Natural Treatment For Kids With ADD/ADHD There are many existing natural remedies that can reverse the symptoms of Attention Deficit Disorder (ADD) and Attention Deficit Hyperactivity Disorder (ADHD) instead of prescribing drugs. In “Arch General Psychiatry”, volume 52, June 1995, it is stated that ; “Cocaine, which is one of the most reinforcing and most addictive of the abused drugs has pharmacological actions that are very similar to methylphenidate hydrochloride (Ritalin), which is the most commonly prescribed psychotropic medications for children in the U.S.”. Food allergies have often been linked to behavioral disorders, which means, changes in diet alone can prove beneficial. A diet prohibiting the intake of salicylates (found in artificial colors and flavors, aspirin, grapes, tomatoes, red and green peppers) and replacing them with mineral soups, whole grains, raw vegetables and fresh fruit. These changes by themselves have been shown to have significant effects on behavior. A study published in the May 9, 1992 issue of “The Lancet” by J. Eggar, M.D. reported that 76 children with behavioral disorders were placed on elimination diets, removing wheat, milk, chocolate, eggs, oranges and sugars from their diets. Behavior improvements were noted in 62 out of the 76 children. The study also noted that vitamins A, B, C, D, E, as well as, Calcium, Magnesium, Chromium, and Zinc were recommended to help increase levels of behavioral improvement. Chiropractic has also been shown to be of great benefit to children diagnosed with ADD/ADHD disorders. Twenty-four children were tested in an independent research project conducted at Texas A & M University. Twelve children received Chiropractic treatment and twelve received medical care. The outcome proved children receiving Chiropractic care improved more than children treated with drugs in areas such as verbal output, reading and comprehension, attitude and self-esteem, coordination and emotional maturity. SOURCE: The Chiropractic Journal, April 2000

 

Attention Deficit Disorder and Ritalin: Look at Research by Bryan K. Bajakian, D.C. November- December 2003 There is extensive research available that demonstrates the need to avoid the use of such drugs as Ritalin, Adderal, or Cylert when "treating" hyperactivity disorders in children. Unfortunately, the drug manufacturers market the drugs very well and to many parents and health care providers, the downsides of such medications are vague or even unknown. I have referenced two specific studies that assessed the role of Chiropractic treatments in the management of children who have been diagnosed with hyperactivity disorders. These studies, both separate from one another, revealed that hyperactivity, and other behavioral conditions responded well to chiropractic care and even exceed results seen from medication. 1,2 One medical study demonstrated the existence of a positive relationship between cranial motion restrictions and learning disabled children, as well as children with a history of an obstetrically complicated delivery. 3 Nerve and spinal system compromise can result from the traumatic pulling, twisting, and compression that a newborn's spine is exposed to during a forceful birth. Traumatic Birth Syndrome is not a new concept; it has been commonly accepted by experts in both the medical and chiropractic fields. Birth trauma often adversely affects the bones at the base of the skull, the brain stem and the soft tissue surrounding it. The cervical (neck) nerve roots are often stretched as the baby's head is pulled from the birth canal. Two prominent German MD's published papers in the late 80's and did clinical work with newborns and infants to address what atlas chiropractors allude to ANVS. Gottfried Gutman, MD addressed what he called "Atlas Blockage" (ANVS) and stressed the importance of having the atlas area of infants examined after birth, especially if the birth was difficult. He treated over 1,000 infants and documented the positive clinical results derived from correction for "Atlas Blockage" by performing specific light force adjustments to the atlas vertebrae.4 Another medical study revealed that due to the physical forces incurred during delivery, 80 % of ALL children born exhibited mis-alignments of their upper cervical spine. Dr. H. Biederman, a German MD, wrote a paper stressing the importance of the neurological structures in the atlas and occipital (base of the skull) areas. Biederman described atlas misalignments is newborns with the term "Kinematic Imbalances due to Suboccipital Strain" (KISS Syndrome). According to Biederman this "blockage" can be corrected by "manual therapy of the suboccipital area of the upper cervical spine".5 Both Gottfried and Biederman specifically attributed these syndromes to the compromised positions that the head and neck of an infant are susceptible to during the birth process. Such Subluxations, as they are known in the Chiropractic profession, have been shown to result in a multitude of dysfunctional disorders within children which include ADD/ADHD, Difficulty Sleeping, Headaches, Asthma and Allergies, Lethargy, Sinus conditions, and acute/chronic ear infections. In 1971 a study entitled "Hyperactive Children as Teenagers: A Follow - up Study" was performed. 