Attention Deficit Hyperactivity
Attention Deficit Hyperactivity Disorder (ADHD): Overview
Many people are unable to sit still, plan ahead, finish tasks or be fully aware of what is going on around them. To their family, classmates or coworkers they seem to exist in a whirlwind of disorganized or frenzied activity. On some days and in certain situations they seem fine, often leading others to believe they can control this behavior. The disorder can adversely affect relationships with others in addition to disrupting their daily life, consuming energy and diminishing self-esteem.
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Incidence
ADHD, once called hyperkinesis or minimal brain dysfunction, is a common mental disorder among children. It affects some 3-5% of all children – perhaps as many as 2 million American children. Two to three times more boys than girls are affected. On average, at least one child in every classroom in the United States needs help for the disorder.
Signs and Symptoms
At present, ADHD is a diagnosis applied to children and adults who consistently display certain characteristic behaviors over a period of time. The most common behaviors fall into three categories: inattention, hyperactivity and impulsivity. ADD (Attention Deficit/Deficiency Disorder) occurs when hyperactivity is not present.
Diagnosis and Tests
Not everyone who is overly hyperactive, inattentive or impulsive has an attention disorder. Are these behaviors excessive, long-term and pervasive, occurring more often than in most others the same age? Are they a continuous problem, not just a response to a temporary situation? Do the behaviors occur in several settings or only in one specific place such as the playground or the office?
According to the Diagnostic and Statistical Manual of Mental Disorders, there are three patterns of behavior that indicate ADHD, and someone may have one or more.
Signs of inattention include:
- becoming easily distracted by irrelevant sights and sounds
- failing to pay attention to details and making careless mistakes
- rarely following instructions carefully and completely
- losing or forgetting things such as toys, or pencils, books and tools needed for a task.
Some signs of hyperactivity and impulsivity are:
- feeling restless, often fidgeting with hands or feet, or squirming
- running, climbing or leaving a seat in situations where sitting or quiet behavior is expected
- blurting out answers before hearing the whole question
- having difficulty waiting in line or for a turn.
To be considered ADHD, the behaviors must have appeared before age 7 and continued for at least 6 months. In children they must be more frequent or severe than in most others of the same age. Above all, the behaviors must create a real handicap in at least two areas of a person's life, such as school, home, work or social settings. Someone whose work or friendships are not impaired by these behaviors would not be diagnosed with ADHD, nor would a child who seems overly active at school but functions well elsewhere.
Other conditions may produce similar symptoms resulting in an incorrect diagnosis. Anything from chronic fear to mild seizures can make a child seem overactive, quarrelsome, impulsive or inattentive. For example, a formerly cooperative child who becomes overactive and easily distracted after a parent's death is dealing with an emotional problem, not ADHD. A chronic middle ear infection can also make a child seem distracted and uncooperative. Living with family members who are physically abusive or addicted to drugs or alcohol can produce effects that may resemble ADHD, but are not.
In other children, ADHD-like behaviors may be their response to a defeating classroom situation. Perhaps the child has a learning disability and is not developmentally ready to learn to read and write at the time these are taught. Perhaps the work is too hard or too easy, leaving the child frustrated or bored.
It's also important to realize that during certain stages of development, the majority of young children tend to be inattentive, hyperactive or impulsive, and yet do not have ADHD. Preschoolers have lots of energy and run everywhere they go, but this doesn't mean they are hyperactive. Many teenagers go through a phase when they are messy, disorganized and reject authority but it doesn't mean they will have a lifelong problem controlling their impulses.
Treatment and Prevention
ADHD is a serious diagnosis that may require long-term treatment with counseling and medication. Medication-free methods should receive a trial before immediately beginning drug use. Identifying the problem can help people understand why they behave in these ways. This understanding can be an important part of coping with the disorder.
Prognosis
ADHD often continues into adolescence and adulthood, and can cause a lifetime of frustrated dreams and emotional pain.
While it was previously thought that Attention Deficit was primarily a childhood problem, it is now believed that only one-third of this population grows out of it.
References and Further Information
Two books that could appear on any suggested reading list include:
- ADHD: A Path to Success – A Revolutionary Theory and New Innovation in Drug-Free Therapy (1998) by Lawrence Weathers and Kelsey Loughlin presents a revolutionary theory that helps parents see through their ADHD child's eyes. Their high rate of success is based on learning how your child's ADHD is not a deficit, but a highly refined skill that helps them survive.
- Driven to Distraction – Recognizing and coping with Attention deficit Disorder from Childhood through Adulthood (1995) by Edward Hallowell, MD and John Ratey, MD is a readable and helpful paperback.
Signs, symptoms & indicators of Attention Deficit Hyperactivity Disorder (ADHD):
Symptoms - Cardiovascular
Symptoms - Metabolic
Hyperactivity
People who are hyperactive always seem to be in motion. They can't sit still and may dash around or talk incessantly. Sitting still through a lesson can be an impossible task. Hyperactive children squirm in their seat or roam around the room. Or they might wiggle their feet, touch everything or noisily tap their pencil. Hyperactive teens and adults may feel intensely restless. They may be fidgety or they may try to do several things at once, bouncing around from one activity to the next.
Counter-indicators
Symptoms - Mind - Emotional
Counter-indicators
Symptoms - Mind - General
Being impulsive/spontaneous or being very impulsive
People who are overly impulsive seem unable to curb their immediate reactions or think before they act. As a result they may blurt out inappropriate comments or run into the street without looking. Their impulsivity may make it hard for them to wait for things they want or to take their turn in games. They may grab a toy from another child or hit others when upset.
Having trouble concentrating
People who are inattentive have a hard time keeping their mind on any one thing and may get bored with a task after only a few minutes. They may give effortless, automatic attention to activities and things they enjoy but find it very difficult to focus deliberate, conscious attention on organizing and completing a task or learning something new.
