Treating ADHD: If Not Drugs, Then What?

adhd1Some children, when asked to attend to certain tasks, do so for shorter periods than most.  Some are also more energetic.  Such children are often said to have Attention Deficit/Hyperactivity Disorder (ADHD).

Although many doctors recommend placing children believed to have ADHD on drugs such as Ritalin and Adderall, many parents refuse to go that route.  The evidence that the drugs do not lead to lasting improved academic and social outcomes are major reasons (see my post titled “The Myth of Ritalin’s Effectiveness” for a review of the effectiveness studies). Other major reasons have to do with concerns about known negative side effects and possible long term harm to such young developing brains.

adhd2Parents who have a child viewed as having ADHD typically face two challenges–disciplining their child and responding to concerns from their child’s teacher. For parents who choose the drug approach, they may come to believe that at least by drugging their child something is being done to deal with the challenges.  They may thus become less motivated to take some other steps because what can be done is being done.  If the child misbehaves, the parent may come to believe that the cause is due to the drug not doing what it’s supposed to be doing.  Maybe the child needs to go back to the doctor to get the dose tweaked, or another drug needs to be added or substituted.

pillsBut for parents who refuse drug treatment, they don’t get confused about all of these drug issues and a clearer path lies before them.  As a school psychologist for many years, I’ve walked with parents down this non-drug path on numerous occasions, and here are some suggestions that I found most helpful.

My Four Favorite Suggestions for Parents Concerned about a Child’s Attention Span or Energetic Behavior

1. Search the internet with the following search terms–“ADHD without drugs.” If you do so, you will find many suggestions on how to address your concerns.  healthymeditationA daily running program and meditation were just a couple of excellent ideas that I found quickly in a recent search of this sought. Many of the suggestions indicate that they have research support demonstrating that they are effective (see for example APA’s article titled “Easing ADHD without Meds“). What I particularly like about having parents search the internet in this way is that they get to select from a wide range of ideas the ones that make the most sense to them.  Moreover, there are always new ideas coming out, and these types of internet searches are regularly updated.

kazdin22.  Get a copy of The Kazdin Method for Parenting the Defiant Child by Alan Kazdin.  Dr. Kazdin is director of the Yale Parenting Center and Conduct Clinic and is a former president of the American Psychological Association. His approach has been well tested in solid research programs with impressive results.

If you can’t afford to buy Dr. Kazdin’s book, you can get a copy at your local library.  If your library doesn’t have a copy, walk over to the the librarian and ask to get it through inter-library loan.  If you have trouble reading books, it is also available on CD.  Listen to these CDs while you are driving, cleaning the house, and washing dishes.  You’ll find a goldmine worth of information.

3.  Ask your child’s teacher to provide you, each week, a list of the main topics that will be covered in class the following week.  Then view at home with your child a lesson on each topic on the Kahn Academy website.

Kahn AcademyThis website is a resource that provides free lessons on all the topics that teachers teach in school.  By having your child review each lesson before hearing it for the first time from the teacher, when the teacher actually presents the lesson in school, your child will now be at least somewhat familiar with the topic.  This is called “priming” and it has been demonstrated to increase the interest level for learners and increase the likeliness that the topic will end up being mastered.  Moreover, once you show your child how the Kahn Academy website works, your child, before each test, can go back to the lesson and make sure he or she has really mastered it.

If you do not have the time to do this with your child, see what you can do to get someone at least four years older than your child to carry out this activity.  You may have to pay a young teenager a little, but it will be better than paying for pills.

This approach leads to real learning.  Once your child starts to make better academic progress in school, he or she will feel better about school in general.

casino14. “Casino for teaching calculation fluency” is a card game that I have found works great for kids who have difficulty learning math skills in the usual manner.  You can find the rules for the basic casino card game on line by typing in your search engine, “Casino card game rules.”  Once you learn the basic rules it will be easy to learn how to apply the game to improve a wide range of math skills.

Basically, the game is played as follows. The dealer deals four cards to each player and four cards face up in the center (these center cards are laid out separately so that all are visible). The aim is to capture cards from a layout on the table, by playing a card from your hand which matches in number a table card or the sum of several table cards. When it’s your turn, if you can’t capture any cards, you have to throw into the center, face-up, one of the cards from your hand. The cards that each player captures are accumulated in his or her pile. The player who ends up with the most captured cards (in the simplest form of the game) is the winner. After each player plays the four cards that are originally dealt, each player is dealt four more cards. The game is over when all the cards in the deck are used up.

casino2To win, a player must learn to do basic addition. Consider this example. Suppose it is my turn and I have in my hand a 9, and on the table, face up, is a 6 and a 3. If I know 6 plus 3 equals 9, I can use my 9 to capture the 6 and the 3. The more cards I capture, the more chances I have of winning. If I am a bit clumsy at addition, this game can motivate me to increase my fluency.

