Attention Deficit or Hyperactivity Disorder (ADD/ADHD)

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Latest Edit: Iva Lloyd, ND 2017-11-04 (EDT)

Attention Deficit Disorder (ADD) and Attention Deficit Hyperactivity Disorder (ADHD) have gained significantly more attention in recent years, and it is estimated that up to 9% of American children may meet DSM-IV criteria for ADHD. ADHD is characterized by an inability to stop certain behaviours and to sustain attention. The characteristics of ADHD make it noticeable and often disruptive in school age children, although it is not uncommon for adults to be diagnosed with ADHD as well.[1]

Attention Deficit or Hyperactivity Disorder (ADD/ADHD)
Adhd.jpg

ADD/ADHD
Causes Dietary Factors, Food Additives, Insomnia, Stress
See Also Neurological Conditions
Books Books on Neurological Conditions
Articles Articles on Neurological Conditions
Check out this book The All in One Guide to ADD & Hyperactivity

Naturopathic Assessment

Causal Factors

In order to stimulate the innate ability of the body to heal the causes of disease must be identified and addressed. With ADD/ADHD the causes are variable and include lifestyle, genetic, social, and environmental factors. A detailed assessment is required to determine which factors are contributing to the development, progression, and expression of ADD/ADHD.

Lifestyle

Article Meditation, Attention and Neuroplasticity, implications for the integrative care of attention-deficit/ hyperactivity disorder , IHP ; 2011 October
Article Attention Deficit/Hyperactivity Disorder, Vital Link; 2005 Spring/Summer
  • Food allergies are associated with symptoms of ADD and ADHD.
  • Several nutrient deficiencies have been associated with ADHD and ADD including: essential fatty acids, magnesium, zinc, iron, B Vitamins.[2]
  • Sucrose intake may contribute to ADHD symptoms, and elimination of sucrose has been shown to have benefit in improving behaviour in patients.[2]
  • A 2010 analysis of past research on links between food dyes and health by the Center for Science in the Public Interest (CSPI) also found compelling evidence that ingestion of artificial dyes can contribute to hyperactivity, restlessness and attention problems in some children, particularly those with ADHD.[3]
  • An estimated 25-50% of children and adolescents with attention-deficit hyperactivity disorder (ADHD) experience problems with sleep.[4], [5]
  • In children with significant symptoms of ADHD, the rapid eye movement sleep in these children is disturbed and may contribute to the severity of their behavioral manifestations.[6]
  • Sleep disruption associated with periodic limb movement disorder and restless legs syndrome and the motor restlessness of restless legs syndrome while awake could contribute to the inattention and hyperactivity seen in a subgroup of ADHD-diagnosed children.[7]

Social

  • Neurodevelopment is greatly affected by violence, chronic stress, and disorganization in childhood. Neonatal and childhood stress negatively affects brain structure and may permanently impair attention span, memory, and spatial sense later in life.[8]

Environmental

Article Links between ADHD and environmental pollutants, Vital Link; 2008 Summer
  • Neurotoxic substances can increase the risk of ADD and ADHD. Exposure may occur in childhood, and even in-utero as many neurotoxins can be transported from mothers to fetuses. There is evidence that maternal tobacco use contributes to increased risk of ADD and ADHD.[2]
  • There remains some debate over the intricate role of environmental toxins in the etiology of ADD and ADHD. The National Children's Study involving 100,000 children from prebirth to 21 years old is underway to better understand the complex interaction between environment and health.[9]
  • Lead toxicity is associated with cognitive deficits and behavioural disturbances. Some studies have shown improvement in ADHD symptoms when children with elevated lead levels undergo chelation therapy.[9]
  • Neurotoxic metals including mercury, cadmium, and aluminum have been shown to adversely affect neurological function and are found in significant concentrations in North American environments.[2]
  • Spending time outside decreases the risk of ADD/ADHD and is beneficial as part of an integrated treatment.

Genetics

Article Avoiding ADHD Triggers, In Utero and After Delivery, NDNR, 2011 September
  • ADD and ADHD are polymorphic diseases involving several genes. Studies have demonstrated a hereditary component, with fifty percent of ADD/ADHD parents having an ADD/ADHD child.[9]
  • Epigenetics play a role in ADD and ADHD development. Methylation of regions of DNA may play a role in the expression of certain genes. External factors influencing methylation of DNA include diet, medications, chemicals, and hormones.[9]

External

  • Activities
  • There is growing concern that computer and video games are associated with an increased risk of ADD/ADHD.

