My son has ADD - what next?

January 16, 2007 5:10 PM

My 6 Year Old has been diagnosed with Attention Deficit Disorder. We are not going to drug him. How can I help him?

After 2 days of testing, my 6 year old son has been diagnosed with Attention Deficit Disorder. (I already hate the label). After some quick research on the web, the diagnosis seems to make sense. (His disorder seems to arise from food allergies which we have been dealing with for 4 years) He is bright, does well in school (B student) and not aggressive or "bad". He has many of the hallmarks of ADD that are described in the literature, and he is often disconnected from the world. As a parent, I want to do everything I can to help him, but I have no idea where to start. One recommendation was that we get a family dog (he loves dogs) who would ideally be an unconditional friend. There must be others in the hive going through this. What has worked for you?

posted by greedo to health & fitness (63 answers total)

(You might want to check through the archives; I know there have been a lot of threads about ADD. This one in particular might be helpful.)
posted by occhiblu at 5:16 PM on January 16, 2007

Thanks occiblu - I had missed that one (didn't know about that search view)
posted by greedo at 5:24 PM on January 16, 2007

(It's not always easy to get to! It took me a couple more clicks than it probably should have.)
posted by occhiblu at 5:26 PM on January 16, 2007

biofeedback may be worth looking into. i have no proof to back this up, but i have done a bit of reading on the technique, and it sounds interesting and logical.
here's an article, a website, the blank">wiki, and the (well-written, very readable) book that piqued my interest in the first place, which is called a symphony in the brain.
posted by twistofrhyme at 5:27 PM on January 16, 2007

i hyperlunk that badly. sorry.
posted by twistofrhyme at 5:28 PM on January 16, 2007 [1 favorite]

I don't have any specific advice but I want to applaud your decision not to run off and put him on Ritalin. My mother taught special education for more than 25 years and she swears that while some students with ADD were difficult to deal with initially, they mostly just needed a teaching style that was different from other students and too often, teachers simply didn't want to take the time to figure out what that was. She thinks that while Ritalin might have been the answer for some students, it was a solution that was not a one-size-fits-all type of thing and sometimes resulted in students getting worse before they got better as their bodies adjusted to the meds. Several of her veteran teacher friends agree wholeheartedly. Best of luck to you.
posted by notjustfoxybrown at 5:32 PM on January 16, 2007

To give the flipside of the above, it's great that you're taking an active hand in helping him through this, and staying away from medication is a perfectly defensible decision. But I'd ask that you not completely rule the option out, or dismiss it as "drugging him."

As unfair as it is to stuff wonder drugs down a six year old's throat to make him 'better', it would be equally selfish to deny a child medication that would help him manage a frustrating condition because the media makes it out as a crutch for bad parents. I trust that you know your son, and that you're making the right decision for him. But don't forget that there are children out there for whom Ritalin, or similar, has been a powerful tool, something that helped them regain control of their lives when nothing else could.

Good luck.
posted by Simon! at 5:35 PM on January 16, 2007 [4 favorites]

Run him around... have him join a soccer team or something.
posted by ph00dz at 5:37 PM on January 16, 2007

Please, always keep in mind that diagnoses of disorders and syndromes are only just assessments of behaviours which are outside some arbitrary norm. It's a good thing that you hate the label. Labels can be incredibly destructive. If his academic and social conduct are satisfactory, as you state, those are two major problems that you thankfully don't have to deal with. What manifestations of this disorder are troublesome for you?
posted by Neiltupper at 5:37 PM on January 16, 2007

Functionality is key. If he is a B student and presents with no over the top challanging behaviors I don't think you have to modify much. Sounds like you are trying to address the allergy issue and dogs are great for all types of people so that might be a good idea. Other than that, and your love/understanding I don't know what else the kid needs at this point.
posted by edgeways at 5:48 PM on January 16, 2007

My brother hated the way drugs made him feel. He is very intelligent but struggled in public schools because public schools, with limited resources and a high student/teacher ratio, are forced to cater to the average, not the unique. If you're son has trouble in school I highly recommend you find a teacher/tutor/school who is willing to meet his individual needs.
posted by Brittanie at 5:50 PM on January 16, 2007

A friend of mine was looking into yoga instruction for her daughter with ADD. She opted for drugs instead, but the idea of doing something that gives focus/coping skill practice in a welcoming environment might not be a bad idea.
posted by Gucky at 6:03 PM on January 16, 2007

I note you said ADD not ADHD (Attention Deficit Hyperactivity Disorder) which gets most of the popular attention of children being drugged to calm them down.

Drugs like ritlin can help ADD and ADHD people by helping them focus. Already people like ph00dz are giving bad advice and demonstrating they don't grasp this distinction.
posted by MonkeySaltedNuts at 6:04 PM on January 16, 2007

Keep his teachers informed. If you don't want him in special education (and it sounds like he's managing fine without it so far), just letting the teachers know that there has been a diagnosis will at least help them put his behavior in perspective.

