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What can I give my child naturally for ADHD?

Studies show that omega-3 fatty acids (with high doses of EPA) are modestly effective in treating ADHD in children. Fish oil, which is associated with few/mild side effects, helps to increase levels of omega-3s that are often naturally lacking in children with ADHD, which in turn helps with brain functioning.

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No treatment plan for attention deficit hyperactivity disorder (ADHD) is complete if it doesn’t harness the power of nutrition, exercise, and sleep to improve wellbeing. What we eat, our physical activity levels, our sleep habits, and lifestyle factors ranging from stress management to screen time have a tremendous effect on health – a fact that’s amplified for ADHD brains and bodies.

Watch Out for Blood Sugar Levels

When working to improve your child’s wellbeing, begin by considering the glycemic index (GI), or how fast the body converts carbohydrates into sugar. All carbohydrates turn into sugar, but some are converted faster (high glycemic index) and some slower (low GI). These rates of conversion affect a child’s energy levels over the day; anything that causes blood sugar levels to quickly spike (like sugary, processed foods) means that the body will work hard to quickly drop that sugar, actually bringing it below normal levels. The result is often an irritable, fidgety, or nervous child who can’t focus as well. To maintain steady, normal blood sugar levels, ensure that your child’s meals, especially at the start of the day, are balanced: Avoid processed carbs and sugars. That means no frozen waffles, pancakes, Pop Tarts, jelly, and other products that readily turn to sugar in the body. Go for low glycemic index foods, like steel cut oats, or true whole grain bread, to boost focus and performance. In one study, children who ate low GI breakfasts had better executive functioning, working memory, and attention compared to children who ate processed foods. 2 That means no frozen waffles, pancakes, Pop Tarts, jelly, and other products that readily turn to sugar in the body. Go for low glycemic index foods, like steel cut oats, or true whole grain bread, to boost focus and performance. In one study, children who ate low GI breakfasts had better executive functioning, working memory, and attention compared to children who ate processed foods. Opt for organic foods as much as possible. Some studies suggest that pesticides may play a role in the development of ADHD. 3 Some studies suggest that pesticides may play a role in the development of ADHD. Opt for protein. Protein is filling and provides consistent energy through the day. Eggs and lean meats are great sources of protein. Protein is filling and provides consistent energy through the day. Eggs and lean meats are great sources of protein. Some fat is OK. Fats are important – they work to decrease the absorption and processing of carbohydrates into sugar.

Food Sensitivities

A significant percentage of children with ADHD are sensitive (not allergic) to some kind of food. In one study that placed children with ADHD on a restricted elimination meal plan, more than half of subjects saw a 40% improvement on ADHD rating scale performance.4 The same results appeared in an older study, where hyperactive children saw improvement in behavior after being placed on a “few foods” plan.5 In my practice, I estimate that about 30% to 50% of children I see do have some food sensitivity. Not sure what food sensitives your child may have? Try this technique I use with my patients: eliminate a whole set of foods – dairy, wheat, corn, soy, eggs (common culprits) – for three weeks. If improvement is detected , start adding the foods back one by one for a couple of days (I usually recommend starting with gluten first). Give it three to four days to see if there are any developing behaviors associated with each food. The process should take six weeks in all. , start adding the foods back one by one for a couple of days (I usually recommend starting with gluten first). Give it three to four days to see if there are any developing behaviors associated with each food. The process should take six weeks in all. If no improvement detected, food sensitivities are likely not an issue for your child. Eliminating foods, in my experience, tend to work on children who primarily present symptoms of hyperactivity rather than inattentiveness. This method also works on children who already have a history of allergies, eczema, gastrointestinal issues, and other allergic-type manifestations.

