The School Battleground

The schools are on the front line of an epidemic. Through their nurses they hand out billions of controlled substances to young children each year for Attention Deficit Hyperactivity Disorder (ADHD). I hear from many school nurses who are not happy about dispensing controlled substances to children. They have asked what they can do to help slow down this epidemic. On the other side of this issue are the parents who say that their child's teacher suggests their child be tested for ADHD and treated. And some teachers are also looking for non-drug options to help their challenging students. I offer the same information and suggestions to all three groups.

The National Institutes of Health published a statement on ADHD and the drugs used to treat it. Their experts determined that there is "no valid test" for ADHD. Identifying children and adults as ADHD is strictly subjective. A teacher who expects children to sit quietly all day may wish to label many of the children as ADHD. Yet a teacher, with the same set of children, may understand that young children need to move about and do lose interest in subject matter. This teacher would think her classroom was filled with normal children without psychiatric problems.

Many of the drugs prescribed by doctors for the symptoms called ADHD are Class II Scheduled, controlled substances in the same category as cocaine. This is what the FDA has to say about Ritalin, the most common drug prescribed for ADHD symptoms:

1. Ritalin is pharmacologically similar to and has the same dependency profile as cocaine.

2. Treatment with Ritalin in childhood predisposes takers to cocaine's reinforcing effects.

3. Chronic administration of Ritalin produces tolerance and showed cross-tolerance with cocaine.

4. Ritalin abuse is neither benign nor rare and is accurately described as producing severe dependency.

Since Adderall and Dexadrine are amphetamines, the above statements should be true of them as well.

At least 95% of the children seen in my office for ADHD symptoms have never had a physical exam before a psychiatric drug was prescribed. In addition to what the FDA says about Ritalin, these are the side-effects that the manufacturers of Ritalin and the other drugs say they can cause: Increased blood pressure, heart rate, respirations and temperature, appetite suppression, weight loss, growth retardation, facial tics, central nervous system stimulation, euphoria, nervousness, irritability, agitation, psychotic episodes, violent behavior, paranoid delusions, hallucinations, bizarre behaviors, heart arrhymias, palpitations, tolerance, psychological dependency and death.

Texas, Colorado, and 46 other states have made resolutions requiring school personnel to use proven academic and/or management solutions to resolve behavior, attention and learning problems. Programs such as tutoring, vision testing, phonics, nutritional guidance, medical examinations, allergy testing and other remedies known to be effective and harmless should be recommended to parents. Here are some suggestions toward compliance with these resolutions:

1. Remove Sugar from The Diet: Sugar does affect behavior. Sugar can cause a reactive low blood sugar reaction called hypoglycemia. When the body becomes hypoglycemic, the chemical adrenaline is then released and the child feels the "fight or flight" energy surge. The pupils in the eyes dilate; the heart rate increases and the child cannot sit still. The child cannot concentrate and can become agitated. The child does not choose to act that way. It is a physiological response.

A Yale study showed that adrenaline levels in children were ten times higher than normal up to five hours after ingesting sugar. All of the children in the study had symptoms of increased adrenaline.

To treat hypoglycemia, change the child's diet. Don't let the child get hungry and eliminate refined carbohydrates, such as candy, cakes, pies and soft drinks.

2. Provide Protein Meals and Snacks Every Two Hours: Children with low blood sugar can have symptoms if they do not eat often enough also. Skipping a meal or not eating often enough can have the same disastrous results as eating sweets. Children with symptoms of hypoglycemia need to eat several small meals each day. These snacks must contain some form of protein (nuts, cheese, and meat).

A child's protein snack can be kept at the nurse's station. Nut butter sandwiches with whole grain bread, (peanut butter, almond butter, etc.) are good options for snacks because they are high in protein, fat and complex carbohydrates. Trail mix snacks contain nuts, seeds and dried fruit. Just providing protein snacks every two hours has resulted in remarkable improvement in behavior and learning.

3. Water: Continual intake of fluids helps improve the body's biochemical functions. It helps flush out toxins and assists in digestion and nutrition. To simply grab a quick drink at the water fountain does not provide an opportunity to drink enough water to quench a thirst much less to take in the required minimum for the body. Children should be allowed to keep water at their desks in order to continuously quench their thirst and obtain enough fluids to allow their young bodies to function properly.

4. Recognize Nutritional Deficiency Symptoms: Specific nutrients are needed in our body to make the biochemical processes work properly. The nutrients act as co-factors for these biochemical reactions. Their importance in learning, attention and behavior are well documented in the literature.

A. Magnesium deficiency in children is characterized by excessive fidgeting, anxious restlessness, psychomotor instability and learning difficulties in the presence of normal IQ. (Magnesium in Health and Disease, Seelig, 1980)

B. Vitamin B6, in a double blind, cross-over study published in Biological Psychiatry (Vol. 14, no.5,1979), was found to be more effective than methylphenidate (Ritalin) in a group of hyperactive children.

C. According to the American Journal of Clinical Nutrition (33, 2,1980), when thiamine deficiency was corrected, behavior improved.

