Since it's founding in 1997, the CYC-Net discussion group has been asked thousands of questions. These questions often generate many replies from people in all spheres of the Child and Youth Care profession and contain personal experiences, viewpoints, as well as recommended resources.
Below are some of the threads of discussions on varying Child and Youth Care related topics.
Questions and Responses have been reproduced verbatim.
I really need some input on treating kids with ADD or ADHD with
something else besides meds. There must be a way to work with these kids
without medication. It just seems so sad to have them medicated daily.
A good book on alternatives for treating kids with ADHD is Thomas Armstrong's The Myth of the A.D.D Child: 50 Ways to Improve Your Child's Behavior and Attention Span without Drugs, Labels, or Coercion, A Dutton Book: New York. 1995.
Regards Stewart Redshaw
There is a really good book called the ADHD Book Lists that is really helpful.
I am firm believer that there is a link to food and ADD/ADHD. Lots of kids with this diagnosis tend to eat high fat, high carb processed food. Study dietary habits and make changes where appropriate, all natural healthy eating really makes a difference.
Willie & Kim Wilson
While I understand your frustration with over medication and quick diagnosis of ADD or ADHD, I still feel that when the child truly has these disorders, medication is a must to help them succeed in life. I have seen children frustrated with themselves, as they feel debilitated with the symptoms of ADHD. For example, one child that I am currently working with has severe issues with ADHD. His issues with ADHD seem to compound his oppositional and defiant behaviors, especially if he does not receive his medication on time. He has sat and cried telling me that he cannot control himself in the morning before he gets his medication, and it upset him that he get into so much trouble during that time.
Don't get me wrong, these children still need help learning how to handle their impulsivity and hyperactivity. Medication will help the child reach a level in which they can function, but it cannot teach them how to handle their symptoms. Some of the methods that I have used with my clients have been based on what I can only call a round about way of getting them back on task.
For example, if I am working with a child with ADHD on his math school work, and they are getting distracted away from their work, I will allow them to go off task for a few minutes, find out what is distracting them, and then relate it back to their math work. I have also found that setting time limits on activities that are attainable to the child's level of attention also helps the child stay on task. I feel that this helps, as it cuts out frustration, which seems to make ADD or ADHD symptoms worse.
I also feel that physical activity helps expend a lot of the built up energy that an ADHD child feels. So if you are working with a child who is starting to get hyperactive during an activity, have them take a walk/run or play some basketball for a while. In closing, I feel that if you are working with children that truly have ADHD or ADD, it would be sad not to allow them to use medication to reach their full potential in life. I hope that what I have written will help you out.
The first step in working with kids tagged with ADD/ADHD classifications is to detatch them from the label and reognize them for who they really are – just kids upsetting adults. If you continue to see them as youngsters suffering from a specific 'disorder' you will be stuck trying to cure something that doesn't exist – with or without medication. Just for the record, there is absolutely NOTHING in the independent scientific literature to refute this stance, other than the the profit margins of the pharaceutical industry. Once you free yourself from the medical illusion you can return to good old professional Child and Youth Care practice.
For kids who 'split off', teach them to stay present. For those who get overly excited, teach them to breathe and relax. For those who are unduly anxious, support them through their fears. For those who are destroying the agendas of their parents and teachers, help to renegotiate the expectations. Above all, get the youngster off medication so you can make direct contact and come to know them, as they really are. Then you can build a relationship and work from there. As the philosopher Red Green would say, "Keep your stick on the ice".
My son, six years old, was just diagnosed with ADD. As much as I don't want to medicate him for years, he is at a very high risk of losing 90% of his very first year in school because he is physically and cognitively unable to concentrate on anything for more than a few minutes. My personal suggestion would be to have the child on the lowest possible dose of med and a strict routine. My son's behavior is much better when he knows what to expect. I have done some research on ADD/ADHD.
Unfortunately there are not many ways to treat it without meds. My only other suggestion is to closely monitor the child's diet, things to avoid are sugar and red food dye. Hopefully this information will be helpful.
My niece was diagnosed with ADHD in 1996. The first response was to place her on Ritalin. This did help, but my sister was not willing to let her daughter become a Ritalin junkie. After spending many thousands on after school visits to special centres, she decided that enough was enough and stopped the medication and centre visitations. The key to success lay in sending her to an absolutely terrific school and by providing a balanced home environment. This also included diet changes as well. Today, the young lady is an achiever and one would never have ever said that she was once diagnosed with ADHD.
There is a very good book worth reading – Scattered by Dr. Gabor Mate. I happened to come across his website, scatteredminds.com while working with a particular difficult youth diagnosed with ADD as well as many other things.This book provides another perspective which may allow a different appreciation of this problem. I have worked with youth who take medication, and those who don't. I believe that the problem is complex and that every child/youth should be viewed individually.
In reply to Willie and Kim's comments about the effects of diet on behavior let me answer with my summary of Derrick Lonsdale's fine piece of work:
In his editorial "High Calorie Malnutrition,"
Derrick Lonsdale's subject is the modern phenomenon that the addictive
high calorie diet is destroying society. His thesis is that our
sugar-rich diet harms humans organically and neurologically, yet we seem
reluctant to change our eating habits. The purpose of his persuasive
article is to raise the awareness of medical professionals about a
problem they may perhaps affect. He uses analogies and examples, quoting
numerous sources to present his case.
