Erratum to: Quality of reporting of randomised controlled trials in chiropractic using the CONSORT checklist

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A randomised controlled trial of the Neuro Emotional Technique (NET) for childhood Attention Deficit Hyperactivity Disorder (ADHD): a protocol

<p>Abstract</p> <p>Background</p> <p>An abundance of literature is dedicated to research for the treatment of Attention Deficit Hyperactivity Disorder (ADHD). Most, is in the area of pharmacological therapies with less emphasis in psychotherapy and psychosocial interventions and even less in the area of complementary and alternative medicine (CAM).</p> <p>The use of CAM has increased over the years, especially for developmental and behavioral disorders, such as ADHD. 60–65% of parents with children with ADHD have used CAM. Medical evidence supports a multidisciplinary approach (i.e. pharmacological and psychosocial) for the best clinical outcomes. The Neuro Emotional Technique (NET), a branch of Chiropractic, was designed to address the biopsychosocial aspects of acute and chronic conditions including non-musculoskeletal conditions. Anecdotally, it has been suggested that ADHD may be managed effectively by NET.</p> <p>Design/methods</p> <p>A placebo controlled, double blind randomised clinical trial was designed to assess the effectiveness of NET on a cohort of children with medically diagnosed ADHD.</p> <p>Children aged 5–12 years who met the inclusion criteria were randomised to one of three groups. The control group continued on their existing medical regimen and the intervention and placebo groups had the addition of the NET and sham NET protocols added to their regimen respectively. These two groups attended a clinical facility twice a week for the first month and then once a month for six months.</p> <p>The Conners' Parent and Teacher Rating Scales (CRS) were used at the start of the study to establish baseline data and then in one month and in seven months time, at the conclusion of the study. The primary outcome measures chosen were the Conners' ADHD Index and Conners' Global Index. The secondary outcome measures chosen were the DSM-IV: Inattentive, the DSM-IV:Hyperactive-Impulsive, and the DSM-IV:Total subscales from the Conners' Rating Scales, monitoring changes in inattention, hyperactivity and impulsivity.</p> <p>Calculations for the sample size were set with a significance level of 0.05 and the power of 80%, yielding a sample size of 93.</p> <p>Discussion</p> <p>The present study should provide information as to whether the addition of NET to an existing medical regimen can improve outcomes for children with ADHD.</p> <p>Trial registration</p> <p>Australian New Zealand Clinical Trial Registration Number: ANZCTRN 012606000332527</p

Chiropractic care for paediatric and adolescent Attention-Deficit/Hyperactivity Disorder: A systematic review

<p>Abstract</p> <p>Background</p> <p>Psychostimulants are first line of therapy for paediatric and adolescent AD/HD. The evidence suggests that up to 30% of those prescribed stimulant medications do not show clinically significant outcomes. In addition, many children and adolescents experience side-effects from these medications. As a result, parents are seeking alternate interventions for their children. Complementary and alternative medicine therapies for behavioural disorders such as AD/HD are increasing with as many as 68% of parents having sought help from alternative practitioners, including chiropractors.</p> <p>Objective</p> <p>The review seeks to answer the question of whether chiropractic care can reduce symptoms of inattention, impulsivity and hyperactivity for paediatric and adolescent AD/HD.</p> <p>Methods</p> <p>Electronic databases (Cochrane CENTRAL register of Controlled Trials, Cochrane Database of Systematic reviews, MEDLINE, PsycINFO, CINAHL, Scopus, ISI Web of Science, Index to Chiropractic Literature) were searched from inception until July 2009 for English language studies for chiropractic care and AD/HD. Inclusion and exclusion criteria were applied to select studies. All randomised controlled trials were evaluated using the Jadad score and a checklist developed from the CONSORT (Consolidated Standards of Reporting Trials) guidelines.</p> <p>Results</p> <p>The search yielded 58 citations of which 22 were intervention studies. Of these, only three studies were identified for paediatric and adolescent AD/HD cohorts. The methodological quality was poor and none of the studies qualified using inclusion criteria.</p> <p>Conclusions</p> <p>To date there is insufficient evidence to evaluate the efficacy of chiropractic care for paediatric and adolescent AD/HD. The claim that chiropractic care improves paediatric and adolescent AD/HD, is only supported by low levels of scientific evidence. In the interest of paediatric and adolescent health, if chiropractic care for AD/HD is to continue, more rigorous scientific research needs to be undertaken to examine the efficacy and effectiveness of chiropractic treatment. Adequately-sized RCTs using clinically relevant outcomes and standardised measures to examine the effectiveness of chiropractic care verses no-treatment/placebo control or standard care (pharmacological and psychosocial care) are needed to determine whether chiropractic care is an effective alternative intervention for paediatric and adolescent AD/HD.</p

