Attention deficit hyperactivity disorder (ADHD) in children can be quite
challenging for the entire family: Kids who have it have a hard time
concentrating, and their kinetic energy tends to exhaust everyone around them.
The conventional approach to treatment relies primarily on stimulant drugs like
Ritalin, but at our integrative clinic we try to use gentler therapies whenever
appropriate.
Before starting down any treatment path, though, it's crucial to have your
child thoroughly assessed. (The best place to do this is at a child development
center that's part of a children's hospital or academic medical center.) Lots of
kids who are thought to have an attention disorder actually turn out to be
suffering from depression, anxiety, or a learning disability; when these
problems are treated, the symptoms that looked like attention problems often
clear up.
An assessment will also pinpoint the particular subtype of attention disorder
a child has, so you can tailor treatment accordingly. In the hyperactive form of
ADHD, impulsive and hyperactive behavior are the biggest symptoms. Another form,
marked by an inability to focus, often doesn't emerge until adolescence. Most
children, however, suffer from a combined version of the disorder, which usually
shows up between the ages of seven and 11.
Here are some of the questions we're most frequently asked about attention
disorders.
Q: My eight-year-old son has been diagnosed with attention deficit
hyperactivity disorder. Is there any chance that changing his diet will make a
difference?
A: There have been quite a few "gold standard" studies
supporting the idea that for certain kids, dietary changes can be a big help.
One type of diet (known as oligo- antigenic) is fairly radical; it eliminates
ingredients that are thought to provoke allergies, including dairy, gluten,
refined sugars, dyes, preservatives, and additives. A theory as to why this
might make a difference has to do with a phenomenon called leaky gut syndrome.
Normally, the intestinal lining serves as a good filtering system for proteins
like those that trigger allergies. But in some people, the gut seems to have a
sort of "leak" that allows these proteins to get into the bloodstream. At that
point the immune system reacts, and this can contribute to behavioral problems.
The pure form of this diet is very restrictive and can be difficult to stick
to. It allows only two types of meat (lamb and turkey), two types of starches
(rice and potatoes), two types of vegetables (cabbage and carrots), and two
fruits (apples and bananas).
A more practical approach might be to test potentially troublesome foods one
at a time. Eliminate dairy, say, for three weeks to see if any significant
changes occur. For most people, this approach is pretty doable, and there's very
little downside to trying it.
As a general guideline, I'd also suggest giving the child unprocessed and
organic foods, to avoid contributing any additional toxic load to the body.
Q: My daughter has the inattention form of ADHD. Are there any
mind-body therapies that might help her focus?
A: Certain forms of relaxation can be very useful. Kids can
learn to do diaphragmatic breathing and muscle relaxation, which they can use on
their own to help themselves calm down and concentrate better.
Meditation can be helpful, too, but the child would need to practice it on a
daily basis to get any lasting benefit.
Kids who receive regular massages often show decreases in hyperactivity and
impulsivity. In one study, parents were trained to massage their children, and
that worked very well. Biofeedback, in which children learn to control their
heart rate or muscle tension, is worth trying, too. To find a good practitioner,
your best bet is to check with a child psychologist, behavioral pediatrician, or
pediatric nurse-practitioner who specializes in this area.
Q: I've heard neurofeedback can help kids with attention disorders.
What exactly is it, and does it really work?
A: It's a new type of biofeedback that trains kids to
control their brain waves. There's mounting evidence that it's both helpful and
safe, and kids tend to be very good at it. It's like a video game for the body.
The practitioner places electrodes on the child's scalp, and the child learns to
control the brain waves -- in real time -- by watching them on a computer
screen. Many kids with ADHD are deficient in beta waves, the high-frequency
brain waves involved in thinking. And they tend to have too much theta wave
activity, which happens when the mind is disorganized and not well focused. One
training strategy works to decrease theta wave activity and increase beta
waves.
The only downside is the time it takes -- usually 30 to 50 sessions of
training are required before a child is fully trained. Since insurance typically
doesn't pay for it, it can be expensive.
This is something you'll want to do with the guidance of a well-trained
professional. Your best bet is to find someone credentialed by the Biofeedback
Certification Institute of America.
Q: Are there supplements that can calm a child with ADHD?
A: Yes. There's some evidence to support the theory that
kids with ADHD are missing normal levels of key vitamins and nutrients,
particularly zinc and essential fatty acids. Studies have shown that when you
replenish these nutrients, some kids definitely do better. So I like to
recommend a good high-potency multivitamin that contains trace minerals, along
with 1,000 to 1,500 milligrams per day of omega-3 fatty acids, preferably the
DHA and EPA forms. These supplements are safe, and any parent of a child with
ADHD would do well to consider them. There are several good EFA supplements made
specifically for children; I like DHA Junior, from Nordic Naturals, and
Coromega, from ERBL.
One herb you hear a lot about is ginkgo biloba, which may help kids function
better by increasing blood flow to the brain. I haven't seen specific research
on this, but holistic child psychiatrists often use it. Another commonly used
herb is lemon balm, which is thought to have a calming effect and to ease
restlessness. These herbs won't work for all kids with ADHD, but they're
certainly worth trying.
Q: How much time should I give alternative approaches before putting
my child on Ritalin?
A: It depends on the severity of the disorder. If it's the
mild-to-moderate form, and the child is keeping up in school, you could give the
complementary approach three to six months. During that time, you'll need to
track the child's progress carefully with school professionals and the child's
doctor.
If a child is more severely affected, I'd begin with the conventional
treatment, then start adding in the complementary approaches. Long term, you'll
want to try to make a gradual transition to the complementary therapies.
Alternative Medicine Magazine
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