Can Chiropractic Care Help Children with ADHD? What Science Reveals

Exploring the evidence behind chiropractic interventions for Attention-Deficit/Hyperactivity Disorder in pediatric populations

The Search for ADHD Solutions Beyond Medication

ADHD Prevalence

Approximately 11.4% of children aged 3-17 years in the United States—about 7 million—have received an ADHD diagnosis ² .

Treatment Gap

Up to 30% of children don't respond adequately to stimulant medications ⁹ .

Attention-Deficit/Hyperactivity Disorder (ADHD) ranks among the most common neurodevelopmental disorders in childhood, affecting millions of children worldwide. Characterized by persistent patterns of inattention, hyperactivity, and impulsivity, ADHD can significantly impact a child's academic performance, social relationships, and family dynamics.

While medication and behavioral therapy remain the most evidence-supported treatments, the limitations of conventional approaches have led many parents to seek complementary alternatives. Surveys indicate that 19% of children with ADHD use complementary and alternative medicine, with chiropractic care ranking as the fourth most popular approach after meditation, yoga, and breathing exercises ¹ ⁴ .

Conventional Treatments

Stimulant medications and behavioral therapy are the primary evidence-based approaches, but they don't work for all children and may have side effects.

Complementary Approaches

Many families explore alternatives like chiropractic care, often in conjunction with conventional treatments.

Understanding ADHD: More Than Just Behavior

ADHD is far more complex than simple behavioral problems. Modern neuroimaging research has revealed structural and functional differences in the brains of individuals with ADHD, particularly in the prefrontal cortex—the area responsible for executive functions like attention regulation, impulse control, and planning ¹ ⁴ .

Prefrontal Cortex Differences: 85%

Sensory Processing Issues: 75%

Delayed Brain Maturation: 65%

Studies consistently show slower maturation, reduced activity, and decreased volume in the prefrontal cortex of those with ADHD ¹ ⁴ . Additionally, researchers have identified neurological deficits in somatosensory processing and sensorimotor integration—the brain's ability to process sensory information and translate it into appropriate motor responses ¹ ⁴ .

These neurological findings are significant because they suggest that ADHD involves fundamental differences in how the brain processes information and regulates attention and behavior—not just a "willpower" or discipline problem.

The Chiropractic Hypothesis: Can Spinal Adjustments Affect Brain Function?

Chiropractors proposing ADHD treatment suggest that spinal adjustments may influence brain function through several theoretical mechanisms:

Enhancing Prefrontal Cortex Function

The primary theory suggests that chiropractic adjustments may enhance prefrontal cortex activity, potentially improving the executive functions that are typically impaired in ADHD ¹ ⁴ .

Improving Sensorimotor Integration

Research indicates that chiropractic adjustments can alter somatosensory processing and sensorimotor integration in various populations ¹ ⁴ . Since children with ADHD often display abnormalities in these areas, this provides a theoretical basis for potential benefits.

Reducing Neural Interference

Some chiropractors propose that spinal misalignments may create neural interference that disrupts normal brain function, and that correcting these misalignments may restore proper nervous system communication ⁵ ⁸ .

Important Note: These mechanisms remain theoretical, with limited direct evidence specifically supporting their application to ADHD.

A Closer Look at the Science: Groundbreaking ADHD Chiropractic Study

Recent research has attempted to bring scientific rigor to this controversial topic. A 2024 pilot randomized controlled trial published in Frontiers in Psychology represents one of the most methodologically sound studies to date ¹ ⁴ .

Study Methodology: Setting Up a Robust Experiment

The study involved 67 children with ADHD who were randomly assigned to one of two groups:

Chiro+UC Group

Received chiropractic adjustments plus usual care

Sham+UC Group

Received sham chiropractic plus usual care

The researchers implemented strict methodological controls:

Blinding: Participants and teachers assessing outcomes didn't know which treatment children received
Standardized assessments: Used validated ADHD rating scales (VADTRS, SNAP-IV, ADHD Rating Scale-IV)
Multiple time points: Measured outcomes at baseline, 4 weeks, and 8 weeks
Sham controls: Designed to isolate specific effects of chiropractic adjustments

Results: Surprising Findings and Important Caveats

The findings revealed intriguing patterns:

**Table 1: Changes in ADHD Symptoms Over Time**
Assessment Period	Chiro+UC Group	Sham+UC Group
Baseline	Elevated ADHD scores	Elevated ADHD scores
4 Weeks	Significant improvement	Significant improvement
8 Weeks	Significant improvement	Significant improvement

**Table 2: Between-Group Comparisons**
Comparison	Result
Chiro+UC vs. Sham+UC at 4 weeks	No significant difference
Chiro+UC vs. Sham+UC at 8 weeks	No significant difference
Overall between-group differences	Non-significant

Both groups showed significant improvement in ADHD symptoms over time, but critically, no significant differences emerged between the actual chiropractic and sham treatment groups ¹ ⁴ .

