In this section we will talk about attention deficit as a learning disability with and without hyperactivity. Here, the child is inappropriate in attention span and impulse control. The child may or may not be hyperactive. The age of onset is usually before the age of four, and almost always before the age of seven. The diagnosis is usually made between the ages of eight and ten. Attention-Deficit Hyperactivity Disorder (ADHD) is ten times more common in boys than in girls. The three signs to look for in ADHD are hyperactivity, inattention, and impulsivity. Hyperactivity is described as excessive fidgeting, running, climbing, not staying seated and not sitting still. Inattention is difficulty concentrating, not finishing tasks, getting distracted easily, or lack of attention or focus on any one subject. Impulsivity is problems with organization, acting without thinking, changing abruptly in activities, and shifting a lot between different activities. Other signs of ADD and ADHD include lower social and physical skills. The child may have difficulty getting along with classmates and seem physically immature compared to others. They may have problems with motor skills such as writing. Children with ADD get excited very easily and can be difficult to manage. Hyperactivity does seem to decrease with age.
The cause of ADHD and ADD is unknown. Several theories dealing with the nervous system and behavior have been proposed. Anatomically the brain is normal on CT scan and MRI. There are no physical or anatomical findings. Normal children display some of the signs and symptoms of ADHD and ADD, making diagnosis difficult. Studies are now showing that ADD can affect individuals into adulthood. Poor social skills and difficulty in learning can continue into adulthood. Hyperactivity seems to reduce with age. When ADD goes into adulthood, it is referred to as Residual Attention Deficit Disorder (RADD). Medical treatment includes the use of Methylphenidate or Ritalin. These are stimulants. A stimulant is used in order to get the child to focus. Side effects may include insomnia, loss of appetite, sadness, and depression. Low dosages are usually tried first. Medication while at school only is tried at first, with weekends and holidays being medication-free. Studies on the long-term effectiveness of Ritalin are inconclusive.
Cognitive behavioral therapy should be integrated into care. Some simple, effective things can be done. Manipulating the environment of noise and light can help a child in school. Therapists also help patients by placing limits and providing techniques to help with impulse control and inattentiveness. Teachers also need to be informed. It is reported that teacher proximity can help some children with ADD.
Food dyes and coloring agents are controversial in ADD and ADHD. Research shows inconsistent results with elimination of food additives and food dyes. Some studies show positive benefits, especially wit hyperkinesias and hyperactivity. One study in particular showed benefits by eliminating the yellow dye Tartrazine. Some of the research in ADD has been criticized as being poorly designed. One study was reported as using a chocolate chip cookie as a placebo. Both chocolate and sugar are thought to increase hyperactivity and should not be used. Another study tested food dyes using thirteen milligrams that were administered twice a day. The problem was, that some children consume as much as one hundred and fifty milligrams a day, and the average dose may be as high as seventy milligrams per day. It is also noted that research from Canada and Australia shows more positive correlations with food additives in ADD and ADHD. Some individuals have speculated that giant food companies like Coca-Cola, General Foods, and Nabisco influence some research to better profit. In light of what happens with the tobacco companies, this is something to think about.
Some studies showed benefits to a hypo-allergic diet. Some researchers point out that children who are sensitive to dyes and preservatives are also sensitive to other foods. They point out that elimination of just dyes and preservatives may not be enough. In some of these studies, children were found to be responsive – or not. This meant you either got good results – or no results. Again, most studies found some benefit to hyperactive children. Elimination of food additives and dyes in food allergy testing and elimination should be tried. Other research points to children as being the most sensitive to food allergies.
Eliminating food dyes and food preservatives will therefore start as the brunt of our work. Food allergy diagnosis, either by lab or hypoallergenic diet, is also appropriate therapy and usually suggested side-by-side.
Other factors will be considered in the treatment of ADD and ADHD. Studies point to iron deficiency as one of the most common deficiencies. Iron deficiency can mimic ADD with symptoms of inattentiveness. Lead has shown in several studies to cause learning disabilities. Some other heavy metals associated with learning disabilities are mercury, cadmium, and copper. Individuals with poor diets are more susceptible to symptoms due to lack of antioxidants. History may give clues to exposure to particular metals. Lab tests are available for some heavy metals to analyze levels. Again, levels can be taken from hair, blood, or urine. Each test has its different positives and negatives. A health care practitioner should help in determining heavy metal toxicity.