Treatment options, from medicine to meditation

Medication is the most common, and perhaps most controversial, treatment for children with attention-deficit hyperactivity disorder.

For the past few decades, doctors have increasingly prescribed drugs with amphetamines and methylphenidates for children struggling with focus, impulse control and other signs of the disorder. A seminal study sponsored by the National Institute of Mental Health (NIMH) showed medication to be particularly effective.

Dr. Ted Mandelkorn, of Puget Sound Behavioral Medicine in Mercer Island, said commonly used medications such as Concerta and Adderall will help up to 85 percent of children suffering from ADHD — provided the right dosage is achieved.

"There is no question that the medications we use are incredibly effective," said Mandelkorn, an expert in childhood ADHD. "They work very well, and they're very safe."

But others have concerns. Susan Burns, a psychotherapist in Bellevue, said parents often feel pressure to put their children on medication because studies have proven it can provide relief from symptoms. But each child is different, she cautioned.

"I've seen some drastic improvements, and I've seen horrible cases," said Burns.

Burns considers social-skills therapy a critical part of any child's treatment, whether she is on medication or not. The NIMH study, which separated children into four different groups, found that combining medication and behavioral therapy was, in some cases, a more effective treatment than providing only medication.

In her Bellevue practice, Burns works with children in groups, teaching them how to control their impulses, how to focus their attention, how to recognize and act upon social cues. She works with parents as well.

"For me, it's always been important to take a real holistic approach, and to see what's going on in the whole system of a child's brain, and their environment," said Burns.

In the search for alternative treatments, several other options have cropped up over the years, from vitamin supplements to biofeedback to occupational therapy. None of them has been studied as well as medication, Burns said.

Dr. Alarik Arenander, of the Brain Research Institute in Iowa, said the practice of transcendental meditation has worked wonders for some children. Children who practice it twice a day, he said, have shown marked improvement almost immediately.

Arenander, who spoke recently at Bastyr University, described the treatment as empowering. Children do not have to rely on a pill, or on a counselor, to improve their behavior, he said. They can improve their own behavior whenever and wherever they choose — on the bus, in the classroom or at home.

"It gives back control to these kids," said Arenander. "They realize they now have a tool that makes them who they want to be."

Cara Solomon: 206-464-2024 or csolomon@seattletimes.com