A clinical investigation of chiropractic neuro emotional technique (NET) for attention-deficit/hyperactivity disorder (AD/HD) in children

"August 2010"Thesis (MSc (Hons))--Macquarie University, Faculty of Science, Department of Chiropractic, 2011.Includes bibliographical references.Introduction -- Literature review: Attention-Deficit/Hyperactivity Disorder (AD/HD) -- Chiropractic care for paediatric and adolescent Attention-Deficit/Hyperactivity Disorder: a systematic review -- Methodology of a randomised controlled trial of net therapy for paediatric AD/HD -- Results of a randomised controlled trial of NET therapy for paediatric AD/HD -- Discussion of the RCT results of NET therapy for paediatric AD/HD.This thesis is an investigation of chiropractic management for paediatric Attention-Deficit/Hyperactivity Disorder (AD/HD). The aim of this thesis was to answer two questions: Q1: Does chiropractic care have a role to play in the management of paediatric AD/HD? and Q2: Does the emotional component of the Neuro Emotional Technique (NET) [a technique used by some chiropractors] have a role to play in the management of paediatric AD/HD? Traditionally AD/HD is managed by paediatricians, developmental and behavourial health specialists, clinical psychologists and allied health professionals. However, as complementary and alternative medicine gains popularity, more parents seek alternative care for their children diagnosed with AD/HD. -- A review of the AD/HD literature was conducted in order to update current understanding on the subject matter. Furthermore, a systematic review of the chiropractic literature was undertaken in order to construct a thorough profile of chiropractic care for paediatric AD/HD to answer the first research question. This systematic review found a paucity of published articles in the area and conclusions drawn that there was insufficient evidence to support the efficacy of chiropractic care for paediatric AD/HD. As a result of these findings, a unique pilot study in the form of a randomised controlled trial (RCT) was conducted on the biopsychosocial principles of NET, following the Consolidated Standards of Reporting Trials (CONSORT) checklist. This RCT was designed and undertaken in order to answer the second research question of whether the emotional component of NET can affect outcomes in paediatric AD/HD by decreasing the symptoms of inattention, hyperactivity and impulsivity. -- This study was a multi-centre study with four chiropractors (certified in NET) providing interventions for sixty-nine children. The children underwent an intense one-month management program of two sessions per week followed by another six sessions administered monthly. The parents of the participants and their teachers were the informants used throughout the study reporting on the children's behaviours, in two different contexts. The Conners' Parent and Teacher Rating Scales (CPRS-R:L and CTRS-R:L) were used as the outcome measures for this study. The results were interesting but not unusual, according to the literature. Conflicting results between the parent and teacher observations were found at months one and seven (i.e. at the conclusion of the study). The complete case analysis for the CPRS-R:L revealed statistically significant results and clinically meaningful changes in some outcome variables. Participants who were unmedicated and did not have comorbid disorders demonstrated greater improvements than the other participants. Furthermore, the intention-to-treat (ITT) analysis revealed significant results for all outcomes by the end of the study. The reliability of the teachers' observations were raised by the author and as a result, the validity of the CTRS-R:L remains uncertain. Accordingly, conclusions were drawn from the parent observations. Findings suggest that the tested aspect of NET therapy may have some role to play in the management of paediatric AD/HD. -- It is important to note that only one aspect of the NET protocol (i.e. emotional components) was examined. A study involving all aspects of the NET protocol (i.e. emotional, chemical, and physical/structural) would be needed in order to test the effectiveness of NET therapy in a clinical setting for paediatric AD/HD. Despite the limitations of this study (i.e. CRS-R low inter-rater reliability, uneven randomisation between groups and high attrition rates), the results suggest that (the emotional component of) NET therapy has some promising outcomes that may be effective in reducing some of the symptoms for some of the children with AD/HD. Definitive recommendations cannot be made about the intervention studied at this time. Despite the difficulties associated with carrying out clinical research in multiple sites and with challenging children over a long period of time, the study has provided a foundation for continuing research in the area of NET therapy for paediatric AD/HD.Mode of access: World Wide Web.xx, 374 p ill. (some col.

