By Cristina Porch-Curren, M.D.
As a physician I can’t tell you how often I am asked, “Do you think my child has ADD?”
This is a common concern among parents, especially those with young boys. I seem to get a lot of questions about the disorder, whether I am at a playgroup with my two young sons, or in the office seeing patients. As an allergist, I also get many questions from parents about a possible link between allergies and attention deficit disorder (ADD), or attention deficit hyperactivity disorder (ADHD). These questions stem from articles in the medical literature reporting that children with allergies are at higher risk to develop ADD/ADHD.
I treat children with hay fever and asthma on a daily basis, and we know that the number of children with allergic disease is increasing. For example, the percent of children with asthma has more than doubled from 1980 to 1995, from 3.6 percent to 7.5 percent. There are many possible explanations for this trend, including increased air pollution, more hay fever, less infectious disease, and earlier diagnosis of asthma. It is estimated that nearly 20 percent of people in industrialized societies suffer from hay fever. The percent of school age children with ADD/ADHD is like to range from 6-9 percent and appears to be increasing.
These facts post interesting questions for us, as parents and doctors. Do allergies cause ADD/ADHD? Or perhaps does hay fever mimic or exacerbate the symptoms of ADD/ADHD?
ADD/ADHD are neuro-developmental disorders more commonly diagnosed in boys. There are multiple variable symptoms including inattention, hyperactivity, impulsivity, and often difficulty sleeping at night. As a result of this symptom complex, success in school can be compromised.
Complicating this issue are the similar characteristics seen in children with allergies, particularly hay fever. Children with untreated hay fever may have problems sleeping, can be described as restless, and have difficulty paying attention to instruction in school. Exacerbating the problem are the various over the counter medications used for allergies. These medicines can cause children to be more sleepy while at school. Think about this in real terms, as they would apply to you as an adult. You can’s sleep at night because your nose is plugged up and you have to breathe with your mouth open. Then you take a medicine, which makes you drowsy. Can you imagine trying to work all day and be productive? Many of our children are expected to do just that and if you combine it with ADD or ADHD the problems are magnified.
As physicians, we have found no clear link or causal relationship between allergies and ADD/ADHD. Some studies have shown a possible relationship between the two, while others have shown that this is not the case. We do know that allergies and ADD/ADHD can co-exist, but there is no direct evidence or consensus that one causes the other. We are faced with the challenge of sorting out the symptoms and determining if they are the result of allergies, ADD/ADHD, or both.
As allergists, we have the training to obtain a careful history and perform simple skin tests to identify if allergen sensitization is playing a role in your child’s symptoms. If allergy is identified, we have the expertise to treat your child in the most appropriate manner. Our goal is to minimize symptoms so your children are best prepared for their daily activities.