VR Helps Teens with Social Anxiety

Could virtual reality be the solution to teens social anxiety, 

ADHD and Aspergers? Research says yes.

By

 Raphael Konforti

 - 

November 23, 2016

Virtual reality is proving to be a viable solution to easing the social anxiety teens with ADHD and Asperger’s syndrome encounter daily. These teens go through tremendous difficulty developing the social skills to interact with peers and adults in what most consider normal social situations. The Center for Brain Health at the University of Texas has been successfully improving these teens social anxiety via VR sessions, helping them to make friends and communicate openly. 

The VR program looks like any other first person video game but actively focuses on engaging in social interactions. Teens might experience an encounter where they invite someone to a party, meet a peer for the first time or even confront bullies. They do this by simultaneously interacting with two clinicians. One clinician role plays the virtual partner while the other provides instructions and coaches them through a headset in an adjacent room. Teens completed 10 of these one hour sessions spread out over five weeks.

Prior to VR sessions, participants were tested on their emotional skills and had a brain scan. Already several studies have been published on the success of this method. Even beyond the data participants felt real, life changing results. “I’ve learned how to start a conversation, just how to break the ice”. Said Jeff, a participant with Asperger’s. 

According to the mother of one participant, “Before it was all about what she thought and then she would impulsively jump in and then she would get a bad response. So, what this has been able to do is let her think about what other people are thinking or feeling and then how she can react appropriately.” 

Researchers are just as excited and proud of the study’s results, “It’s exciting that we can observe changes in diverse domains including emotion recognition, making social attribution, and executive functions related to reasoning through this life-like intervention,” said Dr. Daniel C. Krawczyk, associate professor of cognitive neuroscience and cognitive psychology in the School of Behavioral and Brain Sciences. “These results demonstrate that core social skills can be enhanced using a virtual training method.”

Currently the VR program is only available in Dallas and costs $1800 per student. Researchers are working to get funding to spread the program which could easily be implemented across the country. Researchers hope to only expand the program but grow the reach of each study. 

“This research builds on past studies we conducted with adults on the autism spectrum and demonstrates that virtual reality may be a promising and motivating platform for both age groups,” said Tandra Allen, head of virtual training programs at UT. “This was the first study to pair participants together with the goal of enhancing social learning. We observed relationships in life grow from virtual world conversations. We saw a lot of growth in their ability to initiate and maintain a conversation, interpret emotions and judge the quality of a friendship.”

This study is proof that social anxiety and other social disorders don’t have to be debilitating. Teens and even adults can benefit from practicing controlled social interactions in virtual environments.

Published on Sep 20, 2016

Kicking off our new series Brain Power TODAY, special anchor Maria Shriver visits a teen socialization lab at the University of Texas at Dallas, where a virtual reality program helps teens develop their social skills despite such challenges as ADHD and Asperger’s syndrome.
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Virtual Reality Could Help Teens Deal With Social Anxiety, ADHD, And More | TODAY

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Raphael Konforti

Raphael Konforti graduated from the University of Florida with a Masters of Exercise Science, Go Gators! Holding his PTAGlobal CPT since 2009, Raphael has worked in variety of fitness education roles around the world. He is currently the Fitness Education Coordinator for Youfit in Florida. He prides himself on making the complicated, confusing fitness industry easy to understand. Doing that while slipping in a good joke is his passion. He loves surfing, diving, strongman competitions and yoga, yup pretty random mix.

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20 Tips for Helping Kids with ADHD Succeed in School by Dr. Hallowell

• “Most teachers and adults could benefit from pretending that all kids in their class have ADHD – what is good for kids with ADHD is good for all kids.” – Dr. Hallowell

