Attention-deficit/hyperactivity disorder (ADHD) is a very common neurobehavioral disorder that affects children and adolescents. ADHD can affect the ability of a child to grow academically and socially and can persist beyond adolescence into adulthood. A primary care provider (PCP) should identify ADHD as any other chronic condition and should apply the chronic care model in management and regard a child or adolescent with ADHD as one requiring special health care needs.
Tai chi Traditional Chinese medicine for ADHD is wide encompassing, and includes therapies such as Chinese herbal medicine, acupuncture,), Yaoshan (diet therapy), Tui na (Chinese medical massage and Tai chi chuan (also known as tai chi or Taiji). A combined form of traditional Chinese medicine, which utilizes multiple therapies concurrently, has been found by a systematic review of 34 trials (58), to be equivalent to methylphenidate for use in treatment of ADHD in children for shorter duration, and had a more stable effect in long-term treatment. However, the studies included were all of low methodological quality and many had a potential bias. Tai chi has been gaining popularity in western culture and it is considered a practice of yinyang balance by using slow movements of dynamic and static forms along with breathing techniques (59). Longterm practice of tai chi alone has been found to improve attention, reduces emotional outbursts, irritability, and anxiety in adults (59). One
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Another trial (61) found that adolescents also had improvements in anxiety, hyperactivity, and inappropriate emotions that persisted 2 weeks after the cessation of twice weekly tai chi practice. A very small trial (62) in Portugal with four children, between ages 6 and 10, showed moderate improvements in hyperactive-impulsive symptoms with very minor improvements in inattentive symptoms. All studies were limited in size and were not blinded, but their findings were notable for improvement for some of the behavioral and regulation difficulties in children with ADHD. Some of the benefits of Tai Chi include the low-impact nature of the exercise and ability to practice nearly anywhere with no need for equipment. In addition, unlike Chinese herbal medicine, it is unlikely to negatively impact the concurrent
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Mindfulness The practice of mindfulness has its roots in Buddhist tradition, but, like many other meditative practices, is also becoming more widely used in the western world. It is based on the principle of being nonjudgmental in accepting and being aware of each moment as it comes, which requires focus and attention (63). Neuroimaging supports this, as changes in the brain have been found in regions associated with attention immediately after practicing mindfulness (64). Mindfulness-based interventions are gaining widespread use and have also shown to help in adults with depression, stress and pain (65). However, the impact of mindfulness on attention is what would be beneficial to patients with ADHD, particularly those with the inattentive type of ADHD.A 2017 systemic review (66) attempted to look at benefits of mindfulness in both children and adults who had ADHD, and found that in adults, mindfulness-based interventions had significant improvement in attention. There were not enou
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