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ADHD Without Medication: What Actually Works (According to the Highest-Quality Research) · Raising ADHD: Real Talk For Parents & Educators

0:00
Apryl: If you're parenting an ADHD child without medication, maybe that's by choice, by necessity, or because you're still figuring it out, you've probably asked yourself some version of this.
0:11
Apryl: Okay, what actually works?
0:14
Apryl: Not what's trending on TikTok, not what someone's cousin swears cured ADHD.
0:19
Apryl: What's supported by the highest quality research?
0:23
Apryl: And today's episode is going to give you that.
0:26
Apryl: And we're also going to be giving you the honesty that you deserve, things that most people avoid.
0:33
Apryl: So let's dive in.
0:35
Apryl: Welcome to Raising ADHD, the podcast for parents and teachers raising ADHD kids.
0:41
Apryl: If you've ever felt frustrated, overwhelmed, or just unsure what to do next, you're not alone.
0:47
Apryl: I'm April Bradford, a former teacher and ADHD mom, and alongside my husband, Dr.
0:53
Apryl: Brian Bradford, a child and adolescent psychiatrist, we're here to give you the clarity, strategies, and support you've been looking for.
1:01
Apryl: Every week we break down the misconceptions, answer your biggest questions, and share real tools you can use right away at home and in the classroom.
1:10
Apryl: So if you're ready to feel more confident and less overwhelmed, you're in the right place.
1:15
Apryl: Hey there, welcome back to Raising ADHD.
1:18
Apryl: If you're new here, welcome.
1:20
Apryl: If you're returning, welcome, friend.
1:22
Apryl: We're so happy to have you.
1:24
Apryl: My name is April Bradford.
1:26
Apryl: I'm a former teacher, ADHD mom.
1:29
Apryl: Well, I should say that mom to an ADHD or and wife to an ADHDer.
1:34
Apryl: And here along with me, back with me, is my husband, Dr.
1:38
Apryl: Brian Bradford.
1:39
Brian: Hey, April.
1:41
Apryl: Brian.
1:41
Apryl: Brian is a child and adolescent psychiatrist, and he deals with ADHD every single day.
1:48
Apryl: So today we are breaking down what the best evidence says about non-medication strategies for ADHD.
1:57
Apryl: We have compiled research from the top-tier sources.
2:01
Apryl: So, like the National Institute of Mental Health, Cochrane, peer-reviewed PubMed research, the American Academy of Pediatrics, you get it.
2:10
Apryl: Like this is no fluff.
2:12
Apryl: This is like the real research, evidence-based, what is actually working.
2:19
Apryl: As with all of our episodes, this is for educational purposes only.
2:23
Apryl: This is not medical advice.
2:24
Apryl: Brian is a doctor, but he's not your doctor.
2:28
Apryl: So this is educational purposes only.
2:30
Apryl: Hey there.
2:31
Apryl: Before we dive into this episode, I want to invite you to my upcoming workshop called You Love Your Child, but you don't love who you're becoming.
2:44
Apryl: Like I said, you love your child.
2:46
Apryl: Maybe you don't like them some days.
2:48
Apryl: This masterclass is for you.
2:51
Apryl: We're going to talk all about yelling, how to stop that yelling trap, how to make your home calmer and your life better.
3:01
Apryl: Improve your quality of life.
3:02
Apryl: It's a live workshop coming up.
3:05
Apryl: So go to raisingadh.org slash workshop and you can sign up for the upcoming workshop.
3:11
Apryl: Okay, so let's dive in.
3:14
Apryl: Brian, can you start with the baseline?
3:17
Apryl: Because parents hear a lot of promises and a lot of just things spread out there all over on TikTok and Facebook and all the places.
3:26
Brian: Yes.
3:27
Brian: So a few, a few big points, but really one big one.
3:31
Brian: So the Lancet, which is, I mean, one of the most prestigious journals out there, they did a big systematic review and they found out that compared to medications, the non-pharmacological treatments did not did not really compete very well.
3:45
Brian: NIMH, the National Institute of Mental Health, they stated very directly medication is the single most effective treatment for reducing ADHD symptoms, especially impulsivity, inattention, and hyperactivity.
3:58
Brian: And we've already kind of talked about this, but those are three of the hardest ones to treat with other things like therapy and stuff like that.
4:07
Apryl: Okay, so I want everyone to hear the tone of that.
4:10
Apryl: This isn't a so don't bother.
4:13
Apryl: This is like let's set realistic expectations.
4:17
Apryl: This is what the research shows.
