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The Importance of Treating the Whole Child

ADHD Children and Treatment Approaches

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Updated October 20, 2008

Children with ADD / ADHD and Treatment Approaches

Clearly, there are stressors that can impact our children’s emotional and behavioral health. It is important that we keep these stressors in mind when we assess treatment approaches for our children.

By simply treating symptoms, we may neglect to look deeper into the underlying causes of the problematic behaviors. Thoroughly exploring these issues also helps prevent misdiagnosis and consequently, inappropriate treatment.

Scott Shannon, MD, pediatric psychiatrist and author of the book Please Don’t Label My Child, notes that his first step in treatment when working with families is to help them sort out any external forces that may be affecting their child. He refers to these external forces as “brain stressors” and identifies several he regularly encounters in his work with families:

Family Stress

When the family system is stressed, signs and symptoms of that stress may quickly present itself in a child’s behavior. Happenings such as a new baby, strained parent-child or other family relationships, divorce or change in family configuration such as remarriage, a move or relocation, death of a family member, domestic violence, financial difficulties, etc. –- all these stressors can impact a child’s emotional and mental well-being.

“Helping our kids learn to manage stress is an ongoing process, and whenever you practice a new skill, you’re bound to make mistakes along the way -- we all do,” explains Dr. Shannon. “The challenge is to not shy away from the problem or stress but instead to work to face it as directly and appropriately as possible.”

Dr. Shannon offers some tips to help your child cope with stress:

  • Maintain a safe, serene, well-structured environment
  • Make sure your child gets adequate food and rest
  • Maintain open communication
  • Provide consistent support and encouragement
  • Avoid overprotecting your child (rather than shielding your child from life’s inevitable stressors, allow him the experience of learning to cope with some situations with your support and guidance)
  • Work to build your child’s self-esteem
  • Model appropriate coping skills
  • Nurture problem-solving skills
  • Teach assertiveness
  • Help your child develop an appropriate sense of humor
  • Encourage your child to participate in enjoyable/relaxing activities

Poor Educational Fit

“I see one central issue for children and schools today: poor fit. We need to understand the child’s learning preferences and their strengths and challenges,” explains Dr. Shannon. “Some children are hands on learners and struggle with traditional school formats.” It is important for parents and teachers to find a good “fit” for the early school years and to build a curriculum that optimizes learning for the child as he or she moves into later years.

Assessing, testing, and understanding what works best for each child then developing the most appropriate educational approach –- all these things enhance a child’s learning potential and must be done before children struggle and fail in school. To do this, parents must be in close communication with the school and advocate for their child’s needs.

What Is Your Child's Learning Style?

Dr. Shannon also notes that it is important to closely monitor school size. “Many children need a smaller school setting to thrive. If the child struggles with social skills or anxiety, a smaller school is usually better.”

Trauma

“Basic development for children who experience trauma is often disrupted in a very profound way,” notes Dr. Shannon. “If a child is under siege, it’s nearly impossible for her to acquire age-appropriate skills.” For this child, the world feels unsafe and he feels absolute powerlessness.

Below are several symptoms commonly seen in traumatized children:

  • Hyperarousal
  • Regressed behavior
  • Withdrawn or avoidant behavior (or both)
  • Impaired concentration
  • Hyperactivity
  • Anxiety
  • Fearfulness
  • Depression
  • Aggression and anger
  • Dissociation (disconnection from reality)

“Trauma is probably the number one hidden cause of mental and emotional upset in our kids. It is our job, as parents and practitioners, to address childhood trauma with patience, tenderness, and empathy,” says Dr. Shannon who explains that children need all of the following in order to recover from trauma.

  • Safety
  • Nurturance
  • Stability
  • Predictability
  • Understanding

Inadequate Sleep

“Most kids need a lot of sleep -– much more than most parents plan for or encourage. That’s because we underestimate how crucial sleep is for restoration and growth,” says Dr. Shannon who gives a breakdown of the amount of sleep children need within a 24-hour period.

  • Infant to 6 months: 16 to 20 hours
  • 6 months to 2 years: roughly 15 hours
  • 2 to 6 years: 10 to 12 hours
  • Grade school children (7 to 13 years): 9 to 11 hours
  • High school children (14 to 18 years): roughly 9 to 10 hours (but this may vary greatly day to day)

Inadequate sleep can result in a range of problems from simple cranky, fussiness to poor concentration, inattention and impaired cognitive abilities, to hyperactive and impulsive behaviors, even to a weakened immune system.

The Importance of Sleep

Poor Diet

Unfortunately, many of our children eat a diet that is unbalanced and unhealthy. As parents, we must be aware of the importance of good nutrition and provide foods that nourish our children’s growing bodies. “This is more challenging than it ought to be, because the American diet, especially for kids, is so skewed toward empty calories,” says Dr. Shannon.

A Healthy Diet May Improve Behaviors

In addition to a healthy diet, it is also important that children eat at regular intervals. Skipping meals and snacks can produce low blood sugar levels that result in cranky or moody feelings. Foods that are especially high in processed sugars can also spike blood sugar levels, causing energy spikes and crashes. Food sensitivities is another issue that may cause problems in some children.

Continued on page 2.

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