The term Attention Deficit Hyperactivity Disorder is applied to children who are inattentive, disorganised, forgetful, fail to finish things, can’t keep still, can’t keep quiet and have difficulty behaving appropriately. There is a standard list of symptoms used to diagnose the condition but diagnosis is a question of degree – many children have difficulty with these aspects of behaviour if they have sensory integration issues. It becomes a real concern if it is disrupting their family life or education.

On the sensory integration continuum children with the ADHD label are towards the more severe end of the spectrum and usually present with a large number of immaturities, although they are often very bright. The most obvious problem is their extreme hypersensitivity, emotional as well as physical, which can cause them to shut down the hypersensitive sense or withdraw. They are often hypersensitive to inhaled or ingested allergens also, so cutting out artificial additives, certain offending foods and particularly MSG and aspartame will often produce clear benefits.

The effect of the hypersensitivity is to disrupt higher aspects of sensory development and integration. This may be seen in late speech development, poor listening ability or delayed motor skills, and once they start school their still developing visual system is at risk. Any delay in visual development will affect the acquisition of literacy skills, and the stress involved in surviving a busy classroom and coping with the consequences of academic and behavioural failure can cause regression or halt any further development.

Children with ADHD are enormously sensitive and require a great deal of compassion and understanding, but their problems are generally very poorly understood because the real problems are not exposed.

Suggested Action

Extreme hypersensitivity is often associated with metabolic problems, which cause the children to be inconsistent. Aspartame and MSG should always be completely removed from their diet, and other artificial additives removed as much as possible. Their behaviour can also be affected by odours in the environment. Remember that fragrances are all toxic chemicals and could be having an unconscious effect on a child. Try to use fragrance free products in the household and in personal hygiene and avoid anything unnecessary. Nearly all children with ADHD benefit from fish oil supplementation, but they are also likely to be short of the co-factors for absorption, particularly zinc, magnesium and vitamin B6, so they will benefit from a good quality children’s multi-vitamin mineral supplement also. Toxins, such as heavy metals, are addressed by the Edutherapy programme.

Try to find out what your child finds difficult and make sure the teachers know about it. If he/she has a very bad memory they may not follow instructions because they cannot remember them. If they have an immature vestibular system or immature differentiation they will be on the move when they are trying hard to concentrate and it is most unfair to tell them off. If they are affected by a withdrawal reflex when faced with having to do something they find hard they must be allowed to withdraw because they are in fight/flight and not in control of their behaviour. See also behaviour problems, tic disorders, enigma.

Case Histories

LIAM

Presenting problems

Liam could not conform to the requirements of his infant classroom. He found it very hard to stay in one place and did not observe the normal constraints about wandering off and doing whatever came into his head. He had hardly any ability to stay focussed on a task at near point, so he was not ready to learn to record maths or make a start with reading and writing. He was verbally quite bright, however, and good when he was allowed to be on his own agenda. He was hypersensitive to smell, touch, light and sound and always complained about loud noises. He was extremely sensitive emotionally. His speech development was rather slow and still lacked fluency and precision. His listening skills and memory were poor too,  so he often needed repetition and clarification of instructions.

Assessment

Liam was not really able to cooperate with any testing when he first came for assessment because he was reacting badly to the MSG in some crisps he had been eating. He returned once his diet had been controlled and the impression then was that he could focus reasonably well on his own agenda but found it very hard to stay focussed on someone else's. His balance was very poor on testing, but he had learnt to ride a bike at three years old so it looked as if there had been some regression in his skills, probably as a result of having to cope with school. He managed to perform at an average level on a verbal IQ test, but he found the non-verbal test too difficult. There was clearly a major problem with his visual perception.

He had a lot of trouble with overflow movements when he was concentrating, so he was very fidgety. He was not yet securely right-handed, and he had a left eye dominance at near-point and right dominance in the distance which would make it very hard to focus properly at near-point.  His auditory integration was very poor and he had a poor auditory memory. His motor integration was well developed for his age however, which suggested that much of his development had progressed normally.

Liam's hypersensitivity was clearly having a major effect on his brain integration and the further development of his visual and auditory systems, and this needed to be addressed rapidly before he lost his self esteem. He was not ready to learn to read and write and it was important to make sure that he was not put under any pressure at school. Situations where he was likely to fail should be avoided.

Progress

After a month Liam’s parents were beginning to realise what a bad effect MSG and aspartame had on him, and this in itself was helping to keep him calm. After four months he was much calmer, less aggressive and his vocabulary was developing rapidly. School were being very patient and not overly worried. He was doing well with maths but slow with his letters and reading – which depend on mature visual development. After eight months he had settled down well in class, but he could still wander around when he thought he had done enough work. His teacher was still very supportive, but he was beginning to call himself stupid. After eleven months the school were asking if they could put more pressure on him so that he could catch up with his classmates and by the end of the school year, after just over a year of therapy, Liam was said to be doing amazingly well. There is still some ground to make up in his reading and spelling, but he behaves and concentrates well and he has not lost his sparkle.