ADHD

Studies in Peer Reviewed Journals

An evaluation of chiropractic manipulation as a treatment of hyperactivity in children.

The principle aim of this study was to determine the effectiveness of chiropractic manipulative therapy in the treatment of children with hyperactivity. Using blinds between investigators and a single subject research design, the investigators evaluated the effectiveness of the treatment for reducing activity levels of hyperactive children. Data collection included independent evaluations of behavior using a unique wrist-watch type device to mechanically measure activity while the children completed tasks simulating school-work. Further evaluations included electrodermal tests to measure autonomic nervous system activity. Chiropractic clinical evaluations to measure improvement in spinal biomechanics were also completed. Placebo care was given prior to chiropractic intervention. Data were analyzed visually and using nonparametric statistical methods. Five of seven children showed improvement in mean behavioral scores from placebo care to treatment. Four of seven showed improvement in arousal levels, and the improvement in the group as a whole was highly significant (p = 0.009). Agreement between tests was also high in this study. For all seven children, three of the four principal tests used to detect improvement were in agreement either positively or negatively (parent ratings of activity, motion recorder scores, electrodermal measures, and X-rays of spinal distortions). While the behavioral improvement taken alone can only be considered suggestive, the strong interest agreement can be taken as more impressive evidence that the majority of the children in this study did, in fact, improve under specific chiropractic care. The results of this study, then, are not conclusive, however, they do suggest that chiropractic manipulation has the potential to become an important nondrug intervention for children with hyperactivity. Further investigation in this area is certainly warranted.

Giesen JM, Center DB, Leach RA. JMPT 1989; 12:353-363. PMID: 2607226 (PubMed - indexed for MEDLINE)

Cranial Motion Restrictions and Learning Disabilities. This study examined grade school children and came up with a positive relationship between cranial motion restrictions and learning disabled children, as well as children with a history of an obstetrically complicated delivery.

Upledger JE, The relationship of craniosacral examination findings in grade school children with developmental problems., J Am Osteopath Assoc 1978; 77(10):760-76 / Medline ID: 78193624

Chiropractic Case Studies

1) "After examining several diagnosed ADHD children, we find an upper cervical subluxation that can lead to neurotransmitter involvement."
Larry Webster, D.C. International Chiropractic Pediatric Association Newsletter. January 1996.

2) "When Kevin was 3 he was diagnosed as having ADHD. After trying diet changes, allergy testing and behavior modification techniques, we reluctantly agreed to put Kevin on Ritalin. The medication did its job as far as slowing him down a bit, but he suffered many side effects. In 2 years he grew only 2 inches and did not gain any weight at all. He cried easily, had trouble sleeping, no appetite, and would "zone out" quite often. Finally at age 6 we made the decision to stop giving him Ritalin. He grew 6 inches
in less than 1 year and gained nearly 15 pounds. His sleeping and eating patterns were still erratic, and the schoolwork was horrible…his writing was illegible and math made no sense to him. We brought him to Dr. D'Angiolillo for chiropractic care, twice a week for 6 weeks. This past week when I went to his parent-teacher conference, the first thing the
teacher asked me was had we put Kevin back on Ritalin. I said no, and she showed me samples of Kevin's work and showed me the sudden improvement…for the first time his writing is in the lines, it is easy to read and much more age appropriate. Although he still tends to move around more than the average child does, he is able to concentrate, answer questions correctly and is reading better than most of his class!" A Mother's Testimonial. ICPA Newsletter. July/August 1998 (Dr. Angiolillo is in private practice in North Brunswick, NJ).

3) A six year old boy with nightly nocturnal enuresis, attention deficit disorder and toe walking. International Chiropractic Pediatric Association Newsletter May/June 1997. A six year old boy with nightly nocturnal enuresis, attention deficit disorder and toe walking (walked with his heels 4 inches above the ground). Medical specialist recommended both. Achilles tendons cut and both ankles broken to achieve normal posture and gait.
Chiropractic findings included: C1, Occiput, sacrum and pelvis. After 4 weeks of care both heels dropped 2 inches and bedwetting decreased to 2-3 times/week.

