Children and Alternative Therapies

Information on Children and the benefits of Alternative Therapies.

Attention Deficit Hyperactivity Disorder

Attention Deficit Hyperactivity Disorder

by Tracy Barnes, DC, Kentuckiana Children’s Center

Observe any of the classrooms at Kentuckiana and at first glance all the children might appear to be “normal” school kids.

But look a little closer into classroom one: there in the back at a table all his own is Chris. Chris’ legs are constantly moving, his hands are always busy and his teachers have a difficult time keeping him focused on his work. He continually blurts out answers and pesters his classmates.

Chris is a 10-year-old student who was referred to the Center after being unable to perform in a mainstream public school. He tripped fellow students, played pranks on them and started a number of fights.

Yet through all of his problem behavior, he seemed unwilling to take any personal responsibility for his actions. Chris is far from a dull boy. He has an IQ in the superior range relative to his peers.

Chris is a classic example of Attention Deficit Hyperactivity Disorder (ADHD). However, unlike many of the other children diagnosed with ADHD, Chris is not medicated.

In his three years as a student in the Kentuckiana Special School, and as a patient in the Kentuckiana Clinic, his progress has been characteristically, “four steps up, two steps back; three steps up, two steps back,” says Roberta Davis, M.Ed, director of Special Education at Kentuckiana.

He is a prime example of the need for multidisciplinary care in cases of ADHD.

ADHD’s main components are “developmentally inappropriate degrees of inattention, impulsiveness and hyperactivity.”

It has been estimated that some 5-10 percent of school-aged children are affected. They are commonly diagnosed before four years of age with males being six to nine times more likely than females to have the disorder.

Approximately one-third of all ADHD cases have manifestations that progress into adulthood, although the numbers may be much higher.

Work at Kentuckiana, as well as three known studies show the benefits of chiropractic adjustments on these children. The importance of the nervous system is certainly not to be overlooked.

However, it has been our experience that the stability of chiropractic care is greatly enhanced when combined with other factors affecting the structural, chemical, and mental aspects of this complex disorder.

Among the many possible causes for ADHD, there are those that cannot generally be changed by the time these children enter our offices.

The possible causes are fetal alcohol syndrome and fetal alcohol effect (FAS/FAE), are maternal prenatal smoking, genetics and vaccination.

There are, however, other predisposing factors to ADHD that must be acknowledged and investigated to ensure maximal success in treatment.

These causes include candida albicans proliferation, temporomandibular joint dysfunction, heavy metal toxicity, food sensitivities, environmental allergies, neurologic disorganization, hearing problems, visual perceptual disorders, and multiple aspects of psychological disorders.

As William Crook, MD, describes in the vicious cycle of treating childhood infections with broad-spectrum antibiotics. Yeasts, which are not affected by antibiotics, are allowed to multiply and release harmful toxins into the child’s body.

These toxins weaken the immune system, lower the body’s natural resistance, and in turn set up the child to develop more infections.

Our student Chris had a history of repeated ear infections during his infancy. Even though this was some years ago, it is likely that he is still affected by the disruption of his normal flora caused by the antibiotics.

In addition, Chris has a history of allergies to pollen, dust, ragweed, Johnson grass, eggs, wheat, milk, corn, and chocolate.

His mother attributes Chris’ recurring headaches and sinus infections to these allergies.

The role of allergies and the hyperactive child involves both food intolerance and environmental sensitivities. A recent study looked at 40 children with food-induced hyperkinetic syndrome.

They found some 15 foods that provoked an increase in hyperkinetic behavior including chocolate, colorings, cow’s milk, eggs, citrus, wheat, nuts, cheese, banana, tomato, apple, pears, beef, pork, and beans.

Current literature is in debate as to the role of dietary sugar in hyperactivity. One recent study claims that sugar and Nutrasweet have absolutely no adverse effects on children’s behavior.

However, other reports show sugar consumption to correlate significantly with restlessness and destructive-aggressive behavior. Glucose metabolism has been shown to be hampered in hyperkinetic adults and children.

Other studies show that sugar leads to an increase in deviant behavior primarily when sugar is in combination with a high carbohydrate meal.

The negative effects are sometimes negated when sugar is eaten with a high protein meal.

Having a complete recording of what each child eats for at least one week is the first step toward assessing the importance of dietary change.

Questions concerning artificial sweetener consumption should also be included in the history-taking process since these have been linked to many symptoms common to ADHD.

Heavy metal toxicity is another important piece in the puzzle of hyperactivity. A complete history will also include information concerning where the child lives and plays, paying particular attention to areas of highly industrial nature.

Toxic chemicals such as lead, copper, and aluminum can be found in high levels in many ADHD children.  Locating the source of the chemical toxicity is essential in effectively eliminating its harmful barrage on the nervous system.

Possible avenues for heavy metal ingestion include drinking water, beverages served in aluminum cans, and food prepared in aluminum cookware.

In addition, children who are regularly exposed to second-hand smoke are at risk for increased cadmium intake.

