Mental health statistics from the Department of Health and Human Services report that between 7.7 million to 12.8 million children have mental disorders. More than 2 million elementary school children are believed to have attention deficit hyperactivity disorder (ADHD). During the past two decades there has been a significant increase in the number of youngsters who are diagnosed with mental disorders and who, as a consequence, are put on drugs to treat their “disease.” These are not just teenagers or even older juveniles: According to a study published in early 2000, the number of children between the ages of 2 and 4 years of age taking medications such as Ritalin nearly tripled during the 1990s.

To what is this alarming situation attributable? Are our kids really more troubled than they were 10 years ago? And if they are, how can drug therapy be the best way to treat them?

Attention-Deficit Hyperactivity Disorder

The following example will address the first two of these questions, namely, how the treatment of childhood mental disorders came to be a major area of modern-day psychiatry. Later we will contrast the traditional approach to these disorders with that of orthomolecular psychiatrists and other health care practitioners in order to provide insights into the many different alternatives to drug therapy available in the treatment of children with behavioral, emotional, and mental problems.

Bobby is 6 years old and has just started the first grade. He is precocious and has been reading and writing for at least a year. He is an only child, has been somewhat spoiled at home, and is used to being the center of attention. He is extremely active and often plays from morning until night. Sometimes his activity gets on his mother’s nerves, but on the whole, she and everyone else who knows Bobby find him to be a normal, healthy child who is usually well mannered and considerate.

From the very start, Bobby hits it off poorly with his first-grade teacher. Because he is used to being active, he usually starts to fidget 15 minutes into the class. Often when the teacher asks a question, Bobby blurts out the answer without being called on. The teacher, Ms. Thomas, has admonished him a number of times, and he does try to control himself. Since he already knows what Ms. Thomas is teaching and is not called upon to answer questions, Bobby often becomes bored and restless. He is apt to become absorbed by things going on outside the classroom window to the point where he often does not hear what Ms. Thomas is saying.

Bobby’s teacher finds him to be a disruptive influence and believes that he is hyperactive. She sends him to the school psychologist with a report stating that she suspects that Bobby is suffering from what is technically called attention deficit hyperactivity disorder. A copy of the report is sent to Bobby’s parents, who immediately become alarmed that something may be wrong with their son. The psychologist examines Bobby, notices nothing out of the ordinary, and sends him back to class with a note to both the teacher and Bobby’s parents telling them about his conclusions and asking them to keep an eye on Bobby so that they can alert him if anything new occurs.

A month or so later the teacher files another report. This time, after the psychologist again examines Bobby and fails to notice any aberrant behavior, Bobby’s parents are advised that he should be seen by a psychiatrist. After reading the teacher’s report and examining Bobby, the psychiatrist concludes that Bobby is in fact suffering from attention-deficit hyperactivity disorder and prescribes Ritalin (methylphenidate).Bobby’s parents are somewhat bewildered by this and ask the doctor what the drug is and whether it is really necessary. The doctor explains that while he has not noticed any particular signs of the disorder, symptoms are not necessarily present when the child is having a one-on-one exchange or is in a new setting, such as his office. “Typically,” the doctor says, “symptoms worsen in situations requiring sustained attention, such as listening to a teacher in a classroom or doing class assignments.” This is why Ms. Thomas has been in the best position to notice and report the disease. The doctor tells the parents that he suspects that Bobby is suffering from a chemical imbalance in his brain which, if uncorrected, could start to affect his performance at school and that bad grades could ruin the rest of Bobby’s life. He adds that although scientists do not yet know how it works, Ritalin seems to stabilize children who have this disorder.

At first Bobby’s parents are so confused by the diagnosis, and so alarmed that their child is so ill as to require medication for an indefinite period of time, that they simply go along with it. However, shortly after Bobby starts taking the medication, his parents notice that he has become very nervous and complains that he cannot sleep at night. He also shows a marked decrease in appetite and begins to lose weight. They decide to look into the drug more fully and discover that Ritalin is a potentially addictive appetite-suppressing drug of the amphetamine family with numerous side effects, including those already experienced by Bobby: insomnia, loss of appetite, weight loss, and nervousness. When they discuss this with the psychiatrist, he tells them that the side effects are minimal compared with the damage that the boy could sustain if he stopped taking it and that furthermore, Ms. Thomas does not want him back in her class unless she is assured that he is taking the medication.

This example is hypothetical, but it is by no means exaggerated. Every year children like Bobby are diagnosed with nebulously defined “mental disorders” and receive treatment with Ritalin or other even more potent drugs such as Haldol and Thorazine. Since the “diseases” for which these drugs are prescribed first came into vogue in the 1960s, literally millions of American children, about three-quarters of whom are boys, have been labeled and given drugs to tone down their conduct and make it more acceptable to those with whom their energy and activity may collide. While some of these drugs have been studied for use in older children, they have not been tested for use in younger ones. And they have many potential side effects.

In March 2000, in response to published reports about the staggering growth in drug prescriptions for children, the U.S. government announced that the FDA would begin developing research protocols necessary to provide dosage information and labeling for psychiatric drugs in children.

Historical Perspective

During the 1960s and 1970s many childhood “disorders” were lumped together under the rubric of minimal brain dysfunction (MBD). The history of MBD and how it suddenly became a childhood disorder provides us with an opportunity to more clearly see into the nature and purpose of much of psychiatric diagnosis and treatment.