• There is no substitute for parent understanding the child’s mind and conveying that over and over again to teachers! A child needs an advocate after a diagnosis of ADHD and too often testing results get “filed away”.
• Become a partner with your child’s teacher. Don’t go in with a set of things you “want” from the teacher. Go in with the goal of creating a relationship that will support your child. Consider baking brownies or helping out in class. Treat your child’s teacher as the professional she is.
• Creativity is impulsivity gone right. Encourage it in your child and use it yourself.
• Most kids with ADHD don’t do things the “normal way”. Don’t feel bad about this, and don’t say or do things that will make your child feel badly about his or her unique approach. Also, work with teachers to get rid of the shame in approaching problems and situations in a  non-standard fashion.
• Getting rid of shame and fear are key!! The greatest learning disorder of all is fear. All kids, and this includes kids with ADHD, need to feel emotionally safe in the classroom and at home. Talk with your child about his or her classroom and social experiences to make sure this is happening. Remember Dr. Hallowell’s own experience learning to read with dyslexia and how much having Mrs. Eldredge’s arm around him encourage him to try.
• Set your child up to make progress on something that matters to him. This builds confidence and motivation. (For more on building confidence, see the book “The Childhood Roots of Adult Happiness” by Dr. Hallowell.
• With all children, but particularly with kids with ADHD, simple, consistent rules are the best.  This is true of the classroom and at home. For example, always treat others with respect is a simple rule that can be applied to many situations.
• Use all modalities/multi sensory training: Visual, auditory, kinesthetic.
• Create a predictable schedule at school and at home. Kids thrive in situations that have enough predictability that they don’t need to guess about what is coming next (this does not mean “boring” though!) An important part of that schedule is getting enough sleep. Get your kids into bed early, if at all possible.
• Give warnings about upcoming transitions from one activity to another. For example, “Now we are going to write our practice sentences, then we are going to move into science.”
• Don’t be stingy with accommodations. One example is extended time on tests. The idea of the test is generally to see if a child has mastered certain material. Does the amount of time that is needed on the test make a difference? Why not give all kids untimed tests?
• It is easier to take on a big task if it is broken down into small steps.
• Monitor progress often and give feedback often.
• All kids need escape valves. Make sure to provide time to get up from desk, walk around, have recess, bring some physical activity into what they are doing.
• Make sure to give positive feedback when it is deserved. Don’t fake it, though. Kids know whether or not you are just trying to puff them up.
• Teach outlining and memory tricks
• Make a game out of learning.
• Consider talking with your teacher about having a home to school notebook for quick comments on daily basis and easy communications.
• Family dinner is one of the highest predictors of high SAT scores. Take the time to have family dinner and connect with each other.
• Driving in a car is another great way to connect with your kids. Spending time, anywhere, is important. Check in regularly with your kids.

Meet Dr. Hallowell

Are you looking for practical, how-to solutions to life’s personal challenges? Best selling New York Times author and world-renowned ADHD expert, Dr. Edward (Ned) Hallowell offers groundbreaking advice on how to:

• Survive in an ultra-competitive, ultra fast, attention deficit society while remaining sane
• Raise happy children
• Manage worry
• Forgive
• Bring the best out of your employees
• Get the most out of life with Attention Deficit Hyperactivity Disorder.
• 
  

A graduate of Harvard College and Tulane School of Medicine, Dr. Hallowell is a child and adult psychiatrist and the founder of The Hallowell Center for Cognitive and Emotional Health in Boston MetroWest, New York City, San Francisco and Seattle. He was a member of the faculty of the Harvard Medical School from 1983 to 2004 until he retired to devote his full professional attention to his clinical practice, lectures, and the writing of books.

Dr. Hallowell is a highly recognized speaker around the world. He has presented to thousands on topics such as ADD,strategies on handling your fast-pace life, the Childhood Roots of Adult Happiness, how to help your employees Shine, ADHD and Relationships and other pertinent family and health issues. He has been prominently featured in the media, including 20/20, Oprah, Dr. Oz, CNN, PBS and NPR as well as 60 Minutes, The Today Show, Dateline, Good Morning America, US News and World Report, Newsweek, the Harvard Business Review, Washington Post, New York Times and other popular publications.

From corporate audiences to parent-teacher workshops and national television shows, people who listen to Dr. Hallowell come away stimulated, inspired and empowered to change their lives. He is a charismatic speaker, combining the knowledge of a Harvard instructor with his incredible understanding of ADHD, human nature and the struggles we face in this crazy/busy world.

Dr. Hallowell is considered to be one of the foremost experts on the topic of ADHD. He is the co-author, with Dr. John Ratey, of Driven to Distraction, and Answers to Distraction, which have sold more than a million copies. In 2005, Drs. Hallowell and Ratey released their much-awaited third book on ADHD, Delivered from Distraction. “Delivered” provides updated information on the treatment of ADHD and more on adult ADHD.

