Exercises like rock climbing, structured play sessions and even clapping along to musical beats are being used to help kids with attention deficit hyperactivity disorder, or ADHD, augmenting medication with these structured sessions.

About 11 percent of children have been diagnosed with ADHD, according to the Centers for Disease Control and Prevention. There are three main types: inattentive, hyperactive/impulsive and a combination of the two.

Kids with ADHD typically have trouble with executive function: things like paying attention to something that doesn’t interest them, making priorities, sticking with things until the end and imagining consequences, said Dr. Jeffrey Brosco, professor of clinical pediatrics and associate director of the Mailman Center for Child Development at the University of Miami School of Medicine.
“It’s not a problem when you’re not asking them to sit still and follow the rules and do a lot of boring stuff. But when you do require it, and they can’t do it, it’s a big problem,” he said.

The best way to diagnose ADHD is with a comprehensive psychological evaluation that includes intelligence testing, processing speed, auditory and visual processing, said Gary Lancelotta, a psychologist at Baptist Children’s Hospital in Miami. “You want to get a sense of how attentional issues are impacting the child overall,” he said. An evaluation should include formal parent and teacher reports, and rule out other potential problems, like hearing issues, Brosco said.

Though it is one of the most common childhood disorders, it can be frustrating for a parent trying to determine the best way to treat a child with ADHD.

Tina Chilampath, an occupational therapist with Memorial Hospital West in Pembroke Pines, uses an Interactive Metronome as a tool to improve cognitive and motor skills in kids with ADHD. The computer program gets the child to clap their hands or tap their feet in time to a beat, essentially practicing their concentration skills, she said. The program tracks accuracy, and as a child progresses, it introduces distraction and the task becomes more difficult.

“Kids with ADHD have a very hard time focusing on one thing while other things are going on at the same time,” Chilampath said. “This works to improve attention and coordination. There’s been evidence that it improves language processing and reading skills.”
If you give a child with ADHD a multi-step task, they have a hard time figuring out how to motor plan, sequence, use their time and keep to a rhythm. All of these things are related to being able to pay attention, Chilampath said.

The Interactive Metronome is a tool that can be incorporated into physical, occupational or speech therapy. “It’s something to add to the mix,” she said.

The minimum frequency is twice a week for 15 to 60 minutes. There is also a home-based program that requires parent training.

Chilampath also helps conduct a Social Sensory Group, which meets in eight weekly one-hour sessions and is targeted to kids with ADHD and those who have trouble with social issues. Kids are grouped by cognitive level. “It helps teach them peer interaction and lets them practice what they’re learning in a group, rather than one-on-one,” she said. Crafts, games, obstacle courses and outings are incorporated into sessions.

Another therapy is neurofeedback, which uses sensors to monitor brain activity as a child plays a special video game, Brosco said. Brain waves are recorded, so the child can see when he is most efficient. The idea is, with practice, to retrain the brain to work in the most efficient mode. The therapy is typically done over multiple sessions.

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