ADHD is a religious experience and there are believers and nonbelievers. Different places have different approaches, and these are based on many factors, such as the country’s general cultural belief about children and learning or the economic system that supports healthcare or limits access to healthcare.
The American Journal of Psychiatry reports that the geographic difference is due to collection methods by the researchers rather than true geographical differences. Here is an example of the cultural divide and disparate approaches to prescribing ADHD medications:
Germany requires that parents who are concerned about the possibility of ADHD in their children must try to learn parent-training strategies before the doctors start writing prescriptions for medicine. In contrast, the US health economy is biased toward medication use and we don’t do that much counseling — parent training is not an element that is culturally validated by parents or practitioners.
Almost 11% of children ages 4 to 17 years in the US have been diagnosed with ADHD per a 2012 CDC report while the general worldwide incidence per the American Journal of Psychiatry is 5.29%. Why is there a two-fold difference in the number of children diagnosed with ADHD in the United States compared to the rest of the world? This is an important question since the annual societal ‘‘cost of illness’’ for ADHD in the US is estimated to be between $36 and $52 billion in 2005 dollars or between $12,005 and $17,458 annually per individual, according to the Journal of Pediatric Psychology.
I have been in private practice for 11 years and in two very distinct practice settings. When I worked in a traditional insurance-based office and saw 30-50 children a day, I wrote many prescriptions for Ritalin, Concerta and Strattera. Once I switched to concierge medicine where I see six to ten kids a day, I had time to educate parents, work on parenting techniques, focus on diet as well as natural supplementation. As a result I have only had to place one child on ADHD medication over the past eight years.
Here is a list of natural approaches that have worked well:
1. Minimize Food Additives. A 2007 study of nearly 300 kids ages 3 to 8, published in The Lancet, found that those given drinks containing artificial dye showed significantly higher hyperactivity within a few hours. The British government now requires labels warning that children’s products containing dye may impair attention.
2. Consider an Elimination Diet. A first-of-its-kind 2011 study, also in The Lancet, showed that when 50 kids with ADHD were put on restrictive hypoallergenic diets free of allergens like gluten and dairy for five weeks, their symptoms improved far more than those in the control group. When the eliminated foods were reintroduced, symptoms returned in 63 percent of the children. Deichert says that ADHD patients with digestive problems, recurring ear infections or skin problems— all symptoms of possible food sensitivities—are particularly good candidates for elimination diets.
3. Reduce Electronic Media and Replace with Exercise. Very large studies have associated TV and video game use with a worsening of ADHD symptoms.
4. Buy Organic Foods. A 2010 study of 1,100 children, published in the journalPediatrics, found that the more pesticide residue children had in their urine, the more likely they were to be diagnosed with ADHD.
5. Check Iron Levels. Studies in the Archive of Pediatrics & Adolescent Medicineand elsewhere have shown that children diagnosed with ADHD are more likely to have lower iron levels, and when those that are deficient take iron supplements, their symptoms either subside with- out medication or they react better to lower doses of medications.
6. Safe Supplements. Clinical research is still inconclusive but in my practice ADHD patients have benefited from zinc, ginkgo biloba, acetyl-carnitine and omega-3 supplements.
The diagnosis and treatment of ADHD is a result of cultural bias. Use a therapeutic prism to illuminate the different options available to you. The first step is to find a practitioner that is willing to invest time in your child and explore all the options available under the rainbow.