The therapy of ADD

Synonyms

Hyperkinetic Syndrome (HKS), Psycho-Organic Syndrome (POS), Attention Deficit Disorder, Attention Deficit Syndrome, Fidget - Philipp Syndrome,

introduction

ADS, the attention deficit syndrome, is the German name for ADD, the “Atention Deficit Disorder”.
While children are affected by the hyperactive variant of ADD who can hardly hide their difficulty in paying attention and who appear through inattentive - impulsive behavior, introverted inattentive children are often less noticeable.
Learning problems are often trending. While dyslexia was the “fad” a few years ago, ADD, or the hyperactive variant ADHD, has often been misunderstood in recent years, and has therefore often been misdiagnosed. It is therefore to be warned against rashly excusing any inattentive or fidgety behavior of a child with ADD or ADHD.

As part of the diagnosis, the first steps should therefore only be taken if the inattentive, sometimes impulsive behavior can be observed over a longer period of time (around six months) in various areas of life (kindergarten / school, at home, leisure time). Some development steps or events can temporarily cause such behavior. A targeted approach is therefore sensible and should not be rushed with "Yes, nothing is being done!" be judged.
ADD - children do not only suffer from the corresponding behavior in phases. It is usually the case that the behaviors manifest themselves and usually do not correspond to the age-appropriate behavior. “Childish” behavior - this is how the behavior is often described.

While the hyperactive variant ADHD is often referred to as Heinrich Hoffmann's fidgety philosopher, the ADS type is more likely to be compared with the “Hans-peep-in-the-air”.

Contrary to what one might suspect, this is a “tangible” clinical picture, which is why the diagnosis is ultimately made by the pediatrician. While one was in the dark for a long time with regard to the explanation of the cause, the current state of research mainly assumes that the transmission and processing of information between different brain areas in ADD children functions incorrectly and that various other factors (educational deficits, ...) contribute to the symptoms can strengthen in a special way.

Therapeutic approaches

A distinction is made between various measures in the therapeutic treatment of attention deficit syndrome ADD. This is due to the fact that every child suffers from specific ADD symptoms that have to be treated individually. This could be summarized as follows: cause the same - accompanying circumstances individually different, consequently: individual symptoms of ADD.

In the context of ADD treatment it has been shown that a so-called multimodal therapy is to be rated as the most promising.
A multimodal therapy is understood to be the summary of all therapeutic forms that make sense in individual cases, which build on one another and should always be connected to one another.

In principle, a distinction is made - in addition to promoting the ADD child in the home environment - between various forms of therapy, which in turn combine various therapeutic measures. These are:

• Psychotherapy and curative education in ADD
• The nutritional therapy of ADD
• The drug therapy of ADD

Since the information on the individual forms of therapy is quite extensive, you will find sub-pages that deal with one form of therapy.
Information on the various forms of therapy is listed below. This corresponds to a summary description. Further information can then be found on the respective pages.
The rough overview is only intended to make it clear to you how diverse a therapy for ADD can or should be organized. It should serve you to inform yourself in order to take meaningful measures together with the treating pediatrician or the person you trust.

Promotion in the home environment

It would be too simple and it quickly makes sense: A therapy cannot begin with a therapist, regulate itself by taking pills, etc. These measures together with other measures form the cornerstones, so to speak the framework. The home environment and the measures taken there to facilitate dealing with ADD are an essential factor in the design of the therapy, which means that parents and their support of the ADD child in the home environment are given a very important task.
Since this task can also be very difficult - this is what affected parents almost always tell - the family situation is very often heavily stressed. For more information, see our ADS and Family page.

Read more on this topic: Educational assistance - what is it?

psychotherapy

Psychotherapeutic and curative educational approaches include the following forms of therapy:

• Behavior therapy
• Self-management training
• Occupational therapy
• Depth psychology
• Family therapy
• The Marburg concentration training for school children (MKT)
• Autogenic training
• Muscle relaxation according to Jacobson
• Sports
• Neurofeedback (EEG - Biofeedback)

What are the chances of therapeutic success?

The success of the therapy depends on many factors.
On the one hand, it is important that the ADS is recognized at an early stage. A diagnosis at a young age can ensure that school problems are avoided through attention and behavior training and that psychological well-being is ensured through psychological support.
ADD is incurable, which is why those affected sometimes have to struggle for a lifetime with their poor concentration and attention deficit. However, with the right therapy and psychological care, those affected can lead a normal life in most cases without major restrictions.
The optimal treatment for ADD is unfortunately not always the rule due to the difficulties in diagnosis and the available resources, which is why the therapeutic success chances of the multidisciplinary treated patients are very good, but rather poor in the overall collective of ADD patients.

Nutritional therapy

As nutritional therapeutic options or nutritional therapy, there are:

• Nutritional therapy
• Nutrient therapy

Alternative forms of therapy:

Due to the fact that the effectiveness of alternative forms of treatment has either not yet been adequately checked for effectiveness or explicit warnings have been issued by science in places, you will find further information at the relevant point.

