Q: I am a mother in Mexico, looking for Driven to Distraction in Spanish. Can you tell me how to get hold of it?

A: Driven to Distraction was published in Spanish by Paidos. Contact the publisher for details of where you can get it. We are in the process of updating and overhauling the drhallowell.com website and will include on it a listing of all foreign-language editions of his published books. The revised site with the information should be up in December.

Q: What's the best way to get feedback from my child's teacher on his behavior in the classroom?

A: Personal contact with your son's teacher, so that you are working as a team, is the best approach. We have also seen at least one "worksheet" that is aimed at getting feedback across a consistent set of indicators that could also help. This is a weekly (or monthly) form developed by David Rabiner, a research scientist at Duke University. The teacher fills it out for parents (and guidance departments). A link to this form is below.

Given how detailed the monitoring system is, we think it is important that you develop a strong relationship with the teacher(s) before asking whether they would be willing to fill it out. For the same reason, we think it might be better suited to elementary school settings (where you have only one teacher) rather than for older children. Nonetheless, it is a useful tool for your "aresenal" of ideas for helping you child with ADHD.

There are a number of non-medicinal approaches to treating ADHD, learning disabilities and other co- existing conditions (anxiety, depression, migraine headaches, etc.) At the Hallowell Center we often try medications as a first approach to treatment because these medications have a long and proven record for treating ADHD and tend to help more than 80% of our patients. However, many patients have undesirable side effect to medications. Others simply prefer a non- medicinal or supplemental approach. All of the treatments listed in this article can be used in additional to medications or can be used alone.

The Basics #1: Exercise, Sleep and Nutrition
These are the very basics of taking care of yourself - no matter what - but they are particularly important for people who have ADHD. People don't think of them as "treatments" but they have a huge impact on how your symptoms affect you. Whether or not you are also taking medication, you should be thoughtful about their exercise, sleep and nutrition patterns.

There is a great deal of research that shows that aerobic exercise helps provide focus and mental alertness by changing the chemicals in your brain. New research suggests that it also helps grow brain matter. Assuming that you are cleared to exercise by a doctor, we suggest a minimum of a half an hour a day of exercise that raises your heart rate to the point where you can break into a sweat. A neat "trick"? Exercise can also be used in very short burts to help you refocus (10 jumping jacks can help you get back on track).

Another form of "exercise" that helps create focus is meditation and yoga. There are too many options of these to go into, but we encourage people looking for calm and focus to experiment with both meditation and yoga.

As for nutrition - there is an entire chapter in "Delivered from Distraction" on the topic (and another one on Omega-3 fatty acids.) But here are some quick tips:

• make sure that you get enough Omega-3 fatty acids. The best way to get this is through fish oil supplements, as these have fewer contaminants than the fish themselves. (For an article on this topic, go to this link.) We like both the Zone and Omega Brite fish oil supplements, but for an unvarnished look at supplement quality, go to this link. A good dose for kids is up to 2.5 grams a day and up to 5 grams a day for adults
• eat a diet that minimizes "highs and lows" (or balances insulin). We recommend a well-balanced diet that includes a small amount of protein at all meals, maximizes fresh foods, includes Omega-3 fatty acids, as well as olive oil, and minimized carbohydrates. A good example of this type of diet is the Zone Diet created by Dr. Barry Sears.

Here are a few of the recomendations from "Delivered":

• Eat lots of vitamin C in fruits. C helps modulate the synapse action of dopamine, a key neurotransmitter needed in treating ADHD
• Make sure to get vitamin B-12 and folic acid, which improve cognition and help prevent cell death in the brain
• Vitamin E and selenuim also improve brain function.
• Eat a balanced diet that includes Omega-3s, and a small amount of protein at each meal. Eat as much of your diet as possible in the form of fresh foods. Avoid junk foods.
• Avoid binging on carbohydrates. These give you a squirt of dopamine, but there are much better ways to do this: exercise, making love, meditation.

The Basics #2 - Education and Therapy
We believe that you should find out everything you can about ADHD and about you with ADHD. Your family should be in the know, too. This means read a lot (or listen to tapes), scour the internet for information and talk with a doctor or therapist who has experience with the topic. Since you are reading this newsletter we won't belabor this point except to say that we believe a strengths-based approach to ADHD is best. If someone keeps focusing on the negatives, consider moving on!

Low Energy Neurofeedback (LENS)
This is a safe and non-invasive procedure in which the patient wears electrodes on the skin that monitor and analyzes EEG (brain activity). The system then uses the EEG information as a feedback that gives signals back to the brain that serve to normalize brain activity.