Dr. Hallowell’s most recent book, Driven to Distraction at Work: How to Focus and Be More Productive was published 2015. In Driven to Distraction at Work, Dr. Hallowell identified the underlying reasons why people lose their ability to focus at work. He explains why commonly offered solutions like “learn to manage your time better” or “make a to-do list” don’t work because they ignore he deeper issues that are the true cases of mental distraction.

He is also the host of “Distraction” a weekly podcast series created to explore how we are driven to distraction and offers coping strategies to turn modern problems into new-found strengths.

Learn more at drhallowell.com, sign up for his free monthly e-newsletter and follow him on Facebook, Twitter, linkedIN, Pinterest and Youtube.

In Dr. Hallowell’s book SHINE:  Using Brain Science to Get the Best from Your People he draws on brain science, performance research, and his own experience helping people maximize their potential to present a proven process for getting the best from your people. He introduces the 5 steps in the Cycle of Excellence: Select, Connect, Play, Grapple and Grow, and Shine.  He shows how each step is critical in its own right and translates into actions a manager or worker can do and do now to propel their people to excellence.

In Married to Distraction: Restoring Intimacy and Strengthening Your Marriage in an Age of Interruption, Dr. Hallowell teams up with his wife, Sue George Hallowell, a couples’ therapist, to explain the subtle but dangerous toll today’s overstretched, under nurtured lifestyle takes on our most intimate relationship. The good news is that there are straightforward and effective ways to maneuver your marriage out of the destructive roadblocks created by the avalanche of busy living.

Dr. Edward Hallowell & Sue Hallowell: Married to Distraction on The Today Show – NBC

Dr. Oz intereview –  Dr. Hallowell on “The Medical Condition You Didn’t Know was Ruining Your Marriage.”  Click here to watch Dr. Hallowell discuss Marriage and ADHD.

Dr. Hallowell’s book with Dr. Peter Jensen, SUPERPARENTING FOR ADD: An Innovative Approach to Raising Your Distracted Child, was published in December, 2008. With decades of experience working with ADD children, Dr. Hallowell understands how easily the gifts of this condition are lost on a child amid negative comments from doctors, teachers, and even loving but frustrated parents. He has long argued that ADD is too often misunderstood, mistreated, and mislabeled as a “disability.”

Dr. Hallowell observes that people who do not have ADHD still often show many of its symptoms due to lives that are so busy that they overload their brains. He explores this phenomenon in his book, CrazyBusy: Overstretched, Overbooked, and About to Snap! In this book, Dr. Hallowell shows how the hectic pace of modern life has led our society to suffer from broader, culturally induced ADD. His insight into how to unsnarl frenzied lives and take charge of how we really want to be living provides true inspiration to us all.

In addition to his fame in the world of ADHD and pseudo-ADHD, Dr. Hallowell is also an expert in parenting, how to manage anxiety, and the importance of connection and forgiveness.

Dr. Hallowell lives in the Boston area with his wife, Sue, a social worker, and their three children.

Teaching Kids to Cook—and Care A unique volunteer experience helps kids make a difference

What do you get when you mix kids of all ages with a celebrity chef and give them a mission to cook for people in need? A unique and eye-opening volunteer experience for the whole family.

To my considerable delight, eight-year-old Alister is making dessert. Yes, my youngest son is peeling pears—brow slightly furrowed, tongue poking out of his lips in concentration. Once peeled and cored, the pears will be poached and served with a citrus-infused panna cotta. Pretty fancy for a kid in Grade 3, right?

Cooking with kids

Nearby, Alister’s 12-year-old brother, Cameron, is chopping onions. His eyes are stinging, but with Chef Carl Heinrich nearby, Top Chef Canada winner and co-owner of the popular restaurant Richmond Station—and Bolognese sauce for 50 to prepare—there’s no way he’s going to throw in the towel. Or the chef’s knife.

The boys and I are at the Massey Centre in East York with Kids Cook to Care (KCTC), a unique nonprofit that gives child volunteers a chance to cook for people in high-need communities, acquiring practical kitchen skills with some knowledge of different ethnic cuisines mixed in. Tonight they’re working alongside eight other kids ages six to 16 to make an Italian meal for the young expectant and new moms who live at the centre.

