CHADD's biased "Fact Sheet"
CHADD has a "fact sheet" about alternative treatments at www.chadd.org/facts/add_facts06.htm. Alternatives are described in very negative and misleading ways, and some of the "facts" are completely false. The most promising, common sense alternatives are not even mentioned, while bizarre things I've never heard of, like using candida yeast or anti-motion sickness meds, are featured prominently. The "alternatives" picture they paint is one of sleazy con-artists tricking gullible idiots into buying worthless, unproven treatments. The message is: if you try any alternatives, you too are an idiot.
While I would agree there are some highly questionable products and services on the market, there are also quite a few common-sense alternatives available that cost little or nothing. My personal experience with alternatives has been quite positive. When my son was three years old and having problems at daycare, I tried an alternative form of discipline called "Abuse It - Lose It" -- the opposite from the charts and stickers that CHADD recommends -- and had incredibly dramatic results. Astounding results. At the time, my son was biting, hitting, yelling, running over the other children at naptime, and came home angry, fighting, and completely out of control. The very first day of using "Abuse It - Lose It" I had an entirely different child -- well behaved, affectionate and calmer -- and the results lasted for years.
There are no scientific studies I know of that prove "Abuse It - Lose It" works, yet it worked a miracle for me. CHADD makes a very big deal about scientific studies. Unless reams of studies "prove" an alternative works for the majority of the most extreme cases of ADD, CHADD assumes the alternative is a waste of time for everyone.
Quotes from their fact sheet are shown in red:
"There are still many questions to be answered concerning the developmental course, outcome and treatment of AD/HD. In an effort to seek effective help for AD/HD, however, many people turn to treatments which claim to be useful, but which have not been shown to be truly effective in accord with standards held by the scientific community."
We scientists do not mean for studies to replace common sense and rational thought!
The scientific process is excruciatingly slow, often biased, and most studies are poorly designed. Over the course of 50 or 100 years science brings us closer to the truth, but short term conclusions reached by science are often wrong. And a lack of studies should NEVER be used as proof that something does not work.
In 1959 Dr. Johanna Budwig, a seven-time Nobel prize nominee and world expert on fatty acids, described behavior problems in children deficient in essential fatty acids. Her work was dismissed by the medical community because people at that time did not believe that fats are necessary for good health. It was not until the mid-1990's that researchers at Purdue University bothered to test Dr. Budwigs claim, and they discovered that she was correct. The lower the fatty acid level, the worse the behavior. Yet for three decades Dr. Budwig's claims were scoffed at by the medical establishment as "unproven".
There are many reasons why an effective alternative may not have a lot of studies to support it:
"Questions to Ask Alternative Health Care Providers
"Abuse It - Lose It" met none of the above criteria, but it worked. CHADD assumes that all alternatives come from "Alternative Health Care Providers", but I have found that most alternatives do not. Many alternatives are really tips from books like "The Edison Trait" and "The Myth of ADD." Or they come from other parents. I learned about homeschooling by talking with homeschooling parents on the Internet. And I was in a bookstore when a parent approached me and told me I simply MUST try an elimination diet and keep a food diary -- it worked wonders for her child. "Abuse It - Lose It" was something I found on the Internet for free, written by David Keirsey, a clinical psychologist who worked in California public schools for 20 years as a corrective interventionist. I read the concept and the rationale for it, and it made a lot of sense to me. So I tried it. I don't need some authoritative body giving me permission to try things that I find interesting.
Studies are interesting - but usually flawed. Always keep that in mind. People looking into alternatives do need to be skeptical, but also open-minded. Does an alternative make sense? Does it cost anything? Are there any risks involved? Who is telling you to try it - a person who was helped by the alternative, or someone trying to sell you something? Just use common sense and watch your wallet.
I've read websites and books about the Feingold diet and have never run across anyone who claimed that the diet would benefit all or most people diagnosed with ADD. What proponents of the diet recommend is that all people diagnosed with ADD TRY the elimination diet for a few weeks to see if anything happens. If the diet is strictly followed and there is no improvement, then the diet will not help. There is really nothing to lose -- just a few weeks of inconvenience. There are no dangers involved and no one making money.
"In the past 15 years, dozens of well-controlled studies published in peer-reviewed journals have consistently failed to find support for the Feingold Diet."
On the contrary, The Center for Science in the Public Interest recently reviewed 25 years of data pertaining to diet and ADHD, and found that the best studies DID find a correlation between ADHD and diet. Their report, including a discussion of the studies they reviewed, is available online at www.cspinet.org/diet.html. They further noted, contrary to CHADD's statement, that all the studies were flawed and were often paid for by the food industry, who have a vested interest in disproving the Feingold diet.
"While a few studies have reported some limited success with this approach, at best this suggests that there may be a very small group of children who are responsive to additive-free diets."
Even if the numbers are as low as 1 in 100, that number is significant. For every million kids diagnosed with ADHD, that would be 10,000 children who are reacting needlessly to their diet. If one of those children was yours, I think you would feel the diet was a miracle, and would be angry that CHADD was so dismissive of it.
"At this time, it has not been shown that dietary intervention offers significant help to children with learning and attention problems."
Completely false. It has been extremely significant to some people. The Feingold Association is non-profit organization operated nation-wide by volunteers who had dramatic results with the diet and are motivated to help other people. They are not paid for their work. I have spoken with some of these parents and they speak of their children as "Dr. Jekyll and Mr. Hyde"; children whose behavior deteriorates dramatically after exposure to a specific substance. If the diet never works, then why are there so many parents out there willing to spends hour upon hours volunteering for the organization? And why are there so many people who swear it helped them? Even saved their lives?