4:19
Apryl: Years and years of research, many different research just throughout.
4:24
Apryl: That's what it shows.
4:25
Brian: Yes, so realistic expectations, exactly.
4:28
Brian: I just want to set the set the record straight.
4:30
Brian: When we're we're not comparing non-medications to medications saying, oh, these are equal, you know, take your take your pick.
4:37
Brian: The medications are hand hands down the most effective options.
4:42
Brian: This this episode is really for those who either cannot take medications or for whatever reason, medication just they they need to find those, the non-medication options.
4:52
Apryl: So just like Brian said, the goal is not to replace medication here.
4:56
Apryl: The goal is to build the strongest evidence-based plan possible with the reality you're living in right now.
5:02
Apryl: So whether that is that you can't medicate, you're choosing not to, we're gonna try to help you build the best plan possible.
5:10
Apryl: So let's start with what every major authority agrees on for kids, especially younger kids.
5:16
Apryl: What is that, Brian?
5:17
Brian: So, yes, if there's anything that's gonna compete with medications, it's behavioral parent training.
5:23
Brian: And for the young kids like under six, this is the gold standard.
5:28
Brian: This is you can you can find like the CDC and the American Academy of Pediatrics recommending this as first line before medications for those kids under six.
5:38
Apryl: Okay, and I want to slow down here because parents sometimes think behavior therapy means sitting in a room and talking about feelings.
5:46
Apryl: And that's not what this is.
5:47
Apryl: And I also want to point out that this was parent training.
5:52
Apryl: It's not behavioral training for the kids, it's behavioral parent training.
5:57
Apryl: Brian, can you talk about that a bit?
6:00
Brian: Right.
6:01
Brian: So, and some of you probably have already had these, but these are structured programs.
6:06
Brian: They're gonna have multiple sessions, oftentimes like eight plus sessions, and the parents are gonna learn strategies, they're gonna learn things like positive reinforcement, structure, positive communication, and they're gonna be given homework assignments that they can practice at home between sessions with coaching.
6:22
Apryl: And the CDC makes a point that's honestly revealing here.
6:27
Apryl: Young kids aren't mature enough to change their own behavior without parents being trained.
6:33
Apryl: And I see this in Facebook groups a lot.
6:36
Apryl: Parents are like, oh, we have our kid in behavioral therapy, and I'm thinking, I've read the research, I know what it says.
6:43
Apryl: It is not these kids are too young to change the behavior on their own.
6:47
Apryl: It's the parents that need to be trained.
6:49
Apryl: So it's not why can't my child just do better?
6:51
Apryl: It's we need the tools that match their developmental stage.
6:55
Apryl: And that's what this behavioral parent training is.
6:59
Brian: Right.
6:59
Brian: So here's another thing with some of these things.
7:02
Brian: So there was a Cochrane review that found that parent training not only improves child behavior, but it also reduces parental stress and can increase parental confidence.
7:14
Apryl: So if you're listening and you want the start here, this is it.
7:20
Apryl: There's not an app, not a supplement.
7:23
Apryl: I see that all the time.
7:24
Apryl: What supplements are you trying?
7:26
Apryl: Not some fancy planner or checklist, whatever.
7:30
Apryl: This is where you start.
7:31
Apryl: This is the gold standard.
7:32
Apryl: Behavioral parent training.
7:35
Brian: Right.
7:36
Brian: And I mean, just to rehash, this is one of the most effective things.
7:39
Brian: And for the young kids, it's right there with medication and can have as good a results and less side effects than medications in those really young kids.
7:49
Apryl: So I'm gonna go off for just a second and just clarify a bit with that.
7:53
Apryl: So our young kids were saying under six.
7:57
Brian: Four, five, six is kind of still there.
8:00
Brian: That being said, this behavioral parent training doesn't stop at six.
8:03
Brian: I mean, this can go up through some of your elementary ages also as well.
8:07
Apryl: And the skills that they're learning are gonna carry on throughout parenthood.
8:13
Brian: The skills that you learn, especially if you're able to learn them young, you can use them with your high schooler still.
8:20
Apryl: Perfect.
8:21
Apryl: And another follow-up question to this, Brian, is so we have we get behavioral parent training.
8:26
Apryl: Does that mean that, you know, once our kid is a little bit older in elementary school, six, seven, eight, because we've done parent training, are they they're like, I'm putting this in quotes, fixed.
8:37
Apryl: We don't need medication because we've done this, or what do you see?
