Attention Deficit/Hyperactivity Disorder (ADHD) in Children: Rationale for Its Integrative Management
ADHD begins in childhood and often persists into adulthood. The exact etiology is unknown; genetics plays a role, but major etiologic contributors also include adverse responses to food additives, intolerances to foods, sensitivities to environmental chemicals, molds, and fungi, and exposures to neurodevelopmental toxins such as heavy metals and organohalide pollutants. Mounting controversy over the widespread use of methylphenidate and possible life-threatening effects from its long-term use make it imperative that alternative modalities be implemented for ADHD management. Nutrient deficiencies are common in ADHD; supplementation with minerals, the B vitamins (added in singly), omega-3 and omega-6 essential fatty acids, flavonoids, and the essential phospholipid phosphatidylserine (PS) can ameliorate ADHD symptoms. When individually managed with supplementation, dietary modification, detoxification, correction of intestinal dysbiosis, and other features of a wholistic/integrative program of management, the ADHD subject can lead a normal and productive life.
Synthetic Food Colourings and “Hyperactivity”: A Double-blind Crossover Study
The findings raise the issue of whether the strict criteria for inclusion in studies concerned with ‘hyperactivity’ based on ‘attention deficit disorder’ may miss children who indicate behavioural changes associated with the ingestion of food colourings. Moreover, for further studies, the need to construct a behavioural rating instrument specifically validated for dye challenge is suggested.
Synthetic Food Coloring and Behavior: A Dose Response Effect in a Double–blind, Placebo–controlled, Repeated–measures Study
Behavioral changes in irritability, restlessness, and sleep disturbance are associated with the ingestion of tartrazine in some children. A dose response effect was observed.
Foods and Additives Are Common Causes of the Attention Deficit Hyperactive Disorder in Children
This study demonstrates a beneficial effect of eliminating reactive foods and artificial colors in children with ADHD. Dietary factors may play a significant role in the etiology of the majority of children with ADHD.
Food Additives and Hyperactive Behaviour in 3-year-old and 8/9-year-old Children in the Community: A Randomised, Double-blinded, Placebo-controlled Trial
This carefully controlled study shows that some artificial additives increase hyperactivity and decrease attention span in a wide range of children, not just those for whom overactivity has been diagnosed as a learning problem.
Parallels Between Attention Deficit Hyperactivity Disorder and Behavioral Deficits Produced by Neurotoxic Exposure in Monkeys
Both lead and PCB exposure produce deficits on discrimination reversal and spatial delayed alternation performance; treated monkeys exhibit deficits in their ability to change an already established response strategy and inhibit inappropriate responses. Monkeys exposed developmentally to lead or PCBs also perform differently from control monkeys on a fixed interval schedule of reinforcement, which requires the temporal organization of behavior using only internal cues. Whereas the etiology of ADHD is multifactorial, the possibility that neurotoxic agents in the environment contribute to the incidence of ADHD warrants attention.
Suspected Adverse Methylphenidate– Imipramine Interactions in Children
Two cases are presented which illustrate the dangers inherent in utilizing a polypharmacy approach in treating children with psychotropic medication. In each case, severe adverse effects, including cognitive and mood deterioration, were experienced by the child when treated with a combination of methylphenidate and imipramine. Possible mechanisms at the neurotransmitter level are described as postulated determinants for this pharmacological interaction.
Methylphenidate, Tics and Compulsions
Obsessive compulsive (OC) symptoms following methylphenidate (MPH) administration are seldom reported and usually not even mentioned among its adverse effects. We report here a case of MPH–induced OC symptoms which began ten months after the treatment was initiated and that were exacerbated 14 months later.
Cerebral Arteritis Following Methylphenidate Use
Stroke is a well–documented complication of amphetamine abuse. Methylphenidate, chemically and pharmacologically similar to amphetamines, is widely used in the treatment of attention deficit disorder in children. The possibility of vasculitis connected to methylphenidate should not be surprising. A case is reported of stroke associated with ingestion of methylphenidate in an 8–year–old boy.
The Sleep of Children With Attention Deficit Hyperactivity Disorder on and off Methylphenidate: A Matched Case-control Study
In the present study, we assessed the effects of regular use of methylphenidate medication in children diagnosed with attention deficit hyperactivity disorder (ADHD) on sleep timing, duration and sleep architecture. Methylphenidate in ADHD children prolonged sleep onset by an average of 29 min, and reduced sleep efficiency by 6.5%, and shortened sleep by 1.2 hours. An adequate amount of sleep is integral to good daytime functioning, thus the sleep side effects of methylphenidate may affect adversely the daytime symptoms the drug is targeted to control.
Essential Fatty Acid Metabolism in Boys With Attention Deficit Hyperactivity Disorder
Attention–deficit hyperactivity disorder (ADHD) is the term used to describe children who are inattentive, impulsive, and hyperactive. The cause is unknown and is thought to be multifactorial. Based on the work of others, we hypothesized that some children with ADHD have altered fatty acid metabolism.
