Like birth, menstruation, and menopause, the unfolding of childhood is an inherently natural process. Nevertheless, every morning before going to school, 3 to 5 percent of American schoolchildren take a mind- and behavior-altering prescription drug called Ritalin (methylphenidate).1 They do so because they have been diagnosed as having a “disease,” called “Attention Deficit Hyperactivity Disorder” (ADHD).
It may seem paradoxical to give stimulants to children who are hyperactive in order to calm them down. But this is done because these drugs often have the reverse effect on children than they do on adults. Although the actual impact of Ritalin and similar substances on the brain and mind of young people is poorly understood, children diagnosed with ADHD often continue to take it for years.
What happens to the youngsters who take this medication? Their actions tend to be more goal-directed and “on task” than before. They often become less distracted by things going on around them, and better able to stay focused on their schoolwork. They tend to become less aggressive, less apt to get into trouble, and generally more docile and compliant. They follow rules better.
These changes make them easier for adults to manage. Psychiatrists, parents, and teachers are often pleased with the changes they see in a child who is put on Ritalin, who may appear to be “finally settling down.”
I have been dismayed to learn, however, that the drug usually does nothing to enhance learning or improve actual academic achievement beyond the short term.2 Actively seeking to find evidence for enhanced learning in children on Ritalin, psychiatrists Russell Barkley and Charles Cunningham analyzed 17 studies on the subject, and called the results “uniformly discouraging.”
In 1995, a school board member from Litchfield City, Connecticut named Patrice Fitch publicly described her daughter’s response to Ritalin: “In the classroom, she became more likely to pay attention or do what the teacher instructed. Yet, while she may have had her pencil poised over the work assignment, closer inspection revealed that she was not actually forming the answers but instead imitating the stance. While Ritalin made it possible for Amanda to sit more or less calmly in her chair, it did not help her to learn.”4
Approximately one-third of the children diagnosed as hyperactive do not become less restless on Ritalin. Some actually become more agitated. At best, the drug can help those children who have been accurately diagnosed to focus their minds so they can temporarily absorb information better. But others become withdrawn and stare off into space, not responding to much of anything. While these children no longer make trouble for their teachers or get into fights, they begin to exist in a state of disconnected social isolation.5
Even for those children whose behavior does respond as intended, the effect is only a temporary suppression of symptoms, not a cure. When children stop taking Ritalin, they are back where they started, only now they may also have to deal with a rebound effect from the medication, which may make them more distraught than ever.
And then, as with any drug, there are inevitably adverse side effects.6 Many children crash when their dose wears off, behaving even more uncontrollably than they did before. The Physicians’ Desk Reference lists more than 25 symptoms-ranging from anxiety to hair loss to convulsions-that have been observed in Ritalin users having no preexisting conditions. Reactions include nausea, insomnia, headaches, weight loss, and a slowing of growth. Some children develop bizarre compulsive behaviors, such as insistent biting of their fingers and nails until they bleed. Other reactions include elevated heart rate, increased blood pressure, and a serious disorder known as Tourette’s Syndrome, characterized by repetitive involuntary movements or tics.
Are there long-term side effects from the drug? This is an important question’ because children are often placed on this medication for many years. It is also a frightening question, because to date no adequate longterm studies have been performed.7
Although more difficult to quantify than physical side effects, there are emotional and psychological consequences to labeling a child as having ADHD and putting the youngster on drugs. Having this kind of a diagnosis and treatment become a permanent part of a child’s health files and educational records hardly helps her or him build self-esteem and selfrespect. In 1993, pediatric neurologist Fred Baughman, M.D., asked in the AMA journal, “What is the danger of having these children believe they have something wrong with their brains that makes it impossible for them to control themselves without a pill? What is the danger of having the most important adults in their lives, their parents and teachers, believe this as well?”8
Others have asked what the implications are of telling a child, “Say no to drugs, but don’t forget to take your behavior-controlling, consciousness-altering medication before lunch.” What happens to children when the full weight and authority of the medical profession tells them to take drugs to control their behavior? How will children learn to understand their emotions and deal with them constructively if they are told to take a drug to make them go away?9
When Clinical Psychiatry News discussed the heavy use of illicit drugs among adolescents, the journal lamented the increasing numbers of young people falling prey to substance abuse. Ironically, right next to the article, and visually overpowering it, was a prominent ad for Ritalin.’°
Ciba-Geigy, the company which manufactures Ritalin, says that the drug is not addictive if used as directed. But like cocaine and amphetamines, it is classified by the Drug Enforcement Agency as a Schedule II drug, meaning that among those substances regarded as having medical use, it is considered to have the highest potential for abuse. And even CibaGeigy acknowledges that some youngsters buy or steal the drug from classmates’ sniffing and injecting it to get high.
In England, physicians simply do not prescribe Ritalin or other stimulant medications for children.” They are far more cautious than we are about drug use in children to begin with, and particularly so for drugs with pervasive central nervous system effects. Throughout western Europe children almost never receive medication for hyperactivity.
In the United States, however, it’s a different story. Although the Physicians’ Desk Reference specifically states Ritalin “should not be used in children under six years [of age],” that did not stop U.S. physicians from writing 200,000 prescriptions for Ritalin and similar stimulants in 1993 for children ages five and younger.’2In the U.S., Ritalin has been prescribed to children as young as 18 months old.