It is important to find out who takes care of the hyperactive child on a regular basis and whether or not tobacco smoke is part of the environment.

Other trace mineral imbalances to look for include mercury, calcium, magnesium, zinc, and chromium.

Hair analysis is one method of screening for toxic metals and deficiencies of essential minerals. This analysis provides a way to functionally understand the body chemistry.

Chris’ beginning trace mineral hair analysis showed a lead level of four parts per million (ppm). Levels as low as 1ppm have been shown to correlate with high attentional deficit ratings.

He also had increased levels of aluminum and cadmium. Chris comes from a home where his father smokes a pipe.

On a retest analysis done approximately 19 months later, his aluminum went from 24ppm to 9ppm and his cadmium went from 0.80ppm to 0.26ppm.

Nutritional supplements such as chelated proteinates can help to detoxify and stabilize these nutrient mineral imbalances.

A consistent temporomandibular joint problem is also a part of Chris’ history. His head pain was so intense at times that he would bang his head against the wall.

We have found with some children that addressing TMJ dysfunction has made marked improvement in their behavior. Upon examination of the ADHD child, the TMJ area should be evaluated as well as thorough inspection of the oral cavity.

A high raised palate may be found in many of them.

Another element for Chris is that he was adopted at 21 months. This kind of early disruptive experience can have lasting emotional effects on children. For this reason, psychological evaluation can be helpful in determining the need for individual and family counseling.

Support of the parents in all aspects of treatment can be the determining factor in any success with ADHD children.

Mothers and fathers need to understand the full spectrum of ADHD care and realize the role that they play in its outcome.

Parents may often be pushed by school administrators and others into thinking that they have somehow failed or that they lack proper parenting skills. While appropriate discipline is not to be underestimated, they need to know that ADHD children have a problem.

It is our job to unravel the problem and theirs is to accept it. Together we can do something about it.
Getting good results with calming down an ADHD child takes time.

This is evident in young Chris’ story. In recent months, Chris has been improving academically, but his behavior continues to fluctuate.

When accepting a case such as this, one must be prepared for extended care, frequent re-evaluations and perseverance. The need for research on this subject is evident.

Additionally, it has been our experience that those children who begin their course of treatment before the onset of puberty benefit the most.

With the rush of hormones and the change in body chemistry, it becomes very difficult to affect positive changes after puberty sets in.
There is no cookie cutter approach to dealing with ADHD.

No protocol can universally be applied to its treatment. As in all thorough care, each child must be individually assessed and evaluated to determine where the imbalances lie.

In subsequent articles, we will be examining in detail some of the etiological factors of ADHD and suggest ways of helping the children and their families cope with this disorder. 

References:
Diagnostic and Statistical Manual of Mental Disorders — III. American Psychiatric Association, Washington, D.C. 1987.

Berkow R, et al: The Merck Manual of Diagnosis and Therapy. Merck Sharp & Dohme Research Laboratories, Rahway, NJ, 1987.
Weiss L: Attention Deficit Disorder in Adults. Taylor Publishing, Dallas, Texas, 1992.

Webster L: The hyperactive child and chiropractic. Health Naturally, February 1994.

Pigg N: Chiropractic effectiveness with emotional, learning, and behavioral impairments. International Review of Chiropractic, September 1975.

Giesen J, Center D, Leach R: An evaluation of chiropractic manipulation as a treatment of hyperactivity in children. JMPT vol. 12, num. 5, October 1989.

Caruso K, ten Bensel R: Fetal alcohol syndrome and fetal alcohol effects. Minnesota Medicine, vol. 76, April 1993.

Fried P, Watkinson B, Gray R: A follow-up study of attentional behavior in 6-year-old children exposed prenatally to marijuana, cigarettes, and alcohol. Neurotoxicology and Teratology, vol. 14, 1992.

Berkow R et al: The Merck Manual of Diagnosis and Therapy. Merck Sharp & Dohme Research Laboratories. Rahway, NJ, 1987.

Coulter H: Vaccination, Social Violence, and Criminality. North Atlantic Books, Berkeley, California, 1990.

Crook W: The Yeast Connection. Professional Books Inc. Jackson, TN, 1991.

Crook W: Help for the Hyperactive Child. Professional Books Inc., Jackson, TN, 1991.

Schaub J: Hyposensitisation in children with food-induced hyperkinetic syndrome. European Journal of Pediatrics, vol. 151, November 1992.

Mahan K, et al: Sugar allergy and children’s behavior. Immunology and Allergy Practice, July 1985.

Prinz R, et al: Journal of Behavioral Ecology, vol. 2, num. 1, 1981.

Zametkin A, et al: Cerebral glucose metabolism in adults with hyperactivity of childhood onset. New England Journal of Medicine, vol. 323, Nov. 15, 1990.

Conners C: Medical Tribune. January 9, 1985.

Barnes B, Colquhoun I: The Hyperactive Child. Thorsons Publishers Limited, Wellingborough, Northhamptonshire, 1984.

Tuthill R: Low Hair Lead Concentrations in Children. Doctors’ Data, West Chicago, Illinois, 1982.

