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Children's Concentration

Dear CG,

This most perplexing of disorders affects growing numbers of our children each year. Statistics of use related to the two main medications used for ADD indicate that the problem is reaching an almost epidemic proportion. There is a great deal of controversy surrounding ADD and its diagnosis, and doctors, pharmacists, and educators are all greatly concerned.

You wouldn't know it by the large amount of prescriptions of medications prescribed, but this disorder seems to only strike 5% of all children. The larger percentages of patients are male, and the hyperactivity element, known as ADHD, affects about half those diagnosed. A normal attention span for children is 3 to 5 minutes at a task per year of growth. In other words, if a two-year-old concentrates on a task for 6-10 minutes, they should have a normal attention span. If a six-year-old enters school and cannot concentrate for 18-30 minutes at a time, there may be a problem.

It is difficult to gauge whether a child has ADD because there are no standards of behavior or constant symptoms. 50% of ADD children may have a learning disability, and the most common is auditory processing, or difficulty remembering verbal direction. However, most children affected are of normal or above normal intelligence.

We don't know what causes ADD, but we have some intelligent guesses. From a developmental standpoint, the disability is caused by delayed brain maturity. This delay may mean poor self-control, which requires external controls by parents for longer periods of time. Often this is hereditary.

A percentage of patients suffer because there is a chaotic home environment, but in most cases parental rearing techniques do not cause the disorder. Minor brain damage may be the cause, but there is not enough data to fully support this. New research also suggests that there may be nutritional issues at birth and infancy that may play a role in the development of the disorder.

A Social and Nutritional Primer on Attention Deficit Disorder (ADD)

This most perplexing of disorders affects growing numbers of our children each year. Statistics related to the two main medications used for ADD indicate that the problem is reaching epidemic proportion. This month, we are offering information about the disorder, from both a common sense social understanding and a nutritional support consideration.

There is a great deal of controversy surrounding ADD and its diagnosis, and doctors, pharmacists, and educators are all greatly concerned. This is important enough a subject to produce two months of publication discussing treatment, nutrition, and alternative therapies and my hope is that, through enlightenment, we can all learn to live with ADD.

You wouldn't know it by the large amount of prescriptions of medications prescribed, but this disorder seems to only strike 5% of all children. The larger percentages of patients are male, and the hyperactivity element, known as ADHD, affects about half those diagnosed. A normal attention span for children is 3 to 5 minutes at a task per year of growth. In other words, if a two-year-old concentrates on a task for 6-10 minutes, they should have a normal attention span. If a six-year-old enters school and cannot concentrate for 18-30 minutes at a time, there may be a problem.

It is difficult to gauge whether a child has ADD because there are no standards of behavior or constant symptoms. 50% of ADD children may have a learning disability, and the most common is auditory processing, or difficulty remembering verbal direction. However, most children affected are of normal or above normal intelligence.

We don't know what causes ADD, but we have some intelligent guesses. From a developmental standpoint, the disability is caused by delayed brain maturity. This delay may mean poor self-control, which requires external controls by parents for longer periods of time. Often this is hereditary.

A percentage of patients suffer because there is a chaotic home environment, but in most cases parental rearing techniques do not cause the disorder. Minor brain damage may be the cause, but there is not enough data to fully support this. New research also suggests that there may be nutritional issues at birth and infancy that may play a role in the development of the disorder.

How parents can help their ADD children

Children with developmental issues can improve with parental, nutritional and educational guidance. A large part of this guidance is instilling self-esteem in the youngsters. It is true that many adults suffer from ADD as well, however, we seem to tolerate restless behavior in adults, but refuse to do so with our children. ADD could be considered a social disease and should be addressed in part from a social standpoint.

Accept your child's limitations. You can't change the hyperactivity or restlessness: only bring it under control. Criticism of a child's inherent behavior may bring them more harm than good. A tolerant, patient, parent is an important aid to an ADD sufferer.

Provide an outlet for the extra energy, but don't encourage it. All children should be energetic and ample room for this expression should be maintained. Roughhousing and other types of noisy play may make things worse and should not be encouraged. Don't keep too many toys around that could distract a child's attention from one to several.