The 1980s saw a dramatic increase in Ritalin use among children in the United States which coincided with publication of influential work by the University of Pittsburgh’s Stephen Breuning. His research was believed to have proven that stimulants such as Ritalin were effective answers to hyperactivity. But evidently Dr. Breuning was somewhat lacking in the noble spirit of open-minded scientific inquiry. In 1988, it was discovered that much of his data had been completely fabricated. It turned out that he had reported studies that had never been performed.’3
Breuning was sentenced to prison for this fraud, and articles condemning his actions appeared in major medical journals. Yet many teachers, pediatricians, psychiatrists, and parents are still influenced by the pro-Ritalin wave that washed across the country during the years when his “research” was believed to be genuine.
In the years immediately following Breuning’s exploits, there was an exponential increase in the use of medication for children diagnosed with ADHD. A 1987 study found that 6 percent of all schoolchildren in Baltimore were on medically prescribed stimulant drugs.’4 An outraged public response in that city caused Ritalin use there to decline in the following few years, but in the rest of the nation, the number of children being dosed with this and other medically prescribed stimulants continued to increase.
By 1995, more than 6 million psychiatric prescriptions were being written every year for Americans under the age of 18. 15 And in 1996, the World Health Organization estimated that nearly 5 percent of all elementary schoolchildren in the United States were on Ritalin.16
Which Kids are Put on Ritalin?
The assumption is that these children have a brain dysfunction or disease Yet doctors prescribing Ritalin rarely, if ever, perform neurological tests.” Instead, they take the word of parents or teachers, whose judgments are invariably subjective. The scores that are obtained from the various scales used to diagnosis ADHD give the appearance of scientific precision, as though they were measuring something tangible, like blood sugar levels. But in reality, ADHD is defined entirely in behavioral, nonmedical terms. The numbers merely sum up a particular teacher or physician’s subjective impressions. In fact, a number of studies have shown that when parents, teachers, and clinicians rate the same child, they frequently come up with wildly differing scores.18
Who, then, are the children who get diagnosed with ADHD?
Some, who may be so unruly that they can completely disrupt an entire class, or who are impossible for their parents to handle, may benefit from the drug, at least in the short term. But many are simply children who have a strong sense of their own inner rhythms and timing. These youngsters often feel frustrated in authoritarian situations, and conforming to the rules of a classroom or of autocratic parents can be difficult for them. Such children are potential recipients of an ADHD diagnosis, because the American Psychiatric Association’s criteria for ADHD officially points the finger at children who “interrupt others, and have difficulty following instructions.”
Children who are especially intelligent are often bored in today’s schools, and will sometimes try to answer their teacher’s questions as quickly as possible, in the manner of game show contestant “whiz kids” eager to display their knowledge. This behavior, while hardly evidence of pathological brain chemistry, may nevertheless lead to a diagnosis of ADHD, because another of the of ficial criteria targets kids who “often blu* out answers to questions before they have been completed.”
Children who are assertive by nature may also receive the diagnosis. One of the scales that is most widely used by parents and teachers to assess for ADHD is the Revised Conner’s Questionnaire.’9 According to this scale, children are suspected of being hyperactive if they are “sassy,” and guilty of “wanting to run things.”
Then again, those children who happen to be especially sensitive or timid aren’t exempt, because other criteria include being “shy,” and having their “feelings easily hurt.”
Kids who come from difficult family situations are also likely candidates for the diagnosis. Being “basically an unhappy child,” and “feeling cheated in the family circle” are considered symptoms of ADHD.
It’s hard to avoid the suspicion that just about any kid who doesn’t fit easily into the school or family system might fall prey to the diagnosis and Consequently be treated with Ritalin. The Revised Conner’s Questionnaire actually goes so far as to state that children who behave in a “childish” way are displaying a symptom of ADHD. And here all along I had thought that behaving in a childish way was a natural part of childhood.
In fact, the more I’ve looked at the diagnostic criteria by which children are labeled as having ADHD, the more I’ve begun to suspect that the only children who are completely safe from a diagnosis of ADHD are those who are so frightened to disobey that they are compulsively dutiful and obedient.
Are Our Schools for Compliance or for Learning?
Not being a particularly big fan of either Ritalin or our mass production school system, educator John Holt told Congress plainly that we give kids this drug so that “we can run our schools as we do, like maximum security prisons, for the comfort and the convenience of the teachers and administrators who work in them.”20
I would have to agree that America’s public schools are not particularly shining examples of how to bring out the best in young people. Although thousands of humane, caring people work in schools as teachers, aides, and administrators, a good number of schools end up teaching little more than obedience and conformity. Research by the Carnegie Council on Adolescent Development concluded, “Many large middle grade schools function as mills that contain and process endless streams of students. Within them are masses of anonymous youth…. Such settings virtually guarantee that the intellectual and emotional needs of youth will go unmet.” 21
One of the most penetrating critics of contemporary schooling is New York State’s 1991 teacher of the year, John Gatto. “The school bell rings,” he says, “and the young man in the middle of writing a poem must close his notebook and move to a different cell, where he learns that man and monkeys derive from a common ancestor…. It is absurd and antilife to be part of a system that compels you to sit in confinement with people of exactly the same age and social class…. It is absurd and antilife to be part of a system that compels you to listen to a stranger reading poetry when you want to learn to construct buildings, or to sit with a stranger discussing the construction of buildings when you want to read poetry. It is absurd and anti-life to move from cell to cell at the sound of a gong for every day of your youth, in an institution that allows you no
For the entire school day, students are under constant surveillance. They have no private time or private space. Many teachers do their best to be humane, but pupils are typically expected to sit still for hour upon hour, and to do whatever they are told. This is not only totally unnatural, and profoundly frustrating for children; it also inhibits learning. Human beings are programmed by millions of years of evolution to develop by moving, touching, and being involved in life’s tasks.