The term “minimal brain dysfunction” has been around in medical literature since the 1920s. In its original sense, the term was used to describe learning and behavioral problems that result from identifiable damage to the brain, such as those which sometimes occur at birth or through head injuries. The key was that actual physical brain damage existed that was impairing the child’s or adult’s ability to do certain things according to fairly objective standards. In 1963, however, all of this changed following a conference held by the U.S. Public Health Service and the National Easter Seal Society for Crippled Children and Adults. A report issued after the conference essentially claimed that the cause of the MBD was organic (of a physical origin within the body) and redefined the term so broadly as to include almost any imaginable form of behavior. According to the head of the Public Health Service at that time, Dr. Richard Maseland [quoting from Richard Hughes and Robert Brewin, The Tranquilizing of America], the intent was to single out “that group of children whose dysfunction does not produce gross motor or sensory deficit or generalized impairment of intellect, but who exhibit limited alterations of behavior or intellectual functioning.”

The new definition of MBD was drafted by a special task force led by a psychologist at the University of Arkansas Medical School. It included a list of 99 criteria so vague and all-encompassing that the definition would have been laughable had it not become the basis for the psychiatric labeling and medicating of millions of American children. In The Tranquilizing of America, Brewin and Hughes further explain:

“It would be difficult to write a more all-inclusive definition for this new disorder subsequently used to label millions of children, but the task force didn’t stop there, offering 99 symptoms to help doctors and teachers spot these otherwise normal children. The symptoms include hyperkinesis (too active) and hypokinesis (not active enough); hyperactivity and hypoactivity (activity opposites of a milder nature); ‘rage reactions and tantrums’ and being ‘sweet and even tempered, cooperative and friendly’; ‘easy acceptance of others alternating with withdrawal and shyness’; being ‘overly gullible and easily led’ and being ‘socially bold and aggressive’; being ‘very sensitive to others’ and having ‘excessive need to touch, cling and hold on to others’; and ‘sleeping abnormally lightly or abnormally deeply….’

“It’s unlikely that any child, no matter how normal or healthy, could escape classification under such a hodgepodge of ‘signs’ pointing to an MBD child in need of treatment.”

According to Brewin and Hughes, notwithstanding this basically meaningless cornucopia of definitions, the concept of MBD was enthusiastically welcomed by the psychiatric community, governmental health agencies, educators, and pharmaceutical companies.

How Children are Classified

While the term “MBD” is no longer used in the psychiatric jargon, the concept has by no means been abandoned, nor has the use of amphetamines in its treatment. The DSM-IV (Diagnostic and Statistical Manual of Mental Disorders—the official diagnostic guide for psychiatrists) has an entire section devoted to “Disorders Usually First Diagnosed in Infancy, Childhood, or Adolescence.” This class includes developmental disorders such as “Mental Retardation,” and “Pervasive Developmental Disorders” (including autistic disorder, among others), as well as the “Attention-Deficit and Disruptive Behavior Disorders,” such as attention deficit hyperactivity disorder not otherwise specified, conduct disorder, and oppositional defiant disorder.

Nowhere is the DSM-IV more vague or subjective than in the sections concerning and defining childhood disorders. While some of the developmental disorders do contain somewhat more objective criteria, the diagnoses of the “behavior” disorders are very subjective and the symptoms are so wide-ranging that many healthy children could easily fall within their ambit.

The determination of what constitutes normal behavior and what does not is often made by people who have an interest in labeling such things as restlessness and blurting out answers to questions as pathological. In other words, implicit in many DSM definitions is a belief that certain behavior should be controlled and suppressed simply because those in a position of authority may find it troublesome. Even a cursory examination of these definitions reveals that they are primarily directed at a child’s behavior at school. Ultimately, then, it is in the school rather than the doctor’s office that learning and mental disabilities are first diagnosed.

This is not to say that children do not suffer from emotional and behavior problems that can dramatically affect the quality of their lives. Many doctors treating children for these problems report that such children are often aware of not acting like everyone else and are disturbed and upset by this realization. Few would deny the importance to these children, and to society as a whole, of diagnosis and treatment aimed at getting at the root of their problems and designed to help them live a happy and fulfilling life. However, the treatment of legitimately ill children with safe, caring, and effective therapies is not what we have been talking about here.

Ritalin

Dr. Peter Breggin is a world-renowned psychiatrist and director of the International Center for the Study of Psychiatry. He has authored many books in the field of psychiatry and is considered quite a maverick within the conventional psychiatric community. He shares his thoughts on Ritalin.

“We used to beat our kids and think it was okay. It is no longer considered okay to whip the daylights out of a child. But now we have even more bizarre and potentially more destructive forms of child abuse, such as giving a child toxic substances while that child’s brain is growing. This is the basis for how these drugs become addictive. I have cited the data on Ritalin causing psychosis in children. We have animal studies that show when you give amphetamines to animals in the same dose you give to kids and only for a few times, brain cell loss and permanent changes occur.

“There are also new studies showing if you take Ritalin as a child you are more likely to abuse cocaine as a young adult. Ritalin is a schedule 2 drug according to the DEA, meaning it is in the same class of drugs as amphetamines, methamphetamines, cocaine and morphine. Schedule 2 drugs means they have even more addictive potential than Valium and Xanax. It’s astonishing that we are willing to do this to our kids.

