9 Drug-Free Approaches to Managing ADHD

US News:…In general, rhythmic activities can improve attention in certain children, according to Stanley Greenspan, clinical professor of psychiatry and pediatrics at George Washington University Medical School and coauthor of Overcoming ADHD: Helping Your Child Become Calm, Engaged, and Focused—Without a Pill, a book coming out next month. But such activities are only one part of a comprehensive program described in the book, Greenspan says, which aims to help all areas of development that influence attention. Here’s a tip from the book: Try playing “Simon says,” getting your child to mimic your gradually more elaborate two- and three-step actions.

A pilot study that appeared in a 2008 issue of Current Issues in Education suggests that transcendental meditation may help improve attention and behavior in kids with ADHD. The results can’t be generalized to all forms of meditation since each technique works differently, says Sarina Grosswald, a medical education consultant and lead author of the study. TM affects the brain by reducing stress and anxiety, which allows the prefrontal cortex—the part responsible for attention and focus—to function more efficiently, Grosswald says. Research at the University of California-Los Angeles supporting mindfulness meditation appeared last year in the Journal of Attention Disorders. Neither meditation study compared the results with a group not practicing meditation.

A natural environment.
In a 2004 study in the American Journal of Public Health, researchers found that kids with ADHD showed improved symptomsafter playing outside in a natural environment. A similar 2008 study out of the University of Illinois showed that attention improved in kids who took a 20-minute stroll in the park more than in kids who walked outside in a downtown or residential area without much greenery. These studies suggest that children with ADHD get some benefit from being in nature.

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Better sleep.
A study that appeared in March in the journal Sleep concluded that kids with ADHD slept for less time on average than their healthy counterparts, suggesting that sleep problems may be associated with ADHD. “Up to 25 percent of children who have been diagnosed with ADHD may not have ADHD, [but rather] they may have sleep-disordered breathing,” says Julie Wei, associate professor of otolaryngology at the University of Kansas School of Medicine.

A few years ago, Wei and a team of researchers assessed the behavior of 71 patients (the majority of whom did not have ADHD) after their tonsils and adenoids (lymph tissue behind the nose) were removed. Six months after surgery, the group showed significant improvement in four measures of behavior: inattention, hyperactivity, oppositional behavior, and a measure called the ADHD index. While the ADHD index eventually returned to presurgery levels, hyperactivity, inattention, and oppositional behavior stayed down for at least 2½ years, Wei’s team found. Wei tells parents to pay attention to their kids’ sleep, especially if a child snores habitually, which may be a sign of sleep-disordered breathing.

The Feingold diet, in which patients abstain from food additives and naturally occurring salicylates, has been hyped since the ’70s, even though subsequent research hasn’t been very successful at replicating initial findings that the diet eased ADHD symptoms. And sugar has caught blame for causing hyperactivity. “The scientific literature is confusing,” says Greenspan. The problem is that all children are different, and the research has not created subgroups that would tell us which children are sensitive to dyes or additives in food, according to Greenspan. For that reason, parents have to be very good detectives, he says. If you’re concerned that sugary juices, for example, are worsening problems, try removing them from your kid’s diet for two weeks and watch the effect, Greenspan recommends. Some experts also advise children to take omega-3 supplements if they’re not getting adequate amounts in their diet. Omega-3s, found in fatty fish and other foods, may improve brain function and focus.

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