoculars.
Bring healthy snacks or pack a lunch if you’ll be out during typical snack or meal times. When kids are hungry, they get angry. You don’t want hanger to ruin a fun day!
If there are areas appropriate for sporty activities, bring some balls or frisbees.
What should you not bring?
Leave the electronics at home. This is a great day to unplug!
If you have allergies in the family…
If someone (or many) in your family suffer from allergies, be prepared! I have many tips in a previous blog that covers allergies.
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.
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 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.
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.
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 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).
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.
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.
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 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.
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.
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!
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!
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.
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.
Too much sugar is causing an epidemic of obesity in our kids. Even the ones who aren’t overweight are often less healthy due to food choices. Excess sugar consumption over time is linked to many health issues such as high cholesterol, diabetes, metabolic syndrome, and it can trigger earlier puberty – leading to overall shorter adult height. Not to mention the psychological and social implications of bullying, depression, eating disorders, and more.
Back in the day…
Why is weight so much more of a problem now than it was years ago?
As a child I did not have a perfect diet, yet I was not overweight (and neither were my classmates) because we spent most waking moments outside if we weren’t in school.
My mother packed a dessert in every lunch box. We ate red meat most days. My mother usually put white bread and butter on the table at dinner. I drank 2% milk and ate ice cream every night.
But we walked to school– without a parent by the time I was in 1st grade. (gasp!)
There were only a couple tv channels, and Saturday morning was the only time we could watch tv.
We were able to ride bikes, go to a wooded area, play on a nearby playground, dig in the dirt, you name it – we found something to make it fun!
Why is weight so much more of a problem now than it was years ago?
I think it’s a combination of what they’re eating and what they’re doing.
Today’s kids are shut up in the house after school watching one of many tv channels or playing video games.
Even those who are shuttled to activities get overall less exercise because it is structured differently than free play. They ride in the car to practice or class, then sit and wait for things to start. They might sit or stand while others are getting instruction.
Simply put: They eat a lot of processed and junk food and they don’t get to do active things at their own pace with their own creativity for as long as they want.
Shouldn’t we worry about them getting hurt?
I know parents are worried that their kids will get hurt or abducted if they play outside with friends, especially if they go out of sight from a parent. But I think in some ways we’re killing our kids slowly by allowing unhealthy habits to kick in.
The reality is that most kids won’t get hurt if they’re playing. Yes, some will. But if they play video games all day, they won’t get injured. They are likely to have long term problems though.
I’m seeing adult problems in young kids, such as Type 2 diabetes, high cholesterol, non-alcoholic fatty liver disease, hip/knee problems, and more. The poor kids who are overweight have the potential to suffer long term consequences.
What to do???
On one hand kids need to learn to make healthy choices to maintain a healthy body weight for height, but on the other hand you don’t want to focus so much on weight that they develop eating disorders. I think this is possible if we focus on the word “healthy” – not “weight”.
Starting at school age I ask kids at well visits if they think they are too heavy, too skinny, too short, or too tall. If they have a concern, I follow up with something along the line of, “How would you change that?” I’m often surprised by the answers, but I can use this very important information to guide how I approach their weight, height, and BMI. We talk about where they are on the graph, and healthy ways to either stay in a good place or how to get to a better BMI.
I focus on 3 things we all need to be healthy (not healthy weight, but healthy):
Healthy eating (eat a plant and protein each meal and snack)
Exercise (with proper safety equipment but that’s another topic!)
Sleep (again, another topic entirely!)
Food is a part of our daily needs, but much more than that.
It’s a huge part of our lifestyle.
We have special meals for celebrations but on a day to day basis it tends to be more repetitive.
We all get into ruts of what our kids will eat, so that is what we prepare. The typical kid likes pizza, nuggets, fries, PB&J, burgers, mac and cheese, and a few other select meals.
If we’re lucky our kids like one or two vegetables and some fruits. We might even be able to sneak a whole grain bread in the mix.
If our family is busy we eat on the run– often prepared foods that are low in nutrition, high in fat and added sugars, and things our kids think taste good (ie things we won’t hear whining about).
We want our kids to be happy and we don’t want to hear they are hungry 30 minutes after the meal is over because they didn’t like what was served and chose not to eat, so we tend to cave in and give them what they want.
We as parents need to learn to stop trying to make our kids happy for the moment, but healthy for a lifetime.
There’s often a discrepancy between the child’s BMI (body mass index) and the parent’s perception of healthy.
