Students whose behaviours are regarded as inattentive or disruptive are known to be at risk of poor educational achievement In New Zealand, 80 per cent of 11 year old ADHD children were estimated to have learning disabilities in reading and written language skills in a study in 1988. As well as the risk to the individual, behaviour problems in the classroom reduce the educational opportunities for other students and contribute to teacher stress. So far, the problem for researchers has been to identify which of these problems comes first, the bad behaviour or the educational problems?

Behaviour problems may arise from poor literacy skills according to recent research findings from two studies involving 8,300 preschool and primary school children in Victoria. In one continuing study, teachers at 25 disadvantaged schools received extra training in how to teach literacy skills, while at another 25 schools, a control group of teachers received no extra training. Preliminary results show that improving teachers' literacy training resulted in a 30 per cent drop in children with behavioural problems.

Dr Ken Rowe, an educational psychologist at the University of Melbourne, said the study found that individual teacher performance had the greatest impact on variations in children's literacy levels. "Differences between quality of teachers is what has the impact rather than schools," Dr Rowe said.

The solution to much bad classroom behaviour could be improved teaching skills and placing greater emphasis on early development of children's reading, writing and oral language, say researchers. "The evidence is very strong that if you target literacy as early as possible, even three years old, it's having a massive effect in reducing inattentiveness, restlessness and conduct disorders," Dr Rowe said.

Researchers suggest that many children are being wrongly labelled as inattentive and referred for counselling or medical treatment. Dr Katherine Rowe, a paediatrician involved in the research, said the study suggested that doctors should not focus solely on behavioural and medical strategies without addressing the literacy issues.

The studies use a new rating scale called the Rowe Behaviour Rating Inventory (RBRI) which has been developed to assess and predict children at risk. Students are rated on 16 items in three categories of behaviour, Irritable/Antisocial, Inattentive and Restless. Of these three items, inattention has been found to be much the strongest predictor of potential problems in literacy and numeracy achievement. Since the commonly used Conners 10-item rating scale fails to select children whose main difficulty is inattention, the RBRI has been developed as a more effective alternative. Based on a survey of 34,000 school-aged children in Victoria and Western Australia, the researchers suggest that boys scoring in the top 15 per cent for inattentive and disruptive behaviours and girls in the top 10 per cent are at risk of literacy and numeracy problems.

A combination of pictographs like Compic and phrases as cues (such as "what is your task?", "what do you need?", "are you on-task?") are used to teach children to focus their attention and establish commonality of language between teachers and parents. Students who have particular problems in this area and who have never experienced success should be taught the program as a small group in advance so that they can achieve mastery before the rest of the class. Children are taught to self-regulate their on-task behaviours and are tested for ability to ignore distractions by nominated "pests". Some children will need lots of practice and the chance to use these skills in their mainstream class or they will lose these skills. "The children are so proud when they manage," comments Laine, "because most kids want to achieve. When you put something in place so they can see their achievement, they are happy about it."

With a class of 26, including four with ADD and six other special needs children, Darwin teacher Wendy Jordan is lavish in her praise of the program, which has been running in her classroom of eight and nine year olds for over a year. "I had very little control in my classroom before I introduced this. Now I only have to say "freeze please" quietly and every child knows they have to stop, look, listen, think, be quiet and they sit still." Children are taught self-organisational skills so they can think through what they will need and how they can do a task. They don't have to keep coming to ask "what will I do now?" The result, according to Jordan, is a noticeable reduction in classroom noise and an improvement in learning. Observers say you could hear a pin drop in Jordan's classroom. This program works for every child regardless of their needs. For those who need on-task training at home, parents are provided with pictorial checklists, such as hat, lunchbox, and homework going into schoolbag. The parent cues the child with the same language, "are you on-task?", "what do you need?". Although a few children are annoyed sometimes because the link between home and school is so strong that they can't get away with anything, most say they like the program because "I couldn't get my work finished before and now I can".

ADD Teachers and behaviour

Medication Prescribing survey

Behaviour self-esteem

Education on-task training, dyslexia schools

Diet review of research, Ritalin, EPO and diet

Alternatives Efalex

How your ADD child is treated at school can have an enormous impact on the family. Many of us have experienced schools or teachers who have made our children worse, like a reader in Germany who wrote, "We had very bad experiences with our school. Our son is in another

school now and doing well, because the teachers treat him nicely!". It often is as simple as that, treating a child nicely. A teacher's authoritarian or punitive attitude can turn a child with behaviour problems against authority, prevent learning and cause great distress in the family. Not surprisingly, research shows that children with ADD and learning disabilities do better if they perceive that their teacher likes them.

Has your child ever been told that he or she "must learn to pay attention"? In high school our children often do badly simply because they have failed to hand in assignments of the due date. "They must learn to be organised," say teachers. But these are their areas of disability. They need help. Exam provisions, too, can make a big difference. Some children are refused appropriate exam provisions, such as a scribe. Readers are surprised to find that after struggling with criticism and punishment at school, they are greeted with compassion, understanding and useful assistance at university. After failing in Year 12 English, and being warned by her school that she would be unable to cope with university, one ADD/LD student gained a Distinction in first year university English. "What is the difference?" we asked her. "The people and their attitude," she replied. Her relieved mother comments, "the difference in my daughter is remarkable. She believes she can do it now - before she thought she was dumb, and that is so demoralising".

In this issue we focus on the effects of schools on ADD children, from the fascinating literacy research presented on page 1 and an extraordinarily successful new program to teach children how to pay attention (page 2?), to the introduction of disability discrimination laws which mean that it is illegal for schools to ignore the needs of children with disabilities, and some readers' accounts - both happy and sad - of their experiences with their children's education.

- Sue Dengate, editor

Susi Serfontein is coordinating a book of anecdotes about ADD in adults. Send your contributions to Susi at PO Box 285, Hunters Hill, NSW 2110

Giving zinc supplements to children - or just encouraging them to eat zinc-rich foods such as red meat - could improve their cognitive abilities. In a study of 372 Chinese children aged 6-9, funded by the US Dept of Agriculture, those who receiving food supplements containing 20 mg of zinc per day performed better in cognitive tests than those given supplements without the element. In the US, 10% of girls and 6% of boys consume less than the RDA of 10 mg.

A comment from a reader who is a student teacher: "After year 3 children are reading to learn rather than learning to read, so if they're behind in reading, they'll fall behind in everything."

A report from the National Health and Medical Research Council defines Learning Difficulties as affecting 10-16% of children who exhibit problems in development and academic skills. Learning disabilities refers to a smaller proportion (2-4%) of children who exhibit problems in developmental and academic skills which are significantly below expectation for their age and general ability.

A disabled child has the right to special care, education and training to help him or her enjoy and full and decent life in dignity and to achieve the greatest degree of self-reliance and social integration possible.- from the United Nations Convention on the Rights of the Child, 1989, unofficial summary of main provisions

Teachers and schools are still struggling to understand the implications of the Commonwealth Disability Discrimination Act 1992 and the various state and territory anti-discrimination and disability services acts which have followed. The definition of disability used in the act includes "a condition which means a person learns differently from other people, for example, a person with autism, dyslexia, attention deficit disorder or an intellectual disability". The school's handling of ADHD and LD children has thus become a legal issue. No child can be excluded on the grounds of disability which means that schools must provide facilities to include each child in the normal school structure. This process is called "inclusion". The education systems in each state and territory have their own inclusion guidelines. No student can be refused enrolment or expelled because of a disability. Schools are required by law to protect disabled students from harassment, and to make "reasonable adjustments" from wheelchair provisions to changing assessment procedures and course delivery. Some useful provisions for children with ADHD and LD are the Individual Education Plan (see reader's story "A happy ending") and exam provisions.

You can talk to your child's teacher, special education teacher or principal about what the school can do to help your child with the problems due to his or her disability, e.g. learning, behaviour, lack of organisation. Paralegal Annette Aksenov has won a number of disability discrimination cases by asking "how has your school helped this child to fit in?" For a list of ways that teachers can help ADHD students, we recommend Virginia Potter's excellent booklet, available from the LD Coalition of NSW, phone 02 9540 3300. One reader whose ADHD child was to be expelled for bad behaviour successfully reminded the school that no child can be excluded on the basis of their disability and requested a behaviour modification program. Have you been told your child "must learn to pay attention"? This is their area of disability. You can ask the teacher to help by implementing a program such as the one described on page 2. Other readers have lodged disability discrimination complaints against their schools. While this is time-consuming and difficult, some have received financial compensation and others say their action has had an effect on the school. In these cases it is usually the students coming behind who benefit from their action. Thank you to these pioneers who have improved conditions for others. - by Sue Dengate

You can obtain a copy of the booklet "A user guide to the Disability Discrimination Act" from Human Rights and Equal Opportunity Commission National Office, Toll free:1800 021 199

He was diagnosed with ADHD in his first year at high school, this time a Catholic school for children with special needs, and was on medication but was getting nowhere. They didn't believe in ADD and we heard from their guidance system they thought it was just a yuppie diagnosis. By his second year at high school we had his medication sorted out but the school didn't use any sort of management. They egged him on. When they could see he was getting upset they didn't take that step back. One teacher thumped the desk and made him promise to control his behaviour. When he didn't manage he was confronted with "what sort of person are you that your break your promises? - you have no moral character - what sort of person are you going to grow up to be?" They didn't want him there and suggested we try another school, any school. So our gifted son left school at the age of 14. Our psychiatrist gave him a three month medical certificate to keep him out of school because it was so bad for his mental health.

At 15 he went to work for his father as a builder's labourer. Although he hated school, he still wanted to learn. It took him three years to get over the anger and to be able to go back into a classroom. Now he's apprenticed as a carpenter, at TAFE in a small class of four, treated as an adult, doing wonderfully and enjoying the class. He never says "I don't want to go." He feels good in that class of four because he's got the most experience in everything through having worked already as a labourer, so he knows what he's doing. When I look back, I wonder why did we encourage him to stay at school so long?"

