ADHD Children

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"ADHD children" are found in every classroom. ADHD is a neuro-biological disorder that impacts between 5% and 9% of children and teens in the United States. Depending on the type of Attention Deficit Disorder that they inherit they may have some very serious challenges in childhood to overcome. These "ADHD children" will need lots of help, different kinds of help, to be successful in school and at home with friends.

Many parents report that they knew their child had ADHD from infancy, and there is a lot of discussion taking place today regarding the use of stimulant medications with children as young as four years old. Certainly, as children with ADD ADHD reach school age, they will have new struggles as they leave their comfortable home environment for the structure of a classroom. Often ADHD kids "hit a wall" academically in third grade, and again in the seventh grade.

There are several effective interventions for "ADHD children" including medications, therapy for their family, cognitive and behavioral training, ATTEND and other homeopathic nutraceutical medicines, EEG biofeedback, and ADHD diet interventions.
the ADHD diet is available in full at ADHD diet information site click here

Go to the ADHD Diet Information site to get the full ADHD diet in eBook PDF format, including our UPDATES for 2013. We also have the full 21 minute information video on our ADHD eating program.

Even for children ADHD can have a negative impact on social interactions with peers. For those ADHD children who are impulsive, hyperactive, or have temper outbursts, it is likely that they will not be as well liked as other kids without ADHD, and will have fewer friends.

Most kids like to play sports, and most parents will encourage their children to try at least the most popular team sports such as soccer, baseball, basketball, or hockey. Some kids with ADHD are excellent athletes, and display great endurance. But many ADHD children have co-ordination problems in addition to the problems paying attention and being easily bored. Certain individual sports are a good solution for these kids.

Douglas Cowan, Psy.D., M.S. is a licensed Marriage and Family Therapist in Tehachapi, CA who has been a skillful counselor to children, teens, and adults helping them to overcome ADHD, find relief for depression or anxiety, and solve other problems in life since 1989. He served on the medical advisory board to the company that makes Attend and Extress from 1997 through 2011, and he is the Editor of the ADHD Information Library online resource. His weekly ADHD Newsletter goes out to 9,500 families. Visit his website at for more information on achieving greater health, personal growth, Christ-centered spirituality, stress management, parenting skills, ADHD, working out the stresses of being a care-giver to elderly parents and also being a parent to teenagers, or finding greater meaning in retirement years, Dr. Cowan can be a valuable resource to you.

Douglas Cowan, Psy.D., MFT
27400 Oakflat Dr.
Tehachapi, CA 93561
(661) 972-5953

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If You Think Your Preschooler May Have ADHD

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What do you do when your three-year-old's preschool teacher calls for the fifth time complaining that your child is impulsive, can't stay in his seat, won't take naps with the other kids, and is just really, really active? Do you take your child to the pediatrician, as the preschool teacher suggests, or do you just change preschools? preschoolers and adhd

We were given the opportunity to write an article on the topic, "What To Do If You Think Your Pre-Schooler May Have ADHD" for the online magazine "What To Expect When You're Expecting" at It was quite an honor to be invited to write for them, as their website is one of the most popular in the world when it comes to parenting issues. The article can be found at and if you are the parent of a pre-schooler, I would certainly encourage you to read it. It's a pretty good article - but it's a really important topic.

Also check out Amber's article on the "What To Expect" site as well. Amber is my daughter who edits and produces the ADHD newsletter for me, and she also runs our online store at She's awesome. And she and her incredible husband Tim are adopting a child with a "limb difference." Tim is a prosthetist (he builds arms and legs for people), and Amber is a big adoption and foster child advocate in her county, and they have decided to adopt as child who is missing an arm or leg, and Tim will just take care of the situation. They have a blog at where you can follow their journey. It looks like it will lead them to China (wow, I have another grandchild in China...?). Follow them on their journey at their blog, and check out Amber's article at "What To Expect" here:

And while you're at it, check out the wallets that Tim is making for Christmas gifts. They are custom for iPhones, smartphones, and your credit cards. See what you think.

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ADHD Information in Plain Language

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ADHD Information: Learn About Attention Deficit Hyperactivity Disorder

ADHD is the abbreviation for Attention Deficit Hyperactivity Disorder. ADHD is one of the most common childhood behavior disorders. Of all children referred to mental health professionals about 35% are referred for ADHD, more than for any other condition. Those with ADHD often have problems in most areas of their life, including home, school, work, and in relationships.

