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Alternative treatment for children with ADHD and autism

Posted Aug 06 2011 11:08pm


I firmly believe that if there were a product or treatment with a profound beneficial effect on autism, ADHD, SPD, etc., the world would know about it. That said I do believe that many treatment options may be helpful and perhaps a combination of therapies may produce a good result.

I am going to discuss a number of alternative treatments, and offer information based on clinical opinion. You can decide if something might be right for your child once you have read about the product or treatment protocol.

Natural herbs and supplements.

Alternative treatments are gaining in appeal because they do not generally require medication. Pharmaceuticals such as stimulants, anti-depressants and anti-anxiety can have problematic side effects. It is understandable that parents and caregivers are cautious and want to avoid, if possible, giving their child something which may pose a health risk.

Parents may think that herbs and other natural supplements are safer than traditional medication because they equate natural with being safe. Many of these herbs and supplements are not regulated and have not been scientifically researched. Some of them contain substances which are toxic and can cause harm if overused or used in combination with other products. For example, there is a product called Brightspark which is supposed to help with hyperactivity and other behaviors. The ingredients include hyosycamus, arsen iod and tuberculinum bovinum. Hyosycamus is better known as henbane, which is poisonous. Arsen iod is a derivative of arsenicum. If that sounds like it is derived from arsenic, it is. And the other ingredient I mentioned is tuberculinum which also can be toxic if taken too much.

Natural remedies often are made up of plants and herbs which are poisonous if ingested in large quantities, but beneficial if taken in small doses. The problem is that because these products aren’t regulated, consumers don’t know about potential dangerous side effects. Research is limited and sometimes biased. There is little clinical information about the dangers or benefits of combining ingredients. It is up to the consumer to do their homework.

Some natural remedies may be beneficial. I recommend investigating the product and checking out the ingredients first to ensure they are safe. If these remedies are well supervised and carefully monitored, they are probably fine to try. WebMD states that Zinc and fish oil are the most promising supplements found to date. Melatonin is also recommended as a sleep aid for ADHD children.

Cranial Sacral Therapy

I may take a lot of heat from some occupational therapists and other clinicians on this one, but my advice is “don’t waste your money on this”. I am actually friends with a therapist who is trained in craniosacral therapy, and she would say otherwise. Let me explain how the treatment is performed, and the theory behind it, and then you can decide.

A craniosacral website offers the following descriptionThe intention of treatment is to facilitate the expression of the Breath of Life and so enhance the body's own self-healing and self-regulating capabilities. This is done in a non-invasive way as the practitioner subtly and gently encourages the conditions that allow for the reemergence of primary respiratory motion. Furthermore, the practitioner's deep and clear quality of presence can become a reflective mirror for the patient and an invaluable cue for their potential for change.
The practitioner gently applies pressure to the sutures and skull (pressure is equal to the weight of a nickel) in an effort to alter the flow of cerebral spinal fluid to the brain and influence the central nervous system.
There is absolutely no research to substantiate any part of this theory. I think it is absurd to believe that a gentle external pressure can alter anything internally. The bones of the skull are strong and the sutures are fused from a young age for our protection – thank goodness.

An article which was written by Dr. Steven Barrett ( Quackwatch.org ) articulates my concerns. Here is an excerpt from the article condemning craniosacral therapy
Some of Upledger's beliefs are among the strangest I have ever encountered. Chapter 2 of his book, CranoSacral Therapy: Touchstone of Natural Healing, describes how he discovered and communicates with what he calls the patient's "Inner Physician"
By connecting deeply with a patient while doing CranioSacral Therapy, it was possible in most cases to solicit contact with the patient's Inner Physician. It also became clear that the Inner Physician could take any for m the patient could imagine —an image, a voice or a feeling. Usually once the image of the Inner Physician appeared, it was ready to dialog with me and answer questions about the underlying causes of the patient's health problems and what can be done to resolve them. It also became clear that when the conversation with the Inner Physician was authentic, the craniosacral system went into a holding pattern [7].
The chapter goes on to describe Upledger's care of a four-month-old French baby who was "as floppy as a rag doll." Although the baby had never been exposed to English, Upledger decided to see whether the baby's "Inner Physician" would communicate with him via the craniosacral systemI requested aloud in English that the craniosacral rhythm stop if the answer to a question was "yes" and not stop if the answer was "no." The rhythm stopped for about ten seconds. I took this as an indication that I was being understood. I then asked if it was possible during this session for the rhythm to stop only in response to my question and not for other reasons, such as body position, etc., the rhythm stopped again. I was feeling more confident. I proceeded.

