Indigo Children / Adults
|An Epidemic of ADD or a Matter of Overdiagnosis? Does ADD Really Exist?||31/10/2006|
|Thomas Armstrong, Ph.D., in his controversial book The Myth of the ADD Child, insists that ADD is a diagnosis aimed at forcing children to behave in a particular, narrowly defined manners.2 He claims that children have different learning styles, respond to stress in various ways, and that the condition has been radically overdiagnosed and overtreated. He encourages a wide variety of nondrug interventions including adjustment of the classroom setup, more kinesthetic learning, project-based learning, martial arts classes, visualization, and meditation.
A similar viewpoint is held by Peter Breggin, M.D., author of Toxic Psychiatry and The War Against Children. Dr. Breggin, a psychiatrist who refuses to prescribe Ritalin for his patients diagnosed with ADD, holds a strong belief that there is no evidence that symptoms associated with ADD constitute a diagnosis or a mental disorder. He voices strong concerns about the possibly damaging long-term effects of Ritalin.3
Still a third health professional, child psychiatrist Dr. Stanley Greenspan, writes in his book The Challenging Child that a number of attention problems are due to visual, auditory, motor, and special processing difficulties. Children with all of these individual difficulties, according to Dr. Greenspan, are often misdiagnosed with ADD.4
As homeopathic physicians, we do not believe that it is helpful to lump so many people with widely differing symptoms into one syndrome and treat them all with similar drugs. Having seen several hundred children with mild to major behavioral, learning, and attitude problems, we believe that these children need to be handled as individuals with unique problems rather than treated stereotypically. We also favor a treatment approach, homeopathy, that lasts for months or years, not just a few hours.
What About Neurotransmitters?
Most physicians and mental health professionals attribute ADD to an imbalance in transmitters within the brain, often serotonin. Many studies have attempted to correlate ADD with specific neurotransmitter abnormalities. A group of researchers from the University of Georgia reviewed these neuroanatomical, neurochemical, and neurophysiological theories and studies.5 They concluded that although there is evidence of neurological differences in children diagnosed with ADD, no definitive mechanism has been found for these differences. The authors recommended a differential diagnosis of ADD, learning disability, and conduct disorder. They suggest that it may be more accurate to view the syndrome as a cluster of various behavioral deficits, including attention, hyperactivity, and impulsivity, which share a common response to psychostimulants. In other words, a neurotransmitter imbalance is an impressive way to explain ADD, but remains questionable.
An Overstimulated Society
One correlation which is clear to us is the increasingly rapid pace of our highly technological society and a growing number of children diagnosed with ADD. We live in an extremely overstimulated society. Children spend hours playing Nintendo rather than romping through the woods or playing outside. Many are glued to the television set. Movies are speedier, scarier, and more violent than ever before. There is a growing atmosphere of hurriedness, intensity, and urgency. Many children and teenagers do not leave home without their beepers for fear of missing something for even a moment. We eat fast, play fast, and channel-surf. We eat in fast-food restaurants known to decorate their premises in jangly colors so that their customers will eat quickly and move on to make space for the next shift. People look for caffeine and drugs of all kinds to make them go faster and stay up longer. They buy double espressos to pick them up more quickly. They use highly caffeinated amphetamine-like herbs, including ma huang and guarana, that contain seven times as much caffeine as coffee. Our society places little value on tranquillity, quiet, solitude, and the simple joy of being in nature.
Biofeedback is one method to induce deep relaxation by altering brain waves through selective reinforcement. Some have found biofeedback to be helpful for ADD, but the need for frequent treatments may put it economically out of reach for many children and adults.
Is ADD a Dietary Problem?
