It’s not laziness, the wrong school, the wrong teachers, other kids, lack of motivation or bad parenting. Sometimes medications work great. Sometimes they work for a period of time then become less effective. And, sometimes they make kids feel terrible and don’t work at all. The real reason attentional difficulties are so tough is that it forces you to look at the whole person.The (Real) Reason My Child Can’t Focus.

It’s not laziness, the wrong school, the wrong teachers, other kids, lack of motivation or bad parenting. Sometimes medications work great. Sometimes they work for a period of time then become less effective. And, sometimes they make kids feel terrible and don’t work at all. The real reason attentional difficulties are so tough is that it forces you to look at the whole person.

When I treat kids and adults with ADHD I am always looking at the WHOLE person. I ask questions such as…

How is the sleep quality and duration? 

How much protein is being consumed before 3 PM?

Has there been testing to rule out anemia, hypoglycemia, thyroid and other hormone disorders?

Has there been testing to rule out food allergies and certain vitamin and mineral deficiencies?

Do you take fish oils?

Is there a 504 plan or IEP present?

How are motor skills?

What is the neurophysiological makeup?

 The reason it is so important to look at the whole person is that a person can have symptoms of inattention with very different etiologies.

Sleep: Not getting enough sleep is like having a traumatic brain injury for your brain. Think about when you have gone to bed too late. The next day can feel sluggish, it can be hard to remember things and you don’t feel productive. Sleep deprivation impairs memory, learning and focus. Researchers from the University of California, San Diego found elevated cortisol levels impair cognitive function. People who choose to not get enough sleep, or people who suffer from insomnia have elevated levels of stress hormones, including cortisol. A good night sleep is very important contributor in your ability to focus.

Protein: Did you know that protein in our diet is what creates the neurotransmitters that fire up our brains and help us pay attention? Dr. Vincent Monastra, who has treated thousands of patients with ADHD in his clinic with neurofeedback, recommends 40 grams of protein before 3 PM. That’s 20 grams at breakfast and 20 grams at lunch. That’s a lot of protein! Our brains need this much protein to perform what we need to accomplish at school and at work.

Testing: Hypoglycemia, thyroid disorders, anemia and other hormone disorders can all have characteristics of ADHD. It’s important to rule out these disorders (up to 4% of kids diagnosed with ADHD have a medical diagnosis that have the same characteristics of ADHD.) Food allergies and vitamin and mineral deficiencies can also create symptoms of inattention.

Fish Oils: Omega three fatty acids (fish oils) are very important. These are the neurological building blocks for our brains and as a country we are incredibly insufficient in our intake of Omega three’s. There is a lot of confusion about what brand or dosage of Omega three’s to take. A pharmaceutical grade fish oil with a 3:1 EPA to DHA ratio is recommended. For the average adult 1000 mg is recommended but for someone with attentional issues, the therapeutic dose is 3000-5000 mg. Dr. Barry Sears says “The only way to control cellular inflammation in the brain is to maintain high levels of EPA in the blood. This is why all the work on depression, ADHD, brain trauma, etc., has demonstrated that EPA is superior to DHA.” My favorite right now is Pharmax, High EPA. Two teaspoons mixed with some organic juice in the morning does the trick!

504 or IEP: A student with ADHD may qualify for a 504 plan or an IEP, depending on how severely the disability interferes with their education. These terms can create a lot of confusion for parents understanding what is right for their child and what services they should seek. A 504 plan comes from Section 504 of the Rehabilitation Act of 1973. Schools that receive federal funding are obligated to serve students under section 504. Accommodations such as preferred seating and testing in a quiet area with no distractions are common. An IEP is an Individualized Education Plan. This individualized legal document creates an opportunity for parents, teachers and administrators to work together to improve educational results for children with disabilities. ARC of Jeffco is a chapter of the largest national organization of and for people with intellectual and developmental disabilities and their families. This is an incredible free resource for families navigating their way through the maze of IEP’s.

Motor skills: Poor handwriting, difficulty grasping a pen or pencil correctly, or being clumsy can be indicative of hypotonia (low muscle tone.) This neurological muscle disorder can make a child fatigue easily and make it difficult to pay attention. When a child is not attentive, learning is not taking place. A good Occupational Therapist can assess for this and treat with exercises.

Neurophysiology: As a clinician, I am very interested in someone’s physiological makeup. We can take a “picture” with an EEG to get an image and understand what disregulation is happening in the electrical activity of their brain creating inattention. There are different signatures of ADHD in the brain but the most common are excess slow wave activity in the frontal lobes (the executive command center of the brain,) too much slow wave activity in the frontal lobes with not enough fast wave activity in the parietal lobes (where cognition happens), excess fast wave activity globally, and hypo connectivity (how sites in the brain speak to each other or communicate.) This disregulation in the electrical activity can be “trained” much like an athlete can train for a marathon or a ski race. By learning how to inhibit excess amplitudes and increase connectivity through operant and classical conditioning techniques a patient can alter their neurochemistry, create new neuronal pathways and dissolve symptoms they are seeking treatment for. This process is a “bottom up” approach, treating the underlying physiology that creates the symptoms of inattention. The results are profound, transforming and long lasting.

Whatever the reason for inattention, it is important to treat the person holistically. Medication is one small part of the picture. Understanding the etiology is key for long lasting results, treating the underlying cause, not just putting a Band-Aid on the symptom.

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