By the time my son was nine he was out of control. He couldn't read and he was running away from home all the time. Eventually I learned I could apply for a negotiated curriculum [or Individual Education Plan] where the curriculum was designed especially for his needs. For this I attended a meeting with two behaviour management specialists, his teacher, the assistant principal and the special education teacher. It was supposed to be reviewed once a year, but I insisted on a review every term. Although he started off behind in maths and reading, he learned to read in six months and no longer needed the special education class. One of his teachers had confessed that she found his behaviour a problem. It was a simple matter of moving him to the front of the class and for her to lower her voice. Now he's at year level for everything and his behaviour is rated as satisfactory - but I had to go mad for two years for it to happen.

Queens Park is a small friendly school, in which a caring, family atmosphere is fostered. We are a residential/day school offering a full modified curriculum. Much emphasis is placed upon developing a child's talents and strengths thereby increasing confidence and self-esteem.

Our pupils are taught in small groups with a high teacher/pupil ratio. We use structured, cumulative, multi-sensory phonic programme to remediate language difficulties. Tasks are learner-matched and individual programmes of work are prepared in conjunction with regular tutorials. Reading and spelling assessments are carried out twice yearly. We hold frequent meetings with academic and pastoral staff to ensure that we maintain a constantly unified approach, giving our children a strong feeling of security.

Our academic staff are all qualified and committed teachers with specialist training and experience in the teaching of dyslexic children. The school is registered with the Department for Education and has been accredited by CreSTeD, the accreditation body for the Dyslexia Institute and the British Dyslexia Association.

We offer a wide range of subjects and activities in our endeavour to cater for individual interests. We emphasise the importance of achievement and success. We teach the complete range of core curriculum subjects along with arts subjects such as drama, pottery, art, calligraphy, dance, etc. as well as a wide variety of sports."

The Lab School in Washington is a special school for the most severe cases of ADHD and learning disabilities. At $15,000 a year, The Lab School, and others like it, are expensive - and extraordinary. The staff has developed all sorts of clever strategies to help children get through their days. Teachers put down masking tape in the hall-ways so the children will be reminded of where they should stand. Others will divide desks into different coloured segments: one side for work, the other for storage. Children earn points for self-control and cash them in for rewards or free time. When she talks about Ritalin, Sally Smith, The Lab School's director, likes to hold up a ruler. "This is how much Ritalin does for you," says Smith, pointing to the one-inch mark. "Ritalin makes you available to learn. You and your parents and teachers have to work on all the rest." From Newsweek, 13/3/96

- from Manhood by Steve Biddulph, 1994

"Look what you've done!" Whether they've failed a spelling test or dropped a ball, children with learning disabilities hear those words far too often. It's no wonder they often give up hope. And it's no wonder we sometimes overlook what Dr Brooks calls the "everyday courage" of our children.

Dr Brooks says we need to find each child's "islands of competence" and then build on those strengths. He offers practical strategies for helping children develop the confidence and resilience they will need to succeed.

One of today's leading speakers on self-esteem, motivation, and family relationships, Dr Brooks reaches out to families and individuals with a message based on encouragement, resilience and caring. He is known for the warmth and humour he uses to bring insights and anecdotes to life. His stories are based upon his own experiences as a clinical psychologist, consultant, father, husband and son. These personal stories - funny, touching and unforgettable - give Dr Brooks' presentations a wonderfully unique dimension that has captivated audiences across the US and around the world

Mood, especially irritability, is the symptom most affected by diet, according to a review of 13 significant diet/behaviour studies from 1985-1995. Almost all studies showed a statistically significant change in behaviour with dietary intervention. Responses could be full or partial compared to all-or-nothing earlier expectations of the effects of food. Children most likely to be affected include those with a personal or family history of "allergy", a family history of migraine, young children, and those for whom a definite food reaction has been noticed in either the child or a relative. Foods and food chemicals implicated in reactions include natural and medicinal salicylates, natural and added monosodium glutamate, natural amines and added colour as well as flavour and preservatives, and wholefoods (especially which have produced a definite physical or behavioural reaction in the child or first degree relative at some time), such as milk, wheat, egg, peanut, fish and soy. Non-food items that have been implicated are perfumes, fumes, inhalants commonly implicated in allergy, infections and stress. Many researchers report that most subjects react to more than one test item. Professionals can now be aware of dietary treatment as an option for some children. They can be supportive of parents who wish to consider diet, particularly as motivation is important in the diet implementation. "Rather than saying diet is too hard, or it is easy (just excluding the well known suspect foods)", diet can be most effective with the help of a dietitian, preferably one experienced in this specialised area.

"Nothing is more powerful in the psychology of childhood than the need for love and approval. Unless a child receives clear and tangible demonstrations of these, then he or she will wither like a flower without water. It's as basic as that. I've watched tiny children in hovels in Calcutta dancing for their family and friends, who respond with warm applause and hugs. I've also watched Australian children bring home their report cards from their expensive private school, young faces eager for praise, only to receive cool, critical appraisals from their performance-oriented, uptight parents." - from Manhood by Steve Biddulph, Finch 1994

Pharmacy Direct sell mail-order Ritalin, $39.60 for 10 mg. Your doctor must be registered with the NSW Registration Board. Specialists who write a lot of prescriptions for Ritalin are usually happy to do this. More information from Pharmacy Direct, phone 1800 624563.

"Do what you want to" is a 23 minute audio tape of a group session during which six teenagers discuss how they feel about taking medication. They speak about their fears, the effects and the side effects, the massive improvements in their ability to cope withe school, sport and family responsibilities - the growing realisation of their individual worth. This tape, directed at teenagers, will open the eyes of parents, too. Dr Rick Jarman, Director of Clinical Services at the Centre for Community Child Health and Ambulatory Paediatrics says: "I have already lent my copy of the tape to a few teenagers who have demonstrated significant compliance problems with medication, and this has had a much more powerful influence on their subsequent behaviour than anything I could have told them ..." Send your order with a cheque for $15 plus $2 postage to ACTIVE INC, Ross House, 247 Flinders Lane Melbourne 3000

Changes in the Child Disability Allowance: the reason for these proposed changes, which will probably leave most us ineligible for the CDA, is that "the profile of children attracting the CDA has changed in the 1990s from that of physical and intellectual disabilities to behavioural problems, medical conditions and developmental delay. Currently the most common conditions attracting the CDA are asthma and ADD. In January 1992, the number of children qualified to received the CDA was just over 50,000 but by January 1997 it was 102,000. Parents of very disabled children have been concerned that the CDA payment has been seriously compromised over recent years." - from the 1998 Budget Information Kit

Q. We set up a system where we fined our son 10 cents every time he swears. For a while it worked but now he doesn't seem to care and loses all his pocket money. His swearing is worse than ever. Any suggestions?

A. This system must be aimed at giving, not taking away, tokens [or rewards]. Once the impulsive child starts to see their store of tokens slip away they may go for broke. Many parents have found this out to their great cost. After some minor incident the child sees that they will not get their special treat so they retaliate with the most unbelievably bad behaviour.

- Dr Christopher Green, from his book Understanding ADD.

Q. Are there any "junk foods" that are OK to eat if you're trying to avoid additives?

A. "Junk foods" are generally a high source of the chemicals in food that can cause adverse side effects in sensitive individuals. However, there are a number of snack foods which if used as a treat may be tolerated by sensitive people. These include the potato crisps "Kettle Chips", Pretzels and hot chips from a takeaway outlet where they make the chips at the shop (the frozen chips used in some outlets may have residues of metabisulphite present after cooking). Also plain barbecued chickens (not the seasoned variety) and grilled or battered fish.

- Dr Anne Swain. Dr Swain is a dietitian at Sydney's Royal Prince Alfred Hospital, and co-author of the book Friendly Food

 Networking

A highlight of our meeting was an address by Jan Clifford from the Southern Highlands of NSW Country Womens' Association. Jan read us their motion which was passed at the recent state conference: "CWA of NSW request the Ministers for Health and Education to formulate a policy of awareness, understanding, tolerance and recognition of the needs of children suffering from Attention Deficit Hyperactivity Disorder (ADHD) and to provide appropriate support for their families."

Our biggest project so far is the Australian tour by Dr Robert Brooks. Considerable interest has been shown in this project as can be seen by the list of sponsors so far. These are as follows:
Australian College of Paediatrics, Hunter Area Health Service, ACER Aust Council Educational Research, CSR, The Australian Sugar Industry, The Serfontein Clinic, Catholic Schools Office Maitland/Newcastle diocese (sponsorship so far totalling $23,100) CHERI Children's Hospital Education Research Institute and Belmont 16ft sailing club providing venues at reduced cost (value $6,400). This has been an enormous task for a consumer group to undertake, and one I personally have found both draining and exciting. Discussions have taken place to video Dr Brooks' workshops with children in the Newcastle area. If this takes place this video will be available to the wider community. - Dale Stauffer

Many thanks to Dale for her huge and successful efforts to secure sponsorship and get this major event on the road. By becoming a member of ADDnet, you can help with our aims to educate the community, relevant professionals and governments on the problems related to ADD and learning difficulties, and to encourage a multi-modal approach to treatment of ADD and LD - see "How to subscribe" coupon. - S

ADDnet committee:President Dale Stauffer ph/fax 049 516 513, Vice-president Beryl Gover ACT 06 290 1984, Secretary Rosemary Borg phone 07 3817 2429, Treasurer Jan Clark TAS 004 293 332, Ros Mitchell NSW 02 9411 2186, Geraldine Moore VIC 03 9650 2570, Sue Dengate NT 08 8981 2444, Nayano Taylor-Neumann SA 08 8222 5159, Tracy Willet WA 08 9401 6282

ORDER IN THE HOUSE! production team

Editor: Sue Dengate

Subscriptions: Margie Turner

Cartoons: not to be copied for profit: Joanne Van Os (copyright)

Typesetting: Peter Ezzy Printing: Copycat Printers

Acknowledgements: Thanks for advice, encouragement or contributions to Dr John Ellard, Dr Chris Green, Dr Paul Hutchins, Dr Loretta Giorcelli, Dr Sheila Metcalf, Dr Harry Nash, The Serfontein Clinic, Dr Velencia Soutter, Dr Anne Swain, Joan Breakey, Ian Wallace, Maria D'Iono, Damien Howard, Marion Leggo, Marianne Kunkel; Rosemary Borg, Deborah Harding (Qld), Annette Aksenov, Beth Smith (SA), Jan Clark (Tas), Joy Toll and the LD Coalition of NSW, Ros Mitchell, Julie Appleton, Anne Dibb, Lee Gallagher (NSW), Geraldine Moore, Jill Ladek, Davina Vella (Vic), Tracy Willet, Colin Mason (WA); Brenda Jones, Jane Miles (NT), the many parents who have written, phoned and sent encouraging comments and groups who have sent newsletters. Dr Howard Dengate and Peter Stauffer for paying the phone bills, the kids from the Don Dale Detention Centre for folding newsletters, and CLARE MARTIN'S electorate office for photocopying.

