Caring for children with special needs
By Kira BaileyFeatures Clinical Patient Care
Attention deficit hyperactivity disorder (ADHD) is now considered the
most prevalent psychiatric disorder of childhood, affecting between five
and 12 per cent of school-aged children in North America.
Attention deficit hyperactivity disorder (ADHD) is now considered the most prevalent psychiatric disorder of childhood, affecting between five and 12 per cent of school-aged children in North America. In addition, 80 per cent of those children will still be manifesting symptoms of ADHD, or attention deficit disorder (ADD), as adolescents, and 60 per cent will carry them into adulthood.
Treatment of ADHD has long been considered to be limited to the use of medication such as Ritalin, with only minor references to the successful application of alternative medicine practices such as chiropractic care. Chiropractors are ideally suited to manage the symptoms of ADHD – using their unique tools, techniques and holistic philosophy to offer effective alternative and complementary management strategies.
It is crucial to understand the devastating impact of living with unmanaged ADHD. Those with ADD have a much higher probability of being diagnosed with learning disorders and with multiple other mental illnesses. They have a higher likelihood of repeating a grade in school, being suspended and failing to graduate. When someone in the family has ADHD, everyone suffers.
However, when a practitioner improves the life of a person with ADD, they are improving the life of everyone in that person’s family, friend and social networks.
Chiropractors are perfectly placed to work with children and adults with ADHD using the wide variety of tools in their professional toolbox. One of the biggest skills that chiropractors possess is their wide-ranging and extensive education. This gives them the ability to assess a complex and multisystem symptom picture and to delve further into a person’s history and symptomatology to weed out the truly important facts from the noise.
Understanding functional neurology is a key principle in the management of ADHD. Chiropractors have a deep understanding of the relationship between neurology and its effect on human experience. They also have the perfect tool to affect change in the nervous system – the chiropractic adjustment. When a neurologically balancing chiropractic adjustment is used in the care of someone with ADHD, good things have been shown to happen. There is wonderful preliminary research available demonstrating that children with ADHD under chiropractic care show improvements in behaviour, hyperactivity and executive functioning.
There is a vital relationship between the neurosensory receptor networks found in the spine, spinal cord, dura, joints and muscles and cerebellar function. Spinal mechanoreceptors, and muscle spindle fibres ascending through the spinocerebellar tracts provide the largest source of ascending information to the brain via the cerebellum. When the function of this receptor array is enhanced, improvements in the quality/quantity of information travelling into the cerebellum are noted. This stimulates the mid-brain, limbic system and prefrontal cortex and results in improvements in executive functioning (attention span, ability to concentrate, decision making, memory), improved mood stability, decreased kinetic activity, better emotional control and improved impulse control.
There are other excellent tools a practitioner can use to improve cerebellar function and the co-ordination/integration of neurosensory information. A strong education in biomechanics and neuroscience gives the chiropractor a solid foundation when using “functional movements.”
Occupational therapists, educators, speech and language pathologists have long been using functional movements and educational kinesiology to facilitate improvements in children with ADHD and the same tools are available to the chiropractor. Functional movements, exercises and games focus on improving balance, proprioception, primitive reflex integration, core strength, timing and co-ordination, crossing the midline and oculomotor function. They are used to activate core neurological pathways and facilitate improvements in academic scoring, behaviour, hyperactivity and emotional control.
Metabolic balance is another key concept in the holistic management of ADHD. Although most of the most obvious symptoms of ADHD focus on the behavioural aspects of the disorder, there are a host of secondary symptoms, including a characteristic pattern of poor digestive function and food sensitivities.
The presence of digestive dysbiosis and a “leaky gut” is associated with the ADHD population. Gluten and casein sensitivities are also a part of this picture for many people, creating a doom-loop of digestive inflammation and production of morphine-like derivatives triggering a slowing of digestive function that in turn perpetuates more inflammation. Inflammation in the gut stimulates the sympathetic nervous system, exciting the autonomic nervous system and brain toward a fight or flight state. A sympathetic/adrenergic response in the brain down-regulates executive functioning and as outlined above, this manifests in a poor ability to plan, problem-solve, pay attention and regulate behaviour. Maldigestion and incomplete digestion of food results in vitamin, mineral and other nutrient deficiencies, which can also contribute to the symptom picture of ADHD.
In order to balance metabolism and heal the gut, a process of omission and supplementation of food, vitamins and minerals must be instituted. The most common food allergens must be removed from the diet; hence, a gluten-free, casein (dairy) free, food additive/dye-free, aspartame-free diet filled with low-glycemic index whole foods containing adequate protein is recommended for a minimum of 90 days.
A regimen of supplements should also be considered, including high-quality, soil-based probiotics, pure and high potency EFAs, vitamin B6, vitamin D, and magnesium. There are many other supplements, nutraceuticals and homeopathic remedies that can be added to the diet on a case-by-case basis, and in accordance with the doctor’s level of expertise. The above represents the basics in supplementation and outlines those items that will have a positive effect on the majority of your patients with ADHD.
For the extended version of this article on managing ADHD, visit www.cndoctor.ca. Search: ADHD
Dr. Kira Bailey holds a diploma with the International Chiropractic Pediatrics Association and has special interest in helping children and adults with ADD/ADHD and neuro-sensory processing disorders. She was the clinical advisor for Shine for Doctors, a program that trains chiropractors in the holistic management of ADHD. She can be reached at email@example.com.
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