So your child’s been diagnosed with ADHD: The Next 90 days…

Spruce Kids is pleased to have the opportunity to participate as an ADHD consultant.  Today is our first post and we’ve decided to share our insight on what happens after diagnosis – the first 90 days.  We hope you will find the below piece insightful.  Let us know if you have any questions.

The Spruce Kids Team


You’ve suspected it. Been told he’s all boy. Wondered why you were so exhausted at the end of the day, and now it’s official. As you process this information and the life-long implications of this disorder for your family, consider the following questions.

Is the diagnosis accurate, is it complete?

While a diagnosis is also a label, an accurate diagnostic label can guide you in the right treatment direction. A thorough and detailed diagnosis provides important information about your child’s behavior and development. Your child has strengths and weaknesses. What are they? What are the needs that require specific treatment?

Because there is no biological assay or test for the diagnosis of ADHD, observed behaviors, psychological testing, standardized behavioral questionnaires and computerized continuous performance tests (when appropriate) are required to obtain an accurate diagnosis. Some children are identified as having developmental delays and may be receiving services prior to obtaining the ADHD diagnosis. Unfortunately, parents’ concerns are sometimes not taken seriously by their doctor and as a result, a diagnosis is delayed.

Is there something medical going on?

Medical conditions do exist in the child with ADHD, that, when treated, may improve the core symptoms. Your physician may opt to evaluate for thyroid overactivity or underactivity, sleep disorders, environmental toxicities, severe food and environmental allergies, chronic streptococcal antibodies (PANDAS), etc.

Sometimes sleep issues may be caused by medical problems, including obstructive sleep apnea or gastroesophageal reflux (frequently silent and under-diagnosed). In all cases, regardless of the co-occurrence of medical problems, sleep hygiene is critically important and part of the structured household routine necessary to function with ADHD. (Not House Beautiful, but Structured Household.)

Good sleep hygiene includes limiting daytime sleeping, keeping a regular bedtime and bedtime routine, playing calming music, or cutting all media off 1hour before bedtime, adding Epsom salts to a warm bath each night (1/4 cup), using lavender oil on acupressure points, or infusing into the bedroom, etc.

I have found melatonin to be effective for >50% of all those to whom I recommend it. Melatonin is a physiological protein hormone that is released from the brain in response to darkness. Work with your doctor when considering the use of melatonin for your child’s sleep problems.

First, put the oxygen mask on yourself, then on your child.

Remember that if you want to take the best possible care of your child, you must first take the best possible care of yourself. Get organized, schedule time to recharge, eat right. Do you need to be officially diagnosed with ADHD and treated? Even if you don’t have ADHD yourself, you will need to enhance your own frontal lobe function, because your ADHD child has given you “motherhood induced ADHD”. Your frontal lobe functions are stretched, overextended, and doing double duty. It was easier to run a boardroom than to keep up this room and board gig for your family.

How to expand your own frontal lobe functions:

Get 8 hours of sleep, eat good wholesome foods with limited simple carbohydrates, take 2-4 grams of purified fish oils daily, and eat 2 egg yolks daily (if not allergic) to provide phosphatidylcholine, an important building block of acetylcholine.

Consider joining a support group. Virtual support groups like ADHD momma are excellent and easy. Consider keeping a journal for several reasons; to process frustrations and grief, to help with organization, and to gain a sense of control over a situation that often seems out of control.

Start a notebook with tabbed sections for Communication log, Contact sheet, Evaluation results, IEP or 504 documents from the public school, Behavioral logs, Behavioral strategies and activities we need to try, Medication responses, etc.

You, the parent, are an excellent therapist.

Provide lots of “green time”, movement and swimming. Eliminate the formal living spaces and convert to an area that allows freedom of movement, creative play and self-directed activities.

Move next toward dietary changes. If your child is in the minority and really does have chemical sensitivities to artificial dyes (see post for more information), then begin to eliminate these products as a therapeutic trial.

“Everyone” is deficient in magnesium. Work with your doctor to add magnesium in the form of a magnesium chelate that will calm the nervous system and relax overworked muscles. The Epsom salts as mentioned above will also help to replenish deficiencies.

Many are deficient in zinc. Recent studies suggest that although children with ADHD are more likely to be deficient in trace minerals, normalizing the deficiencies may not be helpful for the core symptoms of ADHD.  As a clinician, however, I am convinced that normalization of nutrient stores will be somewhat helpful, if not in measurable ways.

And vitamin D… nearly all children I test are deficient by laboratory measures. I recommend purified cod liver oil of at least 2 grams daily, for many reasons, including its vitamin D content. This will provide about a day’s requirement for vitamin D, the rest of which can be obtained by supplement s or foods, according to your doctor’s advice.  This vitamin is actually a hormone and may modulate mood, in addition to its other benefits.

Treat allergies aggressively to reduce histamine levels in the blood. This compound mediates allergic reactions but also functions as an excitatory neurotransmitter.

Consider calming neurotransmitter support. L-theanine is now widely available and derived from green tea. It assists with calming by binding near the glutamate receptor and modulating overwhelming excitation at that receptor. Use 200 mg up to several times daily, along with your doctor’s approval, and as long as your child is not too sleepy.

Be as objective as possible. Monitor with rating scales and/or computerized continuous performance tests at the office of your professional team.

Review safety rules, and review again -crossing streets, not running in the street for ball, not diving in shallow pools, avoiding motor vehicle accidents, wear a helmet – take kid-proofing to a new level. Your child has a higher than average chance of also sustaining a head injury.

Consider neurofeedback and computerized cognitive training programs to enhance sustained attention, shifting attention, and to reduce distractibility. These computerized activities can often be used as a reward successfully for those children who are not overly exposed to media.

Reality Check:

Don’t forget that your child is still the same endearing person you loved before the diagnosis. Focus on his/her assets. Most of these children have endearing temperamental features such as “never meeting a stranger”, rapid cognitive processing speed, great sense of humor, and an enthusiasm for life that’s infectious.  Sometimes I ask myself, “Why would I medicate that?”

Karen H. Harum, MD, FAAP
Fellow, Neurodevelopmental disabilities
Spruce Kids, LLC

Spruce Kids

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The "ADHD Mommas" are not medical or mental health professionals, nor an ADHD coach. Any opinions shared here are just that, opinions. I, and the other "ADHD Mommas," are sharing our experiences with our own ADHD children. Please do not re-post or publish any content or photos without a link back to {a mom's view of ADHD}. Have the courtesy to give credit where credit is due. Copyright protected. All rights reserved.

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