No Need for Pills to Treat ADHD

ADHD, attention hyperactivity disorder, is one of the most controversial factors that is highly discussed, evaluated, and studied by scientists and psychologists. Both are investigating the causes of the disorder to establish its roots. The researchers are ambiguous about whether the disorder is genetic or has environmental factors. However, the more they delve into its origins, the more uncertainty they face. Based on a profound examination and elaboration of the causes, symptoms, and behavioral patterns of children with ADHD, one may conclude that the environmental factors have the most influence on the development of a child with ADHD characteristics.

Unfortunately, people sometimes rush to medication, so as to achieve quicker results, and decrease unwanted anger and frustrating that builds up when raising ADHD children. Faster results are effective in suppressing the symptoms, but fail to treat/cure the actual disorder. This paper aims to provide an alternative method with strategies that help parents evaluate their own responses and behaviors, to become stronger, more effective, and, therefore, helpful for their own children. Parents, teachers, and peers, must establish a loving, caring, and understanding environment, free of frustration and anxiety, through which they could decrease, and possibly eliminate, the need to medicate one with ADHD.

ADHD has established symptoms, according to which individuals are being diagnosed. Some children with ADHD primarily have the Inattentive Type, some the Hyperactive-Impulsive Type, and some the Combined Type. Those with the Inattentive type are less disruptive and are easier to miss being diagnosed with ADHD. A child should be found with six or more of these symptoms to be diagnosed with ADHD.

Inattention symptoms:

Fails to give close attention to details or makes careless mistakes in schoolwork

Difficulty sustaining attention in tasks or play

Does not seem to listen when spoken to directly.

Does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace

Difficulty organizing tasks and activities

Avoids or dislikes tasks that require sustained mental effort (such as schoolwork)

Often loses toys, assignments, pencils, books, or tools needed for tasks or activities

Easily distracted

Often forgetful in daily activities

Hyperactivity symptoms:

Fidgets with hands or feet or squirms in seat

Leaves seat when remaining seated is expected

Runs about or climbs in inappropriate situations

Difficulty playing quietly

Often “on the go”, acts as if “driven by a motor”, talks excessively

Impulsivity symptoms:

Blurts out answers before questions have been completed

Difficulty awaiting turn

Interrupts or intrudes on others (butts into conversations or games

The disorder is extremely difficult to diagnose in young children because the symptoms could easily be confused with language delays, adjustment difficulties, mental retardation, and autism; and some children have personality characteristics similar to symptoms of ADHD without having the disorder itself. As a result, according to the statistics, 40% of children are incorrectly diagnosed by physicians. These numbers keep growing, thus evoking turmoil around this topic, fostering and advertising drug treatment, instead of an alternative non-drug therapy, such as a friendly, trusting, and caring, relationship between human beings.

The medications being used by the physicians are extremely effective; however, they have enormous side effects. For example, the cyclic antidepressant called “Norpramin [has significant effects on the heart and] has become the principal reason that there have been a number of deaths in medically healthy ADHD children,” (Wender, 85). Other side effects might appear insignificant, (slowing in growth and losing weight), but no one really knows how these medications would influence the child’s further development, as well as its consequences in the long run.

Scientists claim that the disorder has generic impediments: A chemical imbalance was involved in many cases of ADHD because adults and children diagnosed with ADHD appear to have low levels of dopamine, a chemical that sends messages to the part of the brain involved in attention, movement, and motivation. The medications that are being given to children are not safe, and, moreover, “the long-term safety of these drugs, researchers say, is unknown, and many parents are seeking non-drug alternatives,” (Greene). It is terrifying to know that children are given medications, which long-term effects are not yet discovered.

Scientists also state that about one in four children with ADHD have at least one relative with the disorder, and when one identical twin has ADHD, the other twin almost always has it as well.

Pregnant women who smoke are at increased risk of having children with ADHD. And alcohol or drug abuse during pregnancy may reduce activity of the nerve cells (neurons) that produce dopamine.

Preschool children exposed to certain environmental toxins, particularly lead, are at increased risk of developmental and behavioral problems, many of which are similar to those found in children diagnosed with ADHD. Exposure to lead, which is found mainly in paint and pipes in older buildings, has been linked to disruptive and even violent behavior and to a short attention span. And high levels of PCBs are known to interfere with many aspects of a child’s development, in addition to being human carcinogens. Children may be exposed to PCBs in the womb as well as after birth – both breast milk and certain fish are high in these toxins.

The goal of this paper is not to argue that ADHD may have generic predisposition, but to prove that this disorder could be treated without medications. This conclusion is drawn from a simple factual statement made by a famous professor and a psychologist, Laura Berk. She states that, “the intelligence of children with ADHD is normal,” (Berk, 294). Moreover, Berk claims that these “symptoms are due to an impairment in inhibition,” (Barkley, 294). Such claims suggest that the disorder is psychological, and thus may be treated through therapeutic approach. The entire focus of this research is to suggest a different system through a careful analysis of symptoms, and to propose a non-drug treatment, effective in the long run.

