More on Diet and ADHD / ADD

A couple of days ago, or many a week or so ago, I wrote several comments here and elsewhere about the research coming from the Netherlands on Diet and ADHD. In that research there is a claim (a "claim" I'm writing, meaning NOT TRUE) that changing diets can have a significant effect on the behaviour with ADHD. There are so many serious problems with this bit of research it's hard to list them all. Fist and foremost, it disagrees with many many previous research findings. When a new bit of research disagrees with a huge volume of previous research we usually question the way the research was done. Instead the web is plastered with articles using this research to tell parents to take their children off of medication, and on so many of these web pages and blogs there are adds for "natural alternatives." Of course there is no research to support these, but all they are asking for is your credit card number....how could that hurt?

Look, children with ADHD / ADD have a number of different symptoms. Some are so hyperactive they nearly fall out of my office. Sitting in my waiting room the lights go on and off, the sound machine changes volume, a plant falls over. Others are simply easily distracted, and seem to not "be there" as their teachers and parents say. Some have what Dr. Russell Barkley calls "slow tempo" or slow processing time. Some have all of these symptoms.

In this study about 200 kids were divided into two groups. One group ate a very restricted diet. VERY restricted. Water, rice, turkey, lamb, lettuce, carrots and a few other things. And then they had to stick to this diet. Now just imagine getting your child with ADHD to stick to such a diet. Miricles, I suppose, do occur. The second group were "counselled" about food but ate whatever they wanted.

The study claims that 64% of the kids on the restricted diet showed significant improvement. Now remember, that's measured by parent and teacher reports. Measured by the attitude of the people implementing the diet. See any problems here?

So, lets get the facts straight. Any GOOD research would attempt to be "blinded" so that the individuals getting the treatment don't know. THIS study obviously was not. Parents have expectations, after all that hard work...well...something has to change. And one thing we already know from research is that a structured and controlled environment, where expectations are clearly spelled out and implemented appropriately...well, that alone has been show for years to be highly effective in changing the behaviour patterns of children with ADHD. So...."children with ADHD often improve with regular, focused attention" from adults.

Now, the other issue is, did all these children actually have ADHD? Remember all the problems that have come up lately about the difficulty of diagnosing ADHD in children this age? How, with these issues, can we say that food sensitivity is causing problems in 64% of these children? MAybe a test of parenting skills, observations of the home and classroom environment, and more information on how the ENVIRONMENT was changed by the procedures would be helpful, because it's clear there were significant ...huge...environmental changes for these kids.

I remind you of the 1970's when it was decided, based upon poor research like this, that modifying diets changed children's behaviours. The Feingold diet, as it was called, eliminated foods and additives but achieved only modest results, which most researches saw as resulting from 1) significant changes in the behavioural environment and; 2) actual change for a small, a very small, group of children who had actual food allergies and sensitivities. Really, if your finding that a child's behaviour changes dramatically because you eliminate a specific food or additive, then the chances are greater that the child had a food allergy and not ADHD.

Dr. Jaswinder Ghuman, a child psychiatrist at the University of Arizona says, ""To be sure, the prospect of treating ADHD with diet instead of drugs would appeal to many parents, but parents who want to give it a try should be sure to consult with their child's physician first....it's not that easy to implement appropriately."

Three children I've seen in my practice in the past 10 days have had ADHD / ADD diagnoses for over 5 years. All of them have had 5 plus years of school failure. All were tried on diets, some on "biofeedback" and "neuro-therapy," most had tried vitamin and fish oil suppliments, two had homeopathic medication (it's water dropped on a sugar tablet, you knwo that, right?) and one even went to a chiropractor who treats children with ADHD and autism. All continued to fail and all are only now getting around to being ready to try medication, behavioural interventions and cognitive behaviour therapy (CBT)or psycho-education in combination. Medication, behavioural treatment and CBT have been show, in combination, to work. They are backed by years of research. I suggest these are the treatment options you talk to your medical doctor about. It's difficult at best to make up for years of both academic and social failure, and the time to act is as soon as possible.

Again I remind you that this blog is not meant to provide therapy, intervention advice or a diagnosis. If you suspect you or your child have ADHD / ADD (Attention Deficit Hyperactivity Disorder) you should see your medical doctor and a psychologist to help you with a firm diagnosis and intervention plan (visit the British Columbia Psychological Association website to locate one near you). You can find information about my services for individuals with ADHD at www.adhdhelp.ca or www.relatedminds.com