Long-chain Polyunsaturated Fatty Acids in Children With Attention Deficit Hyperactivity Disorder
Several previous studies indicated that some physical symptoms reported in ADHD are similar to symptoms observed in essential fatty acid (EFA) deficiency in animals and humans deprived of EFAs. In another study using contrast analysis of the plasma polar lipid data, subjects with lower compositions of total n–3 fatty acids had significantly more behavioral problems, temper tantrums, and learning, health, and sleep problems than did those with high proportions of n–3 fatty acids.
Effects of a Restricted Elimination Diet on the Behaviour of Children With Attention-deficit Hyperactivity Disorder (INCA study): A Randomised Controlled Trial
According to this new study, just published in Lancet Journal, a diet free of processed foods significantly reduces the symptoms of ADHD in 78% of 4-8 year old children. This 5-week study involving 100 subjects found that 63% of them experienced a relapse in ADHD symptoms upon re-introduction of problem foods into the diet.
An Evaluation of Chiropractic Manipulation as a Treatment of Hyperactivity in Children
While the behavioral improvement taken alone can only be considered suggestive, the strong interest agreement can be taken as more impressive evidence that the majority of the children in this study did, in fact, improve under specific chiropractic care. The results of this study, then, are not conclusive, however, they do suggest that chiropractic manipulation has the potential to become an important nondrug intervention for children with hyperactivity. Further investigation in this area is certainly warranted.
Cervical Kyphosis is a Possible Link to Attention-deficit/Hyperactivity Disorder
This case study shows that spinal correction using the CBP approach may have effects much greater than relief of musculoskeletal conditions. Altered spinal biomechanics associated with abnormal posture clearly relate to significant neurological stress and malfunction. This is particularly evident when considering the effects on the brainstem and the autonomic nervous system. Thus, even in obscure cases with systemic, organic, or chemical dysfunction like ADHD, we suggest optimal spine equals optimal health.
Manual Therapy in Children: Proposals for an Etiologic Model
This article proposes such a framework through a model: the kinematic imbalances due to suboccipital strain (KISS) concept. This concept groups the symptoms and signs associated with functional disorders of the cervical spine into an entity linked to easily recognizable clinical situations. By using this concept as a term in the communication with other caregivers of infants and children, we may be able to improve the contact between pediatricians and specialists of MTC, thus facilitating the identification of those cases where the use of MTC will be most useful. The definition of a functional disorder that is caused primarily vertebrogenically enables pediatricians, physiotherapists, speech therapists, and others who address infants and schoolchildren to widen their scope of available therapeutic options and to include the “functional approach” [5] in their therapeutic considerations.
Comorbidity of Dyslexia, Dyspraxia, Attention Deficit Disorder (ADD), Attention Deficit Hyperactive Disorder (ADHD), Obsessive Compulsive Disorder (OCD) and Tourette’s Syndrome in Children: A Prospective Epidemiological Study
The patterns of comorbidity occurred with such frequency that it would suggest that there could be an argument for the downgrading of these conditions from disorders per se to symptoms and that further investigation might suggest that the patterns of comorbidity may fit the criteria for a developmental delay syndrome.
Developmental Delay Syndromes: Psychometric Testing Before And After Chiropractic Treatment of 157 Children
Developmental delay syndrome is an increasingly common neurologic and behavioral condition that has a detrimental impact on the children affected and their families. Because the etiology is still uncertain, research continues to identify factors that play roles in this condition.
The relationship between improvements in standardized psychometric test scores (tests that were given immediately pre- and posttreatment), the improvements in this cohorts’ cognitive and social behavior with their family and at school, and the improvement in MMT findings on AK examination suggests there may be a relationship between the chiropractic intervention provided and the improved status in these children. Because there was no control group for this in-office clinical trial, we must be cautious, however, about casually extending these results outside this treatment setting.
Every patient with DDS in this report showed dysfunction of their motor system (determined by the MMT), a finding in agreement with the previous literature cited showing muscle weakness and coordination impairments to be the most common factor in these children. The establishment of a chiropractic literature base for the effect of chiropractic treatment on children with DDS using psychometric testing has commenced with case studies, progressed to larger case series reports such as this one, and ultimately must progress to randomized controlled trials.
Even though the responsible doctor of chiropractic would not claim that chiropractic care is the only health care that children with DDS may require, the available research literature as well as this case series report does suggest a possible role for chiropractic care for this population.
Chiropractic Care for Pediatric and Adolescent Attention-Deficit/Hyperactivity Disorder: A Systematic Review
The search yielded 58 citations of which 22 were intervention studies. Of these, only three studies were identified for pediatric and adolescent AD/HD cohorts. The methodological quality was poor and none of the studies qualified using inclusion criteria. To date there is insufficient evidence to evaluate the efficacy of chiropractic care for pediatric and adolescent AD/HD. The claim that chiropractic care improves pediatric and adolescent AD/HD, is only supported by low levels of scientific evidence. In the interest of pediatric and adolescent health, if chiropractic care for AD/HD is to continue, more rigorous scientific research needs to be undertaken to examine the efficacy and effectiveness of chiropractic treatment. Adequately-sized RCTs using clinically relevant outcomes and standardised measures to examine the effectiveness of chiropractic care verses no-treatment/placebo control or standard care (pharmacological and psychosocial care) are needed to determine whether chiropractic care is an effective alternative intervention for pediatric and adolescent AD/HD.
