With school starting again, I'd like to address a serious health issue that has been a long-standing interest of mine. This fall, more than 7 million American school-aged children1,2, or about 1 in 12, will be placed on a stimulant, similar to ''speed.'' Ritalin or its chemical variants are used to treat Attention Deficit Hyperactivity Disorder (ADHD). ADHD is a non-clinical condition that many of us in the cognitive/communicative research community consider to be a somewhat contrived epidemic.
Just 20 years ago there were less than a half-million children placed on these powerful and potentially dangerous drugs. But between 1990 to 1997 there has been a 700% increase in the use of Ritalin et al3, and the rate continues today unabated. The United States, with only 5% of the worlds population, consumes more than 85% of such medications4.To me, this state of affairs appears out of control!
Perhaps at the heart of this ''epidemic'' is the alliance between the U. S. Department of Education (DOE) and certain pharmaceutical companies5. It appears that billions of federal taxpayer dollars are dangled in front of cash-starved public schools, complete with slick video tape and print materials and workshops, to help the schools find, identify and treat as many children as possible. So aggressive has been the campaign to force this form of treatment and non-clinical diagnosis on parents and the public school system, that already 13 states have passed laws forbidding its recommendation.
In the meantime, more and more, medical doctors who previously resisted doing so have begun ''diagnosing'' without benefit of clinical tests or identifiable physical markers, and giving out prescriptions for powerful drugs like Ritalin, Wellbutrin, Effexor, and Desipramine. These are Class II narcotics ranked with opium, cocaine, morphine, and codeine6. Side effects can include; anxiety (for which anti-anxiety medication is often given), insomnia (sleeping pills for this), kidney failure, enlarged heart, seizures, addictive personality, and even death7.
What are the most common signs and symptoms of ADHD? A child who:
- fidgets and squirms when bored
- drinks Coca Cola (or caffienated anything, including chocolate, coffee, and takes certain pain medications)
- suffers from undiagnosed food allergy
- has a high-sugar (or no) breakfast before school
- doesn't pay attention to the teacher
These, and many more children with explainable underlying psychosocial and nutritional influences stand a near absolute chance of being diagnosed with ADHD. In fact, one might say kids who are ''diagnosed'' with ADHD act like.well, boys8,9, 10,11. Hence, between 75-92% of children placed on ADHD medication are boys in the U.S. today. When we teach in-service training at some school districts we find some schools with no girls in their ADHD program! In others, only a handful. Why is that?
It could be due to the fact that the corpus collosum (the portion of the brain that allows the two hemispheres to talk to each other) tends to be about 30% smaller in young boys than in girls12,13,14. The theory behind our understanding of this neurological differential is that it contributes to gender specification in the development of the brain and body. From this, boys generally develop superior spatial, visual, and gross total body motor skills. Girls tend to develop superior communicative, social, fine-motor skills, and early cognitive development10.
An underdeveloped or developmentally delayed corpus collosum (CC) can cause a wide variety of learning and mental disabilities, including autism (it's higher form is known as Asperger's), dyslexia, stuttering, central auditory function, language delay, ADHD and interhemispheric discontinuity. These conditions are found overwhelmingly in young boys15,16,17,18,14, which in most cases tend to outgrow them during the maturation process.
But there's more: It must be noted that at any given time, 35% of children under the age of three in the U.S. suffer from otitis media with effusion (OME), a type of ear infection that plugs the auditory pathway in the middle ear, and causes speech, learning and cognitive developmental delays if left untreated long enough19, 20. It usually presents without pain or fever, so mom is often unaware of most episodes of OME; just the few that cause pain, discomfort and fever21.
Statistically, OME strikes girls about as often as boys. It is caused most often by inhalant allergy, which is increasing in our population, but often in food allergy, especially sugar20,22,23. The widespread and government-inspired practice of adding toxic levels of iron supplementation to baby formulae has caused untold misery for these kids, especially boys, who more readily suffer from iron toxicity than girls24,25,26.
And since boys' CC typically develops later than girls', boys statistically suffer many times more learning and communicative disabilities as a result of chronic OME than girls. Some say it is part and parcel of gender traits for boys to have more attentional and behavioral challenges during their early years, which if not responded to appropriately can later turn into real behavioral and attitude problems designed to cover seriously lagging academic skills.27
Hence, the rate of school dropouts is disproportionately high in the ADHD and OME groups, which comprise the largest segment of the juvenile justice population, and later, adults in prison. 96% of U.S. inmates today are male. Between 79% and 90% are functionally illiterate28,29,30.
So, the problem is real. But it is notI repeat, it is not a pharmaceutical problem in the vast majority of cases. Treatment for real causes is needed, and there will be variations from child to child. Perhaps a tiny segment of these children can benefit from Ritalin and other drugs. Others may stem from abuse (especially domestic violence) and neglect. But to ignore a huge array of other causes, for which OME-inspired developmental delay leads the list, is arguably both misguided social engineering and possibly medical malpractice2.
In more than two decades of research on this problem, we have found a host of solutions for the current dilemma:
Early treatment for allergies and other underlying causes of OME
Auditory treatment and training, especially for central auditory disorder
Speech therapy and related treatment
Development of musical skills (piano lessons is best)
Avoidance of high sugar, caffeine drinks
Adequate time for restful sleep
High protein, low carbohydrate breakfast before school
Some of these are discussed on our consumer-education website http://www.digicare.org/. There are many other resources for parents and educators from which to draw additional information, some cited in the references section of this article.