“In animal studies these drugs suppress spontaneity and autonomy, all searching, exploring and socializing behavior. Because of their effect on the basal ganglia they enforce compulsive behavior. So a monkey that was previously desperate to get out of its cage and play with its neighbor will instead sit quietly behind the bars and pick at its own skin in a compulsive way instead of grooming another monkey.

“That’s what we are doing to our kids—making good caged animals. Millions of our children are being suppressed with psychiatric drugs instead of having their needs met. Their needs are for everything from nutrition to inspiring education, consistent discipline at home and unconditional love. They are having their needs unmet when we drug them into submission. It is an abomination. Control is now no longer even a strong enough word. When you are damaging a child’s brain in the name of making them sit still in class you have gone beyond social control into brutal suppression.”

Dr. John Breeding, a psychologist from Texas and author of The Wildest Colts Make the Best Horses: The Truth About Ritalin, ADHD and Other Disruptive Behavior Disorders, tells us more. “The Physicians Desk Reference, commonly known as the PDR, is the text that is provided for doctors in which the manufacturers are required to list all the potential effects of drugs…. Among the potential side effects listed for Ritalin are loss of appetite, abdominal pain, weight loss, insomnia, and altered heart rate. And those are just the physical effects….Emotionally we are dealing with things like a basic message to the child that they are defective and that they need drugs in order to cope.”

Alternative Approaches to Childhood Disorders

There are a number of alternative approaches to childhood disorders that people should explore before letting a doctor put a child on drugs. Before we leave this section I believe that we must ask ourselves have we the parents, the teachers, the physicians, allowed the pharmaceutical industry and its medical, media, and legislative supporters to pathologize children? Have we taken normal behavior, including anger, sadness, and exuberance, and turned these into “biologically disordered brain diseases.” Have we done this just to create new products to sell for new imaginary diseases?

FOOD AND ENVIRONMENTAL ALLERGIES One physician who has had considerable success in the treatment of children with emotional and behavior problems is Dr. Doris Rapp, author of Is This Your Child?, Is This Your Child’s World? and the companion video Environmentally Sick Schools. Dr. Rapp practices a branch of medicine called environmental medicine, which looks at the role that the environment plays in people’s overall health and well-being. In particular, doctors such as Dr. Rapp are concerned with so-called environmental allergies.

Dr. Rapp explains that most emotional and learning disorders can be caused by allergies in both children and adults. Children can become moody, depressed, suicidal, hyperactive, agitated, or panicky—all for no apparent reason. They may suddenly cry, spit, or kick or hurt others or themselves. Dr. Rapp has “observed that almost any emotional expression imaginable can occur as a result of an adverse reaction or sensitivity to substances in the environment. It sometimes happens in relation to ingesting certain foods or being exposed to certain chemical odors (such as tobacco or perfume), lawn herbicides, chemicals, or pollens and molds. Any of these can cause problems in some individuals at certain times.”

Dr. Rapp offered the following observation during a radio interview: “In my office I have seen and documented many patients, young children, who have acted in a very bizarre manner when they have been exposed to something that is unusual. For example, I had one little girl, about 5 or 6 years of age, who became very depressed and wished she was dead on days when it was damp and moldy. When she came into our office and we skin tested her for molds, she became very depressed, pulled her hair over her face, and became untouchable. When her mother walked toward her, she would pull away and scream; she wouldn’t let anybody touch her. Then, when we gave her the correct dilution of mold allergy extract, on her own, she walked over to her mother, sat in her lap, gave her a hug and a kiss, and said, ‘Mommy, I love you.’

“I had another little boy, about 9 years old, who never smiled. His mother brought in pictures of him at Easter, Christmas, at birthday parties and things like that, and he always looked very dour; he just didn’t look happy at all. When we placed him on a diet that merely excluded highly allergenic foods, his mother said that she was really amazed because at the end of 1 week, he was smiling and happy for the first time in his life. When I talked to him, he said that he felt much better on the diet; he said that he didn’t want to take Mikey’s knife and put it right here, and he showed me where he thought his heart was. He was going to put a friend’s knife right into his chest.”

WHEN TO SUSPECT ALLERGIES

Dr. Rapp offers some guidelines about when to suspect that allergies may be causing behavioral or emotional problems. “If your parents had hay fever and asthma or any of your children have these conditions, and you have one child who is having behavior and personality problems, you might consider the fact that the dust or the milk that is causing the asthma in one child may be causing bed-wetting or hyperactivity or aggression in the other. If a patient has an allergic history or typical allergies such as asthma or hives, this particular patient may also be having brain allergies—allergic reactions within the brain—that may be affecting his or her behavior or emotions.”

Dr. Rapp also states that children or adults who suffer from allergies often have a characteristic look. They frequently have bags or dark circles under their eyes, and many have bright red cheeks and earlobes when they are reacting. Many children with allergic reactions affecting the brain tend to wiggle their legs, fidget constantly, and have trouble remaining seated. Dr. Rapp has also noticed that very often the handwriting and drawings of children will vary significantly when they are reacting. She explains: “The child who is exuberant and all over the place writes in a very large manner. However, the writing may be upside down or backward or in mirror image. But the child who is depressed and goes into the corner frequently writes in extremely small letters. The writing will be as small as it can be, or the child will just write his or her name as a dot. Then, when you treat the child with the correct dilution of the stock allergy extract, he or she can write, and can act in a normal manner.

