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TOPIC TITLE: ADD/ADHD in yeshiva: how to cope?
Created On 1/19/05 10:13 PM
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notgivingupyet
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1/19/05 10:13 PM
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I'd love to hear from any other families struggling with a child with ADD in the yeshiva environment. We all need chizuk.

Finding support groups other than CHADD, is nearly impossible: no one wants to admit that they struggle with this. However, my child's school administrator estimated approximately 20% of the boys in his school are on ADD medication.

If you or are someone who is on the other side of this, are are a mature, functioning adult with ADD, or have an adult child who is doing well now, please respond. What therapy, guidance, intervention worked to help your child cope, be organized, socialize, etc.? Did you opt for medication?

How did you (or did you) communicate with the administration/ faculty about your child's challenges? How did you effectively work with administrators/ teachers who were unsympathetic with either your child's situation or the route you chose to take with your child?

Thanks in advance.


Edited: 1/26/05 at 10:27 PM by notgivingupyet
 
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Nachum
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2/15/05 7:49 PM
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I am now going to describe a multi-modal program for treating children with AD/HD and other learning disabilities. Anyone who has not stopped at the first or second technique has seen their child excel from being a weak student or at least, profoundly improve.
Several years ago I was working with a little boy in first grade. In the same school there was a boy in pre-1a who you could not help but notice. Everyday at 11:30 precisely the gannenet would drag this little boy to the principal’s office with him punching and kicking her the whole way. She would get to the principal’s office, let go of the boy and run away. The gannenet would run away, not the little boy. The boy was then left unattended running up and down the halls until the one o’clock dismissal for his class. As long as he did not disturb any of the other classes, he was left alone. I had nothing formally to do with this boy and I did not work for the school. My job was to help one boy in a different class. You could call it professional curiosity or you could call it being nosey, but around ten o’clock on a few different days, I peeked into the pre-1a class. He was sitting there like a little angel. Having worked with enough children like this, it was clear what was happening here. He was getting Ritalin at home before leaving for school and going through the roof when it wore off. Thirty to forty percent of children who take Ritalin “rebound” and this boy was a high bouncer. Chaim (not his name) was being thrown out of school and as sort of a last hopeless hope the principal said, “Speak to Rav Nachum, maybe he can help.”
The first recommendation was cleaning up his diet from artificial food color, then a vitamin program, and vision therapy. I also said to take him off the Ritalin, but his mother said she wasn’t ready for that yet. People have asked me if you start all this at once, how will you know what helped. One, the whole program works together, and two, there is no interest here in conducting a double blind, placebo controlled study, let’s first see the child succeed. If you give an unnecessary herb that is nontoxic or a few extra vitamins, these are all harmless substances. The problem is not giving too much, the problem is getting the child to agree to take this whole cocktail.
The next day Chaim was taken out of class at 10:30 (while he was still good) and given GABA (an amino acid), vitamin B6 and magnesium. This is a good combination for three reasons: 1-it is harmless, 2-it often works, and 3-it is cheap. A three-month supply costs about $25 or less. So 10:30 he got the vitamins and at 12, he was fine. Pity we did not get a picture of the ganenet’s face. It was now May and she has just spent almost a whole year scraping this boy off the ceiling, and her knee, and hip and elbow and any part of her he could punch or kick, at 11:30. Over the next four months he went once a week to the vision therapist in Jerusalem. Five days a week a half-hour to an hour a day we did eye exercises together. We also had him on a varying vitamin and herbal programs. From May through the end of July he was receiving 10mg Ritalin at home in the morning. From August until the Succos break he received 5mg a day and from after Succos until now (three years later) he is Ritalin free. A year later one of the Rebbis said to me during recess that one of my charges just stormed into school crying. He told me that Chaim was doing something inappropriate during recess and he told Chaim to stop and Chaim stomped into the building crying. I then asked, “Did he kick you?” “No” was the rebbi’s response. “Did he comply with what you told him to do?” “Yes” “A year ago if you said that to him would he have kicked you?” “Sure” “Would he have complied with what you told him to do?” “No way!” So I said, “Fine! Let him cry.”
Over the course of three years we had him on a varying vitamin\mineral\amino acid\herbal programs. The problem was to find something that was strong enough to have the desired effect, but not upset his stomach. He took adult sized mega multis, GABA, phosphatydylserine (a soybean extract), bach flowers, and herbal mixes that tasted like oven cleaner. A drug is a very potent and dangerous substance, so a little goes a very long way. Nutrients on the other hand need to be taken in quantity. My biggest regret in all this was not starting him on essential fatty acids sooner. We recently tried a vitamin “holiday.” His behavior deteriorated over the next five months. Everyone saw that his behavior had deteriorated. He was out of class on a regular basis(several times a day), he was yelling and screaming and hard to handle at home, and getting into several fights a day. If a child misses a day on a vitamin program, it’s not so bad. The vitamins build up in the child’s system and builds the child. It took him five months for him to get this bad. Anyone who has worked with or parented a child on Ritalin knows what a child who has missed his Ritalin, or other pharmaceutical, is like. The consequences are obvious and immediate. A vitamin program will organically build a child as opposed to artificially imposing a chemical straight jacket. Oddly enough, this sometimes works against the vitamin program. If you miss one dose of Ritalin, you see the consequences immediately, so the Ritalin is taken very seriously. If you miss a few days or even weeks of the vitamins, very often, the child is still fine or at least not so bad. You then may feel that the vitamins are not so important and start missing them more. After a while, you will stop altogether and put the vitamin program out of your mind. Six months later the vitamins are forgotten about and the child is unmanageable again. There is a sense of, “I tried the vitamins and they didn’t work.” I have heard that many times concerning a child who was on a successful vitamin program, then drifted off as described. Drugs rarely, if ever, make a long term change for the better and there is a strong body of evidence saying, in the long term, they do more harm than good.
