In 1980 Attention Deficit and Hyperactivity Disorder was first recognised as a medical condition, 27 years on more cases than ever are emerging some say it's an epidemic. For many parents the only option is to medicate affected children, but is it possible to treat ADHD with few or no drugs at all? Better still, will there ever be a cure?
Jenny Brown and her husband Steven certainly hope so. Three of their four boys have been diagnosed as suffering from ADHD.
"They start fighting, then they start punching then just go right off," says Jenny.
So is this just bad behaviour or is it a disease?
According to child psychologist Dr Phil Brock, "ADHD doesn't exist as a disease per se but it is very much a disorder and kids with these phenomena do have problems."
ADHD usually exhibits itself as an inability to pay attention, impulsive behaviour and overactivity. Doctors say it can't be cured. It can only be treated, generally with medication and for Jenny and her sons it's a three times daily ritual.
"I didn't want to medicate them but couldn't let them go on like that," she says.
Drugs like Ritalin have a calming and focussing effect on an ADHD kid's central nervous system. But is there a drug-free solution?
Jacques Duff, the founder and Clinical Director of the Behavioural Neurotherapy Clinic in Melbourne, says there is: "Why are we medicating those children on these particular drugs when we have no idea what is going on inside the brain?"
Eight-year-old Chris is one of Jacque's patients. He has displayed symptoms of ADHD since he was a toddler.
"We couldn't take him into a shop. We couldn't do anything. He'd be touching everything, grabbing everything. We couldn't get him to sit down, to focus," says Jane, Chris's mum.
Twelve months ago Chris's mother Jane took him to Jacques' clinic. He began treating Chris with neurotherapy which is retraining brain electrical activity.
But how does it work?
"When the brain is dysfunctional it does not product the right mix of brain waves. And what we're doing with neurotherapy is we're displaying those brain waves on a screen, giving the child a chance to control them," says Jacques.
With electrodes responding to his brain waves, Chris can control whether a game moves forward or not. But he can only do that by maintaining his concentration. Jacques feels the skills Chris learns can be applied to life, but has Chris shown any improvement after 12 months of neurotherapy?
According to his mother Jane, he has been much more able to focus: "He is able to pick up a book and sit there and read it and Chris is able to think through things now."
To a parent of an ADHD child, that's nothing short of a miracle.
"Once they've finished neurotherapy they no longer need to have any form of treatment and their ADHD symptoms have completely normalised. And that's for the majority of children about 80 to 90 percent," says Jacques.
But not all child psychiatrists are convinced by neurotherapy it has its critics.
"There is no evidence to suggest that neuro feedback can assist a child," says Dr Brock.
But that's not the end of the line where ADHD is concerned, there is one other alternative to drugs.
In Buffalo New York, a psychologist has developed a new way of treating children with ADHD and the focus is on behavioural modification. For the past 50 years the primary treatment for children suffering from ADHD has been psycho-stimulant drugs like Ritalin.
But is a drug-free therapy possible?
Professor William Pelham has been working with Associate Professor Dan Waschbusch on a new way to treat ADHD.
"We believe that if we first try good behavioural interventions, then many fewer children will need medication. And those that do won't need as much," says Professor Pelham.
So how does it work?
Let's look at the example of five-year-old Kyle Taylor who was diagnosed as suffering from ADHD 12 months ago. In the first treatment step, mother and son are isolated in a sound proof room. Kyle is given a task to perform that requires concentration. Observing their interactions from behind a one-way mirror, Associate Professor Waschbusch relays instructions to Kyle's mum Maureen via her earpiece. This way, she can learn appropriate reactions to Kyle's actions.
"They will interact with their child so if their child is doing a great time staying on task I can prompt them to praise the child for that," says Associate Professor Waschbusch. "Or conversely if the child gets off task or tries to leave the table without permission I can prompt them to what to do in those situations."
Next up, Kyle's father takes a turn at the table. One year ago, Kyle was an out-of-control problem child. Since he began behavioural modification therapy, his parents have seen a substantial improvement.
Ultimately, it all comes down to parenting.
"Good parenting can improve the ADHD even if it didn't cause it in the first place. But parents of ADHD kids have to do it better than other parents because their kids have ADHD," says Professor Pelham.
There is another vital factor in ADHD treatment that they all agree on. It comes in the form of nature's wonder drug Omega 3.
"We have some good studies that children taking Omega 3 are helped with their behaviour and with their conduct," says child psychologist Dr Phil Brock.
This is because brain neurones consist of Omega 3 fatty acids, which are also found in fish, eggs, grass-fed meats and of course fish oil supplements.
But what about a cure for ADHD? Well, that would depend upon finding the cause.
"We don't have any idea what the cause of ADHD is. The first person to discover that will get a Nobel Prize probably. Because it's such a difficult question to answer," says Professor Pelham.
We've still got a long way to go in understanding ADHD. But the good news is it doesn't necessarily mean a childhood sentence of drugs and medication. Ongoing research means more drug-free therapies are on the way and for many parents the alternatives are worth waiting for.
- We mostly hear about children with ADHD, so does that mean it's a disorder they grow out of? In fact, more than seventy percent of kids with ADHD experience symptoms well into adolescence and up to fifty percent continue into adulthood.