Psychologists and environmentalists are convinced that the environment tends to often influence children much stronger than any generic predisposition. Children with these ADHD symptoms are often treated as outcasts and as failures by their, friends, teachers, siblings, and parents. Child’s inability to perform according to expectations evokes aggression from people who are dealing with them, which automatically builds up frustration.

This following quote serves as an example of how the environment/society fosters the disorder. For instance, teachers would make such comments as, “Why can’t you just use your brain?” (Wender, 23). “Thus poor performance leads to criticism, which, in turn lead to the child’s poor opinion of himself,” (Wender, 23). This might discourage the child to continue hard work, and encourage giving up. “If [the child] cannot do well when he is trying to the best of his ability, he tends to give up.” (Wender, 23).

Another interesting factor that Wender emphasizes is that, when many parents revisit an elementary school for the first time in many years, they are wondering how they were able to pay attention as children, in such a boring, tedious, and repetitious environment. These factors primarily point out that the “social structure in most schools makes the ADHD child’s problems greater,” (Wender, 23). Evidently, physiological impairments/factors mentioned above, fuse with the environmental/social factors (previously mentioned) and snowball into complicated behavioral patterns.

There are many examples, of children who are incorrectly treated, and who should not be taking the prescribed medications. One example is Nicholas Hill, a child whose mother decided to take actions about his uncontrollable behavior. “Nicholas Hill was an obstinate and defiant 4-year-old. He exploded into violent rages. He yelled, screamed, and threw his toys. When his parents made reasonable requests, he seemed to take perverse pleasure in ignoring their wishes and doing exactly the opposite.” The mother took this child to the local hospital, and he was diagnosed with ADHD. After this diagnose, the prescribed drugs helped, but the mother did not feel that her son’s behavior was still under control. Not wanting to give him more medications, she began to seek alternative non-drug methods.

This is when she met Dr. Greene, a director of cognitive-behavioral psychology at

Massachusetts General

Hospital

and assistant professor of psychology at

Harvard

Medical

School

, who has developed a drug-free approach to parenting children who are easily frustrated and chronically inflexible, including those with ADHD. Nicholas began to use Greene’s “behavior modification techniques and his mother found, they made a huge difference in managing his outbursts,” (Hill, Sue).

Based on Greene’s research at the hospital, there are two steps to his strategy. “The first step is for parents to identify and avoid situations that habitually frustrate their child. For example, a kid who becomes over-stimulated in the supermarket can be left at home with a babysitter,” (Greene). This is done to avoid unwanted behavior, as opposed to just stimulating it.

“The second step is for parents to teach the child to accept a compromise when his demands can’t be granted immediately. A child can be given permission to sleep over at a friend’s house on the weekend, instead of during the week when homework needs to be completed,” (Greene). In some cases, if parents would follow these strategies, they could achieve agreement with their child and actually avoid medication. The initial goal here is to possibly eliminate child’s anger and frustration, and more importantly acting on these negative feelings.

Moreover, according to Greene, “parents need to prioritize their demands, and he suggests using a system of “baskets” A, B, and C.” Parents should put behaviors that relate to a child’s health and safety (such as wearing a helmet when bicycling) in a nonnegotiable Basket A. These rules are important to enforce even if the child becomes angry and out of control. “Behaviors that are desirable (such as eating a variety of foods) but are not worth daily mealtime tantrums can be put in Basket C and assigned a lower priority for enforcement,” (Greene). “And in Basket B parents can put behaviors that are important but not essential and that can be negotiated with a compromise. For instance, a child who doesn’t want to come into the house might be allowed to play outside for an extra 15 minutes,” (Greene). Greene claims that such strategic points allow parents to “reduce the demands on their children and intervene before the children become irrational.”

Apparently, according to Wender, there are various strategies that help ADHD children and their parents to avoid medication, as well as prevent children from having ADHD. This could be achieved by “producing the healthiest possible psychological environment,” (114). If the child’s actions are criticized, the parent should provide constructive pointers, as to what needs to be changed in the child’s behavior, as opposed to mere negative statements, which would only cause frustration in a child.

For example, “You are a terrible child and you are always making trouble!” “Such an explosion can not be helpful.” Moreover, the child would not know how to stop being a “terrible child.” Parents should find specific behavioral details that need improvement, and only then begin critiquing. For instance, “Mommy gets upset when she asks you to clean up your room and you do not. Nobody likes to look at messy rooms. Please go back and clean it.” In this case, the parent’s anger is directed towards something specific that could easily be changed.

Parents should never refer to their child as “worthless” or “bad,” such referral denies the child as a whole and as a human being, as opposed to effectively criticizing a particular aspect of child’s behavior. Therefore, if criticism if necessary, parents should be as detailed as possible. Another strategy would be learning to praise children’s actions.

