ADD or Malnutrition

[countrykat]

I'm very concerned with my 7yr. old step-daughter.  When with us, 2 weekends a month, I try to provide very balanced healthy meals, limiting the sugar and processed foods, and give her a multi-vitamin.  The problem is the other 26 days of the month at her mother's where she eats mostly fastfood, candy, chips, soda and sugary juice paks, no vitamins to supplement, not made to eat any vegetables, fruits or meat if she doesn't want it.  She has always been given whatever she asks for, and children don't ask for the healthy stuff.  Only eating bread, toast, poptarts and loading up the salt on everything.  She is hyper but tired at the same time, has dark circles under her eyes, constantly scratching at her crotch (told me it always itches and burns) Constantly sick, trouble with concentration not just at school, anywhere.  Some of it I think is just a training issue, teaching a child to sit still during a movie, etc. which her mother won't even take her to a restaurant, movie or to her older sister's choir performances because she doesn't want to "deal" with her.  Dealing with homework is an ordeal, she whines and tries to get you to give her the answer before she has even tried.  Again some of which I believe is mom's lack of wanting to deal with her.  She is struggling in school, reading poorly, spelling, math skills (counting money, switching gears from addition to subtraction, etc) very difficult for her.  She is in second grade.  She is tall for her age but seems very much under weight, size 5 Toddlers still fit around her waist.  Also, all her molars have cavities.  What, if anything, can we do to turn this around? I forgot to mention the peeling, smelly feet, with no other symptoms of athlete's foot, no burning/itching, etc. Without knowing any of this, would she be diagnosed with ADD? How much of the ADD symptoms would go away with changing her diet?  Teacher recommends testing for learning disabilities.  Would malnutrition be detected in any of these tests?

[Rebecca Resnik, PsyD]

Hello,
  I really feel for this child, and am glad that she has you looking out for her! First off, please do take her to the pediatrician if you have legal authority to obtain medical care for her. You should discuss her physical concerns with her mother, and take on a non-judgmental 'problem solving' approach so that you do not sabotage your ability to help the girl.  You need the pediatrician to evaluate her physical symptoms as well as to refer you for a psychological assessment as he or she sees fit. You will need the mother's cooperation to pursue treatment.

The symptoms you are describing are complex, and are most likely not just a matter of her having or not having ADHD. The symptoms you are describing are consistent with ADHD as well as emotional disturbance, depression, learning problems and anxiety.  I would recommend that you pursue a psychological assessment for this child that includes not only testing for specific learning disabilities but also emotional assessment and specific tests of her ability to sustain attention. The assessment data will help the psychologist to help you 'turn things around.' You can let the school test her as well, though not all schools have the resources to do the extensive comprehensive testing this child is likely to need.

With respect to diet and nutrition, our mood is impacted by what we eat. Anyone would feel lethargic on a diet of junk food. The research addressing connections between sugar, preservatives, and sugar substitutes does not show a connection between hyperactivity and these foods (though there was a recent study in the journal Lancet connecting food preservatives with hyperactivity--so our understanding of this may change). I think a common sense approach to diet is the best bet--feed her healthy food most of the time and save junk food for treats.

You may find these websites helpful
www.ldonline.org
chadd.org
http://www.add.org/

Best Wishes
Rebecca Resniik