In this issue:
Is ADHD a Valid
Diagnosis?
Attention Deficit Disorder (ADD), with or without Hyperactivity (AD/HD), is diagnosed in this country more than any other in the world, and in some regions of the U.S. more than others. Is it a valid diagnosis?
Yes and no.
We know that ADD is a neurological disorder that affects concentration, attention and impulse control. When children with ADD are given the proper medication and behavior management, their functioning in school and at home improves dramatically. However, there are many children who appear to have ADD but don't.
For example, a child may engage in what's called "attention-seeking behavior." The child may become overactive, impulsive or concentrate poorly in the presence of adults. This child does not have ADD; instead, the behaviors are reinforced by the reactions of the adults.
Alternatively, a child may be aggressive and noncompliant because of emotional issues, such as feelings of depression and/or anxiety. A teacher may report the behaviors, and the parent may have similar problems with that child at home, leading the adults to think that medication is the answer to the child’s difficulties. But only a careful evaluation by a professional can truly discern the reasons behind the behavior.
ADD is a description of what one sees. It is not an explanation or a determination of cause.
If you see that your child is experiencing problems in the any of the domains pertinent to ADD - e.g., sustaining attention, following through on instructions, organization and planning, or behavioral compliance - then seek information before you decide what to do.
Does
Sugar Affect
Hyperactivity?
Sheila told me the other day that she's again removing sugar from her son's diet. She's convinced from what she's heard and from her own experience that removing sugar from his diet will decrease his hyperactivity.
Many people claim that sugar (such as sucrose), aspartame (NutraSweet), and artificial flavors and colors cause hyperactivity and other behavior problems in children. Unfortunately, it's not so simple.
The notion that food can have an effect on behavior grew popular in 1973 when an allergist, Benjamin Feingold, M.D., published the Feingold Diet. He advocated a diet free of food colorings and artificial flavoring for treating hyperactivity. Many parents deduced that food additives, including sugar, should be avoided.*
However, double-blind studies - in which neither the children, their parents, nor the researchers know which child had sugar and which received a placebo - indicate that sugar in the diet does not affect the children's behavior. (ibid.)
On the other hand, refined (processed) sugars may have a temporary effect on children's activity level. Because refined sugars and carbohydrates enter the bloodstream quickly, they produce rapid fluctuations in blood glucose levels. This process might trigger adrenaline and make a child more active. **
Thus, an observation that eliminating sugar has an immediate effect on behavior is truly credible. But, similar to the process in the rest of us, the change in blood glucose level doesn't last. And for children who do not have to watch their blood glucose levels (e.g., as when they suffer from diabetes), eliminating sugar does not solve the problem of hyperactivity.
Moreover, the expectation that sugar will impact on a child's activity level affects the way we view that child's behavior. A study published in the August 1994 Journal of Abnormal Child Psychology showed that parents who believe a child's behavior is affected by sugar are more likely to perceive their children as hyperactive when they've been led to believe the child has just had a sugary drink (WebMD.com).
Rather, it is the whole context in which that child is managed that impacts on his or her behavior. Monitoring the amount of sweets in a diet is healthy in terms of tooth decay and nutrition; using proper behavior management techniques and setting limits with love and consistency will help the hyperactivity.
* Summary by Dr. Michael Regalado on WebMD.com.
** Medline Plus Medical Encyclopedia
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