As a naturopathic physician specializing in ADHD, I understand the importance of optimizing foundational health and wellbeing to manage ADHD symptoms. And one area that is essential to evaluate is vitamin and mineral deficiencies.

Research has shown that certain deficiencies are actually more common in people with ADHD, and understanding how these vitamins and minerals affect the body can help you determine which ones could potentially have the biggest impact on your health and ADHD symptoms.

Generally, when I work with patients, I like to check-in on the following 5 potential deficiencies, particularly if there are additional health conditions, poor diet, or possible absorption issues in the gut. Remember to talk to your doctor before taking any new supplements!

Magnesium
Magnesium levels can impact sleep, muscle and nerve function, bone health, and your ability to manage stress and anxiety. Most people who eat a standard American diet are deficient in magnesium, although people with ADHD have even higher rates of magnesium deficiency.

I often consider magnesium supplementation for patients who struggle with sleep issues, muscle cramps, constipation, headaches, and/or anxiety. Magnesium supplements exist in many forms–oxide, citrate, threonate, glycinate, and more– and not all forms of magnesium are created equal in how readily they are absorbed. Plus, research seems to point to some forms of magnesium being more suited to specific effects. For example, magnesium glycinate may be more well suited for neurologic benefits of magnesium.

Vitamin D
Essential for calcium absorption, immune function and countless other processes, vitamin D also appears to be linked to levels of neurotransmitters like serotonin and dopamine which are super important for ADHD and mental health overall!

In my experience, most of my patients are deficient in vitamin D, even if they have been taking a standard maintenance supplement. I like to see levels at 50-75 nmol/L on bloodwork, and it is crucial to look at labs for Vitamin D because this is one of those vitamins that can be harmful if you take too much.

Vitamin D is an easy supplement to take and since it can be linked to fatigue and depression, it is part of most of my treatment plans. It is particularly important for people who have IBD or other inflammation in the gut which can make it hard to absorb vitamin D in the diet.

Iron
Iron is another supplement that you definitely want to avoid overdoing, so getting bloodwork to determine your actual values is important. Iron levels can impact energy levels, exercise tolerance, growth, and how well your nervous system functions. Iron deficiency is also correlated with tic disorders and sleep struggles.

Knowing its actions in the body, I always pay close attention to iron levels for my patients who struggle with sleep or those who experience tics. I also think about iron if a patient has heavy periods or eats very limited meat in their diet. Luckily, lab work gives us really great information about whether or not a person’s iron levels are getting low, as long as you are sure to get a ferritin level with your workup. Ferritin can help us understand how much iron your body has in “backup stores”, and this often drops low even before true anemia shows up.

B vitamins
I could write pages and pages about the link between the different B vitamins and ADHD, but in short, we definitely see higher rates of deficiencies in several of the B vitamins in ADHD patients. B6 may be particularly important when fatigue and irritability are major struggles. Folate (B9) can be affected by mutations in the MTHFR gene which make it more difficult for your body to convert folate from your diet into a form that the body can use. Some researchers have proposed that excess hyperactivity and impulsivity in some people with ADHD may be able to be explained by inadequate B12 levels.

As with many of the other nutrients, inflammation in the gut can make it harder for the body to absorb B vitamins. Diet also plays a major role in B vitamin levels. For example, B12 is only available from animal sources or in fortified foods, so strict vegans need to make an effort to add this nutrient into their diet.

The take home message? Your B vitamin levels can be having a major effect on ADHD symptoms and on your general energy and health. This is an easy problem to correct, but knowing whether or not you have any mutations or absorption issues that are playing a role is crucial.

Zinc
Zinc plays an important role in the nervous system, as well as the immune system and growth. It also affects your sense of taste and smell, and appetite. For some patients that find they really struggle with appetite, zinc supplementation can help. I also think about zinc for patients who seem to get frequent respiratory infections and for patients with hair loss or poor hair growth.