The birth of a unique program

KCTC was founded in 2009 by Toronto moms Jill Lewis and Julie Levin. “There was a lack of authentic volunteer activities for kids—little kids—to do in Toronto. So I thought, why not put them in a kitchen, hook them up with a celebrity chef, and let magic happen?”

“We used to live in New York, and when we were there we volunteered at a shelter on the upper west side,” says Lewis. “When we moved here, I promised the kids we would cook and care in Toronto, but no one would let us into their homeless shelters or soup kitchens. It was adult-only or ages 10 and up. So with a girlfriend we decided, ‘Let’s do something, and see if we can make a difference.’”

The importance of volunteering

When Lewis approached me about KCTC, I jumped at the opportunity to participate with my two sons. As with so many well-meaning but busy families, I’d wanted for some time to find a hands-on volunteer opportunity that would allow them to make a difference while getting face-to-face with those who have less. But I never managed to research how to make that happen. Our contributions to good causes had become mostly about making monetary donations to charities, something that can be pretty invisible to kids.

Even better, the opportunity totally fit with my nature, which is to demonstrate affection and concern for others through food. Like the legions of casserole-bearing women before me, I’m all about the food love—in times of crisis (such as sickness or grief) or in times of joy (such as the arrival of a new baby). And in between, there’s the everyday business of sustaining my family with—at least on good weeks—wholesome food.

Heinrich says KCTC holds a lot of meaning for him. “I very much relate to the program, to the kids cooking and especially to the Massey centre. My mother had me when she was 19 years old and I was her second kid. We went through probably more difficult times than most growing up.” His education as a cook began when he was in his early teens and his mom, then in her late twenties, was working full-time and juggling her duties as a single mother of three.

“My oldest sister and I started cooking one meal a week. That’s why I choose this meal because the sauce was one of my first meals cooking for my family. I’d come home from school, open the cans, brown the beef, have a sauce ready, boil some water, and my mom would come home and tell me when the noodles were done. That started, not necessarily the career, but the passion for food. We never ate out at restaurants and we never had expensive ingredients. It was ground beef and frozen chicken breasts, but we ate well on a budget.”

Capable and confident kids

Just as the leftovers from Heinrich’s first batches of spaghetti sauce would be turned into lasagna and then chili later in the week when he was growing up, the kids at KCTC chop enough onions and mushrooms, and—with a little help from some moms who handled stirring over the hot industrial stoves—make enough sauce to leave a giant pot of leftovers for the young women.

Next, the little hands roll balls of pasta dough into long snakes, older kids slice them into pieces, and everyone’s thumbs are put to use shaping the pasta. The kids then fly into action when Heinrich says the meal cannot be served until the kitchen is clean. The other moms and I look at each other. If only we could command such efficiency!

The kids then form an assembly line to plate the pasta, sauce, salad, and garlic bread, and the youngest volunteer—six-year-old Grace—proudly helps ferry the plates from the counter to the residents, many of whom are cradling babies in their arms.

To get to the Massey Centre on time that day, I’d pulled the kids out of school an hour early, a decision that was easy to make given the richness of the experience. When all the guests were served, the kids joined the residents at the tables with the plates of pasta they’d been so eager to taste while working in the kitchen. My boys sat next to a young woman who didn’t yet have a babe in arms. “Stay in school, kids. And don’t cut class either. It’s a bad path to go down.”

There was never any doubt, really, but I couldn’t help feeling that this one moment alone made it well worth having the kids miss last period of school that day.

WRITTEN BY Brandie Weikle  @bweikle  Thenewfamily.com

Brandie Weikle is a parenting editor, writer, and founder of The New Family blog.

7 Practical Tips for Single Moms with ADHD

Single moms with ADHD have a lot of stressors to contend with. Being a single parent is hard enough. But when you have ADHD, as Terry Matlen said, “multiply the stress by a million.” ADHD affects your ability to pay attention, prioritize, plan, organize and recall details, thereby making working and running the household that much tougher. Plus, because ADHD is highly genetic, it’s very likely that one or more of your kids has ADHD, she said.

Matlen’s clients tell her that their biggest concern is that there is no support and they’re constantly on call. “The sense of isolation is huge for these moms.” So is the guilt. They worry that they’re letting down their kids, she said.

