Stimulant medications and behavioral therapy are considered first-line treatments for ADHD in children, but caregivers know that multimodal treatment plans work best to alleviate symptoms. What does “multimodal” look like in real life? In a recent ADDitude survey of nearly 1,000 webinar attendees, about 50% said that stimulants and/or non-stimulants have “most ameliorated their children’s ADHD-associated learning and behavior challenges.” The other half said the following lifestyle factors had the biggest impact:
Improved diet, exercise, or sleep: 11.9% Educational services (eg, tutoring, accommodations): 10.13% Behavioral therapy: 7.34% Limited screen time: 4.56% Supplements ( eg, omega-3, magnesium, zinc): 2.53% Speech, occupational or physical therapy: 2.53% Mindfulness exercises: 1.77%
Comments and questions presented during the webinar, titled “Genes and the Environment: How Biology and Exposures Contribute to ADHD in Children,” focused on the lifestyle and environmental factors with the greatest impact on children. ADHD symptoms.
The importance of diet, exercise and sleep in managing ADHD
Diet, exercise, and sleep are the Big Three—the lifestyle changes with the most significant, scientifically proven effect on ADHD. When these lifestyle factors are optimized, your child may require a lower dose of stimulant medication or may find that their ADHD medication works better, according to Joel Nigg, Ph.D., a clinical psychologist and professor in the departments of psychiatry and behavioral sciences. at Oregon Health and Science University.
Next steps to optimize diet, exercise and sleep:
Q: “Are there specific foods or nutrients that we should increase to better manage ADHD symptoms?”
Omega-3 supplements have been shown to improve ADHD symptoms. Learn more about the benefits of omega-3s in these resources:
Q: “What, if anything, should we eliminate from our children’s diet?”
A part of children with ADHD will respond positively to a diet that eliminates allergens, additives and dyes. Check with your child’s doctor and/or nutritionist to safely follow an elimination diet.
Next steps:
Q: “What about the caffeine?”
The active ingredients in caffeine are clearly beneficial for attention, says Nigg, but what doses of caffeine are safe for children is unknown. Too much caffeine can actually be detrimental to development. It is best to avoid caffeine (eg, see sports drinks and other sources of caffeine) until the late teens.
Next steps:
Screen time and video games
Q: “Do violent video games affect my child’s behavior?”
“There is a good deal of evidence linking violent content to increased aggression in vulnerable children,” says Nigg. Monitor your child’s play activities and redirect if you notice signs of aggression, depression, and irritability.
Next steps:
Stress and family conflict
Q: “My son’s ADHD has gotten worse since the pandemic. Do I need to adjust his treatment plan?”
“The scientific evidence supports their idea that children’s problems have gotten much worse in the last two and a half, three years,” says Nigg. In a chronically stressful situation, it is normal for children to be (and act) stressed. As the stressful situation is reduced, your child’s behavior should return to baseline. In the meantime, please continue to support and coach your child and model appropriate coping behaviors. Talk to your child’s doctor if you notice behaviors that are concerning. There could be more than ADHD in the picture, which will influence your child’s course of treatment.
Next steps:
Remember, ADHD is not caused by “bad parenting.”
Parents of children with ADHD can easily get caught up in negative loops that can inadvertently reinforce challenging behaviors. (Parental ADHD can also complicate the dynamic.) Behavior therapy has been proven to help reduce challenging behaviors in children and create positive family dynamics. Parental self-care is also important.
Next steps:
To learn more about how lifestyle and environmental factors affect ADHD symptoms in children, listen to the ADDitude ADHD Experts webinar, “Genes and the Environment: How Biology and Exposures Contribute to ADHD in Children” by Joel Nigg , Ph.D., which was broadcast live on November 30, 2022.
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