You need to be careful with taking zinc, because the ratio of zinc to copper in the body is very important. If you take a zinc supplement, you may also need to add copper in the right amount in order to keep the correct balance. 
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If you would like to check if a vitamin or mineral deficiency could be contributing to your symptoms, it is important to always talk to your healthcare provider. They can help determine what supplements and doses are best for your specific situation.
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In health,
Dr. McMillin

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I have a major complaint with the majority of books for ADHD: They aren't laid out in a way that's easy for ADHD brains to stay engaged! 
However...
I was so excited to open up Organizing Solutions for People With ADHD and find that it is a book that has helpful information AND is ADHD-friendly. 
Susan C. Pinsky got it right by creating a book that utilizes photos, breaks text into manageable chunks, and organizes sections in a way that makes it easy to jump from one topic to another depending on what is relevant to you.
This is a book I highly recommend for people who are looking to set up some ADHD-friendly systems for staying more organized. You won't find a list of ways to make your space look pretty, but you will find easy ways to organize your stuff that is actually able to be maintained.
While these techniques will be helpful for anyone, they are clearly created with executive function deficits in mind.
So if you are running into a wall because every time you try to organize your space, the system doesn't last, check out Organizing Solutions for People With ADHD by Susan C. Pinsky. It is easily one of my favorite books to recommend to my patients!

1. Change out of pajamas

Your brain picks up all kinds of subconscious cues about your schedule and these have a big impact on your internal clock. When your internal clock gets thrown off it affects your ability to not only fall asleep, but your quality of sleep too.

Often when we are in vacation mode it's easy to just hang out in your PJs until after lunch (or let's be real, all day). But changing out of your sleep clothes or vice-versa can be one of those subconscious cues that helps your brain maintain it's internal clock. Getting dressed in the morning can help you feel ready for the day and move into productive mode, just like changing into pajamas can be an important part of a bedtime routine which helps your body move into sleep mode. 

Even if you take a day to relax, maintaining your normal daily rhythm will pay dividends when it is time to get back to your regular work or school schedule. So keep up with a simple wardrobe change every day over this winter break and see how you feel!

2. Keep mealtimes consistent

Zeitgeber is a fun word for naturally occurring cues like daylight and darkness that can affect our internal clock. Most people don't realize that mealtimes are incredibly powerful zeitgebers, and ones that we can pretty easily adjust when our internal clocks are out of sync.

You may have a slightly different eating schedule on the weekend. Maybe you sleep a bit later and grab brunch at 11, instead of your usual light breakfast at 8 and lunch at 1. Chances are the 2-day weekend won't throw you off too much if you get back to your regular routine on Monday.  But when you have extra holiday breaks sprinkled over a couple of weeks, your internal clock can pretty easily lose its rhythm.

Try to keep mealtimes as close to your regular routine as possible. Even if you aren't able to have a full meal, grab a hard boiled egg or a protein waffle in the morning, snag a quick snack at lunchtime, and avoid eating dinner much later than you usually would--or at least try to limit it to one "off" day at a time instead of a series of them.

3. Avoid overscheduling

I get it. ADHD brains often want to do ALL THE THINGS! But also, ADHD brains can be particularly sensitive to lots of stimuli. And when they get overstimulated, it can be super hard to reset. 

Keep an eye on your schedule and avoid scheduling too many events in a row. Instead, block off a "down day" in between bigger events to decompress and catch up with things like household chores or self-care which get pushed aside when you are in a rush to get somewhere. That extra day can help you prep for your next event so you feel less overwhelmed AND it gives your nervous system a rest!

4. Plan for a "dry run"

No matter what your brain tells you, I can pretty much guarantee your first day back to school, work, or both will be stressful if you don't have a prep day. So block your calendar now with a note to remind yourself of this! I recommend blocking the day before your return, but if you have an event that can't be moved, block off the day before that.

On your prep day, mentally go through what your morning routine will look like and put everything in place. Set backpacks by the door. If your family is like mine, take some time to clean out the backpack and find the lunch that has been there since the first day of break. Make sure you have groceries or a plan for breakfast, lunch and dinner for everyone--especially if you are trying to prioritize healthier foods for the new year! Check that everyone's clothes are cleaned and laid out, the car has gas, and whatever else you might need that day has been located and placed in a central location, ready to go.

Now enjoy your last day of vacation knowing the morning will be a little less stressful!

The abrupt transition to online school last year was less than ideal and has left families dreading virtual classes in the fall. So in order to support a successful year, I have created a Remote Learning Survival Guide, with some simple steps for parents of ADHD kids. Be sure to check out Step 1, Step 2, Step 3, Step 4, and Step 5 before diving into the rest of the guide!

Step 6: Bust out the reward charts

Of course you are very familiar with this step. I feel confident that every parent reading this blog post has used a sticker chart, ticket exchange, or some type of reward system for their child at some point. 