8:40
Brian: Yeah, I mean, it's not a fix because ADHD is an organic disorder.
8:45
Brian: That being said, you're gonna have better results, you're gonna have better school performance and better just calmness in the household.
8:52
Apryl: Yeah.
8:53
Apryl: And going back to household versus school, this is again parent training.
8:58
Apryl: That does not mean that our teachers are trained to deal with the behavior either.
9:03
Apryl: So this is definitely gonna help your household be more calm, though.
9:06
Apryl: So, okay, now that we've talked about the gold standard, um, next pillar that this one was big in the research summary is exercise.
9:17
Brian: Right.
9:18
Brian: And we all hate to hear this because it's like I it's it's a lot of work to exercise.
9:23
Brian: But we know that exercise helps ADHD, it helps anxiety, it helps depression, and it can actually show a pretty decent effect size.
9:32
Brian: And there's a couple types of exercise that we should be talking about.
9:34
Brian: There's the acute effects, so right after you exercise, when you're able to get your heart rate up, 20 minutes, that's all we're talking, you can get like immediate benefits that last for an hour afterwards.
9:46
Brian: So going on a brisk walk right before a test can be beneficial.
9:49
Brian: Other, the other type we're talking about is long-term.
9:52
Brian: If you can get into one of these like moderate high-intensity things, you can imagine like going to basketball practice three times a week, 45 minutes.
10:01
Brian: If you're able to get your heart rate up, that can lead to some lasting effects.
10:05
Apryl: So exercise, there are multiple reviews and research articles that show exercise improves executive functioning, inhibitory control, and cognitive flexibility.
10:19
Apryl: And like Brian said, if you can do a 20-minute session, and this is so big, like I'm like, gosh, I wish I would have.
10:25
Apryl: I mean, we know exercise, like you said, Brian, we know that exercise has so many benefits.
10:30
Apryl: Like as a teacher, especially like, you know, it's so stressful end of your testing, all that stuff.
10:35
Apryl: If I could have taken my kids outside before recess, it's like we always schedule the testing first thing in the morning.
10:41
Apryl: It's like, let's get it in while they're still, you know, not burned out from the day.
10:45
Apryl: No, like let's go out to recess for 20 minutes.
10:47
Apryl: Let's have them play hard on the playground.
10:49
Apryl: Because guess what?
10:50
Apryl: It's gonna help every kid, not just our ADHD kids.
10:53
Apryl: And 60 minutes after exercise, that's huge.
10:57
Apryl: And again, another reason not to be taking recess away from our kids because it's actually going to help the behavior in the classroom if we let them go out to recess.
11:07
Apryl: So the take home is not kids need sports, it's kids need movement that actually activates the system.
11:16
Brian: Right.
11:17
Brian: Moderate, moderate high intensity.
11:18
Brian: That's where you're most effective.
11:20
Brian: Uh and I mentioned basketball.
11:22
Brian: Basketball is a great one.
11:23
Brian: There's other things though, especially for your uh, I don't want to say less athletic, but your kids who are just they're not into sports.
11:29
Brian: Riding a bike, swimming, running, soccer, martial arts, anything where you can get your heart rate up, these can all count towards that.
11:38
Brian: They're all still gonna get those same benefits.
11:40
Apryl: Yeah, jumping on a trampoline.
11:42
Apryl: We have a mini trampoline in our house, which is super helpful.
11:45
Apryl: So you just want them breathing hard but still able to speak.
11:48
Apryl: That's when we're saying moderate to high intensity.
11:51
Apryl: That's what you're looking for.
11:52
Apryl: Here's the actionable home plan based on evidence.
11:56
Apryl: So 20 minutes in the morning, if possible.
11:58
Apryl: I mean, I know with school and all the things, that's not always possible.
12:03
Apryl: But if we can do that, then we get that roughly we get that 60-minute window of benefits.
12:08
Apryl: So it's right before school.
12:09
Apryl: We know that that first 60 minutes of school is gonna be great.
12:12
Apryl: Another movement block after school, so before homework.
12:15
Apryl: I know that like lots of parents are like, okay, get home, do your homework.
12:18
Apryl: No, give them a movement block after school and before homework, and then choose activities with that continuous movement, just like Brian was saying: the running, swimming, biking, martial arts.
12:30
Apryl: And the research notes this tends to work better than activities with a lot of weighting, which totally makes sense.
12:37
Apryl: So look for those types of activities.
12:39
Apryl: Try to find those types of activities that your kiddo likes.
12:42
Brian: You know, one more big push for exercise.
