Hyperactivity is the everyday term for what medical books refer to as ”attention deficit disorder with hyperactivity.” Call it what you will, however, 10 percent of all American children (most of them boys) are now hyperactive to some degree. While there are over 100 possible symptoms of hyperactivity, children with the problem are generally restless, impulsive and agitated.

Their attention spans are often so short that they turn from one task to another without completing any. They frequently swing from quit withdrawal to sudden rage with little or no provocation. They run wild, throw things, whine and pick on siblings.

In short, a hyperactive child is the ultimate ”problem child.” Babysitters are scarce. Parents are at the end of their rope. At school, hyperactive children can't sit through class, so they're often labeled troublemakers. They do poorly at schoolwork – despite normal or even above normal intelligence. Teachers give up.

Hyperactive kids themselves don't feel very good about their behavior, either. They can't control their actions, no matter how much they want to. And they do want to. Not every hyperactive child is the reincarnation of Attila the Hun, of course. Hyperactive behavior varies from occasional outbursts to nonstop ”parent abuse.” and to some degree, hyperactivity may be in the eye of the beholder.

What’s hyperactive to Grandma may be simply normal spunkiness to a more patient adult. How do you know, them, whether or not your Childs is active or hyperactive? If your child’s moodiness and tantrums interfere with schoolwork, alienate all of his or her playmates and disrupt the household, you may be living with a hyperactive. And it's time to do something about it, for your sake as well as the child’s.

The Best Treatment

For years, the only known treatment for hyperactive behavior was daily doses of Ritalin, an amphetaminelike drug that suppresses hyperactivity. Many parents, of course, were uneasy about putting their children on drug. But short of calling in an exorcist, parents were given no other choice.

Even then, Ritalin worked only 50 percent of the children for whom it was prescribed. And while behavior improved, concentration and learning skills did not. Ten years ago, real hope emerged.

The late Benjamin Feingold, M.D., an allergist and pediatrician in San Francisco, proposed that hyperactive behavior is caused primarily by food additives (He also suspected aspirin related compounds known as salicylates, found in various fruits).

Placing a hyperactive child on a diet free of those additives and compounds, said Dr. Feingold, produced a dramatic improvement in behavior in 50 percent of the children treated. Dr. Feingold published his dietary theory program in two popular books, Why Your Child Is Hyperactive and The Feingold Cookbook for Hyperactive Children.

Parents of hundreds of thousand of hyperactive children, eager for an alternative to Ritalin, put their children on the diet. And happily, many children improved. Yet in other children there was no change. Because the Feingold diet worked for some children – but not others – critics began wonder if there was any real basis to the claims that the Feingold diet was a success.

And many pediatricians flatly rejected the notion of any link between diet and hyperactivity (some still do). Other pediatricians, however, believe that the Feingold diet sometimes fails because it doesn’t consider all possible triggers. It's true that food coloring, flavoring and preservatives (such as BHS and BHT) can cause hyperactivity.

But, say these doctors, so can sugar, milk, wheat – or any other food, for that matter. And they point out that hyperactive behavior was first described in medical journals over 100 years ago – long before artificial additives became standard food ingredients.

These doctors have found that once the offending food or food ingredients are identified, diet therapy for hyperactivity works quite well – in almost all cases. One of those is William G. Crook, M.D., of Jackson, Tennessee.

”In my opinion,” says Dr. Crook, ”too much of the controversy over diet and hyperactivity has revolved around the food colors, dyes and additives, rather than taking a broader look at the child’s diet and considering the possibility that the hyperactivity may be related to adverse or allergic reactions to other common foods, including sugar, milk, corn, wheat, eggs, chocolate and citrus fruits.

”In my experience and in the experience of many other physicians who have placed their patients on properly designed and carefully executed elimination diets, most hyperactive allergic children will improve within five to seven days after being placed on such a diet.

However, in approximately 20 percent of many patients, the symptoms do not improve significantly until the offending food or foods are avoided for 8 to 14 days. And occasionally, a three week period of avoidance is required” (Pediatrics, August, 1981). Whether your child responds sooner or later may depend on age.

Over the years, Dr. Feingold observed that younger children seemed to respond much sooner than older children and teenagers, probably because older children have been exposed to chemicals longer. Either way, parents who see their little hellions transformed into cherubic darlings in a matter of days fell their prayers answered at last.

Finding the Cause of Your Child’s Hyperactivity

Naturally, it would be helpful if a test existed to identify the foods as fault in hyperactivity. But as we mentioned in earlier chapters, skin tests rarely detect food allergy accurately, and blood tests are very expensive. For those reasons, many pediatricians feel that elimination diets are still the best method.