“I recently saw one 8 year old, for example, who becomes depressed and suicidal each year during the tree pollen season. Last year when she came in, she drew pictures that were very unhappy with sad faces. Then, after we treated her for tree pollen, she drew a smiling face of a youngster who was very happy.”

Dr. Rapp describes a 9-year-old boy who became very vulgar whenever he ate certain foods or was exposed to molds. His mother found that he was particularly offensive when he went to a particular school. Dr. Rapp explains: “We went to the school with an air pump, collected samples, and then bubbled this air through a saline solution. We took the youngster, who was sensible and normal at the time, and made him vulgar simply by placing a drop of his school air allergy extract under his tongue. He became vulgar in both his speech and his actions. In addition, he jumped on the furniture and scribbled on walls. He threatened to pee on his mother’s leg and do very strange things. When we gave him the correct dilution of the school air, he came right back to normal.”

Dr. William Philpott, a leader in the field of environmental medicine and author of Brain Allergies: The Psychonutrient Connection, provides other examples of how allergic reactions can affect children:

A 12-year-old boy diagnosed as hyperkinetic had the following symptoms on testing for spinach: he became overtalkative and physically violent, had excessive saliva, was very hot, developed a severe stomachache, and cried for a long time. Watermelon made him irritable and depressed, cantaloupe made him aggressively tease other patients. Once he avoided the incriminating substances in his diet, his hyperkinesis symptoms diminished dramatically. A 4-year-old boy diagnosed as hyperkinetic had a variety of reactions. String beans made him hyperactive, and he wanted to fight with everyone. Celery gave him a severe stomachache, after which he cried and became grouchy. Strawberries made him angry and hyperactive and caused a great deal of coughing. Unrefined cane sugar caused him to be irritable, after which he coughed and developed a stuffy nose. A 12-year-old boy became listless and depressed, and cried when tested for bananas. Then he became aggressive and picked up a stick as if to hit another patient. When he ate oranges, he sang at first but then became very tired, impatient, and eventually wild and aggressive. Rice caused him to experience a sensation of heat, followed by rebellious hyperactivity.

As can be seen from these examples, it is not necessarily unhealthy or “junk” foods that are the worst offenders. Virtually any food can cause problems in a given individual. In fact, one of the major characteristics of allergy is that it is an individualized reaction to substances that ordinarily are well tolerated by other people.

Dr. Theron Randolph, considered by many the founder of environmental medicine (also called clinical ecology), estimates that as many as 60 to 70 percent of symptoms commonly diagnosed as mental are actually caused by allergic-type reactions. Many emotionally disturbed people, especially those with psychoses, develop major symptoms when exposed to foods and chemicals that they frequently consume. Wheat, corn, milk, tobacco, and petrochemical hydrocarbons are some of the more common substances that trigger these allergic responses.

ELIMINATION DIET

There are a few tools that environmental medical specialists use in treating children with allergy-related behavioral problems. The first is an elimination diet, which usually is recommended after the first visit with the physician. In certain severe cases the diet may take the form of a total fast, but usually it eliminates only the specific foods the doctor suspects are a problem for the particular patient. The targeted foods are those that are common allergens (substances that provoke allergies in many people), such as chocolate, dairy products, wheat, and cane and beet sugars, as well as foods that the patient has a tendency to abuse. Environmental medical specialists have found that people are often especially allergic to the foods that they eat most often. Sometimes the frequent consumption can even lead to a sort of addictive-allergic reaction where a person craves the very food that is making him ill.

As food residues can remain in the body up to 4 or 5 days, the object of the elimination diet is to clear the body completely of foods that may be causing problems. If allergy is at the root of the problem and the correct foods have been eliminated, the symptoms will clear at the end of the 5-day period. Dr. Philpott gives an example of how this can work:

“Henry, 17 years old, had been mentally ill for 3 years. Prior use of tranquilizers, psychotherapy, and electric shock had not succeeded in helping him appreciably. He believed that people were out to kill him, and he often had to be placed under restraint because of his attacks on innocent children and adults. He was placed on a fast from all foods and given spring water only. He remained mentally ill until the fourth day, at which time his symptoms cleared; he was released from his restraints. He telephoned his parents, saying, ‘I love you. Please come and see me.’ On the fifth day of the fast he was fed a meal of wheat only. Within an hour, he began to feel strange and unreal; within an hour and a half, he thought people were going to kill him. He telephoned his parents again, saying, ‘I hate you. You caused my illness. I don’t want to ever see you again.’ Further testing confirmed the fact that when specific foods were withheld, his symptoms cleared, and when he was given wheat, the same paranoid reaction occurred consistently.”

The body is particularly susceptible to allergens, particularly after the elimination diet. A small drop of an extract of the substance placed under the patient’s tongue can reduplicate symptoms, sometimes very dramatically. This procedure of testing for allergies by placing a drop of extract under the tongue or injecting it subcutaneously is called provocative testing, and it is one of the major diagnostic techniques used by environmental medical specialists.

