The Lifestyle Factors That Ease — and Worsen — ADHD Symptoms in Children

Stimulant medications and behavioral therapy are considered first-line treatments for ADHD in children, but caregivers know that multimodal treatment plans work best for easing symptoms. What does “multimodal” look like in real life? In a recent ADDitude poll of about 1,000 webinar attendees, about 50% said stimulants and/or non-stimulants have “improved their child’s ADHD-associated learning and behavior challenges the most.” The other half said the following lifestyle factors had the biggest impact:

• Improved diet, exercise, or sleep: 11.9%
• Education services (e.g., tutoring, accommodations): 10.13%
• Behavioral therapy: 7.34%
• Limited screen time: 4.56%
• Supplements (e.g., omega-3s, magnesium, zinc): 2.53%
• Speech, occupational, or physical therapy: 2.53%
• Mindfulness exercises: 1.77%

Comments and questions submitted during the webinar, titled “Genes and the Environment: How Biology and Exposures Contribute to ADHD in Children,” centered on the lifestyle and environmental factors with the biggest impact on ADHD symptoms.

The Importance of Diet, Exercise, and Sleep in Managing ADHD

Diet, exercise, and sleep are the Big Three — the lifestyle changes with the most significant, most scientifically proven effect on ADHD. When these lifestyle factors are optimized, your child may require a lower dose of stimulant medication or may find their ADHD medication works better, according to Joel Nigg, Ph.D., a clinical psychologist and a professor in the departments of psychiatry and behavioral sciences at Oregon Health & Science University.

Next Steps to Optimize Diet, Exercise, and Sleep:

• Read: Exercise and Sleep – the Better Brain Therapies Your Child Needs
• Read: 5 Big Natural Remedies for ADHD
• Read: Leveraging Sleep, Exercise, and Nutrition to Improve ADHD

Q: “Are there specific foods or nutrients that we should increase to better manage ADHD symptoms?”

Omega-3 supplements have been shown to improve ADHD symptoms. Learn more about the benefits of omega-3s in these resources:

• Read: Omega 3s – the Ultimate (ADHD) Brain Food
• Free Download: 12 Surprising Sources of Omega-3 Fatty Acids
• Read: “How Do I Get My Sensory-Sensitive Child to Take Fish Oil Supplements?”

Q: “What, if anything, should we eliminate from our child’s diet?”

A portion of children with ADHD will respond positively to a diet that eliminates allergens, additives, and dyes. Consult with your child’s doctor and/or a nutritionist to safely follow an elimination diet.

Next Steps:

• Read: The Truth About Food Dyes and ADHD – What Science Tells Us
• Read: Eggs, Dairy, Nuts, and Soy – Testing for Food Sensitivities with an ADHD Elimination Diet
• Free Download: What to Eat — And Avoid — to Improve ADHD Symptoms

Q: “What about caffeine?”

The active ingredients in caffeine are clearly beneficial for attention, Nigg says, but it’s unknown what caffeine doses are safe for children. Too much caffeine can actually be harmful for development. It’s best to avoid caffeine (e.g., watch sports drinks and other sources of caffeine) until the late teenage years.

Next Steps:

• Read: The Truth About Caffeine and ADHD

Screen Time and Video Games

Q: “Do violent video games impact my child’s behavior?”

“There is quite a bit of evidence linking violent content with increased aggression in vulnerable children,” Nigg says. Monitor your child’s gaming activities and redirect if you notice signs of aggression, depression, and irritability.

Next Steps:

• Read: ADHD and Video Games – Is Your Child Hooked?
• Read: Do Video Games Exacerbate ADHD?
• Free Download: An “Ethics Manual” for Your Child’s Electronics

Stress and Family Conflict

Q: “My child’s ADHD has worsened since the pandemic. Do I need to adjust their treatment plan?”

“Scientific evidence supports your feeling that kids’ problems have gotten a lot worse in the last two and a half, three years,” Nigg says. In a chronically stressful situation, it’s normal for children to be (and act) stressed. As the stressful situation reduces, your child’s behaviors should go back to baseline. In the meantime, continue to support and coach your child and model appropriate coping behaviors. Talk to your child’s doctor if you notice concerning behaviors. There could be more than ADHD in the picture, which will influence your child’s course of treatment.

Next Steps:

• Read: How Do You Reassure Your Anxious Child When You’re Scared, Too?
• Read: How Trauma and Chronic Stress Affect Developing Brains
• Read: Does Trauma Cause ADHD? And Vice Versa?
• Read: Building Resilience Begins Here –  6 Motivation Strategies for ADHD Families

Remember, ADHD is Not Caused by “Bad Parenting”

Parents of children with ADHD can easily get caught in negative loops that may inadvertently reinforce challenging behaviors. (Parental ADHD can also complicate the dynamic.) Behavioral therapy is proven to help reduce difficult behaviors in children and create a positive family dynamic. Parental self-care is also important.

Next Steps:

• Read: Behavioral Therapy for ADHD – A Pragmatic Parent’s Guide
• Read: “None of Us Were Trained How to Be Good Parents” – An ADHD Guide to Behavior Therapy
• Read: A Survival Guide for Parents with ADHD – Strategies from Preschool to High School
• Read: Hey, ADHD Parents – Shoot for Progress, not Perfection
  

To learn more about how lifestyle and environmental factors impact ADHD symptoms in children, listen to the ADDitude ADHD Experts webinar, “Genes and the Environment: How Biology and Exposures Contribute to ADHD in Children” by Joel Nigg, Ph.D., which was broadcast live on November 30, 2022.

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