"Attention Deficit Hyperactivity Disorder" is a neurological disorder that impacts individuals in four main categories:

  • Attention - causing people to have problems paying attention, focusing on a task, or finishing tasks, especially if they are not very interesting tasks.
  • Impulsivity - causing a lack of self-control. Impulsive behaviors, or choices, can cause havoc in relationships, work, school, or life.
  • Hyperactivity - Many (though not all) with ADHD are "bouncy" and hyperactive, always "on the go" and restless.
  • Easily Bored - Unless the task is very stimulating, like a video game or TV program or outside playing, those with attention disorders are often easily bored by a task - especially bored by homework, math tests, balancing checkbooks, or doing taxes, and many of these tasks just never get done.

ADHD: Children, teens, and adults can all suffer from Attention Deficit Hyperactivity Disorder.

"Attention Deficit" impacts about 5% of children and teenagers, and about 3% of all adults. Recent studies show that as many as 9% of children have ADHD, but we are a bit more conservative with our numbers.

Less than half of children with ADD ever "out-grow" it in adolescence or adulthood. If untreated, the disorder can have long-term adverse effects into adolescence and adulthood.

The disorder has different "looks" or "types." This is discussed in great detail under the section the different types of ADHD.

For some it severely impacts behavior, and for others it greatly impacts learning. For the group in the middle, it just impacts their attention, focus, concentration, and getting the job done.

Learn ADHD Facts here...

ADHD Comes in Different Types

The diagnosis of Attention Deficit Hyperactivity Disorder is very broad, including several different types of ADHD.

What are these different types of ADHD?

And in this article we will reveal the best targeted alternative treatment strategies for each of these five types of Attention Deficit Hyperactivity Disorder.

Read this Very Important Chapter...

ADHD Alternative: Attend Nutraceutical Medicine for ADHD

What's new and effective in the treatment of ADHD?

ATTEND is the most advanced "natural alternative remedy for ADHD"

It is an effective alternative to medications such as Ritalin, Strattera, Concerta, Dexedrine, Adderall, or other medications for Attention Deficit Hyperactivity Disorder.

ATTEND is a powerful, all-natural ADHD treatment intervention that is Clinically Tested with computerized testing, in addition to parent reports. See the results of our clinical trials.

Attend results
Attend gets great results with:

  • Specific Amino Acid combinations,
  • Essential Fatty Acids,
  • Phospholipid complexes,
  • and Homeopathic Medicines.

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ADHD in More Boys? Biological Reasons

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Boys have biological reason to be troublesome

Published: The University of Queensland News Online 2007

Children with ADHD have less activity in parietal brain areas while performing attention-demanding problem-solving tasks.

A team of researchers working with UQ's Queensland Brain Institute (QBI) has discovered more compelling evidence that attention-deficit disorder in young boys is substantially attributable to brain development.

UQ neuroscientist, Dr Ross Cunnington said there appeared to be a biological difference in young boys that made them more susceptible to attention deficit hyperactivity disorder, combined type (ADHD-CT).

“ADHD affects about three-to-five per cent of primary school aged children,” Dr Cunnington said. “It is the most common neurodevelopmental disorder in children and causes significant delay in educational and social development.”

In a study of boys aged eight-to-twelve, Dr Cunnington and a team of scientists from The University of Queensland and research centres in Victoria used functional magnetic resonance imaging (fMRI) to map the brain activity of each of the boys as they performed a mental rotation task.

The study focused on imaging the parietal lobe, a region of the brain known to become active when something distracts a person from performing or completing a given task.

“We're looking at the interaction that occurs in the brain between the pre-frontal and parietal lobes,” Dr Cunnington said. “Interactions between these brain areas are crucial for maintaining and focusing attention.

“ADHD can be a problem for young boys because it means they don't do well at school, and there are often serious social consequences as well. Severe ADHD could at times lead to a young person becoming alienated from their friends and classmates – which can lead to low self-esteem and further disruptive behaviour.

“Overall, there is strengthening evidence that ADHD has a biological cause. It's not all bad parenting.”

The good news for parents is that most cases of ADHD reduce with age and there are already several effective therapeutic treatments which help control the condition's symptoms.

The Cunnington group's research "Right parietal dysfunction in children with attention deficit hyperactivity disorder, combined type: a functional MRI study" was published in a recent edition of Molecular Psychiatry.