Once the allergies are determined, a technique known as neutralization dose therapy is often used to eliminate the symptoms. In this procedure the physician uses increasingly diluted extracts of the particular substance until a dilution is found that reverses the patient’s symptoms. This is the neutralizing dose. If you find this confusing don’t worry. It is paradoxical, and science cannot explain how a diluted substance can have a more potent effect in relieving symptoms than a stronger solution of the same substance. Because neutralization therapy often is based on very weak dilutions of things such as wheat, milk, and corn, it is an extremely safe and nontoxic form of treatment providing a food doesn’t cause a life-threatening medical emergency. It is particularly useful for people who have a moderate allergic reaction whenever they eat a particular food.

FOUR-DAY ROTATIONAL DIET

Another treatment commonly used by environmental medical specialists is the 4-day rotational diet. It is especially useful for patients who are not allergic per se to a given food but become “sensitized” to it when they abuse it or eat it frequently. In this diet almost all foods are rotated so that they are not eaten more than once every 4 days. This way the patient not only avoids the food to which he or she may be sensitive but also decreases the possibility of becoming sensitive to other foods that might have been overconsumed to compensate for the decreased consumption of the “abused” food. (See chapter 11 for more on the 4-day rotational diet.)

AMINO ACIDS, HERBS, AND OTHER NUTRIENTS Dr. Ray Wunderlich, who practices preventive medicine in St. Petersburg, Florida, and is the author of many books, explains his approach to treating children with learning disorders or behavior problems: “We try not to give them Ritalin or amphetamines when they have hyperactivity or attention deficit disorders. Instead we look at their basic quality of life and their lifestyle. Are they troubled by any infections? Do they have allergies? Do they have nutritional deficiencies? Do they have chemical toxicities? Is there some kind of nutritional disorder that is underlying the problem?

“We are directly opposed to the conventional approach, which relies primarily on just treating the symptom by the use of medication. We’ve determined that very rarely is it necessary to use prescription drugs for these children. The drugs may be needed on a temporary basis while you’re testing the patient or while the family is discovering how to reform the diet, for example, or deciding which vitamin and mineral supplements to use. However, in the vast majority of cases—90 percent, I would say—we were able to manage the problem, whether behavioral or academic, without the use of drugs.”

Dr. Wunderlich begins by looking at amino acids. “We assess the child’s-amino acid pattern through a plasma amino acid test or a 24-hour urine test to spot the amino acid deficiencies and imbalances. We often find that the essential amino acids are not being received by the child. It could be because the diet is so poor, or it could be that the child’s digestion and absorption are inadequate, so that the child, while eating well, isn’t achieving the amino-acid levels that he needs. We address that issue with supplements to correct either the inadequate input of food or the digestive, malabsorption problem.

“We use herbs in the detoxification process initially. Many of these children are toxic—their bodies react adversely to other elements to which they’re exposed. Sometimes, if you give these children vitamins for example, they are unable to take them. The same applies to adults. And when you see that, you know that there is a high level of toxicity in the body and you have to go to some kind of detoxification process. Herbs are very safe and a very convenient way to do that. You get a good response and the family often will see the difference in the child and will then listen more openly to the nutritional message.” Detoxification should be done under professional supervision, Dr. Wunderlich adds.

Among the herbs used by Dr. Wunderlich are red clover, goldenseal, black walnut, and acansosyanicide, which comes from blueberries and from pine bark. Dr. Wunderlich explains that these herbs “strengthen the blood/brain barrier and that enables us to protect the child whose brain is more or less on fire—hyper-reactive because of reactions to foods, endogenous chemicals or exogenous toxins. These herbs have been a great help in protecting the brain until we can get the diet changed or the environment cleared up so that it isn’t suffering such a toxic assault.

“As far as amino acids are concerned, in some children you have to use just a general, across-the-board supplement including all 8 or 10 of the essential amino acids. In others, we use tryacine, cellalonine, tryptophan, cysteine—particularly the sulphur bearing amino acids—glutamic acids and, of course, the branch-chain of amino acids, particularly in individuals who have an absorption problem.

“Typically we see the most dramatic improvement in the child’s use of his or her intellectual ability. It’s like putting an engine into gear. The child is better able to listen in class, respond in a communicative way, participate in a dialogue, handle visual tasks—this is enormously important because auditory/visual functioning are linked in learning, and control of eye movement in focusing is a big factor in how well one learns. In many cases, the special lenses which optometrists sometimes prescribe for children with learning difficulties can be discarded several months after these nutrients have been added.”

ADD AND NUTRITION Marsha Zimmerman, a certified nutritionist and author of The ADD Nutrition Solution: A Drug-Free 30-Day Plan, says that in many cases problems like ADD may be linked to malnutrition during pregnancy. In fact, she says, it may even be malnutrition before conception.

“We are not really preparing very well for conception and neither young women nor men are properly nourished when they conceive children. The women in many cases had a very poor prenatal history. Either they had not been able to keep food down or they didn’t have adequate dietary counseling, and the child is totally dependent of course on mother’s nutrition during pregnancy.

“The brain develops very early. In fact, between 18 and 21 days the neural fold is developing in the young embryo, and of course the neural fold is what later becomes the brain, spinal cord, heart and all the peripheral nerves. We know of course about the impact of folic acid at that time, but now we are beginning to get insights into the role of fatty acids at that particular time. The brain is uniquely dependent on the correct fatty acids. In particular there is one called DHA or docosahexaenoic acid that the developing embryo needs in very large quantities. The only source of course is the mother. A lot of women are deficient in these fatty acids.”

