We all know that one child that plays up in class; they never seem to listen to instructions, are often easily distracted, have difficulties making and maintaining relationships with other children, and are in the principal’s office every other day. Maybe you are a parent of that child, or were even that child yourself!

Sometimes these children can be mislabelled as ‘problem kids’, who are either ‘lazy’ or ‘poorly disciplined’ by parents. But what if there is more going on than meets the eye?

Attention Deficit Hyperactivity Disorder (ADHD) is a common problem that results in a wide range of difficulties for both children and adults. Key features of ADHD may include (but are not limited to) inattention, distractibility, hyperactivity, and impulsivity. If left untreated, ADHD can have a severe impact on all aspects of life, including school, relationships and employment (Steiner et al, 2014; American Psychiatric Association, 2013).

Now, let’s play some true or false!

ADHD is just an excuse for kids who are lazy or poorly disciplined: False.

Whilst children with ADHD do often respond well to structure, parenting styles do not cause ADHD. And it’s more than being ‘lazy’, it’s brain-based: The latest evidence suggests there is an association between ADHD and changes in the structure, function, brain wave activity and chemical messengers in key areas of the brain involved with attention and impulse-control (Steiner et al, 2014; Shire, 2017; Markovska-Simoska & Pop-Jordanova, 2016). It is widely acknowledged that children with ADHD actually have to work much harder to stay focused on the task at hand.

All children with ADHD are hyperactive: False.

ADHD is an umbrella term that includes three main subtypes; predominantly inattentive, predominantly hyperactive/impulsive, and combined (Shire, 2017).

They will just grow out of it: False.

ADHD will often continue throughout adolescence and into adulthood. Adolescents and adults with ADHD are at increased risk of physical and mental health problems including drug or alcohol abuse, anxiety, depression, low self-esteem, relationship difficulties and employment problems (Ensafi et al, 2014; Faraone & Biederman, 2016; Shire, 2017). A recent Lifetime Impairment Survey was conducted in which 49-50% of adults with ADHD reported that their childhood and teenage years have had a negative impact on what they could have achieved in their life (Shire, 2017).

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Medication is the best/only treatment option for ADHD: False.

In the past, treatment for ADHD was often limited to medication. More recently, it is increasingly accepted that the most effective management for ADHD should be ‘patient-centered’ and involve a range of interventions (Shire, 2017). Other non-pharmacological treatment options that have been proven to be effective for some people include behavioural therapy, psycho-education, brain-based therapies such as neurofeedback, and lifestyle and diet changes such as reducing sugar intake and increasing physical exercise. (Shire, 2017; American Academy of Pediatrics, 2012).

Exercise is beneficial for children with ADHD: True.

There is a growing body of evidence which supports the use of exercise as an adjunct treatment in ADHD. Research shows that exercise triggers the release of important hormones and chemicals such as endorphins, dopamine and serotonin, which have been shown to reduce the severity of ADHD symptoms such as impulsivity, and improve executive functions such as attention, focus and organization (Pontifex et al, 2013). As an added bonus, physical activity also reduces the risk of type two diabetes and cardiovascular disease, improves coordination, and builds and maintains healthy weight, muscles and bones (Department of Health [D.O.H.], 2014)!

Exercise helps children with ADHD to stay focused in class: True.

A study by Pontifex et al (2013) found that a 20-minute bout of moderate-intensity aerobic exercise resulted in enhancements in inhibitory control (the ability to focus on relevant stimuli in the presence of irrelevant stimuli and to override strong but inappropriate behavioural tendencies), and academic performance in the areas of reading comprehension and arithmetic in children with ADHD. Similar results have been mirrored in other studies.

My child does sport twice a week at school, this is enough exercise: False.

The department of health recommends that children aged between 5 and 12 years old engage in at least 60 minutes of physical activity each day (D.O.H., 2014). This is any activity that involves movement, faster breathing and an increased heart rate.

Exercise can be broken up throughout the day: True.

There are many ways for a child to be physically active, and it doesn’t have to be all in one go. It can be accumulated throughout the day in smaller windows of opportunity. All activity is good, but the recommendation is moderate to vigorous activity (D.O.H., 2014). Moderate activities include things such as fast walking, riding a bike or scooter, and vigorous activity includes things like running, playing tag, and sports such as soccer or netball.

It’s good to try and vary the types of exercise my child is doing: True.

On at least three days per week, children should engage in activities that strengthen muscles and bones. Ideas include skipping, hopscotch, using the monkey bars and gymnastics (D.O.H., 2014).

And there you have it – the evidence is mounting that exercise really does benefit children with ADHD! So, if you are interested in increasing the amount of exercise your child gets, perhaps try rewarding them with a trip to the park rather than iPad time, or aim to give gifts such as a bike or kite for birthdays to encourage physical activity.

At The Perth Brain Centre, they focus primarily on providing neurofeedback in conjunction with behavioural interventions, psycho-education, lifestyle and dietary advice. Neurofeedback is recognised by The American Academy of Paediatrics (AAP) to be an effective treatment for ADHD and is featured in Dr Norman Doidge’s book “The Brain’s Way of Healing”, the sequel to his international best-selling book “The Brain That Changes Itself” (American Academy of Pediatrics, 2012).

For further information about how Neurofeedback and other non-pharmacological interventions such as exercise and nutrition can help ADHD please contact Lynda Gibbs (Occupational Therapist) or any other member of team at The Perth Brain Centre www.perthbraincentre.com.au.

About the author - Lynda Gibbs (Occupational Therapist, The Perth Brain Centre).

Reference

American Academy of Pediatrics. (2012). Evidence Based Treatment Guidelines. Retrieved from http://bio-medical.com/media/blog/evidence-based-child-and-adolescent-psychosocial-interventions.pdf

American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders 5th Edition (DSM-5). American Psychiatric Association: United States.

Department of Health. (2014). Australia’s Physical Activity and Sedentary Behaviour Guidelines for Children (5-12 years). Retrieved from http://www.health.gov.au/internet/main/publishing.nsf/content/F01F92328EDADA5BCA257BF0001E720D/$File/brochure%20PA%20Guidelines_A5_5-12yrs.PDF

Ensafi, E., Rostami, R., Dolatshahi, B., Poursharifi, H. & Nouri, M. (2014). The Effectiveness of Neurofeedback on the Working Memory in Children with ADHD. Practice in Clinical Psychology, 2(3), 128-134.

Faraone, S.V. & Biederman, J. (2016). Can Attention-Deficit/Hyperactivity Disorder Onset Occur in Adulthood? JAMA Psychiatry, 73(7), 655-656.

Markovska-Simoska, S. & Pop-Jordanova, N. (2016). Quantitative EEG in Children and Adults with Attention Deficit Hyperactivity Disorder: Comparison of Absolute and Relative Power Spectra and Theta/Beta Ratio. Clinical EEG and Neuroscience, 48(1), 20-32.

Pontifex, M.B., Saliba, B.J., Raine, L.B., Picchietti, D.L. & Hillman, C.H. (2013). Exercise Improves Behavioral, Neurocognitive, and Scholastic Performance in Children with Attention-Deficit/Hyperactivity Disorder. Journal of Pediatrics, 162(3), 543-551.

Shire. (2017). ADHD Institute Website. Retrieved from http://www.adhd-institute.com

Steiner, N.J., Frenette, E., Rene, K.M. et al. (2014). Neurofeedback and Cognitive Attention Training for Children with Attention-deficit Hyperactivity Disorder in Schools. Journal of Developmental & Behavioural Paediatrics, 35(1), 18-27.

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