There are alternative approaches to learning which involve children as active participants and do not produce boredom and restlessness. An example is the classroom of Wendy Borton, an elementary school teacher in the Shoreline District’s Room Nine Program in Seattle, Washington. To teach her ten- to twelve-year-old youngsters about government, she got them involved with an issue that was relevant to their lives. In September 1992, when a bill to ban corporal punishment in the state’s public schools was to be introduced (for the ninth year in a row), the students began researching the issue, reading and discussing articles both in support of corporal punishment and opposed to it.23
They learned that it was legal to inflict physical punishment on schoolchildren that would be considered too severe for prisoners in the state penitentiary. They learned that when an adult hits another adult, it is usually called “assault” and is a crime, but when an adult hits a child, it is usually called “discipline” and is often considered acceptable. They learned that the spanking of pupils by teachers is illegal in every European country, and that in Sweden, television spots advise children of their right not to be spanked. They learned that among the world’s industrialized countries, only the United States and South Africa have persevered in the practice.24
The surgeon general has pleaded for a reduction in spanking as a matter of public health, saying such a shift would decrease the cultural acceptance of violence. Yet in 1993, a poll of primary-care doctors published in the AMA Joumal found that 70 percent of family practitioners and 59 percent of pediatricians still supported corporal punishment.25
After thorough discussions and many heated debates, during which their teacher remained steadfastly neutral and allowed the youngsters to come to their own conclusions, the class decided that corporal punishment should not be allowed in schools.
On February 2, 1993, four students from the class traveled to Olym pie to testify before the state House Education Committee. Saying that “schools are for learning, not hitting,” the youngsters urged that the bill be passed. At the conclusion of the children’s testimony, the comnlittee~s chairperson congratulated them on their excellent presentation.
The bill passed the house, but faced a much tougher battle in the Senate, where it had been soundly defeated in previous years. On March 19, 1993, four different students made the trip to Olympia, this time to testify before the Senate Education Committee. When the senators asked them what teachers could do to maintain order if the option of corporal punishment were removed, the kids showed they had done their homework. One observer recalls: “The students presented several productive, nonviolent ways in which their school deals with behavior problems, including behavior contracts based on agreements among teachers, students, and parents; loss of privileges when contracts are broken, and rewards for achieving contract goals; instruction in creative conflict resolution; and allowing students to help set classroom policy by establishing rules and the consequences for breaking them.”
On April 6, 1993, the Senate passed the measure abolishing corporal punishment. Governor Mike Lowry subsequently signed it into law.
Every Child is Special–Every Child is Unique
Some pupils who are labeled as “hyperactive” may simply have a different learning style than the one dictated by the school environment. Thomas Armstrong, author of Awakening YOUT Child’s Natural Genius, notes: “Research has found that most of the children at risk for ADHD labeling are actually quite good at paying attention…. They often possess superior’incidental attention’ abilities. They pay attention to everything except what they are ‘supposed to be’ paying attention to. In the classroom, they hear Joey tell Suzy about what happened to Billy during recess. They see the funny drawings that Ed made on the chalkboard before the beginning of class-drawings the teacher has not yet noticed. They observe their own inner thoughts, including daydreams…. Is this sort of attentional style truly a disorder? Probably not. After all, infants and toddlers engage in some of the most powerful learning they will ever experience in their lives They master the complex tasks of walking and talking by letting their attention be drawn to points of interest and by absorbing knowledge in incidental ways. Millions of years of evolution may have endowed the human being with this inborn drive toward spontaneous exploration, curiosity, and the need for variety and novelty, so that a person would have the lifelong capacity to search out new possibilities-a decided asset when outer conditions change and new forms of adaptation are required. And children labeled ADHD may be carriers of this special trait.”76
Some children labeled hyperactive are multiscanners. These children are adept at what anthropologist Jules Henry called polyphasic learning-absorbing information through several channels at once.27 Paying attention to many things at the same time is natural for them, and in many environments would be a great asset. But not in a classroom where “central-task” learning requires them to pay attention to one thing at a time. Their natural learning styles do not involve organizing their experience in a linear way, and they can easily feel bewildered when asked to do so. Yet, when exposed to integrated thematic instruction programs (including the use of art, music, field trips, and other multisensory approaches), these children often emerge as not only capable, but brilliant, imaginative, and creative.28
A dreamy child may be destined to a career as an artist or inventor. Asking such a child to be as detail oriented as someone whose future lies in accounting is like asking everyone to wear the same size shoes.
