With more than 6 million U.S. children and teens suffering from ADHD, parents and clinicians are trying new ways to help kids focus.
First, it’s important for parents, caregivers and teachers to understand what Attention-Deficit/Hyperactivity Disorder (AHDH) is. Anxiety, depression, cognitive disabilities, bipolar disorder and other mood disorders can mimic ADHD and lead to misdiagnosis.
“ADD is an old name for ADHD. It is not the type where there is no hyperactivity,” says Dr. Eugene Hershorin, chief of the division of general pediatrics and director of developmental and behavioral pediatrics at UHealth — the University of Miami Health System.
“ADHD comes in three types,” he says: “The inattentive type where they just have attention problems with little or no hyperactivity; the hyperactive type where there is little or no attention problems; and the combined type where you have both.”
Hershorin says parents should consider this diagnosis if teachers say the child can’t stay seated, fidgets all the time, talks incessantly, blurts out answers, can’t stay on task, can’t finish the work and regularly loses things.
“It’s not just the presence of these things,” he says, “but that they occur more than in other kids. These things should be happening at home, as well.”
Researchers from the National Survey of Children’s Health found that in children ages 2 to 17 with ADHD, six out of 10 (62 percent) were taking medication for their ADHD, which represents 1 out of 20 of all U.S. children. Just under half (47 percent) received behavioral treatment.
ADHD drugs fall into two categories: stimulants and non-stimulants, with the former more widely prescribed.
Stimulants — Ritalin, Adderall and Dexedrine — increase levels of dopamine, a neurotransmitter in the brain that aids cognition, attention and focus. But side effects can include insomnia, anxiety, heart problems and loss of appetite.
A Johns Hopkins study shows abuse of stimulants, such as Adderall, is on the rise among teens and young adults.
Non-stimulants can increase norepinephrine, a neurotransmitter secreted during times of stress and which raises blood pressure levels. Other medications, such as the drug Clonidine, lower blood pressure. Non-stimulants treat hyperactivity and aggressiveness, as they can focus the mind.
While some parents swear by ADHD medication, others are trying holistic and high-tech approaches. South Florida hospitals are catching on too, retraining brain waves through technology.
Brandon Korman, Psy.D, is a board-certified neuropsychologist at Nicklaus Children’s Hospital’s Brain Institute and principal investigator of a free home-based “brain-wave biofeedback” study that starts next month.
“With this technology, the brain is ‘taught’ to function at certain frequencies at times when concentration is needed,” he says.
A portable EEG detector, which records electrical activity in the brain, sends brain-wave signals wirelessly to a tablet device, where they are converted into a video game that the user controls with his or her mind.
“The tablet provides visual and auditory information in the form of various games that progress only when your brain performs in the optimal range for focused attention,” Korman says. “Imagine making Pac-Man move faster merely by focusing your mind on him gobbling up dots,” he adds. “The scoring criteria gets progressively more challenging as the brain learns to remain in that optimal zone.
“By retraining brain waves, permanent improvements have been demonstrated, with only an occasional refresher needed,” he says. “By contrast, pharmaceutical enhancement of attention is ‘state dependent,’ working only as long as the medicine is in the child’s system.”
Miriam Amselem, a South Florida yoga instructor and nutritionist, points to meditation and yoga as a way to calm the mind of children.
“I usually have the more ‘hyperactive’ kids/teens right by my side so I can give them a little more attention and encourage them with positive reinforcement,’’ she says. “Many times they end up being the ones who demonstrate the yoga poses and that boosts their confidence, which is great since many of those diagnosed with ADHD suffer from low self-esteem.”
And as a nutritionist, she says she has helped kids control their ADHD symptoms by having them cut their sugar intake and removing processed foods from their diet.
Teaching kids and teens how to breathe when practicing yoga also helps them.
“They understand that if they take 10 seconds to slow down their breath, they are able to calm and soothe themselves.”
Studies show that yoga and meditation reshape the frontal lobe of the brain, which is responsible for planning, memory, decision making and cognitive functions. Yoga and meditation also help decrease stress, depression, anxiety and insomnia, studies show.
According to the Centers for Disease Control and Prevention, boys are three times more likely to be diagnosed with ADHD than girls. This isn’t because girls are less likely to have ADHD, but that symptoms are often understated and harder to distinguish.
Research shows that boys with ADHD generally show externalized symptoms, such as impulsive behavior and trouble sitting still. Girls with ADHD usually show internalized symptoms like inattentiveness and low self-esteem.
Avivit Ben-Aharon, a Hollywood-based speech pathologist, offers an online training program via her company, Great Speech Inc., to help people prioritize tasks, set goals, improve listening and organization skills, and learn to take initiative.
One of her specialties is helping people with “Executive Function Disorder” (EFD), which can occur with ADHD and other learning disorders or can be a stand-alone diagnosis.
“Children and adults with Executive Function Disorder have a pattern of chronic difficulties in executing daily tasks,” she says. “Generally, the problems center around analyzing, planning, organizing, scheduling and completing tasks on deadline.”
Ben-Aharon says the signs of EFD usually appear around the time of puberty when the frontal part of the cortex of the brain matures.
“Inattentiveness is the hallmark of ADHD. But our lives are full of distractions and many of us suffer from inattentiveness due to the constant bombardment of stimuli, from text messages and Facebook notifications, to access to the web and constant streaming of up-to-the-minute news.”
“Most of us have the ability to focus when we have to. But for someone with EFD, related to ADHD, that ability is elusive,” she says. “In the past, individuals with EFD were labeled as disorganized, disruptive and lazy.
“Today, parents are much more proactive and will often bring a tween for testing when the lack of organization and inability to focus starts to disrupt both academic and social success. Medications can control or modify certain behaviors but medications cannot teach the skills needed to make the transition to success.”
Hershorin, with the University of Miami, says an evaluation for ADHD takes at least 60 to 90 minutes and should include standardized rating scales from parents and teachers, a physical exam, and history of the child or teen.
“It’s important to recognize that not all hyperactivity, impulsivity, or inattention problems are due to ADHD,” he says. “The long-term outcomes of ADHD are great. These kids, when they have a comprehensive approach to treatment, do very well and can have little or no limits to their future.”