Diagnostic Testing

ADHD and ADD are diagnosed by clinical investigation and observation. There are currently no helpful diagnostic labs or imaging. A child displaying the following symptoms would normally be referred to a qualified health care practitioner can confirm a diagnosis based on criteria outlined in the DSM-IV.[1]:

  • Hyperactivity
  • Acting out in School
  • Impulsiveness
  • Inattention
  • Concentration difficulty
  • Disruptive behavior

ADHD is diagnosed when the predominant symptoms include hyperactivity, while the term ADD is used when inattention is the predominant symptom.[1]

Related Symptoms and Conditions

Other conditions that are associated with an increased risk of ADD/ADHD include:

  • Mood Disorders
  • Learning Disabilities
  • Leaky Gut
  • Atopic Dermatitis[2], [9]
  • Low self esteem, poor peer relations and strained family relations are also common.

Characteristics

Article Details a 5-year-old boy with ADHD and behavioral problems. “Welcome to the Jungle” , 2010 September NDNR [1]

There are several underlying physiological processes associated with ADHD/ADD. Although it is not clear whether these processes are causal or just related, treatment approaches addressing these processes are often employed successfully in ADHD/ADD.

  • Immune System Impairment
  • Children with ADHD have been shown to have abnormal cellular and humoral immunity.
  • Gut mucosal immunity may be impaired in ADHD/ADD [2]
  • Gastrointestinal Function and Food Allergies/Intolerances
  • As mentioned above there is a correlation between impaired gut mucosal immunity and ADHD/ADD.
  • Intestinal Hyperpermeability has been shown to be present in a high percentage of children affected by ADD/ADHD. [2]
  • Several studies have demonstrated oligoantigenic diets to be beneficial in ADHD/ADD.
  • Inflammatory mediators may be increased after exposure to sensitizing foods, which suggests the mechanism of food allergy contribution to ADHD/ADD symptoms.[10]

Naturopathic Treatment

The goal of naturopathic treatment is to support and work in tandem with the healing power of the body and to address the causal factors of disease with individual treatment strategies. ADD/ADHD is typically a chronic disease and requires an integrated treatment plan.

It is always advisable to work with a naturopathic doctor before engaging in any treatment plan.

Home Care

Do to the nature of ADD/ADHD, parents of affected children need to make special effort in the area of behavioural management in the home. Recommendations include:[9]

  • Define expectations and create structure
  • Use modeling to teach
  • Utilize multisensory communication strategies (both visual and auditory)
  • Be consistent, and reward good behaviour
  • Remain emotionally neutral
  • Be patient

Lifestyle

Lifestyle recommendations include:

  • The connection between diet and behaviour has been well established. The following diets are often recommended for the treatment of ADD/ADHD:
  • Regular exercise can help improve mood and promote relaxation in individuals with ADD/ADHD. There is an association between ADD/ADHD and weakness in motor-coordination, and regular exercise can assist in correcting this deficit.[9], [11]
  • Good sleep hygiene improves attention and concentration tasks.[12]
  • Children can benefit from guided imagery as it allows them to use creativity to explore and address their thoughts and feelings.[9]
  • Self hypnosis can be used to decrease anxiety and develop coping strategies. [9]

Naturopathic Therapies

The prescribing of naturopathic therapies requires the guidance of a naturopathic doctor as it depends on a number of factors including the causal factors, a person's age, prescription medications, other conditions and symptoms and overall health. It is always advisable to work with a naturopathic doctor prior to taking any natural therapies.