Using "yes-no answers," Upledger says, he pinpointed the problem as "a toxin that was inhaled by the mother . . . over a period of about two-and-a-half hours while cleaning the grease off an antique automobile engine" during the fourth month of pregnancy. After "asking many particulars" about what he should do, Upledger was told to "pump the parietal bones that form a large part of the roof of the skull, and to pass a lot of my energy through the brain from the back of the skull to the front." As he did this, Upledger frequently checked with the baby's "Inner Physician." After about an hour, Upledger says, the baby began to move normally.

Although I am sure that craniosacral therapy does no harm, I also think it does no good.


Diet as therapy

Diet plays an important role in health. There is universal agreement that a healthy diet is beneficial for anyone and everyone. Simply put, the body’s engine operates via metabolism , which is comprised of catabolism and anabolism. These are the processes which utilize food and break down molecules and then build up. Food is the fuel which is used by these processes. Nutrients such as protein, carbohydrate and fats are essential to the proper functioning of metabolism. A balanced diet – one with the optimal amounts of each of these nutrients – makes the body run efficiently and contributes to good health.

Sometimes there are disorders which don’t allow the body to utilize food normally. Diabetes and celiac disease are examples of disorders which require modified diets. However, the need for dietary change is because the body lacks normal capability. In type 1 diabetes, your immune system — which normally fights harmful bacteria or viruses — attacks and destroys your insulin-producing cells in the pancreas. This leaves you with little or no insulin. Instead of being transported into your cells, sugar builds up in your bloodstream. Celiac disease is a digestive condition which triggers an auto-immune response in the lower intestine when gluten is consumed. Certain nutrients can’t get absorbed and the lining of the small intestine can be damaged. Glucose is the culprit in diabetes, and gluten is the trigger in celiac disease.

As far as I could determine, there is insufficient research on the effect of diet on “invisible disorders” such as ADHD. There is, however, a growing trend which indicates gastro-intestinal issues exist in children with autism, and that resolution of these problems may help with some behaviors. A new study conducted by Autism Speaks' Autism Treatment Network (ATN) shows that GI symptoms occur in nearly half of children with ASD, and the prevalence increases as children get older. As anyone with an upset stomach knows, discomfort and pain can interfere with functioning. Sleep can be disturbed, attention is compromised and ability to perform is affected. Getting rid of an upset stomach makes anyone feel better.

There is quite a bit of focus on the effect of food additives, chemicals and preservatives on children. Food dye is also a concern. Although I heard directly from a researcher that blue dye was the only dye identified as problematic, it is common sense to avoid all additives and dyes if suspect. An organic, well balanced diet has to be healthier than a diet of processed foods.

The Feingold Diet is a diet which eliminates all the aforementioned additives, and also restricts consumption of certain food groups. It claims that it helps reduce hyperactivity and improve many other behavioral issues. Foods are eliminated one at a time in order to pinpoint the offending food. Followers of the program claim that they do see improvement with their child.

I attended a panel lecture a few months ago and the panelists (ADHD experts) stated that double-blind studies have never been done and that no good scientific evidence supports the claims made by Feingold. One panelist suggested, and others agreed, that the family dynamic improves when so much focus and time is spent attending to the Feingold diet regimen. Behavior in the ADHD child improves as a consequence of the improved interpersonal relationship and not because of the diet.

