Conditions We Treat

Pediatric Care:  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.

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.

Diagnosis of ADHD

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.

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.

Signs of Ritalin (12) 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

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 Legislatureapproved 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 psychoactive medications over an indeterminable and prolonged period of time.

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.

The 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.

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.

If you have any questions or concerns about your condition please call us at (720) 851-2475 to set up a complimentary consultation.

 

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