In this regard, a particular child comes to mind, by the name of Alva. His teacher was a minister, and an observer left us this record of their interaction: “The minister, of course, taught by rote, a method from which Alva was inclined to disassociate himself. He alternated between letting his mind travel to distant places and putting his body in perpetual motion in his seat. The Reverend, finding him inattentive and unruly, swished his cane. Alva, afraid and out of place, held up a few weeks, and then ran away from school.”79
It is fortunate that young Alva lived some years ago, before the medicalization of childhood was under way. His full name, by the way, was Thomas Alva Edison, and today, he would almost certainly be diagnosed with ADHD and given Ritalin. If he had been, we might still be reading by kerosene lamps.
Ritalin helps children to conform to externally imposed Naples and regulations But I have serious questions about drugging children to make them more obedient to authority. What happens to those young people vEose special destiny lies in being innovators, who carry it within themsel~ es to challenge abuses of power in order to help create a better world?
What if young Martin Luther King, Jr., had been drugged as a child? Would the world have ever been touched by his dream, and had the op portunity to make it come true? What if young Rosa Parks had been sub jected to such treatment? Would she have grown into the woman who had the courage to keep her seat on the bus that auspicious day in Alabama? Young Thomas Paine was quite a rebel as a child. If he had been subjected to Ritalin, there might not even be a United States. If a young William Shakespeare had found himself in the hands of modern medicine, I doubt that the world would ever have heard him remind us, “To shine own self be true.”
I’m not saying that the children diagnosed ADHD are all potential Thoreaus, marching to a different and higher drummer. I recognize that some of these children may benefit from medication, and I sympathize with teachers who must cope with certain young people who seem prenaturally gifted at bringing chaos into a classroom. But I also know that some of these youngsters come from very difficult home situations, and act out at school the pain they carry. Tragically, some of these children are the very ones the U.S. Advisory Board on Child Abuse and Neglect was referring to in the recent statement, “Every year, hundreds of thousands of children are starved, abandoned, burned and severely beaten, raped, and sodomized, berated and belittled.”
Some children are rebellious because within them there is creative genius that has yet to find its expression. Others misbehave because they have been badly ill treated. And others who have difficulties in school are simply youngsters whose unique neurological functioning and natural learning styles are incompatible with an authoritarian school system. For one reason or another, many of the children who are diagnosed as having ADHD are poorly suited to the mass production assembly line system of education. When these youngsters are permitted to make more choices about their learning activities, and to feel a sense of control over their learning processes, the results can be stunning.~°
“The wildest colts,” said the Greek philosopher Themistocles, “make the best horses.”
Alternatives to Drugs
I see great importance in respecting young people and providing them an
environment in which they can express themselves as they learn, because
I believe that is the best way to raise them to be self-reliant and self-respecting We awaken in our children the same attitude toward themselves that we hold toward them.
When my son, Ocean, was five, we moved to Victoria, British Columbia, so that he could attend an experimental alternative public school called Sundance Elementary School. There, the school day was divided into periods, during each of which the students could choose from six different activities ranging from physical play to art to a range of academics. Instead of grading the students, the teachers had ongoing discussions and dialogues with the children to help them set their own goals and evaluate themselves. Parental involvement was high. Remarkably, there seemed to be no drop-off in academic achievement among the youngsters, though not all learned at the same pace.
I remember one young friend of my son’s, an extremely high energy boy named Ricky Walker. He had been diagnosed as hyperactive, and was a real problem at his former school. His teacher there said that the only way Ricky could continue in her class was if he took medication.
Ricky’s mother recalls those days all too vividly. “We were at our wit’s ends, but didn’t like the idea of starting Ricky on drugs. He said he hated school, and always dreamed up the most bizarre excuses so he wouldn’t have to go. He was often sick, and many times I wasn’t sure whether he was really sick or just trying to stay home.
“Sundance sounded a little impractical to me. But I visited the school, and was struck by the bright faces and spirit of cooperation I saw. The kids actually seemed to be enjoying themselves. With some apprehension, we enrolled Ricky. And at the same time we made the decision. to clean up his diet, to get rid of the junk food, the sugared cereals, the soda pop and hot dogs and donuts.
“At first, he didn’t like any of this. He didn’t want to eat whole wheat bread and he didn’t want to go to Sundance, but within two weeks he was saying how much better he felt, and that he liked being able to choose his own activities. After that, Ricky became much happier, and actually got to the point that he was eager to go to school. One sign that this was the right direction was that Ricky was hardly ever sick after we made the changes. Even more important, though, was the change in his attitude. He became positive person.”