Also, be warned: special education is a racket. The teachers don't want it that way, the specialists don't want it that way... but when it's all said and done, the whole system is a mess and nobody has any real answers for fixing it.
posted by scaryblackdeath at 6:07 PM on January 16, 2007

Fish oil's been getting a lot of attention as an alternative to ADD drugs. The omega-3 fatty acids in fish oil get incorporated into cell membranes in the brain - if you're deficient in omega-3's some researchers think it shows up as depression, ADD, etc.

I recently started taking fish oil after my 2nd pregnancy - I'd gotten massively depressed and was prescribed antidepressants during both pregnancies, but I'm now pretty sure it was a nutritional deficit. The growing baby got all the omega-3's, leaving me feeling draggy. The difference in my mood after I started taking fish oil was striking.

You can get it in an easy to take form for kids (orange or lemon flavored oils, so it doesn't taste fishy). My email's in my profile - email me if you want me to dig up some scientific studies for you.
posted by selfmedicating at 6:09 PM on January 16, 2007

I have ADD (primarily inattentive, not so much hyperactive), and although I've been taking medication for it, I'm well aware that isn't the best option for everyone. Good for you for not jumping to that option.

What grade is your son in? I was diagnosed with ADD at the end of the 7th grade, when my grades went from B's and A's way way down, giving me a GPA of 1.08. That was a red flag. See if you can find out (preferably from his doctor) at what ages ADD commonly makes its presence known. I remember matching those ages with my performance in school, and I did quite poorly at those times.

I'm not sure if you're in the US or not, but if you are, look into getting a 504 plan for your son. I didn't get one until my senior year of high school, and it wasn't much help to me at that point. A 504 plan will allow him accommodations due to his ADD, such as extra time on tests (great when you keep losing your train of thought or get sidetracked or space out); reducing the amount of homework or classwork; Daily or weekly reports home to parents from teachers (you want this, trust me); assistance in organizational skills (definitely this, too), etc. A 504 plan is invaluable, and depending on your son’s situation you might be able to use this in lieu of medication. A quick google-fu search yielded this, which might be helpful.

And I would like to second what Simon! said. If things do not appear to be working well (and I mean after elementary school; around junior high, high school) for your son, I hope you will please consider discussing the option of giving your son medication with his doctor. In elementary school, there really isn't a need (imho) to medicate your child. I feel I got by just fine without my ADD having been diagnosed. But as I stated before, by 7th grade, it became painfully obvious that something was amiss. When I started taking medication (Adderall, I'm not sure what dosage) it was like my ears had been broken all this time and were now working; I was able to "tune in" to what the teacher was saying. It was incredible. What many parents fail to realize is that medication isn't a "silver bullet." They reach for it right off the bat and do nothing else to help their children. You are taking the opposite (and better) approach; work with your child first. I just hope that you will be open to the idea of providing your child with medication should it prove necessary.

As for being “disconnected” with the world, I’m not sure if I experienced anything like that when I was a kid. Could you elaborate, perhaps?

I’m confused by one thing in your question, though. “His disorder seems to arise from food allergies which we have been dealing with for 4 years.” I’m not quite sure what you mean.

If you would like, I can do a bit of searching through old documents and see if there are any resources online or otherwise that I can recommend that were helpful to me.

Best of luck to you and your son!
posted by CitrusFreak12 at 6:12 PM on January 16, 2007 [1 favorite]

Following up on Gucky's comment, a Yoga Journal article about yoga and kids with ADD and ADHD.
posted by occhiblu at 6:14 PM on January 16, 2007

I'd like to make a clarification: ph00dz was not too far off with his advice, and MonkeySaltedNutz has stated a common misconception.

ADD and ADHD are the same thing. That is why in my post I said I was "primarily inattentive."
Do not think of ADD/ADHD as two different things. It's more like a spectrum. Some people are hyperactive, but have little trouble paying attention. Some people like myself can't focus but are not hyperactive. Some people are both. The severity of the symptoms are unique to the individual.

Some common accommodations for children who are primarily hyperactive is the ability to walk around the classroom to satisfy the urge to move around, so ph00dz does have a point, but given your question, my understanding is that hyperactivity is not the issue.

And though you may hate the label, I would highly advise you to consult the doctor who diagnosed your son, if you have not done so already. As you can see, there are many misconceptions and differences of opinion when it comes to ADD.
posted by CitrusFreak12 at 6:18 PM on January 16, 2007

greedo, you mentioned two really important things; disconnection from the world and unconditional friend.

You are right on the money with your train of thought. Dog? Yes! Soccer or other social endeavors? Yes.

I've found that there is a fine line between what can be diagnosed as ADD and what can be considered GATE or "gifted and talented". It's a silly term but it's used often here.

