January 2007

ADHS research project collects case study reports

by Dr. Yannick Pauli

When I fist met Chirstophe, it struck me that he was probably the best embodiment of the word "zombie." I mean, he looked just like one of those very nice kids you just want to take into your arms to give them a big hug. But he seemed lifeless. You could sense there was some great spirit within him, but that it could not just express itself. His eyes were dull and empty. He did not talk at all.

Christophe had been diagnosed as "having" ADHD and was presently taking Ritalin. Although they would have rather not have had him on a drug, his parents where relieved by the "diagnosis".

Finally, it explained why their son was doing so poorly in school to the point of failing, why was always forget things and seem so disorganized, why they had to put in hours of homework for less‑than‑optimal results.

This situation had taken a toll on the family: the mother was depressed and suffering from migraines, the husband admitted to being a workaholic, just to be away from home and not get mad at his son, and her sister just felt abandoned and unloved because "all the attention was for him and none for me."

Although he had also been diagnosed as having ADHD, Cedric was a different kind of child. During my lengthy first consultation, he was running all over the place, climbing the walls despite his parents many threats of sanctions ‑‑ and despite the fact that he was already on a high dosage of Concerta, the equivalent of Ritalin in a released‑time form.

After falling on the ground due to his excessive activity, he went into one of his too‑frequent temper tantrums and started screaming like someone was ripping his skin of his body, spitting all over my carpet and my desk. Her mother just started crying.

That only added to the already puffy eyes she was having from her close to burnout state. The parents were at the "end of the rope." Two weeks later, as we started Cedric into our pediatric chiropractic neurology specialty program, the family had imploded and the parents had decided to divorce.

Attention Deficit and Hyperactivity Disorder (ADHD) is a very controversial disorder. So is its diagnosis, and, even more, its management, which consists primarily of the prescription of the psychostimulant methylphenidate, better known as Ritalin.

The aspects of this controversy ‑‑ such as the limits and inadequacies of the diagnosis; the prevalence of the disorder (overdiagnosed for some, underdiagnosed for others); the effect of the "disorder" on the brain, or lack thereof; the use and abuse of medication and their potential side effects ‑‑ is an interesting exercise in intellectuality. It tells us a lot about health paradigm, politics and economics of science, expert opinions and the interests of the pharmacological industry.

However, it does not tell us about human suffering.

As a chiropractor, you may be inclined to choose one "camp" over the other. But regardless of whether you believe ADHD to be a real disorder or not, your opinion and belief ‑‑ and mine ‑‑ are irrelevant.

What is very relevant, though, is that millions of families around the world are suffering enough from the behavioral misfeats of their children to place them on a daily regimen of psychotropic drugs. In the US, the rate of children taking psychotropic drugs ‑‑ cost commonly Ritalin ‑‑ increased from 0.9 per 100 children in 1987 to 3.4 per 100 children in 1997, corresponding to 493,000 children treated in 1987 and 2,158,000 in 1997.

This is more than 2 million children depending daily on a pill to function adequately in our society! Today, this number is probably even higher. Imagine 5% of our children population depending on a pharmacological crutch to allow them to fulfill the demand imposed upon them by our society in general, and our school system in particular. And this does not take into account the many other million taking other kinds of mood‑altering drugs prescribed for other types of neuro‑behavioral disorders. Of course, these are conservative estimates.

One study in Virginia found that in two school districts, 17% of white boys at primary schools were taking psychostimulants. Even scarier are the studies showing a large increase in prescription of psychostimulants to pre‑schoolers! It is estimated that as much as 1.5% of children aged 2‑4 years are taking drugs such as Ritalin!

We as chiropractors have been tolerating this situation for too long. It is time we step up to the plate and show the nation that we are the best positioned practitioners to take care of these children. Not to treat their so‑called disorder but to remove the neurological and nutritional insults that affect their growing brains, thereby improving their overall wellness and quality of life.

For the brain to grow properly and optimally, it requires proper nutrition of two kinds: "nutritional" nutrition and "neurological" nutrition. Our brain depends mainly on proper afferentiation for its development and function. And proper afferentiation can only occur if our axial skeleton is free of vertebral subluxation, if our postural musculature is balanced and if our life is full of vital movement.

Who else other than the chiropractor, expert at understanding the proper function of the spine and how the latter controls our brain as well as the importance of a good diet, can offer those children and their families the hope of improved quality of life in a natural, non‑drug dependent, empowering way?

One study and various anecdotal reports are already pointing to what hundreds of chiropractors are witnessing in their offices on a regular basis.

Christophe and Cedric ‑‑ only two of the many suffering "ADHD" children we have seen in our specialty office ‑‑ are now functioning without drugs better than they did before.

Christophe's spirit expresses itself in his eyes, he can concentrate better, his grades have improved and he does not have to spend countless hours to master his academic material. Although the parents of Cedric remain divorced, he is now calmer, respond to the demands of his mother by appropriate behavior and does not have temper tantrums anymore.

However, unlike many other files in your office, the story of these two children will not remain untold, their files collecting dust in an obscure file cabinet. Their story will be told to the world in a properly written, scientific case report.

Many of our colleagues are making their contribution to chiropractic knowledge by taking a few hours to write one or two case reports on the response of children suffering from ADHD to chiropractic care. But we need more ‑‑ many more.

The ADHD Case Report Project is only the initial step of a collaborative effort between the World Chiropractic Alliance and the Journal of Vertebral Subluxation Research to start documenting the effects of chiropractic care in children suffering from ADHD and other behavioral problems.

Imagine if 20, 30, 50 or even 100 case reports on the impact of chiropractic care on children with ADHD were written, submitted to a peer‑reviewed, scientific chiropractic journal, subsequently published and were to hit the mass media.

What a difference it could make for our profession. What a difference it could made in the lives of million of families who, so far, have had no other options offered to them than to drug their children! What a difference it would make for our next generation if 5‑10% of our youngsters would not have to go through life harnessed by a pharmacological straight‑jacket!

If you have experience in taking care of children suffering from ADHD, or even have had just one case, stop procrastinating. Step up to the plate and do something! Be part of our ADHD Project and contact me today at ypauli@jvsr.com. We will assist you as needed through the entire process of case writing and submitting.

(Dr. Yannick Pauli lives in Lausanne, Switzerland where he runs a family, wellness‑oriented chiropractic office specializing in the care of children with ADHD, learning disabilities and behavioral disorders. He has post‑graduate training in Applied Kinesiology, nutrition, chiropractic pediatrics and chiropractic neurology. Dr. Pauli is a member of the International Chiropractic Pediatric Association and is also the President of the Swiss Chiropractic Pediatric Association, as well as an associate editor for the Journal of Vertebral Subluxation Research. He can be contacted at: ypauli@jvsr.com or by phone at: 004‑121‑646‑5238.)