Naturopathic Therapies for ADD/ADHD include:

Article The Vitamin Treatment of Hyperactivity: a Safe and Ethical Way in Which to Treat Our Children, J Orthomolecular Med 2012;Vol27(2)
Article Orthomolecular Treatment of Hyperactivity in Children and Youth: Review of the Literature and Practical Treatment Recommendations J Orthomolecular Med 2012;Vol26(3)
  • Massage Therapy. Studies have demonstrated benefit on hyperactivity with 15-minute daily massage of the neck, shoulders, and back in children with ADD/ADHD.[17]

References

Reviewed by Iva Lloyd, BScH, RPE, ND [2]

  1. 1.0 1.1 1.2 1.3 1.4 Prousky Jonathan. (2008) Principles and Practices of Naturopathic Clinical Nutrition CCNM Press.
  2. 2.0 2.1 2.2 2.3 2.4 2.5 2.6 2.7 Pizzorno Joseph E, Murray Michael T. (2006) Textbook of Natural Medicine 3rd ed, Elsevier 2006
  3. McCann D, Barrett A, Cooper A, Crumpler D, Dalen L, Grimshaw K, Kitchin E, Lok K, Porteous L, Prince E, Sonuga-Barke E, Warner JO, Stevenson J (2007) Food additives and hyperactive behaviour in 3-year-old and 8/9-year-old children in the community: a randomised, double-blinded, placebo-controlled trial. The Lancet;370(9598):1560 – 1567. doi:10.1016/S0140-6736(07)61306-3
  4. Weiss MD, Salpekar J (Oct 2010) Sleep problems in the child with attention-deficit hyperactivity disorder: defining aetiology and appropriate treatments. CNS Drugs.;24(10):811-28. PMID: 20839894.
  5. Silvestri R, Gagliano A, Aricò I, Calarese T, Cedro C, Bruni O, Condurso R, Germanò E, Gervasi G, Siracusano R, Vita G, Bramanti P (Dec 2009) Sleep disorders in children with Attention-Deficit/Hyperactivity Disorder (ADHD) recorded overnight by video-polysomnography. Sleep Med.;10(10):1132-8. PMID: 19527942.
  6. O'Brien LM, Holbrook CR, Mervis CB, Klaus CJ, Bruner JL, Raffield TJ, Rutherford J, Mehl RC, Wang M, Tuell A, Hume BC, Gozal D (Mar 2003) Sleep and neurobehavioral characteristics of 5- to 7-year-old children with parentally reported symptoms of attention-deficit/hyperactivity disorder. Pediatrics.;111(3):554-63. PMID: 12612236.
  7. Picchietti DL, England SJ, Walters AS, Willis K, Verrico T (Dec 1998) Periodic limb movement disorder and restless legs syndrome in children with attention-deficit hyperactivity disorder. J Child Neurol.;13(12):588-94. PMID: 9881529.
  8. Teicher MH et al. (2003) The neurobiological consequences of early stress and childhood maltreatment. Neurosci Biobehav Rev;27:33-44.
  9. 9.0 9.1 9.2 9.3 9.4 9.5 9.6 9.7 9.8 9.9 Rakel D. (2007) Integrative Medicine 2nd ed. Saunders
  10. Anderson J. (1995) Mechanisms in adverse reactions to food. The Brain. Allergy;50:78-81.
  11. Azrin NH, Ehle CT, Beaumont AL (Sept 2006) Physical exercise as a reinforcer to promote calmness of an ADHD child. Behav Modif.;30(5):564-70.
  12. Yoon SY, Jain U, Shapiro C (Oct 2011) Sleep in attention-deficit/hyperactivity disorder in children and adults: Past, present, and future. Sleep Med Rev. PMID: 22033171.
  13. Godfrey Anthony, Saunders Paul Richard, Barlow Kerry, Gilbert Cyndi, Gowan Matthew, Smith Fraser (2010) Principles and Practices of Naturopathic Botanical Medicine, Vol 1: Botanical Medicine Monographs, CCNM Press, Toronto
  14. Boon Heather, Smith Michael (2004) The Complete Natural Medicine Guide to the 50 Most Common Medicinal Herbs, Robert Rose, Toronto
  15. Hershoff Asa (2000) Homeopathic Remedies, A Quick and Easy Guide to Common Disorders and their Homeopathic Treatments, Avery Publishing Group, New York.
  16. Ullman Robert, Reichenberg-Ullman Judyth (1997) Homeopathic Self-Care, the quick and easy guide for the whole family Prima Publishing.
  17. Field T et al. (1998) Adolescents with attention deficit hyperactivity disorder benefit from massage therapy. Adolescence;33;103-108.