During pregnancy, Zimmerman emphasizes a diet of whole grains and fish. Fatty fish are extremely important, as they are rich in omega-3 fatty acids that are needed for healthy development. Women who don’t like or want to eat fish can get these essential fatty acids in a dietary supplement. “Most of the pregnant women that I’m counseling go on a program where they are using DHA in supplement form just to ensure they get adequate levels,” Zimmerman says.

Zimmerman explains that ADD is different from ADHD. Attention Deficit Disorder involves attention and behavior but without the hyperactivity. “This is the child who is daydreaming, can’t complete tasks, has many things going on at the same time but never finishes anything, has trouble following through with instructions.” Children with ADD may have difficulty understanding what time of day it is. “They get confused as to where they are within the day, they forget things, they will complete tasks, or partly complete tasks, and then leave their work at home when they go back to school, and so forth.”

A child with ADD can be treated nutritionally, Zimmerman says. Her ADD nutrition solution is a drug-free 30 day plan that fundamentally alters the way children eat. Take carbohydrates, for example. Research has shown that carbohydrates tend to raise serotonin levels in the brain, and serotonin is a neurotransmitter that’s calming and tends to put children to sleep. But look at how we traditionally feed our kids: “We give them a high carbohydrate breakfast and a high carbohydrate lunch, and they go off to school and we wonder why they can’t concentrate. On the other hand,” Zimmerman says, “protein foods provide the necessary amino acids that are precursors of attention grabbing neurotransmitters, namely norepinephrine and dopamine. Just changing the schedule of how you feed children has a big impact on how they will be able to function in school.”

In addition to the timing of carbohydrate and protein consumption, food additives play a role in children’s behavior. “A child can eat 500 different additives in a day based on the foods that we normally select off the grocery store shelves,” Zimmerman says. “We are constantly hitting the brain with things that are going to change the way it functions. We have to get those additives out of the diet. How in the world do you do that? Well, you stay out of the middle of the grocery store. Yet I see parents mindlessly shopping in the store all of the time and just grabbing things off the shelves that either the child wants because they have seen it on television, or because it’s easy, it’s something that kids like. So we have to reeducate kids’ taste buds.”

In addition, Zimmerman says, we want to replace some of the nutrients that have been lagging because of poor diet. Fatty acids such as DHA, vitamins, zinc and magnesium are especially important.

ADDITIONAL THOUGHTS ON ADHD Dr. John Breeding has some additional advice for parents when a school teacher or counselor brings up the subject of ADHD. “One of the first recommendations I make is to walk through your fear. You need to walk through and realize that you are going to be an activist for your child. Especially if it is a spirited child or a child that doesn’t quite fit or cooperate right with the expectations. In other words they are going to be a little hard to deal with over the years, they ask questions, they talk back, maybe they are not well organized, whatever, they draw attention to themselves. The first step is to walk through your fear, realize that the authorities may be walking you down the proverbial garden path.

“The other thing is parents are under a lot of pressure. They are given information, they are given information sheets, and they are given references that all say this is biologically based, that that is what the professionals say. There is a lot of guilt and a lot of pressure.”

Dr. Breeding says that parents should not be pressured into making snap decisions about their children. “The key here is not to trust the thinking of anyone who is coming at you from a sense of urgency and pressure about your child. You are in there for the long haul…. Slow down, think about it, be involved, but don’t react out of urgency and pressure.”

Dr. Breeding shares some other thoughts about ADHD and behavior concerns in children:

“I’m discovering that a lot of elementary schools don’t even do recess regularly anymore, or they take it away as a punishment, and this is exactly upside down from what needs to happen with these energetic children. There is also what goes in the child’s mouth. Rather than adding toxic drugs, let’s look at what is already going in there and seeing if we can help. Maybe there is sensitivity to sugar or some of these food additives and preservatives. A basic common sense approach to more wholesome nutrition can really help.

“The last piece of good information is that large numbers of children in our society are overstimulated, averaging five-and-a-half hours a day of TV and video versus an average 30 something minutes per week of conversation with their parents. It’s a weird statistic. Five-and-a-half hours a day of video and TV results in central nervous system acceleration. That carries over then to tasks that are less stimulating and there is a withdrawal that has to go with that. There is a lot in terms of what parents can do to create an environment that is more conducive to good functioning of the child.”

Autism

Autism is a childhood behavioral and neurological disorder. No one understands it but it is a real tragedy for the parents who struggle with it. The incidence has been increasing dramatically worldwide. No one is sure why but there are a lot of ideas out there.

Dr. Jay Lombard is chief of neurology at Westchester Square Medical Center in New York and assistant professor of neurology at Cornell University Medical Center. He has authored a book called The Brain Wellness Plan.

“Autism is a very tough disease as any clinician who treats it knows,” says Dr. Lombard. “It is common when you incorporate the different manifestations of the disease. The incidence is much higher than previously thought and appears to be increasing.”

DEFINITION Autism is a developmental disability that typically appears during the first three years of life. Three-quarters of those with autism are male. As defined by the Autism Society of America, “Autism interferes with the normal development of the brain in the areas of reasoning, social interaction, and communication skills.” People with autism vary widely in their abilities and behaviors, but may “have deficiencies in verbal and nonverbal communication, social interactions, and leisure or play activities.” Other characteristics associated with autism may include repetitive body movements such as hand-flapping, difficulty with changes in environment or routines, and unusual responses to sensory experiences (sights, sounds, textures, etc.).