I'm guessing that it worked well for a while and then gradually your kiddo lost interest, or you ran out of ideas for rewards, and eventually you abandoned it altogether.

That's totally understandable.

But I'm here to tell you that this remote learning situation is the perfect time to bring one back on board. If you'd like to change it up, here are a few simple options to try:

Sticker charts

• Probably the most classic standby, sticker charts are usually a line of empty boxes drawn on a sheet of paper. When your child earns a sticker, they place it in a box. When all of the boxes are filled, they have earned their reward.
• Have your kiddo help create the actual chart even, or at least decorate it with pictures of the reward they are working toward to increase excitement about it. 

Ticket exchange

• Use tickets or plastic coins that can be exchanged for different items or activities. They can choose when and how they want to spend these--either cash them in quickly for a small reward or choose to save for a bigger prize

Earned screen time

• Some kids are so motivated by screen time that this may be a simple exchange system. Framing screen time as an earned reward is a positive reinforcement that is more motivating than threatening to take it away.
• This can also help kids to learn how to create balance around videos and video games. For example, spending 30 minutes biking around the park could earn you 15 minutes of screen time. Let them know that if they want to spend more time playing a video game, it should be balanced by having some physical activity too.

Whatever system you are using, there are a few important things to remember:

Make the steps toward a reward small but attainable

• You want to be able to reward the small wins--working hard on a difficult worksheet, taking a moment to calm down when frustrated, brushing their teeth without being asked, etc. This might mean that you will need to increase the number of stickers required to earn that pizza and movie night. But it is most important that you are calling out these wins.

Make the reward something that can be achieved within a week or less

• If the reward is too far in the future, it will likely not be motivating for them. This is particularly true for the ADHD brain, where something a month away feels like a lifetime.

Rewards don't have to be physical items

• Pick rewards that work for your kiddo and your family. It could be a special outing with a parent; a privilege like choosing dinner, dessert, or a movie; an extra 15 minutes of video games; a coupon for getting out of a chore--the options are almost endless!

Most likely you will find that excitement and therefore motivation about earning rewards fizzles out over time. When you notice the reward system isn't serving its purpose, switch it up! You may even be able to rotate through the ones that you use. Keeping things interesting is crucial to the ADHD brain, and shiny new objects are our friends.

It can also be a good idea to get your kiddo's input on what type of system and rewards they would be most excited about. Give them some examples of the types of prizes you would be willing to offer and see how they respond. Getting them excited about earning things will help to make sure your plan is a success!

​You've got this!

The abrupt transition to online school last year was less than ideal and has left families dreading virtual classes in the fall. So in order to support a successful year, I have created a Remote Learning Survival Guide, with some simple steps for parents of ADHD kids. Be sure to check out Step 1, Step 2, Step 3, and Step 4 before diving into the rest of the guide!

Step 5: Have a weekly review

I'm assuming that most of us won't have the time or energy to sit next to their child for every online class and every assignment.

We almost certainly will ask things like: "Do you have any homework today?" and "Did you get your math homework done?" Keeping on top of things even to that degree can be a huge task, especially when you have more than one kiddo on top of your own To-Do list!

I can't tell you how many times my daughter has said, "Yep, I finished everything for today" or my son told me, "They didn't assign math homework today" and I left it at that.

But guess what?

They often didn't actually finish what was needed because they didn't read the instructions completely. Or there actually WAS a math assignment, but they weren't paying attention when the teacher mentioned it.

And I wouldn't be surprised if sometimes they weren't being honest with me.

Not because they don't respect me, or they think lying is okay. But sometimes ADHD kids alter the truth because 1) they are impulsive and the response pops into their head, and 2) they fully intend to actually do the assignment in a few minutes so they think it's close enough to the truth.

The link between lying and ADHD could be its very own blog post, but for now let's at least consider it's a possibility.

So how do you get around this?

The plan:
Schedule a time 1-2 times per week to go over all the assignments from that week. Try to keep the review at 20 minutes or less and at a consistent time (ex. Thursday at 7:00 PM)

This can help to avoid the otherwise inevitable scenario where 2 days before the semester ends you get a notice that your child has 28 missing assignments.

You may find that having an outside person help with these weekly reviews is a better fit for your family. Sometimes your child will be more cooperative working with someone who isn't a parent--and it can improve your relationship to delegate this piece to someone else. Often a high school or college student can serve as a "tutor" that offers more general support instead of teaching a specific subject.