As important as what he did take was what he did not take. An article in the Journal of Pediatric Medicine, Nov 1994 showed a VERY STRONG AND CLEAR connection between synthetic food coloring and behavior disturbance. Out of two hundred children being screened with suspected ADHD one hundred and fifty showed improvement after having tartrazine (a yellow food coloring) removed from their diet. This study was done using only one food color. If you take a look at how many different colors will be found in green or multicolored ice cream or candy it will be eye opening. Other studies have shown the same 75% improvement rate with about 25% having the symptoms ADHD go away altogether. We are talking about 25% of hyperactive children being fine and healthy and another 50% improving. Let us also consider children who are not made ADHD by the food colorings, only they just do not concentrate as well. What if the jellybean that the rebbi gives out is turning a 500 mishna bal peh child into a 350 mishna bal peh child. Look at the effect on the level of discipline in the class in general. It is not uncommon to have a class with two children on Ritalin going up and down the walls depending on when their last dose was given. Another two or three children that the rebbi feels should be on Ritalin, and another ten who are not hyperactive from the food color, only a little jumpy. I also feel that I have understated the numbers here. Incentive rewards are wonderful, JUST NOT FOOD TREATS. Why can’t we be a little more creative?
What was this vision therapy that Chaim received? It is called behavioral or functional optometry. In a very small nutshell, sometimes a child (or adult) will have perfect vision but his two eyes are not working properly together. The “circuits” in the brain will either meld the picture into one, with difficulty, or subconsciously block out one eye, or a number of other coping techniques. These can result in a loss of attention span, eyestrain, letter reversals, or a host of other difficulties. Recently there was a boy in whom I could sense there was a vision problem. He is a sweet bright boy who was failing in the bottom of his class even after having been left behind one year already. Months of begging his mother to have him tested for vision issues, had no effect. She said it sounded strange and was expensive. She was right. One night I said to her to watch this. The boy needed to track my finger as it made large circles in front of his face. He needed to track only with his eyes and not to move his head at all. She could see his right eye tracking smoothly and his left eye jumping all over the place.
The next week when she was in the behavioral optometrist’s office the doctor said that both his vision and the shape of his eyeball were perfect, only he saw the whole world double. After being picked up off the floor the boy’s mother asked her son if he saw two of her. The boy answered in his very sweet, gentle, accepting way, “Yes.” He could read, ride a bike, and catch a ball, he was ten years old and had his eyes tested many times by conventional optometrists and this was never picked up. Why should he find it odd at all to see double, after all, we have two eyes? He might find it odd that the rest of the world sees only one, what do we need two eyes for if we are to only see one thing at a time and not double? To think about the world that this boy saw gives me a headache. Think of looking at a piece of text, seeing it double and over lapping, and being able to read it anyway. His father said, “No wonder he was doing so poorly in school, how many rebbis can you pay attention to at once.” After five months of vision therapy he was doing fine in class. The last night that I tutored him he said the whole first chapter of mishna Yoma bal peh while playing patty-cake (try it sometime) a year later he was one of the top boys in his class. These types of drills are called multitasking and multi sensory integration exorcises. Like playing patty-cake while doing math problems, saying alef-bet, alef-bet backwards, alef-bet backwards skipping letters, to the beat of a metronome. The list goes on and the children find it challenging and fun. They also feel themselves growing and gaining new skills that they find transfer over to their class work in a short amount of time. There is no magic wand involved in this, I am presently training a sixteen year old girl high school to do this as an after school chesed project, and she doing a very professional job.
Studies done fifteen years ago and more, with juvenile delinquent repeat offenders found that 60% to 90% had vision problems that did not show up in a standard vision exam. After receiving vision therapy they had a 15% rearrest rate as compared to 45% to 70% for the untreated or similar groups.
Another rebbi said to me concerning Chaim that this was a miracle. I said this was not a miracle, this was chinuch. This was not a job for a miracle worker, a doctor, or a nutritionist. It was the work of a mechanech. Before starting teaching, I asked every veteran teacher, “What do you do with the slower children in your class?” The answers received were all some variation of teach to the middle, the top third, the top fourth, the top ten-percent, etc. The rest will get what they get. Maybe one of the reasons this did not sit well with me was, besides middle, none of those categories ever included me as a child.
Seventeen years ago Rabbi Simcha Wasserman z”l spoke to a group of potential mechanchim. In the question and answer period I asked this question of Rabbi Wasserman. The first beautiful part of his answer was the sigh of anguish that he gave as the question was asked. The sigh alone spoke, “One of Hashem’s children is struggling with His Holy Torah and he is not succeeding.” Rav Simcha then said, “You need to find the time to help bring them up.” This is the answer that I was waiting for because it was the only possible answer. If it is a d’var sh’b’kiddushah that we are giving over to a child of our own, who our talmidim are, then the day does not end at three or four o’clock in the afternoon and the year does not end in June. Rav Simcha Wasserman z”l also said earlier in that same class that we need to strive in teaching to do at least as good a job as an honest tailor. If one sleeve is too long and another is too short, if the buttons and buttonholes don’t match, if the suit you made is a size 32 and your client is six foot six, and he is coming by at 8:30 tomorrow morning to pick it up, you will find the time and energy at three in the morning to set it straight. Rav Simcha said we, as mechanchim, need to do at least as competent a job as an honest tailor. If it means tossing and turning in bed during the night to find some way to reach one more child, then that is part of the job description in chinuch. If it means learning nutrition and herbalism, and pharmacology, and vision therapy, if no one else is doing it, or no one else is convincing the parents to find these safer and effective methods, then that too is part of the job. Rav Ya’akov Kamentzsky z”l learnt medicine when he was rav of his shtetel because there was no doctor there.
On the point of being tailors there is one more vignette heard from Rabbi Zalman Deutcher shlita. He said that the glazier cuts glass, and the shards fall to the floor and get stepped on. The potter drops excess bits of clay and the tailor cuts away scraps of cloth that also drop to the floor to be stepped on. We as mechanchim and parents we do not have that luxury. We are dealing with neshmos. There are no scraps that get cut away and dropped on the floor.