Making a diagnosis of autism is difficult and confusing. It is based primarily on observations of a child’s behavior. In the Diagnostic and Statistical Manual (DSM-IV), four autism-related disorders are classified under the heading Pervasive Developmental Disorders (PDD). A diagnosis of autistic disorder is made when the child displays a certain number symptoms as listed in the manual. When children display similar but fewer symptoms, the may receive a diagnosis of PDD-NOS (Pervasive Developmental Disorder, not otherwise specified). Asperger’s syndrome and Rett’s syndrome, the remaining disorders, are diagnosed on the basis of observing other specified characteristics.

POSSIBLE CAUSES AND REATMENT STRATEGIES The causes of autism are not known. Currently, researchers are focusing on neurological and biochemical factors. Psychological causes of autism have been investigated and ruled out.

NEUROTRANSMITTER ABNORMALITIES

“One concept is that there are neurotransmitter abnormalities, in particular serotonin, which is derived from the amino acid tryptophan,” Dr. Lombard says. “The patients have too much serotonin circulating but it is not performing its duties. So symptoms like anxiety and sleep disorders are common. One of the strategies is to enhance the beneficial effects of serotonin either nutritionally or pharmaceutically. One of the nutritional compounds that increase brain serotonin levels is L-tryptophan, a precursor to serotonin. The herb St. John’s wort acts as a serotonin enhancer in the brain. A new compound is the modification of the amino acid SamE which is s-adenosyl methionine, shown to increase brain serotonin levels.”

IMMUNE SYSTEM

Dr. Lombard continues, “The immune system is overactivated in many autistic children, meaning they have chronic ear infections or chronic bowel problems. There is some questionable association with immunization with autism although that is certainly not resolved yet.

“Candidiasis or excessive yeast involvement is something we consider in autism. Reducing yeast is very effective in managing some of the symptoms. We administer probiotics like acidophilus which helps increase the natural intestinal bacteria in the gut and reduce the amount of yeast in the gut.”

MITOCHONDRIAL FUNCTION

Dr. Rafael Kellman is the founder of the Center of Progressive Medicine, a holistic medical center in New York that integrates alternative and conventional therapies. He also is an internal medicine physician at the Albert Einstein College of Medicine. He has looked at the mitochondria as a possible cause of autism.

Dr. Kellman says, “There are a number of causes of autism. There are numerous assaults on children today that include antibiotics and vaccinations. The common denominator is damage to the mitochondria. The mitochondria is the part of the cell that produces energy. When we give children random immunizations or frequent antibiotics it not only kills bacteria but it also kills the mitochondria. Mitochondria is part of our own cells that is responsible for producing energy, also called ATP [adenosine triphosphate].”

Dr. Lombard is also looking at the mitochondria. “This is a common theme in neurological diseases,” he says. “Some research I’m working on now looks at the mitochondria. It looks like autistic children are not making enough brain ATP, which is a function of the mitochondria.”

NUTRITION AND SECRETIN

There has been a lot of talk about nutritional imbalances and autism. Dr. Kellman has looked at this closely and uncovered certain nutritional interventions that have helped these children. He describes his theory.

“Secretin is a gastrointestinal hormone that the gut releases and is sent to the pancreas. If you use this hormone on children with autism you see a significant, positive result. There is significant improvement in many of their physiological parameters. The question is, why would a hormone that works in the gut affect what we thought was a brain disease, a neurological disease? There is a lot of speculation but I believe it marks a whole new way of thinking about autism, and probably many other diseases as well. In the past we thought the gut was just a blind, stupid tube, but the gut is really a brain itself. We are beginning to see that the mind is not localized only in the central nervous system (what we think is the brain) but rather the mind is interwoven into other parts of the body as well. An imbalance in the gut from antibiotics, poor diet, refined carbohydrates, etc., causes not only gastrointestinal disturbances like diarrhea, constipation, bloating, [and] pain, but it also causes some imbalance in the mind, in the brain that is found in the gut. That imbalance can cause all kinds of physiological and neurological problems because it is affecting the brain in the gut, and possibly the connections between the brain in the gut and the brain in the central nervous system.

“Now we can better understand when people use the metaphor ‘gut feelings’ or ‘I feel it in my gut.’ We are beginning to see that if you disturb the brain in the gut you are not only disturbing gastrointestinal function but also actually creating autistic children.”

Let’s review this concept again. Food goes from the intestine into the bloodstream and the nutrients get into the bloodstream. The immune system plays a role in all this. It is complex and Dr. Kellman breaks it down into an understandable form.

“Numerous hormones and enzymes are involved with the digestion of food. If the digestion is not adequate, the ecosystem of the gut, meaning the different microbes that are found in the gut, becomes unbalanced. Deficiencies in hormones or enzymes, or an overgrowth of yeast like candida or other unfriendly bacteria, can create havoc in the gastrointestinal system. Then toxins can be absorbed through the gastrointestinal tract into the bloodstream. This can cause problems within the body and also activate the immune system. Most of the immune system, about 70 percent, is harbored in the gastrointestinal tract. If the gastrointestinal tract is not functioning properly due to dietary problems, antibiotics, or even stress, that creates a secondary problem in the immune system. It would also create a problem in the brain because there are messages being sent from the gut from those food particles that are being digested.

