Don’t Our Kids Deserve the Benefit of the Doubt?

by Christine Fusiillo, M.D.
posted on February 09th 2010
Don’t Our Kids Deserve the Benefit of the Doubt?

Attention Deficit Hyperactivity Disorder (ADHD) is the most prevalent problem presented in outpatient pediatric mental health settings. It is estimated that it affects between 4 and 12% of school−aged children, boys more than girls. Studies suggest that the rate of ADHD has risen significantly in recent years. But whether more people have the disorder or whether the diagnosis is being applied more frequently is unclear. 

ADHD is a problem related to brain development that causes attention problems (trouble paying attention), with or without hyperactivity (not able to sit still). It can cause significant emotional, social, and educational problems. While some children appear to “grow out” of their ADHD by adolescence, others have lifelong symptoms. 

Despite years of research, the exact cause of ADHD is still unclear. However, we do know that there are many factors that can contribute to the development of ADHD. They include: genetic factors, premature birth, exposure to tobacco, alcohol, or other drugs during pregnancy, lead poisoning and food additives. While there has been some indication that increased sugar consumption contributes to this problem, this has not been borne out in studies. 

Treatment for ADHD includes the use of behavioral therapy and medication. In recent years, there has been a staggering increase in the number of drugs prescribed for ADHD patients. According to the congressional testimony of Terrance Woodworth, a Deputy Director of the Drug Enforcement Administration, the number of prescriptions written for methylphenidate (Ritalin) has increased by a factor of five since 1991. He further stated that about 80% of the 11 million prescriptions written treat childhood ADHD. The production of Adderall and Dexedrine, also used to treat ADHD, has risen 2,000% in nine years! Woodworth also noted that the increased use of stimulant medicines in the U.S. is inconsistent with other countries around the world. Here in the U.S. we produce and consume 85% of the world’s methylphenidate!! 

The significant increase in stimulant medications prescribed to children has raised concerns that our society is choosing “quick fixes” to treat ADHD. “How we deal with our kids’ problems reflects our thinking and a much larger problem in our culture,” said Lawrence H. Diller who is the author of the book, Running on Ritalin: A Physician Reflects on Children, Society and Performance in a Pill. 

Are we exploring other possible explanations for hyperactivity/behavioral issues in children or are we looking for the “quick fix?” Let’s look at some other possible causes for inattentiveness. 

  1. Foods that we serve our children can influence their behavior. Stimulants such as caffeine, too much chocolate, and additives can result in hyperactivity. 
  2. A chronic lack of sleep can also lead to serious problems in both children and adults. It can lead to hyperactivity, affect a student’s ability to concentrate in school, and even stunt a child’s growth since growth hormones are released while you sleep. 

A recent study conducted at Brown University found that 37% of children in kindergarten through fourth grade suffer from sleep−related problems. The study found that 10% of children have a snoring problem which rouses them from their sleep and that some of them have trouble falling back to sleep. Causes of snoring in children include allergies and enlarged tonsils/adenoids. 

Another study done at Long Island College Hospital explored the connection between environmental allergies and ADHD. The study involved 20 children between the ages of 5 and 18, all of whom had been diagnosed with ADHD. Amazingly only two (2) of these children had been evaluated for allergy problems, even though all of them had a family history of allergies! The researchers screened the children for nasal allergies and skin tested them for several different allergens, including dogs, cats, dust mite, mold, and pollen. The results were very significant: 69% of the children had a positive allergy skin test; 40% were diagnosed with either asthma or eczema; and 23% had nasal allergies. 

Gastro−esophageal reflux (heartburn) can also be disrupting your child’s sleep. However, unless your child is vomiting in their sleep, they may not realize what is causing the disturbance. Some of these children can see positive results by making changes to their diet. Since some forms of food allergy can cause reflux, it is important to have your child evaluated for possible food allergies. 

Therefore, before you accept a diagnosis of ADHD and put your child on medication, I would recommend that his/her diet be considered. Make sure their daily diet does not include stimulants like caffeine. Also eliminate chocolate and all food additives, have their lead levels checked, and have them tested for possible allergies. Since gastro−esophageal reflux can also disturb sleep and affect behavior, have this ruled out as well. 

Make sure your child is getting a good night’s sleep and, if they aren’t, investigate all possible reasons. Instead of accepting hyperactivity as the reason for sleep disturbances, explore all possibilities. If your child can establish a normal sleep cycle, you may see an improvement in his/her behavior which may allow him/her to reduce or eliminate the need for medication. This may not be a “quick fix,” but, in my opinion, it is the right approach. Don’t our children deserve the benefit of the doubt?

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