Dr Cunnington established his laboratory at The University of Queensland in January 2007, where he is a Principal Research Fellow and works jointly in the School of Psychology and the Queensland Brain Institute.

Dr Cunnington says that his research "focuses on Action and Attention in the human brain. I use methods of functional MRI and EEG event-related potentials to measure neural activity underlying the preparation and control of action, as well as the perception of others' actions."

He says that he "began research examining cortical activity underlying movement preparation in patients with Parkinson’s disease during my PhD at Monash University, Melbourne. In 1998, I moved to Vienna as an NHMRC post-doctoral research fellow at the Centre of Excellence in High Field MR, Medical University of Vienna, where I developed functional MRI methods to examine neural activity during the preparation and readiness for action. I then returned to Australia in 2001 as an NHMRC RD Wright Fellow to establish the Cognitive Neuroscience group at the Howard Florey Institute, Melbourne, where my research examined attention, the preparation for action, and spatial working memory, including studies of normal brain function as well as clinical disorders such as Parkinson's disease, Huntington's disease, Autism, and Attention Deficit Hyperactivity Disorder. In January 2007, I established my lab at the University of Queensland where I am currently appointed as Principal Research Fellow jointly in the School of Psychology and the Queensland Brain Institute."

Parents benefit from being involved in parenting programs with experts. Dr. Anthony Kane is a medical doctors who is one such expert, and he has contributed several articles to our newsletters and websites. Dr. Kane has put together a parenting program, complete with the opportunity to consult with him. His program has a tremendous amount of information, ideas, and wisdom to help you parent ADHD children. Here's where you can get his expert help without leaving your home: Dr. Kane's Parenting Resources.

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ADHD in Toddlers or Pre-school Children

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Toddlers or Pre-school Children with ADHD ?

"I never diagnosed a child under the age of five with ADHD," says our clinical director Dr. Doug Cowan. "You see, everyone who has a genetically based ADHD was born with it, and they act like it when they are two, three, four, five years old. They have characteristics of ADD from very young. But there are also a lot of kids, particularly boys, who develop a bit more slowly than their peers, and may be more active than their peers, who can look like they have ADD, but by the time they are eight years old they are fine."

So there are some toddlers or pre-schoolers with ADHD.

The "neurological wiring" in a child's brain is not completely "plugged in" until a child is about eight years old, but according to Cowan, "a eight or nine, what you see is what you get." So many kids who appear to have ADHD at four or five will have developed more self-control and focus by age seven, eight, or nine.

"Also, the younger the child is, the more difficult it is to make a good diagnosis. It is hard to be certain with a six or seven year old child, and it is not much better than a guess with a four or five year old child. The good, objective, diagnostic tools like the TOVA are only normed for kids down to age five, and the norm groups for five year olds are very much smaller than for eight or ten or twelve year olds. You just cannot be as certain with younger children."

"Since about five percent of children have ADHD, that five percent includes two year olds, three year olds, and four year olds too. But the problem is that about twenty percent of two, three, and four year old boys look like they are ADD. Most of them will out grow it and mature into more self-control, but five percent won't. But which five percent? Without the right tools, you really are just guessing."

Which brings us to the discussion in the medical field today on the use of stimulant medications with very young pre-school aged children. See the press release on a recent study of pre-schoolers with ADHD responding to stimulant medication. See our comments on the study of pre-schoolers with ADHD here.

In making the diagnosis of Attention Deficit Disorder in a person of any age, first there must be a problem. Second, they must meet certain diagnostic criteria. Third, other possible causes must be ruled out.

In pre-school children, or even younger toddlers, to establish even that there is a problem one has to compare the child to other children his or her age, and not compare the child to older children.

How many toddlers can pay attention to a task for very long? How many can practice self-control? How many can just sit still and pay attention to a teacher talking? The answer is "not many."

It is normal for a toddler, or a pre-schooler, to want to move, run, explore, and play.

It is not normal for adults to want to make them sit still in a classroom setting. Doing this to three, four, and even some five year olds, will make them look ADHD when they want to get up, move around, play, and not pay attention to the teacher. But these behaviors would be normal for a young child.

