I'm extremely wary of an ADHD diagnosis. Partly because having worked in the school system, I have seen how with certain teachers, that serves as a "red flag" that this will be a problem child. Also, because while I do believe there are plenty of people who genuinely have ADHD, it is seriously overdiagnosed - for any kid who has never learned to sit still, or even kids who are acting age-appropriately. So I'm hesitant to have any testing done on DS9. However, here is the problem. He gets distracted by the tiniest things. He absolutely can not do his homework if the kitchen table is cluttered (and since I'm not much of a housekeeper, that's pretty frequent). If you get him the right book, he can sit and read for hours. But if he is told to read a passage or a book, he loses interest and by the time he's done, can't even tell you what it was about. He recently did AIG testing, and his scores were surprisingly low. (This is not just "proud mommy" talking, his teacher and the AIG teacher both said they didn't think his scores were accurate. However, after the testing, he rattled off about twenty different flags that were on the wall of the room where he was tested. That makes me think he was staring at the flags instead of focusing on his work. His grades are good (mostly A's with a B here and there) but his teacher and I agree that he could be doing better. He doesn't get into a lot of trouble at school, but he squirms a lot. (Even in preschool, his teacher said he used to pace around the room while he was reading).
So I'm thinking it COULD be ADHD, but it could also be just normal boredom. Or just acting like a 9 year old. And if I do decide to have him tested, how do I go about doing it? Is that something the school will do? His doctor? Would it be better to go to someone OUTSIDE of school, so I can decide whether or not it's something that should go on his record at school? (I'm also worried about treatment, if he does have ADHD. I don't want to automatically shove drugs down his throat without exploring all options, and I have seen so many teachers who strongly urge parents to do just that, just to make their jobs easier.)
Everyone agrees that he is a smart kid - but if he is getting good grades, even if I think they could be better, should I just leave well enough alone? If not, how do I approach it?

seaturtle, I went back and re-read your previous post about your ds. What you've described above - distraction with clutter in the field of vision, inability to retain what he's read, distraction in the classroom - sure, those could all be symptoms of ADHD, but they can also be behaviors caused by difficulty with vision - and your previous post mentioned your ds had been evaluated by a behavioral optometrist who found he had visual processing issues. I understand from what you wrote in the previous post that you may have been skeptical of the optometrist's assessment, but as a parent of a child who's had the very same type of behaviors and issues and who used to have people suggesting all the time that she had to have ADHD based on her behaviors... my dd didn't have ADHD, she had vision challenges. I was a total skeptic that things like tracking/convergence/etc could be causing major issues, but they were! I was very doubtful at first, but we took a chance on vision therapy and it made a huge difference in my dd's life. Her reading ability skyrocketed, she started actually *loving* to read, and most of the distracted behaviors that looked like ADHD went away.

Sooo... just my two cents, but rather than worrying about ADHD at this point - when your ds is doing well in school and it doesn't sound like other people are concerned about it (teachers etc), I'd think through the vision info you have first and reconsider what the optometrist recommended.

Also, just wanted to throw this out there - my dd had really REALLY bad vision issues (including double vision)... and at 8 years old, none of us realized it, including my dd - she thought everyone saw the world the way that she did! She also had 20/20 eyesight in each eye at the time, so her regular eye dr didn't find any issues with her eyes. The key was her eyes, although they were individually seeing 20/20, weren't focusing together.

Best wishes,

polarbear

ADHD is rarely just about attention... it typically manifests in nearly ever facet of life. Here's a list of a few things my ADHD hubby & son have problems with, that I would consider very ADHD...

- Forget why they entered a room, opened the fridge/pantry, etc. They will suddenly stop, look confused, and just stand there trying to remember wtf they were doing.

- Trouble with multi-step directions. DS, in particular, can't handle more than 2 steps at a time or he gets lost/distracted before he can finish.

- Routinely misplaces things... shoes, belts, lunch boxes, glasses, cups, etc, etc, etc. This is nearly daily.

- In ability to consider consequences/impulsive-ness. (This is mostly just an issue w/DS.) He had trouble taking consequences into account when making decisions. Immediately afterwards he will realize what he's done, and regret it, but no amount of after-the-fact punishment/consequences can prevent him from making impulsive decisions on the regular.