Parents often tell us that their child's behavior is considerably worse the morning after Halloween or after any sugar binge. Their perceptions have recently been supported by researchers at the Yale University School of Medicine. They found that within a few hours after substantial sugar intake, children release large amounts of adrenaline, which causes them to experience shakiness, anxiety, excitement, and concentration problems. Their brain waves also indicated a decreased ability to focus.6
As naturopathic physicians with considerable training in nutrition, we are appalled that the per capita intake of sugar is over 130 pounds per year in this country and that children are the worst fast-food junkies. Many of the parents of our ADD child patients are very nutritionally aware and have had their children tested for food and environmental allergens. Those children we have seen, despite eliminating cow's milk, wheat, and other foods from their diets, have not experienced a consistent and significant improvement in behavior or learning. Some parents have tried the Feingold dietary approach, which eliminates foods with natural salicylates, artificial colors,
flavorings, additives, and preservatives. Yet a review of the literature indicated that the Feingold diet has helped only a small percentage of children with ADD.7 In those cases where allergies and sensitivities to additives are a major problem, it is helpful to remove or restrict them. A healthy diet which emphasizes whole, natural foods is likely to benefit the health of any child or adult with ADD and is a useful part of the total treatment plan.
Yet both in examining the scientific literature concerning diet and ADD and in interviewing parents of children with ADD, we have found correlations between ADD and sugar consumption, ingestion of food additives and colorings, and food allergies, and hypoglycemic and anti-yeast diets, to affect some children and not others. We have not found that changing a child's diet has nearly as consistent, profound, and lasting impact on behavioral and learning problems as homeopathic treatment. Dietary approaches undoubtedly do work for some children, but not for many others. We admit that children who have enjoyed a great improvement in behavior strictly from dietary change are not likely to turn up in the office of a homeopath unless their dietary measures stop working and the parents seek out an alternative other than dietary intervention.
Is the Diagnosis of ADD Just A Way to Control the Classroom?
How true are criticisms like those of Drs. Armstrong and Breggin that the overdiagnosis of ADD is a means for teachers and parents to stultify children's freedom and individuality? It is true that some teachers are excessively rigid and wish to run their classrooms like a military academy.
These are the same teachers who bring the parents of any unruly child in for a conference and put pressure on them to put their children on stimulant medications. It is also true that many classrooms have more children than the teacher can possibly handle, and that some of these children are frighteningly violent and exhibit an antipathy to learning. However, other teachers sincerely wish to create more relaxed learning environments in which imagination and creativity are fostered. They, too, often find a growing number of restless, disruptive children who find it next to impossible to concentrate.
Try telling the parent of a child with full-blown ADD, who has tried every possible learning style including home schooling, that the diagnosis is all in the mind of the child's teacher and that her child just needs a less structured learning environment. That parent may look at you in disbelief, insist that her child live with you for a week, and then see what you think.
Gifted or Hyperactive?
One group of children that may be included in the diagnostic category of ADD but which has very specific needs is precocious children with ADD-like symptoms. If you had an IQ of 150 and a photographic mind, how would you feel about being in a regular fourth-grade classroom? You would probably be bored to tears unless your teacher created special activities and outlets for your unusual intellectual capabilities. You might tap your pencil on your desk, design paper skyscrapers, or invent a magical world of dinosaurs. Then when the teacher called on you . and Hobbes.. . cops! Sounds a lot like Calvin
James Webb and Diane Latimer address this dilemma: "In the classroom, a gifted child's perceived inability to stay on task might be related to boredom, curriculum, mismatched learning style, or other environmental factors. Gifted children may spend from onefourth to one-half of their regular classroom time waiting for others to catch up-even more if they are in a heterogeneously grouped class."8 They point out that because a gifted child may demonstrate ADD-like behaviors in some settings and not others, one classroom teacher may diagnose her with ADD while the other teachers do not. The authors recommend individual evaluation followed by appropriate curricular and instructional changes to account for advanced knowledge, diverse learning styles, and various types of intelligence. Such individual evaluation is exactly what homeopathy has to offer.
Like Parent, Like Child
We have seen many children who are the spitting image of their parents. They may share one or both parents' behavioral and learning styles. We often hear that the mother or father also had difficulty with reading or concentration, but was never diagnosed as having ADD and somehow made it through school. We have seen little boys with the same explosive tempers and total lack of patience as their type A fathers. We have also seen many a child whose restlessness and inability to concentrate ran through all of the siblings in the family. You will see
this phenomenon reflected in some of our case histories later in the book.