• Oligo antigen diet (Egger diets)
• Diet according to Feingold
• Diet after oats
• AFA - algae therapy

Further information on this topic can be found at: ADD and nutritional therapy

Drug therapy

Drug therapy is probably the most controversial form of ADD therapy. This is due, among other things, to the fact that the drugs are psychotropic drugs - usually stimulants - which influence the psychological functions such as mood, affectivity and emotionality, but also the attention, impulsivity and drive of the ADD child.
Even if this sounds “bad” at first glance, drug therapy definitely has a right to exist and to be used if the ADD diagnosis is exactly established.
For more information on this topic, see: ADD and medication

Which drugs are used?

In ADD, basically the same drugs are used as in ADHD, as they improve signal transmission and blood circulation in the brain regardless of the cause. Psychostimulants such as methylphenidate (in Ritalin®, Medikinet®) are primarily used, but alternatives such as atomoxetine (in Strattera®) or homeopathic substances are particularly popular with ADD, as the typical drugs are often less effective for this attention disorder.

Ritalin®

Ritalin® is the most common drug for the treatment of ADHD and also the first choice for ADD for many doctors. It contains the active ingredient methylphenidate, an amphetamine-like substance that increases the dopamine concentration in the synapses and thus improves signal transmission in the brain.
It is one of the psychostimulants and is very effective and quickly effective, especially in ADHD, but also in ADD. It is therefore very popular with children with major problems at school or otherwise acute distress due to their symptoms.
However, since it often causes side effects, in around half of all patients, it is increasingly being supplanted by alternatives. These side effects mainly include short-term complaints such as loss of appetite, depressive mood and headaches, but longer-term psychological problems are also observed. Especially with ADD, where it often has a less strong effect than with ADHD, non-drug treatment strategies should also be considered.

Read more on the topic: Effect of Ritalin®

What therapeutic approaches are there without medication?

• Education and behavior therapy
  • Understanding the symptoms and how to deal with them correctly form the basis for any further therapy

• Physio, occupational and other physical therapies

  • Physical activity has a direct influence on cognitive performance; this approach can therefore improve the ability to concentrate, among other things. improve

• psychotherapy

  • To increase well-being and to avoid frequently associated psychological problems, thus quality of life despite symptoms

• Diet, lifestyle

  • To support physical and mental health, e.g. Omega-3 fatty acids to increase concentration

• Alternative procedure

  • Meditation, neurofeedback, relaxation techniques, self-help groups ...

Sport as therapy

The positive influence of physical activity on hyperactive ADHD is well known. But even with ADD, many patients benefit from regular sports units, which, depending on the design, can promote their concentration and also increase self-esteem and social skills, such as team sports.
However, this form of therapy is less suitable for very shy and anxious patients who do not enjoy exercising.

Occupational therapy

In occupational therapy, individual movements are not practiced, as in physiotherapy, but specific actions from everyday life. This is to help the patient to plan an action and to bring it to an end, which is often difficult for them in everyday life.
Although occupational therapy does not lead to any proven improvement in ADD, it can support the patient in coping with their everyday life and ensure that they can better cope with their attention deficit.

Neurofeedback

With neurofeedback, the patient's brain activity is shown graphically on a screen using EEG electrodes on the head. For the sake of simplicity, this is usually not done as a typical wavy line, but as a shape or figure that changes with changes in brain activity. In this way, patients can become aware of their brain processes and, ideally, learn to better control them. Especially with children, this method can be designed as a game.

Therapy with animals

Many ADD patients find it easier to deal with animals than with humans. The inclusion of an animal in therapy units ensures a relaxed therapy situation, especially for children, in which they can better master concentration and attention training and increase their psychological well-being.
Pets can also strengthen the sense of responsibility in children and contribute to relaxation, but the welfare of the animal should be preserved and therefore no ill-considered purchase should be made.

homeopathy

According to the principle of homeopathy, the patient receives very small amounts of a substance which, in higher doses, could trigger exactly the symptoms against which it was taken. This sounds paradoxical, but it is effective in many areas of medicine as it helps the body to restore its own internal balance.
Agaricus and Sulfur are particularly important for ADD.

Who pays for the therapy?

The usual treatment measures such as medication or physiotherapy are standard benefits of the health insurance companies.
Some special services are also covered by the health insurances if the doctor justifies them in detail. Alternative and completely new methods are usually in-house work.

How does therapy in children differ from adults?

The appearance of the ADS changes over the years.
In children, attention and concentration disorders are in the foreground, as they can disrupt school performance and intellectual development. The optimal therapy for ADD in children therefore provides for overcoming these problems by means of behavioral and concentration training together with psychological support in order to avoid accompanying psychological problems later.
These then move into the focus of therapy in adulthood. Most adults with ADD develop strategies to compensate for the actual ADD symptoms, but suffer from low self-esteem and are at increased risk of depression and other mental illnesses. These patients therefore benefit above all from psycho- / behavioral therapy and alternative options to increase their well-being and self-efficacy.