Attention Deficit Hyperactivity

By Jiang Liu, Diplomate of Oriental Medicine
AR Licensed Acupuncturist and Herbalist
Acupuncture & Chinese Medicine Clinic
2024 Arkansas Valley Dr., Suite 402
Little Rock, AR 72212

Attention deficit hyperactivity disorder (ADHD or AD/HD or ADD) is one of the most common childhood disorders and can continue through adolescence and adulthood. It is a neurobehavioral developmental disorder. Symptoms include difficulty staying focused and paying attention, difficulty controlling behavior, and hyperactivity.

Classification of ADHD
Predominantly hyperactive-impulsive

  • Most symptoms (six or more) are in the hyperactivity-impulsivity categories.
  • Fewer than six symptoms of inattention are present, although inattention may still be present to some degree.

Predominantly inattentive

  • The majority of symptoms (six or more) are in the inattention category and fewer than six symptoms of hyperactivity-impulsivity are present, although hyperactivity-impulsivity may still be present to some degree.
  • Children with this subtype are less likely to act out or have difficulties getting along with other children. They may sit quietly, but they are not paying attention to what they are doing. Therefore, the child may be overlooked, and parents and teachers may not notice that he or she has ADHD.

Combined hyperactive-impulsive and inattentive

  • Six or more symptoms of inattention and six or more symptoms of hyperactivity-impulsivity are present.
  • Most children have the combined type of ADHD.

Symptoms of ADHD
Inattention, hyperactivity, and impulsivity are the key behaviors of ADHD. It is normal for all children to be inattentive, hyperactive, or impulsive sometimes, but for children with ADHD, these behaviors are more severe and occur more often.

Symptoms of inattention

  • Be easily distracted, miss details, forget things, and frequently switch from one activity to another.
  • Have difficulty focusing on one thing.
  • Become bored with a task after only a few minutes, unless they are doing something enjoyable.
  • Have difficulty focusing attention on organizing and completing a task or learning something new.
  • Have trouble completing or turning in homework assignments, often losing things (e.g., pencils, toys, assignments) needed to complete tasks or activities.
  • Not seem to listen when spoken to.
  • Daydream, become easily confused, and move slowly.
  • Have difficulty processing information as quickly and accurately as others.
  • Struggle to follow instructions.

Symptoms of hyperactivity

  • Fidget and squirm in their seats.
  • Talk nonstop.
  • Dash around, touching or playing with anything and everything in sight.
  • Have trouble sitting still during dinner, school, and story time.
  • Be constantly in motion.
  • Have difficulty doing quiet tasks or activities.

Symptoms of impulsivity

  • Be very impatient.
  • Blurt out inappropriate comments, show their emotions without restraint, and act without regard for consequences.
  • Have difficulty waiting for things they want or waiting their turns in games.
  • Often interrupt conversations or others’ activities.

Causes of ADHD
Several factors may be involved in ADHD. In addition to genetics, possible environmental factors, brain injuries, nutrition, and the social environment might contribute to ADHD. ADHD probably results from a combination of factors.

  • Genetics: Twin studies indicate that the disorder is highly heritable and that genetics are a factor in about 75 percent of all cases. It could arise from a combination of various genes.
  • Environmental factors: Smoking, alcohol use, complications during pregnancy, infections during pregnancy, at birth or in early childhood may have a link to ADHD in children. In addition, high levels of lead may have a higher risk of developing ADHD.
  • Brain injuries: A small percentage of children with ADHD have suffered a traumatic brain injury.
  • Sugar: Sugar or a sugar substitute may be related to ADHD.
  • Food additives: There is a possible link between consumption of certain food additives like artificial colors or preservatives, and an increase in activity.
  • Social factors: WHO states the diagnosis of ADHD can represent family dysfunction or inadequacies in the educational system rather than individual psychopathology, which indicates social factors may be involved in ADHD.

Conventional treatment for ADHD
Currently available conventional treatments focus on reducing the symptoms of ADHD and improving functioning. But there is no cure. Treatments include medication, various types of psychotherapy, education or training, or a combination of treatments. Current medications do not cure ADHD. Rather, they control the symptoms for as long as they are taken. However, these medications have side effects. Different types of psychotherapy are used for ADHD. The aim is to help a child change behavior and teach children social skills. Parenting skills training helps parents learn how to use a system of rewards and consequences to change a child’s behavior.

Chinese medicine
Chinese medicine has 5000 years of history. Treating ADHD with Chinese medicine (acupuncture, herbals, TuiNa and some other modalities of Chinese medicine) has been routine practice in China. In recent years, Chinese medicine, especially acupuncture has started in western world. Here I cite what Nader E. Soliman M.D., a member of the American Academy of Medical Acupuncture (AAMA) said “The commonly prescribed drugs are not treating the core problems that cause ADHD, they are only temporarily alleviating the symptoms,” “Medical acupuncture can help children focus in school by treating the root of the problem, and at the same time reduce or eliminate the need for medications such as Ritalin.”