Nachum Bergos

I am including here the abstract of one of the articles sited
Synthetic food coloring and behavior: a dose response effect in a double blind, placebo-controlled, repeated-measures study.
Rowe KS, Rowe KJ.
J Pediatr 1994 Nov;125(5 Pt 1):691-8.
The results of this study show that intake of tartrazine (synthetic food coloring) is associated with behavioral changes typical of attention-deficit disorder (ADD) in a significant number of children. The study was conducted on 200 children referred for suspected attention-deficit disorder to a children's hospital. They were started on a 6-week period of synthetic food coloring-free diet. One hundred-fifty mothers reported that their children's behavior improved with diet, and worsened when synthetic food coloring was re-introduced. In addition, the researchers conducted a three-week long, double- blind, placebo-controlled trial, to test the behavioral responses of children with ADD and controls, to escalating doses of tartrazine or placebo. Twenty-two of 34 children with suspected ADD and 2 of 20 controls were found to have clear reactions to tartrazine, manifested by restlessness, irritability, and sleep disturbances. All doses produced behavioral responses, and the response was prolonged in children who received higher doses. These results indicate that intake of synthetic food coloring induces behavioral disturbances typical of attention deficit disorder in a significantly high number of children diagnosed with this condition. The symptoms are reproducible, and the responses are dose-related. Based on these results, it seems consequential that dietary approaches entailing removal of artificial food coloring be attempted in every child with suspected ADD, before any other form of treatment is pursued.
 