I realize this information is alarming. I fear we may be throwing out the baby with the bath water, and missing the forest for the trees in the rush for a quick and easy solution. I believe that common sense needs to prevail, and hope to see more of it applied in cases of ADHD!
Dr. Chartrand serves as Director of Research for DigiCare Hearing Research & Rehabilitation, Rye, Colorado, and is a prominent author and lecturer in the hearing health field. Correspondence: http://www.digicare.org/ or fax to (719)676-6882.
1. Baughman, F.A., Jr., Attention Deficit Hyperactivity Disorder, http://www.adhdfraud.com/, (2003)
2. Baughman, F.A., Jr., Malpractice and Violation of Informed Consent, Citizens Commission on Human Rights, (2003)
3. Holland, R., ''Classroom addiction to drug use'', The Washington Times, pg. A19, 17June(1999).
4. Montandon, J.B., and Medioni, L., Evolution of the number of prescriptions of Ritalin (Methylphenidate) in the Canton of Neuchatel between 1996-2000, Pharmaceutical Control and Authorization Division, Switzerland, (2001).
5. Rodie, D., ''ADHD: The New World Disorder'', Holland: Kleintje Muurkrant, March, (2001).
6. National Institutes of Health Consensus Development Conference Statement: ''Diagnosis and Treatment of Attention Deficit/Hyperactivity Disorder ADHD,'' Journal of the American Academy of Child and Adolescent Psychiatry, 1 February, Pg. 23, (2000).
7. Vastig, B., ''Pay Attention: Ritalin Acts Much Like Cocaine,'' Journal of the American Medical Association, August 22/29, Vol. 286, No. 8, pg. 905, (2001).
8. www.ncjrs.org/html/ojjdp/jjbul19712-2/jjb1297f.html, Examining How Well Boys Fit Into the Proposed Pathways'', (2003).
9. Beiderman, J., Mick, E., Faraone, S., et al, ''Infuence of Gender on Attention Deficit Hyperactivity Disorder in Children Referred to a Psychiatric Clinic'', Am J Psychiatry 159:36-42, January (2002).
10. Chartrand, M.S., ''The Gender Factor'', Hearing Health, September/October, pp. 16-18, (1995).
11. Chartrand, M.S., Hearing Instrument Counseling: Practical Applications for Counseling the Hearing Impaired, Livonia, MI: International Institutes for Hearing Instruments Studies, pp. 49-78, (1999).
12. Bermudez, P., and Zatorre, R.J., ''Sexual Dimorphism in the Corpus Callosum: Methodological Considerations in MRI Morphometry'', NeuroImage, 13, pp. 1121-1130 (2001).
13. Calvin, W.H., and Ojemann, G.A., Conversations with Neils Brain: The Neural Nature of Thought and Language, Addison-Wessely, (1994).
14. Harris-Schmidt, G., ''What are the Characterisitics of ADHD and ADD in Persons with Fragile X Syndrome?'', The National Fragile X Foundation, http://www.nfxf.org/, (2003).
15. Hardman, M.L., Drew, C.J., Egan, M.W., Wolf, B., Human Exceptionality: Society, School, and Family, 4th edition, Boston:Allyn and Bacon, (1993).
16. Hellige, J.B., Hemispheric Asymmetry: Whats Right and Whats Left, Cambridge, MA:Harvard University Press, (1993).
17. Smith, C., and Strick, L., Learning Disabilities: A to Z, New York: The Free Press, Simon & Schuster, Inc., (1997).
18. Biddulph, S., Raising Boys, Sydney:Finch Publishing, (1998).
19. American Academy of Audiology, ''Identification of Hearing Loss & Middle Ear Dysfunction in Preschool & School-Age Children'', Academy Documents.
20. Crook, W.G., ''Yeast, ADHD and Ear Infections'', Healthwell, http://www.healthwell.com/, (2003).
21. http://www.drgreene.com/, ''Otitis Media with Effusion'', A-Z Guide, (2003).
22. Randolph, T.G., ''Corn sugar as an allergen'', Annals of Allergy, 7:651-661, (1949).
23. Kaplan, B.J., et al, ''Dietary replacement in pre-school-aged hyperactive boys'', Pediatrics, 83:7, (1989).
24. Blanco, K., ''Iron Overload and Autism'', Med Hypotheses, August, (2003).
25. Schwartz, S., ''Choosing the Right Infant Formula for Your Baby'', Childbirth Solutions, Inc., (2003).
26. Sullivan, J.L., ''Stored Iron and Ischemic Heart Disease'', Circulation, 86:1036, (1992).
27. Chartrand, M.S., and Chartrand, G.A., ''A Cognitive Primer for Parents'', Hearing Library, http://www.digicare.org/, (2002).
28. Weber, W., Illiteracy Problems in America, http://www.csupomona.edu/~wcweber, (1998).
29. Meenan, A.L., and Burns, P.E., Adult Literacy and Technology Conference Proceedings, University Park, PA, (1987).
30. Dalgish, C., ''Illiteracy and the Offender'', Adult Education, London, v56 n1, pp. 23-26, (1983).
This article was originally published on Healthy Hearing (www.healthyhearing.com) on 9/22/03 and is reprinted here, based on popular request.