Artificial Dyes

Several studies show that artificial colors, flavors, and preservatives tend to increase hyperactivity in a sizable portion of children, ADHD or not.6 In addition, studies suggest that a subset of children with ADHD are sensitive to food dyes, and may see symptoms worsen.7 Opt for whole foods to avoid synthetic dyes, and, as with food sensitivities, try to detect through a process of elimination if your child is sensitive to a particular dye. This is the most common supplement used by patients with ADHD. Why? Studies show that omega-3 fatty acids (with high doses of EPA) are modestly effective in treating ADHD in children.8 Fish oil, which is associated with few/mild side effects, helps to increase levels of omega-3s that are often naturally lacking in children with ADHD, which in turn helps with brain functioning. Although dosing amounts are not established, I recommend 1000mg a day of combined EPA+DHA for children ages 5 to 8, 1500 mg a day for children ages 8 to 12, and 2000 mg a day for older children. Many children with ADHD are relatively iron (serum ferretin) deficient9, which may explain irregular dopamine regulation in the brain10. One small study showed that children with ADHD who took iron supplements saw an improvement in ADHD symptoms compared to children who took a placebo.11 Have your child’s doctor measure their serum ferritin levels to see if an iron supplement is necessary. For non-anemic patients, I recommend up to 40 mg of chelated iron a day. (The chelated form is associated with fewer gastrointestinal side effects.) Studies suggest that children with ADHD have lower vitamin D levels compared to neurotypical children, and that supplementation may reduce ADHD symptoms. Zinc: As with other minerals, low zinc levels appear to correlate to greater severity of ADHD symptoms. Zinc supplementation may improve ADHD symptoms. 14 As with other minerals, low zinc levels appear to correlate to greater severity of ADHD symptoms. Zinc supplementation may improve ADHD symptoms. Magnesium: Levels of this mineral tend to be normal in most children. In my experience, magnesium supplements may have a calming effect on some children – helpful for those who struggle to sleep or are rebounding from medication.

Talk to your child’s doctor before starting any supplement.

Multiple research studies shows that many children with ADHD clearly benefit from exercise.15 Even a single, 20-minute bout of aerobic exercise improves attention and academic performance in this group, according to one study.16 Another small study of children with ADHD found that acute exercise normalizes arousal and alertness levels, based on findings from EEG readings.17 Exercise can be so therapeutic for ADHD symptoms that I recommend against sacrificing exercise time for tutoring or because of poor grades. In fact, research seems to indicate that exercise improves academic scores perhaps better than spending the equivalent amount in class or study time.18

What Is the Recommended Amount of Physical Activity for Children?

The American Academy of Pediatrics (AAP) recommends at least one hour of moderate to vigorous exercise a day for children and adolescents.19 I recommend five days a week of exercise for my patients. (Physical education in school can count, so long as it increases heart rate and works up a sweat.) Interestingly, how much exercise helps any particular person may depend on genetics, with brain-derived neurotrophic factor (BDNF) playing a major role in the relationship.20 Some children with ADHD may prefer individual sports, like swimming, tennis, or cycling, as opposed to team sports. Some studies show that martial arts, especially taekwondo, benefit children with ADHD.21 If your child resists exercise, consider tying it to something virtually all children want: screen time. They can have an hour of tablet time, for example, only if they’re on a stationary bike or treadmill during that time. Some adolescents may benefit from working with a personal trainer to keep them accountable and motivated. Don’t forget about time in nature. According to one study, green outdoor activities reduce ADHD symptoms in children more than activities conducted in other settings.22

Unstructured Play Matters

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Unstructured play is not the same as exercise, but it is just as important for all children. Unstructured, creative play is crucial for normal development, as it is where young children learn to work things out independently and forge social relationships23 — important skills for children with ADHD especially. So, let your child ride their bike, run around, or play outside with other children if it is safe to do so. Leave them be if they are on a play date. Find programs that emphasize and maximize independent play. Adequate sleep is crucial for children with ADHD, who are already at a higher risk for a variety of sleep disturbances, like difficulty falling asleep, compared to children without ADHD.24 Inadequate sleep affects ADHD symptoms and overall functioning.

How Much Sleep Do Kids Need?

The American Academy of Sleep Medicine (AASM) establishes the following guidelines for daily sleep amounts in children, which are supported by the AAP:27