12:45
Brian: We know there's three things that come along with ADHD, depression, anxiety, and difficulty sleeping.
12:53
Brian: Exercise helps with all those.
12:55
Apryl: Yeah.
12:55
Apryl: Very good point.
12:56
Apryl: All right.
12:56
Apryl: So that actually leads us very well into the next one is sleep.
13:01
Apryl: So this part surprised me, not that sleep matters, because we've talked about this so many times on the podcast, but that the intervention showed measurable changes in ADHD symptoms.
13:12
Brian: Right.
13:13
Brian: We've we've talked about this.
13:14
Brian: Like you have basically super ADHD when you're lacking sleep and you already have ADHD.
13:18
Brian: That being said, there's some good evidence here.
13:20
Brian: There's a randomized controlled trial out there that found that a brief behavioral sleep intervention led to a decrease in ADHD symptoms at three months, six months, twelve months, even the 12-month follow-up.
13:32
Brian: It improved sleep, obviously.
13:35
Brian: Behavior, quality of life, functioning, and these effects were sustained throughout.
13:42
Apryl: Yeah, and what was interesting too was the report highlighted a key practical point was that brief individualized sleep intervention may be more effective than standardized programs.
13:56
Apryl: So this is individualized for the family, the child, very individual, instead of like, here's a sleep program, follow this.
14:05
Brian: Right.
14:05
Brian: And this kind of goes where seek out your therapist rather than just seek out that online app for help me sleep.
14:12
Apryl: Good point.
14:13
Apryl: Yeah.
14:13
Apryl: I didn't know.
14:14
Apryl: So therapists can help with these like sleep.
14:17
Brian: Yeah, for sure.
14:17
Brian: There's there's a therapy called CBTI or cognitive behavioral therapy for insomnia.
14:22
Brian: It's I mean, it's spectacular.
14:24
Brian: It's one of the best therapies out there.
14:27
Apryl: Awesome.
14:27
Brian: Right.
14:28
Apryl: So here's your family takeaway.
14:31
Apryl: If sleep is messy, which it probably is in an ADHD household, if I'm guessing, it's not just sleep, it's a leverage point that can move symptoms, functioning, and quality of life.
14:43
Apryl: And the research supports brief targeted individualized sleep work, not perfect sleep hygiene forever.
14:50
Apryl: Like Brian said, talk to your therapist about, you know, we need some sleep strategies for our family, not like the Calm app, like something that is actually for your family.
15:02
Brian: Talk to your therapist and ask your therapist about CBTI.
15:06
Brian: Uh, there's a good chance your therapist already does this and could help you with it or could refer you to a therapist that has some good sleep sleep therapy.
15:14
Apryl: Perfect.
15:15
Apryl: Okay, so next one, this comes up a lot, supplements.
15:19
Apryl: I see this all the time.
15:21
Apryl: Hey, have you tried this?
15:22
Apryl: Like random things that people find on Amazon.
15:26
Apryl: People want that magic pill that isn't medication.
15:30
Apryl: So, what does the evidence actually support, Brian, when it comes to supplements?
15:35
Brian: Yes, so this one's a little controversial.
15:37
Brian: We're all like looking for this magical supplement.
15:40
Brian: And for the most part, when we do these studies, nothing stands out with one exception.
15:47
Brian: So that exception is omega-3.
15:51
Brian: And this is not, this is like still a very small, uh, very modest effect size.
15:57
Brian: This is not comparable to a stimulant.
16:00
Brian: You're not gonna go, well, do you want to take omega-3 or Ritalin today?
16:03
Brian: It's it's not the same.
16:05
Brian: It it's very small.
16:06
Brian: That being said, there's actual measurable evidence that omega-3 can help with ADHD symptoms.
16:13
Brian: It's small, but it's there.
16:15
Brian: So I will say this also about it.
16:18
Brian: There was a trial that found that many children did not respond.
16:21
Brian: This isn't just, you know what, I want one or two-point increase.
16:25
Brian: I'm gonna take it as guaranteed.
16:27
Brian: No, a lot of kids, there's no no change at all.
16:30
Brian: In fact, it's more likely you have no change.
16:32
Brian: It's only about a quarter that had any sort of meaningful symptom reduction long term.
16:37
Brian: So if you're really, really dying for a supplement, the one to start with is omega-3.
16:42
Brian: Don't bet the farm on it, though.
16:44
Apryl: Okay.
16:45
Apryl: So you're saying it's not snake oil, but it's also not a replacement and may not work.