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Attend MINIs for ADHD Symptoms

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Attend Nutraceutical for ADHD Symptoms in a Smaller Capsule for Children

Attend is an outstanding over-the-counter alternative treatment for the symptoms of ADHD. And there are a lot of younger kids who could benefit from Attend, but they cannot swallow the capsules, which can seem quite large to a young child. So through the years we have tried emptying the contents (which taste terrible) in strawberry jam, followed by a mouthful of orange juice, and other tricks to try to get the ingredients down, but none are very successful long term.

attend mini sized capsules now available

But, finally, the good folks at VAXA have come up with Attend Minis, the Attend product in ½ size capsules that are much easier for a child, or adult, to swallow.

Here is the answer for most children trying to take the large, but effective, Attend capsules: the Attend Minis … with an easy to swallow capsule size.

Try ATTEND Mini Capsules NOW

Here is the company's press release:

VÄXA Launches Attend mini….a Smaller, Easier to Swallow Capsule of their Top Selling
Homeopathic Medicinal for Attention Support

Tampa, FL. April 28, 2010- VÄXA announced today the launch of their smaller sized capsules of their best selling homeopathic medicinal Attend for attention and focus support. Appropriately named for its miniature size, Attend mini provides the same effective formula as Attend in smaller capsules for easier swallowing for children and adults.

** attend mini for adhd symptoms **With the high success of Attend, and the ever increasing demand for attention support for children, VÄXA created Attend mini to better reach those children and adults with difficulty swallowing pills. For many children, teens, and adults; capsule size plays a major role in whether or not they take a certain medicinal. VÄXA wanted everyone to have the opportunity to experience the benefits of Attend, without pill size being an issue. Now with Attend mini, VÄXA can reach a larger audience and better serve their current customers.

So, what has made Attend one of VÄXA's top selling products since 1987? The answer is easy. It's the advanced, doctor-formulated homeopathic remedies in a base of herbal and nutritional components. Just like the original Attend, Attend mini contains a blend of over 95 ingredients that support focus, promote mental alertness, maintain a balanced mood, and even aid with periodic bouts of nervousness and hyperactivity.

The advanced gluten-free formulation of Attend mini works safely and effectively without sleepy or stimulant side-effects, and will not interact with any other medications. The Attend formulation is accepted for use by the Feingold Program® and is featured in the Prescription for Nutritional Healing, America's #1 Guide to Natural Health.

You can learn more about Attend mini and the entire VÄXA line by visiting our new store at

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Our Response to Preschool Children with ADHD and Low Doses of Medication

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Preschool Children, ADHD, and Medication

If this is all the farther that you read, read this: You can accomplish the same thing as can be accomplished by the small dose of Ritalin used on these children with a protein shake and a little coffee mixed together. See our diet recommendations.

adhd preschool medication studyThis is our grandson at age three. He is active and he really likes to play. He needs to be outside. I simply cannot imagine giving him Ritalin at six, or at five, or at four years old. But here is a study from the National Institute of Mental Health that says it might be a good idea.

Here's the report on the NIMH study:

Recently the National Institute of Mental Health reported on “the first long-term, large-scale study designed to determine the safety and effectiveness of treating preschoolers who have attention deficit/hyperactivity disorder (ADHD) with methylphenidate (Ritalin).” The study was published in the Journal of the American Academy of Child and Adolescent Psychiatry.

The study looked at 300 preschoolers, ages 3-5. According to the study's authors, the children had been diagnosed with ADHD and their families had all been in a 10-week behavior modification program first.

How exactly the children had been diagnoses with Attention Deficit Hyperactivity Disorder is beyond us. There are few, if any, valid tools used to diagnose ADHD in children that young. We do not recommend diagnosing a child with ADHD under the age of five, as there are too many variables, and no good diagnostic tools for this age group.

But the story continues...

"The Preschool ADHD Treatment Study, or PATS, provides us with the best information to date about treating very young children diagnosed with ADHD," said NIMH Director Thomas R. Insel, MD.

"The results show that preschoolers may benefit from low doses of medication when it is closely monitored, but the positive effects are less evident and side-effects are somewhat greater than previous reports in older children."

There are three key points to Dr. Insel’s quote:

1. Preschoolers may benefit somewhat – from low doses – if closely monitored;
2. But there aren’t a lot of positive benefits, and
3. The side-effects are worse than in older children.

11% Drop Out of Study from Severe Side-Effects

In fact, 11 percent of the children had side-effects that were so severe that they had to drop out of the study. The side-effects included weight loss of more than 10 percent of body weight, insomnia, loss of appetite, anxiety and worry, and tics.

