7 yr old ADHD boy; meds vs. therapy?

[Anonymous]

My son was diagnosed with ADHD last year. We're looking for alternative treatment methods before exploring medications. Can you all share your experience?

[Anonymous]

What have you been doing for him since the diagnosis? (What have you already tried?)

[Anonymous]

How severe are the symptoms? What areas of life are most impacted and in what ways?

[Anonymous]

I have a 7-year-old boy diagnosed with ADHD combined subtype. I am not anti-meds but he is not on ADHD meds for medical reasons. We were told his ADHD is severe and I would definitely agree in the inattentiveness realm. From my observations (of him, other kids with ADHD, and other kids in general), I would say that he is somewhat impulsive and that his hyperactivity manifests itself more as fidgeting and slouching rather than large movement. So that is just to give a sense of him.

I think that there are two things that help him enormously: exercise and an extremely consistent routine/household organization. It is evident that when he exercises he is more settled, happy, goes to sleep more easily and generally seems more in control of his body. Swimming seems particularly beneficial. I would love to do martial arts but we haven't been able to find the time.

The other thing that helps him is to create a totally consistent, easy-to-follow routine so that he doesn't have to make too many decisions or think about every part of the activity he is doing or be conscious of his transitions, etc. So I am very protective of overloading him -- he can do one activity at a time (if it is baseball season, baseball and nothing else). I am very rigid about his bedtime and bedtime routine, about the amount of screen time he is allowed. He does his homework in the same place and at the same time every night, in a very clean organized environment. I help him break down the steps but make him go through all the motions (for example, I may have to remind him to put the homework in the folder, may have to remind him to put the homework in the bag but he MUST do each step himself before he is allowed to move on.) I have set up his room so that he can be independent about organizing and cleaning, but it is very easy to do so (lots of labeled bins, cubbies, etc). What I have found with my son is that he can learn new rules/habits/systems, and he is willing to do so, but that it takes an incredible amount of practice before it becomes "natural." I guess I should have said from the outset that making rules and expectations super clear, having him repeat them back, is a must for him (or else he is always shocked and didn't hear...).

I tried some other things and I think they are worth trying though they didn't make a difference in our case, for example, OT and gluten-free diet. We already did eat pretty naturally, preservative and dye-free, so we didn't change anything. We do use supplements as well, though, again, I don't see the effects.

[Anonymous]

For goodness sakes, meds.

[Anonymous]

You could try behavioral therapy. Kennedy Krieger does this in Baltimore and at there Columbia, MD clinic:
http://www.kennedykrieger.org/patient-care/patient-care-programs/outpatient-programs/behavior-management-clinic

There are other practitioners closer to DC.

Does he have a current IEP for school? If he doesn't, I would go through the steps to get this in place for appropriate accommodations. Depending on the school, and what they will allow, some kids do well sitting on a wiggle seat or standing at their desk.

If you're not working with an OT, I would consider doing so to help channel energies. One OT we worked with used the metaphor, "How is your engine running?" High, low, just right--to help the child learn to recognize how to self regulate.

The one thing I would consider though is how he does at school. If he's not able to focus or regulate in the classroom, he can't learn, so meds might be necessary.

[Anonymous]

OP there are many approaches you can take to support him in learning to organize and manage his actions. However none of that changes how his brain is working. If his ADHD is fairly mild and you have great routines, consistency and learning how to manage impulses, he may be able to get by okay without meds.

The problem is that for most kids with ADHD their minds are racing, they are paying attention to everything, they can't inhibit unimportant information and that isn't an enjoyable state of mind to be in.

If your son's ADHD isn't impacting his functioning - he is able to make and keep friends, he is happy and his emotional well-being is good, and he is doing fine at school, then you can keep working on many other alternatives to support him.

If his well-being and functioning are being impacted then you really have to consider all options including medication, just as you would for other health conditions.

Kids with ADHD that isn't managed well and is impacting their functioning get really tired as the years go on of having these overstimulated, non-filtering brains and they often self-medicate as teens with drugs to calm their minds, they do poorly in school and struggle socially leading to overall poor mental health and underachievement.

[Anonymous]

Anonymous wrote:
If your son's ADHD isn't impacting his functioning - he is able to make and keep friends, he is happy and his emotional well-being is good, and he is doing fine at school, then you can keep working on many other alternatives to support him.

If his well-being and functioning are being impacted then you really have to consider all options including medication, just as you would for other health conditions.

This was what it came down to for us. I had no interest in trying medication for my son, as his behavior was quite manageable and pleasant at home. We have very consistent routines at home, which helps him get things done. However, he wasn't able to get anything done at school, even with his many accommodations. The teacher, psychologist, and pediatrician were all concerned about how his school behavior would eventually effect his academics, friendships, and self-esteem. We made the very difficult decision to try medication, and it made a significant difference for him at school. Again, I would look to see how he's doing at school as you decide what option(s) to pursue.