4) ADHD - A multiple case study. Wendel P, International Chiropractic Pediatric Associa-tion. March/April 1998. This is a 12-month study began on October 4, 1997 of twenty-one children: 17 male and 4 female, ages from six to sixteen years. Eight of the children in the study are on Ritalin. As of March 18, 1998, thirteen of the initial twenty-one children are still participating in the study. Five of the remaining children are on Ritalin.



Case Reviews:
1. Female, age 10. The child had poor grades due to lack of focus on homework and parental supervision was needed to complete homework. After three months of care, she received "Most Improved Student" award for bringing grades from an F and a D to an A and B respectively.
2. Male, age 13. History included traumatic birth (cord wrapped around neck) and did not crawl as a young child. After four weeks of care (including learning to cross crawl) he improved his grades from four F's to a B, D and notable improvement in the remaining 2 classes.
3. Male, age 12. Run over by a car while riding a skateboard at age 5. He exhibited severe discipline problems at school with school suspension several times. Failing all classes. There has been little behavior improvement but grades have improved to a B, 3Cs and two Ds.
4. Male, age 15. Tested positive for allergies and had severe hand tremors. After one week of care hand tremors diminished. After 5 months grades improved to 3 As, 2Bs and 1C.

5) Epileptic seizures, Nocturnal enuresis, ADD. Langley C. Chiropractic Pediatrics Vol 1 No. 1, April, 1994. This is an eight year old female with a history of epilepsy, heart murmur, hypoglycemia, nocturnal enuresis and attention deficit disorder. The child had been to five pediatricians, three neurologists, six psychiatrists and ten hospitalizations. Child had been on Depakote, Depakene, Tofranil and Tegretol. She had been a difficult birth, a cesarean had to be performed under general anesthesia. The mother was told the baby was allergic to breast milk and formulas and was stayed on prescription feeding. The doctors told the mother the girl would never ride a bike nor do things like normal children do. The child was wetting the bed every night and experiencing 10-12 seizures/day, with frequent mood swings, stomach pains, diarrhea and special education classes for learning disabilities. Chiropractic adjustments were given C1 andC2 for approximately three times per week. Two weeks after beginning care the bed-wetting began to resolve and was completely resolved after six months. She was also going to leave special education classes to enter regular fifth grade classes. After one year of chiropractic, the seizures were much milder and diminished to 8-10 per week. Patient was also released from psychiatric care as "self managing." Her resistance to disease increased and she can now ride a bike, roller skate and ice skate like a normal child.
After medical examinations, she is expected to be off all medication within a month.

6) First report on ADD study. Webster L. International Chiropractic Pediatric Association Newsletter. Jan. 1994. Two cases from the ADD study are mentioned.
Case #1: Ten-year-old girl on 60 mg. Ritalin/day, severe scoliosis of 48 degrees Cobb angle First seen 11/15/93. After ten adjustments mother reported a happier child, immune system doing much better and endurance much higher. Re-exam revealed scoliosis reduced to 12 degrees. By 1/10/94 off medication.
Case #2: 12-year-old boy diagnosed as ADD, asthma and seizures. First entered clinic 12/9/
93 and after 8 adjustments, parent has withdrawn all medication with the cooperation of
their doctor. Positive personality change has been noted.

7) ADD, Enuresis, Toe Walking. International Chiropractic Pediatric Association Newsletter May/June 1997. From the records of Rejeana Crystal, D.C., Hendersonville, TN. A six year old boy with nightly nocturnal enuresis (bedwetting), attention deficit disorder and toe walking. He walked with his heels 4 inches above the ground. The medical special-ist recommended that both Achilles' tendons be cut and both ankles be broken to achieve normal posture and gait. Chiropractic findings included subluxation of atlas, occiput, sacrum and pelvis…after 4 weeks of care both heels dropped 2 inches and the bedwetting frequency decreased to 2-3 times per week. His doctor could not believe how chiropractic care made such a change.