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DB
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2/28/05 7:29 PM
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HI WHERE DO YOU LIVE MY SON GOES TO A GREAT SCHOOL IN BROOKLYN THAT DEALS WITH ADHD HE IS A NEW CHILD PLEASE CONTACT ME
 
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eagle wings
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3/2/05 2:30 PM
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I would like to point out that CONCERTA, a twelve hour slow release pill of Ritalin, will cover a child for the whole school day, and doesn't have the terriblerebound effect. (My daughter had terrible rebounds, and was sensitive to the varying dosages she got during the day of Ritalin.)
I find that the Concerta helps a LOT. I can not imagine my child be willing to take copious amounts of vitamins tasting like oven cleaner.

I would add: Be sure your child is getting enough SLEEP!


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"Let GO and Let G_D"

Edited: 3/2/05 at 2:35 PM by eagle wings
 
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edna
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3/17/05 4:41 PM
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My daughter is on Concerta, however there is a couple of drastic side effects that me as a mother is not very happy about. The huge big aspect of all these medicines are weight loss. I got so alarmed when I saw my daughter getting thinner and thinner from the Concerta, I rushed her to our family doctor. Her medicine has stopped working as per the teachers and she has been on Ritalin 10mg, Ritalin LA, adderal and COncerta (through the years) What now? Cannot up her dosage (we have finally got her weight back up). I am very sceptical of all these medications. A couple of years ago if anyone would have suggested to me the natural way, I probably would have scoffed and turned towards traditional medicine. Changing diet - to much work, Pricy vitamins e.t.c. But now I do not know but I am leaning more and more towards zoning these medicines out. I understand it will not be easy but hey this is my child I am talking about, do I want the easy way out (a little oblong pill in the morning). I am still undecided. Thank You for the first posting I am going to print it out a read it carefully.

 
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eagle wings
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5/11/05 7:13 PM
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We have not had any problems with weight loss.
Nor do I feel that we have taken the "easy" way out.
My daughter has additional problems besides the ADHD. In addition to the medication, we have had to deal with behavior modification, and with altering the curriculum for her, and getting the outside help she needs. Incidentally, except for catsup, my daughter has nearly no sugar in her diet.
If someone finds that vitamins work, fine. But I think that parents coming here need to know that CONCERTA may work for their child, and that in general many parents have found it more usefull than the regular Ritulin, the dosage being smoother, and not having the rebouns effect.
I feel that the treatment of any child with ADD or ADHD may tend to be multi-faceted. I would ask anyone dealing with a child with ADHD to consider the following, wether or not they use medications:

1 Is my child getting enough sleep? Even if you think "yes", try and see if a bit more sleep is helpfull.

2- check childs sight and hearing

3- Is there any learning disability involved? Get any changes needed to materials, lessons. (My child has trouble wrting, so I optained raised line paper, which has reduced her frustration in this area. Also she gets pulled out to learn math privately. These adaptations helped us more with her behavior than anything else.

4 Does the child eat a breakfast? Is their food healthy? Try cutting down (not necessarily obliterating everything) excess sugars.

5 Have you tried good CONSISTANT behavior modification? With prizes YOUR child REALLY REALLY wants? Are you strong enough to implement consequences when serious misbehavior occurs? (ie, wen I told my daughter that we would get off the bus if she kicked the chair in front of her again, YES we GOT OFF THE BUS when she did it again. Never had to repeat it. She realized that it doesn't pay


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"Let GO and Let G_D"
 
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chanieF
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5/12/05 4:25 AM
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Quote

Originally posted by: eagle wings
2- check childs sight and hearing


right on.
to clarify- you want to make sure you go to the correct professionals to rule out anything related to these that can lead to a learning issue. so a pediatric audiologist (who checks for auditory processing disorders), as well as a behavioral/pediatric optometrist would be the way to go.