16:51
Brian: Yeah, it's not snake oil.
16:52
Brian: This kind of goes along with that uh when we had the caffeine episode.
16:55
Brian: I mean, caffeine's not snake oil, but don't bet the farm on it.
16:59
Brian: Don't don't cancel your medication appointment because you've discovered caffeine.
17:02
Apryl: Yeah.
17:03
Brian: Or omega-3.
17:04
Brian: So I will say this.
17:05
Brian: So with omega-3, it's reasonable to do this as an adjunct, or if for some reason you cannot get medication, this could be something you could try.
17:14
Brian: You just you gotta have realistic expectations.
17:17
Brian: The other thing is it it takes some time for an adequate trial, at least three months.
17:22
Brian: Some data suggesting six months before you're actually able to get a response.
17:27
Brian: This is not a stimulant where you take it on your way to school, and by the time you get to school, poof, you've got all the effects.
17:33
Apryl: Okay, so here is your action plan.
17:36
Apryl: If you're looking for supplements, choose an omega-3 with a higher EPA.
17:43
Apryl: You need to commit to a three to six month trial for this.
17:46
Apryl: You're not gonna see overnight results and watch for meaningful changes rather than tiny daily fluctuations.
17:54
Apryl: You're not like I said, you're not gonna see they wake up tomorrow and boom, there's no change, or there's like all these changes.
18:01
Apryl: No, like look for it over time.
18:03
Apryl: So you've got to commit to that three to six month trial for the omega-3.
18:06
Apryl: So now let's talk about the part that's going to save you time, money, and heartbreak.
18:13
Apryl: What does the research say doesn't work, Brian?
18:17
Brian: So some of these like cognitive trainings, you've seen like the video games and things like this, they do help in the moment.
18:24
Brian: They can help with attention, they can help with inhibition, they can help with memory.
18:29
Brian: The difficulty comes when we try to translate these into real-world changes and we're measuring ADH symptoms like impulsivity and hyperactivity, they they don't hold up very well.
18:40
Brian: So another one is neurofeedback.
18:42
Brian: The NIMH knows that we may reduce some symptoms.
18:46
Brian: In general, though, that reduction is much lower than medication and psychotherapy.
18:52
Apryl: Okay, so the message is if you're doing these because you enjoy them and they fit your family, that's great.
19:00
Apryl: That's fine.
19:01
Apryl: Keep doing what you're doing.
19:03
Apryl: But if you're doing them expecting the kind of symptom change you'd see from medication, the premium sources say that's not realistic.
19:12
Apryl: So now let's put it all together.
19:16
Apryl: Now that we've talked about what does work, what doesn't work, how can we turn this into a plan that parents can actually follow?
19:25
Brian: So tier one, we're gonna call this tier one.
19:28
Brian: These are the things to start with.
19:30
Apryl: These are like the gold standard, like gold standard, good things here.
19:34
Brian: Good things.
19:35
Brian: The behavioral parent training, start there.
19:38
Brian: This is especially if you've got a younger kid, man.
19:40
Brian: This is this is like the the honey right there.
19:43
Brian: Number two, the physical exercise.
19:47
Apryl: Daily physical exercise.
19:48
Brian: Daily physical exercise.
19:50
Brian: Start with that 20-minute window though.
19:51
Brian: Just do the 20 minutes of like intense exercise and then and then see what happens afterwards.
19:56
Brian: I think you'll be surprised with the results.
19:58
Brian: School-based supports, which I mean, we'll cover this in another episode, but I wanna I want you to if you're going through these tiers, you're like, I gotta do the top three, behavioral parent training, exercise, and then these school-based supports.
20:09
Apryl: That'll be in our next episode.
20:11
Apryl: So at home, that means you pick the two you control most, right?
20:16
Apryl: We can't do the school-based uh supports at home, but you can do the parent training and that 20 minutes of exercise.
20:24
Brian: Right.
20:24
Brian: So the next step, if you're if you're like, man, this is this is not quite enough.
20:29
Brian: I need to do the next thing, start with the sleep interventions.
20:33
Brian: The sleep interventions can be very effective, especially if you know that sleep is a big struggle for you and you've noticed, oh man, when my child does have a good night's sleep, things go really well, then then put a priority on the sleep.
20:46
Brian: If it's like, honestly, I think we're sleeping fine, you know, put this down in your priority.
20:50
Brian: This one's kind of like individualized.
20:51
Brian: This could be in tier one for some families.
20:53
Brian: It may not even make tier two in some families.
