The Tomorrow of Treating Childhood ADHD: Beyond Medication

When your child receives a clinical diagnosis of ADHD, many questions/concerns go through your mind.  Most parents say “Does my child have to take medication?” or “What other treatment options do we have?” In the past, ADHD was treated primarily with stimulant medications. The ongoing Multimodal Treatment Study of Children with ADHD (MTA Study) has consistently noted that the best treatment is a comprehensive one that includes a combination of medication, behavioral/social interventions, and educational accommodations. The decision to medicate your child is not an easy one.  Further, when you do decide to move forward with medication, the road is not so easy.  Some children go through several trials of different medications and doses before finding the most effective one.  Still, others do not respond to them or may experience uncomfortable side effects.  Yes, the road to treating ADHD is frustrating and truly is an art, not a science.  Not all children with ADHD are the same. The treatment method that works for one child may not work for another.

The good news is that research continues to seek innovative/alternative ADHD treatments. Most recently, parents are asking about Neurofeedback Therapy and Cogmed Training. Neurofeedback has not yet been proven to help children with ADHD.  However, it is being used with some reported success. Neurofeedback uses brain exercises to reduce impulsivity and increase attentiveness.  Cogmed training is an evidence-based, computer program for helping children improve attention by training their working memory. This treatment can be done using a PC at home and does not require office visits. The goal of this training is to increase functions of the prefrontal cortex of the brain including starting tasks, following through, remembering things, and being more organized. As evidence of benefits for both neurofeedback and cogmed training accumulates, parents may consider whether it is worth trying.  However, these methods are expensive and many parents have trouble justifying the benefits of such investment, especially since the body of evidence supporting their use is still growing.

Many parents also frequently ask about treating ADHD with better nutrition and diet.  Hyperactivity has long been associated with sugary foods such as sodas and candy. Certainly, reducing these types of foods and eating a balanced diet may prevent swings in behavior caused by hunger, vitamin deficiency, and changes in blood/sugar levels.   The whole nutrition/dietary approach to treating ADHD, while introduced a long time ago, is a gray area.  Indeed, you will find “good” studies that have been done, but again they are not empirically validated, evidence based and most importantly can NOT conclude that many of the children with ADHD benefit from these approaches consistently. Because results vary from study to study, nobody knows how many kids are affected by changes in diet and there is no evidence that claims there is one particular diet that is effective for treating all children with ADHD.  How frustrating indeed! Still, that does not mean that families avoid this alternative way of treating the disorder.  My recommendation is that you consult with an allergist or dietician/nutritionist who can speak more about this approach to treatment. In sum, recent research trends are moving towards alternative ADHD treatments.  This presents hope to addressing ADHD in children that do not respond favorably to medication for one reason or another.  As a clinician I encourage parents to think about two questions when considering treatment options; 1) How is ADHD impacting my child’s daily functioning?, and 2) How do we (the parents) measure success?

Maria Kanakos, Psy.D
Licensed Clinical Psychologist

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