The Hallowell Center offers LENS neurofeedback because it works more quickly than other forms of neurofeedback (takes about 1/4th the time) with the same durability of treatment. Research shows that it does help a wide variety of issues. LENS is used to treat ADHD, bipolar, depression, anxiety, OCD, migrain headaches and Asperger's. You can get more information about how it works at the LENS website.

The Hallowell Center in Sudbury offers LENS therapy and can also provide more information about the topic. Call Rebecca Shafir at 978-287-0810 with your questions. If you want to get more information on the internet, go to the site at the link at the bottom of this article.

Cerebellar Stimulation / The DORE Program
This originated in the UK as an exercise-based remediation process for difficulties related to delayed cerebellar development. Patients do exercises for 10-20 minutes a day for about six months to a year. Exercises include such activities as balancing on a wobble board, juggling, moving your eyes from side to side, standing on one leg, etc. These are just a few of the specific movements in this treatment that stimulate the cerebellum.

We have found the Dore method extremely promising for people with ADHD and dyslexia as well as reading issues created by difficulties in eye tracking (so much so that we offer Dore in our Sudbury center). Another form of cerebellar stimulation is provided as Brain Gym. Unlike DORE, we don't have direct experience with it, but have anecdotally heard good reports.

Cogmed Working Memory Training
This is a proven, software-based intervention developed in Sweden specifically for children with attention deficits. Benefits include improved attention, improved impulse control and better academic performance.

Cogmed Working Memory Training can be done in your home, and takes about 30 minutes a day, five days a week for five weeks. The Hallowell Center is one of the medical centers authorized to offer this program. Happily, because it is computerized, the Center offers it to people around the world via phone and internet, not just local patients. If you are interested in participating in the program, call Anita Pliner, neuropsychologist, at 978-287-0810, x111.

The Cogmed website offers an overview of the research on the effectiveness of Cogmed at this link.

Every once in a while a new book comes out that we are just VERY, VERY excited about. Your Child's Strengths: Discover Them, Develop Them, Use Them by Jenifer Fox, M.Ed. is one of those books. Ms. Fox, who is head of the Purnell School, has done nothing short of outline a completely new approach to how education should be provided for our children.

Dr. Hallowell read an advance copy of Your Child's Strengths and had this to say:
"This is a brilliant, innovative, enormously practical, and hugely important work. Where positive psychology and strength-based philosophies usually stumble, this book soars, namely, in practical application. If teachers and parents would all read this and implement its suggestions, our broken educational system would be fixed in no time. Truly, this book could change the world."

The book, which will be released on Feb. 28 of 2008 can be preordered at the link below.

Brains of Children with ADHD do not Mature at Same Rate as Non-ADHD Counterparts: Researchers from the National Institute of Mental Health did an extensive study that suggests that the brains of kids with ADHD reach "peak thickness" on average 3 years later than those without ADHD (age 10.5 vs. age 7.5). For more information about this study, s ee a BBC news article at this link.

NIH Publishes Study Supporting Combined Treatment for Adolescent Depression:
A study published in the Archives of General Psychiatry in October suggests that the most effective treatment for adolescents who are depressed is a combination of antidepressant medication and psychotherapy. However, the study also found that the medication used (fluoxetine, known as Prozac) can pose a risk to teens, particularly if it is used without psychotherapy.

Please go to this news release from NIH for more information.

U.K. Study Suggests that Bipolar Disorder is Often Misdiagnosed as Depression:
Though we question the research methodology of this study, U.K. researchers believe that bipolar disorder is incorrectly diagnosed as depression perhaps 24% of the time. Of particular concern was misdiagnosis of unipolar depression, which is characterized by depressed mood without manic episodes. For more information, go to this posting on PsychCentral.

Mayo Clinic Offers Tips for Stress Reduction: We, of course, think our free weekly CrazyBusy tips are the best, but here are some stress reduction tips from the Mayo Clinic.

Thinking about what to give to members of your extended family this year? If one of your kids has ADHD, consider giving a copy of "Delivered from Distraction" to grandparents, aunts or uncles. This will give your relatives a positive introduction to the subject, and will aid in supporting your child (and you). The more the people who love your kids know about ADHD, the better.

Do you know someone who might like to receive this email? If so, forward this to them and suggest they sign up at www.drhallowell.com or at the link below.

email: morlov@hallowellconnections.com

phone: 508-545-2250 Hallowell Connections or 978-287-0810 Hallowell Center (medical)

web: http://www.drhallowell.com