20:56
Brian: But sleep's very important.
20:58
Brian: The second thing with tier two is you can look into the omega-three supplementation.
21:04
Brian: Again, this is this is very low yield compared to the medications.
21:08
Brian: But if you're if it's diehard, I need I need a supplement.
21:11
Brian: I need the supplement with the most evidence, the omega-3s are where it's at.
21:15
Apryl: Perfect.
21:15
Apryl: And I want to say here, do that tier one first and try it.
21:20
Apryl: It's just like a scientist, right?
21:22
Apryl: Where if you do everything all at once, you don't know what it's actually working.
21:25
Apryl: So if you're like, and we know human behavior, if we're trying to do parent training and do sleep behavior and exercise, like we're just not gonna do it all.
21:35
Apryl: So do tier one first, and then after like a month or two, then be like, okay, let's try some sleep.
21:40
Apryl: Let's try the omega-3, and then take some anecdotal notes to be like, okay, this is working, this isn't working.
21:46
Brian: Also, the end of the episode, we're gonna give you a really amazing way to keep track of symptoms so you can you can track to see if there is an improvement.
21:55
Apryl: Okay.
21:56
Apryl: Sounds exciting.
21:58
Brian: It is exciting.
21:58
Brian: It's way exciting, April.
22:01
Apryl: Okay.
22:02
Apryl: And this is where families feel the biggest quality of life shift.
22:08
Apryl: And it's not because the symptoms vanish, because we know that symptoms don't vanish, but it's because the functioning starts to improve in the household and make that quality of life better.
22:21
Brian: Yep.
22:21
Brian: And so our last tier, tier three, these are, I mean, it may or may not be for you.
22:26
Brian: These are some of those things like cognitive training, neurofeedback, just mindfulness, multinutrients.
22:32
Brian: These are some of these that every once in a while we see like a little bit of benefit, but a lot of the time you're not getting the benefits.
22:40
Apryl: Okay.
22:41
Apryl: So now you have a plan.
22:43
Apryl: I want to talk real quick, Brian, about we need to address is this, is this like an either-or trap?
22:52
Apryl: So, because some people will hear this and think, so if we don't medicate, we're doomed.
22:56
Apryl: It's either medicate or you're just doomed.
22:59
Brian: Yes.
23:00
Brian: The evidence supports a multimodal approach.
23:03
Brian: So what do we mean by this?
23:05
Brian: Well, when you look at the AAP, which is the pediatric big board, they highlight that combining medication and behavioral treatments can lower the doses of each.
23:16
Brian: So you get more effect giving some medication when you're doing behavioral therapy, and vice versa, when you're doing behavioral therapy, you can get away with less medication to get the same effects.
23:26
Brian: You can get improved function, you reduce side effects, you get increased satisfaction.
23:31
Brian: And the original uh ADHD study, the MTA study, which is, I believe, still the most expensive, biggest uh ADHD study there was.
23:43
Brian: Supports the value of multimodal treatment.
23:47
Brian: So this is not like a moral stance.
23:49
Brian: I'm not trying to say like, you know, you need to feel guilt or you need to feel guilt if you don't do it, you need to feel guilt if you do do it.
23:55
Brian: This is a treatment strategy.
23:56
Brian: This is I'm foot on the gas, but I'm also putting in premium fuel.
24:01
Apryl: Well that's so interesting and so good to know.
24:04
Apryl: Um, because again, you don't need to feel guilty.
24:08
Apryl: And if you're not medicating right now, the research base, the research-based approach is stay open to revisiting.
24:17
Apryl: I if you go back to um, I think it was our third episode on if you should medicate your child or not, this is not a lifelong.
24:26
Apryl: If you choose to try medicine, it's not I I'm on medicine now for the rest of my life.
24:32
Apryl: That's not how this works.
24:34
Brian: Right.
24:35
Brian: And and treatment and things like this are so fluid.
24:39
Brian: It's, you know what, we're gonna try medicine.
24:41
Brian: This isn't working for us.
24:43
Brian: I can never ever revisit medicine again.
24:44
Brian: No, that's not how it works.
24:45
Brian: It's, you know what, this isn't for us right now.
24:47
Brian: We tried it.
24:48
Brian: He was six years old and he had some side effects.
24:50
Brian: Let me try it again a date.
24:52
Apryl: Yeah.
24:52
Apryl: And same with the all of these non-medication ways.
24:56
Apryl: It's like try it, see what's working.
24:58
Apryl: Okay, this works.
24:59
Apryl: Okay, maybe it's not working anymore.