83 Children were followed up on, from 2 to 5 years after being diagnosed as hyperactive or as having attention deficit. 92 % of the children were treated with Ritalin. Results were as follows: 83 % had trouble with frequent lying 78 % found it hard to sit still and study 60 % of the children were still overactive and had poor schoolwork (the original reasons for being put on Ritalin), but in addition were now viewed as rebellious 59 % had some contact with police 59 % were viewed as a discipline problem at school 58 % had failed one or more grades 7- 57 % had reading difficulties 52 % were destructive 44 % had arithmetic difficulties 34 % threatened to kill their parents 23 % had been taken to the police station one or more times 15 % had talked of or attempted suicide. 6 1987-Sutterfield Study: "We found juvenile delinquency rates to be 20-25 times greater in our hyperactive drug-treated only group than in the normal control group." In the "Delinquency Outcome for the drug-treated group" the results were: of 61 Boys, 46% were arrested for one or more felony offenses before age 18 30% were arrested for 2 or more felony offenses 25% were institutionalized The authors go on to state "Studies of the long term effectiveness of drugs have been consistently discouraging." 7 1976 - Study by Riddle & Rapoport - it was concluded that among the continuously treated hyperactive children it was found that peer status and academic achievement did not seem to improve. 7 1976 - Study by Hechtman &Weiss stated: Thirty-five individuals aged 17 to 24 in whom severe chronic hyperactivity had been diagnosed 10 years before were studied together with 25 matched controls. Cognitive style tests indicated continued difficulty in reflection (resulting in more errors) but less impulsivity (longer reaction time) in the hyperactive individuals. Compared with controls, hyperactive subjects were continuing to have more scholastic difficulty, although this difference seemed to be less pronounced than 5 years before. Restlessness, both reported and observed, continued to be a problem for the hyperactive individuals, and socialization skills and sense of well being continued to be poorer than in the controls. The authors concluded that methylphenidate (Ritalin) did not significantly alter poor long-term academic performance, delinquent behavior or poor emotional adjustment. 9 1978 - Study by Blouin stated the following: "Clinical treatment with Ritalin was found to have no beneficial effect, and there was some evidence to suggest a poor behavior outcome for the drug-treated group." 1980 - Ackerman report entitled "Report on Drug Withdrawal Symptoms"; "The abstinence (withdrawal) syndrome associated with amphetamines, methylphenidate (Ritalin) is marked by lethargy, sleep disturbances and prolonged depression." "Depression is perhaps the most significant symptom." In review of the reported "school-shootings" perpetrated by minors in schools or relating to other social situations of such age groups, in each case that the shooter's medical files were available for review, Psychotropic drugs were found in the child's system. Such a finding is further bolstered by the follow references. In the book, "Predicting Dependence Liability of Stimulant and Depressant Drugs" researchers Travis Thompson, Ph.D. and Klaus R. Unna, M.D. describe the "chronic effects of stimulants in man": "Perhaps the best-known effect of chronic stimulant administration is psychosis. Psychosis has been associated with chronic use of several stimulants; e.g., d- and 1- amphetamine methylphenidate (Ritalin-P), phenmetrazine and cocaine." 10 1987 - The Diagnostic and Statistical Manual of Mental Disorders III-R, states: That methylphenidate (Ritalin), along with other amphetamine-type drugs and cocaine, can create "persecutory delusions" and may "cause a highly organized, paranoid delusional state indistinguishable from the active phase of schizophrenia." It states "The person may harm himself or herself or others while reacting to delusions." 