ORDER IN THE HOUSE! does not endorse any particular school, service, business, treatment or theory. Articles and announcements are for information only.

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Sept 13 LD Coalition Parent Conference "Tough Kids"- behaviour, anxiety disorders, self esteem, social skills, Sydney, $25 at City RSL, phone 9540 3300

Sept 14 -21 ADD Awareness week

Sept 16-17 Ian Wallace ADD in adults & ADD management, Brisbane, ph 3817 2429

Sept 25-28 Australian Association of Special Education conference, Brisbane, ph 6176 312885

Readers would like to hear from anyone who has an ADHD child who also:

About three years ago we decided to give him a break from Ritalin while on an overseas holiday. Within three days we were all in tears and seriously considered calling the whole thing off. Tom went into terrible rages and exhibited extreme behaviour like running out on to the road and jumping from bed to bed, accidentally landing on other furniture. It was like being caged with a wild animal. We put him back on the Ritalin and continued with our holiday.

After reading about evening primrose oil we commenced a trial in December. We felt that a trial couldn't really be carried out properly while Tom was on Ritalin so we gradually reduced the dose. After being Ritalin-free for five weeks, he was not exhibiting the rages of the past but he was still very naughty. He seemed bearable before going back to school but impossible to live with after school started. One of the factors involved was that he was being bullied, and we took steps to stop that. Inspired by the book Different Kids, we then decided to try the RPA diet. We took him off the evening primrose oil and started the diet. After two weeks of rage, Tom calmed down and is now about the same as when he was on Ritalin, except when he breaks the diet. I would not have believed diet could have so much effect."

Albert Einstein, Tom Cruise, Walt Disney, Galileo, John Lennon, Winston Churchill, Mozart, Henry Ford, Stephen Hawkings, Wright Borthers, Hans Christian Anderson, Sylvester Stallone, Leonardo da Vinci, Thomas Edison, Agatha Christie, Cher, Rodin, John Kennedy, Louis Pasteur, Dustin Hoffman, Robin Williams, Prince Charles, Harry Belafonte, 'Magic" Johnson, Dwight Eisenhower, Whoopi Goldberg - reprinted with thanks from PLAD NEWS (SA) ph 83394119

Could hyper-reactive behaviour caused by chemical toxicity be inherited?

A consistent pattern of behavioural changes can be seen in rats fed on a diet of Lake Ontario salmon, which is known to be high in chemical contaminants such as now-banned PCBs commonly used in the 1940s. Compared to rats fed from uncontaminated Pacific salmon, or to standard laboratory rat chow, they are hyper-reactive to unpleasant events, such as electric shocks or disappointing rewards, but "react normal when 'life is pleasant'". In a parallel study on children of human mothers who have eaten Lake Ontario salmon, the children were also found to be hyper-reactive to negative events. When tested at the age of four, 17 of them refused to be tested on at least one of the tests. Affected rats worked harder and longer at certain tasks than control rats when they were sure of a immediate, satisfying reward. This unexpected finding was explained by researchers as a hyper-reactive response to a positive situation. Researchers also found that the behavioural changes in adult rats fed with Lake Ontario salmon before, not during, pregnancy appeared in their offspring.

Children who come from or have spent time in an area of high lead contamination such as Broken Hill, Port Pirie or Newcastle have a higher chance of being affected by childhood inorganic lead toxicity. The classic text-book symptoms include anorexia (loss of appetite), constipation, irritability, clumsiness, lethargy, behaviour changes, hyperactivity, abdominal pain, vomiting, fever, ataxic convulsions, coma and cerebral oedema. In younger infants there is fine motor dysfunction, language delay and hyperactivity.

You can ask the supplier for information about Efalex on Freecall 1800 064 953.

Further reading: Stevens et al, Essential Fatty Acid Metabolism in Boys with ADHD Am J Clin Nutr 1995;62:761-8

Stevens et al, Omega-3 Acids in Boys with Behaviour, learning and Health Problems, Physiology and Behaviour 1995, 59 (4/5):915-920

In elementary and junior high school, Lisa was quiet and cooperative but often seemed to be daydreaming. She was smart, yet couldn't improve her grades no matter how hard she tried. Several times she failed exams. Even though she new most of the answers, she couldn't keep her mine on the test. Her parents responded to her low grades by taking away privileges and scolding, "You're just lazy. You could get better grades if only you tried." One day, after Lisa had failed yet another exam, the teacher found her sobbing "what's wrong with me?"

Because Lisa wasn't disruptive in class, it took a long time for teachers to notice her problem. Teachers sometimes fail to notice the needs of children like Lisa who are quiet and cooperative. Lisa was first referred to the school evaluation team when her teacher realised that she was a bright girl with failing grades. The team ruled out a learning disability but determined that she had an attention deficit, ADHD without hyperactivity. The school psychologist recognised that Lisa was also dealing with depression.

Lisa's teachers and the school psychologist developed a treatment plan that included participation in a program to increase her attention span and develop her social skills. They also recommended that Lisa receive counselling to help her recognise her strengths and overcome her depression.

Children with ADHD often need some special accommodations to help them learn. Giving a child like Lisa extra time on tests can make the difference between passing and failing, and gives her a fairer chance to show what she's learned. Reviewing instructions or writing assignments on the board, and even listing the books and materials they will need for the task, may make it possible for disorganised, inattentive children to complete work.

Many of the strategies of special education are simply good teaching methods. Telling students in advance what they will learn, providing visual aids and giving written as well as oral instructions are all ways to help students focus and remember the key parts of the lesson. In Lisa's class, the teacher frequently stops to ask students to notice whether they are paying attention to the lesson or if they are thinking about something else. The students record their answer on a chart. As students become more consciously aware of their attention, they begin to progress and feel good about staying better focused. The process helped make Lisa aware of when she was drifting off, so she could return her attention to the lesson faster. As a result, she became more productive and the quality of her work improved.

Lisa is about to graduate from high school. She's better able to focus her attention and concentrate on her work, so that now her grades are quite good. Overcoming her depression and learning to like herself have also given her more confidence to develop friendships and try new things.

Lately she has been working with the school guidance counsellor to identify the right kind of job to look for after graduation. She hopes to find a career that will bypass her attention problems and make the best use of her assets and skills. She is more alert and focused and is considering trying college in a year or two. Her counsellor reminds her that she's certainly smart enough. Lisa is working to make a good life for herself, not by being cured, but by developing her own personal strengths.

The above story is an extract from "Decade of the Brain", a statement about ADHD from the National Institutes of Mental Health in the USA, via the Internet. Thanks to the Canberra & Queanbeyan ADD support group for publishing the entire report.

An act of courage

"All too often, schools become places where deficits, not strengths, are shown. For students who go to school, every day is an act of courage." So says Dr Robert Brookes, a clinical psychologist on the faculty at Harvard Medical School and author of The Self-Esteem Teacher. Dr Brooks promotes the best way to keep ADD and learning disabled children happy at school: to give them positive experiences and recognise their strengths. He suggests that the images teachers convey will stay with their students for the rest of their lives.

This psychologist is clearly an original. In a discussion on the use of humour in therapy with adolescents he gives an account of his dealings with one particularly hostile teenager. After being greeted by "You're the ugliest shrink I've ever seen", Dr Brooks responded by hiding in the closet for the 45 minute session, while the surprised teenager asked "are you still in there?" After two such sessions, the no-longer-hostile teenager invited him out of the closet and agreed to talk.

ADD ADHD without hyperactivity p1

Medication Allegron, US Committee report

Behaviour Raising Difficult Kids

Education Teaching self-esteem p2

Diet An inattentive 6 year old

"Why isn't there any information about ADD without hyperactivity?" ask many parents. It has been called ADD-H, ADD (as opposed to ADHD), hypoactivity, "the quiet, vague, dreamy ones" and now officially "ADHD, predominantly inattentive". Features include such items as: seems not to listen, makes careless mistakes, difficulty paying attention, fails to finish schoolwork or chores, disorganised, loses necessary items, forgetful, and easily distracted. These are the children who go through school with "could do better if he/she tried" on their report cards. Even in schools where ADHD with hyperactivity is well-known, children without hyperactivity may miss out on the extra help they need. Hypoactivity or lethargy appears to be the neglected symptom of ADD. In this issue, we present a number of articles and reader stories on the people with inattentive ADD, including our front-page story.

Thanks to the vision of ADDnet president, Dale Stauffer, psychologist Dr Robert Brooks will visit Australia next year. I cannot think of a more practical way to help children with ADD than to make them feel better about themselves. Every parent and teacher can benefit from Dr Brooks' interesting ideas of how to help these children (see p? and ?).

And finally, I wonder how many of you can relate to this reader's comment? "I have an ADD 9 year old son and a very demanding "unofficially diagnosed" ADHD farmer husband (who I might add is more difficult at present than the 9 year old) - we need a little order in our house!!"