Preschool-age: 10 to 13 hours, including naps

School-age: 9 to 12 hours, including naps

Teens: 8 to 10 hours

Helpful Sleep Strategies for Children

Limit screen time before bed. Light from screens disrupts sleep. 28 A good rule of thumb is to turn off screens at least 45 minutes before sleep time. Light from screens disrupts sleep. A good rule of thumb is to turn off screens at least 45 minutes before sleep time. Implement a bedtime ritual. A 15- to 20-minute routine can prep the body for sleep. A 15- to 20-minute routine can prep the body for sleep. Try calming activities , like reading, white noise, or guided audio meditation. , like reading, white noise, or guided audio meditation. Herbs like valerian and chamomile are popular natural sleep aids for their proposed soothing properties. 29 are popular natural sleep aids for their proposed soothing properties. Avoid vigorous exercise close to bedtime so as not to awaken the body. so as not to awaken the body. Avoid overly hot baths close to bedtime. While research shows that a warm bath before bed can help with sleep by lowering the body’s temperature 30 , a bath that is too hot may have the opposite effect. While research shows that a warm bath before bed can help with sleep by lowering the body’s temperature , a bath that is too hot may have the opposite effect. Consider melatonin. Melatonin is a hormone that regulates sleep and can be helpful when administered as a supplement (especially if ADHD medications are causing sleep-related side effects). A low liquid dose (easier to control) of up to half a milligram) helps most children sleep, based on my observations. Talk to your child’s doctor about whether melatonin is right for your child. If sleep problems persist, consult with your child’s medical providers. They may be able to run a sleep study to test for disorders. Behavioral professional psychologists and counselors can also help with implementing healthy sleep routines. Ask the pediatrician to check your child’s serum ferritin levels, as low levels are associated with restless sleep.31 By far, screen time/digital media use is the most difficult and argument-producing problem among the many families I help. Many studies link excessive screen time to issues like poor sleep quality, poor mental health, emotional dysregulation, lower academic achievement, lower levels of physical activity, and even developmental delays in children and teens.32 33 Studies correlate increased screen time with symptoms of ADHD. According to a study of preschool-age children, those who had more than two hours of screen time a day were more likely to exhibit clinically significant symptoms of inattention compared to children with less than 30 minutes of screen time per day.34 Another study found that higher frequency of digital media use was associated with subsequent symptoms of ADHD in adolescents after a two-year follow-up.35 Note, however, that research does not establish a causal link between screen time and ADHD.

How to Limit Screen Time

For children 2 to 5 years of age, the AAP recommends one hour a day at most of co-viewed high-quality programming.37 For older children, it recommends a personalized media use plan that considers the individual child’s age, health, temperament, and developmental stage.38 Additional recommendations include the following: Turn off televisions and other devices around the household when not in use.

Keep bedrooms, mealtimes, and parent-child playtimes screen-free.

Designate media-free times and media-free locations in the home.

No screen time in the hour before bedtime; remove devices (TVs, computers, smartphones) from bedrooms before bedtime.

Discourage children from using entertainment media while doing homework.

Develop a family media plan that includes consistent limits on media use (hours per day) and types of media used, as well as appropriate media behaviors.

Have ongoing conversations about online citizenship and safety.

Problem-solve screen use issues, like setting limits, with pediatricians.

In addition to the above guidance, I also encourage families to think of the following for managing screen time:

What is the effect of screen time on your child? How does it affect their mood and attention?

What is your child doing with their screen time? (There is a difference, I believe, in building cities in Minecraft with friends versus playing a violent video game alone versus scrolling through TikTok videos for hours on end.)

What is your child not doing because of screen time? Are they missing out on homework? Sleep? Physical activity?

Could your child benefit from a reset? I frequently recommend Reset Your Child’s Brain by Victoria Dunkley, M.D., — a book that outlines a four-week digital detox plan.

Behavior Management

Consider behavioral parent training or to help improve your child’s behavior and self-control. (Look for therapists who specialize in the Nurtured Heart Approach, my definitive favorite positive parenting approach.)