Some of these side-effects are due to the nature of the medication: they are stimulants, and stimulants decrease appetite, increase anxiety, and keep you awake.

Others of these side-effects are most likely due to mis-diagnosis of these children. Children with anxiety disorders, when given stimulants, get anxiety. Children with Tourettes Syndrome, when given stimulants, get tics.

The medication also seemed to slow the children’s growth rate during the study. But we have noted elsewhere (at the ADHD Information Library) that initially stimulant medications inhibit the release of growth hormone in children, but over time stimulant medication will actually enhance release of growth hormone. So initially growth rate is slowed, but about a year later it is accelerated, and if a child is treated for three years or more, it all evens out.

But it is not a good things to risk with preschoolers.

The amount of Ritalin administered to the children were, on the low end, roughly equivalent to the caffeine in one cup of coffee all day, and on the high end to three cups of coffee per day.

So why give the kids Ritalin?

The bottom line is that small doses of stimulants like Ritalin improve brain performance. But there are side-effects to deal with.

But giving many of these kids a protein shake with a spoon of instant coffee once, twice, or if needed, three times per day, is superior to giving them Ritalin, because they won’t experience the severe side-effects.

We strongly recommend that families try our eating program, or someone else’s eating program, before trying stimulant medications.

100 mg of caffeine is roughly equivalent to 5 mg of Ritalin.

You can read about the NIMH study here.

You can see our ADHD diet and eating recommendations here.

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Preschool and Ritalin

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The first long-term, large-scale study designed to determine the safety and effectiveness of treating preschoolers who have attention deficit/hyperactivity disorder (ADHD) with methylphenidate (Ritalin) has found that overall, low doses of this medication are effective and safe.

ADHD, Preschool Children, and Medication

However, the study found that children this age are more sensitive than older children to the medication's side effects and therefore should be closely monitored. The 70-week, six-site study was funded by the National Institutes of Health's National Institute of Mental Health (NIMH) and was described in several articles in the November 2006 issue of the Journal of the American Academy of Child and Adolescent Psychiatry.

"The Preschool ADHD Treatment Study, or PATS, provides us with the best information to date about treating very young children diagnosed with ADHD," said NIMH Director Thomas R. Insel, MD. "The results show that preschoolers may benefit from low doses of medication when it is closely monitored, but the positive effects are less evident and side-effects are somewhat greater than previous reports in older children."

Methylphenidate is the most commonly prescribed medication to treat children diagnosed with ADHD. But its use for children younger than 6 years has not been approved by the Food and Drug Administration. And until PATS, very few studies—and no large-scale ones—have been conducted to collect reliable, consistent data to help guide practitioners treating preschoolers with ADHD.

the ADHD diet is available in full at ADHD diet information site click here

Go to the ADHD Diet Information site to get the full ADHD diet in eBook PDF format, including our UPDATES for 2013. We also have the full 21 minute information video on our ADHD eating program.

Design of Preschool ADHD Study

The 303 preschoolers enrolled in the study ranged in age from 3 to 5 years. The children and their parents participated in a pre-trial, 10-week behavioral therapy and training course. Only those children with the most extreme ADHD symptoms who did not improve after the behavioral therapy course and whose parents agreed to have them treated with medication were included in the medication study. In the first part of the medication study, the children took a range of doses from a very low amount of 3.75 mg daily of methylphenidate, administered in three equal doses, up to 22.5 mg/day. By comparison, doses for school-aged children usually range from 15 to 50 mg total daily.

The study then compared the effectiveness of methylphenidate to placebo. It found that the children taking methylphenidate had a more marked reduction of their ADHD symptoms compared to children taking a placebo, and that different children responded best to different doses.

"The best dose to reduce ADHD symptoms varied substantially among the children, but the average across the whole group was as low as 14 mg per day," said lead author Laurence Greenhill, M.D., of Columbia University/New York State Psychiatric Institute. "Preschoolers with ADHD may need only a low dose of methylphenidate initially, but they may need to take a higher dose later on to maintain the drug's effectiveness."

To ensure the safety of the very young children involved, the study was governed by a strict set of ethical standards and additional review boards. The children's health was monitored carefully and repeatedly throughout the study's duration. Their parents were repeatedly consulted for consent prior to every step of the program. The researchers also reviewed the teacher ratings of the children who attended preschool at various stages in the study.

