01 Apr Can you treat ADHD in children without medication?
My son started to have problems at school and playdates since he was 4 yrs old. I was often called into school by the grade teacher complaining of his fidgetiness, lack of focus in class and his temper tantrums.
At that point, we were in India, where I now believe, society is more tolerant of mischievous kids passing them off as cute or “ oh! he is just a small child”. The concept of ADHD is not foremost in the society.
We moved to South Africa in January 2012, and the cute or mischievous child soon became a problematic, inattentive child who suffered at school. We, as parents, endured each time the teacher complained. Our lives became miserable in battling to comprehend whether this was a settlement issue in a new country, hyperactivity of toddlerhood or ADHD as the teachers were pointing out with conviction.
The journey from that point of diagnosis of ADHD, constant visits to psychologists and doctors till the present day of a well-adapted, socially happy and compatible child has been a long one. It had its ups and its downs.
Having crossed many obstacles and helpless moments, I feel the need to reach out to more parents like us who may be struggling with their kids. This blogpost is aimed at providing necessary awareness and a perspective about how to deal with ADHD in kids especially without medication.
What is ADHD?
Attention deficit hyperactivity disorder is a neurodevelopmental disorder. It presents in children between 5-6 years or later in teenage years. If undetected and untreated, it can lead to ADHD of adulthood. During childhood, it affects the child’s outcome at school and his relationships with peers. In adulthood, it may present with co-morbidities like depression, social incompatibility and suicidal tendencies.
Therefore, early diagnosis is crucial. Timely measures should be put in place to make sure the child develops as holistically as possible.
ADHD presents mainly as three types :
- Combination of both
What are the symptoms of ADHD?
Toddlers are, by nature, energetic, hyperactive and will jump quickly from one activity to another. How then do you, as a parent, recognise the difference between hyperactivity of toddlerhood and ADHD?
Let’s look at a list of the various ways in which ADHD can present:
Lack of focus
The child may seem to zone out, and can’t remember what you just said or asked him to do. He/ she often appears to be daydreaming.
- Avoids tasks that need concentration: Sustaining attention during long hours of a class or assignments at home seems to become a challenge every time.
- Does not complete tasks: Due to the lack of focus, the child usually leaves his assignments or projects incomplete. He/ she often jumps to the next activity that catches their attention.
- Makes repetitive mistakes: The assignments show a range of errors due to carelessness rather than lack of age-appropriate knowledge. Lack of focus is the main reason for the child often wanting to do tasks in a hurry and not caring about mistakes. These mistakes are often repetitive.
- Disorganised: The child cannot organise his thoughts or his work in an age-appropriate manner.
- Forgetfulness: Tends to forget about the task assigned and loses things easily.
- He/she seeks attention most of the time.
- Interrupting others: The child seems to interrupt the teacher, other children or adults often and speaks out of turn. He/ she has to be continuously reminded to wait their turn.
- Emotional outbursts happen often.
- He/She shows violence towards other kids that is more a result of an emotional outburst than a wrong intention.
When do you judge that medical help is required?
These symptoms or behaviour patterns are present in every other toddler. However, a child with ADHD will have:
- Several of the above symptoms
- The symptoms may be inattentive/ hyperactive type/ combination of both
- The symptoms are frequent.
- The symptoms present in school, home, playdates, restaurants, consistently in all places.
- The symptoms affect the child’s performance at school and his relationship with peers.
- The child becomes socially unhappy.
What is the way forward?
There are different treatment modalities for ADHD. First and foremost is the diagnosis.
Seek a psychologist near you who has experience in childhood behavioural disorders. It is worthwhile to meet the psychologist without the child so that you can evaluate whether he/ she would be compatible to work with your child on an emotional and communicative level. Logistically, nearer the clinic to your residence, the better. The therapy sessions could go on for months, and you should be comfortable to travel the distance each time.
He/ She may ask you and the child’s grade teacher to fill out a questionnaire that deals with incidents and situations to evaluate most of the symptoms of ADHD. These are then scored by the psychologist to come to a conclusion and diagnosis.
What are the different treatment modalities for ADHD:
1)Medication: Used in children six years or older
Stimulants (e.g. Ritalin, Concerta ) that work by increasing neurotransmitters in the brain.
Non-stimulants (e.g. Strattera) used alone or in conjunction with stimulants.
2)Behavioural therapy: Used as the first line of treatment in younger children and mainstay in all ADHD cases. Counselling mainly aims at improving behaviour and social skills.
It is finally the parents’ decision to decide the modality they are comfortable with, based on the age of the child, severity of symptoms and severity of social incompatibility.
My story and role as a parent of a child with ADHD.
My son was diagnosed at the age of 5 years, in a foreign country, with no family support and disbelief that he could have ADHD.
Incidents of constantly disturbing the class, doing gymnastics while the teacher taught or hitting other kids at playtime made his teacher complain about him all the time. He would come back after having sat down in a time out chair for the majority of his class hours, confused and upset. We would be anxious every time we picked him up from school since we knew the teacher would be waiting to complain. We would apologise, leave, only to come back to the same frustration day after day.
“We started to feel inadequate.”
The diagnosis brought its own set of doubts and decisions. One such decision was to start Ritalin during school hours. I remember that the drug effect would start waning off by noon when I picked my son to drive back home. Throughout the drive, he would be kicking and screaming and somewhat uncontrollable until we reached home, where I would hold him and comfort him out of this phase.
A visit to France that summer and Disneyland in Paris was an eyeopener. My son just stood there like a zombie, not relating to any of the magical things that most kids love at Disney.
In fact, with the high level of concentration and focus that Ritalin induces, he could not deal with the loud noises and the crowds. That was the day we decided that we didn’t want to medicate him anymore and have never done so after that.
So what helped?
Parental Intervention as the mainstay of ADHD treatment
Here are some of the natural methods and ways that worked for us :
- Behavioural therapy with a psychologist was the mainstay for learning how to cope in different situations.
- Setting discipline and a routine at home for study, play and bedtime hours helped to set a predictable schedule.
- Ensuring timed meals and avoiding long gaps between meals to maintain blood sugar levels. This helped in reducing craving for sugary food.
- Ensuring a sugar and preservative-free diet.
- Fish oil supplementation. Omega-3 helps in developing focus.
- Enrolling him in a sport of his choice, soccer, in this case, to burn out excessive energy. He was also able to focus on his studies better after games.
- Restricting screen time to two hours over weekends.
- Encouraging playdates with friends and supervising the playdates to track and correct behaviour patterns.
- Supervising homework initially and offering a reward for completing tasks without losing focus.
- Reinforcing good behaviour by praising him or just giving a hug.
- Using a “time out” strategy during incidents of emotional outbursts or temper tantrums.
Behavioural therapy introduces a lifestyle modification not only for the child but for the entire family. It is a tough ride.
“During this journey, one has to remind themselves constantly that the adaptations learnt through behavioural therapy are a life skill for an individual with ADHD. They are his lifeline.”
There is no cure for ADHD. One can only hope to reduce symptoms and learn coping mechanisms in different situations. This therapy aids in reducing disruptive behaviour, improve performance at school and improve their quality of life.
It has been my endeavour to touch on the various aspects of ADHD in children with the hope of creating a perspective from personal experience. My son now leads a medicine-free, happy, socially adjusted, independent and confident life.
If you found this blog useful, seek advice you may need or have insights to share, please do leave comments in the section below.