Saturday, January 16, 2010
Does Chiropractic Treatment Help ADHD?
This morning I scanned the articles on one of my usual webpages for something interesting. What caught my eye was a headline about chiropractic treatment for ADHD. As a psychologist who frequently deals with ADHD and educating the public about treatments I was skeptical about the optimistic sound headline and knew that this treatment has been one of many that are not supported by research as effective.
I clicked on the link and watched a compelling human interest video about a family where the daughter had a bad response to the more common treatment for ADHD, medication. In fact, it is not just more common, but is actually supported by a mountain of research as helpful for many people suffering from ADHD. Behavioral interventions are also well supported, but not mentioned at all in this video. The video did not bother to mention these comparative supports in the various treatments. They just made it seem as if the use of pills was "popular".
In this compelling case study, the child was eventually given chiropractic treatment which led to a reduction of symptoms. Then the chiropractor talked about the theory behind why chiropractic treatment should help with ADHD. An author who wrote a book about ADHD talked about how he endorses anything that is safe and legal and if it works, wonderful.
This entire piece would probably lead many parents to want to try the "safe" and non-medication approach. Why? Many parents want to avoid medication due to the impression that medication can be unsafe while there is no impression given that chiropractic treatments can ever be unsafe, in this video. However, all treatments have some possibility of harm. Manipulation of bones can be harmful. Not getting more effective treatment can also be harmful. I have often seen parents who have delayed treatment for years while their child is falling further behind in school, having discipline problems, and often suffering emotionally due to the difficult disorder of ADHD. This video did not show any case examples of that, but showed the most positive case example of success with ADHD.
This is not how research is done. We do not cherry-pick the most positive case and ignore the ones where there is no positive effect and there are negative effects. However, the use of anecdotes is more compelling for people, despite the fact that it is a poor way to make informed decisions about treatment. The fact that there are coincidental changes that may or may not be resulting from an intervention and the fact that there are powerful placebo effects that are not controlled for in anecdotes are two reasons to be skeptical of such evidence.
I searched for some more objective evidence of the efficacy of chiropractic treatment as opposed to the mountain of evidence supporting medication and behavioral treatments for treating ADHD. On a website called healthcentral.com, I found some information about the use of chiropractic treatment with ADHD. The author of the article, Bailey (2010) wrote:
"Chiropractic care is sometimes used to treat symptoms of ADHD. This is based on the belief that trauma to the spine occurs throughout our lives, beginning at birth and causes a misalignment of the spine. This impacts our body’s ability to function properly. Another theory is that when the skull is misaligned, there is uneven pressure on certain parts of the brain. Chiropractors work to correct misalignments and proponents of this treatment claim that the realignment will help to alleviate symptoms of ADHD (para. 1)."
"Modern knowledge of human anatomy does not agree with this assessment. Medical science has shown that the bones in the skull do not move. (para. 3)"
Furthermore, Bailey pointed out that the research supporting ADHD treatment with this procedure is minimal.
"To date, there has been only one study that evaluated the results of using chiropractic care to treat hyperactivity. Dr. Joel Alcantara, a chiropractor, noted in an article, Attention Deficit Disorder, “The results of this study ... are not conclusive.” Other than this study, no additional scientific information is available to substantiate the claim that this type of treatment helps, improves or cures symptoms of ADHD (Bailey, 2010, para. 2)."
Bailey, E. (2010). Chiropractic care. Healthcentral, Retrieved from http://www.healthcentral.com/adhd/alternative-treatments-200135-5.html