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Regular Features

Dr. Steven Richfield provides articles on many different aspects of raising a child with ADHD.                                   

Each month we our advocate will be answering questions from our visitors about yours and your children's rights in the educational system.    

A mother is trying to help her teenage son learn anger management.   

Five great ideas for motivation, including The Shoe Race, Trading Places and more.  

Organize your child at home, and maybe find some tips that will help you as well.  

Headlines about ADHD, Learning Disability and Mental Disorders

Study on ADD and TV
The recent study published on watching television between the ages of one and three and the possible link to ADD/ADHD did not take many considerations into account. The author of the study even admits that he cannot conclude that television watching and ADD/ADHD are linked.

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The Feingold Program
Jane Hersey
  National Director, Feingold Association
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Tell Me About Your Child
bulletDoes your child get upset too easily? 
bulletDoes she seem to not hear what you are saying?
bulletIs his motor stuck on fast forward?
bulletAfter you have carefully explained why he cannot do something, and he seems to understand, do you turn your back only to have him repeat the behavior?
bulletDo you sense that she really can't help the way she behaves?
bulletDo all the teachers in the school know your child's name?
bulletDo other children avoid playing with your child?
bulletDoes she have difficulty interacting with children her age?
bulletDoes he always seem to be touching every person and object in his reach?
bulletIs she fine one minute, and out of control the next?
bulletDo all the games have to be played his way, with his rules?
bulletDoes she seem to be off in her own little world?
bulletCan he go from here to there and lose something?
bulletIs homework lost, forgotten, or mutilated on a regular basis?
bulletDoes he have a hard time understanding subtle cues, like facial expressions?
bulletDoes she laugh too loud, or inappropriately?
bulletIs he really just like other kids, only much more so?

This is a sampling of some of the symptoms that can be triggered by exposure to chemicals in one's food or environment.

Can a Diet Help Improve Your Child's Behavior?
Mothers often notice that there are times when their child's behavior seems to change after he has eaten.  It could be apple juice, or jelly beans, or a bologna sandwich.  It could be Halloween candy or birthday cake that seems to set him off.   You may have tried to avoid certain foods or food additives, only to find yourself bewildered as you attempt to sort out the likely trigger.
Perhaps when you go to a fast food restaurant you get her the orange drink to avoid the caffeine in cola.  Within two hours of eating there you have a little terror on your hands.  (The cola would probably have been a far better choice than the synthetically colored and flavored orange drink.)  Have you ever thought your child might be allergic to chocolate since it seems to "turn him on?"  (Most chocolate contains synthetic vanilla flavoring, called "vanillin," and this is a much more likely culprit than the caffeine, the chocolate or the sugar.)  Did you ever notice, as I did, that after a few days of an illness -- and not eating much -- your child is strangely calm?
The frustrating thing is that you are operating on scant information, and trying to reach your destination with no road map.  In order to identify the likely triggers for your child's behavioral outbursts, you need both information and direction, not to mention good advice and lots of support.
The good news is that you don't have to figure out your own test diet; this has already been done.  There is a systematic step-by-step technique that will guide you through the process of testing your child's sensitivities.  It is surprisingly easy -- kind of like a math quiz that is very easy when you know the answers!  More than two decades of successful experience by thousands of families have resulted in the Feingold Program. 

A brief background of the Feingold Program
As early as the 1940s, allergists began to publish reports of patients who were sensitive to tartrazine (Yellow dye No. 5).  The medical literature contains many references to symptoms such as hives, asthma and nasal congestion. Doctors also found that aspirin and other substances, commonly found in some fruits and vegetables, have a chemical similarity to synthetic yellow dye.  (The chemical name for aspirin is acetylsalicylic acid, and from this comes the term "salicylate," used to refer to those substances.) Physicians later found these chemicals affect children as well as adults, and that they can trigger behavior and learning problems.  The doctor who first observed this was Ben F. Feingold, M.D., Chief of Allergy at the Kaiser Permanente Medical Center in San Francisco.  Dr. Feingold was both a pediatrician and an allergist, and was a pioneer in the fields of allergy and immunology.  In addition to yellow dye and salicylates, he also removed other synthetic food dyes and all artificial flavorings.  Dr. Feingold would later expand what he named the "K-P Diet" to exclude the preservatives BHA, BHT and TBHQ.  In 1973 he reported the results of his work at the annual conference of the American Medical Association. His research received widespread publicity, and Random House asked him to write a book parents could use to help their children.  The publisher titled the book Why Your Child is Hyperactive.  As a result of thousands of parents reading this book and using the diet Feingold outlined, volunteer support groups began to spring up around the country; they chose the name "Feingold Associations" to honor the doctor who had made such a difference in their lives.  These parent associations began to share information, research brand name foods, and develop programs to make it easier for the new family to successfully use the diet.  Since it covers far more than just food, the Association calls it the Feingold Program.

