Attention Deficit Hyperactivity Disorder (ADHD) affects millions of Americans -- adults as well as children. By definition, ADHD is a neurologically based disorder and should, therefore, be treated by the experts in functional neurological disorders: doctors of chiropractic.

The drug Ritalin has not been tested for long-term side-effects or for any withdrawal-related complications, yet it is routinely given to individuals diagnosed with ADHD.

At best, Ritalin is simply masking the underlying neurological dysfunction associated with ADHD without doing anything to help ascertain a cure. Unfortunately, at its worst, the drug may be destroying the lives of millions of children. I find neither extreme appealing.

How can chiropractic help?

Probably the best way to begin helping an individual with ADHD, or their parents, is by educating them -- not about ADHD, but about chiropractic. A good starting point is to make sure they understand that chiropractic doesn't treat ADHD. Instead, inform them that chiropractic's goal is to treat the underlying cause of ADHD.

Once the involved individuals understand the value of a treatment that addresses the cause of ADHD, the doctor should further educate them regarding chiropractic. Quite simply, it is important to teach people that "subluxations" are structural misalignments that cause neurological dysfunctions, and that the specific purpose of chiropractic is to identify and eliminate such subluxations.

Symptoms give clue

If course, there is no one specific subluxation that leads to the neurological manifestation of ADHD. However, the symptoms related to ADHD (hyperactivity, inability to pay attention, impulsivity) seem to indicate a disturbance with brain stem function. This idea of brain stem dysfunction is actually supported by the manufacturer of Ritalin who admits that although "how" Ritalin works is not completely understood, it does appear to affect the brain stem.

I find this correlation between brain stem dysfunction and ADHD extremely interesting for chiropractic because a subluxation to the upper cervical (C1-C3) area can be the cause of brain stem dysfunction. Therefore, although every segment of the spine should always be assessed, chiropractors must pay special attention to the upper cervical region when treating individuals with ADHD.

One manner in which upper cervical subluxations can affect brain stem function is through direct pressure. Many upper cervical techniques are aware of the potential of this occurring and teach this along with their technique procedures. A second, and in my opinion more common, manner in which upper cervical subluxations can affect brain stem function is through altered proprioceptive input to the brain stem from the C1-C3 vertebrae and the related soft-tissue structures.

Proprioceptive "input" from the upper cervical area is required by the brain stem before a variety of neurological "outputs" or functions can be performed. Like a computer, the quality of the upper cervical "input" will determine the quality of the "output". Therefore, if the input to the brain stem is altered (as is the case with an upper cervical subluxation), the output from the brain stem will also be altered.

In my opinion, ADHD is simply one example of altered brain stem "output". The key to correction, therefore, lies not in treating the ADHD, but in treating the altered sensory input that caused the ADHD. Although somewhat confusing, I believe that understanding this is paramount to understanding how chiropractic "works" in cases involving ADHD.

It is only fair to state that, although proprioceptive information from the upper cervical area is the most important spinal-related source of sensory input to the brain stem, it is not the only source of such input. Proprioceptive, or more accurately, "position sense" information is also sent directly to the brain stem from the vestibular and visual areas. Once in the brain stem, the sensory input from all three areas (upper cervical, vestibular, and visual) is utilized to determine many brain stem functions, including activity (or hyperactivity) levels.

Although the subject of craniopathy is often controversial in our profession, cranial misalignments do exist and they are capable of producing nervous system interference. For this reason, cranial misalignments that alter the "position sense" of the vestibular or visual areas will also contribute to the manifestation of functional neurological disorders such as ADHD. Therefore, it is not unusual to find sphenoid, maxilla, and/or temporal bone subluxations (as well as upper cervical subluxations) in children with ADHD.

Correcting subluxations, regardless of their location, is a vital contribution that only chiropractors can offer to children with ADHD. These children, along their parents and teachers, need to be educated regarding the dangers of Ritalin and also about the power of chiropractic. Ultimately, all children should be able to experience the joy of a well-adjusted body.