pediatric housecalls Robert R. Jarrett M.D. M.B.A. FAAP

Hyperactivity Treatment: Is There ANYTHING That Really Works?

January 29, 2017

Ok, in this series so far we’ve talked about ADHD or hyperactivity, we’ve learned that there are new standardized criteria for its diagnosis and what they are; AND, we’ve even met a 12-year-old and followed him through his whole evaluation and diagnosis.

Now to tackle what we know helps children with this condition—not just speculation, conjecture or “secret knowledge” but what we know for sure. [By “sure” I mean reproducible by others without “vested interests,” showing benefit in spite of patients not knowing they’re getting it, duplicable even when the researchers don’t know which treatment is given (double blind) and producing results greater than just by chance.

I’d like to help you understand the “real” issues and be better able to defend yourself from all the money-making schemes of people with “vested interests.”

I’m talking about the scheming people who prey on the naivety and gullibility of parents wanting to do the best for their child—but who are just hoping against hope that there really is a “magic bullet” somewhere to quickly “make it better” without much effort or change of life-styles.

Please don’t think that last sentence is critical of parents or patients. It’s not, because I deal with sorely stressed patients till my heart breaks and understand first hand how much effort it takes to merely “live life” these days for someone afflicted with any kind of illnesses.

And I am disgusted when I see the scum-bags preying on those afflicted with chronic illness of ALL kinds—no matter what kind of “degree” they’ve got behind their name. Not even cancer is beyond their greed!

Treatment of ADHD
“HOW do we know what works?”

Honest clinicians with integrity and the patient’s welfare at heart bend over backwards to meticulously avoid the pitfalls of “the placebo effect“—which inhabits the recesses of ALL issues dealing with behavior and emotion.

Vested Interests and alternative “treatments”

Notice how I described the clinicians I’m referring to here because even those with the highest integrity have seen first hand examples of the effect and know it is real; and may even have been “bitten in the butt” by how it can blind-side you if you aren’t careful.

A terrible waste for us has been the fact that literally millions of research man-hours and dollars have been needlessly wasted refuting all the crap claims made by charlatans and others—let alone how much we’ve wasted defending the treatment that we know works.

Almost four years ago I reported on a massive review of almost THREE THOUSAND studies about ‘non-drug’ ADHD treatments which found that only 54 of them actually had used unbiased judges of the children’s behaviors!

They went on to reveal what those 54 unbiased studies actually showed and I’ll bring my post about it into this latest series for you to peruse. The placebo effect is still here these many years later and so are the charlatans.

Placebo Effect and Patients

The best thing I should do right now is to have you go look up the term on your own; because, for some of you this may be a tough point to swallow. If you ever watched MASH back in the “old days” you saw it in action.

One of their plots had the good old 4077 completely out of morphine which they used for pain. Colonel Potter had them make up a batch of “sugar pills” which looked like the morphine they had been getting and it worked too.

That’s not fiction! The human brain (even yours) works in mysterious ways and honest truly if I took a hundred ADHD children and gave them sugar pills under the guise of a “new active medication” a substantial number of parents would actually “see” improvement! Around 15 to 20% in many cases.

Over and over scientists meticulously trying to be true and unbiased are tripped up and led down the garden path. And, if the placebo “cure” is expensive and an inconvenience, then the placebo effect can even be over 20% and make some recipients literally evangelical.

I’m sure you all learned this in high school. Your college psych classes had whole chapters on this. This is the kind of thing that completely fills the internet with what others may call “alternative treatments” but I, perhaps more clearly, describe as scams.

Unproven and Controversial Treatments for ADHD

Part of the “alphabet soup” of hyperactivity and school failure I talked about in the first post of this series is due to honest physicians trying to get a handle on those who merely throw a diagnosis at a kid during a 15-minute office visit—and unfortunately all too often, follow that with a prescription.

Laziness and sloppiness, however, is hard to “cure” and we still have a lot of it going on. Sheer greed is nearly impossible to cure and that seems to be multiplying like the plague.

Heightened awareness of, and accountability to, “standards” have seemed to help and the new guidelines I’ve mentioned may help even further; but, only if savvy patients learn what “good” and “quality medicine” looks like and shop for medical care as if it’s THEIR life which depends on it.

BOTTOM LINE: (We’ve wasted too much space on this already) those of us who have seen hundreds of children with these issues universally advise parents to be wary of:
1) any company boasting “miracle” cures that work for ADHD;
2) claims based on results of just one study or that lack a “control” group;
3) claims that the product is a “natural” remedy; and
4) any product ad that attacks established, mainstream medical treatments, especially those claiming “doctors don’t want you to know” how wonderful they are.

Here is a list of some of the most common (again I’ll call them scams) which either fall into the above categories OR where good studies have actually disproven their claims to treat ADHD:

interactive metronome training,
dietary interventions,
nutritional supplements,
sensory integration training,
anti-motion sickness medication,
optometric visual training,
applied kinesiology,
treatment for lead toxicity,
thyroid dysfunction, and
“candidas yeast” therapy.

Most of us also list the so-called “bio-feedback” training in this list too; although, the final word isn’t out on that yet. One of the treatments we KNOW works has to do with some basic parenting techniques which bio-feedback may just be mimicking or supplementing.

So what DO I need to know?

Now that we’re all on the same page, there are TWO treatments where nearly all patients respond and see dramatic improvement: behavioral training and medication. Well, three if you count the combination of the two which we do because they are additive to each other. And there are FOUR Pillars of treatment which every child with ADHD should receive from his doctors, teachers and parents.

It’s just that after writing all the above stuff I feel like we should take a break, so all the things that work aren’t on the same page as all the other cruff. Take a breath, get a drink of water and I’ll see you on the next page.