I would look it up and see if it applies. Considering that your son is doing well scholastically, I wouldn't be surprised. Good luck and hang in there.
posted by snsranch at 6:20 PM on January 16, 2007

"ADD" is the older (and outdated) terminology. What you're looking at is a DSM diagnosis of 314.01 (or 314.00, but not as likely as you have a boy). First off, the diagnosis - was there a CPT or a TOVA? These are actual performance tests, not just "what your overworked first grade public school teacher has observed" or other assessments that are basically, well, sadly qualitative, and therefore very, very subjective. If your diagnosing physician, pediatrician, child psychologist, whomever, did not conduct a CPT or TOVA, pull the ripcord. Go to a specialist who actually performs said tests. I cannot stress this enough. You may find out that your child does not have ADHD at all. CPTs and TOVAs are the closest thing you can get to giving your child a PET scan to verify (yes, ADHD can show up on a PET scan).

I have also seen people do a lot of wacky nutritional things, usually based on testimonials from people who think that the plural of "anecdote" is "data." Biofeedback? Didn't work, and the guy who ran the study really, really wanted it to work. Pycnogenol with the super-funky bioflavinoids? The study didn't pan out. And so forth.

If your child takes the tests and has ADHD, then what they have is a small area of the brain that just isn't quite up to snuff (see aforementioned PET scan). Getting a dog, etc., is not going to fix this. What you're looking for is a coping strategy. I'm not advocating medication as the panacea, however, a properly titrated, time-release medication can, wiht tests monitoring his performance, can help bring your son up to his maximum performance level, which occurs before the "drugged out walking zombie" state, usually. The efficacy of the medication typically follows an inverted U shape. There are also a variety of medications out there.

Now, as for actual coping mechanisms, you can certainly ask for an IEP from your school, engage a tutor who has dealt with these kids before, etc. You will probably have to ask for more frequent updates from the teachers - ADHD kids tend to build up piles of unfinished math assignments and the like. I have spent a little over a decade working with these kinds of kids, and I can tell you that you must engage, strongly. The teachers will be annoyed by you asking so frequently - tough.

If you have more questions, let me know.
posted by adipocere at 6:47 PM on January 16, 2007 [3 favorites]

As someone who has ADD, first, let me applaud you for not just going along with medication:

A few bits of advice:

1st: If you are not comfortable with your sons psychiatrist, shop around until you find one that you are comfortable with.

2nd: Keep your negative opinions about either medication or ADD to yourself. Don't do anything to make your child feel stigmatized. Even if he's not taking medication now, there may come to be a time where it's necessary later, and you don't want to make him feel like a failure.

3rd: Organize, Organize, Organize. If there is one thing that can help an ADD person diagnosed early, it's developing good habits. You are going to have to be on him all the time to do homework and chores, and it's going to be a constant struggle. Don't give up, and don't just start doing things for him. Get him used to working from to-do lists and calendars as soon as you can. Kids with ADD often have 'memory' problems that are really just 'not paying attention' problems. So make sure that he has everything written down, and that you don't let him have free time until everything that needs to be done is done.
posted by empath at 6:48 PM on January 16, 2007 [1 favorite]

Also, if you're not going to medicate him, make sure to keep away the caffeine as well, too.. because caffeine is a form of self medication for ADD...
posted by empath at 6:50 PM on January 16, 2007

I _really_ appreciate these answers. Thank you. I have taken note to keep an open mind about medication in the future. I am going to look up the fish oil.

He does get regular exercise (karate, swimming, skiing and park league soccer) but on days he doesn't (like any kid) he can get wild. Yoga is something I had not considered I am also going to look into it.

We are lucky on that his grade 1 teachers have been supportive instead of labelling and went through this testing process as part of plan to see how to help. He is already allowed to stand (while others are sitting) at his desk, and has part of his blanket stitched under his desk for sensory relief. They don't know the results yet. It seems to me, that being up front and working with his teachers can only help him.

@CitrusFreak12 - as a toddler he had skin rashes that we finally discovered were caused by food sensitivites (primarily dairy). My impression is that food sensitivities has been identified as one of the triggers for ADD and I have seen his behavior change with his diet.

The Psychologist's comment that really struck me though was about his connectedness to the world. He is not anti-social, but he never gets invited to friends houses. Often, he will just want to be alone, and drift off into space. He is often troubled by people talking to him and trying to have a discussion. I know he is there - thinking and taking it all in because I see it in his eyes and he can come back and respond to whatever has been asked. When he does get excited or wants to communicate something, it often comes out in a way that seems hyper or crazy - and while I have come to recognize the clues these are often missed by others. I don't want to "change" who he is, but I want to make sure that he is happy. Sometimes he complains about 'hating the world' and this worries me.

We have a follow-up appt now with the Psychologist(parents only).

(and thanks again)
posted by greedo at 6:52 PM on January 16, 2007

@adipocere -thanks for the clarifications and I will be asking more detailed questions at our next meeting with the Psychologist.
posted by greedo at 6:55 PM on January 16, 2007

#greedo: he is often disconnected from the world.