Many experts have documented a hereditary aspect to ADD. We saw one child whose chief problem was absentmindedness in spite of intellectual brilliance. All he wanted to do was to read about atoms and quarks and to contemplate the boundlessness of the universe. His father was the same way: brilliant, but he could barely remember to change his socks. His father's father was a renowned educator who had had a number of car accidents because he couldn't be bothered to keep his car on the road. They were like carbon copies of each other.
Yet we see other children whose tantrums, violence, and excessive restlessness seem to come out of nowhere. They may have very mellow parents who have limited their children's exposure to guns, sugar, and violent movies and who have raised them in a very loving, safe environment-and they still behave like wildcats.
A Matter of Predisposition
Even if they have two parents with ADD and eat sugar all day, some children will develop ADD and others will not. What can account for this disparity? Homeopaths believe that the reason some children and adults suffer from ADD and others do not lies in susceptibility. If you ask the parent of a child with ADD when he first noticed problem behaviors or tendencies in his child, he will likely say from infancy or toddlerhood. Such a child may have been hyperalert and have tendencies to wake frequently during the night, to be fussy and hard to satisfy, to run as soon as he could walk, and to climb all over the furniture as soon as he was mobile. This predisposition
to ADD-like behavior often occurs at a very tender age. Homeopaths frequently observe that this predisposition or susceptibility depends on the constitution of the individual from birth and may even be affected by the state of the parents prior to conception and during pregnancy.
How is this susceptibility passed on? Genetically? Homeopaths recognize these common traits among parents and children and hypothesize that there is some mechanism which we do not yet understand for these impressions or threads to be passed on generationally.Researchers at the University of California, Irvine recently reported finding the first abnormal gene associated with ADD. The gene controls dopamine receptors in the brain. Children with a more severe form of ADD have an abnormality of this gene, causing less sensitivity to dopamine, a neurotransmitter. Ritalin is known to stimulate dopamine release, perhaps accounting for the drug's efficacy.9
Most important to the homeopath are the unique tendencies or predispositions of the individual child or adult, regardless of what specifically may trigger the susceptibility. The phenomenon of susceptibility varies from individual to individual and cannot be stereotyped. But the individual can be carefully listened to and deeply understood. And from this understanding, a homeopathic medicine can be matched to the individual which will shift that susceptibility and bring the person into balance.
No Single Cause of ADD
Our conclusion, which is not particularly surprising given that we are homeopaths, is that each child or adult with ADD is individual. The cause of his ADD is no more stereotypical than his symptoms. Other than saying that anyone with ADD must have a predisposition to it, be it hereditary or environmental, we believe it is fruitless to ascribe all of the individual ADDs to one causative factor. Even if researchers conclude that every person with ADD has a deficiency or excess of one specific neurotransmitter, it is still an observation and not the underlying cause of the problem.
Judyth Reichenberg-Ullman N.D., M.S.W., DHANP
2. Thomas Armstrong, Ph.D., The Myth of the ADD Child (New York: Dutton, 1995).
3.The Merrow Report, op.cit.
4. Stanley, Greenspan, Ph.D., The Challenging Child (Reading, MA: Addison-Wesley, 1995).
5. C.A. Ricco et al., "Neurological Basis of Attention Deficit Hyperactivity Disorder," Exceptional Children, 60 (1993): 118-124.
6. Journal of Pediatrics, February, 1996 cited in Well BeingJournal, May/June 1996.
7. E.H. Wonder, "The Food Additive-Free Diet in the Treatment of Behavior Disorders: A Review," Developmental and Behavioral Pediatrics 7 (1986):35-42.
8. James T. Webb and Diane Latimer, "ADHD and Children Who are Gifted," ERIC Digest, #E522, 1993.
9. Study Links Gene Abnormality to Hyperactive Children," Seattle Times, May 1,1996.