They Are What You Feed Them: How Food Can Improve Your Child’s Behaviour, Mood and Learning. Dr Richardson Alex

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СКАЧАТЬ resources are scarce (and stimulant drugs are cheap), so I’m sorry to say that in my experience this kind of detailed examination and testing certainly does not usually happen.

      The ‘ADHD’ label can cover a multitude of different things. Any co-existing conditions can make a big difference; and either hyperactivity-impulsivity without inattention, or attentional difficulties without hyperactivity both fall into this same diagnostic category. (There used to be a separate label for the latter—Attention Deficit Disorder, or ADD.) This huge variability between different children who are given the ADHD label guarantees that no single management approach is going to ‘work’ with all of them. However, the first thing that’s usually offered to parents if a child receives this diagnosis is stimulant medication.⁷

      I am not opposed to medication for ADHD, when it is clearly warranted—as I think it can be for some children—but I do think that it should always be the last resort, not the first.

      We often hear that around 70 per cent of children with ADHD get at least some benefits from stimulant medications. That’s very impressive, but it still leaves 3 children in every 10 who gain nothing from this kind of treatment—and many parents are understandably worried about possible side-effects, which can include difficulties with appetite and sleep, stunted growth, undesirable mental symptoms and increased risks of certain physical disorders. Any ‘benefits’ are also limited to behaviour, as no advantages for academic achievement have ever been demonstrated from the use of stimulant medications. (If they behave better and concentrate better, why don’t they learn better?)

      Most children can pay attention in at least some situations—it just depends on what these are, how motivated the child feels (what’s the pay-off for him?), and what the child’s perception is of the situation and his role in it (what demands does he feel under, and whom is he trying to impress?).

       ‘…all that was needed was to change the ‘‘pay-off’’ [in a test], so that the child who tried to rush through the test without even trying would pay a worse penalty than the one who spent time trying to work out the correct answer. This time, the computer would not move on to the next item until some time had elapsed (the time that most non-ADHD children would spend, on average, trying to solve the problem). For any child who just pressed the button early, their reward was to have to look at a blank screen for the rest of the time period. The next item would appear no sooner that it would have done in any case. Under these conditions, the well-known “deficits” of the ADHD children simply didn’t show up!’

      What we don’t usually hear is that in certain subgroups the proportion who benefit from stimulant medications is much lower. For example, it may drop to 30 per cent for children with anxiety as well as ADHD (and some evidence suggests that negative side-effects may be more likely in these children).⁸ In other words, for 7 out of 10 of these anxious, often ‘moody’ ADHD children, stimulant drugs may be no use at all.

      Before accepting any stimulant drugs for your ADHD child, or antidepressants, do make sure that ‘bipolar disorder’ has been ruled out. A large-scale survey of parents of bipolar children concluded that children with undiagnosed bipolar disorder can sometimes be ‘thrown into manic and psychotic states, become paranoid and violent…unstable and suicidal…’ if they are given these drugs before their mood has been stabilized.⁹ Worryingly, they suggest that one-third of all children diagnosed with ADHD in the US are actually suffering from early symptoms of bipolar disorder. According to the American Academy of Child and Adolescent Psychiatry, ‘…a third of the 3.4 million children who first seem to be suffering with depression will go on to manifest the bipolar form of the disorder’. If medications are to be used, it’s worth making sure they’re the right ones.

      Autism (ASD)

      Autism is the most severe form of what is now recognized as a range of ‘autistic spectrum disorders’ (ASDs). Features include restricted or absent social and interpersonal skills; a preference for repetition and routine; and interest in objects over people. ASD is much more common in boys than girls (perhaps not surprisingly, given that autism has even been characterized as simply an extreme of the archetypal ‘male’ brain!).

      If your child is autistic, he will show poor social interaction—in fact, this learned skill may be absent altogether. He’ll try to avoid interacting through conversation or cuddles, and may be viewed as aloof, withdrawn and ‘living in a world of his own’. Autistic individuals generally find objects easier to deal with than people—probably because the behaviour of objects is much easier for them to anticipate. A small percentage of autistic children have islets of high functioning-to-genius abilities and are known as Autistic Savants, but as with all the conditions considered here, ASD can occur in children with any level of general ability. In those with normal or high ability, areas of strength may include computing, engineering and any occupations where good ‘people skills’ are not essential.

      The number of children diagnosed with ASD has increased dramatically in recent years. For example, in Scottish schools, diagnoses nearly trebled between 1998 and 2005. In the US, autism diagnoses in school-aged children rose from 5,400 in 1991-2 to a massive 97,800 in 2000-2001. Better recognition and diagnosis may account for some of this increase, but cannot explain it all away. Something else is going on. As I’ve emphasized, the autism label is purely descriptive, so looking for any single ‘cause’ is likely to be fruitless. The real causes are likely to be multiple, highly complex, and will vary between different children. In my view, the simplest broad-brush explanation is the combination of two things: on the one hand, increasing exposure to potential toxins (from synthetic chemicals, heavy metals and other environmental contaminants), and on the other, decreasing intake of many essential nutrients needed to ‘defuse’ and get rid of those toxins. For genetic reasons, some children may have less efficient ‘detoxification’ systems, and/or metabolic inefficiencies that increase their need for certain nutrients. It is interesting that the earliest reports of autism show that it was regarded as a metabolic disorder, and special diets were often recommended. (See the Resources chapter for some excellent books on this subject.)

      Common Indicators of ASD

      Autism is now recognized as having varying degrees of severity, captured by the term ‘autistic spectrum disorders’.

       Before the age of three, shows delays or regression (permanent loss of previously acquired abilities) in social interaction and language skills

       May show repetitive movements of part or all of the body (rocking, tapping, head-banging or self-stimulation)

       At any age, shows a lack of spontaneous, imaginative play appropriate to his age

       Shows poor or limited ‘non-verbal’ behaviours, such as eye contact, facial and body expressions

       Has difficulties making friends and reciprocating socially or emotionally (may not appear interested in showing or telling you things)

       Has difficulties with speech and limited use of gestures (if language skills are developed, conversational skills are still poor)

       Shows restricted patterns of behaviour, interests and activities (preference for repetition and familiarity, and behaviour may be ritualized)

       May be preoccupied with certain objects or their parts (for example, often attracted by things that move or spin)

      Alternative labels have been springing up in recent years. СКАЧАТЬ