“Not only is [a single mom with ADHD] trying to maintain her own stability, supporting and caring for her children singlehandedly, but she’s feeling almost like she’s drowning in trying to do it all herself.”

Many moms also struggle with depression and anxiety, because understandably, this is a lot to navigate.

Thankfully, there are many things you can do. Below, Matlen shared key suggestions and reminders.

Prioritize treatment.

“It’s imperative to get your own ADHD optimally treated. If not, life with ADHD and kids will be very, very difficult,” said Matlen, MSW, ACSW, a psychotherapist and coach who specializes in adult ADHD. If your kids have ADHD, make sure they’re receiving treatment, as well, she said. (See here and here for more info.)

When your ADHD is properly treated (with therapy, medication or both), you’ll see improvements in all areas of your life and your kids will, too.

Lower your expectations. 

Matlen stressed the importance of being realistic about your situation. Don’t let others make you feel bad either. It’s OK if your house is more cluttered than your friend’s house or dinner includes shortcuts, she said.

Look at the areas of your life where you’re holding sky-high expectations, and set more realistic expectations. See how you can make your life easier and thereby more satisfying.

Get support. 

Having emotional support is vital. Get support from friends and family and women in similar situations, said Matlen, author of several books on ADHD, including The Queen of Distraction: How Women with ADHD Can Conquer Chaos, Find Focus and Get More Done. Because many women are pressed for time, she suggested finding support groups online. Matlen runs a Facebook group for women with ADHD, and many are single moms. This site features free resources for women with ADHD.

(Matlen also runs a fee-based program for women with specific meeting times; they get together to work on paperwork, chores, time management and other concerns.) CHADD offers some online groups here.

If you do have time, check out support group meetings in your area. CHADD has meetings in some cities. You can see if there are any in your area here. There might be other meetups in your area, as well, like this one.

Get creative with childcare. 

If you can’t afford childcare, try a co-op where moms take turns caring for children, Matlen said. “For the working single mom, this may only make sense on the weekends, but it may be worth it to save your sanity and give yourself time away from the kids.”

Find a gym that has childcare, if you enjoy taking classes or using machines. Split the cost of a sitter with a friend, Matlen said. Or barter with your friends. “For example, offer to watch your friend’s children on a weekend in exchange for them keeping an eye on your kids.”

See if you can make adjustments with work.

For instance, Matlen suggested asking to work part of the time from home, or asking for flextime. This way you have more control over your schedule. Also, consider if you can work part-time – and supplement your income in other ways. Many women sell items on eBay or Etsy, or tutor and work as virtual assistants, she said.

Many women with ADHD make excellent entrepreneurs, “as long as they have administrative help to take on the detail work that often makes them crazy.”

Matlen suggested consulting with a career counselor. (Some career counselors also specialize in ADHD.)

Get creative with chores.

Because your time is limited, try “twinning” activities, as Matlen calls combining tasks. For example, while watching TV, fold laundry. Your young kids can even match socks.

Also, make chores fun, she said. “Get an over the door basketball hoop with a laundry basket below and have the kids toss their dirty clothes in there.”

Plan out meals. 

“Have a family pow-wow every Sunday — check your schedule for the week ahead and write down your dinner plans for each night on your calendar or planner,” Matlen said. Get everything you need at the grocery store instead of scrambling at the last minute.

On particularly busy days, pick something quick and easy, such as carry-out, she said.

Being a single mom with ADHD comes with many challenges. But there are helpful strategies that can simplify your life and reduce stress. Make sure you’re getting support and receiving proper treatment for your ADHD (and your children are too). Try to get creative with household tasks and childcare.

And remember that you’re doing your best. You really are.

Mom and daughter photo available from Shutterstock

About Margarita Tartakovsky, M.S.

Margarita Tartakovsky, M.S., is an Associate Editor at Psych Central. She also explores self-image issues on her own blog Weightless and creativity on her blog Make a Mess: Everyday Creativity.

View all posts by Margarita Tartakovsky, M.S. →

ADHD Diet Plan

(We're bringing this information to you from our good friends at OurFamilyEats.com)

How I solved my daughter’s behavior problems by using an all natural diet.