Keep an organized environment at home. Keep wake-up times, meals, snacks, chores, naps, and bedtimes constant when possible. A calm, quiet home environment will help children learn to read, listen, or think without the distraction of a TV or radio. Children can become disciplined by routine.

Do not allow your child to become fatigued. Tired ADD children lose their self-control, making things worse. Early bedtimes, big breakfasts, and encouragement to rest will aid in controlling fatigue and decrease "episodes" of hyperactive behavior. I will approach nutrition later, but a good breakfast is crucial.

Maintain firm discipline. While more difficult to manage, ADD children can remain disciplined with good parental involvement. Inappropriate behavior is not encouraged with any child, but aggressive ADD behavior cannot be tolerated. Avoid, however, excessive or unattainable rules; for instance, don't expect hands and feet to remain still, they won't.

Avoid constant comments like, "Don't do this" or "Stop that," since ADD children do not respond to these. A few strong and consistent rules can be enforced with the addition of other rules at your child's pace.

Enforce rules with nonphysical punishment. Physical punishment suggests that physically aggressive behavior is OK. Remember that a calm, patient approach teaches children to be less aggressive. Punishment should be immediate. Studies indicate that the "time out" system is a crucial part of appropriate punishment and should be dosed in measures of one minute per year of age.

Stretch your child's attention span. Reading to your child, encouraging attentive behavior and praising your child for this behavior all prepare them for school. Set aside time during your day to encourage attention. You will find it hard work, but the rewards in preparation will be worth it.

Protect your child from the "cold, hard world." Children with ADD can't help it if others see their behavior as inappropriate. Perhaps the hardest part of the disorder is their knowing somehow that they are different, and the response by neighbors and other children can harm ADD children greatly. Asking neighbors to help keeps them from the assumption that the child is "bad." Your attitude at home should be a mirror of this. Letting your child know they are "good" goes a long way in building self-esteem and as long as there is acceptance, self-esteem survives. If your child is doing poorly in school, find a hobby in which they can excel. All children need success.

Utilize special programs at school. The education system has made great strides in aiding those with special needs. You cannot create a special environment at home, and then expect your child to accept the "norm" at school. Request evaluation and testing programs for your child, once they enter the school system. Work closely with children's teachers and get involved in any extra curricular activities designed to aid special need students. There is no shame in special education and it should be used. As a taxpayer or tuition payer you are entitled, and it will help. Trust teachers to be in charge at school, while you handle the home front.

With ADD, it is crucial to understand the illness in order to affect it. If you choose to fight for your child's right to a good life, you will not settle for Ritalin or other medications alone. You will also give serious thought to the environmental, nutritional and allergenic elements that could be affecting your child's cognitive development.

ADD and Nutrition:
Dietary Supplement Considerations and Theories

Probiotic support may be crucial. There are mounting studies confirming the connection to yeast in the system contributing to ADD. Following a lifetime scenario, an infant is fed inadequate amounts of intestinal growth factors and beneficial bacterial flora in breast or formula milk, which combined will establish good intestinal health and allow nutrients to be properly assimilated in the immune system. The inability to establish good intestinal health with the proper inoculation of beneficial flora sets off a series of problems that researchers now believe may result in ADD.

Early in infancy the child might develop thrush and often the mother and child might share a thrush-related yeast condition, known as candida, by transferring the yeast back and forth during breast-feeding. Children studied followed a similar pattern of early immune difficulties, such as ear infections and colds, which are generally treated early with antibiotic therapy. The medical regimen further destroys the already compromised intestinal flora, which results in either allergy development or recurring low-grade infections or other immune disorders. Several years into childhood, concentration and behavioral problems develop and ADD is often diagnosed.

The initial problem of wasted flora remains, resulting in life-long immune problems and antibiotic therapy. Intestinal permeability is often compromised, allowing proliferation of candida or pathogenic entry into the body, as well as the mal-absorption of nutrients intended for the endocrine and immune systems. Further, the connection between decreased lipid transportation and the decreased utilization of B vitamins creates a crisis in brain nutrition.