Similar to 1999 results found in NIMH's Multimodal Treatment Study of Children with ADHD (MTA study), and other studies on school-aged children, the medication did appear to slow the preschoolers' growth rates. Throughout the duration of the study, the children grew about half an inch less in height and weighed about 3 pounds less than expected, based on average growth rates established prior to the study.

Currently, no data exist that track long-term growth rate changes among preschoolers with ADHD who are medicated with methylphenidate. However, a five-year-long follow-up study is underway to track the children's physical, cognitive, and behavioral development, as well as health care services the family is using to care for the child. Those data will be available in two to three years.

Preschoolers, ADHD Medications, Results

Eighty-nine percent (89%) of the children tolerated the drug well.

But 11 percent—about 1 in 10 children—had to drop out of the study as a result of intolerable side effects.

For example, while some children lost weight, weight loss of 10 percent or more of the child's baseline weight was considered a severe enough side effect for the investigators to discontinue the medication. Other side effects included insomnia, loss of appetite, mood disturbances such as feeling nervous or worried, and skin-picking behaviors. Despite concerns that stimulants may increase blood pressure or pulse, any changes seen in the children's blood pressure or pulse were minimal.

"The study shows that preschoolers with severe ADHD symptoms can benefit from the medication, but doctors should weigh that benefit against the potential for these very young children to be more sensitive than older children to the medication's side effects, and monitor use closely," concluded Dr. Greenhill.

PATS was conducted by researchers at Columbia/New York State Psychiatric Institute, Duke University, Johns Hopkins University, New York University, the University of California Los Angeles, and the University of California Irvine, in collaboration with NIMH staff under a cooperative agreement.

The National Institute of Mental Health (NIMH) mission is to reduce the burden of mental and behavioral disorders through research on mind, brain, and behavior. More information is available at the NIMH website.

The National Institutes of Health (NIH) - The Nation's Medical Research Agency - includes 27 Institutes and Centers and is a component of the U. S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical, and translational medical research, and it investigates the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit

Greenhill L, Kollins S, Abikoff H, McCracken J, Riddle M, Swanson J, McGough J, Wigal S, Wigal T, Vitiello B, Skrobala A, Posner K, Ghuman J, Cunningham C, Davies M, Chuang S, Cooper T. Efficacy and Safety of Immediate-Release Methylphenidate Treatment for Preschoolers With ADHD. J Am Acad Child Adolesc Psychiatry. 2006 Oct 4; [Epub ahead of print]

Wigal T, Greenhill L, Chuang S, McGough J, Vitiello B, Skrobala A, Swanson J, Wigal S, Abikoff H, Kollins S, McCracken J, Riddle M, Posner K, Ghuman J, Davies M, Thorp B, Stehli A. Safety and Tolerability of Methylphenidate in Preschool Children With ADHD. J Am Acad Child Adolesc Psychiatry. 2006 Oct 4; [Epub ahead of print]

McGough J, McCracken J, Swanson J, Riddle M, Kollins S, Greenhill L, Abikoff H, Davies M, Chuang S, Wigal T, Wigal S, Posner K, Skrobala A, Kastelic E, Ghuman J, Cunningham C, Shigawa S, Moyzis R, Vitiello B. Pharmacogenetics of Methylphenidate Response in Preschoolers With ADHD. J Am Acad Child Adolesc Psychiatry. 2006 Oct 4; [Epub ahead of print]

Kollins S, Greenhill L, Swanson J, Wigal S, Abikoff H, McCracken J, Riddle M, McGough J, Vitiello B, Wigal T, Skrobala A, Posner K, Ghuman J, Davies M, Cunningham C, Bauzo A. Rationale, Design, and Methods of the Preschool ADHD Treatment Study (PATS). J Am Acad Child Adolesc Psychiatry. 2006 Oct 4; [Epub ahead of print]

Swanson J, Greenhill L, Wigal T, Kollins S, Stehli A, Davies M, Chuang S, Vitiello B, Skrobala A, Posner K, Abikoff H, Oatis M, McCracken J, McGough J, Riddle M, Ghuman J, Cunningham C, Wigal S. Stimulant-Related Reductions of Growth Rates in the PATS. Stimulant-Related Reductions of Growth Rates in the PATS. J Am Acad Child Adolesc Psychiatry. 2006 Oct 4; [Epub ahead of print]

This story's web page.

