{"id":11978,"date":"2013-10-17T06:00:37","date_gmt":"2013-10-17T12:00:37","guid":{"rendered":"http:\/\/www.miridiatech.com\/news\/?p=11978"},"modified":"2026-06-30T14:33:15","modified_gmt":"2026-06-30T20:33:15","slug":"addadhd-case-study-part-1","status":"publish","type":"post","link":"https:\/\/www.miridiatech.com\/news\/2013\/10\/addadhd-case-study-part-1\/","title":{"rendered":"ADD\/ADHD Case Study"},"content":{"rendered":"\n

Because I have 9 kids, I was sure when I started a practice, my focus would be on children and pregnant women\u2013since I’ve obviously had so much experience with each.<\/p>\n\n\n\n

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We can’t talk about treating kids with acupuncture without discussing the world-renowned, pediatric<\/strong>-acupuncture-specialist, Alex Tiberi<\/strong>.<\/p>\n\n\n\n

Have you ever seen or heard of Alex?<\/strong><\/h4>\n\n\n\n

I met him in my first semester at Pacific College of Oriental Medicine in San Diego. He arrived on his motorcycle with a leather backpack, straggly curly hair, mega tattoos, and cowboy boots.<\/p>\n\n\n\n

When I heard he was one of the founders of our school, and the most popular pediatric acupuncturist in the nation, I was shocked. He just didn’t look like a kid friendly<\/em> kind of guy.<\/p>\n\n\n\n

Once I met him, it didn’t take long for me to realize why kids love him. He’s real.<\/strong><\/h4>\n\n\n\n

He talks about snot, diarrhea, vomit, and temper tantrums just like a kid would\u2013facial expressions and all. Eventually, I learned he’s a genius when it comes to kids. Alex taught me that everyone should have his\/her own style.<\/p>\n\n\n\n

Quote:<\/strong><\/h4>\n\n\n\n

“Alex Tiberi practices and encourages his students and fellow practitioners to practice Oriental medicine as an Art, where culture, style, expertise and individual expression come through in treatment. He instills in his patients a confidence that they are in capable hands.”<\/em><\/p>\n\n\n\n

I never wound up opening a full-on pediatric clinic, but I do treat a lot of kids (and pregnant women) in my family practice. It was my privilege and opportunity to study with the best-of-the-best.<\/p>\n\n\n\n

Do you ever treat kids?<\/strong><\/p>\n\n\n\n

In this case study, we are going to talk about ADD\/ADHD in terms of TCM pattern diagnosis combined with graph analysis. AcuGraph has been a great resource for pediatric acupuncture in my clinic.<\/strong><\/p>\n\n\n\n

I started out with my basic TCM knowledge. Now that I’ve been able to add graph analysis<\/span> to my diagnostic skills, I have more insight to the needs of my patients.<\/p>\n\n\n\n

Parents appreciate a modern approach to Traditional Chinese Medicine. Kids… Well, they just think I’m cool (because computers are cool)!<\/p>\n\n\n\n

This blog will be a two-part series. First, we will discuss ADD\/ADHD from a TCM Pattern identification approach.<\/p>\n\n\n\n

**********<\/strong><\/span><\/p>\n\n\n\n

.<\/span>There are four main TCM patterns relating to ADD\/ADHD.<\/strong><\/span><\/p>\n\n\n\n

Heat \u2013<\/span> MOST COMMON (according to Alex Tiberi)<\/span><\/em><\/span> <\/strong><\/span><\/p>\n\n\n\n

Symptoms<\/strong>: HOT, red face, red lips. Anger, tantrums, biting, can’t sit still. Disturbed sleep, wakes up early.<\/p>\n\n\n\n

Social:<\/strong> Argumentative, runs around shouting, screaming and disturbing others.<\/p>\n\n\n\n

Pathomechanisms<\/strong>: Heat in the body rises up and affects the Heart, which houses the spirit. The Heart is easily affected by heat\u2013leading to irritability and restlessness.<\/p>\n\n\n\n

Heat Pathogenesis<\/strong>:<\/p>\n\n\n\n

\u2022 Food: hot\/spicy, flavorings, food colorings
\n\u2022 Lingering pathogens
\n\u2022 Lingering fever
\n\u2022 Womb heat (transferred through the placenta from Mom)<\/p>\n\n\n\n

*If antibiotics are used to clear a fever, heat can be lodged in the system. Immunizations can also cause lingering heat pathogens.<\/p>\n\n\n\n

Treatment principles:<\/strong> Clear heat from the Liver; calm the spirit.<\/p>\n\n\n\n

Heat + Phlegm<\/strong><\/span><\/h4>\n\n\n\n

Symptoms<\/strong>: Hot symptoms PLUS mania-type symptoms including aggressivity, and violence.<\/p>\n\n\n\n