Paediatric attention-deficit/hyperactivity disorder and complementary and alternative therapies

According to the systematic reviews the data on the safety, effectiveness and efficacy and long-term use of stimulant medications for paediatric Attention-Deficit/Hyperactivity Disorder (AD/HD) is conflicting. Uncertainty still surrounds the balance of risks and benefits of long-term drug treatment. Current evidence strongly points to significant parental concerns about exposing their children to psychopharmacological interventions. This appears to be the case despite the evidence base for the use of stimulant medications. Children with AD/HD who are treated with stimulants often show side-effects. Across studies, the most frequently examined adverse effects of stimulant medications have been appetite suppression, weight loss, sleep disturbances, irritability, stomach aches, headaches, rashes, nausea, fatigue and occasionally the development or aggravation of tics. Cardiovascular effects and reductions in growth velocity have also been reported. Controversy over the safety and appropriateness of stimulant treatment has led to increased parental anxiety and the increased use of complementary and alternative medicine (CAM) therapies. Many parents prefer to find more natural treatments for their children with AD/HD. In general, parents seek CAM therapies for their children because a particular allopathic treatment was considered ineffective, dissatisfaction with conventional medicine, fear of drug adverse effects and a need for more personal attention for their children. As a result of this controversy, CAM therapies are sought more often by parents who have children with developmental and behavioural disorders such as AD/HD, than with any other condition. The following chapter outlines the variety of CAM therapies available for paediatric AD/HD.28 page(s

Nutritional complementary and alternative medicine for pediatric attention-deficit/hyperactivity disorder

Increasing prevalence rates of pediatric and adolescent attention-deficit/hyperactivity disorder (ADHD), concerns over the safety and efficacy of psychostimulants, and fears about long-term use of psychostimulants have led many parents to seek alternative therapies for their children. Numerous environmental factors have been suspected of influencing ADHD. Over the last few decades, there has been an increasing awareness of the importance of nutrition and the potential role it has on influencing ADHD and ADHD symptomatology. This article focuses on nutrition, dietary modifications, and nutraceuticals, which are the most commonly used complementary and alternative medicine (CAM) therapies for the management of pediatric and adolescent ADHD. The aim is to present a narrative literature review for dietary modifications and nutritional supplementation for pediatric and adolescent ADHD. Searches were made in full-text English language articles from 2000 to February 2012 in the PubMed Central, Medline, Cochrane Library, Psych INFO, Scopus, and CINAHL databases. The review revealed a full range of research strategies, but this article concentrates on randomized controlled trials, observational studies, longitudinal studies, epidemiological studies, surveys, qualitative reviews, narrative reviews, systematic reviews, and meta-analyses. The literature reveals a mixture of results in respect to dietary modifications and nutritional supplementation for children and adolescents with ADHD; however, the future of nutritional research appears promising.20 page(s

Children with attention deficit hyperactivity disorder (ADHD) managed by the neuroemotional technique (NET): A twenty case series

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A Comparative clinical investigation to determine whether the addition of the Neuro Emotional Technique (NET) to an existing treatment can improve outcomes of children with Attention Deficit Hyperactivity Disorder (ADHD)

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