Attention Deficit Hyperactivity Disorder (ADHD) is an often misunderstood condition that affects focus, control of the body, emotion regulation, and it involves underdeveloped executive functioning skills. For anyone who is unfamiliar with the term executive functioning, it has to do with our ability to plan and organize ourselves to complete tasks and take care of our responsibilities. The CDC* estimates that almost 10% of kids will be diagnosed with ADHD between the ages of 3-17. This is an overall estimate. There are differences in rates across genders, ethnicities, and there are even differences from state to state. The most common forms of effective treatment involve medications. Some parents are, however, understandably resistant to putting their child on medication for ADHD. Doctors tend to point out that there are legitimate differences in brain structure for people with ADHD, and the medications are designed to help the ADHD brain have the ability to slow down so that they can find success in school, work, and social interactions. Nonetheless, this is a decision that should be made on an individual basis by families and their team of medical professionals. There are some things that families can also do to help children learn to help them find relief, and that will be the focus of this blog.
First of all, I’ve mentioned before that the top three things we can do to positively impact our own mental health is to eat the right amounts of the right things, get a healthy amount of sleep, and exercise. This holds true for kids with ADHD too. Due to their deficits in executive functioning, they shouldn’t be allowed to pick their own bedtimes. Help these kids out by giving them a strict, age-appropriate bedtime that is based on allowing the proper amount of sleep before the time that they need to wake up. For kids who aren’t used to going to bed at an appropriate time, it may take a couple of weeks of persistence before they start to feel tired when they should. They shouldn’t have screens to watch at bedtime either because it can make it more difficult to get to sleep (as well as tempting to view at night). I recommend removing phones, tablets, and computers from their rooms, and if they have a tv, it should be disabled at bedtime in some way. On the general topic of screen time, the research is clear that it is bad for us to have too much screen time and especially too much social media. Screen time should be monitored, and limited. Doctors recommend no more than 1 hour per day. Anecdotally, I just want to add that I’ve worked with a lot of kids, and those who have unlimited screen time tend to struggle the most with controlling their emotions, focus, behavior, and hyperactivity.
As far as diet, all kids need an appropriate amount of calories and the right nutrients, but it should also be noted that being hungry can be dysregulating for kids with ADHD. Consider protein-rich meals and snacks to help with this instead of chips and sugary snacks because protein takes longer to digest. There is a lot of information out there regarding red dyes and sugar. I’m not a nutritionist, so I’m not going to address this directly, but I do know that when we fuel our bodies with the right food we are also correctly fueling our brains. Focusing on good nutrition is great for kids’ developing bones and muscles, but it is also better for their developing brains.
Exercise is good for everyone, but long workouts aren’t necessarily required for improving focus. Consider that a quick heart rate increasing exercise or even just going for a walk can increase concentration. Overall, regular exercise helps to increase focus and develop a more positive mood. A hallmark of individuals with ADHD is that they experience things at a 10 (on a 1-10 scale). Kids with ADHD can quickly become highly emotional about things that others may be able to brush off. Regular exercise can help with this as well.
I teach mindfulness techniques to many of my clients, but I usually practice this regularly with my younger clients. I’ve written a lot about mindfulness, so I won’t go into it in detail again in this blog, but at its core, mindfulness is specifically focusing on something in the present. This is a pre-frontal cortex activity, which is also where planning and organization happens (again, executive functioning). Mindfulness is like physical exercise in that taking some time to be mindful is calming and regulating, but the best effects come from long-term regular practice, not just as-needed.
Kids and adults with ADHD frequently tell me that they have a poor memory. Whether it is because they are engrossed in something else later or just simply forget, it can be hard for them to remember to complete tasks or take care of their responsibilities. I tend to tell people that if they have a bad memory, try to make it so that you don’t have to remember things. Using a planner/daily organizer or utilizing a calendar on their phones or laptops with alerts set to go off at specific times can be a game changer for kids who frequently forget to do their assignments, or even to take out the trash. They will need help with this, though. Their limited executive functioning skills will make it hard to organize themselves, so they will need someone to help walk them through this organization/planning process until they master it.
I’ve mentioned executive functioning a lot in this blog because deficits in this area seem to create the biggest overall problems for kids with ADHD. The fact that the brain doesn’t finish developing until the age of 25 and the last area to finish is the pre-frontal cortex, means that kids with ADHD will need help in developing skills related to executive functioning, and they will probably need help for a long time. Adults who think of themselves as an external pre-frontal cortex for their kids can have a great opportunity to help these kids develop the skills that they will need in order to be self-sufficient adults. Just be patient with them, know that their skills are limited (even when they are very smart), and assume they are doing the best they can. With your help and assistance now, you can help them gain the skills that they will be able to use in the future.
*https://www.cdc.gov/ncbddd/adhd/data.html