- Sue Dengate, editor

In Victoria, six ADD teenagers discussed medication in a forum mediated by a paediatrician Dr Chitra Chandran and psychologist Dr Sam Ginsberg. The participants agreed that they had all been scared at first, "I thought it would make me go insane or something", said one boy. Another was afraid of addiction. A third feared he would be shunned if his friends found out, but later discovered that medication "worked wonders" for him and allowed him to make a wider circle of friends. ACTIVE N/L Feb 97

Following the case of a three year old admitted to hospital after an overdose of clonidine, Dr Michael Ryan, staff specialist of the New Children's Hospital has warned parents to use child-proof containers for medications for young children with ADHD.

The way boys act at six years of age is a reliable predictor of whether they will turn into teenage drug and alcohol abusers, according to researchers in the US and Canada. In behavioural assessments of more than one thousand boys, those who scored highly for hyperactivity and fearlessness when aged six were more likely to try drugs and get drunk in their early teens. These two measures successfully predict 75 per cent of the boys who will later become drug and alcohol abusers. Researchers suggest targeting these younsters in drug education programs. - from New Scientist, 15/2/97 p12

Rather than blame food for their children's behaviour, parents should "turn off the TV, spend more time with their kids, and look at their own problems" according to Geoffrey Annison, Scientific and Technical Director of the Australian Food Council, at the Sydney Sugar and Behaviour workshop in January.

ADD children often love computers. A reader with 3 sons recommends "Klik & Play" (Europress Creativity). She says, "Die-hard game players have to create their own games. Unlike the cover, most game scenarios don't include action/violent figures. Approximately $50, it's a hit at our house." For ages 10 and up.

"Failure to shine at school or college often proves not to be a bar to future brilliance", says high-energy particle physicist George Lafferty. He has identified the following "successful failures": Winston Churchill, Ulysses S Grant, John Major, Charles Darwin, Albert Einstein. Great scientists who were not top of their class include J.J. Thompson, discoverer of the electron, James Clerk Maxwell, founder of electromagnetic theory and Thomas Malthus, famous for population theory. New Scientist, 1/3/9, p 51

Intelligence may be artificially manipulated by raising pH levels in the brain, according to a team of British researchers at the John Radcliffe Hospital in Oxford Measurements of brain pH were compared with WISC standard IQ test results in boys between 6 and 13. Over a pH range of 6.99 to 7.09, the boys IQs more than doubled, from 63 to 138. Some scientists suggest that IQ may be increased by dietary supplements perhaps by altering brain pH. - New Scientist, 17/8/96, p16

For people with reading problems, audio cassettes are a great way to learn. A set of five audio cassettes covering learning disabilities, attention deficit disorder and related problems has been compiled by the LD Coalition, PO Box 372, Sutherland 2232, phone 02 9540 3300, Fax 02 9540 3266. $8 each plus postage.

"After two days, I got so incredibly tired, I thought I was getting sick. All I wanted to do was sleep; I felt like a slug. Now, I have excessive energy normally so this was quite a change.

When I stopped the bread I felt better overnight."

Tricyclic antidepressants (TCAs) improve mood and hyperactivity but do not improve concentration. For this reason, they are considered the second choice after the stimulants for treatment of ADHD. However, we have received numerous reports from mothers who are pleased with the effects of Allegron (Nortriptyline), one of the tricyclic antidepressants, compared to Ritalin, Dex and Catapres. A big plus is the single daily dose. Children don't have to take tablets while they are at school. And there's no rebound effect. Are there any side effects? asked several readers. We found common and important side effects listed in an article by doctors about medication for ADHD..

"The most worrying consequence is sudden death. There are four reports of children dying on desipramine (the most adrenergic of the TCAs). With careful selection and monitoring, TCAs can be relatively safe.

TCAs have anticholinergic activity and so can cause dry mouth, sedation, orthostatic hypotension, constipation, blurred vision and urinary retention. The toxic effect of overdose is another concern, especially if there is suicidal ideation.

In view of the cardiac toxicity of TCAs and the possible action of stimulants on the heart, the combination of these two drugs must be viewed with some caution. Studies so far have failed to substantiate these fears."

Reference: "The Use of Psychotropic Drugs in Childhood" by Dr Sian Hughes and Dr Colin Feekery, Centre for Community Child Health and Ambulatory Paediatrics, Royal Children's Hospital, Melbourne.

 Books

"Raising Difficult Children" by Dr Peter Powell and Brenda Inglis-Powell

Dr Peter Powell is a registered psychologist and a minister in the Uniting church. As a result of experience with their own son, he and his wife Brenda developed the "Raising Difficult Children" program for which this is the textbook. We are left in no doubt that the authors know what parents of ADHD child are going through. Their book is packed with sensible, practical, helpful information and thought-provoking examples. It will make you think about what is happening in your house, from daily battles to hitting to yelling to clutter to teenagers, for example: Many parents find teenagers selfish, aggressive and uncooperative and may seek out programs in order to help "fix" their child. The reality is that many quite "normal" teenagers can aptly be described by such words and, without any intervention by professionals, may well develop into quite healthy adults. Rather than the teenager needing to be changed, parents may need to learn less reactive ways of responding to the teenager's behaviour. As paediatrician Dr Rory McCarthy comments, "this book needs to be "prescribed" at least as often as medication."

"Raising Difficult Children" ($24.95 plus $3.00 postage) and information about seminars is available from the Pastoral Counselling Institute, 16 Masons Drive, North Parramatta 2151, phone 02 9683 3664 Fax 02 9683 6617.

Lethargy - the neglected symptom

Hypoactivity, or lethargy, seems to be the overlooked aspect of ADD in adults. It is acknowledged as a problem in some books or articles, but there is usually just a sentence or two about it. Lethargy is very prevalent in my life (I have flipped from overactivity in childhood to underactivity in adulthood) and is the most debilitating aspect of ADD for me.

My life consists of "good days" and "bad days" glued together in some arbitrary way that fate decided on; and of which I can make little sense - except that there is definitely a hint of Premenstrual Syndrome about the pattern. On the best of the "good days" my thinking is crystal clear and I have unlimited resources of energy to draw on (my "get up and go" days). On the worst of the "bad days" (when my "get up and go" got up and went!) I can barely function - physically or mentally.

On the "bad days" I withdraw socially. This is partly because trying to concentrate is so draining. I am in a kind of trance where I am aware of things going on about me, but my mind wants to "float" and focus on nothing in particular. (I'm sure there is something going on in my brain, but God knows what!) If I am required to focus on a topic of conversation for instance, it is only with enormous effort that I can manage to do it.

It must appear to those who don't understand that I am a lazy and strange person; I can spend days, weeks, sometimes months, completely "tuned out" top the rest of the worked, not wanting to see anyone and unable to do anything much at all. It isn't by choice.

Exercise for ADD adults

Exercise vigorously and regularly. You should schedule this into your life and stick with it. Exercise is one of the best treatments for ADD. It helps work off excess energy and aggression in a positive way, it allows for noise-reduction within the mind, it stimulates the hormonal and neurochemical systems in a most therapeutic way, and it soothes and calms the body. When you add all that to the well-known health benefits of exercise, you can see how important exercise is. Make it something fun, so you can stick with it over the long haul, i.e. the rest of your life.

From an article on the internet called 50 Tips on the management of adult ADD by American psychiatrist Dr Edward Hallowell, co-author of Driven to Distraction, and Answers to Distraction. These excellent books for adults are available from Silvereye Educational Publications 049 87 3457 and recently available in paperback.

For years both our children were on medication for different kinds of ADD. Our daughter was extremely quiet and withdrawn and sometimes it was like living with a ghost. The tablets helped her to survive school, but only survive. She left during year 11 because she was unable to take them - not being able to eat or sleep. We eventually found our daughter should completely avoid salicylates. If she has any salicylates her brain shuts down and that is that. The tablets help with the levels of concentration and organisation needed for studying. Now 19, she's on a combination of diet, Dex and clonidine, and is outgoing, thoughtful and socially comfortable.

... a page-turner about alcoholics. Not the usual book we review in these columns, Lush is another compulsive read by best-selling author, Peter Benchley. It is the only book I have ever encountered which appealed equally to every member of my family, from age 11 upwards. No-one could put it down. If anyone in your family is or has been dependent on alcohol, and we all know addiction is more common in ADD families, then this is a worthwhile read. Thunderously funny and touchingly compassionate.

"Lush" by Peter Benchley, Arrow Books, 1989. Contains medium level coarse language.

I started to notice what I thought were "normal" problems with our son James in preschool. Although he loved going to preschool, he was dreamy, inattentive, not thinking well, slow with putting words into actions, easily distracted and generally irritating. We had to tell him nearly everything more than a few times. In transition, I often helped out in the classroom, and again I noticed how he was inattentive in a quiet, dreamy manner.

We did a lot of homework with him. He had trouble learning to read until we made up flash cards. We set up "com-pics" drawings to get him through activities like cleaning teeth and getting dressed. We also used star charts. At the end of transition James was second top in his class.

The next year, James's problems really came to boiling point. He was being kept in nearly every lunch time to finish his work and then he still wouldn't get it done. He didn't seem to know how to think anymore. The teacher was unhappy, James was on a different planet and John and I were about to depart for another galaxy!!! We were very upset by what was happening and I spent one Friday morning at school crying my eyes out and muttering things like not wanting him as our child anymore. We were very worried and desperate for an answer. When the paediatrician told us to go to a dietitian we were astounded. We have always eaten well and fed the boys a high level of fresh fruit and veg, breads, whole grains, cereals, meats and fish with only a few take-aways. We wondered how a diet was going to solve the problem.

We enjoyed a full on, chocolate-packed Easter break and then started the elimination diet. I'm sure that during the first week we mourned the loss of our "old foods", but after that we were quite happy with the pears, meats, limited veges, one brand of bread and ice-cream, philly cheese, golden syrup, noodles, rice, etc.