Psychological diagnosis and classification is still pretty much near the witch-doctor stage (but even a witch-doctor can be effective).

Another notion to check is Asperger syndrome, 2, 3.

A problem with witch-dococters psychological specialists is they can have favorite explanations. Go to one that specializes in ADD/ADHD and you will get a ADD/ADHD diagnosis. You may get the corresponding diagnosis if you go to an Asperger specialist.
posted by MonkeySaltedNuts at 7:00 PM on January 16, 2007

Greedo: IANAD, but I have never heard of food (or anything else) "triggering" ADD... it isn't a reaction to something. It's a neurological disorder.

As for your son being disconnected to the rest of the world, I second MonkeySaltedNuts' recommendation of Aspergers. I've heard of a few cases of the two being mixed up before. However, looking back on my own childhood, I was a bit of an odd one, and had friends who were a year or two older than me, but not many my own age. I wasn't ever too popular in school, but I'm not sure if I can attribute any of this to ADD or not. Just throwing it out there, FWIW. If I had a six year old son who said he "hated the world" I would definitely take a therapist of something of that nature into consideration.

I'm happy to see many answers contain things I didn't think of, and I can see you're getting a lot of good answers.
posted by CitrusFreak12 at 7:14 PM on January 16, 2007

My cousin was diagnosed with ADD, after doctors ruled out every other possibility. He has been medicated, and it seems to work for him, but other things that have showed promise are his low GI diet and a fish oil/multivitamin regime.
posted by cholly at 7:14 PM on January 16, 2007

Here's what we're doing four our son:
special ed preschool
soccer class
The Dinosaur School

Here's what we're doing for us.
posted by The corpse in the library at 7:27 PM on January 16, 2007

IANAD, but I have never heard of food (or anything else) "triggering" ADD... it isn't a reaction to something. It's a neurological disorder.

I've actually read a fair amount about food contributing to ADD, either due to allergies or more sugar/additives than the kid's system can handle. A number of alternative schools (that is, schools whose students were kicked out of other schools) have begun changing the lunchroom diets to organic, non-processed food and found that almost all behavioral problems ceased.

Food is very directly tied into brain function. It may not "cause" ADD or other problems, but it's certainly strongly linked to behavior and brain functioning.
posted by occhiblu at 7:33 PM on January 16, 2007

(I didn't mean to contradict greedo in my last statement; I'm sure he knows more about his kid's case than I do. I just meant that while *I* had no studies or statistics on whether food allergies can cause ADD, I certainly do believe they're tied together for at least some people.)
posted by occhiblu at 7:35 PM on January 16, 2007

I teach early childhood special ed, and have taught many kiddos with ADD. Someone above mentioned a 504 plan - a great resource for your son (his teacher/principle can give you more information). I know families who have altered diet and notcied huge improvments in their children - gluten and casin free diets are espeically "popular" now. And an appropriate outlet for his energy (a sports team, tumbling, etc.) would be a great way for your son to meet friends, develop confidence and blow off some steam.
posted by enaira at 7:44 PM on January 16, 2007

Have you considered a montessori elementary school?
posted by rbs at 7:46 PM on January 16, 2007

There was a long article about this recently in the New York Times. It talks about a few programs that train parents in using cognitive behavioral therapy techniques with their kids. If you don't live near any of these programs, they might be able to give you some information or recommendations if you get in touch with them.
posted by lullabyofbirdland at 8:16 PM on January 16, 2007

#CitrusFreak12: I have never heard of food (or anything else) "triggering" ADD

I guess you have missed out on the claims trumpeted against such as white sugar or high fructose corn syrup. A current cliche is that giving children a high sugar breakfast will make them so Hyeractive that they start bouncing off walls. (i.e. the H in ADHD is caused by sugar consumption, not by some innate problem.)

Yes, sugaring up kids is a bad idea, but blaming ADD/ADHD on diet is a worse idea.
posted by MonkeySaltedNuts at 8:18 PM on January 16, 2007

It's not simply sugar; there are other diet issues associated with worsening or ameliorating ADD.

But again, I think we can let greedo be the authority on his own child here, please?
posted by occhiblu at 8:30 PM on January 16, 2007

occhiblu: That's very interesting! I'll be looking into that...

MSN: Oy. I hate when they do that. Sugar 'causes' it, too much television 'causes' it, bad parenting 'causes' it... ::grumbles:: But upon reading occhiblu's comments, and doing a little research, this just might have some credibility.