Today, Ricky is a successful teacher of martial arts and skiing. I recently isked his mom whether she thought it was the change in school or the ‘hange in diet that had made the most difference. “We made both changes at the same time,” she answered, “so I can’t separate them. They were both important-two good things that multiplied each other’s benefits.”31
If You Love Me, Don’t Feed Me Junk Food
Among the many factors that shape the lives of children, nutrition often plays a critical role. What children eat exerts a profound influence over the molecular environment and neurochemical functioning of their brains, governing the way they process information, and influencing the way they think, learn, and act. Many studies have found, for example, that children with higher intakes of B vitamins and other brain-active micronutrients do better in school than those children whose diets are lower in these nutrients. Others studies have found that children who are exposed to heavy metals (such as lead, cadmium, or mercury) through their food, air, or water have reduced learning and memory, and impaired functioning of the central nervous system.32
A landmark 1990 study concluded that lead poisoning in childhood is the single most important predictor of criminality among adults, far outweighing poverty, the absence of a father in the household, and other major social factors commonly cited by criminologists. In 1996, Dr. Herbert Needleman and his colleagues at the University of Pittsburgh School of Medicine reported in the AMA Joumal that even nominal doses of lead, well below those associated with poisoning, can lead to antisocial behavior and delinquency in young boys.33
If exposure to even minute amounts of lead can disturb children’s brain chemistry and behavior so dramatically, is it possible that other forms of chemical pollution, such as artificial food additives, might underlie some cases of ADHD? It was just this sort of question that led to the remarkable work of Ben Feingold, M.D., of the Kaiser-Permanente Medical Center in San Francisco.
In 1973, this distinguished pediatric allergist told a meeting of the AMA that food additives were responsible for 40 to 50 percent of the hyperactiv~t~v he had seen in his practice. He had found that a substantial number of hyperactive children improved dramatically when they stopped eating foods that contained artificial colorings, flavors, and certain preservatives.34 Add~tionally, he found that a variety of childhood learning disabilities and Other behavioral problems were reduced by the same diet changes.
The Feingold program is based on the fact that although most human beings have the ability to tolerate a certain amount of exposure to harmful substances, some of us are more reactive biochemically than others. Some of us are not having an easy time coping with a world where neither our water nor our air is pure, where we are exposed to countless chemicals every day that have never been known in nature until the last few decades, and where our food has been subjected to processing and refining that removes essential nutrients and adds a plethora of artificial chemicals. For children who happen to be especially sensitive, the three most troublesome chemicals-synthetic food dyes, artificial flavorings, and preservatives-can cause a host of physical, emotional, and mental reactions, and lead to being diagnosed as hyperactive.
Unfortunately, many parents, educators, and physicians believe that the Feingold program has been disproven. This erroneous idea stems from a series of studies undertaken during the late 1970s which purported to find Feingold’s methods wanting, and which were widely quoted.35 But serious questions have been raised about the validity of these studies.36
One study, for example, eliminated only eight of the more than 3,000 additives in our food supply, and when children did not show major improvement, wrote the program off as worthless. Others were undertaken by the Nutrition Foundation, an organization funded by the makers of Coca Cola, Fruit Loops, C & H Sugar, and other junk food manufacturers.37 The studies took hyperactive kids, gave them doses of either additives or placebos, and then noted very little difference in response. But an analysis of the controversy, published in the journal Science in 1980, disclosed that the researchers had used doses of the additives that were far too small to produce a noticeable effect.38 In fact, when the amounts were raised to a level commensurate with children’s actual eating habits, the hyperactivity/food additive link was confirmed. Some 85 percent of the hyperactive children reacted adversely when they were exposed to realistic levels of artificial colorings, flavorings, preservatives, and other synthetic food additives.
In 1985, Lancet published the most convincing evidence to date In an extremely well designed study, 79 percent of hyperactive children Improved when suspect foods were eliminated from their diets, only to become worse again when the foods were reintroduced. Artificial colorings and flavorings were the most serious culprits; sugar was also found to have a noticeable effect.39
When parents are willing to try the Feingold approach, the results can be extraordinary. One such mother, Gayle Giza, described a long history of disappointment and frustration with her son, Mark. Finally, she tried the Feingold program. Mark was willing, she says, because he “had become so unhappy with his life by the time he was ten years old, he welcomed a chance to change things…. After we began the program he no longer had problems which we hadn’t even identified as problems! He could come to the dinner table and sit down without spilling everything, could go to sleep without rocking, and stopped talking out in his sleep. He stopped incessantly teasing his sister, being argumentative, and could now turn off the TV without a confrontation. I soon received a letter from his teacher, which said, ‘Mark is a pleasure to have in crass.’ after ten years of worry and search ing, I can’t describe the feelings this brought. Needless to say, I still have the letter. Mark had no problems with reading or spelling after that, and sixth grade was a real success story…. The day our ten- year old told us, ‘I really like me the way I am now,’ I knew no amount of effort would have been too much.”40
Of course, a program can generate marvelous anecdotal success stories without being grounded in scientific testing. It may work for a few kids here and there without being of any use to the vast majority. Do programs that improve nutrition and remove chemical additives in children’s diets actually have value on a large scale? I have found that the scientific literature supporting such programs, though not widely known to the general public, is impressive.
A series of studies in the 1980s removed chemical additives and reduced sugar in the diets of juvenile delinquents. Overall, 8,076 young people in 12 juvenile correctional facilities were involved. The result? Deviant behavior fell 47 percent.
