Expert: Norm Bishop - 3/20/2010

Question
Hello,
My 9 year old son is diagnosed with PDD NOS and ADHD.  His school has suggested to me to medicate him.  I do not wish to do this at this time.  My personal belief is that medication is a last resort and we should first do all we can behaviorally.  I don't feel we are ready to go the medication route.  The school have asked me to see a Neurologist to determine if he should be medicated.  I don't mind seeing a Neurologist, we saw several when he was younger.  The only thing is that medication is such an integral part of Neurology.  I am not sure that there is a Neurologist who would not suggest medication.  It is like asking a Behavior Analyst whether or not we should do Applied Behavior Analysis.  A friend suggested that we go to a Neuropsychologist instead.  We live in Massapequa, NY.  What are your thoughts?

Answer
I am not a physician and thus cannot give you medical advise.  However, I can tell you that in my experience about 50% of those students I have observed taking stimulant medications for ADHD respond favorably to it, which means they have better control of their behavior.  The other 50% simply remain the same...part of that is due to improper diagnosis.

Second, the school might suggest that you see a Physician for consideration of treatments, but has no place suggesting that you need to medicate your child, unless, of course, one of the school officials has been to medical school.  

If I had a child with ADHD, clearly diagnosed, I would explore all options.  I would be like you in relation to stimulant medication.  I would want to try everything else that may have promise before I tried the medication.  Right now, the research indicates that there may be several causes to ADHD, meaning that not every child responds the same to every intervention.  

Dr. Daniel Amen, http://www.amenclinics.com/ using spect image has done pioneering research into how the brain reacts under different circumstances.  You may want to visit this website, see if there is information there.

I typically suggest that you look at four variables that may or may not help you child.  1) Sleep patterns, make certain that you child sleeps at least 8 hours per night, enters Rapid Eye Movement, doesn't thrash about the bed, sleepwalk, or not remember dreams.  Lack of deep sleep seems to be a huge factor in ADHD behaviors.  2) Reduction or elimination of sugar, especially anything that contains High Fructose Corn Syrup, Corn Syrup, or otherwise highly processed form of sugar.  3) Reduction or elimination of packaged foods which are high in sugar content, salt content, preservative content and dye content.  4) Finally, create as much positive structure as you can in your home.  Create a behavior management system that gives the child rewards for great behavior...a point system works well.  In addition to this, it would not hurt anything to see a Neuropsychologist.  I am more inclined to find a doctor who has extensive practice in the treatment of ADHD and PDD.  

There is an Amen Clinic in Reston, VA, but that is as close has his practice gets.  I like his research and what he is doing.  I have not purchased or recommended purchase of any of his products, however.  

Good luck with whatever you decide.

Norm