Doris J. Rapp, M.D., author of Allergies and Hyperactive Child (Sovereign Books, 1979), has done some of the most extensive work on diet and hyperactivity.

To find out if hyperactivity in a child is related to food, Dr. Rapp recommends that parents put their child on ”a simple diet composed solely of fruit, vegetables and regular meats (no sausage, luncheon meats and the like) for one week, and then restore the questionable foods one each day during the second week (i.e., milk, wheat, eggs, dyes, corn and chocolate) and note the effect of each food (Lancet, May 15, 1982).

Incidentally, salicylates containing foods may cause the problems in children allergic to aspirin, a salicylates compound. But Dr. Feingold told us that he had reconsidered the role of salicylates and thought that they weren’t nearly as much of a problem as additives.

To help identify those children who are most likely to respond to a change of diet. Dr. Rapp gives this thumbnail sketch of the child who most often experiences food related hyperactivity: ”If they have dark eye circles, bright red ears and a glassy look when the Jekyll and Hyde behavior develops, the answer may be a food.

”These children often have associated classical hay fever or asthma symptoms, headaches, abdominal complaints, leg aches and (other) behavioral problems. ”The symptoms are often triggered by the very foods they crave (sugar, peanut butter, orange juice, apple juice) or foods they detest” (Lancet, May 15, 1982). The nicest thing about dietary control of hyperactivity, say doctors who use it, is that it's totally safe.

”In medical school we learn, or common sense tells us, that if a treatment will not harm and may help the patient, then it should be available to the patient and used,” says Richard G. Wanderman, M.D., of Memphis, Tennessee in a letter written to a medical newspaper and supporting dietary therapy of hyperactivity.” Is there anyone who will say that a good, nutritious diet without added chemicals, overly processed foods and poorly prepared foods will harm a patient?” (Family Practice News, June, 1982).

An added bonus is that even normal but active children behave better on a controlled diet. In a study of 300 elementary school children, researchers found that after two weeks on the Feingold diet, even nonhyperactive children were less easily distracted, could concentrate on work or play, and were less fidgety and demanding of attention (Journal of Learning Disabilities, March, 1981).

The only real problem with a controlled diet is that some hyperactive children may begin to see themselves as sickly or somehow different from other children. Parents can minimize that problem by taking a positive attitude toward dietary changes and following these tips.

• Don't give a hyperactive child the impression that you find preparing special dishes to be a burden or nuisance. Instead, make ”safe” foods that the whole family can enjoy.
• Include the child in meal planning so he or she feels that his or her personal preferences count. That way, the diet will seem more like a game than punishment or therapy.
• Keep the child off cola drinks, tea, chocolate and other caffeine containing foods. The last thing an overactive child needs is more stimulation.
• Read labels like a hawk. Be sure to watch out for unsafe ingredients in products such as toothpaste and chewing gum – or anything that goes into your child’s mouth, for that matter.
• Routinely record your child’s behavior and diet, even if it is a simple matter of rating how good or bad the day’s behavior was on a scale of 1 to 10 (10 being excellent or uneventful, and 1 being the worst).
• In addition to eliminating the bad foods, increase the good. That will build up the child’s resistance to colds, sore throats and ear infections. Your child will be sick less often and have a better self-image.
• Don't overreact to minor infractions. Kids can't be expected to have any more willpower than adults when it comes to sticking to a diet 100 percent. Accept the fact, once in a while, Johnny or Susie will sneak a soda or whatever. To help minimize these opportunities, though, keep plenty of safe foods in the cupboard and refrigerator – with enough variety available so that your child has lots to choose from. And be sure to send your child off to school with a favorite ”safe” snack or two tucked in his or her lunch.
• Be on the alert for all forms of sugar, including corn syrup, honey, brown sugar and molasses. Doctors say that sugar in any form seem to fuel hyperactivity, no matter what else the child is allergic to. A pediatrician in Denver told us that he recommends diluting fruit juices with 50 percent water, to help reduce a child’s total sugar intake.

Set an example. Children are born mimics, and you’re going to have hard time getting youngster to avoid sugar and additives if your routinely swig soda and snack on junk food.