Both my DS and DH CAN maintain attention on tasks they enjoy. No amount of distraction can pull DS away from a good book, or DH away from a favorite video game. Hyperfocus all the way.

I wouldn't "leave well enough alone." A smart kid with ADHD may develop the sense that he's not good at things, when he really is very talented but truly can't muster the executive functioning to get things done. The self-esteem issues are real. Lots of late-teens and young adults with ADHD will self-medicate with alcohol or drugs if they get frustrated enough, which all of a sudden makes Ritalin look like not such a bad deal if prescribed responsibly.

I'd not trust school to evaluate for ADHD, nor would I ever let the regular pediatrician medicate my kid for this kind of thing. A neuropsychologist can do the right kind of testing; ours worked in tandem with a developmental pediatrician, which was a good combo for us (let us look at physical and behavioral factors). We have a developmental ped. we trust who prescribes meds for us; she has seen a lot of kids, and she knows we are conservative in our outlook about meds, and she tries hard to balance all our concerns.

Nobody I know of has medicated their kid because it's fun, or to make a teacher happier. Usually it's because the kid is really suffering serious self-esteem issues because he can't manage his own behavior and attention, and the medication is a last resort of sorts. As I understand it, the best practice for an elementary-age kid is to use medication and then, because the kid is now focused enough to learn well, you can teach the missing skills.

DeeDee

This list makes me think I should be tested for ADHD.

I was excellent at the pick things up and move them somewhere else game.

Generally, I only had some vague sense that I had touched said object at some point previously.

The problem arose when whatever I was randomly moving didn't belong to me.

Ah, childhood memories.

Seaturtle he sounds just like my DS8 (dx w/ADHD combined type).

I'm not sure if an ADHD diagnosis is really helping us. It would be different if I wanted to try medication, but I'm holding off on this for DS. I'm not against medicating, but I don't think it's the answer right now. (Anyway, that's a whole other thread).

As for the testing, we used a private psychologist. It's fairly pricey ($2,000) but luckily my husband had some coverage (we ended up paying about $600 out of pocket). This gave us the opportunity to withhold it from the school if we chose to do so.

We ended up submitting it, because he was also diagnosed with a language processing disorder, and that diagnosis gets him time in the school with a SLP.

Overall, I'm not happy... mostly with the lack of variety in the funded treatment options available to the diagnosis (there's just medication, medication, medication).

Here's the thing that makes me crazy... there really are other ADHD treatment options out there, but they're not covered under our medical system (I'm in BC, Canada). For instance, friends of ours decided not to medicate their daughter and opted for cognitive training instead (ie interactive metronome, etc). It cost them about $8,000, but IT WORKED. She's like a different kid. Why isn't that covered by medical?

Anyway, you don't need a diagnosis to pay out of pocket for cognitive training. The only thing (that I'm aware of) that an ADHD diagnosis can help with is access to medication if you decide to try that route.

Medication is the only covered treatment for ADHD because it's the only legitimate treatment for it, as far as science is concerned. There have been some promising treatments, but there are no peer-reviewed studies showing any of these cognitive training/neurofeedback-type treatments cure or have long-term effects on ADHD.

Having said that, ADHD is almost exclusively diagnosed via matching symptoms to a list (subjective, easily effected by bias), as opposed to brain scans (obviously expensive and rather involved.) This probably results in a lot of kids getting diagnosed that do, in fact have some sort of developmental delay in regards to executive functioning, but NOT full-blown ADHD. ADHD actually shows up quite clearly on brain scans... and I'm not sure I believe things like cognitive training or neurofeed back can alter the brain the way they claim in a few short weeks/months.

Pet theory... If you start from the overexcitabilities concept, your brain gets oversaturated with information so you need very selective control to not be overwhelmed. Once you have that control, you may have the ability to focus or not focus as you decide.

BUT, that isn't the "normal" state, focus would normally be much more automatic. Once focus is under executive function control, you may not be wired for ADHD but to all intents and purposes you act as if you are, but you can also pull away a ton of resources from other regular mental activities (e.g. reinforcing todo lists or people's names, awareness of space, reading other people's non-verbal communication, acquiring physical skills through observation, spacial awarenesss, encoding automaticity, etc.) to amp up your smarts even further.