11 This American Psychiatric Association's Manual goes on to state: "Initially, suspiciousness and curiosity may be experienced with pleasure but may later induce aggressive or violent action against 'enemies'. Delusions can linger for a week or more, but occasionally last for over a year." This DSM III-R also states "Suicide is the major complication of withdrawal from methylphenidate and other amphetamine or amphetamine-like drugs."12 1991 - Journal of Behavioral Optometry, "The Efficacy of the Use of Ritalin For Hyperactive Children". This study evaluates 22 previous studies/articles since 1976 concerning Ritalin use for hyperactive children. It states: "The fact that the above studies do not show the efficacy of Ritalin for helping hyperactive children should be apparent to the skeptic and make a skeptic out of the believer. But the argument should not stop at this point. The weak evidence of the value of Ritalin must now be viewed in the light of its reported side effects." And it concludes: "...at this time there is scant evidence for the use of Ritalin in hyperactive children to produce improved learning. This lack of evidence is consequential because of the many side effects produced by Ritalin administration." 1988 - Journal of the American Academy of child and Adolescent Psychiatry, January 1988 Case Study entitled: "Methylphenidate-induced Delusional Disorder in a Child With Attention Deficit Disorder With Hyperactivity" discusses a case study involving a 6 year old child, J. R. who was placed on 20mgs of Ritalin in the morning and 10mgs in the afternoon, but due to measurable weight loss after 1 ½ months the dosage was decreased to 20mgs. After 4 months the child was placed on 20mgs of the sustained released Ritalin, the results were as follows: "Approximately 6 months into therapy, J.R.'s mother reported that the child was becoming physically and verbally aggressive and difficult to manage. He was agitated and verbalized repeatedly that "someone" was " going to kill "him." .. .the child was suspicious and delusional, accusing others of thinking homicidal thoughts towards him " "J.R.'s the stimulation (Ritalin) therapy was terminated and his behavioral disorganization and psychosis resolved completely over the next several days but only with a full return of his attention problems and hyperactivity." The conclusion: "J.R.'s psychological disturbance certainly seemed to have been associate with his methylphenidate therapy." The final paragraph of this study states: "Young (1981) suggested that psychotic reaction to stimulants in children may be common, as prescribing physicians are generally less alert to possible signs of toxicity when these medications are prescribed within normally accepted dose ranges. J.R.'s reaction was certainly more intense than what has usually been described and it is unlikely that his behavioral changes would have gone unnoticed indefinitely. On the other hand, as most reported instances of psychotic reactions in children have involved less dramatic behavioral changes, such as tactile hallucinosis, there may be considerably potential for such changes to remain unrecognized for prolonged periods of time." 13 Ritalin is speed. A representative from the DEA (Drug Enforcement Agency) stated that neither humans nor animals can differentiate between Cocaine and Ritalin. Ritalin has the same drug classification as morphine, opium and cocaine. In fact the Diagnostic and Statistical Manual of Mental Disorders states that Ritalin is an extremely addictive substance and that classical symptoms of Ritalin usage and cocaine dependence are the same. Also stated in the Manual is the main complication of withdrawal from Ritalin substance is suicide. According to Medical Economics, chronic use of Ritalin has produced psychosis. Ritalin is definitely not a safe drug. The late Robert Mendelson, M.D. made a most interesting comment about ADHD and the use of Ritalin, Dr. Mendelson stated that "So many children are being called hyperactive by the experts that I wonder whether many of them actually are perfectly normal in contrast to the hypoactive children who serve as the reference base. If we're not careful, we'll soon find the non-hyperactive being drugged with prescriptions for hypoactivity to arouse them from there lethargy. In the publication, Physiological Medicine, Roselise Wilkinson MD. states "We deplore the careless manner in which Ritalin use is regarded by many educators, psychologists, and medical personnel. It is often prescribed hastily, without adequate evaluation and by authority figures who are placing unreasonable pressure on parents who wish to do the best for their child." Ritalin itself is used mainly in school age children and is the subject of much debate. Ritalin is a central nervous system stimulant that activates the arousal system in the brain stem and cortex, in effect producing increased alertness. How it does this is unknown. The only other indication for use of Ritalin is for the condition of narcolepsy, a disorder of abnormal sleep. (An oxymoron perhaps). The manufacturer of Ritalin (Ciba-Geigy) warns that the drug should not be used