Wender claims that affectionate attention should only be provided when the child is behaving “desirably;” thus, “praise should [also] be specific,” (116). For instance, if the “child is eating nicely, say, “You are eating in a very grown-up fashion and that pleases me,” (116). As opposed to randomly uttering, “You are a wonderful child,” or “You have been marvelous today.” Such comments, Wender states, could be recognized as “phony,” and “false.” Thus, praise should only relate to specific aspects of child’s behavior, and not be general and enlarged. It is much more important to tolerate a good behavior than to use mere clichÃ?©s that are not constructively helpful. It is also important the children learn to recognize and distinguish good and bad behavior. Parents should also teach children to distinguish between feelings and actions.

Wender points out that children should learn that to have feelings is normal, and that “they should be expressed, even if they are bad.” Children, just as all human beings, tend to have feelings that are negative such as, jealousy, anger, envy, resentfulness, and the major principle is that “feelings and actions are not the same thing.” As a result, parents and children should learn that actions could be “changed and shaped,” but feelings could not, and so “they should not be treated as if they could be,” (Wender, 117). A child should have set boundaries between thinking and doing.

Wender also states that, “if the child sees that his parents recognize and tolerate his/her feelings, the anxiety about having them may be relieved,” (117). It is important that the child realizes that bad thoughts/feelings are acceptable, and they do not mean being a “bad” and “worthless [person].”

Another interesting technique is labeling. Its goal is to help children recognize themselves as individuals, and the purpose is to help the child gain self-control. For example, parents could say, “what are you doing?” and have the child “label his own behavior,” (119). Psychologists suggest that “self-labeling is the first step in self-control, and the sooner the child learns to label what he is doing, the sooner he can control himself,” (120). Wender supports this statement and says, “my clinical experience has impressed me with the usefulness of labeling as an additional parental technique,” (120).

Interestingly enough, this technique is very similar to the mirroring technique that, according to Margaret Mahler, a well known psychoanalyst, babies need to feel “that the world is in complete harmony with [their] wishes,” (307). This strategy is used by the mother to help the child establish identity and sense of “oneness.” One aspect of this technique is that it should start when the baby is one to five months old. Hopefully, with this strategy, the child would develop self-confidence, and would be able to recognize and identify “his [her] own troublesome behavior,” and, perhaps would work on decreasing it.

Children should not be the only ones to blame if they are having a tantrum. However, most of the times, parents or adults dealing with children, do not realize that. Adults begin to scream at children who, for example, refuse to do something, but screaming is ineffective. Adults might assume that something is wrong with the child, and never want to admit that they may be doing something wrong. What this means is that, ways in which one might chose to deal with a child, are not always efficient, pleasant, or even acceptable for the child. Adults should try to reach a consensus about why it is important to perform a certain task, and also ask they child why he/she does not want to participate in a certain activity.

Parents would discover that sometimes children do not want to make up their own bad. In this case, parents could demonstrate how the room looks when the bad is made and when it is not. If this does not work, another way should be tried. It could be merely because the child does not enjoy this boring activity. In this case, the parent could model this strategy and do it with music on, or some other exciting source, and engage a child, thus to demonstrate that even something as boring as making a bad, could essentially be fun. By nature, children do not refuse to perform enjoyable tasks.

It is obvious that children, hyperactive or not, demand much attention, and this may also frustrate the parents. In this case, it is imperative that parents take vacations, devote some time to themselves and relax. It is important to take periodic vacations, to prevent parents’ relationship from suffering, (Wender, 129). This is not a sign of “selfish value of the parents. [Instead] If [parents] are able to spend some time alone with each other, and enjoy themselves, they may be more relaxed in handling their children [hyperactive or not] when they return, which would benefit the child, [as well as the entire family],” (Wender, 130).

Another interesting suggesting made by Dr. Greene, is that not only parents should be helping the child with ADHD, but also teachers and students. Parents should inform teachers that the child has ADHD, and perhaps even provide a list where they indicate how to adequately respond to certain behaviors of their child. For instance, a child who is easily distracted by activity visible through door or windows should be seated front and center, away from distraction. If the child reaches across desks to talk to or touch other students then increase the distance between desks.

Another important factor is that children do physical activity during the day, to relax from studying. Also, teachers should “allow student to run errands or to stand at times while working,” (Teachers, Quick List). A child simply cannot function as a robot, and so it is natural that he/she might go differently about performing a certain task. Teachers need to acknowledge that and avoid interfering as long as the behavior is not disruptive.

If the class is working together, it is likely benefit the child’s performance as well. For example, if one is having difficulty with a task then the entire class should help him or her and work as a unison to complete the given assignment, (Greene, 283). Moreover, if one students is having a tantrum, and disturbs others than the class could write him/her a letter saying that they care and miss the student, and invite the child to join their group. This strategy was proven to be very effective, and it shows that trough love and care, great results could be achieved.

Obviously, the entire process is much easier in theory and requires much dedication, passion, and patience from those around the ADHD children, but, this method is very effective in the long-term, and, as opposed to medications, does not have side effects that are still undiscovered.