Micronutrient treatment for children with emotional and behavioral dysregulation: a case series.
BACKGROUND
In clinical studies of adults and children, broad-spectrum micronutrients (minerals and vitamins) have proven beneficial for improving mood regulation and attention. We report here pilot work whose primary objective was to evaluate the feasibility of studying micronutrient treatment in school-aged children with emotional and behavioral problems. Issues examined included feasibility of participant recruitment from a culturally diverse population, probability of sample retention for a 12-week trial, acceptability of the outcome measures, supplement adherence, as well as trends in treatment benefit.


METHODS
The families of two boys (ages 5 and 6) and one girl (age 14) were invited to participate in a 12-week pilot trial of micronutrients carried out during the summer months. All children were enrolled in the private school at which future research was being considered. During the previous school year, all three had been extremely difficult to educate due to their inability to pay attention and learn, as well as their behavior problems. Although the two younger children had not been formally diagnosed, parents and teachers provided reports of hyperactivity and inability to focus on education in the classroom. The oldest child was often aggressive, and had been diagnosed with bipolar disorder, attention deficit hyperactivity disorder, and oppositional defiant disorder. All three children were Hispanic and spoke both Spanish and English. For 12 weeks, after signing consent forms, the children's parents provided weekly ratings on the parent-report Child Mania Rating Scale; the children consumed the micronutrient formula daily and provided a daily rating of how they felt. The parent ratings revealed significantly improved behavior, p = .002. Children's ratings approached the ideal level of 7, indicating "happy" self-reports. Parent interviews confirmed the weekly scores. Several feasibility questions were answered: all three children completed the 12-week trial, all scores were completed by parents and children, adherence to the protocol was excellent, and no adverse reactions emerged.


CONCLUSIONS
Family physicians and pediatricians are often confronted with the challenge of improving the lives of families whose children experience school crises due to emotional and behavioral dysregulation. Three children, who participated in pilot work to determine the feasibility of further investigations, experienced impressive changes that clearly warrant both research and clinical exploration.
Faculty of Medicine, University of Calgary, The Child Development Centre, 3820 - 24 Avenue NW, Calgary, AB, T3B 2X9, Canada. Kaplan@ucalgary.ca.
Bonnie J
BJ
Kaplan
, 59 Dogwood Trail, Ocala, FL, 34472, USA. paulaehilbert@gmail.com.
Paula
P
Hilbert
, 1501, 1410 1 St SE, Calgary, AB, T2G 5 T7, Canada. ekaterina.tsatsko@gmail.com.
Ekaterina
E
Tsatsko
D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000178:diet therapy* / Q000523:psychology*; D000067290:Behavior Rating Scale; D002648:Child; D002675:Child, Preschool; D004644:Emotions; D005260:Female; D006801:Humans; D008297:Male; D018977:Micronutrients / Q000627:therapeutic use*; D010865:Pilot Projects; D000066553:Problem Behavior; D057566:Self Report
D018977:Micronutrients