There is no specific test for ADHD so the diagnosis is essentially a judgment call. American authorities report that about half of the children diagnosed with ADHD and referred to specialists did not have the disorder.
Psychiatrist Dr. Peter Breggin, author of Talking Back to Ritalin (Common Courage Press, 1998) says that the criteria for ADHD focus on behaviours that parents find frustrating and disruptive. Conflicts between children and adults are redefined as diseases or disorders within the children. Breggin believes that ritalin suppresses creative, spontaneous and autonomous activity in children, making them more docile and obedient, and more willing to comply with rote, boring tasks such as classroom school work and homework.
"Parents are not informed that they are trading behaviourial control for toxic drug effects." says Breggin, "The label is attached to children who are in reality deprived of appropriate adult attention..."
Not that ritalin cures the problem, at best it is only a short term solution. Little is known about the long term effects of treatment with ritalin and other drug combinations. Follow up studies after ritalin use show no impact on future school achievement, peer relationships or behaviourial problems.
Dr. Ivo Bianchi, an Italian endocrinologist, believes that ritalin overstimulates certain areas of the brain, and changes the immune reactivity of children. American physician Dr. Mary Ann Block, author of No More Ritalin: Treating ADHD Without Drugs (Kensington, 1996), is concerned about the over-diagnosis of the condition and believes it should only diagnosed after a thorough assessment including history, physical and blood tests to rule out other conditions.
But even given a correct diagnosis, it still makes sense to experiment with natural therapies before resorting to drugs. The natural approach involves a multifactorial attack and may involve a team of alternative practitioners.
Food and environmental allergies are a key part of treatment. The Feingold diet that restricted foods containing additives and salicylates has proven helpful for some, but does not go far enough. A more useful approach has been pioneered by the American pediatrician Dr. Doris Rapp.
Rapp says that most kids' behavioral problems are due to delayed allergic reactions to food, dust, pollen, moulds, animal danders or chemicals. She has captured on video the dramatic effects of giving an allergy causing agent to children, and then reversing the effect by giving the appropriate desensitizing shot. The most common problem foods are sugar, milk, wheat, egg, corn, and citrus. Delayed food allergies don't usually show up on traditional allergy tests but can be accurately determined through an elimination diet such as described in Rapp's book, Is This Your Child? (Morrow, 1991).
Aside from allergies, too few children are meeting even the minimal requirements of the food rules resulting in widespread nutritional deficiencies. It makes sense for hyperactive children to be on a high quality multi-mineral and vitamin, preferably a liquid, available in health food stores. In addition, green drinks containing sprouts and blue green sea algae like spirulina supply essential trace minerals, antioxidants and other plant nutrients.
Hyperactive kids are commonly deficient in zinc, iron and B vitamins. Holistic physician Dr. Zoltan Rona, author of Return to the Joy of Health (Alive, 1995), says that the expression, "no zinc, no think" is not without merit. He refers to studies showing that zinc supplementation is helpful for memory, thinking and IQ. As well, cognitive impairment may be associated with low iron blood levels. Rona also points to the accumulation of lead, cadmium or other heavy metals as a cause of ADHD in some children.
Omega-3 fatty acids are essential for the brain's normal functioning and ADHD children have lower levels of them than healthy children. This can be easily remedied through taking flaxseed oil or fish oil daily.
Other important supplements include lecithin which enhances memory, ginkgo biloba which increases blood flow to the brain, and calcium magnesium combined which has a calming effect. A new nutrient called phosphatidyl serine is a key building block for nerve cells and helps normalize brain biochemistry and physiology at every level.
The herbs valerian, passion flower and lemon balm are safe for children and have a calming effect. St. John's Wort helps to improve sleep and lessen anxiety without drowsiness.
Homeopathy may be prove very valuable for children, who often respond to it more rapidly than adults. Naturopathic doctors Dr. Judith Reichenberg-Ullman and Robert Ullman, author of Ritalin Free Kids (Prima, 1996) have treated over 400 ADHD kids with a success rate of 70 percent. An experienced homeopathic doctor is usually needed to determine the right remedies.
Biofeedback can be helpful to teach kids to retrain their brain waves into calmer patterns. Cranial-sacral therapy may help some children especially those who have had traumatic birth experiences. Dr. Block has also found osteopathic manipulation a valuable adjunct for the treatment of ADHD.
Naturopathic doctor, Dr. Skye Weintraub has written a comprehensive new book called Natural Treatments For ADD and Hyperactivity . (Woodland, 1997) It gives detailed and practical information on nutritional, environmental, and physical therapies to help overcome the behaviourial problems of ADHD.
Many factors contribute to a child exhibiting signs of hyperactivity or inattention, says Breggin, in a letter to the editor of the New York Times (May/20/96) "including a spirited, creative nature that defies conformity, inconsistent discipline or lack of unconditional love, boring and oversized classrooms, an over-stressed teacher, lack of teacher attention to individual educational needs, anxiety due to abuse or neglect at home or elsewhere, conflict and communication problems in the family and misguided educational and behavioral expectations for the child."
With children, the least treatment that does the least harm should be our goal. As psychiatrist Felix Yaroshevsky and psychotherapist David Schatzky cautioned in a Globe and Mail commentary: "People who advocate medication as the first way to make children behave without exploring their life situation and real needs might as well treat unhappiness with cocaine."
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