Staying on top of things each week can help to make projects less overwhelming for ADHD kids too. Think of it like straightening your room for 15 minutes at the end of every day instead of waiting until you can't see the floor anymore--small bites are far easier to handle!

You've got this!

The abrupt transition to online school last year was less than ideal and has left families dreading virtual classes in the fall. So in order to support a successful year, I have created a Remote Learning Survival Guide, with some simple steps for parents of ADHD kids. Be sure to check out Step 1, Step 2, and Step 3 before diving into the rest of the guide!

Step 4: Consider the learning environment

An uncomfortable desk or seat is a distraction for the whole body. So it's a good idea to do a quick check to see if making an adjustment to your child' working environment could be helpful. 

A general rule of thumb for finding the right chair and desk size is: they should be able to have their feet rest flat on the floor and be able to sit with their elbows on the desk and their chin resting comfortably in their hands.

Taller kiddos may need a taller chair and desk, while shorter (often younger) children need a shorter chair and table. 

If their feet don't reach the floor easily, something as simple as adding a footstool may be helpful.

Some kids focus much better at a standing desk. This doesn't have to require purchasing an expensive new piece of furniture. Another option is to set their computer on top of a heavy duty box or something like an adjustable laptop stand that goes on a table or desk.

If seating seems to be at the correct height, but they fidget a lot with their feet, try tying resistance/exercise bands around chair or table legs. Some kids also do well with a foot roller or swinging foot fidget bar. When my daughter is feeling particularly fidgety, we have a small weighted medicine ball that she rolls around with her feet while sitting at the table.

For those that need more of a "whole body fidget," I like wiggle cushions and yoga balls to sit on. My favorite is the kind of yoga ball that is weighted. This still requires all the muscles that maintain posture to be constantly activating in order to keep balance, but doesn't roll around excessively.

Another tool that can be helpful for minimizing environmental distractions is a simple tri-fold board placed around their work area. This can be particularly useful if you have more than one child at the same table! I love this option because it is inexpensive and folds up easily to be stored out of the way.

Many of these suggestions come down to what I talked about in Step 1-- Be flexible. You may find that you have a few different seating options for your child and what they need one day is a bit different from what they need the next. Involve them in the process of problem-solving. You might say, "You seem to be having trouble sitting in your chair today, would you like to try your wiggle cushion to see if that helps?"

There are so many more options for what you can use to help minimize distractions and improve focus, so if the ones I've mentioned aren't the right fit for your kiddo, don't give up. Tap those innovative ADHD brains to find the best tools for you!

You've got this!

The abrupt transition to online school last year was less than ideal and has left families dreading virtual classes in the fall. So in order to support a successful year, I have created a Remote Learning Survival Guide, with some simple steps for parents of ADHD kids. Be sure to check out Step 1 and Step 2 before diving into the rest of the guide!
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Step 3: Reduce ​workload when possible

Sometimes the solution for getting through an assignment and avoiding burnout is simple: shorten the assignment.

In fact, reducing the length of assignments is a common accommodation for ADHD in school, particularly when kids also have slower processing speed, or learning disabilities such as dysgraphia and dyscalculia.

For things like worksheets and math assignments, this can look like having your child do every OTHER problem. Or choosing selected questions to do instead of all of them.

For writing assignments, you can reduce the number of words, or paragraphs required.

You or your kiddo can talk to the teacher about which problems are most important to focus on. Usually kids can understand and practice new concepts without doing EVERY question on the page. And pushing them to their burnout point just results in more frustrations, anxiety, and negative self-image.

Most teachers agree that the goal of homework is not to have your child sit for 3 hours, struggling to finish an assignment. The goal is to practice and solidify the skills they are learning.

So keep an open dialogue with the teacher about how much time your child is spending on assignments, and work together to find ways that make sense to reduce the workload.

It is also important to remember that kids (especially ADHD kids) may be using up all the "focus power" they have during remote learning classes. This leaves even fewer reserves for working on assignments too!

Hopefully this technique for reducing workload will help your child to succeed in a remote learning environment. Stay tuned for more techniques and tools to support your family!

You've got this!

To be notified of future blog posts, you can subscribe to my feed or follow me on Facebook.

