Active Play as a Non-Medicated Approach to Therapy for Kids with ADHD

To honor ADHD awareness month this October, we are focusing on non-medicated treatments for ADHD that stimulate parts of the brain through appropriate rewards and active play.

Some areas of the brain that are involved in ADHD include the vestibular system, basal ganglia, amygdala, and pre-frontal cortex.

• The vestibular system is connected to the ear and affects balance, coordination, motor skills, and spatial orientation. Our therapists work with your child to stimulate the vestibular system and improve balance and coordination by using balance beams, climbing walls, and swings during therapy sessions in our state-of-the art facilities.
• The basal ganglia takes information from all areas of the brain and relays messages to the appropriate region of the brain. A deficiency in this area can interfere with the brain’s communication and leads to inattention and impulsivity.
• The amygdalae are two walnut-shaped structures located deep inside the brain. They play an important role in emotions, decision-making, and reward. Problems with the amygdala can cause inattention, restlessness, and emotional volatility.
• The pre-frontal cortex is located at the front of the frontal lobe, and is the last part of the brain to develop. The pre-frontal cortex is responsible for executive function, such as organization, planning, self-motivation, and delayed gratification. Kids with ADHD and autism may have issues with executive function, such as self-control, organization, being disruptive, and a lack of self-talk.  At River Pediatric Therapies, we work individually with your child to understand what motivates him or her so that we can make therapy fun and help your child learn self-control, time on task and other essential skills. In addition to brain structures, neurotransmitters, chemical substances that carry messages from one nerve cell to another, are involved in ADHD. Three of these neurotransmitters are dopamine, serotonin, and norepinephrine.  
• Dopamine is released when we get rewarded and is linked to pleasure and motivation. In kids with ADHD, nerve receptors that receive dopamine are harder to stimulate, which leads these kids to seek activities that are pleasurable and exciting, such as extreme sports.  Low levels of dopamine in kids with ADHD also contribute to poor impulse control and a greater tendency toward addictive behavior. 
•  Serotonin influences mood, balances out excess stimulation, and interacts with dopamine to affect hyperactivity and impulse control. 
• Norepinephrine impacts alertness and attention, and is released in response to stress. Low levels are associated with inattention and lack of motivation. Our therapists work with these children from a young age to find acceptable external rewards that stimulate them. These rewards help kids learn appropriate behaviors, such as impulse control, increasing time on task, and aid in motivation. Parents and therapists can train kids on appropriate behaviors using a variety of external rewards, including egg timers and a dry erase marker on a normal clock face. Stacey, a Physical Therapist, shows one client pictures of activities that he crosses off, which provides a visual representation of the activities he has finished. If he completes a given number of activities, he receives a reward of his choice. This boy especially enjoys jumping on the trampoline and playing a “pizza dough game” that involves Stacey rolling a therapy ball on him. Diet is also an important factor in non-medical interventions for ADHD. A diet high in protein, such as meat, eggs, fish, and legumes, can raise norepinephrine and dopamine levels.

Besides biological factors, note:

• Container Baby Syndrome describes a collection of disorders that result from babies spending too much time on their back in a container, such as a car seat. This lack of movement can lead to speech and hearing problems, decreased muscle strength and coordination, head and face deformities, and a higher risk of ADHD. To prevent Container Baby Syndrome, we encourage parents to increase tummy time through supervised play.
• Today, children are watching TV and viewing screens more than ever before. Increased screen time can contribute to behavior problems, less ability to recognize emotions, limited imaginary play, weight gain, decreased motor and cognitive development, and aggressive behavior.

At River Pediatric therapies, we encourage active play in therapy and in the home because it stimulates many different areas of the brain, including the pre-frontal cortex, which helps kids with ADHD improve learning, executive function, such as delayed gratification and organization, and communication skills.  Exercise and movement increase norepinephrine, dopamine and serotonin levels, leading to less stress, more focus, greater happiness, pleasure, and an appropriate reward. Play also helps with motor development, vision, hearing, and problem solving.

Parents should also get involved in the play. A Journal of Pediatrics study revealed that children’s activity increased 60 percent when parents and children played together. Active play is a key component of a child’s development and can improve executive function, emotional volatility, and attention in kids with ADHD.

Interested in individualized therapy for your child that includes active play?  Call River Pediatric Therapies today for an appointment at (412) 767-5967.