Social<\/strong>: Willfully destructive\u2013tearing things apart, breaking toys; hitting, kicking, and cruelty to other children. Kids do things they know are wrong, but don’t care because their morals are blotted out.<\/p>\n\n\n\n

Pathomechanisms<\/strong>: Heat combined with phlegm rise up to affect the Heart and disturb the spirit\u2013leading to anger and willful acts of aggression. Phlegm causes the mind to be clouded, which can lead children to do things they know are wrong\u2013without feeling moral consequences.<\/p>\n\n\n\n

Phlegm\/Heat Pathogenesis<\/strong>:<\/p>\n\n\n\n

\u2022 Lingering pathogen from immunizations
\n\u2022 Food: dairy, refined sugar, wheat
\n\u2022 Accumulation disorder: Eating the same damp\/heat creating foods over and over<\/p>\n\n\n\n

Treatment principles<\/strong>: Clear heat, resolve phlegm.<\/p>\n\n\n\n

SPLEEN DEFICIENCY<\/strong><\/span><\/p>\n\n\n\n

Symptoms: <\/strong>High energy, poor appetite, bloating, gas, poor memory; anxious, restless, fidgety, can’t sit still. Instead of having heat boiling up inside like the above two patterns, this patient is pale or gray in the face with possible feelings of cold.<\/p>\n\n\n\n

Social<\/strong>: Needs attention and acts out when attention is not received; manipulation, hatred.<\/p>\n\n\n\n

Pathomechanisms<\/strong>: When the child isn’t getting the energy from the Spleen through good nourishment, he\/she reaches out to those around them (typically the parents). If qi is withheld for some reason, the child gets angry, probably because he\/she is frightened from loss of energy. The qi becomes deficient and the blood does not circulate properly, withholding nourishment from the Heart. The child then becomes anxious, restless, fidgety, and can’t sit still.<\/p>\n\n\n\n

Spleen Deficiency Pathogenesis<\/strong>:<\/p>\n\n\n\n

\u2022 Immunizations
\n\u2022 Lengthy childbirth
\n\u2022 Anesthetics in childbirth
\n\u2022 Long-term food accumulation disorder
\n\u2022 Drinking too much fruit juice
\n\u2022 Not having boundaries<\/p>\n\n\n\n

*These children seem to be good at manipulating parents. They manage to get their way in most things. They draw on their parents’ energy, which in turn becomes more and more exhausted\u2013thus parents are not able to stand up to the child.<\/p>\n\n\n\n

Treatment principles:<\/strong> Tonify the Spleen<\/p>\n\n\n\n

Kidney Deficiency<\/strong><\/span><\/h4>\n\n\n\n

Symptoms: <\/strong>Frail and weak, tends towards hyperactivity when they are tired or excited. Don’t like to go to bed even though they are tired. Even though they are hyper, they don’t generally become violent. During the day they might be weak and lethargic.<\/p>\n\n\n\n

Social<\/strong>: Easily startled, slow development.<\/p>\n\n\n\n

Pathomechanisms<\/strong>: The Kidney energy is weak\u2013thus can’t hold the energy down, and it rises up to the Heart and mind resulting in hyperactive behavior. Symptoms are worse when the child is tired.<\/p>\n\n\n\n

Kidney Deficiency Pathogenesis<\/strong>:<\/p>\n\n\n\n

\u2022 Constitutional Kidney weakness\u2013weakness from the parents, genetic disorders, severe illness during pregnancy
\n\u2022 Long-term illness
\n\u2022 Severe illness<\/p>\n\n\n\n

Treatment principles:<\/strong> Tonify kidney yin, regulate the nervous system, bring energy up.<\/p>\n\n\n\n

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**********<\/strong><\/span><\/p>\n\n\n\n

.<\/span><\/p>\n\n\n\n

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You’ll notice each of the TCM patterns listed above affect the Heart and mind. We can’t talk about a modern-day diagnosis without considering the effect of modern lifestyle choices. I found this quote in a pediatric TCM textbook:<\/p>\n\n\n\n

“Hyperactivity is almost unknown in China, whereas it is now well-recognized in the West as a major problem.”<\/em><\/p>\n\n\n\n

Isn’t that sad?<\/strong> The lifestyle we have created in the West is obviously hurting our children.<\/strong><\/span><\/p>\n\n\n\n

Here’s a list of common Western lifestyle choices leading to hyperactivity and Attention Deficit Disorder.<\/p>\n\n\n\n

\u2022 Spicy Foods                         \u2022 Greasy Foods
\n\u2022 Antibiotics                           \u2022 Immunization
\n\u2022 No Parental Boundaries   \u2022 No Exercise
\n\u2022 Over-stimulation                \u2022 TV, Computers, and Digital Devices
\n\u2022 Disruptive Home Life<\/p>\n\n\n\n