**I now offer personalized consulting and meal planning services to help you start the ADHD Diet Plan so you don’t have to do this alone! Check out my Services page to learn more!**

The ADHD Diet Plan is a step by step program to help you eliminate the chemicals and artificial ingredients in your diet. I struggled for years with my daughter’s behavior and what I thought were ADHD symptoms. After months of research I decided to change our eating habits as a last ditch effort to change things. I eliminated artificial ingredients and within 36 hours my daughter was like a new person. Since then I’ve worked with countless other families who have seen the same improvements in their own children by following the same steps I used. 

I made the changes all at one time, which is a radical change that not all families are willing or able to undertake. My ADHD Diet Plan is structured so that you can make all the changes at once or tackle one part of the diet each week. You can begin the diet at any time and go at your own pace. Each week I focus on a specific group of additives, give you all the information you need to make the switch for that week, and most importantly, cheer you on.

What can you expect from making these changes?

Many people report seeing a difference in their child’s behavior within the first week. If you need a little more persuading about whether making the change to an all natural diet is worth the trouble, please take a minute to read these success stories. The feeling you get from watching your child transform right before your eyes is like none other.

Before you start

This article I wrote for Circle of Moms, called “How Artificial Ingredients Can Lead to Artificial Kids” will give you more background on how we got where are today. For a little inspiration and motivation, check these Success Stories from real parents who have followed the Challenge.

SIX WEEK ADHD DIET PLAN:

Week One: Artificial Colors and Flavors

Week Two: Preservatives

Week Three: Excitotoxins (artificial sweeteners and MSG)

Week Four: Artificial Fragrances

Week Five: Body Care

Week Six: Medications, Supplements, and things to watch for



A FEW HELPFUL LINKS TO HELP YOU

GET STARTED WITH THE ADHD DIET PLAN:

– Adapting to a new way of eating
– Favorite Kid Approved, All Natural Recipes
– All Natural on a Budget
– How To Stock Your Pantry with All Natural Foods

Also be sure to check out my recipes for easy, family friendly meals. breakfasts, snacks, and desserts that fit within the guidelines of the diet.
If you ever have any questions about anything related to behavior or eating an all natural diet, or are just in need of some support, don’t hesitate to email me at contact.ourfamilyeats [at] gmail [dot] com, or leave a comment.

Are you feeling overwhelmed by all the information? Do you need direction or support? Want answers from someone who’s been in your shoes? Let me help! I offer personalized consulting services to help you manage the entire process so you can see the results you want in no time. I even offer meal planning services to make the change a breeze. Check out my services page for more information. You can do this!

Disclaimer: I am not a medical professional and do not claim to diagnose, treat, or cure ADHD. This post is for informational purposes only and should not be taken as medical advice. Always consult with your doctor before making any changes to your diet or lifestyle.

Neurofeedback & ADHD/ADD

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Mary T. Lindsey, MS, LMFT

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Neurofeedback effectively trains the brain to function better... enhancing physical, emotional, and psychological well being...

ADDRESS: 201 W. Fourth Street, Suite 200 Claremont, California 91711

PHONE: 909.626.5313

EMAIL: mary@claremontcenter.com

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Autism. Meltdowns. Predisposing Factors.

Published on Dec 1, 2014

Six factors that can make meltdowns more likely to occur. Which one's effect your child with autism or adhd? What can you do about them?

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Diet and attention deficit hyperactivity disorder

Can some food additives or nutrients affect symptoms? The jury is still out.

Diet alone probably isn't the driving force behind the multiple behavioral and cognitive symptoms that plague children with attention deficit hyperactivity disorder (ADHD). But several studies have renewed interest in whether certain foods and additives might affect particular symptoms in a subset of children with ADHD.

All of the qualifiers in the previous sentence are intentional. Traditional research finds no support for radical diets like the Feingold diet — which eliminates nearly all processed foods as well as many fruits and vegetables — for the majority of children with ADHD. And there is no easy way to identify the few children who might benefit from diets that prohibit particular foods.

Yet parents — and some researchers — wonder if more modest dietary changes could supplement standard multimodal treatment that includes behavioral therapy and other evidence-based psychotherapies, school support, medication, and parent education. Here's a brief review of the evidence on the dietary interventions that have received the most mainstream attention.