Probiotics are known to re-inoculate the intestines with beneficial flora, which will aid in the proper nutrient delivery to the immune system, allowing the body to fight immune problems and allergies without the use of antibiotics, which continually deplete the flora so necessary to our health.

Probiotic therapy should be considered as a part of an antibiotic regimen, and the result of this may be an enhanced immune system, receiving nutrients more effectively in the intestinal villi. A possible link also exists between food allergies and intestinal dysbiosis, as they relate to this disorder.

Consider a full spectrum Probiotic formula with lactobacillus acidophilus and bifidobacteria. These two strains of probiotic activity have been proven to encourage good nutritional support for the immune system and aid in the proper balance of flora and yeast in the intestinal tract. A base of growth factors, including pantethine and FOS are also important, (fructooligosacchrides.) FOS has been studied extensively as important to nutrient/bowel balance.

Essential Fatty Acids are an important part of the ADD protocol. Researchers have shown that a deficiency of fatty acids is often associated with the ADD disorder. EFAs are essential for proper neurological development, and humans often lack the necessary enzymes to process them. This means that diet and supplementation are the only methods of introducing essential fatty acids to the body.

In particular, the supplementation of docosahexaenoic acid (DHA), an Omega-3 fatty acid found in deep-swimming marine animals, should be considered as part of the ADD protocol. Studies indicate that the deficiency of GLA/DHA is prevalent in children with ADD.

Phospholipids are important in the process of nutritionally supporting patients with ADD. These fats play a key role in neurotransmission, and a deficiency of this nutrient adversely affects our levels of brain chemicals, so important in behavior. Supplementation of this nutrient might help in the functioning of cognitive behavior, concentration, attention span and memory. Lipid transport nutrients such as phospholipids are crucial in many bodily functions, and their role in the intestines furthers the theory of intestine-brain synergy. Phosphatidylserine is used by the body to regenerate damaged neurons and support general neurotransmitter tone. It is only one of the important constituents of phospholipids. Other derivative, including choline and phosphatidylcholine enhance mental functions associated with learning and memory.

B vitamins may be helpful in the treatment of ADD. Certain deficiencies of this vitamin group are studied extensively in association with reduced mental performance. B vitamins are essential for proper development of the nervous system. Vitamins B-6, B-12, and folic acid deficiencies are related to behavioral problems, as well as depression and personality disorders. Studies conducted in Spain indicate that B-6 and folic acid supplementation clinically improve mental functioning, both in behavior and performance in classroom settings.

Deficiencies of B-12 have been widely studied, in relation to neurological functioning. Studies at Baylor University have proven that B-12 is essential for the proper transmission of nerve impulses and deficiencies can contribute to impaired neurological and psychiatric conditions.

Minerals also play a role in supporting the nervous system. Iron and magnesium deficiencies have been studied in relation to children's behavior, and studies conducted in Canada indicate that behavioral problems might be attributed to a lack of proper levels of these minerals. One study showed that 80% of our children are deficient in magnesium and low levels of this mineral are a common factor in ADD patients between the ages of four and 13.

Supplementation of magnesium vastly improved the behavior of children studied. Mineral deficiencies and chronic exposure to heavy metals can be attributed to neurological imbalance. If the brain is deficient in minerals, it may accept and store heavy metals such as lead, mercury and aluminum instead.

There is a great deal of research centering on a valuable brain nutrient DMAE. This nutrient plays a role in the process of mental functioning, and studies are indicating that the supplementation of this nutrient is providing good results for patients with ADD.

CG, while this seems like a lot of products, you can find nutritional formulas that contain good quantities of these ingredients and are targeted to enhance mental clarity. You can click here to purchase some, or contact me to discuss your child's particular issues. I am happy to counsel you on dietary, emotional and supplemental methods of supporting your child (or ADD adult) in their efforts to stay…well, normal.

After all, ADD is not something that has to limit your loved one. It makes them special, but not particularly in a bad way. Understanding the disorder will go a long way toward all involved being happy and helpful. Best of luck and contact me if you have any questions.

Mike Casso, R.Ph.