By Interactive Metronome, Bricole Reincke - August 23, 2011

ADD and ADHD: To Medicate or Not?

Many parents who hear the diagnosis ADD or ADHD are sent into a tailspin of information overload and “friendly” advice from a variety of sources. As a pediatric Occupational Therapist, I am often faced with the task of helping parents and caregivers interpret what the information they have been given means for their child. Here are a few common questions I get during evaluations: “Will medication really help my child?”; “Why aren’t the medications helping my child sleep at night?”; “When can we expect to wean our child off medication now that he’s started therapy?” and, “Will a special diet be a substitute for medication?”

In today’s world, we have access to lots of information, both good and bad. And let me remind you that each child will react differently to medications, diets, environmental stimulus, therapy, and feedback. As a parent, your role is challenging – in that you need to carefully discern and balance lots of different advice. For instance, if your primary care physician is “pro” medication, you can expect him/her to write a prescription and make a recommendation that you begin to medicate your child – even before you’ve had a chance to process the new diagnosis. On the other hand, if your doctor is well versed in metabolic and blood nutrition, you can probably expect to be handed a set of dietary guidelines that look like the Ten Commandments! Where to start?

My suggestion as a therapist with 20 years experience working in the field of pediatrics and (raising four children of my own) is to recruit a “team” to help you navigate the different options you have. For instance, there are a few professionals you would definitely want on your team:

  1. Your Pediatrician or Primary Care Physician
  2. A Pediatric Psychologist or Psychiatrist
  3. A Functional Neurologist or Chiropractor
  4. A Pediatric Occupational Therapist
  5. A Nutrition specialist (dietician, naturopathic care provider – etc.)
  6. A mentor (someone from a support group, church group, or school)

Other professionals such as a Pediatric Dentist, Behavioral Therapist, and Speech Pathologist may also be helpful to have. Once you have your “team”, start to put bits of information in your playbook. Maybe you consider and research medication one week; the next week maybe you consider different therapies (cognitive, behavioral – etc.); maybe you try eliminating one food group every 14 days or so – dairy, gluten, corn – etc. As you take time to process the information, ask questions. Set up appointments ahead of time to speak with your care providers and teammates. Use email as a quick and easy way to get feedback (many professionals today will respond quicker to email than they will to a phone conference).

I would also encourage you to make a list of the primary or “urgent” needs of your child and let that be your guide in exploration. For instance, if your child has self regulation or behavioral outbursts that are affecting your family or her school performance, you may want to begin by talking with your Occupational Therapist. He can give you suggestions that will help eliminate or suppress sensory integration difficulties. You may find that a few tips in this area will help your child gain more control over her behaviors and increase her confidence, allowing you to explore the next area of concern.

I understand that many children appear “out of control” and as parents you are tired. It’s no fun to feel out of synch with your family, children, work, and home! As I’ve mentioned above, I would encourage you to gather your information and take your time in making decisions. To help you in the short term, I’m going to list five suggestions below that I’ve seen have considerable positive effects with the ADD and ADHD population.

  • Use a cup of Epsom salts in a tepid or warm bath each night before bed. 15 minutes in the bath will really help your child unwind and relax. You can also add a few drops of lavender essential oils to the water (try a little on the skin first to make sure your child is not allergic).
  • “Heavy Work” is a must for an active child – not just once a day, but several times a day. Some ideas: lifting or pushing a loaded box or laundry basket for 5 min or more; “helping” mom unload the groceries (paper bags that are carried like a baby); carrying a backpack of books around the house or around the block; pushing baby brother around in the wagon or stroller, wrestling (controlled) with dad…
  • Crunchy foods, strong smells (coffee, peppermint), and cold water “wake up” a slow mover in the morning; soft oatmeal, comfort smells (vanilla), and warm water introduce an active child to a more calm environment.
    A heavy blanket or comforter at night can calm your child and help him sleep more soundly. Fans and “white noise” will eliminate auditory distractions.
  • Playing a metronome (a slow, steady beat – at 60 tempo, for example) will help your child subconsciously stay attentive. When she is showing signs of moving or clapping to the rhythm of the metronome, it's time to look into Interactive Metronome or IM-Home treatment (www.imhome.org).

I hope that helps. Stay strong and hang in there – you are your child’s best advocate!

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