Artificial colorings and additives

Since the 1970s, researchers have investigated whether the synthetic dyes, flavors, and preservatives found in many commercially prepared and "junk" foods might contribute to hyperactivity or other symptoms of ADHD. Many of the studies are small or flawed, and there is no consensus about how such additives might contribute to ADHD symptoms in children.

Interest in the topic of additives has been reignited by a well-designed study in Britain, not least because its results convinced the United Kingdom's Food Standards Agency (roughly equivalent to the FDA) to urge food manufacturers to remove six artificial coloring agents from food marketed to children in Britain.

The researchers designed a randomized, double-blind, placebo-controlled study to test the effects of the preservative sodium benzoate and six artificial food colorings on hyperactivity in 153 preschoolers (who were 3 years old) and 144 elementary students (who were 8 or 9 years old). The researchers intentionally conducted the study in a community sample of healthy children, rather than restricting it to those diagnosed with ADHD. But they did ask teachers to fill out a questionnaire to assess hyperactivity for the children at the start of the study, to provide some baseline measures.

For six weeks, the children consumed foods and drinks free of sodium benzoate and the six coloring agents. At weeks 2, 4, and 6, the children consumed plain juice (placebo) or juice containing one of two additive mixes every day for a week.

Mix A contained the preservative plus the colorings sunset yellow, carmoisine, tartrazine, and ponceau 4R; mix B contained the preservative plus sunset yellow, carmoisine, quinoline yellow, and allura red AC.

The drinks had the same flavor and color from one week to the next, but contained different amounts of the added mix. For the older children, the daily amount of additives in mix A equaled the amount of food coloring found in two bags of candy, while the daily amount in mix B was equivalent to four bags of candy.

The researchers asked parents and teachers to assess the children's behavior using standard clinical instruments, and also asked independent reviewers to observe the children at school. The older children were also assessed with the Conners' Continuous Performance Test II, which uses visual cues to assess attention and hyperactivity.

The investigators found a mild but significant increase in hyperactivity in both age groups of children — across the board, regardless of baseline hyperactivity levels — during the weeks when they consumed drinks containing artificial colors. This replicated findings of an earlier study they did in 3-year-old children. Using a complex calculation of "effect size," the investigators estimated that the additives might explain about 10% of the behavioral difference between a child with ADHD and one without the disorder.

This was similar to the effect size reported in an earlier meta-analysis conducted by researchers at Columbia University and Harvard University. Their analysis of 15 trials evaluating the impact of artificial food coloring suggests that removing these agents from the diets of children with ADHD would be about one-third to one-half as effective as treatment with methylphenidate (Ritalin).

But like the authors of the British study, the authors of the meta-analysis cautioned that only a minority of children are particularly vulnerable to the effects of artificial additives. They also pointed out that determining which children are susceptible is difficult, though not impossible. Although some experts have recommended testing children with ADHD for food reactions, there is no test for additives.

Parents could try eliminating the major sources of artificial colors and additives — candy, junk food, brightly-colored cereals, fruit drinks, and soda — from their child's diet for a few weeks, to see if symptoms improve. One practical challenge to keep in mind, however, is that studies of sugar elimination have shown that parents may wrongly assume that changes in their child's behavior reflect consumption of a "problem" food.

In one frequently cited study about sugar, researchers recruited 35 mother-and-son pairs. All the mothers believed their sons — then ages 5 to 7 — were sugar-sensitive. The researchers told the mothers their sons would be randomly assigned to an experimental group that received a high dose of sugar or to a control group that received aspartame. In reality, all the boys received aspartame. The mothers who thought their sons ingested a large amount of sugar reported that their child's behavior was significantly more hyperactive afterward. The researchers concluded that parental expectation may color perception when it comes to food-related behaviors.

Omega-3 fatty acids

Essential fatty acids fuel basic cell functioning, improve overall immunity, and enhance heart health. By definition, the body cannot make essential fatty acids, so these nutrients must be consumed in the diet. One group, the omega-3 fatty acids (eicosapentaenoic acid [EPA], docosahexaenoic acid [DHA], and alpha-linolenic acid [ALA]), is obtained from salmon, tuna, and other cold-water fish, as well as from some seeds and oils. The other group, the omega-6 fatty acids (especially linoleic acid), is obtained primarily from vegetable oils.