25:01
Apryl: Maybe they're getting a little older, whatever.
25:03
Apryl: Maybe we throw in some medication and we try that with these different approaches.
25:07
Apryl: But like Brian said, the multimodal approach is actually the best.
25:11
Brian: So it's the best, yeah.
25:13
Brian: That's that's so common to mental health.
25:15
Brian: I mean, depression, we know medications plus therapy destroys either individually.
25:21
Brian: Anxiety is the same way.
25:22
Brian: I mean, anytime you can kind of throw the whole the whole farm at it, that's the way to go.
25:28
Apryl: And you're essentially treating the whole person.
25:29
Brian: You're treating the whole person, yeah.
25:31
Brian: Yeah.
25:31
Brian: And you know, another thing, I don't know if we really talk about this enough.
25:34
Brian: The the medications help different symptoms at different rates.
25:39
Brian: And so some of the medications can really help with, say, like impulsivity or attention, but they're maybe not helping with sleep or some of these other symptoms that are coming along with ADHD.
25:50
Brian: It's not just take this medication and you're cured.
25:53
Brian: And everything's fixed, yeah.
25:54
Brian: It's a few of your ADHD symptoms are better.
25:56
unknown: Yeah.
25:56
Brian: Better than they were.
25:57
Brian: Not fixed, better than they were.
25:59
Apryl: Yeah.
25:59
Apryl: And well, and I think that's where this comes into play of like, okay, what is I like to call them, you know, like our battle zones.
26:06
Apryl: What's our biggest battle zone here?
26:08
Apryl: Like, what's our biggest problem that we're facing?
26:10
Apryl: If sleep is your biggest problem, then maybe a stimulant isn't what's going to help you because you're like, my kid doesn't sleep.
26:18
Apryl: Like, I need help with sleep, you know?
26:21
Apryl: So you've got to take everything and look at your family, your household dynamic, your kid, and see what works best for you.
26:30
Apryl: And pretty much you're just kind of like a scientist.
26:33
Apryl: What's working, what's not.
26:35
Apryl: And that actually leads in well here because as a scientist or you know, mom, dad, you need to be monitoring the progress so you know what's working.
26:46
Apryl: When you try, you know, 10 different things and it feels like nothing works.
26:50
Apryl: Well, that's not very helpful to take to your doctor.
26:53
Apryl: So you've got to be able to track and review what's working.
26:56
Apryl: So, Brian, how would you suggest that parents do this?
26:59
Brian: Right.
26:59
Brian: So there's a few things that you can do.
27:02
Brian: You can choose like a couple behaviors, like we're gonna see what what time homework is done for the for the week, or you know, how much trouble did you get at school?
27:13
Brian: Just like a couple little things you can sit and follow.
27:16
Brian: You can follow academics because that's very easy because they send home a report card.
27:21
Brian: You can follow like stress in life.
27:24
Brian: You can just say how how stress is the rest of the family.
27:27
Brian: Another thing, though, you can do is they have some rating scales.
27:32
Brian: And a lot of you are probably diagnosed initially off of a Vanderbilt rating scale.
27:37
Brian: It's one of the most common ones out there.
27:39
Brian: So if this sounds familiar, this is the thing that you probably brought to your school teacher, and then you also filled one out.
27:45
Brian: The parents filled one out the very first time.
27:47
Brian: So they don't advertise this in very well, but there's actually follow-up Vanderbilt scales, and you can fill these out and keep them and date them, and you can have the teachers do this as well.
27:58
Brian: So just Google Vanderbilt ADHD scales.
28:01
Brian: It's a free scale.
28:02
Brian: They they give it out everywhere.
28:04
Apryl: And we'll put it in the show notes.
28:05
Apryl: Don't find it for the screen.
28:06
Apryl: We'll put a link in the show notes.
28:07
Brian: Don't do the initial, I mean, you can do the initial, but you've probably already done it.
28:10
Brian: But the follow-up ones that you're are the ones you're looking for.
28:14
Brian: One for you, one for the teacher, and try one at the beginning of the semester, try one at the you know, middle of the semester, the end of the semester, and you'll be able to track each individual symptom in basically in real not in real time, but kind of in real time, like track the progress as you go along.
28:30
Brian: And it as you try each individual thing, it's like, oh, you know what?
28:33
Brian: I've noticed that this is improving, and the teachers noticed that this is improving.
28:36
Brian: Could this be the intervention we tried?
28:38
Apryl: Yeah.
