Old and new controversies in the alternative treatment of attention-deficit hyperactivity disorder.

Division of General Pediatrics, Children's Hospital Boston, Boston, MA 02115, USA.
Mental Retardation and Developmental Disabilities Research Reviews (Impact Factor: 3.8). 02/2005; 11(2):116-30. DOI: 10.1002/mrdd.20064
Source: PubMed

ABSTRACT Use of complementary and alternative medicine (CAM) for treatment of attention-deficit hyperactivity disorder (ADHD) has become widespread in both referral and primary care populations. We review the purported mechanism of action and available evidence for selected CAM therapies for ADHD. Enduring controversies, such as elimination of artificial food additives, colors, and/or preservatives; the effect of sugar on behavior in children; and the use of EEG biofeedback, have been well studied but lack support as effective sole treatments for ADHD. The initial evidence for some emerging CAM therapies, such as essential fatty acid supplementation, yoga, massage, homeopathy, and green outdoor spaces, suggests potential benefits as part of an overall ADHD treatment plan. More rigorously designed studies are needed to evaluate their effectiveness as single therapy for ADHD.

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    ABSTRACT: This paper presents a review of research on the use of prescription and over-the-counter medications by parents for infants and young children. The primary causes of misuse are due to medical error, administration error, independent parent medication decisions, and medication interactions. Epidemiological studies of the misuse of medications by parents for infants and young children are reviewed. In addition, methods of preventing misuse and abuse of prescription medication are described. Finally, the value of collaborative relationships among parents, medical professionals, psychologists, and educational professionals in the identification and treatment of medication misuse and abuse is explained.
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    ABSTRACT: Objective: To evaluate sustained improvements six months after a 40-session, in-school computer attention training intervention using neurofeedback (NF) or cognitive training (CT) administered to 7–11 year olds with attention-deficit/hyperactivity disorder (ADHD). Methods: One hundred four children were randomly assigned to receive NF, CT, or a control condition, and evaluated six months post-intervention. A three-point growth model assessed change over time across the conditions on: Conners 3-Parent report (Conners 3-P), Behavior Rating Inventory of Executive Function (BRIEF) Parent Rating Scale, and a systematic doubleblinded classroom observation (Behavioral Observation of Students in Schools; BOSS). ANOVA assessed community-initiated changes in stimulant medication. Results: Parent response rates were 94% pre- to post-intervention and 90% at the six-month follow-up. Six months post-intervention, NF participants maintained significant gains on Conners 3-P (Inattention ES=0.34, Executive Functioning ES=0.25, Hyperactivity/Impulsivity ES=0.23) and BRIEF subscales including the composite (ES=0.31), which remained significantly greater than gains found among children in CT and control conditions. Children in the CT condition showed delayed improvement over immediate post-intervention ratings on Conners 3-P Executive Functioning (ES=0.18) and two BRIEF subscales. At the six-month follow-up, NF participants maintained the same stimulant medication dosage, while participants in both CT and control conditions showed statistically and clinically significant increases (9mg, p=0.002 and 13mg, p<0.001 respectively). Conclusion: NF participants made more prompt and greater improvements in ADHD symptoms, sustained at six-month follow-up, than did CT participants or those in the control group. This finding suggests that NF is a promising attention training treatment for children with ADHD.
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