NIMH publications are in the public domain and may be reproduced or copied without the permission from the National Institute of Mental Health (NIMH). NIMH encourages you to reproduce them and use them in your efforts to improve public health. Citation of the National Institute of Mental Health as a source is appreciated. Preschoolers and Ritalin

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Why Other Children are Rejecting Your ADHD Child

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by guest author Anthony Kane, MD

Developing healthy peer relationships is critical for the normal development of a child. Peer relationships have been found to be an important predictor of positive adult adjustment and behavior. Difficulty in finding friends leads to feelings of low self-esteem and these feelings usually continue into adulthood. Children with poor social skills are at risk for delinquency, academic under-achievement, and school drop out. Even though the inattentiveness, impulsiveness, and restlessness frequently persist into adult life, these problems are of less importance as the child gets older.

Rather, the main difficulty ADHD patients encounter as they reach maturity is their inability to interact appropriately with others. An ADD ADHD child often lacks the social skills that are essential to success in life. These children can be socially inept, and their lack of interpersonal skills may cause them a multitude of difficulties. In addition, positive relationships with friends in childhood provide a critical buffer against stress and help to protect against psychological and psychiatric problems. ADHD children lack these positive interactions and thus are at risk for a number of emotional problems. Probably 60% of ADHD children suffer from peer rejection. ADHD children are less often chosen by peers to be best friends, partners in activities, or seatmates.

As the children grow older, their social problems seem to get worse. Their inappropriate behavior leads to further social rejection and exacerbates their inability to relate to others appropriately. Long term these children are more likely to have difficulty finding and maintaining successful careers. This is not surprising since social aptitude can make or break careers and relationships in the adult world.

Causes of Poor Peer Relationships

ADHD children are frequently disliked or neglected by their peers. It is difficult to determine all the factors that make a child unpopular, but children who frequently display aggressive or negative behavior tend to be rejected by their peers.

Impulsivity and Aggression

ADHD children tend to be more impulsive and aggressive than other children. Teachers observe that the social interactions of ADHD children more often involve fighting and interrupting others. These children are more intense than others and behave inappropriately in social contexts. For example, ADHD children are more likely to yell, run around and talk at unsuitable times.

They also tend to want to dominate play, engage in off task behaviors and engage more in teasing and physical jostling of peers. This sets up a process of peer rejection.

Academic Problems

ADHD children often do not do well in school. Poor school performance by itself does not result in social rejection. However, the way the child responds to his academic difficulties can contribute to inappropriate social behavior.

Children who cannot engage themselves with classroom work assignments often disrupt and irritate their peers.


ADHD children have difficulty with sustained attention. Deficit in attention seems to be related to peer rejection independently of the aggressive, impulsive, and hyperactive behaviors of ADHD children. These children become bored more easily than other children. As a result, they are more likely to become disruptive in the classroom.

ADHD children have difficulty in modulating their behavior and changing their conduct as the situation demands. They have apparent social-cognitive deficits that limit their ability to encode and recall rules of social cues. Children with ADHD pay less attention to others verbally in games and other activities. Many ADHD children are aware that they are socially inept. Children who are anxious or fearful about peer relations are unlikely to behave in an effective manner.

These children withdraw from peer interactions and, in this way, limit their ability to gain acceptance and friendship. Children are rejected by peers when they appear to be different. Similarity fosters social acceptance. Because ADHD children do not learn social clues as well as other children, they tend to be viewed as strange.

Bad Behavior

One of the keys to your child's social success is proper behavior. If your ADHD or ODD child frequently misbehaves, it is your obligation as a parent to teach your child how to improve his behavior. If your child is aggressive or defiant, if he does not accept the authority of adults, or if he conducts himself in a such a way that children his age will view him as a behavior problem, then your child will have a difficult time making and maintaining friendships. The friends he will attract are other aggressive problem children, the type of child with whom which you would rather your child not associate. All children need friends. Behavior problem children have trouble making friends with others, so these children tend to congregate together.

They reinforce each other's bad behavior. If you are an aware parent and you have control of your child you can put a stop to friendships with these children. However, you must have control of your child's behavior in order to help him to avoid the trap of bad friends.


Helping children with ADHD build close peer relationships is an important goal to focus on, and is one that often may be overlooked. You, as a parent, have the ability to help your child accomplish this important social goal.