Under this framework you can easily achieve five blind men describing an elephant in diagnoses. Visual processing disorder, check. Dysgraphia, check. ADD, check. Pragmatic language disorder, check. Maybe that's why I read of some pediatricians using drugs to diagnose, because the answer is quicker that way.

If it is a valid framework, then cogntive type behavior training on redeveloping automaticity and attention splitting may be a great generalized first step.

My apologies for the fly-by here, but fwiw, my insurance was willing to pay for 6 months of neurofeedback as a treatment for ADHD.

polarbear

That's fantastic My friend wasn't so lucky, unfortunately.

If this is true (and I'm assuming you're right) why is this the case? If medications have been around for 40+ years, surely this has been enough time for science based studies of non-medication alternatives?


I was told by our school district psychologist to medicate DS8 diagnostically. (You're right, it's probably much faster.) He said worst case scenario it would take about 6 months (assuming the first or second medication didn't work - by 6 months he meant that's about as long as you'd continue to try changing meds/doses that weren't working before you'd assume that it actually isn't ADHD).

Wow. A lot to think about here. Polarbear, it might be a vision issue, but I seriously doubt it. (If it turns out NOT to be ADHD, I will look into that, though). He had a muscle issue with his eye which made it hard for him to focus both eyes on one spot, and we had the option of either doing surgery (covered by insurance) or eye therapy (not covered by insurance). We ended up dropping over $4000 out of pocket for the therapy, and it worked really well. The suggestion of visual processing problems was made by the optometrist during a routine eye exam, not due to actual testing.
I'm thinking I may check with my insurance company to see if testing is at least partly covered. My husband is military, and in the 11 years we have been married, the eye therapy has been the only thing any of us have needed that is not covered, so I can go from there to see how to approach it. I agree that I don't think I want the school to do it - I have issues with the fact that school employees are overworked and underpaid, as well as the fact that the school gets extra money for every kid that is labeled as having a learning disability.
Diagnosing ADHD by using drugs? Are you kidding me? As I said, I'm not opposed to medication IF it is really needed, but really - how is that even legal?

Epoh - Your list sounds JUST like my son! Just this morning, before school, I told him to go brush his teeth and hair, and get his shoes and socks on. He got the teeth, remembered the hair only because he caught a glimpse of himself in the mirror, then sat on the couch with a book. When I asked him why he wasn't wearing shoes and socks, he said, "Oh, is it time? You never told me!" Or last night when he was working on his homework. The directions were to draw TWO figures with a specific perimeter, then compare the areas of each. He drew one, found the area, then moved on to the next problem. ARGH!

Has anyone tried changing the child's diet? I've heard that a high protein, low sugar diet helps, both for kids with and without ADHD. But I have found basically no actual research on the subject. Just parents who swear by it. I was thinking of trying dietary changes before I actually took him to a doctor.

There have been some good studies in the UK regarding diet & behavior. It was not specific to ADHD, but a diet with lots of fresh veg, high in protein and low in sugar produces better behavior and better concentration (=test scores) in children. That all happened, iirc, around the time Jamie Oliver was working on changing the UK school lunch system. I'm still wading through my morning work emails, but if I get a chance later I'll dig them up.

One thing that's also been recommended, but there aren't really any studies for is large Omega-3 supplements (like 2 or 3x what's normally recommended). Again, there's really not much down-side, so we do this as well. I can't say I see much difference with the fish oil, but I'm sure it's not hurting anything either, and everything I've read says fish oil is good for you.

We did a lot of diet changes with DS when he was younger... from about age 3-7 red dye would turn him into a crazed monster. It was pretty insane. It doesn't appear to effect him much anymore (thank god), but you might try eliminating food dyes and then slowly adding them back after 2 weeks and see if there are any reactions (red and yellow seem to be the more common triggers.)


I also wanted to add, I do not have anything against alternative treatments for ADHD! Neurofeedback seems very promising, and I've heard of some people seeing results from the CogMed stuff. My only concern is people spending thousands and thousands of dollars on something, without understanding the true efficacy of it.

We were struggling with what to do with suspected ADHD in our 6 yr old last fall. After researching and talking with some behavioral health professionals I respected, we decided on a course of action.