What is the Feingold Program?
First of all, it is a test.  For several weeks, you use only foods that are free of synthetic dyes, artificial flavors and three preservatives, as well as a group of foods known as "natural salicylates."  All of these acceptable foods are likely to be well tolerated.  If this trial results in an improvement in your child's behavior, or in other target symptoms, then the test becomes the treatment.  You simply continue to enjoy the foods and the positive change in your child.  After a few weeks of success you can gradually expand the food choices, adding back natural salicylates one at a time, and watching for any return of the old behaviors.  The Program is a form of the time-honored allergy elimination diet.  The focus, however, is on all the foods that are allowed, not on those removed.
We've come a long way!
In the 1970s it was difficult to be on the Feingold diet because many foods had to be made from scratch, and eating out was risky.  Today, however, the food supply has changed, and Feingold research enables members to shop at supermarkets, use many convenience foods (including candy and ice cream) and even eat at fast food restaurants.  Many hard-to-find treats are available through mail order companies.  Feingold Foodlists include over a thousand acceptable brand name foods and non-food products.

Questions Parents Ask

Is there some type of test to determine if a diet will help my child's symptoms?
The Feingold Program is a test. By removing the most likely culprits, you will be able to see if synthetic colors, flavors, certain preservatives, or salicylates are playing a part in your child's problems or in your own health problems. 
How soon can I expect to see a change?
There is no way to predict exactly how long it will take, or how much of a change you will notice.  For a preschool child who is not on medication, it is typical for parents to notice a significant change in a few days to a week.
How can I be sure that a diet program will help at all?
While there are no guarantees, there is a very high probability that your child will be helped.  Volunteer organizations do not even form, let alone persist for decades, unless the volunteers experience positive feedback from their work. 
Will my child's schoolwork be helped?
There is generally a significant improvement in schoolwork.  Eliminating these additives won't teach the child math, but should enable him to pay attention so he can learn what is being taught.  Behavior is likely to be the first thing to improve, with academic performance showing a more gradual but steady improvement.
My child's symptoms are so severe; how can a simple change in food make a real difference?
A switch from brand A to brand B may seem simple, but removing toxic chemical additives from a child's diet is not a simple matter.  Food processing is complex, and it has taken many years for volunteers to become proficient at identifying places where additives can be hidden. Once the dietary changes are made, parents and professionals report even severe symptoms have shown improvement.
Is this program hard to follow?
Replacing the food in your pantry with "Feingold acceptable" is harder than using what's already there, but easier than getting through the day with a child who is aggressive, destructive and rarely sleeps.
Being selective about which foods you buy at a fast food chain is harder than ordering anything you want, but it's easier than handling that dreaded daily phone call from the school.
Using pear juice in place of apple juice (a natural salicylate) might be inconvenient, but so is washing wet sheets every morning.
Is it expensive?
That depends on the type of food your family likes.  My grocery bill went up in some areas and down in others. 
Is this a "health food" diet?
There are many items in a health food store that are "off limits" to the family new to the Feingold Program. You will find lots of food in both supermarkets and health food stores that are acceptable; select those your family likes best. 
Do I have to cook "from scratch"?
No.  If you have a current Foodlist you should be able to use the processed foods listed.  
Can our family still eat out at restaurants?
People who are experienced on the Program can eat out at nearly any restaurant and do very well.  By carefully avoiding the additives/ salicylates in the beginning, many people appear to lose much of their sensitivity.  It's been many years since my family began the Program, and we can eat virtually anywhere, make educated choices and not experience a reaction.
My child is a very picky eater; how can I get her to accept new foods?