under the age of six, yet the fastest growing age group has been documented to be the 2-5 year olds. The long-term effects of Ritalin have not been established and of course the mechanism of how Ritalin works in the body is admitted in writing by the company who manufactures the drug as, "not understood". Some side effects of Ritalin are: stunting of growth, depression, chronic headaches, nervousness, skin rash, blood pressure and pulse changes and development of Tourette's Syndrome. I currently maintain serious concerns about training children to take drugs to deal with their problems, rather than seeking safe and natural means as an initial resort. Since the answers involve actual active parental involvement, dietary supervision, and periodic spinal check-ups to assess the degree of function of a child's nervous system, it is only too easy to offer a chemical solution in the form of a pill. I won't argue it is easier to prescribe a pill than it is to actively work with a child in how they deal with the problems that live has to offer them. It has been estimated that our current generation experiences more stress in one year of our lives than our grandparents experienced in their entire lifetime. With the advance of technology and the increased demands being placed on our children to adhere to a set of societies guidelines of what "normal" behavior entails, the tendency to offer a quick yet potentially deadly solution is definitely becoming more attractive. Too many tragedy's have resulted from the practice of prescribing very powerful drugs for our children, and then reading in the papers as to how a seemingly "normal" child failed to wake in the morning or went to school and violently took the lives of other children. I always refer to children as our future. We must ask ourselves if we taint our children today and we instill in them flawed social, physical, and emotional traits, what kind of future have we created for our children and our grandchildren? This article written by Bryan K. Bajakian, D.C., was originally a letter written to a school teacher that Dr. Baajakian met at the store. The letter writing was prompted by their conversation about children, ADD and the current modes of treatment. Dr. Bryan is a Life University graduate, an excellent chiropractic educator, a current I.C.P.A member and a successful family practitioner in NJ. He can be visited at: www.chiropractic4all.com

 

Attention Deficit Hyperactivity Disorder Dr. Joel Alcantara ADHD - attention deficit hyperactivity disorder. Of late, the disorder has been addressed a great deal in both the popular media and the scientific literature; particularly with the great number of children being diagnosed with the disorder and even more alarmingly by the type and amount of medication given to treat the condition. The amount of information on the topic of ADHD is enormous, both in the scientific literature and the popular media such as newspapers and the Internet. For the pediatric chiropractor, attitudes towards the diagnosis and treatment of children with a diagnosis of ADHD runs counter to accepted medical practice to say the least. It is from this perspective that I address the topic. History of ADHD The original clinical description of ADHD is usually attributed to George Still, who in 1902 described 43 children with characteristics of aggression, defiance, emotionality, disinhibition, limited sustained inattention, and deficient rule governing behavior. Still hypothesized that the central feature of this disorder was a "defect in moral control". Still also noted that this disorder could occur in individuals with or without cognitive deficiency and with or without known neurologic disorders. He considered it a deficiency of sustained attention. In the first half of the 20th century, the disorder was examined based on its relationship to insults to the brain, including infections, toxins and head trauma. It was noted that the characteristics were similar to animal and human findings with characteristics resulting from damage to the frontal lobes of the brain. Hence, the term "minimal brain damaged" was coined and later to "minimal brain dysfunction" to reflect the finding that no known damage could be found. Hyperactivity became a central focus of etiology and diagnosis in the 1950’s with the term "hyperkinetic reaction of childhood" was coined. Interestingly enough, its been known since the 1930’s that stimulant medication improved symptoms but its widespread use did not gain popularity until the 1960’s. In the 1970’s, the central role was placed on the deficit of sustained attention and the term "attention deficit disorder" was coined. In the 1980’s, the focus on "inattention" came into question and that the deficit may be the processing between the incoming information to the brain and