You should make every effort to help your child in this area. His psychological health and his happiness, both now and in the future, are very much dependent upon how successful he is at making and maintaining childhood friendships.

Parents benefit from being involved in parenting programs with experts. Dr. Anthony Kane is a medical doctors who is one such expert, and he has contributed several articles to our newsletters and websites. Dr. Kane has put together a parenting program, complete with the opportunity to consult with him. His program has a tremendous amount of information, ideas, and wisdom to help you parent ADHD children. Here's where you can get his expert help without leaving your home: Dr. Kane's Parenting Resources.

Anthony Kane, MD
ADD ADHD Advances
Anthony Kane, MD is a physician and international lecturer. Get ADD ADHD Child Behavior and Treatment Help for your ADHD child, including child behavior advice and information on the latest ADHD treatment.

Editor: The opinions expressed by out guest authors are not necessarily those of the ADD ADHD Information Library or Dr. Doug Cowan

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ADHD and Caffeine

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ADHD and Caffeine: a Treatment Option?

For many years our ADHD diet has promoted the use of moderate amounts of caffeine in the morning, along with a protein drink supplement and the nutraceutical medicine Attend, as a part of the program. Parents have reported success using the program, both with their ADHD children as well as in their own lives.
the ADHD diet is available in full at ADHD diet information site click here

Go to the ADHD Diet Information site to get the full ADHD diet in eBook PDF format, including our UPDATES for 2013. We also have the full 21 minute information video on our ADHD eating program.

Caffeine is a mild CNS stimulant that can be used with ADHD children, teens, and adults, if used purposefully and in moderation. All stimulants are vaso-dilators, meaning that they allow the blood vessels to increase in size and increase the blood flow in the brain. One of the primary physiological problems causing ADHD seems to be a lack of blood flow to certain regions of the brain, and stimulants help to improve blood flow and reduce symptoms caused by this problem, at least temporarily.

It is estimated that 100 mg of caffeine is equivalent to 5 mg of Ritalin, which is the lowest therapeutic dose, and the usual starting dose for children. It is similar to Ritalin in that caffeine is absorbed and begins working in about 45 minutes, and the benefits wear off after about three to four hours. And, of course, caffeine can have the same kinds of side effects as other stimulants.

There may be times when it would be advantageous to have caffeine available for someone with ADHD who is successfully using stimulant medication, such as to avoid the “rebound” or “trough” effects of the stimulants, or on weekend outings, etc.

Also, if 5 mg of Ritalin is a successful therapeutic dose, parents and physicians should at least talk about using caffeine instead.

Caffeine is the most commonly used psychoactive drug in the world, with about 80% of the world’s population drinking down caffeine every day. The average daily consumption of caffeine among American adults and teens is about 260 to 300 mg per day, but about one person in four consumes more than 600 mg each day. And yes, caffeine in large amounts, over a long period of time, is addictive.

How does America get its caffeine? Here’s a pretty good list:

  • Coffee, 8 oz cup has 135 mg
  • Instant coffee, 8 oz cup has 95 mg
  • Expresso, 1 oz shot has 50 mg
  • Tea, 8 oz cup has 60 mg
  • Green Tea, 8 oz cup has 30-40 mg
  • Coca-cola, 12 oz has 35 mg
  • Diet Coke, 12 oz has 45 mg
  • Dr Pepper, 12 oz has 40 mg
  • Mountain Dew, 12 oz has 55 mg
  • Pepsi cola, 12 oz has 37 mg
  • Sunkist Orange, 12 oz has 40 mg
  • Red Bull, 8.5 oz has 80 mg
  • Full Throttle, 8.0 oz has 70 mg
  • SoBe No Fear, bottle has 160 mg
  • Pain Relievers such as Excedrin, Bayer max strength, Midol have 60-65 mg

Drinking sodas, coffee, “energy drinks,” and other beverages with caffeine, should never replace drinking water. The human body, and specifically the brain, needs an adequate supply of water ever day in order to function optimally. Drinking a diet Pepsi is not a substitute for water. So make sure that your ADHD child or ADHD teenager is still drinking 4 to 8 glasses of water per day, depending on their body size, how hot it is outside, how active they are during the day, and so on.

Of course, whenever possible we would recommend using our ADHD diet recommendations, our specific treatment strategies for ADHD, including Attend, and other alternative treatments for ADHD, in lieu of Ritalin or stimulant medications.

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