Counter-indicators
(Very) low level of spontaneity
People who are overly impulsive seem unable to curb their immediate reactions or think before they act. As a result they may blurt out inappropriate comments or run into the street without looking. Their impulsivity may make it hard for them to wait for things they want or to take their turn in games. They may grab a toy from another child or hit others when upset.
Conditions that suggest Attention Deficit Hyperactivity Disorder (ADHD):
Symptoms - Mind - General
Counter-indicators
Risk factors for Attention Deficit Hyperactivity Disorder (ADHD):
Childhood
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Attention Deficit Hyperactivity Disorder (ADHD) suggests the following may be present:
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Attention Deficit Hyperactivity Disorder (ADHD) could instead be:
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Recommendations for Attention Deficit Hyperactivity Disorder (ADHD):
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Diet
Food Additive Avoidance
The belief that food additives can cause hyperactivity in children stemmed from the research of Benjamin Feingold, M.D and is commonly referred to as the Feingold Hypothesis. According to Feingold, perhaps 40-50% of hyperactive children are sensitive to artificial food colors, flavors and preservatives. They may also be sensitive to naturally-occurring salicylates and phenolic compounds in foods.
Dr. Julian Whitaker, MD has observed: "Feingold's assertion that food additives are a problem in learning disorders has been subject to great debate over the past two decades. Practices that are profitable carry on and major economic interests have responded by hiring their own researchers to combat the results. Questions are asked in ways that will produce answers that undercut the challenging work and please the funding interests." The media publishes "conflicting reports"; politicians and regulators cite this conflict as their reason for inaction. Habits do not change easily. Feingold's work has stimulated a classic example of such debate, because the American food supply and American agribusiness is profitably enmeshed in the use of food additives.
Dr. Feingold made his original presentation to the American Medical Association in 1973. His strong claims were based on experience with 1,200 individuals in whom behavior disorders were linked to consumption of food additives. Follow-up research in Australia and Canada has tended to support Feingold's thesis." [Dr. Whitaker's Guide to Natural Healing, Prima Publishing, 1996]
The Hyperactive Children's Support Group of Great Britain recommends that the following food additives be avoided:
Amaranth, Benzoic Acid, BHA, BHT, Brilliant Blue FCF, Caramel, Carmine, Carminic Acid, Cochineal, FCFV, Indigo, Potassium Nitrate, Quinoline Yellow, Red 2G, Sodium Benzoate, Sodium Nitrate, Sulfur Dioxide, Sunset Yellow, Tartrazine,
Try to avoid foods, such as the following, with high salicylate content, to see if their removal causes a difference in behavior:
Almonds, Honey, Peppermint Tea, Peanuts, Peppers, Plums (canned), Prunes (canned), Raspberries (fresh), Strawberries (fresh), Tomatoes – and many spices, including Cardamom, Cinnamon, Cloves, Curry, Oregano, Paprika, Pepper, Rosemary, Sage and Turmeric.
Organic Foods
Starting when they are infants, it is best to feed children organic whole foods in order to bypass the pesticides, herbicides, preservatives, colorings and other additives – often toxins – that impair concentration and increase hyperactivity in some children.
Not recommended
Increased Fish Consumption
Nearly all fish and shellfish contain traces of mercury, which it is believed can reduce childrens' ability to concentrate. The main types of fish to avoid include shark, swordfish, king mackerel and tilefish.
Drug
GHB (Gamma-Hydroxybutyrate)
GHB has been report to help decrease hyperactivity and learning disabilities in some children.
Laboratory Testing
Test for Gluten Sensitivity
In the general population, only 1% of people are sensitive to gluten. However, in children with ADHD the percentage is much higher. If the child is gluten-sensitive, removing gluten from the diet can produce dramatic and almost immediate results.
Test for Food Allergies
Allergies to one or more foods are often found in children with ADHD. Frequent offenders are milk, cane sugar, chocolate, American cheese, and wheat. [Annals Allergy Vol. 72, 1994, pp. 462-8]
Test Zinc Levels
Hyperactive children may be deficient in zinc, manganese and vitamin B6 and have an excess of lead and copper.
Mineral
Magnesium
Magnesium is often given as part of a treatment for hyperactivity in kids, usually along with vitamin B6.
Physical Medicine
Manipulation
Some chiropractors believe that ADD is commonly caused by an occiput that is jammed too far forward on the cranial base, caused as a common result of any sort of birth trauma, even when minor. As many as 60% of children with ADD are claimed to have this mechanical problem and a high percentage experience improvement with adjustment.
Supplements
DHA (docosahexaenoic acid)
ADHD is much more common in boys with low levels of DHA. Studies show that low DHA intake in infancy can lead or contribute to Attention Deficit Disorder (ADD) and Attention Deficit Hyperactivity Disorder (ADHD). A preliminary double-blind placebo-controlled trial found some evidence that a supplement containing fish oil and evening primrose oil might improve ADHD symptoms [Presented at 2nd Forum of European Neuroscience Societies; July 24-28, 2000; Brighton, United Kingdom].
In a double-blind placebo-controlled trial of children already using stimulant therapy, the addition of the essential fatty acid docosahexaenoic acid (DHA) for 4 months failed to further improve symptoms. [J Pediatr. 2001;139: pp.189-196.] It remains to be confirmed whether DHA will provide any benefit in those not using stimulant therapy.
For children with ADHD, the recommendation is supplementation with 400mg of DHA per day.
Vitamins
Multiple Vitamin Supplement
Although all children should benefit from multivitamin supplementation, it is especially important for children with ADHD.
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Last updated: Jul 20, 2023