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Spokane, Washington  Est. May 19, 1883

The question of medication: Life modifications might be an option for children with ADHD


“There are more kids in Spokane on ADD medication than in all of France,” Dr. Leonard Sax said during our conversation about raising boys for last week’s column.

Sax, the author of the insightful “Boys Adrift,” was on the money. I was surprised but not shocked. America is an overmedicated country. Swallowing a pill is easier than modifying your diet and, more so, your life. That’s the case for children and adults, as well.

It takes doctors less time to hand over a prescription than spend considerable time, more than typically is allotted, during a doctor’s visit to assess whether a child needs Ritalin.

Some children absolutely require a drug, which helps them focus. Kids do suffer from attention deficit hyperactivity disorder.

Dr. David L. Hill, a North Carolina-based pediatrician, strongly suggests parents with a child, who might have attention issues, to be proactive.

“ADHD is a real thing and if someone has it, you can’t ignore it,” Hill said while calling from his Wilmington, North Carolina, practice. “When it comes to ADD, you can find differences on an MRI. You can find differences on various tests on function. There is a descriptive diagnosis. There are tests, which track eye movements and motor functions, which identifies whether a child has ADHD.”

There is no doubt some children need medication to quell their impulses and home them in on schoolwork, but why is it that comparable countries around the world have far fewer children on ADHD medication? What should parents do when they suspect their children’s lack of attention could be a problem in school?

Before visiting a physician, parents should take a look at their child’s actions and environment. Examine their diet, activity and sleeping patterns. If a child is exhausted, it impacts their attention span.

Dr. Gregory Charlop, an authority in wellness and advanced nutrition who wrote the book “Why Doctors Skip Breakfast: Wellness Tips to Reverse Aging, Treat Depression and Get a Good Night’s Sleep,” believes rest is most critical for kids and particularly teens.

“What parents might not realize is that teenagers need more sleep than prepubescent children,” Charlop said while calling from his Pasadena, California, office. “Sleep for teens is a big deal.”

Sleep is so significant that California Gov. Gavin Newsom signed into law California Bill 328 in October that requires high schools to begin classes no earlier than 8:30 a.m. and middle schools at 8 a.m.

“It’s a progressive move by California, and it makes so much sense,” Charlop said. “Teenagers’ circadian rhythms shift. They naturally want to go to sleep later. Teenagers are night people. They’re designed to go to bed later and get up later. If high school starts at 7 a.m., a tired student could be viewed as a teen who has attention deficit disorder.”

Diet is as significant as sleep. “Children need to eat and eat properly,” Hill said. “Attention will decline if a child doesn’t eat. Is there enough food in the home? Is the food healthy? Avoid sugary snacks. A good balance of foods is essential for growth and attention.”

Sedentary children often have energy issues. “Children need to be active,” Hill said. “What I never understand is when I hear about how a child is punished in school. What happens often is that they’re not allowed to go to recess. You don’t want to take away physical activity.

“That leads to behavior issues. You want kids to run around the football field a couple of times. They need to get that energy out, or they may have trouble focusing in the classroom.”

Anxiety, which can cause attention deficit, can be an issue. “Is there something at home traumatizing a child,” Hill said. “Is there domestic violence or substance abuse? Those are reasons a child can be unsettled in class.”

If your child is sleeping eight hours or more a night, eating healthy, is active and lives in a stable home and still has issues, it’s time to visit a medical professional.

Dr. Jacqueline Jones, the author of “Medical Parenting: How to Navigate the Health, Wellness & Medical System With Your Child,” believes parents should schedule a thorough examination.

Jones suggests a neuropsychological evaluation. It’s a three-hour test that details how a child’s brain works. The pro of the test is that it provides a detailed examination. However, the con is the test is expensive, and insurance typically doesn’t cover the procedure. If you want answers and can afford the test, it’s a great investment.

However, if that’s not so, what’s best is scheduling an appointment that is extensive. Parents need to do their due diligence. “You don’t want your children to fail or fall behind, so if there are issues, visit a doctor to see what the next step is,” Jones said.”You don’t want your children to be misdiagnosed.”

Dyslexia, bipolar disorder and oppositional defiant disorder are examples of medical conditions that might appear like attention deficit disorder.

Sax suggests exhausting all options and doing your best to determine if your child has ADD. It isn’t easy for a parent to discern whether a child has an attention deficit. It’s best not to just let a child try the medication.

Sax recalls a conference he attended 14 years ago at Harvard University titled “Learning and the Brain.” MIT professor John Gabrieli’s team obtained permission to give powerful ADHD medications to children without attention issues and those with issues. The medication for ADHD improved the performance of children who were ADD addled, but the same was so for those with normal attention spans.

So if a parent were to witness their child even more focused with better grades, they would probably think the medication was necessary. Sax is convinced America is overprescribing stimulation medications.

Sax suggests trying to find a pediatrician or family physician who has training and experience to perform a sophisticated assessment of a boy in the kindergarten age range. That medical professional can determine whether that child’s difficulties are due to ADHD or another problem.

It’s apparent that a drug like Adderall will improve academic numbers just like the medication will enhance a baseball player’s performance. The drug is prohibited by Major League Baseball.

It doesn’t take long for children and parents to realize ADHD medications have side effects. Appetite suppression is a common issue children have who take Concerta or Ritalin. Sleep issues, dizziness and moodiness are some of the problems the meds might cause. A number of my children’s friends have pretended to consume the medication. I’ve had friends find the medication hidden in their kids’ rooms.

“You don’t want your children to be on medication if they don’t need to be on it,” Sax said. “A parent must do what’s best for their child. It takes quite a bit of work to be a parent.”

But it’s worth every bit of the effort. It’s a role that is fleeting. That’s evident for me since I have a daughter in college, and a son who will experience life at his university in the fall. I have a high schooler and another in elementary. The ride will be over soon. Part of the experience was finding out whether my boys have ADD. It was a process, but it was just part of the parenting journey.