Inattentive ADHD Treatment Questions From the Primarily Inattentive ADD Mailbox

Inattentive ADHD Treatment Questions From My Mailbox

As many of you have likely gathered, I am posting only very sporadically now.  With one of my sons in middle school and the other in high school, I am finding that I am spending more time supporting them both by being at home for them and by working more to be able to afford their very expensive private school.

I am answering emails and lately I have had some good questions that I wanted to share with you.  None of these questions have pat answers but if you are a regular reader of this blog, you know that there are no "one size fits all" answers.  This question is kind of a composite of the questions that I have answered of late.

Hello Tess,

I recently came across your website as I was searching for info on how to help my son.  He is 12 years old and was diagnosed at age eight with inattentive ADD.  He is on a very lose dose of Ritalin SR (10 mg) daily and this does seem to help him a little bit.  

He is really struggling at school despite having a tutor (since the beginning of the year) twice weekly.  The tutor is charging us $80 per hour and our family can barely afford her.  More importantly, I am not sure that she is making any difference.  His grades have not changed, he is still really struggling in school and cannot seem to focus on his schoolwork for any real length of time and homework time is always "meltdown" time at our house.

I am sure that, like you, I had this going on as a kid – teachers couldn't believe that I was actually smart and I had an amazing imagination and daydreamed all the time – still considered “spacey” by many.  My son is me times 10.  When he was tiny, I knew we were kindred souls, and we are very similar in many ways. 

We struggle with this diagnoses as you know very few people know the distinction of ADHD and ADHD-I.  We are constantly looking at schools where we might qualify for financial aid and that might be a better fit but have not succeeded in finding one that we are willing to take the leap of faith with.

Any suggestion that you might have that could help our son would be greatly appreciated!

My Answer

Hi,  Thanks for your questions.  I guess, before I can make any suggestions, I have a few questions about your son.

What does he love to do?
Does he focus when he plays sports?
Does he have any other medical, emotional, psychological (anxiety, depression, hearing, Celiac...)?
What subjects in school are the most difficult?
Does he like school?
Does he have friends?
Does he ever focus on something?
How is your relationship with the school?

The reason I ask all these questions  is that all these factors matter.  If he loves sports and focuses during sports, he should continue to do them.  ANYTHING that teaches an inattentive kid to focus (not counting hours of video games) will help them in the long run. 

 Melt downs over homework are really common.  Forging a plan as a team (it sounds as though you are doing this) helps.  Breaking down the tasks into pieces and interjecting fun activities, snacks, breaks all help. If you can meet with the teacher and have her make sure he stays on task at school, this would help.  Sometimes asking the teacher for a recommendation of a kid who could do the homework with him (not for him but with him) with you out of the picture helps inattentive kids focus as they tend to "sync" better with someone their own age (Or slightly older. In the 4th grade my son had a neighbor in 7th grade who I paid $7 an hour to be a "homework" helper.  Later, I got him a High School senior to be a homework helper for $10 an hour-my son never melted down with the homework helpers and they are cheap!!). 

 If he likes school, that is a real plus.  I do not know what you do but if you could help out at school, that often makes kids feel more like school is a family event rather than somewhere they are "sent off to".  Since you had ADD as a kid, try to draw on your own experiences of what helped you.  Kids with ADD/ADHD (as I am sure you know) often have other medical/emotional/psych things going on.  They all do better if these things are treated.

Let me know if any questions that you might have.

Music and Inattentive ADD

Music and Inattentive ADD
Recently I was asked by a reader if there was  a connection between music and performance in kids with inattentive ADHD.  This reader was a parent who had found that her ten year old daughter could do her math problems faster and with more accuracy if a certain type of music was playing.  It seemed that music helped her attention.

As it turns out there is a correlation between math and music.  Many composers have been found to have amazingly advanced mathematical minds and neurobiologist have found that music can stimulate the part of the brain that is used for memory and higher brain functions such as reasoning and spatial problem solving.

It may be that music also helps kids with ADHD do better in school.  In one study (see below) boys with ADHD were tested on classroom performance with music on and off.  Some, but not all of the boys, benefitted from having music playing while studying.  

The differences in performance and the reason why some boys benefited from the music and others did not might be related to genetics.  The second study listed below seems to point to the fact that music can act beneficially because it acts on some of the genetically determined pathways that are amiss in ADHD.  

Not all music helps.  It seems as though the tempo of the music makes a difference.  Rock, Rap and some types of classical music seem to help more than say folk music.  In my family, my son studies wearing ear phones and he listens to classical type music.  He really feels that it helps him stay focused.

As I mentioned, it may not help everyone with Inattentive ADD but what the heck, if you have not tried working while listening to music, give it a try!

J Abnorm Child Psychol. 2011 Nov;39(8):1085-98. doi: 10.1007/s10802-011-9529-z.
Music and video as distractors for boys with ADHD in the classroom: comparison with controls, individual differences, and medication effects.

This study examined the effects of music and video on the classroom behavior and performance of boys with and without attention deficit hyperactivity disorder (ADHD) and examined the effects of 0.3 mg/kg methylphenidate (MPH or Ritalin). In one study, 41 boys with ADHD and 26 controls worked in the presence of no distractor, music, or video. Video produced significant distraction, particularly for the boys with ADHD, and MPH improved the performance of boys with ADHD across distractor conditions.There were individual differences in response to the music such that some boys were adversely affected and others benefited relative to no-distractor.In a second study, music and MPH were assessed in an additional 86 boys with ADHD to examine further the music results. In the presence or absence of music, MPH improved performance relative to placebo. Similar individual differences were found as in Experiment 1.

Med Hypotheses. 2010 Mar;74(3):513-20. doi: 10.1016/j.mehy.2009.10.008. Epub 2009 Nov 14.
Do dopaminergic gene polymorphisms affect mesolimbic reward activation of music listening response? Therapeutic impact on Reward Deficiency Syndrome (RDS).