Q: Is lead or dietary testing worthwhile for adults and children with ADHD?

A: Yes, I think it is, but recognize that this is not the current standard of care, so if your clinician doesn’t want to do it, they are only following this standard of care. Personally I would check it for a few reasons: even a little exposure to lead seems to be correlated if the child is genetically vulnerable. Since we can’t prove genetic vulnerability, then it makes sense to go ahead and reduce whatever lead exposure your child is getting. We list those steps in the book (Chapter 7) but examples are filtering your water, cleaning up old paint around the house, and testing the soil. With diet, we do know that there are some kids with ADHD that have low levels of omega-3 or other nutrients in their blood. This is a direct target that would be worth checking, but you can do dietary supplemental things even without blood tests. You can try these things and see if you notice benefits. We have details on each of these ideas in the book as well (Chapter 3). Get yours here: https://www.guilford.com/books/Getting-Ahead-of-ADHD/Joel-Nigg/9781462524938?promo=2E

Q: Which ADHD Skills Training or Coaching Programs would you recommend for the classroom?

A: You are already helping your ADHD students by investigating options. At least two ADHD coaching or skills training programs  have been proven beneficial by double-blind randomized trials in educational settings:

Homework, Organization and Planning Skills (HOPS) and Challenging Horizons Program (CHP).

I discuss these two programs (and others) on pp. 216-222 in my book, Getting Ahead of ADHD: What Next-Generation Science Says about Treatments That Work- and How You Can Make Them Work for Your Child. Curricular changes are not easy, but if you have the resources to get started, these look extremely promising.

Additional information for educators at http://oucirs.org/educators-mh- professionals/

Adult ADHD- Current Recommendations

Listeners from last week’s webinar sent in several great questions: I can’t answer all of them in depth but I will summarize the key themes and try to address them. One big theme concerned adults with ADHD and the heart of these questions was:

Questions: 
  • Should adults do anything different or try the same stuff that seems to work for kids?
  • How good is the evidence for different lifestyle factors for adults?
  • How does inflammation, and hormones, and lifestyle all interact with medication?

Answer:

Overall, we have a lot less information about adults with ADHD, but that doesn’t mean we can’t make some headway right now. We do know that because the brain and body mature all the way into our 20’s, the biochemistry of ADHD and response to medications and other interventions is somewhat different for adults. But that said, there’s enough evidence to know that the basic proof in adult animals, in developing animals, and in human children gives us quite a bit of confidence for adults in trying the recommended lifestyle changes, particularly around exercise and healthy diet. Adults, unlike children with ADHD, can also benefit more from cognitive coping strategies (mindfulness meditation, reframing, and so on). (Children and teens much more require their parents to do that for them or with them). Also, for adults there is more evidence of benefit from getting training or coaching in organizational skills and executive functions. One good book there is “Smart But Scattered” by Peg Dawson, Guilford Press. It is notable that several of you wrote in to note your own experiences with, particularly, reducing inflammation in your diet.

I will write more as I continue to gradually digest the email messages coming in. Thank you for your interest in trustworthy, science based updates.

My next webinar September 20th – Beyond Genes: How Sleep, Diet & Exercise Impact a Child’s ADHD 

Good health to you all,

Dr. Nigg