I am very uncomfortable with the subjective nature of using checklists solely to diagnose a child with ADHD. Too much risk for me. Instead we opted to do SPECT Brain Scans through the Amen Clinics. Dr. Amen is very cutting edge in what I believe will eventually become mainstream approaches for diagnosing and treating Neuropsych issues. He likes to ask why Psychiatrists are the only doctors who never look at the organ they treat.

My son had 2 brain scans and a full evaluation with one of the Amen clinics. The Neuopsychiatrist who handled his case showed me pictures of his brain where I could SEE his ADHD pattern, his anxiety and PTSD, and even a processing issue all showing up in his brain. Seeking a definitive diagnosis was important to me because the outcomes are quite serious for those with untreated ADD yet I didn't want my HG child labeled inappropriately if other things were really at work with the issues he was having.

In the clinics' extensive practice, they have found that many of their patients have vitamin deficiencies in nutrients that impact healthy brain function. My son was clinically deficient in Vitamin D (this is very common)and on the bottom end with his Iron which was far below the theraputic levels the clinic looks for. Also tested were Zinc and Copper. Those 4 are very significant for ADD as well as other brain issues since they impact things like the production, release, and distribution of insulin as well as being the building blocks for some critical neuro transmitters.

Our treatment has begun with correcting these deficiencies which has already had a promising effect on behavior without any prescriptions thusfar. We are following up with blood tests to get his levels up where they need to be.

A surprising effect of our foray into ADD has been that we have discoved several adult family members who had never been diagnosed but had many impacts in their lives including struggles with addictions from self medicating their ADD symptoms. ADD is one of the most heritible of psychological disorders with a 60% chance of having a child with it if one parent has ADD and a 90% chance if both do. It's been a truly fascinating journey.

As you are deciding what to do with your child, a great book to read would be Dr. Daniel Amen's 6 Types of ADD. These types are the result of thousands of brain scans with these recurring patterns. The critical point of the 6 types is that they respond best to different treatment approaches. My son's type in particular reacts very poorly to the standard ADD meds tending to become worse rather than better. I have a lot of confidence in the balanced approach Amen recommends with diet, excercise, vitamins, and prescriptions when needed.

The downside to this is expense. The scans are expensive and few clinics know about this approach. When we researched cost we found a local place that did the SPECT scans but found the cost to be almost equal to that at one of the 5 Amen Clinics. We choose to travel several states away to the "pioneers" of this approach given the similar cost.

I hope you find your answers. There is some peace for us with understanding and we are more patient and thoughtful with our parenting as a result.

Oh, dear! Vitamin deficiencies! He is kind of a picky eater, and I have never forced him to eat anything. While he has gotten better, it would not be entirely surprising if he had a vitamin deficiency.

I know... I agree. If only it wasn't so expensive. In my friend's case it wasn't a big lump sump payment, it was successive small payments (like visits to the chiropractor, for instance), and I guess they saw that it was working so they continued.


One of the first things our pediatrician recommended was a Vit. D supplement for DS (400 IU). I bought the drops and add one to his protein shake every day.

I've heard (from other ADHD parents) that caffeine works as well. When I asked my family doctor she had never heard of it for treating ADHD, but said that carefully done in small doses would be safe enough. I'm not sure how to get DS to drink tea or coffee without the sugar though. That's the problem... there's caffeine everywhere that they'll eat/drink (chocolate bars, pop, etc) but it's full of other garbage. Getting caffeine isn't the problem - isolating it from the other crap is. lol.

Funny you mention zinc - today I just bought up lemon zinc lozenges. Hopefully those will help too.

To get to therapeutic levels of Vitamin D the clinic recommendation is 4000 IUI D3 daily whenever you cannot get full summer sun. Our family doc initially prescribed 2000 IUI.

If anyone has concerns about vitamin deficiencies your doc can run the blood tests to check but remember the lab's norms aren't going to be the same as the therapeutic levels. Generally the majority of docs haven't kept up with the recent research on non-pharma treatments and the recommended levels haven't been updated in eons. I'd be glad to share the target levels we were given if anyone wants them. It made a lot of sense to me that not getting enough vitamins could negatively affect brain function and we have our share of food issues. In addition a number of things can limit the absorption even if someone is eating a stellar diet.

