Understanding treatment options for ADHD

You’ve worked, worked and worked with your child on homework, appropriate classroom behavior, organizational skills and everything else you can possibly think of. But finally, your child is diagnosed with attention deficient hyperactivity disorder (ADHD). Your child is not alone, and as a parent, neither are you.

According to the Centers for Disease Control and Prevention, one in every 11 children between the ages of 4 and 17 has been diagnosed with ADHD, which can manifest in one of three forms: the inattentive form, the hyperactive form and the combined form.

“Children with the hyperactive form get noticed earlier,” said Mary Lynn Bundy, M.D., pediatrician with Norton Children’s Hospital Medical Associates – Jeffersonville. “These children are extremely active and impulsive. They can be disruptive, and their lack of impulse control can be a safety issue. Their increased impulsivity can affect emotions as well as behavior; these children can be prone to sudden outbursts of temper.

Dr. Bundy explained that children with the inattentive form of ADHD struggle with organizational skills, become easily distracted and have a hard time starting a project and sticking with it.

“These children daydream, but they don’t misbehave, so they are often overlooked,” Dr. Bundy said.

Some children have the combined form of ADHD, making it difficult to stay focused on a task and control their behaviors.

“There are medical and therapeutic treatment options when it comes to managing ADHD,” Dr. Bundy said. “Having a predictable daily routine, ensuring adequate sleep, plenty of exercise, good nutrition and limiting screen time are the foundation. Making the school aware of your child’s diagnosis is essential. This sets the stage for a compassionate, flexible, supportive educational environment for your child. In addition, seeing a counselor or therapist can help your child work on self-mastery and organizational skills.”

The medications approved for the treatment of ADHD work on the brain chemistry to strengthen executive function, according to Dr. Bundy.

Executive function is the term used to describe a child’s control over cognitive processes, including memory, reasoning and problem solving,” she said. “So the medication is working on the chemistry of the brain that helps your child make decisions like ‘should I say this’ or ‘should I do that’ before they do something that will get them into trouble.”

As with any medication, there is an adjustment period for determining if or how well your child’s medication is working, as well as the optimum dose. And some children take more than one medication.

“The stimulant class of drugs is most commonly prescribed for ADHD treatment, because they are the most effective,” Dr. Bundy said. “There are nonstimulant ADHD medications as well, and they may be prescribed alone or in conjunction with a stimulant. Each patient is unique, and their treatment should be individualized. I review the options with parents in the beginning and throughout follow up, discussing expected benefits and possible side effects.”

According to Dr. Bundy, the most common side effect is a decrease in appetite. For that reason, it’s key for the child to take medicine with or after breakfast. Children need a substantial breakfast with fat, protein and carbohydrates. Even if your child is served breakfast at school or a summer activity, provide a meal beforehand in case your child chooses not to eat what is served.

After school, most children are ravenous. Your child probably needs a substantial healthy snack but might need encouragement to eat it.

At dinner time, if the medication is still lingering and your child isn’t hungry, don’t turn it into a fight. Know that when the medication wears off your child will be hungry and will eat. Be prepared with a well-balanced choice of fats, proteins and carbohydrates.

“It may seem nontraditional to let your child eat a later than normal dinner, but that’s OK,” Dr. Bundy said. “Make nontraditional your new tradition.”

Dr. Bundy offers a few additional tips:

  • Avoid caffeine. It is a stimulant just like the ADHD medication. Adding stimulants together can have unpredictable effects.
  • Limit sweets. Eating sweets will cause your child’s blood sugar to go up and then come right back down, causing more emotional swings.
  • Always have snacks on hand. Offer protein-rich snacks such as peanut butter crackers, nuts or cheese sticks. Plan ahead for after-school appointments and take snacks with you.

“ADHD medications are safe for your child,” Dr. Bundy said. “And when administered consistently and monitored by the pediatrician regularly, they are very effective in managing the symptoms of ADHD.”

Dr. Bundy also stresses that these medications need to be taken as prescribed, year round.

“With ADHD, your child’s mental function is consistently inconsistent. By giving the medication every day, you are providing them a more consistent cognitive plan in the classroom and in society,” she said.

To learn more about ADHD, including some of the myths around the diagnosis and treatment options, talk to your child’s pediatrician. If you do not have a pediatrician, or to find a pediatrician in your area, visit Norton Children’s Hospital’s Find a Doctor database or call (502) 629-1234.

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