Notice that under the heading of "Dietary Intervention" CHADD addresses only the Feingold Diet. There are other forms of dietary intervention. For example, food allergies. It is well known that common food allergies, such as those to milk, wheat or chocolate, can cause behavior problems in children. Children who don't feel well don't behave very well and they have trouble concentrating and paying attention. Again, a parent simply puts a child on an elimination diet to see if there are any changes. It is tedious, but it doesn't cost anything and it is risk-free.
Another form of dietary intervention is to reduce carbohydrate loading, especially in the morning. Some preliminary studies have shown that ADHD children metabolize carbohydrates differently, and are effectively suffering from reactive hypoglycemia. There is a blood sugar spike, followed by a crash. Their brains do not get enough blood sugar, which is consistent with studies showing reduce glucose metabolism in the brains of people diagnosed with ADHD. The treatment for this is to provide meals with a higher protein and fat content, especially in the morning before school. I have heard from several people who said this helped significantly -- one to the point where the child's teacher had assumed the child had been put on medication.
I generally agree with this assessment. I would, however, draw your attention to the the line "these studies are seriously flawed by the use of small numbers of children with ambiguous diagnoses." It is interesting that CHADD is careful to point this out when studies show (surprisingly?) positive results for alternative treatments, yet they ignore the very same flaws when studies show negative results, and actually call them "good studies." This is very typical of CHADD' subjective and biased approach towards alternative treatments.
I would also point out something very significant with regard to ADD studies in general. Note that children with "ambiguous diagnoses" were said to be used in the study, and that is considered a flaw. Most studies in fact do not use "typical" ADHD children. Instead, they use the most severe cases: children who are highly dysfunctional and NOT representative of the AVERAGE child officially diagnosed with ADHD in the real world. They then take their findings and extrapolate those to all children diagnosed with ADHD, including gifted and creative children. Parents who have a child diagnosed with ADHD want to know what might help that child, even if the diagnosis might be considered "ambiguous" by researchers. If the results of a study are going to be used to describe all children diagnosed with ADHD, then studies should be designed using average ADHD children, not only the most severe cases (which are less likely to respond to alternative treatments).
Optometric Vision Training
While I am also somewhat skeptical, I don't think CHADD has any business telling people not to try it, since there are no risks or side effects. The statement they cite is from 1972, which is suspicious. A great deal of progress has been made in this field, and there may be some different opinions about it today. Again, it seems like CHADD simply dismissed an alternative without really giving it much thought.
What about other alternatives?
Many "alternatives" are simply common sense strategies that parents can try out. An alternative is anything other than the standard approach (automatic medication and possibly "behavior modification" involving elaborate charts, stickers, a rigid structure, and that sort of thing). An alternative may be tried with or without medications. Some of the alternatives seem ridiculously obvious, like getting enough sleep, yet there are problem children out there who are struggling, and getting labeled ADD, simply because they aren't getting enough of sleep. Here are some alternatives not addressed by CHADD:
Surprisingly, CHADD does not really caution readers about potential risks of some alternatives. Notably, the use of many herbal products is of concern, especially when children take them. Some of the less common products, available from homeopaths and naturopaths, have not been studied for toxicity. I know of one case where a child was given "arsenica album" -- arsenic -- for behavior problems, even though arsenic is known to be a very strong carcinogen at any level. Spider venom was also given. Now this is an alternative I would avoid!
Megavitamins and Mineral
I have never even heard of anyone promoting very high doses of vitamins and minerals, and I have been researching alternatives for several years. Vitamins and minerals are often promoted, but not at "very high levels". In fact, I have always seen cautionary notes not to take more than a specific amount.
Although vitamins are virtually synonymous with health, there is a complete lack of supporting scientific evidence for this treatment. There are no well-controlled studies supporting these claims, and of those studies in which proper controls were applied, none reported positive results. Both the American Psychiatric Association and the American Academy of Pediatrics have concluded that the use of megavitamins to treat behavioral and learning problems is not justified.
There are quite a few good studies that have linked nutritional deficiencies to ADHD, behavior problems, depression and anxiety. "Megavitamins" are not needed to correct deficiencies, only small to moderate amounts large enough to correct deficiencies.
For example, a Purdue University study, among others, linked low fatty acid levels to ADHD and behavior problems. They found that the lower the levels of fatty acids, the worse the behavior. Fatty acids used to be included naturally in our diet, but studies now find that 60% of the U.S. population is deficient, and 20% have NO detectable fatty acids in their blood. Since fatty acids are the building blocks of neurological tissue, this is quite significant. This does not necessarily mean that fatty acid supplements will cure ADHD, because it is possible that irreversible damage was caused by a chronic deficiency, in the same way that taking calcium supplements does not reverse osteoporosis. Even so, it make sense to take fatty acid supplements, or eat fatty fish, because we all need essential fatty acids. That's why they call them "essential." In Japan, parents have been giving fatty acids to their children for years because it is well know that fatty acid deficiencies lower your IQ. Back in the old days, parents gave children Cod Liver Oil, loaded with fatty acids (and contaminants - don't use cod liver oil!).
Following are some scientific studies related to diet and ADHD. This is a partial list only:
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