ADHD. Steps in the PROCESS

As I talk with mothers and teachers from all over South Africa, the main cry is:
 “My child (let’s call him Joe) has been diagnosed ADHD. And I don’t know what to do! Who can help me?”
The following are suggested steps, more-or-less in order. Those of you who have already taken some of these steps could consider going back and checking that you have covered all the bases. Some of them are not that expensive but some are.

STEP 1. Learn more about ADHD.

Buy or borrow a good book on the topic. After you, and hopefully your husband, have learnt more about the whole topic, you will be in a position to start asking the right questions and maybe making the right decisions regarding the interventions. You don’t have to become experts you just need the general background so you can start putting the pieces together. You can also get a considerable amount from the Web. (Google “adhd” and you’ll get over 14 million results.)

You will find out that there are basically two types: ADHD and ADD (without the Hyperactivity). The ADDers are more often girls who find difficulty in concentrating on schoolwork and other non-social topics, while the Hyperactive types are more often boys. However, this is not always the case.

STEP 2. Omega-3.

Start Joe on a course of Omega 3 fatty acid supplementation. Overseas studies and our own Professor van der Merwe say that the ADD brain needs up to eight times more intake of the Omega-3 essential fatty acid than the rest of us. And because of the way our foods are produced the rest of us are also in need of it. The brain is composed of 80% fat and unless it is supplied with these essential fatty acids the rest of the neuronal linkages are impaired. The idea is to give your brain the best shot at using all the other interventions by preparing it to function properly.

STEP 3. Learn about Food.

You and Joe will need to learn which foods, beverages, smells, etc., trigger episodes of hyperactivity.  The objective is to find, through trial and error, which are the “baddies” (probably the family of salisylates) and help Joe understand why these are “No-No’s” for him. During this process Joe will learn which foods, etc., are “goodies” or “Yesses” for him and how, by choosing them, he can be a more effective person.
My information is that diet will not cure AD/HD but by avoiding the “Baddies” and increasing the “Goodies” life for all is much more manageable. And in this respect each person has individual requirements even though general principles apply.

One mother “fixed” her son’s problem by buying a bread machine and excluding commercial bread (and hence propionates) from the family’s table and lunchboxes. Another mother found that it was the sugar cycle that was the problem and by getting the whole family on the Zone Diet everyone felt better.

STEP 4. Consult a Paediatrician

Ask your GP to refer you to a paediatrician who has experience in dealing with ADHD. Get his or her professional opinion, which may or may not include assessments from a neurologist. The paediatrician will consider all the factors, including your family life-style, and will then be able to discus whether medication will help or not.  They will also be able to assess whether there are any of the overlapping conditions present in Joe which may require slightly different medication and/or treatment.

STEP 5. Behaviour Modification.

Much as parents these days would prefer not to medicate “My Kid”, sometimes medication will be necessary to allow you to even start this next step which is some form of what is called “behaviour modification”. Joe must learn, in some way or other, that if he behaves in ways that are unacceptable to others there are consequences and punishments and that there are other behaviours that are encouraged and rewarded. You can learn about these techniques for reward and punishment from books but it is better to have guidance, especially in the beginning from a psychologist or occupational therapist that has specialised in the topic. 
ALL children have to learn what is acceptable behaviour and what is not. This is nothing new and applies in slightly different ways in each family and throughout society. But with the ADHD child, because of the condition, the strategies need to be a little more structured and agreed by all, including dad and the other siblings.

STEP 6. Interdisciplinary

There are many “one-stop” clinics that offer the medical as well as a psychological facility as a collaborative service. ADHD may have general labels but the condition changes over time and manifests in different ways in each individual. Therefore, it is in the implementation of various techniques that some success is going to be achieved.  And particularly it is in the realisation by Joe that he is, indeed, rather a special person and needs special care and no-one is better able to give this care than himself. Parents are often surprised at how much a six-year-old can assimilate for their own benefit.
I recall watching the USA specialist, Dr John Taylor, at a conference on ADHD, where he was the main speaker over three days. This is an exhausting program for any presenter especially one who has been ADHD all his life. With the help of his wife, (she keeps the stock of supplements in her bag), he starts the day right by taking the required vitamins and minerals that have worked for him over the years. He also makes sure that he has a little protein seven times a day. He also avoids his “No-No’s”. He, therefore, implements what works for him and he lives a full life as a professional in a demanding field.

STEP 7. Support Groups

Meeting with other parents with similar problems helps in a number of ways. You realise that even though you may think that you have THE WORST child in the world, when you hear the other mother’s stories you realise that you are not so badly off after all. You pick up strategies and ideas that have worked for others and that may well work for you. You can share resources, info and books.

STEP 8. Start Early.

Most children, as part of their growing up process, will “chance their arm” with the boundaries of what they can and cannot do. But there are those who seem to have this inner compulsion to be active and constantly on the go all the time until they collapse and go to sleep; for a while. Parents always have a dilemma: Is the kid just a normal kid “pushing the envelope”? Or does the kid have a brain that “compels” him or her to behave this way. i.e. It’s not their fault.

When young, these active children usually “get away with” behaviours that irritate others but as they move up to school age these behaviours are not acceptable in a classroom situation. The child is then usually assessed and, as mentioned in the first paragraph above, the parent’s cry: “Why me? What can I do?”

The onset of hormonal puberty, (the capacity to make babies), often brings changes in the way the ADHD manifests and research shows that the brain matures at a different rate to the hormonal system. It seems that the capacity to “make mature decisions” in the pre-frontal cortex can be delayed until the early twenties.

Parents of teenagers know that to change a teenager’s behaviour is extremely difficult if not impossible as their peers have much more influence than the parent. So the advice is: Start as early as is practical in implementing the suggestions above.

The relationship you develop with the child will change over time but the basic trust should always be there.
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