In Virginia, 276 juvenile delinquents at a detention facility housing particularly hardened adolescents were put on the diet for two years. During that time, the incidence of theft dropped 77 percent, insubordination dropped 55 percent, and hyperactivity dropped 65 percent.42 In Los Angeles County probation detention halls, 1,382 youths were put on the diet. Again, the results were excellent. There was a 44 percent reduction in problem behavior and suicide attempts.43
These and other studies have found that when troubled youngsters are put on a healthy diet based on nutrient dense foods like whole grains, vegetables, and fruits, and avoid sugar and artificial colors, flavors, and preservatives, the results are predictably outstanding.
Supplementary vitamins and other essential nutrients also often help. A number of double-blind placebo-controlled studies have found that the frequency of antisocial behavior in juveniles is lowered significantly by appropriate supplementation.44
One remarkable double-blind, placebo-controlled study actually compared Ritalin directly with vitamin B6. Published in 1979 in the journal of Biological Psychiatry, this study found that high doses of vitamin B6 actually did a better job than Ritalin at reducing hyperactivity.45 Vitamin B6 is, of course, far cheaper (Ritalin prescriptions cost $30 to $60 per month), and far safer than the drug, and the study’s protocol was outstanding.
In 1992, Jane Hersey, executive director of the Feingold Association of the United States, explained why she and others work as volunteers for the organization:
- “I hear some chilling stories from parents of troubled children. They are told that their children are abnormal and have a deficiency that can be corrected by Ritalin. Some doctors call it ‘replacement therapy,’ es though the drug were a naturally occurring substance. We hear about teachers and counselors telling parents-‘If you really loved him, you’d agree to give him the medication.’ We hear of doctors prescribing Ritalin or Valium to two-year-olds. We know of parents coerced by treatment centers to agree to multiple medications, and of families facing bankruptcy as a result of these expensive yet unsuccessful therapies. We know of ADHD groups run by professionals with a vested interest in the choice of treatment, and of pharmaceutical industries supplying money to such groups. The trend appears to be growing, and with frightening speed.”46
(The Feingold Association of the U.S. can be contacted at: P.O. Box 6550, Alexandria, VA 22306.)
One Million American Schoolchildren Change Their Diets
Perhaps the most amazing study of all those ever undertaken regarding the Feingold diet and children occurred when no less than 803 public schools in New York city were put on the diet for four years.47 Dr. Elizabeth Cagan (the chief administrator of the Office of School Food and Nutrition Services for the New York City Public School System Board of Education) and Barbara Freidlander Meyer (city-wide nutrition education supervisor) decided to test what effect, if any, the Feingold diet would have on academic performance. Over a period of several years, they gradually eliminated all artificial colors and flavors, and the preservatives BHA and BHT, from the schools’ cafeterias, while also reducing the amount of sugar available.
It was an extremely large-scale, ambitious, and ingenious experiment. The dietary modifications were introduced in a series of steps that took place simultaneously in all 803 schools. The alterations took place in the school years 1979-1980, 1980-1981, and 1982-1983. The reason no changes were made in 1981-1982 was to insure that any results that might be obtained during the course of the experiment would in fact be due to the dietary improvements, and not due to some other unknown occurrence that might be taking place simultaneously.
The schoolchildren were tested each year using the standard California Achievement Test. The testing began several years before the dietary modifications commenced, and continued throughout.
The results were spectacular. In the three years before the experiment began, the schools had placed in the 41st percentile, the 43rd percentile, and the 39th percentile, compared to other schools in the country. After the first year of dietary improvement, during which the Feingold pros gram was partially implemented, the schools advanced to the 47th percentile. The second year, when the program was implemented further, the schools jumped to the 51st percentile. Interestingly, the next year, when no further dietary improvements were made, no increase in academic performance was found. The schools simply held steady in the 51st percentile. The following year, when the program was implemented further, the schools advanced again-this time to the 55th percentile.
When the study was published in the International Journal of Biosocial Research, the authors wrote, “In short, New York City Public Schools raised their mean national academic performance percentile rating from 39.2 percent to 54.9 percent in four years, with the gains occurring in the first, second and fourth years [precisely when the dietary improvements were made].”48
This was the largest such gain ever measured in any comparable period of time in any metropolitan school district in the country. But that’s not all. The researchers added: “In 1979 [before the dietary changes], 12.4 percent of the one million student sample were performing two or more grades below the proper level. Yet, by the end of the 1983 year, the rate had dropped to 4.9 percent. Again’ all gains were found in 1980, 1981′ and 1983 [corresponding exactly to the dietary improvements].”49
National Rankings of 803 New York City Public Schools Before and After Diet Changes
Percentile Rankings Based on CAT Scores
Source: Stephen J. Schoenthaler, et al. “The Impact of a Low Food Additive and Sucrose Diet on Academic Performance in 803 New York City Public Schools,” International Journal of Biosocial Research, VoL 8(2): 185. 196, 1986.
Such stunning results were obtained even though only at-school meals were modified. No attempt was made to alter what children ate at home. Since these children only ate a relatively small percentage of their daily diet at school, we can only imagine how great the benefits would be if children’s entire diets were improved.
When foods containing artificial additives are eliminated and foods high in sugar are dramatically reduced, the resulting benefits are not simply due to the elimination and reduction of offending substances. This kind of dietary change inevitably involves a corresponding shift to more whole and natural foods. Diets become higher in fresh fruits and vegetables, whole grains, and more plant-based proteins. They become lower in fat, and lower in adulterated, refined, and highly processed foods.
