ADHD: 7 things you can start today to help your child
This article provides some suggested resources and tools for parents and/or guardians who suspect, or know, their child may have ADHD. I’ll outline lifestyle and dietary suggestions that I think of first when someone suspects ADHD, as well as supplements and labs that I use often. I am not always against medication for ADHD, because sometimes this is the best treatment at this time for that child and that family, but if you are looking to understand other options this is a great place to get a well-rounded summary on the natural treatment for ADHD in kids.
Personally, I think medication for ADHD is used as a first resort treatment too often; but I understand natural and alternative diagnostics and treatments are not available to every family because of time or money constraints. I’ve seen medication help kids; I’ve also seen this stuff below work just as well. If you have started your child on medication, it’s not too late to try to add in natural treatment options to supplement your child’s care or to wean them off medication. If you haven’t started medication, I encourage you to explore the topics below.
How to get your child diagnosed with ADHD. To get the most reliable diagnosis of ADHD for your child you should seek out a psychologist (PhD) or a psychiatrist (MD or DO) specializing in pediatrics. As of March 2022, we no longer use the term ADD, instead your child may be diagnosed with ADHD inattentive type, hyperactive-impulsive type, or combo type. A diagnosis of ADHD is not necessary to start helping your child if they are exhibiting symptoms similar to ADHD, but it is the safest way to proceed if you would like to start ADHD-specific medication for your child and know that you are getting them treated appropriately.
64% of kids who are diagnosed with ADHD have an underlying disorder of anxiety, other behavioral disorder, or depression. Treating these conditions can reduce ADHD symptoms without having to initiate specific ADHD treatments. I have seen lots of kiddos (and adults) who exhibit symptoms of ADHD, but when we treat their sleep quality/quantity, anxiety, depression, stress response, or diet they often feel better and teachers & parents no longer are concerned about ADHD symptoms.
#1 Complete one of these screening tools, specific to ADHD only.
· Conners Abbreviated Symptom Questionnaire (pretty good, quick, but outdated):
https://www.aafpc.net/Connor_s_Abreviated_ADHD_Rating_Scale__10_item_.pdf
· Vanderbilt ADHD teacher and parent rating scale (best screening questionnaire, but a psychiatrist/psychologist’s assessment is still better since this ONLY screens for ADHD and not other contributing mental illness): https://www.nichq.org/sites/default/files/resource-file/NICHQ-Vanderbilt-Assessment-Scales.pdf
· Since 70-88% of children diagnosed with ADHD have a family member who also has ADHD, here is a screening tool for adults too: https://add.org/wp-content/uploads/2015/03/adhd-questionnaire-ASRS111.pdf (Faraone SV, Larsson H. Genetics of attention deficit hyperactivity disorder. Mol Psychiatry. 2019 Apr;24(4):562-575. doi: 10.1038/s41380-018-0070-0. Epub 2018 Jun 11. PMID: 29892054; PMCID: PMC6477889)
Quick overview of additional diagnostic criteria:
1. Persists for at least 6 months
2. Presents prior to age 12
3. Presents in more than 1 setting (e.g. school and home)
4. Impairs function in academic, social, or occupational activities.
5. Excessive for the developmental level of the child
6. Not caused by other mental disorders
#2 Is your child getting enough sleep? If your child has trouble falling asleep, staying asleep, or getting enough sleep hours (and they are fatigued) then this is a great starting point for the treatment of ADHD.
Sleep needs based by age group:
Ages 4-5 years old: 11-11 ½ hours (total, with naps)
Ages 6-9: 10-10 ¾ hours
Ages 10-14: 9-9 ¾ hours
Ages 15-18: 8 ¼- 8 ¾ hours
#3 Is your child eating the right food for breakfast?
Common American breakfast options for kids are high in sugar, low in protein, and low in fiber. Making sure your child is getting the right food in the morning is one of the most important tools you can use to help to optimize their brain function while at school. Here are some “easy” guidelines to follow (some kids may need more strict food guidelines):
· 10 grams or less of sugar in the meal
· Healthy protein: 1.8 grams/ per kg of body weight
· 5 grams of fiber
· No artificial flavorings, colorings, preservatives (especially sodium benzoate).