The perception of calorie needs and actual calorie needs can be very mismatched. I have seen a number of parents who worry that their toddler or child won’t eat, so they encourage unhealthy eating unintentionally in a variety of ways:
turn on the tv and feed the child while the child is distracted
reward eating with dessert
refuse to let the child leave the table until the plate is empty
allow excessive milk “since at least it’s healthy”
allow snacking throughout the day
legitimize that a “healthy” snack of goldfish is better than cookies
Any of these are problematic on several levels. Kids don’t learn to respond to their own hunger cues if they are forced to eat.
If offered a choice between a favorite low-nutrition/high fat food and a healthy meal that includes a vegetable, lean protein, whole grain, and low fat milk, which do you think any self-respecting kid would choose?
If they’re only offered the healthy meal or no food at all, most kids will eventually eat because they’re hungry.
No kid will starve to death after 1-2 days of not eating.
They can, however, over time slowly kill themselves with unhealthy habits.
So what does your child need to eat?
Think of the calories used in your child’s life and how many they really need. Calorie needs are based on age, weight, activity level, growing patterns, and more.
It’s too hard to count calories for most of us though.
If kids fill up on healthy options, they won’t be hungry for the junk.
Offer a plant and a protein for each meal and snack. Plants are fruits and vegetables. Proteins are in meats, nuts, eggs and dairy.
Don’t think that your child needs to eat outside of regular meal and snack times.
One of my personal pet peeves is the practice of giving treats during and after athletic games. It’s not uncommon for kids to get a treat at half time and after every game. Most teams have a schedule of which parent will bring treats for after the game.
Do parents realize how damaging this can be?
A 50 pound child playing 15 minutes of basketball burns 39 calories. Think about how many minutes your child actually plays in a game. Most do not play a full hour, which would burn 158 calories in that 50 pound child.
A 50 pound child burns 23 calories playing 15 minutes of t-ball, softball, or baseball. They burn 90 calories in an hour.
A non-competitive 50 pound soccer player burns 34 calories in 15 min/135 per hour. A competitive player burns 51 calories in 15 min/ 203 in an hour.
Find your own child’s calories burned (must be at least 50 pounds) at CalorieLab.
Now consider those famous treats at games.
Many teams have a half time snack AND an after game treat. Calories found on brand company websites or NutritionData:
Typical flavored drinks or juice range 50-90 calories per 6 ounce serving.
Potato chips (1 ounce) 158 calories (A common bag size is 2 oz… which is 316 calories and has 1/3 of the child’s DAILY recommended fat intake!)
Fruit roll up (28g) 104 calories
1 medium chocolate chip cookie: 48 calories
Orange slices (1 cup): 85 calories
Grapes (1 cup): 62 calories
Apple slices (1 cup): 65 calories
So…Let’s say the kids get orange slices (a lot of calories but also good vitamin C, low in fat, and high in fiber) at half time, then a fruit drink and cookie after the game. That totals about 200 calories.
The typical 50 pound soccer player burned 135 calories in a one hour game. They took in more calories than they used.
They did get some nutrition out of the orange, but they also ate the cookie and fruit drink.
The cookie has fewer calories than other options but no nutritional value and a lot of added sugars.
The kids end up taking in many more calories than they consumed during play.
What’s wrong with WATER? That’s what we should give kids to drink at games.
They should eat real food after the game if only they’re hungry. Snacks are likely to decrease appetite for the next meal, so if they’re hungry give a mini-meal, not a sugar-filled, empty calorie treat every game.
There are many resources on the web to learn about healthy foods for both kids and parents. Rethink the way you look at how your family eats.
Offer a fruit and vegetable with a protein at every meal and snack. Fill the plate with various colors! (As I tell the kids: eat a plant and a protein every time you eat ~ meals and snacks!)
Picky kids? Hide the vegetable in sauces, offer dips of yogurt or cheese, let kids eat in fun new ways – like with a toothpick. Don’t forget to lead by example and eat your veggies!
Buy whole grains.
Choose lean proteins.
Don’t skip meals.
Make time for sleep.
Get at least 60 minutes of exercise a day!
Eat together as a family as often as possible.
Turn off the tv during meals. Don’t use distracted eating!
Encourage the “taste a bite without a fight” rule for kids over 3 years. But don’t force more than one bite.
Don’t buy foods and drinks with a lot of empty calories. Save them for special treats. If they aren’t in the home, they can’t be eaten!
Drink water instead of juice, flavored drinks, or sodas.
Limit portions on the plate to fist sized. Keep the serving platters off the table.
Eat small healthy snacks between meals. Think of fruit, vegetable slices, cheese, and nuts for snacks. I tell kids all the time: eat a plant and a protein every time you eat – both meals and snacks. Think of snacks as mini-meals!