Treating Attention Deficit Without Medication: When Ritalin Isn’t the Answer

In these days of instant messaging, cell phones, and fast-food dinners, we expect a quick-fix solution to all of life’s problems. If you have a headache, high cholesterol, a weight problem, or any other condition, just pop a pill and be done with it. But just because modern medicine and advances in technology make quick fixes possible doesn’t mean it’s always the best way to approach a problem, especially a behavioral disorder like ADHD.

When you think ADHD, do you instantly think of Ritalin and other prescription drugs? Many parents do, and sometimes medication is the only answer. About 4 million Americans take stimulant medications for ADHD, including nearly 10 percent of 10-year-old boys. But there are a growing number of parents who are looking for non-medical treatments for their children – treatments that don’t include side effects like nausea, insomnia, headaches, blurry vision, psychosis, and in rare cases, death.

Over the years, a wide variety of non-medical interventions for attention deficit have been explored. Behavioral therapy is one of the most studied and well-supported treatment options, with a number of other approaches gaining in popularity, including neurofeedback, interactive metronome training, zinc supplementation, dietary interventions, and fatty acid supplementation. Below is a discussion of just a few of the alternative approaches to treating ADHD.

Elimination Diets
A healthy, balanced diet is critical for people of all ages, lifestyles, and conditions. According to the Centers for Disease Control and Prevention, eating properly can help lower the risk of many chronic diseases. But can a healthy diet help treat ADHD?

The widely publicized and studied Feingold diet, which cuts out artificial colors, flavors, and preservatives as a way to improve symptoms of ADHD, is a popular “elimination diet.” Despite a few positive studies, the majority of the evidence shows that only a small percentage of children with ADHD respond to the diet. Similarly, research has also shown that the simple elimination of sugar or candy does not affect ADHD symptoms, despite a few encouraging reports.

Herbs and Other Nutritional Supplements
Unlike elimination diets which attempt to remove something from the diet, nutritional supplementation seeks to add something to the diet that is missing. Some believe that nutritional deficiencies in zinc, iron, magnesium, and other vitamins cause or worsen ADHD symptoms. Others believe hypericum, Gingko biloba, Calmplex, Defendol, pycnogenol, and other natural products and herbs reduce symptoms of ADHD.

For example, one study assessed the efficacy of pycnogenol, an extract from the bark of the French maritime pine, as a treatment for children with ADHD. Study participants included 61 6- to 14-year-old children diagnosed with ADHD who were randomly assigned to receive either pycnogenol or a placebo at breakfast each day for one month. During this time period, the children’s teachers noted significant declines in inattentive and hyperactive symptoms, and researchers documented significant increases in the children’s intellectual functioning. No serious side effects were reported. However, parents did not observe a decrease in ADHD symptoms and the study findings have not been replicated in a new sample of children.

Unfortunately, studies like these are few and far between. There is no systematic data to show that these vitamins or herbs actually treat ADHD. Furthermore, certain vitamins like “megadose” multivitamins have not only failed to show a benefit in controlled studies, but have been proven potentially dangerous.

Since ADHD is a brain-based disorder and nerve cell membranes are composed of phospholipids containing large amounts of polyunsaturated fatty acids (omega-3 and omega-6), many scientists have hypothesized that fatty acid supplementation would help treat ADHD symptoms. Unfortunately, the scientific evidence is inconclusive and experts believe further controlled studies are needed.

Another popular alternative ADHD treatment is glyconutritional supplements, which contain basic saccharides necessary for cell communication and formation of glycoproteins and glycolipids. Although two small studies have shown a reduction in inattention and hyperactivity symptoms after a program of glyconutritional supplements, a third study found no impact of the supplements on symptoms. Thus, further research is needed before this approach can be endorsed as a treatment for ADHD.

Like diet, physical fitness is an important part of a healthy lifestyle. For children with ADHD, exercise may be an ideal way to ease the symptoms of the disorder. If children don’t move around, they become restless. Team sports can be a great way for children with ADHD to follow a regular schedule, work off energy, and build concentration and organizational skills. Studies show that exercise increases levels of two key brain chemicals – dopamine and norepinephrine – that help people focus. Of course, exercise alone won’t “cure” ADHD, but many parents believe it reduce inattention and hyperactivity.

Limiting Television and Computer or Video Games
Many parents have questioned whether television and computer or video games impact a child’s ability to concentrate. In the past 10 years, children have begun to spend most of their free time in front of the television or computer and less time playing outside or reading. A 2004 study in Pediatrics found that infants and toddlers who watch a lot of television are more likely to have trouble concentrating in their early school years. Moreover, every extra hour of TV raised the odds of having attention problems by 10 percent. As such, the American Academy of Pediatrics recommends children watch no TV before the age of 2 and older kids watch no more than two hours a day of high-quality shows.

Psychotherapy, one form of talk therapy, can help people with ADHD explore upsetting thoughts and feelings, find positive ways to deal with emotions, and accept themselves despite their disorder. Another form of talk therapy, cognitive-behavioral therapy, has been shown to help people with ADHD find practical ways to change behavior so they can cope better with problems. Children with ADHD may learn to organize tasks or schoolwork, think before they speak or act impulsively, control their anger, and deal with difficult situations.

Therapists also can provide social skills training to teach children with ADHD better ways to interact with others. Here, the therapist may describe and model appropriate behaviors through role-playing, such as following rules, waiting for a turn, sharing toys, or asking for help.

Another helpful form of therapy is parenting skills training. Parents may need to develop and practice special discipline techniques to manage a child with ADHD. Parents can use “time-outs” to calm a child down when he loses control, as well as rewards, penalties, or stress-reduction methods like meditation, stretching, or focused breathing. Therapists encourage parents to provide positive feedback, praise good behavior, and emphasize the child’s strengths and abilities while spending quality time as a family playing a game, reading a book, or taking a walk.

Neurofeedback has been used as an intervention for ADHD because of findings that many individuals with attention deficit show low levels of arousal in frontal brain areas. The brain emits different types of brainwaves depending on whether the person is in a focused and attentive state or a drowsy and inattentive state. In neurofeedback sessions, a child with ADHD is gradually taught to inhibit “daydreaming” brainwaves and increase the “attentive” brainwaves. The downside to neurofeedback is that treatment takes a long time (typically 40 sessions) and each session can be very costly ($100-150). Studies as to the efficacy of this treatment have been inconclusive, though you can find dozens of “success stories” online.

There are too many treatments that claim to help with ADHD to describe here. From megavitamins, magnets, and sound treatment to visual training, homeopathy, and yeast eradication, parents have to find what works best for their child. Obviously, a balanced diet, exercise, and healthy sleeping patterns benefit everyone, including children with ADHD.

When considering an alternative, non-medical therapy for ADHD or any other disorder, weigh all of your options and take the necessary precautions to make sure it is safe. Talk with your child’s doctor about the benefits and possible hazards associated with alternative therapies. Not every approach will get results, but you’ll have peace of mind knowing you considered every possible option for your child.