I've been surprised how much affect we have seen from *just* vitamins. I wouldn't have believed it could help so much.

My response to this is very long, my time is very short... Let's see how I go.

There is mounting evidence that careful elimination diet absolutely helps with the symptoms of ADHD - look for an article published in the Lancet last year. My own children are on elimination diets, my child with aspergers has the most dramatic response to diet (and is the most restricted), she was previously diagnosed with ADD and medication trial did not work convincingly so it was quickly stopped. Diet alone continues to be a critical part of her life. My middle child responds to diet enough that we keep doing it, she responds less than my eldest and got many more foods back during the challenge phase, so she is much less restricted (just numbers, dairy and gluten). She has combined type ADHD and for her medication is dramatically effective, far more so than diet. So to recap I have one child for whom diet is crucial and medication did not help her attention issues (and has since been diagnosed with Aspergers). And one child for whom diet helps but medication is dramatically more effective.

My personal feeling is that for children with neurological differences like ADHD/ASD they have very very sensitive systems and are more reactive than other people to diet, chemicals in the environment, heck even the weather. So controlling those things as much as possible can help enormously (we use no cleaning chemicals, carefully selected washing powders, shampoo, etc). But for many children who truly have ADHD diet alone will not be enough.

My DD is pretty well behaved, her teachers were not complaining to us about how disruptive she was. We have always taken the most natural approach to everything that we possibly could, so medication was hard for us to come at. But after a lot of reading and research I ended up concluding that a trial was worthwhile and the results that we see in our middle child are simply indisputable. She's a little girl who deserves to be able to hear when she is spoken to, say "Yes, I'll do that!", actually do it and enjoy the success of regularly being able to do what is expected of her, her handwriting is radically improved on medication, her piano playing, her reading, her ability to look you in the eye and talk back to you... It's really quite astonishing. For us we also feared where we could see things going with her oppositional behaviours and wanted to simply not go there. And I think that a lot of that behaviour is rooted in it being too hard to even process the instructions off medication - so she will pretend she doesn't WANT to listen/comply in order to save face because she doesn't want to show that she actually CAN'T listen/comply.

Final thought - My child for whom diet makes the biggest difference was an extreme picky eater. She refused solids until 2.5yrs+ and it took us until 8-9yrs old to get her eating a reasonable range of foods (slowly, gently and respectfully working on it all the time). She lost almost ALL the "healthy" foods she had never wanted to eat in the first place and is healthier for it.

My 9 year old has ADD, and after having her tested I realized I have it too. I only wish my own parents had thought beyond the stereotype of ADD/ADHD being a hyper kid that can't sit still, my life may have been very different. We both take meds now and it's like another world. My house has never been cleaner for a start!

She displayed all of the symptoms back when we lived in Europe and she had never eaten an artificial color or flavor in her life (they are few and far between now but much harder to avoid). We tried elimination diets, she takes a multivitamin and omega 3, we tried martial arts, nothing worked like this. I was super wary of her being misdiagnosed, and terrified of medicating her, but the difference was noticeable almost right away. She is on the lowest dose of med, and we plan on trying to get her off them as soon as she feels she can handle it. But I'm glad we did it.

As for why there aren't studies on the efficacy of non-drug treatments, it's because drug companies pay for studies. There's no benefit to them funding any of those studies, so they don't get done. Sad but true.

And: stimulant meds have been around for ages (since the 50s, maybe?) so there are longitudinal studies. All the computer-based treatments are quite new, most still in development or recently released, so it's hard to get a longitudinal perspective on them.

And: I believe there ARE studies on medication vs. "talk therapy" type treatments. My understanding (note: I have not read the literature on this) is that the behavioral therapies really start working around middle school age and up, but not before.

DeeDee

Further to DeeDee's post I believe that best practice shows that "talk therapy" treatments, or any treatments really, work best when the child is on medication and able to actually pay attention to and make use of what you are teaching.

We note with our DD that the skills she was only able to learn while on medication are retained off medication - but are much more difficult for her to execute.