8) The effect of chiropractic treatment on students with learning and behavioral impairments resulting from neurological dysfunction (part 1). Brzozowske WT, Walton EV. J. Aust Chiro Assoc 1980;11(7):13-18.

9)The effect of chiropractic treatment on students with learning and behavioral impairments resulting from neurological dysfunction (part 2). Brzozowske WT, Walton EV. J. Aust Chiro Assoc 1980;11(8):11-17.
A group of 12 ADHD students reviing stimuland medication were compared to a group of 12 ADHD students receiving chiropractic care.
The group receiving chiropractic care both hyperactivity and attentiveness improved along with gross and fine motor coordination.
In the medicated group, hyperactivity and attentiveness improved initially (not gross and
fine motor coordination) and the medication effectiveness decreased requiring higher dos-ages. Over half the medical group had personality changes, loss of appetite and insomnia relating to their treatment. The study concluded that chiropractic care was 20-40% more effective than medication.

10) Case Studies. Male - age 7 years. Webster, L. Chiropractic Showcase Magazine, Vol. 2, Issue 5, Summer 1994.
The child was placed under care on February 14, 1994 with the following clinical picture:
Hyperactivity, stuttering, slow learner, retarded growth, left leg approximately 1" shorter than right with a limp while walking. Medical plans were to break the left leg, insert metal rods in an attempt to stimulate growth and equalize leg lengths. Our examination consisted of Metrecom evaluation, full spine X-rays, and chiropractic examination of the spine. Areas of subluxation were as follows: Sacrum anterior, inferior on left, 5th lumbar body left, atlas, anterior superior left. Patient was placed on an intensive correction program of 3 times weekly for a period of two months.
During the first seven visits the legs were never balanced, however, each time a reduction of the short leg occurred. On the 8th, visit the legs balanced for the first time. Also noticed by 8th visit:



1. The stuttering had stopped.
2. The grades in school had risen from non-satisfactory to satisfactory.
3. The hyperactivity had abated.
4. The limp was no longer constant.

11) Case study: the effect of utilizing spinal manipulation and craniosacral therapy as the treatment approach for attention deficit-hyperactivity disorder. Phillips CJ. Proceedings on the National Conference on Chiropractic and Pediatrics (ICA), 1991:57-74. A 10-year-old boy with a three year history of hyperactivity, also suffering from ear infections,
headache and allergic symptoms. Chiropractic analysis revealed multiple cervical, thoracic and pelvic dysfunctions. The boy also had multiple cranial faults. By the 11th chiropractic adjustment hyperactivity symptoms had abated (his other health problems had cleared up from earlier spinal adjustments). After 5 1/2 months relatively symptom free he had two
falls and hyperactivity, headache and allergy symptoms returned. A single session of spinal and cranial adjusting revolved this exacerbation. A strong link between spinal "dysfunc-tions" and hyperactivity is suggested.

12) A multi-faceted chiropractic approach to attention deficit hyperactivity disorder: a case report. Barnes, T.A. ICA Int'l Review of Chiropractic. Jan/Feb 1995 pp.41-43. From the author's abstract: an 11-year-old boy with medically diagnosed Attention Deficit Hyperactivity Disorder has been a patient and student at the Kentuckiana Children's Center for three years...His case shows a history of early disruptive experience, repeated ear infections, consistent temporomandibular joint dysfunction, heavy metal intoxication, food allergy, environmental sensitivity and multiple levels of biomechanical alteration. This report emphasizes the need for care in all aspects of the structural, chemical and mental triangle of health in children with attention deficit hyperactivity disorder. "He has improved academically and has advanced to the next grade level...he recognizes that he has control over his behavior and there is hope that he will be mainstreamed back into a regular public school setting soon...his mother says she notices improvement in his attention span and temper."