D. Niacin, was found to be helpful for the symptoms of hyperactivity, poor school performance, perceptual changes and inability to maintain social relationships (Schizophrenia, 3, 1971).

E. Zinc levels in children diagnosed with ADHD were found to be significantly lower than controls (Biol.Psychiatry, 1996).

F. DMAE, a neurotransmitter precursor, has been used for years to improve behaviors, mental concentration, puzzle solving ability and organization (J.Pediatrics,1958).

G. Lower levels of Omega-3 fatty acids were discovered in children who had more temper tantrums and sleep problems. (Stevens LJ, Zentall SS, Deck JL, Abate ML, Watkins BA, Lipp SR, Burgess JR.

H. Essential fatty acid metabolism in boys with attention-deficit hyperactivity disorder. Am J Clin Nutr 1995;62 (4):761 8).

5. Provide Time to Move Around: Physical activity is very important. Children need to take a break, get up and stretch, and get the circulation going. They have a greater physiological need to be active. When a child is fidgety and having difficulty concentrating it is time for a break. That is why recess is so important. Physical activity helps to revive energy and alertness so that the child returns to class more attentive and ready to learn. Physical play is an active form of learning. It is essential to development. It promotes gross motor skills necessary for learning. It enhances perceptual abilities through interaction and movement in a three-dimensional environment. Play reduces the tension and helps the child relax.

If the child has adrenaline on board, the physical activity will help expend it, helping to bring the body back to a calm, more chemically balanced state. A child who is having difficulty sitting still needs more time to move around, not less. Research by the American Association for the Children's Right to Play (Issue No. 55-Spring 1998 htttp://www.ipausa.org/s99newletter.htm) looked at fourth grade children on recess days, PE days, and no break days. The results found that children were significantly less fidgety and more focused on their task after having recess.

6. Remove Perfumes, Fragrances and Other Stimulants from the Classroom: Clean, non-polluted air is extremely important to the health of our children. Fragrances can affect the nervous system sending inappropriate chemical messages through the nervous system, causing learning and behavior symptoms. Visual stimulation can also affect attention and behavior. Classrooms that are too busy can have a stimulating effect on students. If the teacher wears an "interesting" outfit with lots of colors and designs, or noisy jewelry, it can distract a student who is trying to listen in class.

7. Let Students Fiddle with Something: Many children with learning difficulties are right-brain, tactile learners. Right-brain learners are people who use the right side of their brain (the creative side) for learning and processing information more than the left side. These people tend to be very creative. Tactile learners learn best with their hands. I call these right-brain/tactile-learners, "RBTL's."

"RBTL" children can be frustrated in school because schools are set up to accommodate left-brain, auditory and visual learners. "RBTL" children have difficulty learning in this type of classroom setting. Although they see and hear the information, the brain doesn't process that information through the auditory and visual senses very well. They prefer to learn and explore through their sense of touch (tactile). "RBTL" children are still going to try to learn, but because they are tactile learners, they may pick up their pencil and flip it or fiddle with something. Then they get in trouble, when all they were trying to do was learn through touch. Even though they are very bright, they very often get labeled as learning disabled or trouble-makers. Most of these children improve immediately when they are given something to hold and feel (fiddle with) while reading, listening and doing other learning activities. This helps tactile learners use their visual and auditory senses more effectively. I recommend a small smooth stone or some other quiet object that feels good to the child.

8. Use Mozart Music with Ear Phones: Researchers have discovered that people who listened to ten minutes of Mozart before taking an intelligence test scored higher than people who listened to ten minutes of relaxation instructions or who for ten minutes sat in silence. Scientists speculate that some kinds of music stimulate certain neural pathways in the brain. I recommend that my patients listen to Mozart audio tapes while studying or reading. I always recommend that these students use headphones because it blocks outside distractions. Many parents have reported that homework time is cut in half. If the teacher has given the class instructions and wants them to sit quietly and work on their own, they can put the headphones on and listen.

9. Be Aware That Allergies Affect Behavior Adversely: According to Annals of Allergy, 1993, allergies can cause learning impairment. The researchers found that the allergic child was significantly less knowledgeable than controls and that, children with allergies were less successful in school in every way. Allergies affect the brain as well as the nose eyes and lungs. A child with allergies may be unable to sit still and concentrate because of allergies, not ADHD.

10. Let the Student Help Others: Everyone has strengths in some area. Children that struggle in reading may be very creative and excel in art. Acknowledge the child's ability and provide him/her with an opportunity to help someone else work on an art project. This makes a very strong statement to that student and the rest of the class that everyone has valuable abilities. It builds self-esteem and helps to promote new skills in the other students. It also teaches each student that it is okay not to know how to do everything as successfully as someone else. It also provides opportunities to learn new skills.

I recommend that we see only the best in our children. All children want to learn and want to please us. With a balance of calm and active time, in a healthy environment, where they are well fed, with quenched thirst, and helpful tools available, they can learn in their own styles. I hope these ten steps will help arm you in the battle against the unnecessary drugging of our children.