the response that is generated, whether appropriate or inappropriate (1,2). Epidemiology of ADHD Prevalence studies have been performed as early as the 1960's and 1970's (before diagnostic criteria were established) and yielded prevalence rates of 5%-10% of elementary school-aged children with characteristic of "hyperkinesis syndrome" or "hyperactivity" (3,4). In the 1980s, the Psychiatric Association published the criteria for what would be eventually called attention deficit/hyperactivity disorder (5). Based on established diagnostic criteria, prevalence rates fall between 4% - 12% in the 6-12 year-old age group. A recent publication by Barbaresi et.al. (6) found the highest estimate of the cumulative incidence at age 19 years (with 95% confidence interval) of AD/HD (definite plus probable plus questionable AD/HD) was 16.0% . The lowest estimate (definite AD/HD only) was 7.4%. Based on these and other reports, ADHD is perhaps one of the most common psychiatric diagnosis for children less than 18 years of age (7). One may wonder as to the varying figures in these prevalence studies. This question highlights the first controversy of ADHD that will be addressed. That of the diagnosis (or misdiagnosis) of children with ADHD. Diagnoses of ADHD In recent times, the diagnostic criteria for ADHD have undergone refinement and changes. The diagnostic criteria for ADHD are shown in Table 1 (5). As you read the diagnostic criteria, ask yourself if you, a child you know, a friend or a relative, would fit the diagnosis of ADHD. It is well accepted that the characteristics associated with a diagnosis of ADHD occurs along a continuum. Certainty in the diagnosis of ADHD has many pitfalls due to the day-to-day variabilility in most children. The stringency with which a clinician applies the diagnostic criteria in making a diagnosis is a factor, and unlike other clinical conditions, evaluating the behavior associated with ADHD is completely subjective. ADHD is diagnosed based on a cluster of behaviors with no biological markers. As Wender (8) commented, "The published diagnostic criteria lend an aura of objectivity to the diagnosis, but the application of these criteria is based on subjective judgments regarding the accuracy of information given by parents and teachers. This is the nature of psychiatric disorders, including ADHD. Only when, and if, biological markers can be found to identify the condition will this subjectivity be eliminated." When one considers the differential diagnosis associated with a child's inattention, impulsivity and high level of activity, there bounds to be abuse or misuse with the diagnostic criteria (see Figure 1). (9). Diagnostic criteria for ADHD (Table 1) A. Either (1) or (2): (1) Six (or more) of the following symptoms of inattention have persisted for at least six months to a degree that is maladaptive and inconsistent with developmental level: Inattention: (a) Often fails to give close attention to details or makes careless mistakes in schoolwork, work, or other activities (b) Often has difficulty sustaining attention in tasks or play activities (c) Often does not seem to listen when spoken to directly d) Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (not due to oppositional behavior or failure to understand instructions. (e) Often has difficulty organizing tasks and activities (f) Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (such as schoolwork or homework) (g) Often loses things necessary for tasks or activities (for example, toys, school assignments, pencils, books, or tools) (h) Is often easily distracted by extraneous stimuli (i) Is often forgetful in daily activities (2) Six (or more) of the following symptoms of hyperactivity-impulsivity have persisted for at least six months to a degree that is maladaptive and inconsistent with developmental level: Hyperactivity: (a) Often fidgets with hands or feet or squirms in seat (b) Often leaves seat in classroom or in other situations in which remaining seated is expected (c) Often runs about or climbs excessively in situations it is inappropriate (in adolescents or adults, may be limited to subjective feelings of restlessness) (d) Often has difficulty playing or engaging in leisure activities quietly (e) Is often "on the go" or often acts as if "driven by a motor" (f) Often talks excessively Impulsivity: (g) Often blurts out answers before questions have been completed (h) Often has difficulty awaiting turn (i) Often interrupts or intrudes on others (for example, butts into conversations or games) B. Some hyperactive-impulsive or inattentive symptoms that caused impairment were present before age 7 years C. Some impairment from the symptoms is present in two or more settings (for example, at school (or work) and at home) D. There must be clear evidence of clinically significant