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Michael is a lively, sensitive, impulsive, verbally adept thirteen-year-old of high intelligence with a wide general knowledge that would put many adults to shame. However, he is severely underachieving at school and at times his behaviour is inappropriate.

He is uncoordinated, disorganised, untidy and clumsy. He has problems settling down to tasks at school and organising his books and equipment. His difficulties in fine motor skills show in his slow and laborious handwriting and his inability to copy writing at an average speed. He has a poor auditory and visual memory resulting in a lack of concentration, along with difficulties remembering, following instructions and planning ahead. He avoids sport at all cost as his lack of balance, co-ordination and insensitivity to spatial awareness makes him feel inadequate in front of his peer group.

The teachers were totally exasperated with Michael as he was disruptive in class. Eventually, a destructive cycle resulted whereby the teachers repeatedly sent Michael out of the classroom, exacerbating Michael's problems, and further lowering his fragile self esteem.

Eventually, Michael was diagnosed, by a psychiatrist, as having elements of Dyspraxia and Attention Deficit Disorder, as well as clinical depression. At the same time the headmaster gave him a warning of expulsion.

Michael's mother rang me in complete despair as the only help offered was a handout on Dyspraxia and the drug therapy of Ritalin. She wanted more information on both conditions and wondered whether nutritional therapy would help.

I explained that both Dyspraxia and Attention Deficit Disorder were related and caused by minimal brain dysfunction. Little is known about Dyspraxia other than it is an immaturity of the brain resulting in messages not being properly transmitted to the body. Motor co-ordination and sensory integration are affected which results in the child feeling a failure. Dyspraxia affects 1 - 10 % of the population to varying degrees and like Attention Deficit Disorder the majority affected are males. The single most important diagnosis criterion is a significantly lower IQ performance than verbal IQ score. There is very little documented evidence with nutritional approaches.

Attention Deficit Disorder, on the other hand, is marked by hyperactive, impulsive behaviour and inattention. Dr Alan Zametkin has traced Attention Deficit Disorder to a lack of dopamine in the brain, which affects mood, emotion and motivation. Studies carried out by L Colquhoun and L. J. Stevens found low and altered fatty acid metabolism in children with Attention Deficit Disorder. There is also evidence to prove that food sensitivities contribute to the behaviour manifestations of this disorder. Ben Feingold brought this to the public's attention in 1975. More recently the work of Sally Bunday with the "Hyperactive Children's Support Group" shows that considerable improvement can be made with a diet eliminating additives, chemicals, and some foods such as cow's milk, oranges, wheat and chocolate.

Michael's mother arranged a consultation and various tests showed that Michael was indeed allergic to dairy produce and sensitive to wheat and tomatoes. He was also low in the essential fatty adds, B6, magnesium and zinc. Using kinesiology testing I found that the dopamine pathway was also underfunctioning.

With Michael's help I designed a diet which avoided the food allergens and sensitivities, all additives, preservatives, colours and sugar foods. Having been allergic to cow's milk products from birth, Michael understood the relevance of a quality diet, and we didn't have the usual problems of eliminating chocolate and milk. We agreed on lots of recipes which included oily fish, white fish, white meat, baked potatoes, brown rice, soya milk, nuts, seeds, oats, rice flakes, sugar flee jams, fruit and vegetables, Ryvitas and Marmite. Lots of filtered water was to be drunk throughout the day. Healthy snack bars, carob bars, organic crisps and cakes made without sugar were allowed occasionally. He agreed to take a packed lunch to school each day as long as he could have a fizzy drink made with carbonated water and fresh fruit juice. Michael had 4 small meals each day with fruit as snacks between meals to ensure a constant supply of blood glucose to the brain.

The conventional treatment of Ritalin, an amphetamine that stimulates the central nervous system, with potential side-effects, was avoided and replaced with a supplement programme. This included a children's multi-vitamin and mineral capsule and the omega 3 and omega 6 fatty adds in the ratio of 2:1. Pyridoxal 5' phosphate was given to support both the essential fatty acid and dopamine pathways along with tyrosine, the starter nutrient for the dopamine pathway.

Other strategies included kinesiology exercises to improve brain functioning and "Apex Flower" remedies to work on his spirit. To increase his self esteem he was also encouraged to pursue roller blading and swimming, the two sports he enjoyed and could achieve at.

To allow him a fresh start he changed to a more understanding school which allowed his mother to work with the special needs department. An individual education plan was produced to help Michael achieve his academic potential. The short-term aims were an improvement in attention and concentration within lessons, organising himself and his equipment and to produce some homework Praise was to be given for any improvement in these areas.

The outcome, after twelve weeks, is that Michael is more contented and relaxed, less stressed and happier. He looks healthier, has more good days than had days, and has made some friends at his new school. He organises himself better, talks less in lessons, hasn't been sent out of the classroom and has produced some good pieces of homework. In his S.A.T.S. he did reasonably well in most subjects and came top in science. He now understands that be has difficulties and he is trying to cope with them rather than hiding behind them.

I understand that everything is an effort for Michael, but he is now achieving in some areas, which is a great boost to his self esteem. At the end of his first term he was thrilled to receive a certificate of achievement awarded by the headmaster for "A Good Beginning".

References

Feingold B.F. Why your child is hyperactive New York, Random House, 1975.
Psychopharmacologic Drugs. Drug Evaluations Subscription. Volume 1, Section 3. Chicago. American Medical Association Spring 1992.
Guggay S.S. 1985. Clumsiness.In P.J.Vinken, G.W. Bruyn, and H.L.Klawans (Eds.), Handbook of Clinical Neurology (ref. Series) (pp. 159-167). New York: Elsevier. Children with Developmental Dyspraxia – Information for Parents/Teachers. September 1995 by Sydney Chu MSc. SROT, OTR. Published by the Dyspraxia Foundation.
Colquhoun Land Bunday S.A lack of essential fatty acids as a possible cause of in children.Medical Hypothesis 1981:7:673-9.
Stevens L.J., Zentall S.S., Deck J.L., Abate M.L., Watkins B.A., Lipp S.R. and Burgess J.R. Essential fatty acid metabolism in boys with attention-deficit hyperactivity disorder. American Journal of Clinical Nutrition 1995:62;761-8
Brain Gym. Simple activities for whole brain learning. By Paul E . Dennison ,Ph.D. and Gail E.Dennison. Published by Edu-Kinesthetics,Inc. Post Office Box 3396 Ventura, CA 93006-3396 U.S.A.
Dyspraxia Foundation.8,West Alley, Hitchin, Herts SG5 IEG.Telephone Helpline 01462 454986.
Hyperactive Children's Support Group. Sally Bunday, 71 Whyke Lane, Chichester, West Sussex PO19 2LD