Finding Containing Natural Salicylates

Salicylates foods may be reintroduced to the diet following four to six weeks of avoidance, provided no history of aspirin allergy exists in the individual or his or her family

Almonds	Currants	Peaches
Apples, cider and cider vinegar	Gooseberries	Plums and prunes
Apricots	Grapes, raisins, wine and wine vinegar	Raspberries
Blackberries	Mint	Strawberries
Cherries	Nectarines	Tomatoes
Cloves	Oranges	Oil of wintergreen
Cucumbers and pickles

Source: Benjamin F. Feingold, Why Your Child Is Hyperactive (New York, Random House, 1975).

Ten Tips for Coping with a Hyperactive Child

Barton Schmitt, M.D., a pediatrician at the University of Colorado Medical Center in Denver, gives parents of hyperactive children the following general advice:

1. Accept your child’s limitations. Parents must accept the fact that their child is basically active and energetic – and possibly always will be. A parent should not expect to totally eliminate hyperactivity, but merely to keep it under reasonable control.
2. Provide outlets for the child’s excess energy. Hyperactive children need daily outdoor activities such as running, sports or long walks. In bad weather, it help to have a recreational room where the child can do what he or she wants without criticism.
3. Keep the home environment organized. Mealtimes, chores, bedtime and other household routines should be kept as consistent as possible to help the hyperactive child accept order.
4. Don't allow hyperactive children to become fatigued. When they're exhausted, the children’s self control breaks down and hyperactivity increase.
5. Avoid taking children to formal gatherings. Settings where hyperactivity would be extremely inappropriate and embarrassing – church, restaurants and so forth – should be avoided. Don't take the child to stores or supermarkets unless it's absolutely necessary. After a child shows adequate self control at home, he or she can gradually be introduced to those situations.
6. Maintain firm discipline. Hyperactive children tolerate fewer rules than normal children. Set down a few clear, consistent, important rules, formed mainly to prevent harm to the children themselves or others. Parents should avoid constant negative comments such as ”Don't do this” and ”Stop that.”
7. Enforce rules with nonphysical punishment. Striking or shaking the child should be avoided since they need to learn that aggressive is unacceptable. Instead, send the disobedient hyperactive child to his or her bedroom or other ”time out place” to settle down.
8. Stretch the child’s attention span and reinforce nonhyperactive behavior. Dr. Schmitt suggest activities such as reading to the child, coloring pictures together and matching pictures, followed by games of increasing difficulty – building blocks, dominoes, card games and dice games. The child shouldn’t not be given to many toys – that can be distracting. And, of course, the toys should be unbreakable.
9. Try not to reinforce the child’s neighborhood reputation as a ”bad kid.” Refer to the child as ”a good boy (or girl) with a lot of energy.” Otherwise, problem behavior becomes a self fulfilling prophecy.
10. From time to time, get away from it all. Living with a hyperactive child 24 hours a day would make anyone a wreck. Periodic breaks help parent to tolerate hyperactive behavior. Occasional evenings out or other time away from the child relieves pressure and helps parents to rejuvenate themselves.

Source: Adapted from ”Guidelines for Living with a Hyperactive Child,” by Barton Schmitt, Pediatrics, September, 1977.

Adults Can Be Hyperactive, Too

Parents may find themselves a lot calmer after their child’s been on a good diet for a few weeks. First of all, they have a less disruptive child to contend with. Second, they may have been a little hyperactive themselves and not realized it. While most hyperactive behavior appears in children, adults aren’t immune.

After all, we eat a lot of the same foods (in fact, one of the very first people whom Dr. Feingold noticed reacting to food additives was a 26 year old woman). The only difference between us adults and our children may be that we’ve learned to modulate our behavior. How can you tell if you've been a little hyperactive?

Well, you probably couldn’t concentrate on your work for more than five or ten minutes at a time. You didn’t sleep well. You were easily irritated and always a little exited. In fact, a lot of the impatient, aggressive ”Type A” behavior exhibited in people at high risk for heart disease and other stress related disorders may be a reaction to foods to which they are allergic.

So if you tend to be fidgety and impulsive, you should take a serious look at what you’ve been eating too. That’s especially important for mothers of hyperactive children who are expecting another child. Dr. Feingold told us that there’s a good chance that exposure to hyperactivity triggering foods during pregnancy plays a big role in determining whether or not the child will be hyperactive.

And, as we explained in Rotary Diets, breastfeeding is the best insurance you can take against food allergies of any kind. Child or adult, however, a successful response to a change in diet reinforces good behavior: once behavior improves, and when an individual feels better about himself or herself, self esteem goes up and hyperactive behavior fades away into a bad memory.

It's a real joy to see the face of disruptive, moody child transformed into one that says, ”Color me happy.” Because hyperactive behavior often overlaps with learning problems, we suggest that you also read the entry on Learning Disorders.