Then, after about two weeks, we suddenly noticed - James was a different child. He was interested, interactive, motivated, talking more, spontaneous, happy to do things, had received a good note home from school, his writing and drawings improved markedly and his teacher was very pleased with his behaviour and school work. James was more loving towards us and less emotional over silly little things. In fact, the whole family felt better - we were sleeping more soundly and woke up brighter and a little earlier.

When we challenged salicylates, after four days James came home, had a note of how he had been inattentive in class again and just sat down and cried -"I don't want to be on these salicylates any more - I just want to be back on the good food". Thus we abandoned salicylates forever... James is very good at saying the word "salicylates" - they are his number one enemy !! It took about a week to clean him out again and now he is back to being a happy, attentive, thinking child again. We now have fun trying new recipes and the boys are involved in that too. We drink lots of water and thank our lucky stars that we can have a happy family life once more.

If you don't receive your copy of OITH, please make sure we have your details, including forwarding address. Christa (?) of "the ADD support group", phone 5599 1990, please ring back with your area code. Telstra couldn't help us.

The LD Coalition of NSW is a coalition of nearly 80 groups supporting people with learning difficulties and ADHD all over NSW. The NSW Department of School Education has funded a coordinator for the head office in Sutherland. Sandra Scott will be in the office Monday to Friday 10 am to 4 pm, phone 02 9540 3300.

ADDSUP's second Camp ADDventure will be held on 7th-13th September for 40 primary aged children. Cost $60. Enquiries phone 0364 293332

Dr Ernest Luk, Associate Professor of Psychological Medicine at Monash University spoke to ACTIVE about "Where are the girls with ADD?" Dr Luk hypothesised that pure attention deficit disorder without hyperactivity/impulsivity may be much more common in females. Fewer girls than boys have the combination of hyperactivity, impulsivity and attention deficit. While pure attention deficit disorder is the commonest form of the disorder in girls, in boys it is less common.

Q. Does medication help children who have ADHD without hyperactivity?

A. Approximately 90 per cent of children with ADD are helped by medicine. The proportion of children who are helped is greater for those with the hyperactive form of ADD than those with the dreamy, vague form of the condition. In the latter group, the success rate is approximately 50 per cent.

- Dr Mark Selikowitz, from his book All About A.D.D.

Q. Does diet help children who have ADHD without hyperactivity?

A. You don't have to have hyperactivity to have a behavioural reaction to food. Some people become more tired and lethargic, or can't concentrate. Some become more hyper. Yes, it is worth investigating diet for non-hyperactive ADD.

- Dr Anne Swain. Dr Swain is a dietitian at Sydney's Royal Prince Alfred Hospital, and co-author of the book Friendly Food

What is doesn't say is that all those receiving the CDA will be reviewed in February 1998. Officers from social security have stressed to us that parents often do not give enough information to qualify. You should write down as much detail as possible and include written reports.

Well-known for his entertaining style (see p 2) and important message about self-esteem, Dr Brooks has agreed to visit Australia from May 8-28 as a guest of ADDnet. He will speak in Melbourne, Sydney, Newcastle, Brisbane and possibly Canberra. Sponsors for Dr Brooks' visit so far include the Australian College of Paediatricians, providing the international airfare; the Serfontein Clinic, domestic airfare; CHERI (Children's Hospital Education Research Institute), venue at Sydney University and other details; and Hunter Area Health will sponsor a program in the Hunter area which includes public talks and workshops with children. This will be a major event for raising awareness of ADDnet and providing information about self-esteem which is important not only to ADD families but to every child and adolescent.

Many thanks to Dale for her huge and successful efforts to secure sponsorship and get this major event on the road. What a wonderful way to raise awareness of ADDnet as well as provide valuable information about self-esteem for all families! - SD

ADDnet committee:President Dale Stauffer ph/fax 049 516 513, Vice-president Beryl Gover ACT 06 290 1984, Secretary Rosemary Borg phone 07 3817 2429, Treasurer Jan Clark TAS 004 293 332, Ros Mitchell NSW 02 9411 2186, Karen Presutto VIC 03 9650 2570, Sue Dengate NT 08 8981 2444, Annette Aksenov SA 08 260 4420, Jenny Grayson WA 09 298 8262.

ORDER IN THE HOUSE! production team

Editor: Sue Dengate

Mailing list: Margie Turner

Cartoons: not to be copied for profit: Joanne Van Os (copyright)

Typesetting: Peter Ezzy Printing: Copycat Printers

Acknowledgements: Thanks for advice, encouragement or contributions to Dr John Ellard, Dr Chris Green, Dr Paul Hutchins, Dr Loretta Giorcelli, Dr Sheila Metcalf, Dr Harry Nash, The Serfontein Clinic, Dr Velencia Soutter, Dr Anne Swain, Joan Breakey, Ian Wallace, Maria D'Iono, Damien Howard, Marion Leggo, Rhonda Nelms (Qld), Annette Aksenov, Beth Smith (SA), Jan Clark (Tas), Joy Toll and the LD Coalition of NSW, Ros Mitchell, Julie Appleton, Anne Dibb (NSW), Geraldine Moore, Jill Ladek, Davina Vella, Marina Dalla Rosa (Vic), Elaine Morris, Colin Mason (WA); Leanne McGill, John Humphries, Jane Miles (NT), the many parents who have written, phoned and sent encouraging comments and groups who have sent newsletters. Dr Howard Dengate and Peter Stauffer for paying the phone bills, the kids from the Don Dale Detention Centre for folding newsletters, and the Northern Territory Lotteries Grant for paying the typesetting and printing bill this time.

ORDER IN THE HOUSE! does not endorse any particular school, service, business, treatment or theory. Articles and announcements are for information only.

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August 6th Organisational Skills for adults, 2 hour/week x 4 course with Dr Stephanie Whitmont, researcher into psychophysiology of adult ADHD at Westmead Hospital, Syndey. Phone 041 999 4199

August 8-9 two-day conference sponsored by Hunter Area Health, at the University of Newcastle, guest speakers include Dr Loretta Giorcelli, visiting from the USA. Further information from Trevor Waring at James Fletcher Hospital, phone 049 246 500.

August 29 Raising Difficult Children workshop begins Narara Baptist Church. Contact Neil Harris 043 285 550

September 25-28 Australian Association of Special Education conference, Brisbane, phone 6176 312 885

"Unfortunately, some children receive drug treatment for long periods without (initial) evaluation and without continuing evaluation during therapy" according to a medical committee report in Pediatrics. The report recommends that "medication for children with attentional disorders should never be used as a sole treatment ... Proper classroom placement, behaviour modification, counselling, and provision of structure should be used, even if pharmacology is being considered ... Medication should not be continued if clear-cut benefits are not observed."

Recommended drugs include Ritalin and dexamphetamine. Some findings: doses of Ritalin greater than 1.0 mg/kg per dose may lead to decreased performance in attention testing and memory. The manufacturer does not recommend a daily dose larger than 60 mg for children. Results with sustained release Ritalin have been disappointing because the duration of the effect is highly variable.

Other potentially useful drugs include tricyclic antidepressants. The report mentions "a very small number of reports of sudden death in children receiving these medications" and warns that electrocardiographic monitoring does not help clinicians identify the children at risk. There is a warning about misuse: "the use of alternative drugs such as tricyclics and clonidine must be approached with caution because they have the potential for causing death when ingested intentionally by emotionally fragile children or accidentally by their siblings".

Further information. Committee on Children with Disabilities and Committee on Drugs, Medication for Children with Attentional Disorders, Pediatrics,1996;98,2;301,304

About three years ago we decided to give him a break from Ritalin while on holiday. Within three days we were all in tears and seriously considered calling the whole thing off. Tom went into terrible rages and exhibited extreme behaviour like running out on to the road and jumping from bed to bed, accidentally landing on other furniture. It was like being caged with a wild animal. We put him back on the Ritalin and continued with our holiday.

After reading about evening primrose oil we commenced a trial in December. We felt that a trial couldn't really be carried out properly while Tom was on Ritalin so we gradually reduced the dose. After being Ritalin-free for five weeks, he was not exhibiting the rages of the past but he was still very naughty. He seemed bearable before going back to school but impossible to live with after school started. One of the factors involved was that he was being bullied, and we took steps to stop that. Inspired by the book Different Kids, we then decided to try the RPA diet. We took him off the evening primrose oil and started the diet. After two weeks of rage, Tom calmed down and is now about the same as when he was on Ritalin, except when he breaks the diet. I would not have believed diet could have so much effect."

Chemical contaminants will have an effect on behaviour before they reach levels high enough to have a measurable physical impact on a baby, according to researchers in a unique set of rat and human studies in America's Great Lakes area. Investigating the effects of eating contaminated fish, researchers found the higher the level of synthetic chemicals called PCBs in the mother's fatty tissues, the higher the level of behavioural disturbance of her children. There is no difference in behaviour as long as life is pleasant and uneventful, but both children and rat pups react more to negative events. "Every little stress will be magnified," says researcher Helen Daly.

Grandmother rat studies suggest that contaminants taken in by the mother can somehow have effects that reach across two generations and affect grandchildren as well as immediate offspring. PCBs do not break down, so avoiding fish during pregnancy had no effect. The mothers' stores of PCBs were passed to their children through the placenta and breastfeeding. PCBs (polychloride biphenols) are one of a number of substances, including lead, cadmium, DDT and Bisphenol-A, which mimic hormones in the body. As well as behavioural problems in children they have been associated with reduced fertility, low sperm count, enlarged prostate, breast and testicular cancer and undescended testicles. Although PCBs are no longer manufactured, they are so widespread that when researchers tried to find people for an uncontaminated control group, they were shocked to realise that there weren't any.

Further reading. Theo Colborn and others, "Our Stolen Future", Abacus Books, 1996, $16.95, pages 190-194

Lead is a neurotoxin that has been associated with reduced intelligence, attention deficits, aggression and destructive behaviours in children. Damage to the central nervous system may be permanent, resulting in school failure and anti-social behaviour. The danger is highest to young children at risk of exposure from

Young or developmentally delayed children who engage in hand-to-mouth activities are most at risk. When a six year old autistic child was found to have a high blood lead level, the child's school, a special school for children with learning disabilties, was assessed for lead contamination. Significant lead contamination of the school environment was found, due to the use of lead-based paint on the older-style, renovated building. The affected child had exhibited aggressive and often violent behaviour for at least 18 months before treatment. Parents and doctor had assumed this was part of autism. After chelation therapy, the mother commented on the reduction in aggression and how easy the child had become to manage.