Finding the right dietary guidelines for your child may involve working with a provider who is knowledgeable about nutrition. Studies have shown significant improvements in kids with a formal diagnosis of ADHD who switch to a gluten and dairy free diet. In fact, a study published in the European Child and Psychiatry journal showed that kids on an anti-inflammatory diet for 9 weeks no longer met the diagnostic criteria for ADHD compared to no change in kids on the control (“normal”) diet.
#4 Meditation
Since we have scientific data showing that 64% of kids diagnosed with ADHD have an underlying disorder of anxiety, a behavioral disorder, or depression; it’s worth exploring a useful tool to help with these 3 concerns: meditation. The pros about mediation: it’s free, there are no side effects, it takes very little time each day, and the person leading meditation practices for their child will benefit as well. The cons about meditation: it takes daily commitment on the part of the child and the adult implementing it.
My recommendation for kids is 5-20 minutes a day, with a goal of 21 days in a row to get this into practice for your family. Typically, parents report some improvements in mood, attention, and/or sleep within 2-5 days of implementing a meditative practice. I like to do this at night if there are sleep difficulties and in the morning if there is anxiety prior to the school day.
Two of my favorite resources you can access for free (as a trial):
· Headspace: https://www.headspace.com/meditation/kids
· Insight Timer: https://insighttimer.com/meditation-topics/kids-meditation
#5 Parent training
Not specific to ADHD, but worth mentioning, are positive parenting tools to help with challenging behaviors in our kids. These tools are aimed at disruptive behaviors and non-compliance in home settings. These tools are evidence-based (not just another parenting book based on one person’s experience) and help empower parents with positive strategies to change some negative behaviors they are seeing in their kids.
The goal here is to praise good behavior, ignore bad behavior, give effective instructions to increase compliance, and set firm limits. This is based on the “social learning model” which basically means we need to model the behavior we want to see in our kids. In other words, do as I say, not as I do: just doesn’t work. Our kids are going to model how we behave, and for the record trying to act like we are perfect doesn’t help them. They benefit from seeing our struggles and watching the tools we use to feel and act in a “better” way.
Here are some resources and books to learn more about this topic:
· The Incredible Years: https://www.incredibleyears.com/
· Defiant Children: https://www.goodreads.com/en/book/show/289097
· Triple P: https://www.triplep.net/glo-en/the-triple-p-system-at-work/training-and-delivery/resources/
· Everyday Parenting Toolkit (this is the book I recommend the most often when I’m not worried about oppositional defiance disorder): https://www.goodreads.com/en/book/show/15814524
There are limitations to this approach: may not work in all settings (i.e. home versus school), it’s less effective in adolescents, and the maintenance of benefits are unclear after the intervention ends.
#6 Supplements to try
Using supplements to self-treat or treat your child for presumed ADHD is rarely effective without a proper assessment from a medical provider. It can be a huge waste of money to try supplements on their own. Supplements do work to treat ADHD, but just like medication, not all supplements work for everyone and it can take some time to find the right one or the right combination. Finding the right solution for your child should involve getting an assessment from someone with proper medical training.
Disclaimer: Supplements are generally safe but there are side effects and concerns with even natural treatment options. Some supplements can interact with medications and can be contraindicated with certain medical conditions, so it’s best to consult your medical provider before starting anything listed here.
1. Essential Fatty Acids: I typically start with 1 gram (DHA is most important) and increase every 2 weeks as tolerated up to 3 grams a day.
2. Zinc: Helpful to increase serotonin production. Needs to be used with copper for supplementation beyond 3 months of continued use.
3. Magnesium: 6 mg/kg for kids. Helpful in neurotransmitter production and to calm excitatory hormones in the brain. Best given prior to bedtime.
4. Iron: only give if you know their labs are abnormal, otherwise it can be dangerous for liver health.
5. SAMe: helpful to breakdown stress hormones and improve concentration. It’s an expensive supplement, but I’ve seen great success with this.
6. Amino acids are a great tool, when applied appropriately. They can mimic the effects of some medications and most people respond as quickly to amino acids as with medication use. Typically I will use amino acids for 3-9 months and then I start to taper down this supplement use. This includes supplements of GABA, tyrosine, glycine, l-theanine, and tryptophan.