RBS: There is a montessori elementary school right next to where I work! The kids often use the church basement (where I work) for certain activities, and they seem to get more than enough time to 'blow off steam' on the playground outside. I would definitely recommend that, if only because it seems like a place I would have liked to have gone when I was a(n undiagnosed ADD crazy) kid.
posted by CitrusFreak12 at 8:32 PM on January 16, 2007

(Sorry, last link didn't work. Just search for "ADD diet" on PubMed.)
posted by occhiblu at 8:53 PM on January 16, 2007

There's some great advice here. Although I don't have any nuts and bolts advice, I do have a few suggestions that come directly from a childhood of diagnoses and medication.

1. If you do take the medicine route (and I applaud you for not rushing there), try with all your might to make it a route to somewhere beyond the medicine. In other words, try to get him off the medicine as quickly and safely as possible. In the long run, you'll be glad you did.

2. It's good that you hate the label. He is only 6 and may very well be on his path somewhere and going through a rocky stage where he is distracted, hyperactive, etc. It is very possible that he will grow out of the label into something bigger than it, (e.g., use his hyperactivity to become a spectacular artist), or learn to manage his symptoms in such a way that the label no longer fits. Just like the medicine, abandon the label as quickly and safely as possible. Let Timmy be Timmy, not Timmy with ADHD. In the long run, you'll be glad you did.

3. I very strongly suggest you experiment with many different types of diets. You may not be able to eliminate the "symptoms," but you with effort, I am sure you can find a diet that mollifies them instead of exacerbating them. And he is still young enough that you can shape his behaviors.

Most psychiatrists are loathe to admit it, but diet really can make all the difference in the world. For example, I had tons of psychiatrists go at me as a child. Turns out, I had a very, very bad case of hypoglycemia, which didn't cause my symptoms, but certainly prevented them from being easily manageable. I don't remember one psychiatrist ever suggesting diet could have contributed to my problems.

Good luck. You sound like a wonderful parent.
posted by milarepa at 9:00 PM on January 16, 2007

with regard to diet - I do know that there are certain foods that trigger a reaction in my son's behavioir. When he was a toddler and we changed his diet, his behaviour immediately improved.

That being said, I am new to this subject and still learning about the nature of ADD and ADHD. I am fairly certain that the best diet in the world won't solve some of the challenges.

@lullabyofbirdland - That NYT article struck a chord.
posted by greedo at 9:03 PM on January 16, 2007

I have ADD, diagnosed at age twenty, treated with Adderall with much sucess and happiness, but also with behavioral modifications. I found most of these behavioral modifications in the book, "Driven To Distraction", which IMHO is the best and most thorough book on the subject.
Consider a "coach" as well. There are many options to cope with ADD, and medication is just one of them. I applaud your efforts to actually participate in the treatment of your child, because parental understanding and family coping is one of the most important aspects of sucessful treatment.
posted by nursegracer at 9:12 PM on January 16, 2007

*are some of the most important....stupid ADD.
posted by nursegracer at 9:13 PM on January 16, 2007

I don't think a kid who may already have brain issues ought to be playing a sport where sharp blows to the head are a primary means of scoring points, therefore I would avoid soccer for your son.

I don't have any definitive study to link to, but there are lots of people who claim that food sensitivities and allergies are associated with myopia, and undiagnosed myopia is the royal road to early failure in school, so watch out (sorry!) for that. If he is nearsighted, I think it's important not to undercorrect (as has been popular in an attempt to retard progression) and to test his vision frequently.
posted by jamjam at 10:06 PM on January 16, 2007

#occhiblu: It's not simply sugar; there are other diet issues associated with worsening or ameliorating ADD.

I might respect you opintion more if you had given a link that had any content.
posted by MonkeySaltedNuts at 10:08 PM on January 16, 2007

You did see the apology and follow-up? Or did you want to dwell on my mistake for some practical purpose?
posted by occhiblu at 10:39 PM on January 16, 2007

I was diagnosed with ADD as an adult, and I love, love, love my drugs. That said, I deeply respect your decision to look into non-pharma options for your little one. Not having my condition diagnosed in childhood probably caused some academic and social issues that could otherwise have been avoided, but it also meant that I developed a myriad of useful habits and strategies that continue to serve me well. Here are some of them:

(1) Emphasize organization, but emphasize SIMPLICITY in organization. Any system that involves a hierarchy of lists, or an intricate array of folders, is doomed to failure. Your kid most likely won't be able to stick to it, which will make him feel guilty, thus increasing his anxiety, and intensifying other symptoms.

For instance: Putting a basket in his room for "School papers" is a good idea. Giving him a binder with different folders for different subjects, wherein he has to separate stuff that's been graded from stuff that's due, might not work so well. This piece is kind of counter-intuitive, but trust me. For more info, check out this excellent book.

(2) Sleep is key: If I'm seriously sleep deprived, my Focalin capsules might as well by Flintstones vitamins.

(3) Schedules are key: By this, I don't mean crammed, planned-out-to-the-minute days that he'd need a Blackberry to keep track of. I just mean: "Breakfast is at X time, lunch is at Y, you do your homework at Z, bed time's at Q." If you have ADD and you let the framework for your days fall apart, everything else falls apart with it.