Stress Management

Stress is a natural part of life. But some children with ADHD, in my experience, are very sensitive to stress. Part of it is that these children – more than neurotypical children – can be exposed to a great deal of negative feedback on a regular basis which affects self-esteem and wellbeing.40 Use the following strategies to mitigate your child’s stress: Focus on strengths. Make sure your child has time to do what they are good at. Make sure your child has time to do what they are good at. Ensure a positive family relationship. Recognize and encourage what your child does right as frequently as possible. Follow an authoritative parenting approach. Recognize and encourage what your child does right as frequently as possible. Follow an authoritative parenting approach. Don’t overload schedules. Monitor the type of feedback your child receives from school. Studies show that children with ADHD experience poorer student-teacher relationships compared to neurotypical peers, which may influence school performance and self-esteem.41 The content for this article was derived from the ADDitude Expert Webinars “How Nutrition, Sleep, Exercise & Behavioral Interventions Can Reduce ADHD Symptoms” and “Lifestyle Changes with the Biggest Impact on Kids with ADHD,” with Sanford Newmark, M.D., which were broadcast live on April 24, 2018 and August 4, 2022, respectively. Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you. 1 Del-Ponte, B., Quinte, G. C., Cruz, S., Grellert, M., & Santos, I. S. (2019). Dietary patterns and attention deficit/hyperactivity disorder (ADHD): A systematic review and meta-analysis. Journal of Affective Disorders, 252, 160–173. https://doi.org/10.1016/j.jad.2019.04.061 2 Cooper, S., Bandelow, S., Nute, M., Morris, J., & Nevill, M. (2012). Breakfast glycaemic index and cognitive function in adolescent school children. British Journal of Nutrition, 107(12), 1823-1832. doi:10.1017/S0007114511005022 3 Roberts, J. R., Dawley, E. H., & Reigart, J. R. (2019). Children’s low-level pesticide exposure and associations with autism and ADHD: a review. Pediatric Research, 85(2), 234–241. https://doi.org/10.1038/s41390-018-0200-z 4 Pelsser, Lidy M et al. (2011). Effects of a restricted elimination food plan on the behaviour of children with attention-deficit hyperactivity disorder (INCA study): a randomised controlled trial. The Lancet, Volume 377, Issue 9764, 494 – 503. https://doi.org/10.1016/S0140-6736(10)62227-1 5 Carter CM, Urbanowicz M, Hemsley R, et al.(1993). Effects of a few food plan in attention deficit disorder. Archives of Disease in Childhood, 69:564-568. 6 Nigg, J. T., & Holton, K. (2014). Restriction and elimination food plans in ADHD treatment. Child and adolescent psychiatric clinics of North America, 23(4), 937–953. doi:10.1016/j.chc.2014.05.010 7 Nigg, J. T., Lewis, K., Edinger, T., & Falk, M. (2012). Meta-analysis of attention-deficit/hyperactivity disorder or attention-deficit/hyperactivity disorder symptoms, restriction diet, and synthetic food color additives. Journal of the American Academy of Child and Adolescent Psychiatry, 51(1), 86–97.e8. https://doi.org/10.1016/j.jaac.2011.10.015 8 Bloch, M., Qawasmi, A. (2011). Omega-3 Fatty Acid Supplementation for the Treatment of Children With Attention-Deficit/Hyperactivity Disorder Symptomatology: Systematic Review and Meta-Analysis. Journal of the American Academy of Child and Adolescent Psychiatry, 50(10), 991-1000. https://doi.org/10.1016/j.jaac.2011.06.008 9 Konofal, E., Lecendreux, M., Arnulf, I., & Mouren, M. C. (2004). Iron deficiency in children with attention-deficit/hyperactivity disorder. Archives of pediatrics & adolescent medicine, 158(12), 1113–1115. https://doi.org/10.1001/archpedi.158.12.1113 10 Wang, Y., Huang, L., Zhang, L., Qu, Y., & Mu, D. (2017). Iron Status in Attention-Deficit/Hyperactivity Disorder: A Systematic Review and Meta-Analysis. PloS one, 12(1), e0169145. https://doi.org/10.1371/journal.pone.0169145 11 Konofal, E., Lecendreux, M., et.al. (2008). Effects of iron supplementation on attention deficit hyperactivity disorder in children. Pediatric Neurology, 38(1), 20-26. https://doi.org/10.1016/j.pediatrneurol.2007.08.014 