7. Botanicals: one of my favorite ways to treat kids is with the use of botanicals. I like to combine something from above, which gives me quick effects, with an herbal combination below. The herbs usually help create longer-term shifts in brain chemistry, which means I can wean kids off having to take as many pills and liquids for their mental health in the long term.
1. Bacopa (leaf, flower, stem, root) Significant improvement in cognitive and memory function and decreased hyperactivity and attention deficit. Restores cholinergic function, modulates GABA and/or serotonin, reduces B amyloid levels, reduces free radical damage, alters brain hormone levels, decreases neuroinflammation.
2. Gotu kola: Improves cognition, memory, mood, and impulse control with especially with older adults.
3. Saffron: 15-30 mg. Helpful in depression, anxiety, and ADHD. Study completed that showed it worked as well as methylphenidate (common medication for ADHD)
4. Ginkgo: Inhibits breakdown of catecholamines (works like a stimulant in some kids/adults)
5. Pinus pinaster (bioflavinoid extract from pine bark): Decreases hyperactivity, improves attention, improves visual-motoric coordination and concentration. May improve DNA damage.
8. Homeopathics: so many options, best to be prescribed by a provider (a traditional homeopath or another licensed Naturopathic Doctor) who understands how to prescribe homeopathics.
#7 Tests to complete to look for underlying causes of ADHD. These labs should be ordered by a provider knowledgeable about natural and integrative treatments and testing for ADHD, and the results should be reviewed and interpreted by that provider in order to inform patient-specific treatment options. To give you a sampling of labs that may be considered (and trustworthy labs I use) here are some options I go to:
Labs requiring a blood draw:
1. RBC zinc: low zinc levels can reduce a person’s response to medications or supplements that effectively treat ADHD
2. Omega panel (I don’t do this as often in kids since it requires fasting)
3. Lead screen: a blood test will only screen for increased lead exposure from the last 60 days
4. Hormone testing (after puberty only) for estrogen dominance or low testosterone in post puberty males
5. Thyroid testing: TSH, thyroid antibodies, reverse t3, free t4, free t3
6. Check for diabetes: hemoglobin A1c
7. Anemia screen: iron, CBC, Vitamin B12, folate
Urine labs ordered by your provider through a specialty lab company:
1. Heavy metal test: nonchallenged urine test in kids through a company like Doctor’s Data (https://www.doctorsdata.com/urine-toxic-metals/)
2. Mosaic labs OATs test (https://mosaicdx.com/test/organic-acids-test/)
Stool and Blood labs ordered by your provider through a specialty lab company:
1. Diagnostic Solution GI MAP stool test (https://mosaicdx.com/test/organic-acids-test/) or Doctor’s Data CSAP stool test (https://www.doctorsdata.com/Comprehensive-Stool-Analysis-Parasitology-CSAP21)
2. US Biotek Food sensivity testing (https://www.usbiotek.com/food-sensitivity-testing)
In summary, natural treatments for ADHD in kids and adults work; but it’s not as simple as a one-time appointment for a new prescription from your pediatrician. ADHD medication works really well for some kids, and there is no shame in trying this first once your child has been properly assessed by a psychiatrist or psychologist.
If you are looking for treatment, beyond medication, for your child then there are a ton of options that can really help.
Trying a supplement, herb, or homeopathic advertised for ADHD is unlikely to work when you are not using whole person medicine alongside it. These treatments are best applied by a trained medical provider who understands conventional and natural/alternative healthcare; like a Naturopathic Doctor who went to a 4-year medical school (like myself). The best place for you to start at home is to complete the screening tools above and to start addressing your child’s sleep and dietary habits. This is a great starting place everyone can do themselves.
Also, don’t be afraid to raise your concerns about attention and mood with your child’s teacher. Teachers, teacher aides, and school medical health providers can be wonderful assets that help you approach your child’s health as a team. Getting your child assessed by a psychiatrist or psychologist can help you obtain an IEP (individualized education plan) that helps your neurodiverse child with tools they need to make their learning environment more adherent to how their brain works. If your child is struggling with their learning or their emotional regulation, there are amazing solutions out there to help. I hope this article gave you some insight on where to start.
In health,
Dr. Sara Norris, ND