“A number of neurotransmitters and neuropeptides found in the gut are activated by digestive food particles. If there is a problem with that digestion, then the messages that are sent from food to the cells in the gut and to the neurons in the gut break down. Numerous toxins in the body caused by an immune imbalance that can cause a host of medical disorders. Toxins can cause central nervous system dysfunction, allergies, asthma, and a whole variety of autoimmune diseases. The brain in the gut is not going to send proper messages to the higher brain, the organ found in the cranium in the central nervous system. Results of this improper communication are numerous—headaches, chronic fatigue, depression, anxiety, attention deficit disorder, and autism. I believe autism comes from this primary pathology. That is why you see many autistic children with seizure disorders and hyperactivity. What is the common denominator behind all of this? There is something wrong with the nervous system of the gut and the central nervous system.”

Dr. Kellman goes on to explain how to correct the imbalance he sees. “The first thing is the use of the hormone secretin. It is a natural hormone found within the body and not foreign to the body. When we inject secretin into these children with autism the results are really quite phenomenal. We have now treated well over 25 children and I would say about 80 percent of these children have significant changes. For example, children who have made no eye contact in the past are now making eye contact. One child who was never able to go to the bathroom by himself and flush the toilet now can. Some children are now hugging their parents or hugging and kissing their siblings, [children] who were never able to do that before. They are sleeping better. We are doing something to the gut and seeing profound psychological and neurological changes. I would say 90 percent of these children have obvious gastrointestinal disturbances and many of these problems are getting better as well. We have seen absolutely no side effects from it.

“However, this has to be cojoined with a comprehensive approach to improving gastrointestinal function, improving the ecosystem found within the gut by changing the diet, removing foods that create havoc within the gut, changing the whole approach to food, diet and life in general. Some of these children need up to 6 to 8 digestive hormone pills and nutra-supplements. Unfortunately the lay audience takes their advice from the press or popular health food magazines, and they say, ‘we’ll just take digestive enzymes in 1 to 2 tablets.’ These children need a lot more digestive enzymes perhaps than I do or you do. Everyone has to be evaluated individually. Some of these children need extremely high doses of digestive enzymes. Some of them need high doses of hydrochloric acid or zinc. They have an increased need, they are not absorbing their nutrients properly and their whole ‘metabolic machinery’ is vastly different from the average person.”

Part of Dr. Kellman’s program involves detoxification. With this program he can unload the toxins and support the liver to do a better job of detoxifying the body. “When the gut is imbalanced, numerous toxins are secreted into the bloodstream. They overload the liver and central nervous system and any type of neurological or psychiatric disease can occur. Most doctors dismiss these people as crazy because they don’t fit into their medical categories. The detoxification program also involves a number of nutrients that help the liver enzymes so the liver can better detoxify. Each person has a unique biochemical need and therefore the detoxification program has to be tailored to each specific person. Luckily the testing is available to them but of course is not known to most conventional medical doctors.”

MEGADOSE VITAMIN THERAPY

Dr. Bernard Rimland, a research psychologist, has done extensive work in childhood disorders. While recognizing the role that load allergies can play in many of these disorders, Dr. Rimland has also explored the role that vitamins in “megadoses” can play in such conditions as autism and hyperactivity. Dr. Rimland focused his research particularly on autism, a condition that manifests before the age of 3.

Dr. Rimland’s research, which has been confirmed by researchers in France and around the world, indicates that children with autism have deficiencies in certain nutrients, in particular vitamin B₆. For some unexplained reason, these children require these nutrients in much larger amounts—up to 50 milligrams a day more—than typically developing children, who require only 10 to 15 milligrams daily. To maximize the effectiveness of this B₆ supplementation program, magnesium is also given. It is a very important mineral here because it can dramatically enhance the effectiveness of B₆. In addition, Dr. Rimland gives the rest of the B-complex, zinc, and other complementary minerals. “If that is done,” he explains, “the individual’s body has the maximum chance of using the vitamin effectively when it is given in large amounts to correct the metabolic error it is prescribed to correct.”

Dr. Rimland’s studies indicate that between 30 and 50 percent of children treated with vitamin B₆ and other nutrients show significant improvement. Not only do they improve behaviorally, his studies have shown that their objective tests improve as well. Urine tests run on children with autism indicate that they have much higher concentrations of a phenol called homovanillic acid (HVA). When given vitamin B₆, their HVA levels often normalize along with their behavior. Additionally, certain abnormal brain waves tend to normalize after the treatment. “So,” says Dr. Rimland, “the B₆ and magnesium treatment has been shown to improve autism behaviorally, electrophysiologically, and biochemically.”

Another study showed that vitamin B₆ is at least as effective as Ritalin in ameliorating hyperactivity in children. The B₆ was found to be safer and cheaper, and its beneficial effects lasted longer. Even though this was a well-documented, carefully controlled double-blind study published in a reputable medical journal (Biological Psychiatry) it could not shake most medical professionals from their bias against nutritional approaches to mental and behavioral disorders. “Pediatricians, psychiatrists, and other physicians,” observes Dr. Rimland, “continue to give kids Ritalin instead of B₆ to control their hyperactivity.” Several orthomolecular clinicians have used vitamin B₁₂ injections as well as sublingual lozengers with positive benefits to their patients.