So, quick update: I have started trying to give him natural foods as much as possible, and at least low sugar, high protein foods when totally natural is not available. I also let him start running with me. (with severe allergies and moderate athsma, I'm certainly not Olympic material, but I try). Obviously, it's too early to tell if it's working. But it certainly seems that way. He did a diagnostic test today without getting up and wandering around, and only made one careless mistake out of 25 problems. I only had to ask him to do his homework once. I didn't have to ask him to do his chores at all. And this morning he brushed his teeth and hair, put his stuff in his backpack, and got his shoes and socks without me even having to ask! Obviously, it could just be that he is having an unusually good day. But so far, it's looking promising. Maybe he doesn't have ADHD, and is just fidgety. Or maybe he does, and this is working. Or maybe it's a coincidence. In any case, if this continues to work, I'm far more comfortable with this than I am with drugging him!
Thanks for the input!

Please if you are going to do a diet do a proper elimination diet with a dietician. Food chemicals are so much more complex than I ever understood previously and it's nearly impossible to get consistently right without a good guide. We use the RPA hospital's elimination diet handbook but there must surely be something available in the states. Sue Dengate's books are Australian too, but might be more easily available?

Have you considered neurofeedback? I ask because my DS7 was given a misdiagnosis of ADHD and the diagnosis has been ruled out by two neurofeedback providers. My DS has been doing neurofeedback on and off since Aug and we've seen big improvements.

Neurofeedback is being seen as a non-invasive, drug-free alternative method to treating ADHD or ADHD symptoms. It can give you a more definitive answer on whether ADHD is present or not based on actual brain wave activity. Either a child has high theta brain waves or they don't. High theta brain waves are characteristic of children with ADHD. So neurofeedback is less subjective.

Neurofeedback providers often work with dieticians or nutritionists for help. Some may even recommend a particular elimination diet. There is the Healing Young Brains: The Neurofeedback Solution (http://www.amazon.com/Healing-Young...012&sr=8-1&keywords=healing+young+brains) as well as ones by Dr. Amend and others.

DS has been on a gluten-free, dairy-free, sugar-free, processed-free, etc. diet since August. There's tons of recipes online to make things like black bean brownies or avocado chocolate pudding which are healthy alternatives for kids (and things that they might actually like to eat).

Mumofthree - I hardly think it is necessary to consult a dietician before giving my child a healthier diet with less sugar and more protein. This is simply closer to what is recommended anyway. However, before I do anything drastic, I can assure you that I will talk to a professional.
Cdfox - this has been suggested before, and is one if the options I am considering if the change in diet does not work. The plan is to see if it is something easily fixed, like too much sugar. If that works, there is no need to even get him tested. If not, we will see if the diagnosis is even there - then look at all the options and start with the least invasive. I didn't realize there were so many ways to diagnose, and so many different treatment options! Thanks to everyone!

Seaturtle - Yes, you could definitely try changing the diet before pursuing other treatments or interventions. I really hope that works for you (and others).

It's not easy changing a child's diet. We had to do it overnight. It was tough and seemed completely overwhelming, but we were committed and determined to do it. I'd say it took a good couple of months to get the hang of it and have enough alternative recipes/ingredients to fall back on.

DS's first neurofeedback gave us a list of foods to avoid/include. She advised us to bump up the good fats for healthy brain development such as avocado and extra virgin oil and to bump up the healthy proteins and vegetables. She said anything that converted to alcohol and that could negatively affect the brain was out. She said that we could slowly introduce something like oats after x number of months, but to initially eliminate it. This sounded logical to me, though I realize some may disagree and find this controversial.

It's not rocket science though and there's a lot more coming out on the topic (GMO-free, soy-free, corn-free, etc.) with various diets (Paleo, Fuhrman, raw, superfoods, etc.). The first neurofeedback provider (a brain injury specialist) suggested we take a look at Radiant Recovery concept of sugar (http://www.radiantrecovery.com/). She squabbled with some of foods here and there which Radiant Recovery included, but overall they agreed on the concept of eliminating sugar from the diet.

When the neurofeedback gave us this list, we went through our cupboards, read every label, and got rid of more than half of the food since it had contained soy, corn, or some form of sugar. We're now making sure the fruit is limited to one serving per meal and is low in sugar content (i.e. berries). We're using coconut or date sugar as alternatives. We're also trying to include more superfoods like spirulina in our diet and being more creative.