Basic management of young children with elevated blood lead levels includes identification and removal of the source of lead, improved nutrition including calcium, iron, zinc, low to moderate-fat diet, education about minimising lead exposure, and chelation therapy where necessary.

Reference: Bawden-Smith & others "Lead exposure at a school for children with developmental disabilities", NSW Public Health Bulletin, 1995,6(11):124-127. More information, including the article "Can exposure to lead cause ADD?" by Jason Bawden-Smith from The LEAD Group, phone 02 9716 0132, FREECALL 1 800 626 086, PO Box 161 Summer Hill NSW.

 Substance abuse

Inhalant abuse can result in death. First time users account for 38 per cent of all inhalant abuse deaths. Irreversible brain, liver and kidney damage can also result. Nearly one in four admitted to deliberately abusing inhalants in a survey of more than 13,000 high school students in NSW and Victoria in 1992. Products most abused include felt-tip markers, glue, spray paint and paint thinners, typewriter correction fluid, toluene, petrol and a range of aerosols. To identify chronic inhalant abuse in your child, look for:

Talk about this with your children before they are offered their first "happy can".

An OITH reader whose 7 year old son has been diagnosed with ADHD, ODD, Aspbergers and "a touch of Tourette's syndrome" was found to be highly sensitive to chemicals. Although her son improved on a combination of medication and diet, the smell from a tin of paint was enough to cause an uncontrollable outburst of swearing and lashing out. This mother reports that zinc supplements have "helped a lot". Thanks to the Australian Chemical Trauma Alliance for the following article.

Multiple Chemical Sensitivity (MCS) can result either when a person is exposed to a large chemical contamination or to very small chemical exposures over a long period of time. MCS sufferers can react to minute amounts of chemicals, either mildly or severely, and the symptoms are varied. Children are the most susceptible as their immune systems are not fully developed. Some of the symptoms can include: headaches, poor concentration, confusion, rashes, depression, nightmares, fine or gross motor coordination problems, learning, developmental and behavioural problems which include ADD and hyperactivity, drowsiness and fatigue, asthma and respiratory problems, bed-wetting, recurrent flu-like symptoms and infections, eye irritations, intestinal problems and food intolerance. Ultimately, liver and kidney damage and cancers may develop. Many children have been helped by reduced-chemical diets and by decontaminating their environments as much as possible.

Since the second world war, 600 million chemicals have been unleased on the world. In the US alone, 250 billion kilos of chemicals are manufactured each year. There are 3500 chemicals used in foods. It cannot be expected that the human race would adapt to 50 years of chemical assault without producing some side effects. These are now becoming more apparent and in some instances, epidemic.

- by Tracy Brown, Australian Chemical Trauma Alliance (ACTA), phone 067 252421 or 067 255521.

We parents are often told that our children behave badly because we don't spend enough time with them. Psychologists confirm that parents spend progressively less time in leisure activities with their problem child. Dr Christopher Green says, "Young children want parents who will play with them." A mother from Victoria comments, "I don't get home until 6.30. I'm tired and I have to cook tea. I don't have time for behaviour management." In this article we look at psychologist Dr Russell Barkley's suggestions for improving the parent-child relationship by spending small amounts of enjoyable time together, as a first step in reducing defiant behaviour.

Think about the worst boss you have ever worked for. What are five characteristics of this person's management style? Now do the same for the best boss you have ever had. Which one got you to perform your best? Which one of these two are you most like when you are relating to your problem child?

Most parents confess that they are more like the bad boss. Yet a good boss, who makes his employees feel valued through recognition, positive feedback and encouragement rather than commands and criticism, is more likely to obtain the best work from his subordinates. Like employees, it is possible that defiant children may be "on strike" because of poor management and work conditions in the home. It is difficult to manage a child who perceives that his whole life consists of criticism and punishment. The same principle applies to the classroom. Not surprisingly, studies show that children behave better for teachers they believe like and care about them.

The aim of the following exercise is to help parents and children to rebuild a positive relationship. Each parent is required to spend 15-20 minutes in special one-to-one play sessions with the child. There should be at least five sessions in the first week and then three to four a week until problems are over. Some parents say they are too busy for this kind of activity. Dr Barkley comments that this is the sign of a major problem, where the parents attach little time or importance to child-rearing. Only half joking, he suggests that parents consider putting the children up for adoption if they are unable to find even 15 minutes in a day for their child.

Choose a time. For children eight and under, choose a time for your daily session. For preschoolers this might be morning. Or it can be after school or after dinner. For children aged 9-12 find a time when your child seems to be enjoying a play activity alone and join in. This program is not recommended for teenagers.

Make it one-to-one. Choose a time when other children are busy or can be minded.

Which activity? You can ask the child "this is our time to play together, what would you like to do?", or if your child is already playing, you can ask "can I join in?" Watching television is not an acceptable activity for this exercise.

Relax. Be unhurried. Give your child top-quality attention.

Make comments. Describe what your child is doing occasionally throughout the play session. This is to give children the idea that you are interested in what they are doing. Young children often enjoy their parent commenting on the action in the manner of an involved sports newscaster.

Your child is in charge. This is your child's special time. Do not take over. Give no commands and ask as few questions as possible. Cooperative games are easier than competitive games. For example, if you are playing a competitive game, the child must be allowed to make up new rules or even to cheat. The aim is for your child to enjoy the time, not to be taught or corrected.

Feedback. Provide occasional praise, approval and positive comments about your child's actions. Be honest, not excessive. eg. "I like it when we play quietly like this ... I really enjoy our special time together ... look how nicely you have made that ... it's nice when you ... that was good the way you ... nice going! ... super! ... great! ... you know, six months ago you couldn't do that as well as you can now ... you did that all by yourself - way to go ... I am proud of you when ... I always enjoy it when we ... what a nice thing to do ... wait until I tell your mum/dad how well you ...". Don't forget nonverbal signs of approval like hugs, a pat on the head or shoulder, affectionate rubbing of the hair, place arm around child, a smile, a wink, a thumbs up sign, a light kiss. Give immediate feedback, say exactly what you like and avoid backhanders like "that's good. Why couldn't you have done that before?".

If your child begins to misbehave ... look away for a few moments. If bad behaviour continues, tell your child the special playtime is over and leave the room. Tell your child you will play later when he or she can behave nicely. For extremely disruptive, abusive or destructive behaviour during play, discipline the child the way you normally do.

If you make mistakes ... most parents give too many commands or questions, or make too few positive comments about the child at first. This will improve with practice. Each parent should spend time with the child in this special playtime. Some parents find these so beneficial that they start a special playtime with other children in the family.

This exercise is not a miraculous cure for defiance, but it is a good beginning. Most parents report a renewed sense of pleasure in playing with their child when following these guidelines, and find an improvement in their relationship after only one week. The children enjoy themselves and often request additional playtimes. To change defiant responses outside playtimes it will also be necessary to use other behaviour management principles such as the other steps in Dr Barkley's ten-step Defiant Children program or any standard behaviour management course. These include how to give effective commands, increasing compliance to commands and requests, decreasing disruptiveness, increasing independent play, how to set up a point reward system and effective use of time out.

Barkley, RA Defiant Children, $49.95 (Set of two: a clinician's manual for parent training plus a book of parent-teacher assignments)

Barkley, RA Taking Charge of ADHD, $29.95 (A book for parents which includes a shortened version of the Defiant Children program)

Dengate, S Different Kids, $17.95 (A former teacher describes how she used the Defiant Children program in combination with diet for successful management of oppositional defiance in her own child.)

Wallace, I. You and your ADD child, $17.95 (By a Sydney psychologist, this book includes suggestions about behaviour management, including defiance and conduct disorder in teenagers.)

The above books are all available from Silvereye Educational Publications, a mail-order bookshop specialising in ADD and Learning Disabilities. PO Box 715, Raymond Terrace NSW 2324, phone/fax 049 87 3457.

The following extracts are from letters by an OITH reader who served time in prison for armed robbery. After release he learned about attention deficit disorder and is now taking Dexamphetamine.

Diagnosis of ADD: "I'm a newcomer to the world of ADD. It's amazing how much better I am and the way I feel about myself. As the months go by I look back and see how much I have improved. I now have control over my life and I'm where I want to be. It was hard in the beginning to face the fact that for most of my 31 years, I have always been in trouble with someone. I left home around 13 years of age. Even though I've had girl friends and I have children, before I was diagnosed I suspected that something was wrong with me because I couldn't get anything right and I have always been alone."

The system: "I was in prison for 18 months. The system is wrong. The prison is more like a metal asylum. There is no stimulation there at all, nothing for rehabilitation. I was there for drug-related crime and they had no drug counselling program. ... There was a lad, he was only young, they were treating him with drugs for schizophrenia. I saw how they affected him. They made him more like a zombie. Being so young, he left with more scars than he went in with. I think if he isn't getting help, he will be a very hostile person now."

Amphetamines: "Didn't affect me like all my friends. Instead, I felt relaxed and wanted to go to sleep. The main problem was buying bad batches, when they cut it with poisons. One night I thought I was going to die, other times I felt bad and lashed out."

How to reduce the prison population: "Why don't they screen prisoners for ADD? I reckon they could reduce the prison population by doing that. If medical staff had taken the time to go over my background, I could have been diagnosed for ADD while I was in prison. ... Even while I'm taking Dex, I can notice some foods, like oranges, affect me. I had no idea food could be so important. Why don't they change the food in prison? I bet there are lots like me in there."