Once your child has learned to add smoothly, you can change the rules of the game to learn more advanced math skills. For example, you can make the new rule as follows: the only way to capture cards is by using subtraction; or multiplication.

abacusThe game can be played in groups of 2, 3, or 4. Besides a deck of cards, it will help to learn math if you will get an abacus.  Any student having trouble with learning basic arithmetic should be taught how to use an abacus, and should get a great deal of experience using it. It visually displays how our system works, with the ones line, the tens line, and the hundreds line. The manipulations are fun, and they begin to make conceptual sense after regular use.  You can buy an abacus on line for just a few dollars and they come with directions.

The abacus is used as follows. Suppose Sue, who is playing Casino with Jill, attempts to use a 7 in her hand to capture a 6 and a 2. She can use the abacus to see if 6 and 2 equals 7. In a short period of time, Sue will learn to add without the abacus.

thinking2An interesting psychological aspect of playing this game is that even when it is not the turn of the other players, all the other players are motivated to do the calculation of the person whose turn it is in order to make sure she or he does not cheat. Moreover, whenever a player can’t make a capture, and therefore throws a card from her or his hand onto the table, all the other players start to make calculations in their heads to figure out how the new card can be utilized. Consequently, there is an enormous amount of additional calculations going on than one might think by watching the player whose turn it is. This is a large reason why this game is so effective.

Now, once your child learns the basic rules of the game, usually within a half hour of playing time, the rules can be changed so that your child begins to work on learning fluency of the math facts at his or her level. So, if Sue is learning to be fluent in learning single digit addition facts, the group plays the game in the standard manner.

thinking1If Sue is learning fluency in mastering two digit addition facts, the game is changed so two decks of cards are combined. Both decks get a little doctoring. The parent takes out the four jacks from one of the decks and crosses out their J, and writes beside it the number 11. In a similar fashion, queens, and kings have respectively, the numbers 12, and 13 written on them, replacing their Q and K. For the cards in the second deck, their numbers are changed so that they are given numbers that range from 14 to 27. Both sets of cards are shuffled together, and the game is played like the basic version of the game but there is far more addition facts that can be employed in order to capture cards.

For students learning fluency in mastering single digit subtraction facts, the same rules are applied as the single digit addition form of the game but players can only capture cards by applying a subtraction fact. For example, if Fred has a 2 in his hand, and there is an 8 and a 6 faced up on the table, if he recognizes that 8 minus 6 equals 2, he can capture with his 2 both the 8 and the 6.

For students learning fluency in mastering two digit subtraction facts, the same rules are applied as the two digit addition form of the game but players can only capture cards by applying a subtraction fact.

In a similar manner, the game can be played as well so it is designed to teach fluency in basic multiplication or division.

math is funMath is often a stumbling block for children who have trouble paying attention to topics that bore them.  By making learning these skills fun, these skills are quickly learned.  When your child then goes to school, his success in math class will greatly improve his or her overall school experience.

Okay then, those are some ideas to help children thought to have ADHD.  There are of course far more options to discover.

Until you join us again, have a great week.



Some people will enjoy reading this blog by beginning with the first post and then moving forward to the next more recent one; then to the next one; and so on. This permits readers to catch up on some ideas that were presented earlier and to move through all of the ideas in a systematic fashion to develop their emotional intelligence. To begin at the very first post you can click HERE.

The Myth of Ritalin's Effectiveness
The Mental Illness Construct: Does it Reduce Shame and Guilt?

About the Author

Jeffrey Rubin grew up in Brooklyn, received his PhD from the University of Minnesota and has taught conflict resolution there as well as at a psychiatric clinic, a correctional facility and a number of public schools. He has published articles on anger and conflict resolution and has authored three novels.


  1. Excellent resource! I wanted to share I know a little girl, now 6, who is great until she gets sugar, in any form, and gobbles it down. She is fine until that evening and then BAM all hell breaks loose. Her parents are very observant and noticed this also, now this girl gets persimmons and fruit, and occasionally stevia sweetened chocolate and she is normal delightful self. I know another young man, high energy which is good and what I would expect, but would destroy things like plants and in general be a terror, his father took him to a specialist who determined an allergy to food colorings in his food was the culprit and I witnessed the kid within a week of a simple diet change chill right down to normal high energy.

  2. Thanks, Jim, for your observations that certain foods appear to be associated with behavior concerns. I wish there was more money to thoroughly look at these types of issues. I read a study a few years back that found that some type of elimination diet was able to identify what foods led to these concerns. After the success of the in initial study, I expected to soon hear about a more thorough follow-up study, but I have not seen it. I guess prescribing drugs is so lucrative that the motivation to discover other approaches is not sufficient there.

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