Haddad P, Garralda M: Hyperkinetic syndrome and disruptive early experiences. British Journal Psychiatry, vol. 161, Nov. 1992.

Children use Alternative Therapies

A recent article in the electronic edition of Pediatrics sought to compare the use of “alternative therapies” by children with cancer vs. children receiving routine checkups in a medical outpatient setting.

While this study has a significant bias in that it only includes children receiving care within the medical model, it still underscores a trend that the medical community cannot help but recognize.

The study interviewed the parents of 81 children with cancer and 80 children receiving routine medical care.

What they discovered is that most parents who utilize medicine for their children’s health care also utilize forms of care that extend beyond what is traditionally offered under the medical model.

The authors begin by reciting the usual litany on the significance of alternative therapy in the United States:  “Alternative therapy (AT), also known as complementary, non-allopathic, unconventional, holistic, or natural therapy, refers to healing practices that have become increasingly popular with the general public, but not widely accepted by the medical profession.

Examples of AT techniques include therapeutic massage, acupuncture, imagery, energy healing, prayer, and use of medicinal herbs.

According to 1990 data, the number of visits to practitioners of AT was greater than the number of visits to all primary care physicians nationwide.

2. Reasons patients use AT include a belief that it will cure or help a condition not treatable by conventional medicine, dissatisfaction with allopathic medicine, and a desire to use more natural methods of healing.

It is estimated that Americans spend $10 billion a year on unproven cancer remedies.

3. AT is thought to be used more frequently in patients with cancer than in patients with minor illnesses.

According to Fletcher4, between 20% and 50% of cancer patients use or consider using AT.” One of the unique qualities of this study is its inclusion of “prayer” in the list of  “alternative medicine used.”

But the authors defended their decision citing:
“Many parents questioned the inclusion of prayer as an AT. We included it when it was being used specifically to treat illness, because few physicians prescribe prayer or consider it part of standard therapy.

Religion and spirituality are not consistently addressed in medical school curricula, and even may be considered inappropriate teaching subjects.

However, physicians are beginning to recognize the role of spirituality and prayer in the healing practices of their patients, as indicated by conferences sponsored by the National Institutes of Health.

The findings suggest that many Americans use prayer and faith healing as a therapeutic adjunct. Discussions of spiritual practices may improve well-being and compliance.

In a much reported study, Byrd conducted a randomized, double-blind study of 393 patients, in which patients on the University of California, San Francisco, coronary care unit were prayed for by various religious groups who had only their first name and a brief description of their condition.

The test patients and families did not know they were being prayed for. Fewer patients in the prayed-for group died, and significantly fewer developed pulmonary edema, received antibiotics, or needed intubation.

The researchers concluded that the prayed-for group endured less suffering. Although this study has been criticized for its design, it shows the important role that prayer may play in illness.”

The authors conclude that “use of AT is not limited to children with life-challenging illnesses, but is commonly practiced by those with routine medical problems.”

They go on to cite the increase inclusion of “AT and other integrated health approaches” in half of the US medical schools. They also discuss the need for MDs to learn more about alternative forms of care.

But there is a louder message for the chiropractor.  This study shows that a majority of parents seek alternative care for their children. And while most don’t give a reason, they learn about the benefits of alternative care from their friends and family.

The use of chiropractic is quite low in children who routinely seek medical care. Why? The parents are obviously open to alternative care, but they haven’t heard about chiropractic enough to make that choice.

Chiropractic has attracted a significant portion of the population that is dissatisfied with medical care. But, according to this study, only a tiny percentage (less than 2%) of the children of current medical users are also chiropractic users.

This group obviously represents a majority of the US population. The chiropractic profession should explore ways to better communicate with this portion of the public, particularly through current chiropractic patients who are the “friends and family” of those who routinely utilize medical care.

References:
Friedman T, Slayton WB, Allen LS, Pollock BH, Dumont-Driscoll M, Mehta P, Graham-Pole J. Use of alternative therapies for children with cancer. Pediatrics December 1997, vol. 100, no. 6, p. e1.
Eisenberg DM, Kessler RC, Foster C, Norlock FE, Calkins DR, Delbanco TL. Unconventional medicine in the United States. Prevalence, costs, and patterns of use. N Engl J Med 1993;328:246-252.
Cassileth B, Lusk E, Guerry D. Survival and quality of life among patients receiving unproven as compared with conventional cancer therapy. New England Journal of Medicine 1991;324:1180-1185.
Fletcher DM. Unconventional cancer treatments: professional, legal and ethical issues. Oncol Nurs Forum 1992;19:1351-1354.
King D, Bushwick B. Beliefs and attitudes of hospital inpatients about faith healing and prayer. J Fam Pract 1994;39:349-352.
Marwick C. Should physicians prescribe prayer for health? Spiritual aspects of well-being considered. JAMA 1995;273:1561-1562.
Dossey L. Prayer and healing: reviewing the research. In: Healing Words: the Power of Prayer and the Practice of Medicine. New York, NY, Harper Collins, 1993, pp. 179-184.