Seaturtle I was recommending a proper elimination diet, which does require dietician advice. Given that there is published scientific evidence on elimination diet and ADHD this is the path I think is the best approach to take. There are a gazillion diets around, many with great benefits for various issues, many with overlaps. But if you are looking at ADHD and there is an option with published research that seems like a good start to me. But it's hard to get right at the start and you have to be sure to do it safely....

And one of the things about an elimination diet approach is that it won't elimnate sugar - it will eliminate the other stuff that goes hand in hand with sugar in almost all purchased products. While we try to sensibly limit how much sugar our kids eat, as you would at any time, sugar is not one of our strictly controlled foods at all (colours, flavours, preservatives, salicylates, amines are very strictly controlled). Probably compared to a more typical diet they do have a low sugar intake, and certainly they have protien at every single meal.

MumOfThree - Yes, that's very true about an elimination diet and the sugar. Fruit juices are often high in sugar and more than a serving size of fruit for 8 oz or more; and a lot of people don't blink or think twice about it either. After all, it's fruit and fruit is supposed to be healthy for you, which it is.

I think that's why the neurofeedback provider gave me a yes/no list on foods when we started. It's very deceiving today with the foods; and you can hear so much conflicting advice. It was no to rice and white potatoes, for instance, but yes to yams and sweet potatoes (which have more nutritional content in them). Of course, she also said no to all those ingredients (colours, dyes, artificial sugars or honey, grains, etc.) you mentioned. That's why we probably tossed 3/4ths of our food out at the time.

Breakfast and snacks were initially tricky. We had to change some our habits and preferences. Breakfast was a bit of a carb-fest in our house. Neurofeedback provider suggested we have salmon for breakfast. Well, I might, but DS7 won't touch the stuff. So I had to find recipes and ingredients that would work and I could fall back on. I'm now thinking about making homemade hemp milk which might help too.

I would say if there's any suspicion, have him fully and properly evaluated. There's nothing worse than feeling abnormal, dumb and like a failure when at the same time parents and teachers are telling you that you're smart, or worse, an underachiever. You begin to distrust them all and feel hopelessly alienated because nobody is on your side.

ADHD is insidious. I wasn't diagnosed until my 30s. Being unconscious of it was an awful burden for all those years. You go from telling yourself "I'm a failure. I'm smart but I'm stupid" to "That's why I failed. I'm smart but my brain has problems performing certain functions."

I think that's my most important point: You and he and the teachers must become conscious of it if he has it. Then when the going gets rough you know where to point the finger and where to focus the energy finding solutions. Then he won't blame himself and they won't blame him.

Diet and exercise do help mightily, but remember that medications don't have to be an all-or-nothing situation. I do best on very small as-needed doses. A couple of mg of a non-extended release stimulant, for instance, can work wonders to calm the mind, turn off the noise, and aid focus. It's in an out of the system in just a few hours.

One thing I was not conscious of was the anxiety that ADHD produced by me having to constantly control my impulses to simply get up and get the heck out of dodge. No, I don't want to sit still; no, I don't want to look at people when they talk; no I don't want to act all calm, but I have to do all these things to be socially acceptable. It's like a thousand cuts having to suppress that all the time. This is where meds, diet, and coping techniques can help greatly, but one has to first become acutely self-aware of these otherwise unconscious, instinctive realities.

Well, there's always the underlying question of "Do I want to be socially acceptable if it's too annoying for me?" and "Am I *really* getting any benefit from engaging in pro-social behavior?"

Keep in mind there are different levels of severity for ADHD. Your DS might not have it at all, or he might have a mild version, in which case dietary tweaks and extra exercise might be enough to help him

Why take meds when neurofeedback may possibly eliminate or greatly reduce the need for them?

Not if you have a salicylate intolerance it's not... I have one child that can scoff down fruit all day with no problems what so ever, as can my husband. And one who can eat very, very strictly controlled amounts and only certain kinds of fruit, and never in combination with other salicylates... And absolutely never, ever fruit juice.

