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Help for ADHD

My 9-year-old son was “diagnosed” with ADD last year. I have some reservations about the diagnosis to begin with because no tests were done and the diagnosis was based on nothing more than the doctor talking to me. My son was placed first on Concerta, then Metadate and most recently we have been told he is being switched to Ritalin. The Metadate does not appear to be having any noticeable effect any more, but I am far from convinced that changing drugs again is really the right way to go. He is easily distractible, but he has never had any of the really serious symptoms and disruptive behavior that I have read about in researching this condition. I have heard that omega-3 fatty acids have shown some promise, as well as calcium/magnesium and behavior modification. I have not found any conclusive studies about herbs. Do you have any information or suggestions that would help me?
D.B.
Culpeper, Virginia

Khalsa responds: Your story is, unfortunately, all too familiar. Attention deficit diagnosis rates are rising, but it is unclear whether this is just the result of doctors becoming more aware of the disorder and its diagnosis and management.

This disorder is technically called Attention Deficit/Hyperactivity Disorder (ADHD). Attention Deficit Disorder (ADD) is an outdated term. In common discourse, ADD and ADHD are used interchangeably.

It is estimated that approximately 2 million U.S. children have ADHD — between 3 and 5 percent of kids. The main features of ADHD are inattention, hyperactivity and impulsivity. Impulsiveness and hyperactivity usually precede inattention, which may not come forward for a year or more after the initial symptoms appear.

Symptoms may vary in different settings, depending on the child’s self-control and the circumstances. One who “can’t sit still” or is disruptive will be obvious in school, but the inattentive daydreamer may not be noticed. The impulsive child who acts before thinking may be labeled a “discipline problem,” while the passive child may merely seem unmotivated. Both may have different reflections of ADHD.

All children are sometimes restless, impulsive and sometimes daydream the time away, all of which is normal and healthy. When the child’s behaviors or mental states begin to affect performance in school, social relationships or behavior at home, it may meet the threshold for an ADHD diagnosis. ADHD is not easy to diagnose. This is particularly the case when inattentiveness is the primary symptom, as it seems to be in your son’s case. Professionals recognize three subtypes — hyperactive/impulsive, inattentive and combined. Obviously, this is just a spectrum, and diagnosis is quite subjective. A diagnosis is based on a checklist of symptoms from DSM-IV, the official diagnostic manual. To be ADHD, the behavior must be demonstrated to a degree that is inappropriate for the person’s age, appear before age 7, continue for at least six months and create a real handicap in at least two areas of the person’s life.

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