When Anna was in preschool, she had behavioral problems — emotional meltdowns, social trouble with peers, difficulty focusing and more. The problems seemed to occur at random, with no common triggers. Her mother, Amanda, suspected that Anna had ADHD and made an appointment with the Center for Management of ADHD at Children’s Hospital of Philadelphia.
Dietary changes can improve ADHD symptoms
Amanda and Anna met with Marianne Glanzman, MD, a developmental pediatrician with expertise in the diagnosis and treatment of ADHD and other learning disabilities.
Anna was diagnosed with ADHD, but Amanda was wary of the medications often given to children with ADHD. Dr. Glanzman recognized Amanda’s concerns. Before considering medication, she suggested a change in Anna’s diet. Dr. Glanzman gave Amanda information about the Feingold diet, which has been found to be helpful for some children with heightened sensitivity to artificial colorings and preservatives and to natural foods high in salicylates, such as apricots, almonds and certain berries.
Dr. Glanzman referred Amanda and Anna to CHOP’s Integrative Health Program, where physicians look for opportunities to combine conventional medical treatments with evidence-based complementary health practices, such as dietary changes, mindfulness, yoga, massage and acupuncture. Anna’s dietary changes lead to immediate improvements that her mother saw right away.
“There were fewer meltdowns at home. And a decrease in rigid behavior.”
Finding the right dietary treatment
After being on the diet for a couple of months, Anna came in for a scheduled appointment with the Integrative Health Program. They met with pediatric gastroenterologist Maria Mascarenhas, MBBS, Director of the Integrative Health Program and Medical Director of the Clinical Nutrition Department, and with nutritionist Maria Hanna, MS, RD, LDN.
Dr. Mascarenhas examined Anna and found a previously undetected problem: She was suffering from constipation and gut dysbiosis — the bacteria in her digestive system was out of balance.
Dr. Mascarenhas wanted to continue the Feingold diet and consulted with Maria Hanna to make some adjustments. The team refined the diet to ensure that Anna’s dietary intake was balanced, varied and complete, and they took into account her dietary restrictions and food preferences. The diet also included more foods with fiber and inulin — foods like asparagus and papaya — to resolve the constipation. Guidance was provided to the family on safe and appropriate nutrient supplementation as needed.
Amanda saw even more improvement in Anna’s behavior after adopting the new diet. She also noticed a relationship between Anna’s constipation and her behavior. When she was constipated, Anna had more emotional swings and less focus.
Adopting integrative health techniques
Anna returns to CHOP every three months to meet with Dr. Mascarenhas. In addition to dietary changes, Dr. Mascarenhas has introduced Amanda and Anna to mindfulness practices, a form of meditation. Mindfulness aims to increase a person’s awareness and acceptance of daily experiences. It is currently used in many healthcare settings to help patients and their families reduce stress, control emotional swings, and regulate their attention.
Anna has learned to stop and think about how she feels. And at bedtime, she and her mother do a brief gratitude exercise. They talk about the positive things that have happened that day.
Anna is paying more attention to her emotions. “She’s aware that her behavior impacts other people and feels really bad after she loses control. She can be the sweetest thing ever,” noted her mother, Amanda.
Anna likes to play outside, and rides horses at a local riding center. She also loves coloring and drawing, and she likes to read.
“We’re so happy going to CHOP,” says Amanda.
“I thought we were headed down a different path with medication, and I’m pleased that they’ve recommended a more holistic approach.”