Intolerance is very hard to get your head around at first because it's a load issue. You may be able to tolerate none, or maybe a small amount, but not a large amount of amines - but most people have no idea that chocolate, oranges and cheese all have high amine content, so they say there is no pattern to which foods cause problems and it's not a food issue. If you have a low amine tolerance then maybe you can have one piece of chocolate, but not a whole bar, or you can have one piece of chocolate but not with a cheese sandwich... We understand this concept just fine with alcohol - we understand that if we drink a glass of beer, a glass of wine and a glass of whisky in quick succession that the effect is cumulative. We also understand that some people have very low tolerance for alcohol (the proverbial cheap drunk) and that some have a very high tolerance (my girlfriend from years ago that could drink a man twice her size under the table), and even that you can increase your tolerance over time (but is that actually good for you?). But very few of us understand all the other chemicals that some people have lower tolerance for that are in a wide variety of "healthy" foods... Who knew my DD hated broccoli for a reason?

Is there a test for this, or is it just by elimination that you figure it out? DS8 (my ADHDer) is crazy about fruit, and this is something I've heard of but haven't looked into yet.

To work out food intolerance you really need to do a strict elimination program and do it properly. You can't do things one at at time or without professional guidance there are too many foods with multiple chemicals. We do the Royal Prince Alfred Hospital diet, which is an Australian model, they publish a fantastic handbook and a cookbook too, and then we had a local dietician to help us get started and to help make sense of our results along the way. Now it's a life style and nothing much has changed in a really long time.

You can google for the RPAH elimination diet handbook and I think they have the whole introduction online so you can read it. But their site is broken at the moment so I can't provide a link, presumably it will be fixed soon though.

Sue Dengate's books (for example Fed Up with Food) are very similar, though I am not sure if they are as strict, but they may be easier for you to get in the USA. Or maybe there is some local equivalent of our hospital based program.

My personal advice is also that if you are going to do it particularly for ADHD, go all out and eliminate dairy and gluten from the start (these would then be the first two you try to get back). Gluten, Dairy and Salicylate seem to be the most likely culprits. From the children I personally know who the diet helps, all of them have a problem with at least one of Dairy and Gluten, most have lost at least one of Amine or Salicylate, and all are preservative, flavour and other "number" free. But all of them have different sets of what they can and can't have.

I have to say though that I think the biggest impact from diet is on the hyperactivity/behaviour, which certainly makes your child easier to live with and less likely to get into trouble at school. However, I am not convinced it's done much for either of my children's inattentiveness and from what I understand research shows that this is the part of ADHD that is most harmful to a child's success academically (and presumably at work).

MumofThree - well said! That's it. Everyone thinks fruits are healthy, but no one questions the contents of the fruit or the quantity, it seems. Have to agree with you about too many foods having multiple chemicals.

My DS's hyperactivity has faded away at school... it's all inattentive now. Same with DD. sigh. They're both pretty hyper at home, but I don't have any issues with it (if anything I appreciate it, because it makes them easier to keep fit). At school they're calm... and somewhere else.

What do you think of eliminating gluten Vs. having a blood test? DS8 tested non-reactive to gluten with both scratch and blood testing. I wonder if it's still worth trying to eliminate gluten?

A blood test for celiac disease rules out celiac (essentially allergy to Gluten), it doesn't rule out intolerance. You can definitely have problems with gluten even without having celiac disease. Some people can't tolerate any at all, some people can manage ancient grains but not wheat... None of my family are celiac, we are all gluten free though (well my husband cheats and eats low gluten grains sometimes, he doesn't seem to have too much of a problem). The elder two children are clearly reactive to gluten both behaviorally and physically, my youngest has been raised gluten free and there is no benefit to letting her have it and too much risk in trying so she's not likely to ever eat gluten.

When I say diet hasn't obviously helped with the inattentiveness it's hard to pin down exactly. My eldest (who does not benefit from ADHD medication) still seems like a complete pixie to me most of the time, but many things are much improved and we saw massive improvement in school performance the first year on the diet and it has been maintained. I am not sure what has changed to make her more able to learn when she still seems to spacey, but the performance change was overt. She started the diet in the last weeks of her yr3 school year, she had the same teacher in yr3 and yr5 (so the same teacher saw her after a one year break, during which she was on the diet) and I know her teacher was astonished at the progress DD had made in a number of areas, reading in particular. It's hard to say exactly which factors had the most impact, diet was not the only approach we used with her, but given how she falls apart with a diet mistake I am confident in saying diet was definitely one of the factors.