(4) Manage hyperfocus: With ADD, it's very possible to lose yourself, to a pathological degree, in things like computer games, the internet, puzzles, etc. If you see that becoming a problem, get him a timer or a stop-watch. Having a little bell go off to bring him back to reality will help keep him from losing days and days in first-person shooters.

(5) Don't let him beat himself up if he goofs: A kid with ADD is going to forget things, and lose things, and miss things, especially without los drogas. Obviously, you don't want to let that slide. But when you do call him on it, make sure you don't foster development of an -identity- as a kid who loses things, misses stuff, and forgets. Once established, that kind of self-image is totally counterproductive and hell to shake.

(6) Regular exercise is key. Daily cardio and sleeping well, combined, are almost as effective at managing my ADD as Focalin alone. As he gets older, make sure he continues to be active.

(7) Remember that his condition is also a strength. When it's adaptive, ADHD can produce curiousity, creativity, and a profound capacity to work. Don't lose sight of the good things!
posted by palmcorder_yajna at 11:51 PM on January 16, 2007 [3 favorites]

These are good tips for your whole family to reduce stress and increase health:

1. Low GI carbs
2. Vitamins
3. 9 hours of sleep a night

The most important thing you can teach your inattentive young person is self discipline. The best way to teach it: practice practice practice. Help him accomplish tasks that take focus by rewarding those tasks disproportionately.

Computer games that require planning and strategy are very useful, as opposed to racing games and shoot-em-up.

Play chess with him.
posted by ewkpates at 3:09 AM on January 17, 2007

I haven't read the entire list of responses (just caught this before heading off to bed) - so excuse this if it's been previously discussed, BUT ...

Omega 3 fatty acids (Fish Oil) is getting extremely good scientific backing for dealing with ADD (as an alternative to Ritalin).

Here is one reputable link on the matter - there are plenty more.

Good luck.
posted by strawberryviagra at 3:44 AM on January 17, 2007

Also, if you're not going to medicate him, make sure to keep away the caffeine as well, too.. because caffeine is a form of self medication for ADD...

I have a friend with an 8-year-old who has ADD, for which she refuses to give him medication, but she does give him an espresso in the morning which she swears calms him. This was recommended to her by her doctor.
posted by essexjan at 4:08 AM on January 17, 2007

Wow! I had no idea so many people knew so much about ADD without having it!
I have a 9 year old boy with Asperger's, ADD is a feature.
I recognise many things in your post, particularly heartbreaking for me is the fact that while (unusually) my son is extremely sociable he is rarely invited over to others to play.
Palmcorder hits the nail on the head. Sleep and routine are key. For the tasks he simply must get used to doing without distraction we use an electronic egg-timer. We can set whatever time we think is enough for whatever task and he loves it. It's a game for him to see if he can beat the clock. We have to show him that taking time is often as important ( brushing his teeth for the full 3 mins) as beating the clock but we don't discourage the joy he takes in carrying out any activity. He has a star chart and at the end of every 20 stars he can do something or have something ( of treats:- has to be worked out in advance, otherwise he's break the bank!) Luckily for us his treats are things like having a friend over, or one of us reading his favorite Encyclopeadia of Disgusting Things with him.

I tried the fish oils for a year and noticed no appreciable difference but, hey, they're healthy.

I find he does not do well with competitive sports, especially one-on-one as he wants the whole class to move at his pace and according to the drummer he hears, which ain't gonna happen! So even on his soccer team, he is the goalie, so we now read all we can about famous goalies, saves, exciting moments in a goalies life...

I have found that the reasons some kids don't invite him back is more to do with the way he communicates. When talking about his favorite obsession du jour (Sharks right now) he does not see the facial or other cues that they would like to move on to something else. So we role-play conversations and teach him what these facial and communicative cues are. I know there is also a computer programme for more autistic children who are "face-blind" but so far the role-play is going OK.
Also, he is invariably honest which is not always welcomed, so again we have to point out to him the difficult concept of not always saying what you think. Most obvious example, when asked "do you want to play X, Y, or X..." he could say "No that's stupid," or "that's for kids" thereby alienating the questioner as well as being plain rude. Over time he's started to get the idea that the correct response is "No, but would you like to play...."
We've also worked very hard to encourage the relationships that work for him, which tend to be with boys slightly younger. His best friend is 6 and my son loves to teach him new things.
Do concentrate on the positives, he's highly intelligent and I'm impressed with the kinds of facts he knows, so he gets to teach us something when we've finished a role-play. Also his honesty will one day be valued.
There are so many books and approaches out there. The one that helped us best was Blakemore-Brown's who calls these "Tapestry Kids".
Good luck
posted by Wilder at 4:59 AM on January 17, 2007

I think one of the most important things is being sympathetic and understanding.... accept that someone with ADD simply does not think the way another person might. Unfortunately the public school system is not very forgiving of this. That's probably not a big problem now but as your son gets older he will probably experience more and more frustration, as his teachers expect a linear thinking pattern and a level of focus that he may be incapable of applying.

