Winter holidays are over. Things are back to normal at home (yeah, right, normal). School is ramping up and children with developmental concerns become even more challenged.
There is a constant stream of parents, these days, seeking relief because they are told that their child has Attention Deficit – Hyperactivity Disorder. They ask, “How do we get through the rest of this year,” and “What should we do about the next semester?”
Every child should have an appropriate workup leading to a clear, accurate diagnosis. ADHD can be a part of autism, thyroid disorder, gastro-intestinal problems, allergies, asthma, vitamin deficiency, etc. By properly diagnosing and managing a primary condition, many of the behavioral concerns may abate.
Before becoming too aggressive with pharmaceuticals, consider the age of the child. A three- or four-year-old has time to mature and achieve self-control, while there are more academic demands on a eight-year-old.
Evaluate the difficult behaviors to better decide which intervention(s) will have the optimal chance for success with the least side effects. Occupational therapy is great if there are major sensory issues, neurofeedback might be helpful for focus, and behavioral intervention (ABA) might be more appropriate for disruption issues. Even if a parent still has to resort to medical intervention, lower doses and less frequent changes may be a result of this strategy.
Consider that inattention and poor focus could be due to mixed, missing and/or crossed signals in the CNS. With such a situation, non-preferred activities are much more difficult and therefore resisted even more than in typical peers. Until improved methods for overcoming learning disabilities are discovered, more patience and practice is required – and less criticism.
For children who take stimulant medications, those who are able to tolerate drug ‘vacations’ will suffer less of the consequences of decreased appetite, sleep and linear growth. Sometimes, it is only for summer vacation, and other children are able to experience drug-free weekends.
Children who do not appear to be listening, are often simply listening without looking. That is not acceptable in a large, general education classroom. Nevertheless, medications that supposedly help focus and distractibility, might not do that, either. Anti-anxiety medications, starting with Intuniv, and sometimes even escalating to Prozac, are often suggested. If possible, the best improvement should come when the reason for gaze difficulty is understood.
Once parents make the decision to give medication a try, expect the most successful outcome when there is a clear understanding about positive and negative effects. It takes time to get the most desired results, and that knowledge can help the family withstand rocky periods. An ability to contact the responsible practitioner leads to increased compliance.
Be careful (and appreciative) when a treatment plan is working. Attempting to fine-tune a lingering shortcoming can lead to disastrous results. External stresses, from an ear infection to visiting relatives can disturb the calm. The child who maintains a healthy diet and necessary supplements is better prepared to weather the storm.
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