While a balance of omega-3 fatty acids and omega-6 fatty acids is best for overall health, the typical American diet contains too few omega-3s, often in a one-to-10 ratio or lower with omega-6 fats. Researchers have explored whether a deficiency of omega-3 fats might contribute to symptoms of ADHD because these fatty acids perform a number of functions in the brain, such as affecting transmission of the neurotransmitters dopamine and serotonin and helping brain cells to communicate. ADHD and an omega-3 deficiency also share two symptoms: excess thirst and increased need to urinate. Some evidence suggests that children with ADHD may have low levels of essential fatty acids.

Only a few randomized controlled studies have evaluated omega-3 supplements for children with ADHD. A review by the American Psychiatric Association's Omega-3 Fatty Acids Subcommittee included two placebo-controlled studies that found DHA supplements alone were ineffective at alleviating symptoms of ADHD, and another three that concluded combining omega-3 and omega-6 supplements might help. But because of the way the studies were designed, it was difficult to determine the specific benefit of omega-3 supplements.

Although other studies have been published since the APA review, none have resolved the question of whether omega-3 or omega-6 supplements might help children with ADHD. Several clinical trials are under way and may provide such answers in the future.

In the meantime, the recommendations of the APA subcommittee are a helpful guide: encourage children with ADHD to consume levels of omega-3 fatty acids recommended as part of a healthy diet. For children, that means consuming up to 12 ounces (two average meals) a week of a variety of fish and shellfish that are low in mercury, such as shrimp, canned light tuna, salmon, and pollack, along with daily plant sources of unsaturated fats.

Micronutrients

Deficiencies of particular vitamins or minerals — such as zinc, iron, magnesium, and vitamin B6 — have been documented in children with ADHD. But the results of trials testing whether supplementation with vitamins or minerals alleviates ADHD symptoms have been inconsistent.

Although vitamin or mineral supplements may help children diagnosed with particular deficiencies, there is no evidence that they are helpful for all children with ADHD. Furthermore, megadoses of vitamins, which can be toxic, must be avoided.

What's a parent to do?

A diet or dietary supplement that eases the symptoms of ADHD would be a boon for anyone living with this disruptive disorder. So far, though, the evidence provides only limited support for restrictive diets, avoiding preservatives or artificial food colorings, consuming more omega-3 fats, or taking specific vitamins or minerals.

For now, the consensus on a sensible approach to nutrition for children with ADHD is the same recommended for all children: eat a diet that emphasizes fruits and vegetables, whole grains, healthful unsaturated fats, and good sources of protein; go easy on unhealthy saturated and trans fats, rapidly digested carbohydrates, and fast food; and balance healthy eating with plenty of physical activity.

A healthful diet may reduce symptoms of ADHD by reducing exposure to artificial colors and additives and improving intake of omega-3 fats and micronutrients. But it certainly willimprove overall health and nutrition, and set the stage for a lifetime of good health.

Freeman MP, et al. "Omega-3 Fatty Acids: Evidence Basis for Treatment and Future Research in Psychiatry," Journal of Clinical Psychiatry (Dec. 2006): Vol. 67, No. 12, pp. 1954–67.

McCann D, et al. "Food Additives and Hyperactive Behaviour in 3-Year-Old and 8/9-Year-Old Children in the Community: A Randomised, Double-Blinded, Placebo-Controlled Trial,"Lancet (Nov. 3, 2007): Vol. 370, No. 9598, pp. 1560–67.

Schab DW, et al. "Do Artificial Food Colors Promote Hyperactivity in Children with Hyperactive Syndromes? A Meta-Analysis of Double-Blind Placebo-Controlled Trials," Journal of Developmental and Behavioral Pediatrics (Dec. 2004): Vol. 25, No. 6, pp. 423–34.

Weber W, et al. "Complementary and Alternative Medical Therapies for Attention-Deficit/Hyperactivity Disorder and Autism," Pediatric Clinics of North America (Dec. 2007): Vol. 54, No. 6: pp. 983–1006.

Another perspective on diet and ADHD, from Attention Magazine (published by CHADD):
http://www.chadd.org/AM/Template.cfm?Section=Sites&TEMPLATE=/CM/ContentDisplay.cfm&CONTENTID=10218

For more references, please see www.health.harvard.edu/mentalextra.

Originally published: June 2009