The Healthy School Lunch Program, a project of EarthSave International, is today working to change the food served in schools in a healthier direction. Parents and teachers throughout the country who vould like to see these kinds of changes implemented in their local schools are invited to contact EarthSave at P.O. Box 68, Santa Cruz, CA 95062 (1-800-362-3648). School districts consistently find that when they improve the food available to their students, the young people become
healthier, the rates of ADHD and antisocial behavior plummet, and there are substantial gains in academic achievement.
Sometimes Miracles Do Happen
Doris Rapp, M.D., clinical assistant professor of pediatrics at the State University of New York, is quite familiar with the importance of diet in children’s lives. One of the world’s foremost experts on food and environmental allergies, she became well known to the general public after her appearances on the Donahue show in 1987 and 1988. Her presentations, along with those of the children she had treated and their parents who appeared with her on the show, generated more than 140,000 letters. In her outstanding book Is This Your Child?, she shows parents how to identify the common foods, chemicals, or allergenic substances that can be the culprits behind a wide range of problems in children (and adults). She tells the poignant story of a young boy named Paul.50
When Paul’s mother was advised, three days after the boy started kindergarten, to see a doctor for his hyperactivity, she was not surprised. The lad had exhausted his entire family for years. He was constantly jumping around, and was known to roller-skate through the living room at 3:00 A.M. To say he was “out of control” was an understatement.
His mother had feared there might be trouble when Paul started school. She understood when the kindergarten teacher said the boy was “too much” to handle. He was, well, the word exuberant was a polite way of putting it. There was no doubt about it, he could be a problem.
Paul’s mother took the five-year-old boy to a neurologist, who didn’t take very long to start him on Ritalin. The doctor warned her, “Don’t believe what you read about the drug having side effects. It’s best just to not read that stuff.”
Ritalin made Paul calmer, which was at first a welcome relief. But he soon became depressed and crabby. His mother called the neurologist, who reassured her that the boy would be fine in a little while. After a time, however, the school psychologist called, saying that she was concerned because the boy would stand out on the playground, just staring at the other children. She suggested that the boy be taken off the drug.
Disturbed, Paul’s mother took him back to the neurologist. She told the doctor that each time Paul took the medication, he became very with- drawn, and then became overwhelmingly sad. The doctor advised her not to worry, and made some adjustments in the dosage.
When Paul entered first grade, he had been on Ritalin for a year. His new teacher commented that the boy “acted like a zombie, and never ; smiled.” Paul’s mother was becoming increasingly alarmed.
She knew the medication had relieved Paul’s overactivity, but now at times he refused to eat or drink. The school nurse said she could barely get him to drink enough water to swallow his Ritalin tablet. Socially, the boy was not doing well. He was gradually becoming more and more moody, nasty, and morose. What had happened, his mother wondered painfully, to the spirited rascal he once had been? Now when he came home from school, he slammed the door and went angrily to his room. When she tried to talk to him, he would yell, “Why can’t everyone just leave me alone.” He seemed to have forgotten how to play, laugh, or even ~ smile. Every day he complained that no one liked him. His mother would I hear him alone in his room moaning bitterly, “Everyone hates me.” He I had no friends, and had to be forced to get on the school bus every mornI ing. The other children pushed him around, refused to let him sit next to I them, and made fun of him.
Paul told his mother he wished he could go to heaven because he’d I be happy up there. He asked her repeatedly, if people killed themselves, I could they go to heaven? At night when he said his prayers, he would beg l God to please let him die before morning so that he could go to heaven’ and be happy. His mother listened helplessly as he lay in bed for hours crying before finally falling asleep. Sometimes she cried, too. She thought she must be an awful mother because he was so troubled and she couldn’t help him. She began to think seriously that maybe she should give him away.
She made an appointment with Paul’s pediatrician, and told him Paul | had become severely depressed. She was told to continue giving him the drug.
Then Paul tried to kill himself. He took the screen off his bedroom 1 window and tried to jump out. After that, his mother decided that she must I take him off the Ritalin. After checking with the neurologist, who assured her that an abrupt, complete withdrawal from the drug could not harm Paul because Ritalin “was not addictive,” she stopped giving him the medation. Within days, Paul became hysterical. His mother found him crying uncontrollably, thrashing about, kicking his feet, and holding a pillow Over his head as tightly as he could. As he tried to suffocate himself, he moaned, “I wish I was dead, I wish I was dead.”
Paul’s mother took him to a psychologist who told her that the boy’s
behavior problems were her fault because he had not been disciplined correctly, and she was letting him manipulate her.
She asked another doctor whether it was possible that Paul might have allergies that were behind the problems, but he scoffed at the idea and told her not to waste her money with that sort of thing. In spite of his advice, however, she took the boy to a board-certified allergist. He told her that diets were not helpful in treating hyperactivity. He said all that had been disproven. He was adamant that the boy’s behavior was unrelated to additives or foods. “There’s nothing you can do,” he declared. “He’s never going to have any friends. He’ll have to be put away someday.”
Paul’s mother took the boy to yet another pediatrician, who told her he was learning disabled.
