ADHD

ADHD (attention deficit hyperactivity disorder) is a neurodevelopmental disorder characterized by inattentiveness, impulsivity and hyperactivity. While it can be caused by many factors, ADHD is primarily related to the development of the brain’s self-management system and linked to the presence of motor deficiencies, including balance deficits.

How is Childhood ADHD Diagnosed?

The diagnosis of ADHD is done by taking input from multiple sources including the child/adolescent, parents, teachers, and sometimes even those involved with kids' extracurricular activities.

The DSM-V criteria for a diagnosis of attention deficit hyperactivity disorder requires:

• Six or more symptoms of inattention for children up to the age of 16, or five for adolescents and adults over the age of 17, over a period of at least six months:

• lack of attention to detail/careless mistakes
• difficulty holding attention
• appearing not to listen
• failure to listen to instructions
• difficulty with organization
• avoiding tasks that require prolonged concentration
• losing things necessary for completing tasks
• distractibility
• forgetfulness

• Six or more symptoms of hyperactivity and impulsivity for children up to the age of 16, or five for adolescents and adults over the age of 17, over a period of at least six months:

• fidgeting/tapping/squirming
• inability to stay sitting down
• running/climbing inappropriately
• inability to play quietly
• always “on the go”
• talking excessively
• blurting answers before a question has been finished
• difficulty waiting turns
• interrupting/intruding

• The symptoms were present before the age of 12, are displayed in at least two different settings, impact on daily functioning, and cannot be explained by another mental condition

How Common is Treatment-Resistant Childhood ADHD?

While ADHD is typically responsive to first line stimulant therapy (for example, Adderall® and Concerta®), treatment resistance is common, with 30% of people not reaching a clinically significant reduction in their symptoms.

Integrative Approaches to Childhood ADHD

If your child/adolescent has not responded to ADHD medication, you may wish to consider an integrative approach to treatment. This can include various therapies, assessments, and dietary interventions including supplements.

Often those with “treatment resistant ADHD” actually have other diagnoses and learning challenge(s) as well. In these cases, psychoeducational and/or neuropsychiatric testing is often warranted.

Psychological testing enables mental health clinicians to measure and gain a better understanding of a person’s behavior, emotions, and/or thoughts. A variety of tests (for example interviews, behavioral observations, formal assessments, personality assessment surveys) can be used to determine both your child’s strengths and their areas of need. Testing helps to inform the most complete treatments and therapies to be recommended.

These might include:

• Psychotherapy
• Group Therapy
• Educational therapy
• Occupational therapy,
• Speech therapy,
• Therapy for central auditory processing disorders
• Vision therapy

Untreated depression, anxiety, trauma, and sleep apnea can also play a significant role in the onset of ADHD. For this reason, it is very important to take a careful view of personal history and spend time evaluating an individual so the appropriate psychotherapies and/or medication can be utilized.

Childhood trauma can play a significant role in the onset of ADHD. Trauma can impact the development of the brain, and may partly explain why a child/adolescent has developed ADHD. Therapeutic intervention can help to bring these traumas into the open, where they can be worked through and resolved.

Therapy for Childhood ADHD

Unlike many other conditions treated in Child Psychiatry, the mainstay of treatment is medication. Therapies can help with social skills and with executive functioning including planning, organizing, and following through on tasks. Recent research has also shown that activities, sports, and therapies that include balance can greatly reduce ADHD symptoms.

Diet & Supplements for Childhood ADHD

If there dietary sensitives, intolerances, or allergies are causing or exacerbating the symptoms of your child/adolescents ADHD, we may pursue an elimination diet to isolate the trigger.

We may also consider supplements such as omega-3, and micronutrient formulas for the treatment of ADHD symptoms in combination with other treatments. Using such supplements often allows us to use much lower dosages of conventional medications than normally would need to be used.