May I Have Your Attention Please? Part II
[This is the second part of Dr. Lamar’s article on Attention Deficit Hyperactivity Disorder (ADHD). Click here to read Part 1].
[originally published in KCN, April 2003]
Last month I brought to your “attention” a disorder which is currently termed Attention Deficit Hyperactivity Disorder (ADHD). Its prevalence has literally skyrocketed over the past decade. It has affected nearly 4 million children and strangely only seems to occur, for the most part, within the borders of the United States. It’s a disorder whose diagnosis is often questionable — primarily because there is no way to objectively prove its existence, making it a subjective diagnosis — one of opinion. Observations of a child exhibiting hyperactivity, impulsiveness, and an inability to pay attention are enough to bring about the label of ADHD. But perhaps the most questionable aspect of ADHD is the treatment of choice by most doctors: Ritalin. It’s a drug that is classified as a Schedule II Drug of the Controlled Substances Act, and is remarkably similar to cocaine. The side effects are appalling, personalities are being lost, and children are becoming addicts — actually seeking it out in the streets. Meanwhile, the drug manufacturer’s wallet is getting fatter. What someone doesn’t want you to know is that there are other treatments available — other treatments that are effective and will spare your child.
But before we get into things that we can do to the child, let’s make sure we are doing what we can for the child by looking in the mirror. Perhaps the out of control behavior is a disguised cry that we’ve dropped the ball in the discipline arena, or that we aren’t spending an appropriate amount of “quantity” time with our child. If this is the case, it’s a tough thing to own up to, but step up to the plate — your child is counting on you. Talk to other parents you trust. Go to the library and get the resources you need. It won’t be easy, but you will reap dividends in the end.
With that having been said, another place to begin looking at is your child’s diet. Interestingly, the concept of diet, and its effect on hyperactivity and learning disorders, is not new, dating back to 1922. The most popular diet linked with ADHD is the Feingold Diet which hit the scene in the mid-70’s. Dr. Feingold claimed that up to 50% of all hyperactive children were sensitive to food additives (artificial colors, flavorings, and preservatives) as well as to salicylates that occur naturally in some foods. His research found nearly 3000 different offending food additives. He ran into a little problem though: food additives are big business in the United States. So it should come as no surprise that studies originating in the United States that set out to “verify” Feingold’s findings have not been supportive of the diet. In fact, they were sponsored largely by the Nutrition Foundation, a corporate food lobby group. Studies conducted outside the U.S., however, find that the diet works.
Dorris Rapp, M.D., a pediatrician with considerable experience with ADHD and diets acknowledges that removal of artificial food coloring and preservative from the diet is crucial for sufferers of the disorder. However, she maintains that doing this alone will seldom eliminate the symptoms. Instead allergies to the foods themselves need to be also identified and eliminated. According to Rapp, two-thirds of children diagnosed with ADHD have unrecognized food allergies that generate most, if not all, of their symptoms. A simple elimination diet can usually identify these offending foods and clear the child’s symptoms.
A comprehensive article on ADHD in Alternative Medicine Review notes that data from
two double-blind studies indicated that 73-76 % of ADHD children responded favorably to food elimination diets. The percentage jumped to 82% when the diets were even more restrictive in nature. The effectiveness of the diets was underscored when the offending foods were added back into the diets, and the symptoms reappeared.
Most of us know that sugar contributes to hyperactive behavior. A study published in the New England Journal of Medicine would have you think otherwise though. The study’s conclusion was practically written before testing was conducted. The control group (of children ages 6 to 10) on the “low” sugar diet was really not very low at all — 5.3 teaspoons of refined sugar per day. The children were also allowed to drink soft drinks. So, naturally, it was hard to see a discernible amount of symptoms when the “controls” were compared to the test group on the higher amounts of sugar. At the end of the study the authors acknowledged their gratitude to General Mills, Coca-Cola, PepsiCo, and Royal Crown.
Finally, there is compelling evidence that children exhibiting an Omega-3 fatty acid deficiency are more likely to be hyperactive, have learning disorders, and display behavioral problems.
Of course, this wouldn’t be a very good chiropractic article if I didn’t tell you that chiropractic also can have a favorable affect on children with ADHD. A study in 1975 in the International Review of Chiropractic, directed by E.V. Walton, Ph.D., Sc.D., M.D., director of Psychoeductional and Guidance Services, and included a clinical psychologist and a superintendent of schools, compared chiropractic care with drug treatment in children with ADHD symptoms. The medication was found to be effective initially but required increased dosages as time went on to maintain its effect. Furthermore, half of those taking the medication experienced personality alterations, loss of appetite, and insomnia. Those receiving the chiropractic care, on the other hand, not only had a reduction of hyperactivity and improvement in attention span that was approximately equal to that of the medication, but they also had improvements in other areas that the medication had no effect on whatsoever like improvement in effort, motivation, and relief of nervous tension — all without side effects. And when the improvements seen in the medication group started to wear off, the chiropractic group maintained its effectiveness. Overall, chiropractic treatments were statistically 20-40% more effective than medication.