My brother (10) has ADD and has been off medication until just recently. He is very smart, and actually skipped third grade. However, he is very forgetful and has a hard time remembering to do anything, so forgetting his notebook/homework/backpack etc is a nearly daily appearance. Some teachers are forgiving of this and can work with a student like this, and some really can't. Often he did his homework and then forgot it, which made him very frustrated and then he had panic attacks, which certainly didn't help him focus better.

So, probably one of the most important things to do is connect with your sons teacher early on every year and explain his challenges and what you're doing to help (e.g. helping him stay organized or remember stuff). But even more important is to be sympathetic... and understanding... and help your child realize that everyone has different cognitive approaches, that people are different and that's okay, and that whatever challenges he faces are really not such a big deal, that his talents and abilities are also unique and those are more important to his identity.
posted by crackingdes at 6:32 AM on January 17, 2007

Flylady is a home organizational guru but a lot of people on her site say their kids with ADHD have benefited greatly from her methods. She teaches you how to develop simple, fun routines that keep life running on autopilot.
posted by selfmedicating at 6:59 AM on January 17, 2007

You are going to drug him, trust me. In the meantime read all the books from your local bookstore on ADD without medication. Who knows, what they say may work for you. However, I would be careful with the highly restricted diet stuff. Try it if you want, but if it doesn't work let the poor kid go back to his normal diet pronto. You should also research sensory integration disorders. They can present symptoms similar to ADD but respond to non-drug treatments very well. In the end if none of the non-drug treatments work for your son, please do not deny him needed medication.
posted by caddis at 7:25 AM on January 17, 2007

Check out Thom Hartmann's work (not that I'd suggest taking his hunter/farmer thing literally.) Here are some education alternatives; some are explicitly designed for ADD students, some aren't.

I'm another ADDer who opted as an adult for medication who applauds your decision to not seize it as the first approach for your child. I'd suggest, though, that in the years to come, you speak of medication in a way that leaves your son comfortable with the idea of choosing to try it if other things still aren't working. (On rereading the thread, what empath said.)
posted by Zed_Lopez at 7:44 AM on January 17, 2007

palmcorder_yajna's post is inspirational, and speaks the truth. Ditto with adipocere's post. Read these two posts again, these are very important for you to fully comprehend, and for two reasons:

#1) ADD is a condition that may require drugs, like any other psychiatric disorder.

#2) You now have a child with ADD, whom you have to live with. That's a powerful motivator, to be sure. But even more powerful: He will be an ADULT with ADD sooner than you think, and the coping mechanisms and assistance you provide him will carry over into his adult life, and make or break him. Take it from me: I was never diagnosed as a kid, and I've had to struggle -- HARD -- to learn/integrate management and coping techniques into my daily life. It's a bitch.

Please ignore anybody that has a strong opinion about what kind of treatment you should look to, and talk to your doctor about that. Then, look at books on coping and managing skills for ADD (both for adults and for children, good habits start early). Consider drugs, and if that means bouncing through a dozen doctors to find the one that cares enough to carefully measure a dosage based on its ability to manage his condition, SO BE IT.

Finally: While lots of people are jumping up and saying "labels suck", I've got a reality check for you: They're required in school if you want the support that your child is going to need. Like profanities and racial slurs, labels themselves shouldn't be a concern, just the assholes using them. If you're not an asshole, it's not a label, it's just a word that could actually make a difference in your kid's life.
posted by Merdryn at 8:01 AM on January 17, 2007

I agree with palmcorder, from my anecodtal experience growing up with my younger brother. My mother went through a lot of different experimenting with diet/behavioral management, and she came up with a few things:

1. My brother definitely, positively is made more hyper, agitated, and unfocused when he has dairy products. Removing them from his diet made him instantly more agreeable and calm.

1a. A warning about school: it was often very hard for my mother to convince teachers that this was true. She packed my brother's regular lunch and he didn't drink milk, but at class events/parties the teachers invariably would give my brother ice cream (and what kid is going to turn down ice cream?). Without fail, my mother would get a phone call to the effect of, "Your son is being a terror."

2. Structure, structure, strucutre is key. My brother had a list on his bedroom door of the things he needed to do before school. It was simple - eat breakfast, brush teeth, check backpack - but it was amazing how much easier it was to get him ready when all my mother had to do ask was "Did you finish your list?" Same thing goes for setting timers - knowing that he could play outside (or on the computer, or watch tv) until the "bing" made sure he didn't lose track of time.

2a. The major benefit of the structure, really, was the amount of independence it let him have. Only having one thing to remember - checking the list or setting the timer - meant that he could do it by himself and didn't have to depend on anyone else to monitor him. It also meant he didn't have to endure nagging, or being punished for forgetting.