Detailing chemical changes in the brain affected by nutrition, he explains links between delinquency and high calorie malnutrition. He shows that our limbic brain [responsible for reflexive animal behaviour like sex and fighting] is not as hampered by sugar as the cortex [responsible for impulse control and thought]. He makes reference to defence lawyers who have successfully attributed antisocial behaviour to excess dietary sugar. Physiologically speaking, when the brain receives high calorie levels, the result is the same as low vitamin and mineral levels. The ratios, not the quantities, are what determine sufficient oxygen metabolism (redox) in the brain. To prove his case, he points out that indicators of exaggerated limbic [impulsive] activity disappear with balanced nutrition.
Lonsdale notes that diet is linked to the brain's pleasure center, the wellspring of addictions. Citing public acquiescence, lack of discipline, and the food industry climate, he doubts that society will deal with this problem without increased awareness of the physiological components.
Reference Lonsdale, D. (2002). High calorie malnutrition. Journal of nutritional & environmental medicine, 12 (2). Retrieved February 2, 2004, from EBSCOhost.
... I hope you find this useful. I recommend reading Lonsdale's original article to gain an appreciation for the details of how sugar affects redox in different parts of the brain, and how that specifically inhibits impulse control. He also delves into the mechanism whereby a high sugar diet during adolescence can PERMANENTLY hamper higher brain functioning. My Mom was right all along!
I work in a community with very high rates of diagnosed FASD, ADD, and ADHD. Many more children present with the same types of symptoms but have not been formally diagnosed. The degree of affect varies from person to person. Some of the parents I work with have the skill level, or the cognitive ability to acquire the skill level, required to manage their children's condition/behaviour without medicating, and some do not. Some of the children I work with are affected to such a large degree that their impulsivity restricts them from being able implement either skills they have already learned, or any new skills the helping people in their lives continue to throw at them to help them modify their behaviour.
The combination of incapable or unwilling parents and out-of-control children invariably leads to disastrous results. These are often the children that get bombarded with messages of how bad, rotten, disrespectful, dangerous, exasperating, out-of-control, annoying, hyper, lazy, useless, and stupid they are. They are burdened with the understanding that their behaviour is contrary to what is socially acceptable, wanting to be the "good kids", but powerless to actually be those kinds of kids. Most of these children are singled out because they cannot function cohesively in a classroom with their peers because of uncontrolled and disruptive behaviour or inability to stay focussed. They are often our society's outcasts or social misfits who feel like failures, and whose futures look bleak to say the least.
Diet, exercise, and strict consistency and routine can be enough of an intervention for many children whose degree of affect presents them as somewhat hyper individuals who may or may not struggle academically, but who are successful to some degree in their peer groups and generally content in their lives. Children who fail miserably at school, home, and with their peers require much more. In these cases, and whether I like it or not, I've found that the best intervention begins with close monitoring by a reputable pediatrician and, unfortunately, medication.
Here are a couple of my many thoughts on the discussion so far.
As I look at the responses, a theme emerges of changing the behaviour of the adults/caregivers. I recall reading once, somewhere, that the main ingredient in changing 'allergy' reactions in kids was the devoted attention of parents that diet changes required. Whatever the source, it makes sense to me.
I also think it is dangerous to ignore the given variability of biology/brain structure/development, etc. I seem to hear something that sounds like fear of science, which I personally embrace as a tool to use, in conjunction with other tools and strategies. I do not see that an either/or approach is helpful, over all.
Re Gingko for children: PLEASE be careful using herbs/plant compounds. I was just looking for my source and have not found the correct book on my shelf yet, but Gingko is not clearly identified as a remedy for anything, yet. One of the dozens of chemical compounds in it (and all plants are complex compounds) is a blood thinner, a salicylate as I recall. It may...help reduce minor blood clots in someone at risk for that, or increase blood circulation to the brain, also in someone with circulatory disorder, but think first if this is what you want to do. Blood thinners should be used with caution and in conjunction with dietary and other medical considerations. There is a distinct risk for hemorrhage, as with ASA and other blood thinners. p.s. I love herbs, but am very cautious.
I would like to echo your comments about the value of new research and scientific evidence pertaining to ADD. Each decade that goes by, we discover how much more we did not know about this disorder. I strongly recommend that readers look at the findings of Dr. Daniel G. Amen. His web site is www.amenclinic.com is very, very good. His book, Healing ADD- The Breakthrough Program that allows you to see and heal the 6 types of ADD is a major breakthrough on how brains function differently for different people with ADD. It may tie in some of the discussions tied to diet along with medication in a way all of us may see as useful. We have so much yet to learn.
I have read through all these entries regarding ADHD. I am a child & youth worker who works with children between 7 -10 yrs old in a school. All but one of our 12 children diagnosed with ADHD do not take medication. I do believe in medication and behavioural treatment for children with ADHD. In my class there are two CYW's (one being a college student 3rd year) and a teacher who also has education in this disorder, also to mention there are only 6 students in the class at a time. My point is with all these supports in place and three qualified adults managing and teaching these children they still require medication in order to be able to access the treatment. Without medication these children are way too impulsive and unfocused to use the techniques we are attempting to teach them. I am also a mother of a 7 yr old boy that was diagnosed with ADHD a year ago. I have chosen to medicate him only during school hours, Concerta 18mg, and at home non-medicated using structure/routine and predictablity.
In my opinion,
Kathleen Jobin, Toronto Canada