Too many children are stuck in cyclical lifestyle that promotes ADD\/ADHD. What help are these kids getting from their Western medical doctors? Drugs. That’s it. We, as responsible, well-educated, medical providers, need to educate our communities regarding the benefits of a Traditional Chinese Medicine approach to ADD\/ADHD\u2013involving not only acupuncture and herbology, but lifestyle changes.<\/p>\n\n\n\n

Alex Tiberi taught me that kids don’t really want to misbehave.<\/strong><\/h4>\n\n\n\n

“They do not want to be like this; they are often desperate to stop their behavior and are miserable because of it. With your treatment, you can actually ‘bring them back’ to their parents and family. They turn from aggressive, difficult children into happy, lively, and contented kids who are a joy to be with. “<\/em><\/p>\n\n\n\n

It doesn’t take much to make an energetic shift in a kid’s body\u2013yet the changes that occur are literally life changing for these kids.<\/p>\n\n\n\n

The following section shows a graph report from a child with ADD, and discusses how meridian imbalances were affecting his ADD and other symptoms in his body.<\/p>\n\n\n\n

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<\/p>\n\n\n\n

\"Green<\/a><\/figure>\n\n\n\n

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.<\/span><\/p>\n\n\n\n

Case Study:<\/strong><\/span><\/p>\n\n\n\n

11-year-old-male<\/p>\n\n\n\n

\u2022 Emotions<\/strong>: Frustration, worse in the morning; parents have to constantly push, which leads to yelling. Occasional panic attacks. Holds emotions in and then screams into his pillow as an outlet. Better if he can run or ride his horse.
\n\u2022 Diet<\/strong>: Grilled cheese and pizza kind of kid. Would choose these always IF mom would let him.
\n\u2022 Digestion<\/strong>: Gas and stomach ache.
\n\u2022 Sleep<\/strong>: Trouble falling asleep and staying asleep; bad dreams 50% of the time; nighttime incontinence.
\n\u2022 School<\/strong>: Dyslexia, likes to read, self-confidence issues.
\n\u2022 Pain<\/strong>: Headache between the eyes (at Yin Tang), radiating up to the top of his head, caused by yelling or dehydration, sharp and throbbing in nature; neck and shoulder  tension.
\n\u2022 Other<\/strong>: No palpitations, but feels heartbeat in the tip of his forefinger and his neck; eye twitching.<\/p>\n\n\n\n

Chief complaint: ADD<\/strong><\/p>\n\n\n\n

I’m going to walk you through my own thinking process when I’m looking at a graph for a new patient. I’ll also alert you to things I’m seeing in the graph, which lead me to ask further questions.<\/p>\n\n\n\n

STEP 1:<\/strong><\/span><\/p>\n\n\n\n

Baseline Graph<\/strong><\/span><\/em><\/p>\n\n\n\n

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<\/p>\n\n\n\n

In the baseline graph, I’m looking at the differences between the hand and foot channels. What is happening in the upper body (hand) channels versus the lower body (foot) channels.<\/p>\n\n\n\n

For this patient, you’ll notice there seems to be more excess in the lower body channels than the upper body channels. An easy way to confirm my thoughts is to look at the Ratio Graph….<\/p>\n\n\n\n

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Notice how the red plus sign is lower. When the upper body and lower body channels are well balanced, the cross will be find right in the center of the screen.<\/p>\n\n\n\n

Thought:<\/strong> I may consider treating the Dai Mai for this patient…. TE 5, GB 41<\/span><\/em><\/p>\n\n\n\n

 <\/p>\n\n\n\n

STEP 2:<\/strong><\/span><\/p>\n\n\n\n

Yin\/Yang Graph<\/strong><\/em><\/span><\/p>\n\n\n\n

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<\/p>\n\n\n\n

The significant thing I see here is excess in the Small Intestine and Bladder channels in the Tai Yang channel pairing. I’ve typically found that when there is excess in these channels it relates to tendinomuscular problems.<\/p>\n\n\n\n

Question:<\/strong> Are you having any neck, back or shoulder pain?<\/span><\/em><\/p>\n\n\n\n

I also notice that the Triple Energizer is deficient in comparison to the Gallbladder in the Shao Yang channel pairing.<\/p>\n\n\n\n

Thought<\/strong>: More confirmation for treating the Dai Mai… TE 5, GB 41<\/span><\/em><\/p>\n\n\n\n

 <\/p>\n\n\n\n

STEP 3:<\/strong><\/span><\/p>\n\n\n\n

Element Graph<\/strong><\/em><\/span><\/p>\n\n\n\n

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<\/p>\n\n\n\n

He has several elements out of balance, but the first one that jumps out at me is Wood. Both the Liver and GB are high.<\/p>\n\n\n\n

Questions<\/strong>:<\/span><\/em><\/span><\/p>\n\n\n\n