impairment in social, academic, or occupational functioning E. The symptoms do not occur exclusively during the course of pervasive developmental disorder, schizophrenia, or other psychotic disorder and are not better accounted for by another mental disorder (for example, mood disorder, anxiety disorder, dissociative disorder, or a personality disorder)   Medical approaches to ADHD Although there are several medical approaches to the treatment of patients with ADHD (i.e., behavioral modification, alternative therapies, etc.), methylphenidate (Ritalin) is the medication that is almost universally prescribed for children with ADHD, while selective serotnin reuptake inhibitors (SSRIs) is gaining widespread popularity. Ritalin is a central nervous system stimulant that affects the core behavioral features of ADHD; namely, age-inappropriate levels of inattention, impulsivity and hyperactivity. It has effects similar to both amphetamines and cocaine. Ritalin is a schedule II controlled substance, and both its production and distribution are tightly controlled. Concerns about possible over-diagnosis and over-treatment of children with ADHD have been prominent in media reports, as have various competing claims about the safety and efficacy of the various treatments. A study by Zito et.al. (10) published in the Journal of the American Association indicated that psychotropic medication increased dramatically between 1991-1995, with a great number of the medications being "off-label." "Off-label" is a term used to describe a medical doctor's drug prescription for a condition wherein the drug is not specifically approved for it. Children are most likely to be treated with "off label" medication. Ironically, the warning label on Ritalin states, "Ritalin should not be used in children under six years, since safety and efficacy in this age group have not been established." Last year, doctors estimated that 70 percent to 80 percent of drugs used on children had not been tested in children. In 1999, 9.9 million U.S. prescriptions were written for Ritalin. Non-medical illicit use resulted in 1,478 hospital emergencies during the year. White and Yadao (11) investigated the frequency, risk, symptoms and outcome in the use of Ritalin reported to a regional poison control center. Of 289 patients, methylphenidate exposure was associated with symptom development is 31% of the cases, particularly in the 6-11 year old age group. Common symptoms reported were tachycardia, agitation, lethargy or a combination thereof. Signs of Ritalin overdose include the following "Agitation "severe confusion "convulsions or seizures "dryness of mouth or mucous membranes "false sense of well-being "fast, pounding, or irregular heartbeat "fever "severe headaches "increased blood pressure "increased sweating "large pupils "muscle twitching "overactive relaxes "seeing, hearing, or feeling things that are not there "trembling or tremors "vomiting In a very recent publication, Rappley et.al. (13) identified patterns of diagnosis and treatment of ADHD in 223 very young children enrolled in the Michigan Medicaid program. What they found was alarming to say the least. In children 3 years or younger with diagnosed ADHD, psychotropic medication use was markedly variable based on little or no clinical guidelines. Twenty two different psychotropic medications were used. In addition, these children had comorbidities (i.e., other health conditions and injuries) and based on the study authors' comments, "attest to these children's vulnerability." A meta-analysis by Schachter et.al. (14) examined the efficacy and safety of short acting methylphenidate in children and adolescents with ADHD. Of the 62 randomized trials examined, the following interpretations were made. One, there was substantial publication bias such that the studies demonstrating no effect of methylphenidate or when it fared less well than placebo, "may not have been published." Second, adverse events to the medication were underreported. Third, the effects of methylphenidate beyond 4 weeks was found questionable, particularly with the lack of long term studies. As the study authors noted, "Collectively, these observations reflect a less-than-ideal state of affairs given the long history of extensive, and ever increasing, use of methylphenidate for ADD, particularly in North America for groups that now include preschoolers and adults." Concern about Ritalin use in the school systems throughout the country is such that the Texas Board of Education adopted a resolution that schools consider non-medical solutions to behavior problems. The Colorado School Board has approved a similar resolution. In Connecticut, the Legislature approved unanimously (and signed by Gov. John G. Rowlands) to prohibit teachers, counselors and other school officials from