You will probably be able to find natural versions of those few foods she likes, and you may be surprised to find some of her favorites are already on the Foodlist.  Stay as close as you can to the foods your child enjoys.  As she becomes more reasonable, you will probably be able to gradually expand her choices.
What happens when she's away from home and someone offers her food?
If you present the Program in a positive way and your child experiences the benefits it brings, you probably won't have to be concerned about this.  It has been our experience that once they understand it, most of the children are very determined to stick to their diet.  (I know you probably don't believe this.  I wouldn't have either!)
How will I know which brands of food are OK to use?
The Feingold Association researches foods and publishes books listing acceptable brand name products.  In many cases, a company makes several products that are acceptable and other varieties that are not.  It can be pretty tricky, so follow your Foodlist carefully.
Can't I just read labels and avoid the additives that way?
Much of the effort of our Product Information Committee is spent tracking down additives that are in foods but are not included in the ingredient listing.
What are food additives made from?
You might wish you hadn't asked, but here goes: Food dyes used to be made from coal tar oil (yummy!) but are now synthesized from petroleum.
Artificial flavorings can made from virtually anything; there are no rules.  A single flavoring might be made from hundreds of different chemicals.
The preservatives BHA, BHT and TBHQ are made from petroleum.
Does the Feingold Program eliminate all additives?
No. Only those found to be the major source of learning/behavior problems are eliminated.  A few others are a problem for some, but not all, of our members (MSG, sodium benzoate, nitrites, corn syrup, calcium propionate, fluoride and sulfiting agents).  They are not removed, but many people choose to avoid them.
The Association recommends members avoid the use of synthetic sweeteners such as aspartame, saccharine and cyclamates.
If the additives are harmful, why doesn't the government ban them?
This is a long and complex story (spell that "$tory").  Many dyes and other additives have already been banned; it's the stubborn survivors that are causing so many problems.
What about all those pesticides?
Our family was successfully on the Feingold Program for over a decade before we had our first organic carrot.  If you can easily obtain organic foods, that's great, but it isn't required. 
Will my child have to be on this diet for the rest of his life?
As a child gets older and stays away from synthetic chemicals, he tends to develop a tolerance level.  But as you become more knowledgeable about food and food additives the question may shift from "Why can't we eat imitation red cherry gelatin?" to "I can just as easily make natural cherry gelatin that tastes terrific; why would I want to eat the other stuff?"
Even the very young children catch on to the fact that disgusting chemicals added to foods enable companies to save money by eliminating real ingredients from their products.  
I've heard that scientific studies show that diet either does not help learning/behavior problems, or that it helps only a tiny fraction of children.
Feingold volunteers have heard this too!  If you go back to the early studies and read what the scientists conducting the research originally reported, you would see a very different conclusion.  Although none of the studies were a test of the Feingold Program as it is actually used, and most had design flaws and other mistakes, they still yielded very supportive data.
Newer studies have been more carefully designed and have yielded extremely positive results.  But such information is not favorable to the many vested interests dealing with foods and food additives and their effects, so this information is not likely to be publicized.
Suppose I just avoid the obvious additives by checking ingredient labels on foods -- would this help?
By all means, avoid things like food dyes and artificial flavorings whenever you can.  Any harmful additive you can remove is a good idea.  But you will not be able to test the Feingold Program in this way because you will still be consuming hidden additives.  If you do see an improvement in your child as a result of making small changes, that's great!  But if you see little or no improvement, please don't conclude that the diet won't work; you probably have a fairly sensitive child, and perhaps one who is also sensitive to natural salicylates.

For most children it isn't a cut-and-dried case of "the Program working" or "the Program not working."  It's generally a matter of how much help the Program provides, of whether the family needs to go further to get an even better response.  We rarely hear from a member who reports that they are not having any success.