Edited: 5/12/05 at 4:27 AM by chanieF
 
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notgivingupyet
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8/10/05 11:32 PM
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How exactly do you get your child to "sleep more"? My child's brain needs to go through every second of the day and every book read in order to relax enough for bed. He jumps around, kicks the walls, comes in and out of his room, turns on lights to read, decides he's hungry at 10pm. This can take as long as 2hours, after a warm bath, book, shema, lights out. Yoga no longer helps: he uses it as an opportunity to fool around. He'll read till midnight until exhaustion overtakes him. It is a horror to wake him for school.

Add medication to this mix, and it can take 3 hours for my child to fall asleep after bedtime. I thought inability to relax and sleep was part of ADHD.





 
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Motek
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1/3/06 2:26 PM
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My son is turning 5 and I am looking for a new school to send him to that would welcome him with open arms and positively instruct and work with my husband and I to see my sons potential.
 
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frumsw
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1/27/06 1:34 AM
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my daughter finds a back or leg massage and having multi-layers of blankets-particularly fuzzy ones in her bed and a sand filled cushion ( which is supposed to be used a heating cushion after you heat it in a microwave) on top of her helpful.


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eagle wings
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1/30/06 4:48 PM
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I heard once (saw the site) that one can buy weighted blankets, which can be helpfull (similar to the cushions mentioned in the post immediately above.


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"Let GO and Let G_D"
 
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YOUNGLDY
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4/4/06 12:14 AM
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hi, are we talkinkg about sleeping problems here. because i have a daughter who cannot fall asleep at night, no matter what. help.....
 
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madscientist
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4/7/06 7:50 AM
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Hi

I had ADHD as a child and eventually was prescribed ritalin which I was not so happy about taking even though it helped alot. The food colouring is definately something to watch and another point to note is lots of excesise. I joined a gym but any way of excersising helps alot to calm the person down.
 
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eagle wings
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Getting my daughter to sleep:
-first, I give her Concerta the moment she awakens- thus it is active by the time she gets to school, and is finished by 7pm.
- try and get her OUT and EXERCIZUNG every day
- insists that she lie in bed from bed time, with a night light SHE can choose to turn on or off
-makes sure she had supper before bedtime--- no eating as an excuse


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"Let GO and Let G_D"
 
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chashahellinger
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11/22/06 7:22 PM
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My son is on Concerta 18mg at about 8-8:30 AM. He goes to a small, private Yeshiva. He is 7 years old. We also had a sleep problem and used to use Benadryl or generic a few hours before bed. That stopped working and he became hyperactive from it. The doctor precribed Clonidine HCl .1 mg (used to lower blood pressure) . I give one at about 5 PM. For the first time, he actually asks to go to bed, at about 8 or 9 PM. The child must have blood pressure checked before starting. Good luck.


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addontheweb
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There is no Adult ADD Support Group for Frum Adults. There is a support group for Adults with ADD/ADHD & it meets in NYC. The Manhattan Adult ADD Support Group has been meeting for over 16 yrs. Several Orthodox people attend their meetings. The websdite: http://www.maaddsg.org.[L=null]http://www.maaddsg.org.null[/L]
 
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Mark3000
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7/4/07 10:20 PM
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Before you consider those horrible medications. Please consider taking your child to a naturepath. Please cut the sugars and artificial sugars out of his diet and make sure he takes fish oil and eats vegtables. Just those few things may curre your child and please report back to me.
 
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webjunkie
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7/5/07 9:55 AM
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I have seen alot of messages posted on the subject of ADD/ADHD.

As an adult with ADHD, I can tell you that there is NO difinitive solution.
The meds we're prescribed are intended to help aleviate some of the symptoms.
They work fairly well for some, not at all for others.

I have looked myself for an Org that devotes itself to adult ADD/ADHD in the Jewish Community.,
I have looked for yrs, know how to use Google as well as the next person, but have yet to find one.

My best answer to one and all is to look at the website that my support group put on the web.
It FREE, Noon-Commercial & provides honest info.

http://www.maaddsg.org.

If you live in NYC, you can come to our group meetings. It is a non-denominational group.
ADD/ADHD knows no barriers with respect to race, ethnicity, religion, etc.

Our unified purpose is to help one another, and form a caring, knowedgeable community.

 
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frumsw
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7/21/07 11:43 PM
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Just heard on the radio about a study that found children with ADHD who were treated with medication or intensive behavior therapy or both, did equally as well when they were tested a few years after beginning treatment.


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frumsw
 
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gad
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7/22/07 5:03 AM
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That's very interesting.

But I would assume that the medicine and therapy is still very important because it enables a kid to stay in the class and function.
 
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