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Children with ADHD: Different Approaches Compared

Mills River Family Chiropractic
Drs Tom and Laura Gross

The following pages are taken almost directly from an article which was published in the Journal of the American Chiropractic Association in July 2002 and authored by Natalia V. Schetchikova, PhD entitled “Children with ADD: Medical vs. Chiropractic Perspective and Theory.”This original published work is a 16 page fully referenced article.I will be summarizing key points and will provide a complete list of references upon request.

Treating a person or a diagnosis?

Drug abuse, rampant in our culture, is a seriously frightening topic for American parents.This of particular concern for the parents of an estimated 8 million children labeled with Attention Deficit Disorder (ADHD).Government officials, schoolteachers and medical doctors say that if the children do not take Ritalin now, they will “self-medicate: with illegal substances later in life.Many parents are worried because Ritalin itself is an addictive substance that produces pharmacological effects similar to those of cocaine and amphetamine, and their children may have to take it all their lives, gradually increasing the dosage.

Ritalin is the No. 1 physicians’ choice for ADHD treatment.The troubling fact is that in the past decade, doctors have seen a massive increase in Ritalin prescriptions, says Robert Melillo, DC, DABCN whose multidisciplinary clinic specializes in treatment of neurological disorders.“From 1990 to 2000, world-wide use of Ritalin increased five fold, and 90 percent of it is consumed in the U.S.When I learned this, my first reaction was that doctors are over-prescribing the drug, that this is the latest fad, and that pharmaceutical companies are pushing the medication.”

But when Dr. Melillo started interviewing schoolteachers, he learned the situation is more complicated: “Teachers told me that all children are now more impulsive, have shorter attention spans and more language problems, and demand quick gratification.”More objectively, a comparison of the standardized fourth –grade tests of the ‘60’s and ‘80’s showed the tests have become easier, which should predict better grades.But the opposite is true.

The preliminary diagnosis of ADHD is usually made when a child’s behavior or academic performance starts troubling teachers.The parents take the child to a general practitioner or a pediatrician who makes the final diagnosis and prescribes a stimulant medication, typically Ritalin.The problem with this scenario is that the people involved shouldn’t be making the diagnosis. “before placing a child on medications and pinning him or her with a diagnosis of ADHD, first get a second opinion from a healthcare professional that specializes in this disorder, such as a psychiatrist, psychologist, or doctor specializing in neurology and/or in ADHD specifically,” says Toni Ward, DC, DACBN, a former instructor of clinical nutrition at the Southern California University of Healthcare Sciences.

But even for a qualified specialist, ADHD is not always easy to diagnose.ADHD belongs to a spectrum of disorders with no known physiological basis, says Dr. Melillo.“The spectrum goes from attention deficit disorder (ADD) and ADHD through Learning disabilities, Obsessive – compulsive disorder (OCD), and Tourette’s syndrome, to pervasive developmental disorders and Autism.The neurological mechanisms involved in these disorders are very similar and many of these disorders happen together at the same time in the same individual.

Children can also be at the high end of the normal range of activity or have difficult temperaments. Poor vision or hearing, seizures, head trauma, acute or chronic medical illness, poor nutrition, insufficient sleep, anxiety disorders or realistic fears, depression, various drugs or the sequelae of abuse or neglect can also cause poor attention.

The similar symptomatology and co-occurrence of these conditions increases the possibility of misdiagnosis.ADHD is not a learning disability but it can affect the ability to progress in society and the ability to learn, says Frederick Carrick, DC, PhD, DABCN, president of the ACA Council on Neurology.Many children are misdiagnosed with ADHD “although they have learning disabilities, or receptive and expressive language problems, “says Joan Fallon, DC, FICCP, chair of the ICA Pediatrics Council.

Some children have difficulty learning specific subjects, but schools often push to diagnose the child with ADHD, says Scott Bautch, DC, DACBOH, immediate past president of the ACA Council on Occupational Health.“The higher the number of disabled kids in the school, the more funding the school gets.There have always been children who learn at different speeds, but the ADHD diagnosis has increased because teachers are not tolerant of children who learn things differently.But when children are labeled with ADHD, the stigma stays with them.”

Communication with the patient is the key to a correct diagnosis, explains Dr. Bautch.“Ask the child and the parent about the frustrations the child has.Too active? Bored? Problems at home?Dyslexia or a different learning pattern? Problems with the teacher’s style?If the child is a cognitive-visual and the teacher is not, the child may simply not be taught in the way he/she can learn.

Dr. Ted Carrick, D.C., Ph.D., DABCN summarizes true ADHD as characterized by behavioral problems in reacting to an average situation.“The diagnosis is based on the history of displaying three types of state of the art diagnostic and treatment facility especially devoted to helping these children overcome their special needs.