Especially as he got older, learning these coping skills helped him function without medicine. He's in college now, and he still sets an alarm sometimes and uses checklists. I don't mean to talk down medication if it's really needed, but in a lot of cases learning new skills - instead of modifying the body to be able to use the old, "normal" ones - is more effective in the long run. I have some peers who have been taking medicine for ADD since they were kids (we're now in our early twenties), and it's a bit sad that they never got a chance to learn how to function without it.
posted by CtrlAltDelete at 8:38 AM on January 17, 2007

Nobody's mentioned the Feingold diet that I can tell; you should look into it.
I have a friend who is keeping her little boy on this diet, which avoids all artificial ingredients, among other things, and it has really improved his ability to control his behavior, from what I hear.
posted by Sprout the Vulgarian at 9:45 AM on January 17, 2007

CtlAltDelete's post brings up a point that I recently read (the article was actually in defense of drugs, but I think it works both ways): Drugs change your brain structures. Learning changes your brain structures. If you can find effective ways to teach a child, then you're not really "depriving" him of the actions that a similar drug would cause, you're just creating the desired change in his neural pathways in a different way.

So it would seem to me, as CtlAltDelete and others have pointed out, that if you're not using medication, then the important thing is that your son learns how to manage his condition; that is, not just that you have a checklist of things he needs to do, but that he starts to understand (in an age-appropriate way, of course) why those things are important, and to take over as many of those tasks as he can when he's able to do so, so that his brain learns to function in the ways that work for him. (And given how bright you say he is, I would imagine that could be a really fun, interesting process overall.)
posted by occhiblu at 10:39 AM on January 17, 2007

I've seen some horrible (long-term) side effects from stimulant anti-ADHD medications. This was in friends of mine from elementary and high school. Congratulations on your decision.
posted by rxrfrx at 11:27 AM on January 17, 2007

FFS, stop congratulating someone for taking a valid treatment option off the table, people.
posted by Merdryn at 10:00 AM on January 18, 2007

I was diagnosed with ADHD three years ago and have been on medication since then. A marked improvement began when I started them, and it's not the horrible thing that most people seem to assume. In fact, giving a child espresso every morning would worry me far, far more than a regulated, pharmaceutical drug each day.

As several others have pointed out, ADHD medication changes the way your brain's neurons interact with each, and the neural pathways they travel. When a child has ADHD, these pathways don't function at what is considered a "normal" level, therefore leading to dividing attention and loss of impulse control. The medication prescribed only improves the way the neurons interact with each other and the neural pathways function more efficiently.

While I agree that one should not necessarily jump into drugs as a form of coping, I do NOT think they should be nixed as an option from the start. Especially at such a young age, "teaching" a child how to cope with what they'll most likely see as a disability (as it is labeled as such by various institutions, a real downer to kids,) is going to be incredibly difficult to do, and may not help at all.

The best thing to do if you want to keep them off of drugs for now is reinforce stable relationships with them, keep things as routine as possible at home with something special to do every couple weeks to keep them from feeling bored. Sports (or any hobby,) is a great suggestion. I took up drawing and programming shortly after my diagnosis. I'm now looking into a career as a graphic/web designer.

Also, art is a fantastic form of expression for all children, though I'm convinced that those with AD(H)D are the ones who excel at abstraction and Andy Warhol-like work. Introduce them to it, take them to a museum and take note of what enthralls them.

Good luck, the fact that you're seeking knowledge about your child's condition is heartening! Too many people think they know everything!
posted by InsanePenguin at 10:53 AM on January 18, 2007

FFS, stop congratulating someone for taking a valid treatment option off the table, people.

Oh, sorry, I didn't realize it was a valid option until you said so.
posted by rxrfrx at 11:39 AM on January 18, 2007

rxrfrx: It is a valid option. I'm not sure what "horrible longterm side effects" your friends (who I assume had ADD) incurred from taking the medication, perhaps you could explain a little?
Such a thing is certainly not the norm.
posted by CitrusFreak12 at 12:12 PM on January 18, 2007

As an adult with ADHD, I highly recommend the book ADD - A Different Perception by Thom Hartmann. It reframes ADHD as being merely a different way of thinking as opposed to a disease or disorder.

Basically the author's main thesis is that those of us with ADHD have a "Hunter" mentality (always on the lookout, ready to strike at any moment) - living in a "Farmer" world (one that values behaving conservatively and planning ahead, classroom succes, assembly-line culture, etc.). It also includes suggestions for making your ADHD traits work for you - such as pursuing activities where Hunter characteristics work for you and where creativity and entrepreneurial thinking are valued.

For what it's worth, I have been both on and off stimulant medication in my life, and I will be straightforward with you - I would not have been able to graduate from college without the aid of stimulant medication. As hard as it was, I had to make some concessions to this Farmer world.
posted by peppermint22 at 8:43 PM on January 18, 2007