ADHD is involved in imbalance between yin and yang, dysregulation of qi and blood, or loss of coordination or cooperation among organs such as heart, liver, spleen and kidney. ADHD is classified into the following:

  • Kidney deficiency and liver over-sufficiency
  • Heart and spleen deficiency
  • Liver and kidney yin deficiency
  • Heart and kidney deficiency
  • Heart fire domination
  • Phlegm wetness blockage inside
  • Phlegm heat disrupting inside
  • Yin deficiency and yang over-sufficiency
  • Liver-yang domination and wind moving
  • Spleen deficiency and liver over-sufficiency
  • Phlegm and heat disturbing shen (mind)
  • Wind and phlegm agitation
  • Yin deficiency and wind moving
  • qi stagnation and blood stasis

Herbal treatment

  • Kidney deficiency and liver over-sufficiency
    Principle of treatment: Tonify kidney and suppress liver.
    Herbal formula: Zuo gui yin, da bu yin wan and zhi bai de huang wan.
  • Heart and spleen deficiency
    Principle of treatment: Tonify heart, strengthen spleen, tonify qi and suppress
    Herbal formula: Si jun zi tang and gui pi tang-plus or minus according to the symptoms.
  • Liver and kidney yin deficiency
    Principle of treatment: Tonify liver and supply kidney.
    Herbal formula: Liu wi di huang wan, da bu yin wan and zi bai di huang wan.
  • Heart and kidney deficiency
    Principle of treatment: Tonify heart and nourish kidney.
    Herbal formula: Shi chang bu, yuan zhi, long gu, ui ban and yi zhi ren-plus or
    minus according to the symptoms.
  • Heart fire domination
    Principle of treatment: Clear and eliminate heart fire.
    Herbal formula: Xie xin tang and wan dang tang-plus or minus according to the
  • Phlegm wetness blockage inside
    Principle of treatment: Strengthen spleen and eliminate phlegm.
    Herbal formula: Du dong ning-plus or minus according to the symptoms.
  • Phlegm heat disrupting inside
    Principle of treatment: Suppress heat and eliminate phlegm.
    Herbal formula: Huang lian wan dan tang-plus or minus according to the
  • Yin deficiency and yang over-sufficiency
    Principle of treatment: Tonify yin and suppress yang.
    Herbal formula: Liu wi di huang wan and da bu yin wan-plus or minus according
    to the symptoms.
  • Liver-yang domination and wind moving
    Principle of treatment: Tonify yin, nourish blood, suppress liver and eliminate
    Herbal formula: Da ding feng zhu (plus or minus according to the symptoms).
  • Spleen deficiency and liver over-sufficiency
    Principle of treatment: Smooth and soften liver and strengthen spleen.
    Herbal formula: Shi jie ming, bai ji li, hang jiu hua, hang bai shao, shi chang pu,
    chuang yu jin, jiang can, chang yi, be he, fu ling and zhan yao-plus or minus
    according to the symptoms.
  • Phlegm and heat disturbing shen (mind)
    Principle of treatment: Clear phlegm and eliminate heat.
    Herbal formula: Qi re hua tan tang-plus or minus according to the symptoms.
  • Wind and phlegm agitation
    Principle of treatment: Suppress wind and eliminate phlegm.
    Herbal formula: Huang lian wu dan tang-plus or minus according to the
  • Yin deficiency and wind moving
    Principle of treatment: Smooth liver, suppress wind and tonify yin.
    Herbal formula: Shen de, bai shao, gou qi zi, gout eng, mai dong, nu zhen zi, bai ji li, wu song de long and gan cao-plus or minus according to the symptoms.
  • Qi stagnation and blood stasis
    Principle of treatment: Regulate qi, stimulate blood circulation and eliminate
    Herbal formula: Bu yang huan yang tang-plus or minus according to the
  • Simplified kidney deficiency
    Huang lian jiao tang for kidney water deficiency; Er xian tang for kidney qi
    deficiency and kidney essence deficiency.

Acupuncture and other modalities
ADHD can be treated with body acupuncture, auricular acupuncture, electrical acupuncture, TuiNa, or moxibustion. Accupoints can be chosen according to the classifications or symptoms of ADHD. For example, baihui, yintang, taixi, sanyinjiao are used for Kidney deficiency and liver over-sufficiency; Shenmen, naiguan, tongli, zhusanli, qiuchi for Heart and spleen deficiency; or xinshu, shanshu, jianshi, shenmen for heart and kidney deficiency. Different acupoints can be chosen according to the symptoms such as baihui, siahenchong, daling if there is lack of attention; anshen, anmian and xingshu if there is hyperactivity, shenting, shanzhong and zhaohai if there is irritable, restless or fretful.

For acupressure, body accupoints such as baihui, jiaosun, shugu, fengfu, shengting, tianzhu, xinshu, shenshu, guanyuan, hegu, shenmen, zusanli, sanyinjiao, or yongquan can be used; Auricular areas such as kidney, brain, heart, shen men, brainstem can be major points and adjunct points can be chosen from liver, spleen, cerebral cortex, or sympathetic system. Yi zhi ren can be used for accupressing.

Electric acupuncture can be used for body or auricular points. Also, according to the situation, electrical acupuncture can be used for body and auricular points at same time.

TuiNa can be very effective to ADHD. TuiNa can open up the meridians, tonify heart and nourish kidney, clear liver and suppress yang, and peace mind and spirit. According to different classification and symptoms of ADHD, specific acupoints are chosen.

Dietary regulation: ADHD is related to multiple factors. Studies have found that limiting some food intake (such as high lead-contained food, high sugar, artificial colorings, or added preservatives) may ameliorate some symptoms of ADHD. Also some food (such as sea products, white meats, bean products, Dairy products, vegetables and fruits) may be beneficial to ADHD patients.


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