Attention Deficit Hyperactivity Disorder, better known by its acronym ADHD, is a condition that can affect children and adults alike. Nearly 6.4 million children between four and seventeen have been diagnosed with ADHD. According to the DSM-IV, the diagnosis of ADHD is made when an individual has six or more of the symptoms of inattention and/or hyperactivity for six months or more. Some of these symptoms must be present in the individual before the age of seven, and there must be some impairment from the symptoms noted both at home and at school. Medication through various amphetamines (Adderall) and methylphenidates (Ritalin, Concerta, Metadata, and Daytrana) seem to be the first line approach in managing this condition. Currently, nearly 10% of second through fifth graders are taking medication for ADHD.5 There has been an explosive increase in the prescription of ADHD medications over the past 10 years. The increased dependence of medications to manage this condition, and their associated side effects, have left many parents and professionals seeking alternative treatments for ADHD.
There is an apparent overlap between the signs and symptoms of ADHD and normal childhood activity. This leads many parents concerned as to whether or not their child needs to jump right to medication at such a young age. Another concern with many parents is dealing with the side effects of the medications which include: a decrease in appetite, increased blood pressure, increased heartrate, nervousness, mood lability, sleep disturbance, and stunted growth. There are many other drug free options in managing this condition that should be attempted either before using medication, or to eventually control the symptoms without the use of medication long term.
Making a Case for Chiropractic
There are many theories as to what causes ADHD. Inheritability, family environment, culture, lead poisoning, fetal anoxia, maternal smoking or use of alcohol, and many others are listed as possible culprits. Whatever the cause, there appears to be a processing dysfunction in the motor cortex of the brain. Resulting in inappropriate motor responses to stimuli.9
The most prevalent theory is that ADHD is a result of a dysfunctional reticular activating system (RAS). This is the "attention center" of the brain and is shown to be under functioning in those with ADHD. Sensory input from the body is an important source of stimulation to the RAS, which in turn could cause an individual with ADHD to manifest hyperactive behavior in an attempt to self-stimulate by bombarding the RAS with stimuli to increase cortical activity, awareness and attention.5 The chiropractic adjustment is proposed to affect the physiology of the nervous system by its effect on the inflow of sensory information to the central nervous system.4,6 In this way, the chiropractic adjustment minimizes aberrant sensory stimulus which directly impacts the processing centers of the brain and nervous system, maximizing the body's natural self-healing capabilities.8
A case report conducted in 2009 followed a six year old boy with ADHD through six weeks of chiropractic care. At his six week re-evaluation, the child's mother noted an improvement in his focus as well as more compliance with directives. She also noted that the child had been successfully off all ADHD medications.12 Chiropractic care has been shown to improve many conditions by improving the way in which the nervous system functions.
What Else Can You Do?
If medication is something you and your child would like to avoid there are other options for managing this condition. In our office, we encourage parents to present an organized schedule for the child. Structure is very important, especially early on in care, and the schedule must be understood and followed through consistently in order to be effective. It is also important to praise the child's effort in school and home activities and not focus so much on the outcome. Learning needs to be fun and entertaining. If too much focus is placed on the final grade, children have a tendency to become nervous and the symptoms of ADHD actually worsen.
A careful evaluation of the child's diet, adding sensory integration exercises (exercises used to improve the vestibular function, eye tracking, and auditory integration1,3), and supplementation are all proven to be beneficial.
Diet and Supplementation
Dr. Russel Blaylock, a retired neurosurgeon, recommends removing food additives, like preservatives and dyes that are toxic to the brain. Studies have shown that many of the artificial additives that are put in food can increase a child's hyperactivity. In our office, cod liver oil, Dimethylglycine (DMG) with folic acid and vitamin B12, and a liquid/chewable multivitamin are recommended to help manage ADHD. Many studies have proven these supplements to be beneficial for many cognitive disorders, and we have noticed a significant improvement when children started on them in our clinic as well. Below is our recommend list of supplements that we support in our office.
Cod Liver Oil
Several studies and papers show that children with ADHD have low levels of essential fatty acids.1-2,6-8 Omega 3 fatty acids are vital to brain and nerve impulses needed for normal brain functioning. Essential fatty acids, specifically omega 3 fatty acids, have repeatedly been shown to improve symptoms of ADHD when supplemented.1,5,11 Cod liver oil is one of the best sources for omega 3 fatty acids, as well as containing high amounts of vitamin A and D.
Carlson Kid's Cod Liver Oil, Lemon Flavor
This product is sourced from wild caught and sustainably sourced cod from deep, unpolluted water. I have found that this company produces a high quality, dependable product that is independently tested by an FDA-registered laboratory. This oil is also naturally flavored with lemon which eliminates the "fishy" smell and is more enjoyable for children to take.
DMG's main role in the body is enhancing neurotransmitter function and is thought to support healthy mental function in some children.4
DMG (Dimethylglycine) Liquid by Kirkman Labs
Kirkman’s proprietary liquid DMG is easy to swallow, tastes delicious, and is both gluten and casein free.
Solaray Children's Chewable Vitamins & Minerals
Children's Chewable by Solaray is an easily digestible children's multi vitamin and mineral supplement designed specifically to meet a child's nutritional needs. We like this product because it contains no sucrose, no yeast, no artificial flavors, and no artificial colors. I must note that this supplement does contain iron. Iron is left out of many children's multivitamins because accidental overdose of iron-containing products is a leading cause of fatal poisoning in children under 6. You MUST store this product away from children and follow the usage directions on the label.
2. Antalis DJ, Stevens LJ, Campbell M, Pazdro R, Ericson K, Burgess JR. Omega-3 Fatty Acid Status in Attention-Deficit/Hyperactivity Disorder. Prostaglandins Leukot Essent Fatty Acids. 2006 Oct-Nov; 75(4-5): 299-308. Epub 2006 Sep 8.
3. Ayres, AJ. Sensory Integration and the Child. Los Angeles: Western Psychological Services; 2000.
4. Bell R and Peiper H. The A.D.D. and A.D.H.D..Diet. revised ed. Markham: Safe Goods/ New Century Publishing 2000; 2001.
5. Barkley RA. Behavioral inhibition, sustained attention, and executive functions: constructing a unified theory of ADHD. Psychol Bull. 1997;121:65-71.
6. Colter A, Cutler C, and Meckling KA. Fatty Acid Status and Behavioural Symptoms of Attention Deficit Hyperactivity Disorder in Adolescents: A Case-Control Study. Nutrition J. 2008 Feb 14; 7(8). http://www.nutritionj.com/content/7/1/8.
7. Melillo R, Leisman G. Neurobehavioral Disorders of Childhood: An Evolutionary Perspective. New York: Springer Science + Business Media, Inc; 2004.
8. Pickar JG. Neurophysiological Effects of Spinal Manipulation. Spine J. Sep; 2(5).
9. Richardson AJ. Omega-3 Fatty Acids in ADHD and Related Neurodevelopmental Disorders. Int Rev Psychiatry. 2006 April; 18(2): 155-72.
10. Schetchikova N. Children with ADHD Medical vs. Chiropractic Perspective and Theory. J of American Chiropractic Association. 2002 July: 28-38.
11. Souza, T. A. (2001). Differential Diagnosis and Management for the Chiropractor (2nd ed.). Gaithersburg, MD: Aspen.
12. Wittman, R., Vallone, S., & Williams, K. (2009). Chiropractic management of six-year-old child with attention deficit hyperactivity disorder (ADHD). J Clin Chiropr Pediatr, 10, 612-620.