28:39
Apryl: So I just want to um pull out a few things that you said, Brian.
28:42
Apryl: Number one, choose like one to two behaviors that you're targeting and looking at because we can't change everything overnight.
28:50
Apryl: So choose one to two behaviors and then choose, you know, like the tier one interventions and try those and monitor those.
29:02
Apryl: And before you try it, do the follow-up Vanderbilts, fill those out, and then like, okay, in two months, we're gonna see how this is again.
29:13
Apryl: Send it to the teacher.
29:14
Apryl: You don't even have to include your doctor in this, like literally, it can be you print out the form, right, Brian?
29:19
Brian: Right.
29:20
Brian: Or you yeah, or when you do get the data from the forms, bring it into your doctor and just be like, hey, when we tried those, we've been filling these out as we go.
29:26
Brian: When we went up on his meds, these things got a little better.
29:29
Brian: What do you think about the next dose?
29:30
Brian: Or, you know, we they got a little worse.
29:32
Brian: Maybe we're overshooting here.
29:34
Apryl: Yeah, perfect.
29:35
Apryl: So, you know, you I mean, you can do this without your doctor.
29:38
Apryl: That's what I'm saying is like you can do this on your own.
29:42
Apryl: You don't have to go to the doctor and be like, Can I get follow-up Vanderbilts?
29:45
Apryl: This is what I'm doing.
29:46
Apryl: No, like this is such great anecdotal notes to be to the doctor, like, hey, we tried this, this, and this at home.
29:52
Apryl: Here's what we saw.
29:53
Apryl: We did a pre, pretty much like a pre-test and a post-test.
29:56
Apryl: Here's the results.
29:58
Apryl: And then you have so much data that the doctor can be like, oh, like this is working, this isn't, let's do this.
30:04
Apryl: And you can create a more informed plan for you and your kiddo.
30:08
Brian: Right.
30:08
Brian: And it's also, since it's symptom-based, this isn't just are you getting better, yes or no.
30:13
Brian: This is broken down by each individual symptom of ADHD.
30:16
Brian: So very, very useful.
30:20
Apryl: Perfect.
30:20
Apryl: So there is your plan.
30:22
Apryl: If you are wondering about how to help your kiddo without medication, there is your plan.
30:29
Apryl: Next episode, we're gonna talk about school because the National Institute of Mental Health and the other major institutions are clear.
30:37
Apryl: School-based behavioral interventions and accommodations are a core part of care, not an optional bonus.
30:45
Apryl: So, in this episode, we're gonna get really practical what to ask for, what to prioritize, and how to make exercise timing and behavior supports actually fit in to a school day.
30:56
Brian: Right.
30:57
Brian: So, in finishing, I just want to repeat medication remains the single most effective treatment.
31:02
Brian: Is it is number one.
31:04
Brian: After this, we're talking second place, which honestly it's it's behavioral parent training.
31:08
Brian: That's that's a solid second.
31:10
Brian: After that, though, you've got exercise, you've got sleep, you've got some of these like lower evidence things like omega-3 that we could talk about, but really medication is number one, behavioral parent training number two.
31:22
Apryl: Nothing is going to be as effective as medication.
31:25
Apryl: Just what it says.
31:26
Brian: Nothing is going to be as effective.
31:28
Brian: If it is an option, it's worth talking to your parent or your doctor about.
31:32
Brian: We understand that there are definitely people who are not going to be able to get medications that their child doesn't tolerate it, whatever.
31:40
Brian: But if it is an option, it's it's worth talking to your doctor about.
31:44
Apryl: And if you're worried about it, I'll link this in the show notes our our episode on medication and what to talk to your doctor about and things like that.
31:53
Apryl: Listen to that episode because Brian does break down very well on the different types of medications and, like I said, things to ask your doctor about and all the stuff.
32:03
Apryl: So listen to that episode if you're nervous about medication, and we will see you next week where we talk about school supports because we all know that we need help there.
32:13
Apryl: All right.
32:14
Apryl: We we will see you next week.
32:16
Brian: Thanks so much for joining us for today's conversation on raising ADHD.
32:21
Brian: Remember, raising ADHD kids doesn't have to feel overwhelming.
32:24
Brian: Small shifts can make a big difference.
32:26
Brian: If you found this episode helpful, it would mean the world if you would hit subscribe, if you would leave a review, or if you shared it with another parent or teacher who needs this support.
32:36
Brian: And don't forget to join us next week for more real talk, practical tips, and encouragement.
32:40
Brian: Until then, you've got this and we've got your back.