Editorial

Seven months ago my daughter had an operation for a ruptured appendix, following soon after by a bad bout of the flu from which she did not recover. Now she has been diagnosed with Chronic Fatigue Syndrome, which, like ADD, is a controversial diagnosis. This time, I knew what to do. I phoned the library immediately for the contact number of the support group, and they provided me with more information than my doctor. I talked to people in the same situation, and I read books. Unlike many ADD (and CFS) families, we were lucky that we happened to go to a doctor who is knowledgeable about this condition. Not much is known about CFS, but the research is clear on one thing - people with late diagnoses are likely to recover more slowly, if at all. I'm sure the same can be said of ADD. Thus doctors who fail to diagnose these conditions can be causing harm to their patients. A reader who is convinced his time in prison could have been avoided by early diagnosis, gives his poignant account on page **

After years of battling the school system, we have now become a home-schooling family due to Rebecca's illness. Are you horrified at the thought of staying at home with your ADD child? Readers report surprising results (page **).

A reader writes: "I can't tell you what a support and encouragement your newsletter is to me and some of the parents in our small group. As you will understand, we get tired and sometimes just knowing that your team is there, sifting through all the information, is comforting." All of us at OITH and ADDnet are volunteers working to promote the interests of ADD families. Enclosed with this newsletter you will find a leaflet for ADDnet. Please show your support by joining.

- Sue Dengate, editor

My reaction to the first self-hypnosis cassette "I'm not hyper, angry or lazy" was "Forget the kids, I'm going to use this myself". A year later, I'm still a regular listener. Readers say they and their children are more relaxed, feel better about themselves and sleep better when using it. Now there's a double-sided version of I'm Not Hyper and a new cassette. Aiming for Clear skin, Calm mind, and Healthy body the new release revisits old favourites like the warm dark tunnel, crystal stream, and boat at anchor but adds a new star-shaped chamber, more upmarket sound effects and a faster tempo, designed to appeal to teenagers and adults. Comments one mother for whom getting her teenager up in the morning has always been a battle, "After using the tape for three weeks, David got himself up earlier and has been going to school earlier. A few days later he came home from school saying he had made an appointment to see the school counsellor about organising his time better. These are just two incidents showing some positive action from David that astounds me."

Available from Natural Symphonies, PO Box 252 Camden NSW 2570, phone 046 55 1800, fax 046 55 9434, email: Natsym@flex.com.au

Research shows that homeschoolers as a group do well. They consistently score better than public school students on standardised achievement tests, and do well at universities. A study in 1986 found the self-concept of a group of homeschoolers to be "significantly higher" than that of their publicly schooled peers. There are some famous homeschoolers who have made significant contributions to society including inventor Thomas Edison, scientist Albert Einstein, artist Andrew Wyeth, anthropologist Margaret Mead, and author Mark Twain. Some of these are also considered to have had ADD.

Prize-winning American author David Guterson homeschools his own four children while teaching at the local high school. He suggests that schools stifle the child's natural desire to learn. Socialisation is another issue. "My students' parents have often expressed dismay at how school has shaped their children," he explains, referring to the alienation of children from parents and the unnatural massing of children with their own age group which leads to peer obsessiveness and the clique mentality. Homeschooling, he concludes, allows children to develop a more balanced set of relationships.

"I couldn't have contemplated homeschooling my son until he went on the diet", said one mother. "I couldn't stand him. I sent him to school to get rid of him". For those doing diet, homeschooling is easier. It avoids peer pressure, school canteens, fast food vouchers and adds cooking to the curriculum.

Combining school and home, at Twin Ridges school district in California, homeschooling families are provided with access to school libraries, special classes, computers, videos and science kits. Two home-study teachers are provided for counselling, advice and assistance to parents.

In Australia, correspondence or distance education schools often provide many supports for parents along with lessons. OITH readers are generally enthusiastic about the quality of education from these schools, but gaining entry can be difficult unless the child has already been expelled from other schools. Why wait until the children have hit rock-bottom? Mixing with a smaller group of a wider age range, working in a one-to-one situation, following the child's own interests, and proceeding at the child's own pace will obviously benefit most ADD children. The mother of the 15 year old who was expelled above, reports: "Since he has been doing Distance Education his marks (except Maths and Science) have improved - he is better socially - he is nicer to be around".

Further reading: Family Matters: why homeschooling makes sense by David Guterson, 1992, Harcourt Brace Jovanovitch

Wouldn't you like your child's teacher to know this: "ADD is a handicap. Though it cannot be seen, it is as real as a physical or sensory disability and requires tolerance, reasonable accommodations and assistance from the wider community. There is no blame for the presence of ADD in a student." (Potter) And: "Accommodations are various strategies that teachers can use to increase the likelihood of successs for students with learning difficulties. They include adapting and adjusting teacher attitude, curricula, instructional methods and classroom organisation." (Spencer). Spencer reviews research about learning and quotes the findings in an organised, interesting and easy-to-apply manner eg. "there is no more positive reinforcement more effective than success". Potter's book describes ADD, behaviours to expect in the classroom and suggestions for how secondary teachers can help their ADD students, including in specific situations, such as difficulty with class behaviour, difficulty getting organised to work, difficulty completing work, difficulty in mathematics. These two booklets are enormously popular with teachers throughout NSW.

Both clear, well set out A4 size spiral-bound booklets available from the LD Coalition of NSW, PO Box 472, Sutherland NSW 2223, phone 02 540 3300, Fax 02 540 3266. Add $1.25 each for postage within NSW, $1.50 for interstate. A useful gift for your school.

When simple behavioural techniques are ineffective it is time to re-evaluate all available methods. Parents must not expect a miracle, instead they find what techniques bring them some success, then dump the rest. Parents find it hard to let go of usually effective methods which, in their child, are clearly not working. "Are you telling me we should stop punishing his bad table manners?" "Is this working?" I respond. "No, it makes things worse." "Well, why do it?" "Are you telling me to let him get away with everything?" "No, but if it's not getting you anywhere, let's back off."

Parents who do not accept the ADHD child as different, and make no special allowances, are in for trouble. Those who are hell-bent on bringing up their children with the same rigid discipline of their parents' generation are also heading for a failure.

In academic circles the thought of smacking is taboo, but in the real world it is an extremely common form of punishment. For children with an easy temperament smacking may occasionally work but there are much better forms of discipline. In the challenging child, smacking is ineffective, escalating and dangerous. Parents smack to 'make' their child conform. He defies, they smack harder - he resists, and things get out of control.

Parents who live with a demanding, difficult young child feel trapped and have no space. If putting on a favourite video gives a short period of peace, this must be encouraged, despite current criticism of child-minding by television.

Paediatricians and parents are uncomfortable with the use of stimulants under the age of five years. Having stated this, it is our experience over the last fifteen years that stimulants can be surprisingly safe and successful in three and four-year olds. In theory, the drug Clonidine and the tricyclic anti-depressants might be considered ahead of stimulants, but in our clinic, stimulants, with their quick action and clearly documented effects, remain the first choice.

At this age introduction and adjustments should be in quarter-tablet (eg 2.5 mg Methylphenidate) increments. Medication is only trialed with informed consent and on the parent's request. We trial both stimulants, Methylphenidate and Dexamphetamine, as these two preparations are definitely not equal in effect and side effects. After an initial three-week trial no drug will be prescribed unless the parents, with feedback from the nursery school, are certain of the benefits and freedom from unwanted side effects.

Medication response is quickly coded on a four point scale. Four out of four is a miracle improvement. Three out of four is extremely good. Two out of four is good but there is room for improvement and one out of four is minimal. Most children who start on medication have a score of two and a half or above.

Some young children seem to metabolise quickly and rebound as their level drops. To combat this some are maintained on four, or occasionally five, small doses to give an even response throughout the day. A few who are extremely difficult will get their first dose the moment they wake.

During our trials of medication the most common parental complaint is of withdrawn, teary, upset behaviour, often with unexpected anger and irritability. In our experience this is more common with the drug Dexamphetamine than Methylphenidate and can usually be eliminated by changing the preparation or lowering the dose.

Ten years ago we were reluctant to use medication in young children, but have now realised that, with drugs we can reach, and then teach. This makes our behavioural techniques much more effective. It also helps parents communicate with their children and become closer in their relationship.

It's not fair, it shouldn't happen, but the child is there and no one is going to miraculously change their temperament. Over the years we have moved from proposing clever behavioural programs that rarely work, to regroup and promote the art of "survival psychology".

The first step is to accept the reality of the situation, then become committed to a few firm rules, then steer around the strife. If lengthy time in the supermarket is a nightmare, avoid this, use late night shopping or bundle the child in the trolley and use the 'smash and 'grab' approach. If gatherings with friends and family cause embarrassment, drop in for a high quality half hour and leave before the bomb blows. If travel is a torment, stay near home. If the child is a runner, fortify the compound. If ornaments get broken, lock them away. If the video is being reprogrammed, put it in a playpen.

It is not the way it should be, but it is easier to spend time playing with the child than getting nothing done as you squabble and resent. They enjoy getting out, but don't let two hours of fun in the park be destroyed by an argument on the way home. We are not looking for conflict, our aim is peaceful coexistence and a child who is still close to their parents at the age of eighteen. The general rule for all our ADHD children is, when in doubt use an olive branch not a stick.

Children who present with extreme ADHD behaviour at preschool age will probably continue to be a challenge for many years. We can't wait until the age of six to take this seriously, if we don't get it right at the start, relationships can become permanently derailed.

Recently I worked with an explosive ADHD three year old and his defeated mum. I asked if his behaviour was as difficult for everyone, to which she replied, "Even our German Shepherd guard dog is frightened of him!" With redirecting the discipline, survival psychology and a successful trial of medication, she returned for a review. When asked the questions "What's different?" she was quite clear, "Now I love him".

To be in the draw for a free book, complete at least one question on the enclosed questionnaire. This is from psychologist and author Dr John Irvine, to help with his third book. Your chance to have a say! Post to: Dr J Irvine, Suite 11, 1/5 Baker Street, Gosford NSW 2250.

