In the past couple of years many pediatricians, especially those in Sears Family Pediatrics, have changed the way we diagnose and treat ADHD. Once upon a time it was primarily treated with the pills model: “Child diagnosed with ADHD, take this drug…” The new and improved way of treating ADHD, and the one that is more science-based, is the skills-before-pills model, meaning what the child and parents can do before what the child can take. For example, we are finding that instead of ADHD, many children have other “Ds”: NDD (nutrition deficit disorder), MDD (movement deficit disorder), and another NDD (nature deficit disorder). In a nutshell, we’re going back to a “treatment” which mothers have always advised: “Eat more fruits and vegetables and go outside and play.”
Once children began sitting more and moving less, as well as eating more junk food, the number of children diagnosed with ADHD went up. Any correlation? In fact, studies are now proving mother’s wisdom of going outside to play. The more hyperactive children are advised to get outdoor exercise, the better they behave and learn. One such program was done at a school in Naperville, Illinois, where they began a zero period trial – having children come to school early for a half-hour of vigorous exercise before regular class started. Other programs, such as the ABC (Activity Bursts in the Classroom) for Fitness™, put together by my friend Dr. David Katz, Director of Yale University’s Prevention Research Center, has found amazing results by getting kids moving. Dubbed the “recess before Ritalin” approach, some schools are finding that vigorous exercise programs have increased children’s attention, improved their behavior, and lessened the need for medication in those children previously labeled with “ADHD.”
A common complaint that teachers often make about children with ADHD is: “He keeps staring out the window.” That’s because he wants to be out the window. I still remember being in the fourth grade and wise Sister Mary Bonifice would say: “Billy, go take a walk for a few minutes and then come back and settle down.” It worked, long before modern scientific studies showed the calming and intellectual benefits of movement and nature on the brain. Perhaps nature, along with movement, is the mind’s best medicine.
In my medical office when I see a child for “ADHD counseling,” I take the following skills-before-pills approach:
- Require more moving and less sitting, such as getting the child into sports, even moving while watching TV, such as Dance Revolution, or simply using exercise bands. I request that the parents insist upon having the child have at least as much movement time as they do computer or video game time, preferably more.
- Correct the nutrition deficit disorder: begin the day with a brainy breakfast, eat wild salmon at least twice a week, eat a real-food diet, graze on good foods, and dejunk their diet.
- Keep a journal of how they’ve increased activity, decreased junk food, and increased real food in the child’s diet.
Then I see the child in my office again in 3-4 weeks along with his journal where he documented these healthy changes. Only after we’ve cleaned up the child’s diet and increased physical activity do we discuss medications.