recommending psychiatric drugs for any child. Other states are following suit (15) Alternative Therapies Within the last decade, complementary and alternative medicine ( CAM) have been a focus of interest and discussion in the popular media (including the internet) and in funded research in the scientific community. Parents of children with ADHD actively seek out "alternative" treatments due to concerns of the risks of their children being given powerful psychoctive medications over an indeterminable and prolonged period of time. A recent review paper by Chan (16) examined the epidemiology of CAM use for ADHD. Using the CAM conceptual model of a therapeutic wheel by Kemper (See Figure 2), Chan examines the various alternative approaches to the care of the child with a diagnosis of ADHD. Biochemical therapies include herbal remedies, vitamins and nutritional supplements. Lifestyle/Mind-Body therapies include exercise, nutrition, environmental changes and mind body techniques such as hypnosis, psychotherapy and biofeedback. Bioenergetic therapies include acupuncture, therapeutic touch, prayer and homeopathy. These therapies are based on the notion that they restore harmonious balance of an invisible energy or spirit that surrounds and flows through the body. Biomechanical therapies include surgery, massage and "spinal manipulation" (including chiropractic)." According to Chan, very few studies of children in ADHD exists. And she's right. Furthermore, Chan admonishes the aggressive and widespread alternative therapies advertised as "miracle cures" for ADHD in the lay press and Internet. For your interest, I have provided in the newsletter reference section (see below), articles and websites that Dr. Chan has listed as resources for CAM and ADHD. To empower you with addressing questions from parents and medical doctors alike, you should be aware of these websites and be able to address the issues involved. Chiropractic Perspective Recent research efforts are now bringing into fruition supporting evidence upon the chiropractic principle of the supremacy of the nervous system. ADHD is a central nervous system disorder Attempts at understanding the underlying neurobiology of ADHD remains a challenge. In chiropractic, to the best of my knowledge, the first and only documentation in the scientific literature addressing the effects of chiropractic care in children with hyperactivity was performed by Giesen et.al. (17). The principle aim of their study was to determine the effectiveness of chiropractic manipulative therapy in the treatment of children with hyperactivity. Using blinds between investigators and a single subject research design, the investigators evaluated the effectiveness of the treatment for reducing activity levels of hyperactive children. Data collection included independent evaluations of behavior using a unique wrist-watch type device to mechanically measure activity while the children completed tasks simulating school-work. Further evaluations included electrodermal tests to measure autonomic nervous system activity. Chiropractic clinical evaluations to measure improvement in spinal biomechanics were also completed. Placebo care was given prior to chiropractic intervention. Data were analyzed visually and using nonparametric statistical methods. Five of seven children showed improvement in mean behavioral scores from placebo care to treatment. Four of seven showed improvement in arousal levels, and the improvement in the group as a whole was highly significant. Agreement between tests was also high in this study. For all seven children, three of the four principal tests used to detect improvement were in agreement either positively or negatively (parent ratings of activity, motion recorder scores, electrodermal measures, and X-rays of spinal distortions). 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 care has the potential to become an important non-drug intervention for children with hyperactivity. Further investigation in this area is certainly warranted. Considering that all of the alternative therapies as described by above are incorporated in a number of chiropractic practices or at least networked into by most, it is my contention that chiropractic provides the best "alternative" for children with a diagnosis of ADHD. References & additional resources available on-line at: http://www.icpa4kids.com/chiropractic_newsletter_references.htm   This article appears by kind permission of Dr. Alcantara and the International Chiropractic Pediatric Association.  © Dr. Joel Alcantara ABOUT THE AUTHOR Dr. Joel Alcantara serves as the Research director for the International Chiropractic Pediatric Association. Their mission is to provide parents with the information to make informed health care choices. Their site may be accessed at: www.icpa4kids.org