Attention Deficit/Hyperactivity Disorder (ADHD) in Children: Rationale for Its Integrative Management
ADHD begins in childhood and often persists into adulthood. The exact etiology is unknown; genetics plays a role, but major etiologic contributors also include adverse responses to food additives, intolerances to foods, sensitivities to environmental chemicals, molds, and fungi, and exposures to neurodevelopmental toxins such as heavy metals and organohalide pollutants. Mounting controversy over the widespread use of methylphenidate and possible life-threatening effects from its long-term use make it imperative that alternative modalities be implemented for ADHD management. Nutrient deficiencies are common in ADHD; supplementation with minerals, the B vitamins (added in singly), omega-3 and omega-6 essential fatty acids, flavonoids, and the essential phospholipid phosphatidylserine (PS) can ameliorate ADHD symptoms. When individually managed with supplementation, dietary modification, detoxification, correction of intestinal dysbiosis, and other features of a wholistic/integrative program of management, the ADHD subject can lead a normal and productive life.
Outcome-based Comparison of Ritalin versus Food-supplement Treated Children with ADHD
Numerous studies suggest that biochemical heterogeneous etiologies for AD/HD cluster around at least eight risk factors: food and additive allergies, heavy metal toxicity and other environmental toxins, low-protein/high-carbohydrate diets, mineral imbalances, essential fatty acid and phospholipid deficiencies, amino acid deficiencies, thyroid disorders, and B-vitamin deficiencies. The dietary supplements used were a mix of vitamins, minerals, phytonutrients, amino acids, essential fatty acids, phospholipids, and probiotics that attempted to address the AD/HD biochemical risk factors. These findings support the effectiveness of food supplement treatment in improving attention and self-control in children with AD/HD and suggest food supplement treatment of AD/HD may be of equal efficacy to Ritalin treatment.
Some Food Additives Raise Hyperactivity, Study Finds
Common food additives and colorings can increase hyperactive behavior in a broad range of children, a study being released today found. It was the first time researchers conclusively and scientifically confirmed a link that had long been suspected by many parents. Numerous support groups for attention deficit hyperactivity disorder have for years recommended removing such ingredients from diets, although experts have continued to debate the evidence. But this new, carefully controlled study in The Lancet Journal shows that some artificial additives increase hyperactivity and decrease attention span in a wide range of children, not just those for whom overactivity has been diagnosed as a learning problem.
The Chiropractic Care of Children with Attention-deficit/Hyperactivity Disorder: A Retrospective Case Series
A retrospective case series of ADHD patients under chiropractic care is described. This provides supporting evidence on the benefits of chiropractic spinal manipulative therapy. We encourage further research in this area.
Chiropractic Care for Pediatric and Adolescent Attention-Deficit/Hyperactivity Disorder: A Systematic Review
The search yielded 58 citations of which 22 were intervention studies. Of these, only three studies were identified for pediatric and adolescent AD/HD cohorts. The methodological quality was poor and none of the studies qualified using inclusion criteria. To date there is insufficient evidence to evaluate the efficacy of chiropractic care for pediatric and adolescent AD/HD. The claim that chiropractic care improves pediatric and adolescent AD/HD, is only supported by low levels of scientific evidence. In the interest of pediatric and adolescent health, if chiropractic care for AD/HD is to continue, more rigorous scientific research needs to be undertaken to examine the efficacy and effectiveness of chiropractic treatment. Adequately-sized RCTs using clinically relevant outcomes and standardised measures to examine the effectiveness of chiropractic care verses no-treatment/placebo control or standard care (pharmacological and psychosocial care) are needed to determine whether chiropractic care is an effective alternative intervention for pediatric and adolescent AD/HD.
Effects of a Restricted Elimination Diet on the Behaviour of Children With Attention-deficit Hyperactivity Disorder (INCA study): A Randomised Controlled Trial
According to this new study, just published in Lancet Journal, a diet free of processed foods significantly reduces the symptoms of ADHD in 78% of 4-8 year old children. This 5-week study involving 100 subjects found that 63% of them experienced a relapse in ADHD symptoms upon re-introduction of problem foods into the diet.
Complementary and Alternative Medical Therapies for Children With Attention-deficit/ Hyperactivity Disorder (ADHD)
Attention-deficit/hyperactivity disorder (ADHD) is a commonly diagnosed childhood disorder characterized by impulsivity, inattention, and hyperactivity. ADHD affects up to 1 in 20 children in the United States. The underlying etiologies of ADHD may be heterogeneous and diverse, and many possible risk factors in the development of ADHD have been identified. Conventional treatment usually consists of behavioral accommodations and medication, with stimulant medication most commonly being prescribed. Parents concerned about the side effects and long-term use of conventional medications are increasingly seeking alternatives to pharmacologic treatment. Complementary and alternative medicine (CAM) offers parents various treatment options for this condition, including dietary modifications, nutritional supplementation, herbal medicine, and homeopathy.