A more recent study in the Journal of Manipulative and Physiological Therapeutics (1989), involved a handful of ADHD students. All subjects had evidence of the vertebral subluxation complex [the thing we chiropractors treat]. Following chiropractic care, not only were chiropractic-related improvements seen, but 71.4% showed a reduction in “overt behavior activity,” and 57% showed improvements in parental ratings of hyperactivity.
How does chiropractic help? Well, the truth is we really don’t know — but then again, the makers of Ritalin readily admit the same when asked how their drug benefits ADHD. There are several different theories regarding chiropractic, however. Since ADHD is a neurologically based disorder by definition, it would seem logical that chiropractors, who correct structural and functional misalignments of the spine (vertebral subluxation complexes) that cause neurological dysfunctions in the body, might be able to help. Scientists theorize that the symptoms of ADHD seem to indicate a disturbance with brain stem function. Vertebral subluxation complexes of the upper neck vertebrae can have an affect on brain stem function — either possibly through direct pressure or altered proprioceptive (position sense) input. Before certain neurological outputs can be carried out by the brain stem, proper inputs must be received. If the inputs are altered due to the vertebral subluxation complex, output will also be altered — one of which is level of activity (or hyperactivity). Misalignment of the cranial bones can also alter this proper proprioceptive input and thus play a part in ADHD.
One of the most interesting explanations for why chiropractic can have a positive effect on ADHD relates back to the dietary information discussed above. Chiropractors have known for a long time that the vertebral subluxation complex can occur due to physical, emotional, and/or chemical causes. Chemicals in this case could apply to certain foods. The theory refers to the spine as a “shock organ.” In other words, the spine will misalign, or subluxate, after an offending food, preservative, dye, or additive is ingested. [This of course could then lead to the altered proprioceptive input scenario discussed above]. In Today’s Chiropractic (1988), Larry Webster, D.C. described how he conducted a study in which each child kept a two-week diet diary. The diary was analyzed and the suspected food products were then tested. The child’s spine was examined, findings recorded, and then the child was instructed to eat the suspected food product. The chiropractor found an immediate change in the spine after the ingestion of certain preservatives, food dyes, and processed sugars. Having the child change his diet improved the spinal findings. However, once the improvement was achieved, if the child reingested the offending food product, the abnormal spinal findings immediately returned. Interestingly, he found that with chronic vertebral subluxations, as was the case with his participants, it “took less and less chemical irritant each time to maintain the subluxation.”
Really it all boils down to this. If you think, or are told by a teacher, that your child has ADHD — make sure that’s what it is. One article I read explained how a teacher told a parent that her 4-year-old child had ADHD and strongly suggested he be put on Ritalin. The parent was warned that if the child’s behavior did not change, he would not be allowed back into class. As it turned out, the child actually had a chronic bout of “gas” that was fueled by a chronic subluxation in his thoracic spine, which brings me to my next point. Seek out the appropriate specialist (typically someone in the mental health field or one who specializes in ADHD specifically) to determine if your child indeed has the problem. The actual diagnostic criteria is very extensive and requires in-depth interviews with many different individuals (including the child). What you want to avoid is a rather quick diagnosis by a doctor who immediately suggests “trying” a course of Ritalin. But even with the proper professional on your side, be forewarned, there is compelling evidence to suggest that ADHD might not even exist. Dr. Tim O’Shea, chiropractor, details out in a well-researched article that “overwhelming evidence shows that [ADHD] was invented in 1980 by the American Psychiatric Association in order to bolster the position of its failing profession.” Check out his article entitled ADD/ADHD: The ‘Designer Disease’” for more information. (http://www.chiro.org/pediatrics/ABSTRACTS/add.shtml).
Then ask yourself, if your child indeed has ADHD (provided that it actually exists), are you willing to take the additional effort required to battle this disorder naturally, or will you default to the convenience of giving your child a schedule II drug. My wife vividly recalls conferencing with a parent whose child was on Ritalin. When inquiring if the parent had looked into dietary measures such as the Feingold Diet, the mother simply replied that she did not have the time, and that it was much easier to give her son a pill. An article written by a chiropractor asked this poignant question: “What price are we willing to pay to maintain our high tech lifestyles and busy schedules or to have our kids be ‘perfect’?”
You know, if Ritalin had been around, some of our greatest minds would have been robbed by it — minds whose shoulders we now stand on that ultimately allow us to enjoy the technological and scientific advancements of today. Ironically, the knowledge base that is required to design and manufacture a drug such as Ritalin might never have come to pass. They say that Albert Einstein would probably have ended up on Ritalin. He did not speak until he was four years old and didn’t read until he was seven. He teacher described him as “mentally slow, unsociable, and adrift in his foolish dreams.” He was expelled and refused admittance to the Zurich Polytech Institute. Are we shooting ourselves in the foot? Does the mystery of ADHD lay “trapped” in a numbed, Ritalin-altered brain of one of our children? Let’s hope not.