Dad says, “He has continuously asked me for help with concentration”

I received this email today from a friend, the father of a senior in high school:

“My son is having a hard time focusing when in class and doing homework. He says he’s taking the breaks and even getting up and walking around during class to try and get focused.

He has been keeping a list of things to do every day. He’s getting good grades and not in any trouble but he has continuously asked me for help with concentration. He is now asking about what doctors do to help ADD. Any suggestions?”

Start by asking the right questions

If you have a child with similar concerns, I’ll explain what goes through my mind when I read this letter so you can ask the right questions:

• Is it possible that this child has ADHD and should see a professional? If I think they might have ADHD, I’ll often recommend that they get tested by a reputable Neuropsychologist.
• Now, I need to ask questions that get to the bottom of which factors affect this child’s concentration:
  • Food: Do they eat enough healthy fat? The brain loves to use fat as fuel (avocados, nuts, seeds, meats, real butter, eggs, etc..) Do they start the day with carbohydrates (cereal, sugar, bread, jelly, juice)? Carbohydrates tend to make it more difficult to concentrate, spike blood sugar and cause blood sugar crashes later in the morning. They tend to make kids more foggy. Is this child eating foods that nourish the body or do they tend to eat foods that just make them feel full?
  • Sleep: Is the child waking up rested? What can be done to improve the sleep environment (electronics out of the room, alarms to signal when it’s time to wind down, etc.)? Can the sleep routine be improved?
  • Exercise: Is this child getting plenty of physical activity or are they learning sedentary habits?
  • SSS: Does the child have a Sacred Study Space at home that is optimized for focus? Is it free of distractions? Do they have a standing desk or fit-ball chair, both of which help with concentration? Do they slouch, thus telling the body to get in rest mode rather than focus mode?
  • Classroom environment: Is the student’s seat in a good place? Are they constantly distracted by something? Are they in the back, far from the teacher?
  • Study routine: Is there an actual routine in place? What would be ideal?
  • Study habits: Does the student “pre-study“? In other words, do they know how to study proactively, how to be prepared for class by getting familiar with the content that is about to be covered? Do they know how to take notes effectively? Do they have study partners? etc..
• I also want to find out what else could be going on. Are there social pressures that are interfering with concentration? Is the content uninteresting to the child? Is the teacher burnt out and legitimately boring? I might even look into things you may not expect, for example, is there a vitamin D deficiency?

So, in this situation I had a conversation with this student to get to the bottom of it. Often, parents and teachers do not dig deep enough. Instead, they think the student needs to just “try harder“. But real solutions come when you can help the student take a proactive role in changing the factors that might be affecting concentration. This has the added benefit of helping the student develop an “internal locus of control”, which means that they learn that they have the power to change and improve their own life. We definitely want to teach this so our children don’t grow up feeling like powerless victims who blame the outside world for their woes. So take time to really dig deep with your child, and help them learn to uncover their own solutions as much as possible.

But what do doctors do to help ADHD?

Now, in the letter above, the high schooler asks what doctors do to help adhd. Well, there is a lot to say, but the short answer is:

1. They will often give a questionnaires to diagnose the problem. Often they give one for teachers to fill out, one for parents to fill out and one self-assessment.
2. They will sometimes prescribe a commonly used stimulant, like Adderall or Ritalin (there are many). Sometimes they prescribe other types of drugs.
3. Some doctors will “titrate”, which means that they are communicating with you thoroughly about the effects of the drug and making adjustments carefully. They may adjust the type or amount of a drug. In my experience, doctors don’t do this enough, they sometimes just prescribe and send you on your way. Therefore, you may have to advocate by asking your doctor specifically how they titrate.
4. They may refer you to a specialist.
5. They may help you determine if other factors may be causing the problems.

One problem with medications is that, while they may help a child focus, pills do not teach the skills a child needs to be a successful student. A lot of people miss this point and this is where a good teacher, coach or mentor can help.

Hope this shed some insight for you.

Best of luck,
Seth