The researchers concluded that while it's feasible to study chiropractic care for ADHD, the lack of between-group differences means we cannot attribute improvements specifically to chiropractic adjustments ¹ ⁴ . The similar improvements in both groups may result from placebo effects, natural maturation, or other non-specific factors.

The Researcher's Toolkit: How Scientists Measure Chiropractic Effects on ADHD

Conducting rigorous research on chiropractic care for ADHD requires specialized tools and methods:

**Table 3: Key Assessment Tools in ADHD Chiropractic Research**
Tool	Purpose	How It Works
Vanderbilt ADHD Diagnostic Teacher Rating Scale (VADTRS)	Measures classroom behavior and academic performance	Teachers complete questionnaires about specific behaviors
Swanson, Nolan and Pelham Teacher and Parent Rating Scale (SNAP-IV)	Assesses core ADHD symptoms	Rates frequency and severity of inattention, hyperactivity, impulsivity
ADHD Rating Scale-IV	Evaluates DSM-IV defined ADHD symptoms	Structured assessment aligning with diagnostic criteria
Pediatric Quality of Life Inventory™	Measures health-related quality of life	Assesses physical, emotional, social, and school functioning
Strengths and Difficulties Questionnaire	Evaluates behavioral adjustment	Screens for emotional, conduct, and peer problems

Weighing the Evidence: What Does the Research Really Say?

The 2024 pilot trial reflects the broader scientific literature on chiropractic care for ADHD, which remains limited and inconclusive:

Supportive but Limited Evidence

Some lower-quality studies have reported positive findings:

A retrospective case series of four patients found improvements in hyperactivity, impulsivity, and inattentiveness
A retrospective review of 180 children reported statistically significant improvements in hyperactivity and quality of life ³
Several case reports have described individual children who improved with chiropractic care ¹ ⁵

However, these study designs cannot establish cause and effect, and they lack appropriate control groups.

Systematic Reviews: Insufficient Evidence

More rigorous evaluations tell a different story:

A 2010 systematic review found no high-quality studies supporting chiropractic for ADHD and concluded there was "insufficient evidence to evaluate efficacy" ⁹
A 2024 comprehensive review of pediatric chiropractic care concluded there is "little evidence of efficacy" for ADHD ⁷
Most experts agree that the evidence remains preliminary and insufficient to recommend chiropractic as a primary ADHD treatment ⁶ ⁷

Evidence Timeline: Evolution of Research on Chiropractic for ADHD

Early Case Reports (1990s-2000s)

Initial anecdotal reports and small case series suggested potential benefits but lacked scientific rigor.

Systematic Review (2010)

First systematic review found insufficient evidence to evaluate efficacy of chiropractic for ADHD ⁹ .

Retrospective Studies (2010s)

Larger retrospective reviews reported improvements but still lacked control groups and randomization.

Pilot RCT (2024)

First randomized controlled trial with sham controls found no significant difference between real and sham chiropractic ¹ ⁴ .

Safety Considerations and Professional Guidance

When considering any treatment for children, safety is paramount:

Adverse Events

Serious adverse events from pediatric chiropractic care appear to be rare, with most techniques being gentler than those used on adults ⁷ .

Delayed Diagnosis

Significant risks have been documented, including delayed diagnosis and inappropriate use of chiropractic for serious conditions ⁷ .

Unproven Therapies

Some chiropractors may promote unproven therapies or supplements that could interact with medications ⁸ .

Important Warning: Medical professionals emphasize that chiropractic care should never replace evidence-based treatments for ADHD ⁷ ⁸ . The American Academy of Pediatrics recommends behavior therapy as the first-line treatment for young children, with medication added for older children when appropriate ² .

Conclusion: Navigating Treatment Options for ADHD

The current scientific evidence suggests that while chiropractic care appears relatively safe for children, there is insufficient evidence to support its use as a primary treatment for ADHD. The improvements seen in some studies may result from placebo effects, natural development, or the additional attention children receive during treatment rather than specific benefits of spinal adjustments.

Recommendations for Parents

For parents considering chiropractic care for their child with ADHD, the most prudent approach would be to:

Do

Prioritize evidence-based treatments first (behavioral therapy and/or medication)
View chiropractic as a potential complementary approach rather than alternative to conventional treatment
Discuss all treatments with their pediatrician to ensure coordinated care
Choose practitioners who are properly trained in pediatric care and who respect conventional medicine

Don't

Replace evidence-based treatments with unproven alternatives
Fall for bold claims without scientific backing
Use chiropractic care as a standalone treatment for ADHD
Delay conventional treatments while exploring complementary approaches

Final Thought: As research continues to evolve, we may gain clearer answers about whether chiropractic care can play a meaningful role in ADHD management. For now, parents should maintain healthy skepticism toward bold claims and focus on treatments with strong scientific support while remaining open to safe complementary approaches that don't interfere with evidence-based care.

The journey to find the right combination of treatments for a child with ADHD is deeply personal. By grounding decisions in scientific evidence while respecting individual needs and preferences, families can make informed choices that offer the best chance for success and well-being.