Reviewed in the last issue, this behaviour management video has readers telling us "it really is magic". Over the last two years, Westlake Macquarie family support worker Paul Arrowsmith has shown 1,2,3 - Magic in three-hour workshops with handouts, to 1300 parents. We would like to see every Family Support Service offering this video. More information about workshops in the Macquarie area from Paul Arrowsmith on 049 59 6604.

Children with dyspraxia, a condition that makes them extremely clumsy, can become much better coordinated if they add fish oil to their diet. In the last Diet Page we reported on Jacqueline Stordy's work with dyslexics and essential fatty acids at the University of Surrey in Guildford. In a new study 15 dyspraxic children aged 6 to 12 took fish oil rich in essential fatty acids for three months. There were highly significant improvements in the children's balance and dexterity. According to Stordy: "Before, the children couldn't catch a ball. Now they can." This study will be published in the American Journal of Clinical Nutrition.

The national phone-in last September received calls covering about 270 students. Most had experienced problems such as outright denial of enrolment or subtle persuasion to go elsewhere, partial enrolment, negative attitudes by teachers and principals, failure of teachers to stop bullying and harassment by other students, lack of practical support, harassment and many others. More information from Christine Flynn, senior project officer, National Children's and Youth Law Centre Disability Discrimination in Schools Project, phone 02 9398 7488.

Children are nearly three times more likely to suffer from ADHD if their mothers smoked during pregnancy, according to research published in the latest American Journal of Psychiatry. [Is this because more ADD adults smoke? - Ed] The study also found that children's IQ is lower if their mothers smoked during pregnancy.

Poor Jack. His mother's having a baby and he's going to stay with his cousins. But they don't want him. He's bad at ball games, terrible at maths, untidy, forgetful, disorganised, always in trouble and everyone dislikes him. Whatever is wrong with him? Of course, it turns out to be ADD, Jack takes his "special pills" and everyone lives happily ever after. This is a book for children from 8-10. The children who read it for me commented "there are a lot of things about ADD this book doesn't mention", "they didn't talk about diet" and "what about when your pills don't work and you have to try new ones?" But they all loved the story. It is very easy identify with Jack's troubles.

- Reviewed by Sue Dengate, author of Different Kids: Growing Up with ADD

Dyslexia vacation schools for children and adults are offered in Brisbane by dyslexia consultant Christina Alexander. Courses are based on Christina's own "big, bold and beautiful books with attractive, shiny, gold covers", lavishly illustrated by prize-winning artists and written during 18 years of dyslexia research. More information from PO Box 134 Kenmore Qld 4069, phone 07 378 3915.

The Pindari Centre at Peakhurst in Sydney is a project of the Association for Children with Learning Disabilities which has operated specialist services to children with Learning Disabilities and their families for 24 years. For information and brochure phone 02 9534 1710, 12-14 Pindari Road, Peakhurst, email: learning@acld.asn.au

Q. Does Ritalin stop working in teenagers? My son (14 years) has been taking it for three years but it doesn't seem to be doing anything for him and he doesn't want to take it anymore.

A. Ritalin (and dexamphetamine) continue working into adolescence and adulthood in most cases. There are several possibilities that your son's medication is not doing its job. Firstly, he may not be taking it (many teenagers actively refuse medication as the result of peer pressure or Oppositional Defiant Disorder). Secondly, the dose may no longer be effective and he may require an increase in dosage. Thirdly, he may have developed a tolerance to Ritalin and may need to try an alternative medication such as dexamphetamine for several weeks, after which time Ritalin will be effective once again. The issue of non-compliance should be discussed with his physician.

Q. What is the best age to do the elimination diet?

A. If everything else has been excluded and the problem is severe enough, then when the parents are ready they can do the diet. This can be when the baby is fully breastfed, when the baby has been weaned or when the child has become a little older, or during teenage. So it can be at any stage of a person's life, when they find that the problem is severe enough, or when they are ready to look at whether food may have a role. Anyone doing an elimination diet should get in contact with their local dietitian to make sure than good nutrition is being maintained during that period.

Boston psychologist Dr Robert Brooks specialises in fostering self-esteem in children and adolescents. A regular speaker at CHADD conferences, Dr Brooks has agreed to speak in Australia in 1998 as a guest of ADDnet. To help in fundraising for this, Newcastle Rotary have offered ADDnet participation in a raffle. Prizes (car, computer, TV etc) and tickets are organised by Rotary. ADDnet sells tickets ($2 each) and receives 80% of takings. If your group can sell tickets, please write to Lynne Mulley, 6 Watt St, Raymond Terrace 2324, ph 049 873 249.

Sugar industry workshop

The scientific evidence that sugar has no effect on children's behaviour was presented at a sugar industry workshop by Professor mark Wolraich from Vanderbilt University in Tennessee. As consumer representatives, ADDnet stressed the importance of parental observations in evaluating the problem and the need for support for families in difficult circumstances.

CHERI (Children's Hospital Eductaion Research Institute) Research Seminar

Research into aspects of ADHD was presented to invited professionals and ADDnet representatives at this seminar. Of special interest was a trial presented by Dr John Kramer of the Division of General Practice in Coffs Harbour, NSW, in which a multi-disciplinary team (parent, teacher, GP, speech pathologist, etc) meets once a month at the school concerned to plan and monitor the progress of the child in question. Another study, currently awaiting publication, compares the efficiency, side-effects and predictors of response of Dex and Ritalin. This was presented by Dr Daryl Efran from the Centre for Community Child health and Ambulatory Paediatrics in Melbourne.

What is it? The first recorded use of this compound occurred in the 16th century, when explorer Jaques Cartier's ship became frozen into the St Lawrence's waterways for the winter. His crew developed scurvey, an often fatal disease common in sailors, caused by vitamin C deficiency due to lack of fresh vegetables and fruit. After 25 deaths, Cartier noticed that local Indians cured themselves using a tea brewed from the bark and needles of a local pine tree. Drinking this tea, the rest of the crew recovered in six days. Four hundred years later Professor Jaqcues Masquelier found the active ingredients in the tea were bioflavonoids and Vitamin C. He eventually patented a procedure for extracting the active compound, called Oligomeric Proanthcyanidin (OPC). According to advertising material, OPC is a powerful antioxidant, twenty times stronger than vitamin C and 50 times stronger than Vitamin E. Antioxidants protect healthy cells by destroying free radicals contained in air pollution, cigarette smoke, radiation, pesticides and preservatives. OPC occurs naturally in pine bark, grape seeds, and red wine, and to a lesser degree in peanut skins, many berries and several herbs.

Does it work? We have heard from readers in Australia and New Zealand that Pycognenol works well for some but not others. Some children require a very high dose which is expensive.

Where do I get it? Pine bark extract from the white pine (Pinus strobus) is available in Australia, called Revenol, from Neways International, 162 Fullarton Road, Rose Park SA 5067, phone 08 8364 3660 for the name of your closest distributor. Revenol retails for $49.95 in 60 tablet packs. Pcynogenol extracted from the maritime pine (Pinus Maritima) which is considered to be stronger, is available overseas but still being reviewed by the Therapeutic Goods Administration in Australia. You can enquire about this product from Kaire Australia Pty Ltd, fax 02 9899 7300 or Kaire New Zealand Pty Ltd, Unit D, 6 Jack Conway Avenue, Manakau, New Zealand, phone 0011-64-9-262-2558, or fax 0015-64-9-262-0909. New Zealand time is two hours ahead of Australia's east coast.

For his final school exam, one student applied for: time extension (like many with ADD, this student has difficulty in completing tasks on demand within a given time frame), coloured paper, enlarged print, special lighting (all for scotopic sensitivity) and separate supervision (for scotopic sensitivity and distractibility). All requests were refused, and instead, the use of a writer was granted.

As he had no experience in working with a writer, the student felt this would make him distracted and anxious. After an appeal, all requests except enlarged print were granted for three out of five subjects. After further negotiating with the help of a conciliator from the Anti Discrimination board, the student was granted approval for enlarged print in all subjects. Still no time extension for the extra two subjects.

"As the exams in question are over for my son there are no further gains to be made for him."

His mother writes: "The next, and only step, now left available is to take the matter to the Anti Discrimination Tribunal. The conciliator is prepared to recommend the case. To this point I have had support from specialists in the education field who are encouraging me to pursue the matter. As the exams in question are over for my son there are no further gains to be made for him. Therefore, if I pursue this, then it will only be to gain justice for other ADD students so they can be allowed to compete with equity in exam situations. Naturally, this is too big an ask financially for me to cover. Therefore, I am requesting help from any reader with expertise who is prepared to speak for these students for no fee. We will need a lawyer with skills in anti discrimination and perhaps some understanding of ADD sufferers and learning disabilities along with specialists in the areas of ADD, learning disabilities, speech pathology, research, psychology and any others who feel they have something to offer, such as those who have assisted in other cases. Should it be successful then we can pave the way for other students." Please reply ASAP to Exams c/- OITH, PO BOx 85, Parap NT 0804.

A school in England has asked parents to stop children's "tuck:" money because it believes crisps and fizzy drinks are making pupils impossible to teach. The action comes after teachers noticed improved behaviour among a group of boys who were denied snacks at Hinchinbrooke School in Huntingdon, Cambridgeshire. Deputy head Cherry Lazenby said "Immediately after morning break and lunch-times, children are 'hyper'. They are noisy, rowdy and they can't sit still or concentrate. It is not just the exuberance of break-time being carried over, it is much worse. They fill up on sugar and additives and misbehave immediately afterwards".

Regional spokesman for the National Union of Teachers, Alan Williams, said "There is a problem nationally with this and it is causing a lot of concern. Children are being affected by what they consume at break-times and their behaviour is suffering as well as their health".

- from The Times, February 1997

The Food Advisory Committee in England is to take another look at a possible link between hyperactivity and food additives, reviewing all available scientific and medical data. If you have a case history, send it, stating that it is for distribution to all the FAC members, to: The Secretary, FAC, Room 239b Ergon House, 17 Smith Square, London SW1P 3JR.