The abrupt transition to online school last year was less than ideal and has left families dreading virtual classes in the fall. So in order to support a successful year, I have created a Remote Learning Survival Guide, with some simple steps for parents of ADHD kids. Be sure to check out Step 1 before diving into the rest of the guide!

Step 2: Take breaks

This. Is. So. Important.

I mentioned breaks a bit in Step 1, but I'm giving them their very own step here. Research shows that our brains need breaks in order to learn and to sustain attention. But what should a break look like? And how frequent should they be?

Generally, I recommend a routine like this:

• 10-20 min of work
• 5 min break
• 10-20 min of work
• 5 min break
• 10-20 min of work
• 20 min break

Everybody is different when it comes to how long they can focus on work, and it can also vary topic to topic. 

For example, my 4th grader really struggles with math. So for this subject, she works hard for 10 minute intervals and takes 5 minute breaks.

A high school student working on an essay, however, may find 20 minute intervals of writing with 5 minute breaks works better for them.

What constitutes a break?

Well, really it's just disengaging from the task, but I always insist on at least standing up, stretching, and getting a drink of water. This creates a clear break for the brain and the body, which can help to improve focus once you sit back down to work.

There are lots of ways to make breaks more interesting, though. Some of my favorites are:

• Sing or lip sync a song (if only Bohemian Rhapsody wasn't 6 minutes long!)
• Play rock, paper, scissors with a friend
• Grab a quick healthy snack
• Put on some hand lotion
• Get up and pour yourself a cold drink
• Walk up and down the stairs a few times
• Do your 3 favorite yoga poses
• Give your pet some love
• Watch a funny animal video
• Dance to an awesome song
• Go outside and breathe in some fresh air
• Do a quick mindfulness exercise

To make things a little more fun at our house, we write our break ideas on slips of paper and put them in a "brain break jar." When it's time for a break, you draw a slip and do what it says. As a bonus, we add 1 slip of paper that says "PRIZE!" When you pick this one, you get a small surprise!

For more info on effective ways to take breaks, check out information on the Pomodoro Technique. And remember that you may need to make adjustments based on your child, the subject, and sometimes even how the day is going.

You've got this!

To be notified of future blog posts, you can subscribe to my feed or follow me on Facebook.

The abrupt transition to online school last year was less than ideal and has left families dreading virtual classes in the fall. So in order to support a successful year, I have created a Remote Learning Survival Guide, with some simple steps for parents of ADHD kids. Over the next few days I will be posting details on how to make these 7 steps work for you. 

Step 1. Be Flexible

I truly hope this is an easy transition for your family. But more likely than not, there will be some frustrations and rough patches.

THAT'S OKAY

Remote learning is still new for most students and teachers, and not ideal for many. But you will learn what doesn't work, you will find things that DO work, and you will adapt. It's sort of like when you start a new job--you expect that first few months will be less than ideal. This is no different.

When you do run into problems, try to pinpoint the specific hurdle and then consider some solutions.

For example, maybe your child is incredibly distracted during online math lessons. Let's say these presentations are 30 minute videos or video calls with the teacher and you notice that after 15 minutes your child is just can't pay attention any more. The problem may be that it is just too long of a period of time for your child to stay engaged. Solution: Break math time into shorter segments of 10-15 minutes, with short breaks in between. If it is a video call, ask the teacher if it can be recorded so you can do this.

Here's another example. Perhaps the class is assigned to read a specific book together, with one chapter of at-home reading per day. Your kiddo may technically read the chapter but is so distracted they don't remember anything they just read. Solution: Try getting the book on audio book--information that is heard is processed differently in the brain than information that is read. Still distracted? Have them listen to the audio book in the bathtub. Add some epsom salts to the tub to help relax the body, and you may find they can follow the story better.

Ask your child if they have any ideas on how to overcome a specific problem they are running into. ADHD brains are innovative brains, and they may come up with a creative solution too! You've got this!

The start of a new school year is just around the corner and for many families, this means a return to remote learning.

The abrupt transition to online school last year, was less than ideal and has left families dreading virtual classes in the fall. So in order to support a successful year, I have created a Remote Learning Survival Guide, with some simple steps for parents of ADHD kids.

These steps are:
1. Be Flexible
2. Take Breaks
3. Reduce Workload
4. Check Environment
5. Review Weekly
6. Bust Out the Reward Charts
7. Be a Cheerleader

I will be going into more detail on how to apply each of these steps, with examples of common struggles and how to overcome them. You've got this!