12Gan, J., Galer, P., Ma, D., Chen, C., & Xiong, T. (2019). The effect of vitamin d supplementation on attention-deficit/hyperactivity disorder: A systematic review and meta-analysis of randomized controlled trials. Journal of Child and Adolescent Psychopharmacology, 29(9), 670–687. https://doi.org/10.1089/cap.2019.0059 13Li, H. H., Yue, X. J., Wang, C. X., Feng, J. Y., Wang, B., & Jia, F. Y. (2020). Serum levels of vitamin a and vitamin d and their association with symptoms in children with attention deficit hyperactivity disorder. Frontiers in Psychiatry, 11, 599958. https://doi.org/10.3389/fpsyt.2020.599958 14Granero, R., Pardo-Garrido, A., Carpio-Toro, I. L., Ramírez-Coronel, A. A., Martínez-Suárez, P. C., & Reivan-Ortiz, G. G. (2021). The role of iron and zinc in the treatment of ADHD among children and adolescents: A systematic review of randomized clinical trials. Nutrients, 13(11), 4059. https://doi.org/10.3390/nu13114059 15Christiansen, L., Beck, M. M., Bilenberg, N., Wienecke, J., Astrup, A., & Lundbye-Jensen, J. (2019). Effects of exercise on cognitive performance in children and adolescents with ADHD: potential mechanisms and evidence-based recommendations. Journal of Clinical Medicine, 8(6), 841. https://doi.org/10.3390/jcm8060841 16Pontifex, M. B., Saliba, B. J., Raine, L. B., Picchietti, D. L., & Hillman, C. H. (2013). Exercise improves behavioral, neurocognitive, and scholastic performance in children with attention-deficit/hyperactivity disorder. The Journal of Pediatrics, 162(3), 543–551. https://doi.org/10.1016/j.jpeds.2012.08.036 17Huang, C. J., Huang, C. W., Hung, C. L., Tsai, Y. J., Chang, Y. K., Wu, C. T., & Hung, T. M. (2018). Effects of acute exercise on resting EEG in children with attention-deficit/hyperactivity disorder. Child Psychiatry and Human Development, 49(6), 993–1002. https://doi.org/10.1007/s10578-018-0813-9 18McPherson, A., Mackay, L., Kunkel, J., & Duncan, S. (2018). Physical activity, cognition and academic performance: An analysis of mediating and confounding relationships in primary school children. BMC Public Health, 18(1), 936. https://doi.org/10.1186/s12889-018-5863-1 19Lobelo, F., Muth, N. D., Hanson, S., Nemeth, B. A., COUNCIL ON SPORTS MEDICINE AND FITNESS, & SECTION ON…(2020). Physical activity assessment and counseling in pediatric clinical settings. Pediatrics, 145(3), e20193992. https://doi.org/10.1542/peds.2019-3992 20Hopkins, M. E., Davis, F. C., Vantieghem, M. R., Whalen, P. J., & Bucci, D. J. (2012). Differential effects of acute and regular physical exercise on cognition and affect. Neuroscience, 215, 59–68. https://doi.org/10.1016/j.neuroscience.2012.04.056 21Kadri, A., Slimani, M., Bragazzi, N. L., Tod, D., & Azaiez, F. (2019). Effect of taekwondo practice on cognitive function in adolescents with attention deficit hyperactivity disorder. International Journal of Environmental Research and Public Health, 16(2), 204. https://doi.org/10.3390/ijerph16020204 22 Kuo, F. E., & Taylor, A. F. (2004). A potential natural treatment for attention-deficit/hyperactivity disorder: Evidence from a national study. American Journal of Public Health, 94(9), 1580–1586. https://doi.org/10.2105/ajph.94.9.1580 23 Lee, R., Lane, S., Brown, G., Leung, C., Kwok, S., & Chan, S. (2020). Systematic review of the impact of unstructured play interventions to improve young children’s physical, social, and emotional wellbeing. Nursing & Health Sciences, 22(2), 184–196. https://doi.org/10.1111/nhs.12732 24 Bondopadhyay, U., Diaz-Orueta, U., & Coogan, A. N. (2022). A systematic review of sleep and circadian rhythms in children with attention deficit hyperactivity disorder. Journal of Attention Disorders, 26(2), 149–224. https://doi.org/10.1177/1087054720978556 25 Hvolby A. (2015). Associations of sleep disturbance with ADHD: Implications for treatment. Attention Deficit and Hyperactivity Disorders, 7(1), 1–18. https://doi.org/10.1007/s12402-014-0151-0 26 Wolraich, M. L., Hagan, J. F., Jr, Allan, C., Chan, E., Davison, D., Earls, M., Evans, S. W., Flinn, S. K., Froehlich, T., Frost, J., Holbrook, J. R., Lehmann, C. U., Lessin, H. R., Okechukwu, K., Pierce, K. L., Winner, J. D., Zurhellen, W., & SUBCOMMITTEE ON CHILDREN AND ADOLESCENTS WITH ATTENTION-DEFICIT/HYPERACTIVE DISORDER (2019). Clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Pediatrics, 144(4), e20192528. https://doi.org/10.1542/peds.2019-2528 27 Paruthi, S., Brooks, L. J., D’Ambrosio, C., Hall, W. A., Kotagal, S., Lloyd, R. M., Malow, B. A., Maski, K., Nichols, C., Quan, S. F., Rosen, C. L., Troester, M. M., & Wise, M. S. (2016). Recommended amount of sleep for pediatric populations: A consensus statement of the american academy of sleep medicine. Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine, 12(6), 785–786. https://doi.org/10.5664/jcsm.5866 28 Shechter, A., Kim, E. W., St-Onge, M. P., & Westwood, A. J. (2018). Blocking nocturnal blue light for insomnia: A randomized controlled trial. Journal of Psychiatric Research, 96, 196–202. https://doi.org/10.1016/j.jpsychires.2017.10.015 29 Guadagna, S., Barattini, D. F., Rosu, S., & Ferini-Strambi, L. (2020). Plant Extracts for Sleep Disturbances: A Systematic Review. Evidence-Based Complementary and Alternative Medicine: eCAM, 2020, 3792390. https://doi.org/10.1155/2020/3792390 30 Haghayegh, S., Khoshnevis, S., Smolensky, M. H., Diller, K. R., & Castriotta, R. J. (2019). Before-bedtime passive body heating by warm shower or bath to improve sleep: A systematic review and meta-analysis. Sleep Medicine Reviews, 46, 124–135. https://doi.org/10.1016/j.smrv.2019.04.008 31 Cortese, S., Konofal, E., Bernardina, B. D., Mouren, M. C., & Lecendreux, M. (2009). Sleep disturbances and serum ferritin levels in children with attention-deficit/hyperactivity disorder. European Child & Adolescent Psychiatry, 18(7), 393–399. https://doi.org/10.1007/s00787-009-0746-8 32Madigan, S., Browne, D., Racine, N., Mori, C., & Tough, S. (2019). Association Between Screen Time and Children’s Performance on a Developmental Screening Test. JAMA Pediatrics, 173(3), 244–250. https://doi.org/10.1001/jamapediatrics.2018.5056 33 Stiglic, N., & Viner, R. M. (2019). Effects of screentime on the health and well-being of children and adolescents: a systematic review of reviews. BMJ Open, 9(1), e023191. https://doi.org/10.1136/bmjopen-2018-023191 34 Tamana, S. K., Ezeugwu, V., Chikuma, J., Lefebvre, D. L., Azad, M. B., Moraes, T. J., Subbarao, P., Becker, A. B., Turvey, S. E., Sears, M. R., Dick, B. D., Carson, V., Rasmussen, C., CHILD study Investigators, Pei, J., & Mandhane, P. J. (2019). Screen-time is associated with inattention problems in preschoolers: Results from the CHILD birth cohort study. PloS one, 14(4), e0213995. https://doi.org/10.1371/journal.pone.0213995 35 Ra, C. K., Cho, J., Stone, M. D., De La Cerda, J., Goldenson, N. I., Moroney, E., Tung, I., Lee, S. S., & Leventhal, A. M. (2018). Association of digital media use with subsequent symptoms of attention-deficit/hyperactivity disorder among adolescents. JAMA, 320(3), 255–263. https://doi.org/10.1001/jama.2018.8931 36 Vaidyanathan, S., Manohar, H., Chandrasekaran, V., & Kandasamy, P. (2021). Screen Time Exposure in Preschool Children with ADHD: A Cross-Sectional Exploratory Study from South India. Indian Journal of Psychological Medicine, 43(2), 125–129. https://doi.org/10.1177/0253717620939782 37 COUNCIL ON COMMUNICATIONS AND MEDIA (2016). Media and Young Minds. Pediatrics, 138(5), e20162591. https://doi.org/10.1542/peds.2016-2591 38 COUNCIL ON COMMUNICATIONS AND MEDIA (2016). Media Use in School-Aged Children and Adolescents. Pediatrics, 138(5), e20162592. https://doi.org/10.1542/peds.2016-2592 39 Antshel, K. M., Faraone, S. V., & Gordon, M. (2014). Cognitive behavioral treatment outcomes in adolescent ADHD. Journal of Attention Disorders, 18(6), 483–495. https://doi.org/10.1177/1087054712443155 40 Harpin, V., Mazzone, L., Raynaud, J. P., Kahle, J., & Hodgkins, P. (2016). Long-Term Outcomes of ADHD: A systematic review of self-esteem and social function. Journal of Attention Disorders, 20(4), 295–305. https://doi.org/10.1177/1087054713486516 41 Zendarski, N., Haebich, K., Bhide, S. (2020). Student-teacher relationship quality in children with and without ADHD: A cross-sectional community based study. Early Childhood Research Quarterly, 51, 275-284. https://doi.org/10.1016/j.ecresq.2019.12.006

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