The turning point in this six-and-a-half-year-old child’s life began when his mother saw the Donahue show that featured Doris Rapp’s work with hyperactive children and allergies. She heard another mother tell of her experience with a hyperactive child who “sounded just like Paul.
With the help of Doris Rapp’s book, she immediately put Paul on a Multiple Food Elimination Diet, and within three weeks he was transformed into a happy, contented child. She says she knew for certain that they were on the right track the day his teacher remarked how nice it was to see him smile. The teacher had never seen the boy smile before.
The final confirmation of Paul’s improvement was dramatic and heartrending. He came home from school one day, and rang his own doorbell. His mother opened the door and there was Paul, all smiles, tightly clutching a little boy’s hand. Bursting with happiness, he said, “Mommy, I have a friend.”
In the first five years of the 1990s, Ritalin use among children in the United States nearly tripled.51
For most of the kids taking Ritalin today, none of the many alternatives have been tried before resorting to drugs. Their classroom env~ronments are mass production assembly lines, and no effort has been made to discover what or how they want to learn. Their diets are full of art~fic~a chemicals, and no responsible attempt has been made to discover any foe allergies that they-like Paul-might have.
There are so many alternatives to Ritalin that have proven helpful for countless children that it seems a shame to put a child on the drug without first trying these other approaches. To my eyes, the best strategy often turns out to be a combination of enhanced nutritional support, the creation of a more nurturing atmosphere at home, and a more responsive learning situation at school. The human body and spirit are designed with a basic mtelhgence, and often respond exquisitely to loving attention and a healthy lifestyle. Human beings can be beautiful, creative, and powerful, but need support and the opportunity for self-expression. When we provide a nurturing environment and diet for children, many of the problems that otherwise tend to be treated by pharmaceutical interventions simply disappear.
I have a hard time seeing so many children drugged, and yet it is certainly not my intention to condemn the many parents or teachers who mean well for their youngsters and have given them Ritalin. Often they have been directed to do so by medical authorities, whom they have been taught to trust. Often they have known no other course to take.
One uncontrollable child can so disrupt a whole class that learning becomes impossible for everyone involved. There are parents and teachers who are at their wit’s end, and many who do not have the time, information, or financial resources to make adequate positive changes. And there are certainly some children for whom the judicious and temporary use of Ritalin has value, bringing at least a semblance of normalcy and un, wmding vicious cycles in which they have become caught.
But given the outstanding results that have so very often been obtamed when life-affirming and drug-free approaches are used, what can be said about the medical and psychiatric establishments who have so far simply ignored them? Unlike drugs, the alternative approaches typically enhance learning, build self-esteem, promote overall health, encourage self-reliance and have no side effects. They do not so much seek to make children more “manageable,” as to make it easier for children to manage the challenges and opportunities life brings them.
When I called the American Dietetic Association’s National Center for Nutrition and Disease in late 1995 to ask about the Feingold program’ I was greeted by a recorded voice cheerfully telling me: “This month, the nutrition hotline is supported in part by grants from Kellogg Company, Glaxo-Wellcome [pharmaceuticals], Meade-Johnson, and Quaker.~, Not overly impressed with the organization’s impartiality, Iplodded forward and soon found myself being told by a spokesperson for the organization that there is no reason to worry about chemical food additives in children’s diets.
The American Dietetic Association does promote a consumer fact sheet on diet and health that focuses on ADHD, and an accompanying booklet titled “Questions Most Frequently Asked About Hyperactivity.”52 After asking-“Is there a dietary relationship to hyperactivity? Should I restrict certain foods from my child’s diet?”-the material responds: “The answer to both questions is ‘No.”‘ As if this were not enough, the fact sheet adds: “Sugar has a mildly quieting effect on some children,” and then goes out of its way to find fault with the Feingold program. I find it troubling that these materials, promoted by the American Dietetic Association, were written and produced by the Sugar Association.53
Similarly, in 1995 the American Academy of Pediatrics (AAP) accepted $50,000 from the Sugar Association and $70,000 from the Meat Board to fund a nutrition video for children.54 The AAP’s position paper on ADHD thoroughly endorses medication and drug treatment, and contains not a single word about diet or nutrition.55
What would happen if instead of cozying up to the junk food industry, our medical authorities stood up and demanded that our children be fed a healthy, natural, and uncontaminated diet? Our children might have a better chance to grow up calm and clear. We might see fewer of them becoming trapped in substance abuse, and more of them becoming balanced and capable human beings.
What would happen if organized medicine became an advocate for the creation of healthy learning environments for our children? Our schools might begin to become places of learning that nurture the wholeness and well-being of young people.
What would happen if instead of resisting and ignoring the use of proven alternatives, the medical establishment offered its support? Perhaps fewer of our children who are having difficulties would be pathologized and drugged, and more would grow into competent people with joy to share and a contribution to make.
What would happen if the American Psychiatric Association, the National Institutes of Health, the American Medical Association, the American Academy of Pediatrics, and other representatives of organized medicine threw their considerable weight behind safer, more effective ways of responding to children’s problems?
– Our youngsters would be healthier and happier. Their lives would be blessed with greater opportunity for fulfillment and meaning. They would become increasingly centered and self-reliant, and better able
The future would look a lot brighter for all of us.