Dr. Steven Barrett made the following observation. Although the Feingold Diet seems to do no harm to children, there are some potential risks to consider• Teaching children that their behavior and school performance are related to what they eat rather than what they feel
• Undermining their self esteem by implanting notions that they are unhealthy and fragile
• Creating situations in which their eating behavior or fear of chemicals are regarded as peculiar by other children
• Depriving them of the opportunity to receive appropriate professional help (medication, psychotherapy, or both).

Gluten Free, Casein Free diets are gaining in popularity. Many parents whose child is autistic believe that this diet is helpful. It eliminates gluten and milk products based on the body’s perceived “ sensitivity” or “intolerance ” to the proteins. Benefits and health effects are mostly anecdotal at this point. There is no substantiated research to support the use of this diet as an autism treatment. There is concern that a casein free diet may lead to Vitamin D and calcium deficiencies which can result in less bone density.

The need for an appropriate diet is vital for a growing child. What is good for one, may not work for another. But I think that whichever diet is implemented, safe nutrition has to be part of the diet.

Neurofeedback

The following was written by Natalie Baker, LMHC of NeurofeedbackNY .

How does neurofeedback work? There are a number of different neurofeedback technologies used to help with the cluster of behaviors we have come to call ADHD. NeurOptimal neurofeedback works by training the brain to use the present moment to decide what to do next, rather than old, often maladaptive patterns. It does this by triggering what’s called the orienting response, which is the brain’s ability to sense change in the environment and take in new information about what is different.

More specifically, during a neurofeedback session, EEG sensors are placed on the head and ears to collect the information about the brain’s activity, which gets fed into the technician’s computer. You sit and listen to music (often children watch a movie or listen to their favorite music). When your brain is about to do something new, i.e. change states, it does a certain kind of “electrical dance”, which the software identifies. When that “dance” is detected the computer program stops the music in milliseconds. What the stopping of the music does, is trigger the orienting response and the brain “comes into the present” and sees what it was about to do and also takes in information about the external environment. And all of this it does in milliseconds and outside of your conscious awareness.
How does triggering the brain’s orienting response lead to alleviating symptoms? When the brain orients it sees what it was about to do habitually and whether it is an efficient and effective response to the here-and-now. Some of our habits are efficient and effective--the brain won’t shift that functioning-- but some of our habits, such as those that are labeled ADHD, aren’t. The brain sees what it is doing that is not effective or efficient, and because of its design—to function optimally—the brain starts to shift its behavior. It also learns that the best way to function is by relying on the present moment to gather information, rather than using old, out-of-date information.


I think that neurofeedback has potential to be an effective therapy for ADHD. It re-trains conditioned responses over time so that better responses can be integrated. It is important to get a well trained therapist to administer the neurofeedback. Time and expense are factors to consider as well.

This article ran much longer than I expected, so I wasn’t able to explore other treatments such as Integrated Listening Systems , Interactive Metronome, And the Astronaut board system. I can say that learning to play chess and learning a musical instrument can help with executive function skills in children with ADHD.

I want to summarize by saying that each parent has to make a decision based on what is best for their child. I believe it is important to consider all the possible consequences of trying an alternative therapy. Is it too time consuming? Does it make your child feel fragile or different from others? Do the benefits outweigh the drawbacks? Is the change big enough to warrant the demands of the treatment? These are questions each family has to ask and answer for themselves. Hopefully, I have provided good food for thought.

Nancy Konigsberg is a pediatric occupational therapist and child development specialist with more than 16 years experience. She has a six year old son recently diagnosed with ADHD. Nancy has a blog called Milestone Mom which discusses ADHD and a variety of other developmental disorders. In it you can find disorder specific information and symptoms along with exercise treatment and therapy techniques. Readers from all over the world can write to Nancy and get suggestions tailored to their individual situations.
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