Effect of Fish Oil Supplements
on ADHD & Reading Ability
Fish and evening primrose oil combination improves educational and behavioral measures in children with developmental coordination disorder
Author: Donald Brown, ND
Reference: Richardson AJ, Montgomery P. The Oxford-Durham study: A randomized, controlled trial of dietary supplementation with fatty acids in children with developmental coordination disorder. Pediatrics 2005;115:1360-6.
Design: Randomized, double-blind, placebo-controlled clinical trial
Participants: 117 children (ages 5 to 12 years; 78 boys and 39 girls) with a diagnosis of developmental coordination disorder (DCD). DCD, as defined in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), involves specific impairments of motor function independent of general ability. It affects approximately 5% of children to a serious degree and shows substantial overlap with ADHD, dyslexia, and autistic spectrum disorders. In the academic setting, the primary difficulties are with written language (i.e., the overlap with dyslexia) and/or difficulties with organizational skills, attention, and behavior (i.e., overlap with ADHD symptoms), although these are typically compounded by low self-esteem and behavioral problems.
Study Medication and Dosage: The active treatment was capsules containing 80% fish oil and 20% evening primrose oil -- children received 2 capsules t.i.d. Six capsules supplied 558 mg of eicosapentaenoic acid (EPA), 174 mg of docosahexanoic acid (DHA), 60 mg of gamma-linoleic acid (GLA), and 9.6 mg of vitamin E (alpha-tocopherol). Placebo capsules contained olive oil. The source of the essential fatty acids (EFA) and placebo capsules was not disclosed.
Duration: 3 months, followed by a 1-way crossover from placebo to active treatment for an additional 3 months
Outcome Measures: The primary outcome measures were the changes observed during the 3 months of treatment on age-standardized tests of (1) motor function (assessed with the Movement Assessment Battery for Children), (2) reading and spelling achievement (assessed with the Wechsler Objective Reading Dimensions), and (3) teacher-rated ADHD-related symptoms (assessed with Conners' Teacher Rating Scales, Long Version CTRS-L]).
Key Findings: During the 3-month parallel-group phase, the mean increase in reading age was 9.5 months for the EFA group compared to 3.3 months for the placebo group (p < 0.004). The mean increases in spelling age were 6.6 months for the EFA group compared to 1.2 months for the placebo group (p < 0.001). On the CTRS-L, scores decreased from a mean of 74.7 to 58.1 in the treatment group compared to almost no change in the placebo group (p < 0.0001). After 3 months of treatment, only 24 children still had CTRS-L scores that placed them in the clinical range for ADHD. Among those receiving EFA, 7 of the initial 16 no longer fell into this category compared to only 1 of 16 in the placebo group. There were no significant differences in motor skills between the two groups. After crossover, similar changes were seen in the group previously taking placebo during the 3-month, parallel group phase and children continuing on EFA treatment maintained or improved their progress.
Practice Implications: This amazing study is the first of its kind with children diagnosed with DCD. In this group of children, delays in literacy development usually increase over time, indicating the value of early intervention. As noted in the results of the study, children in the placebo group fell even more behind, although they did show some average progress in reading. In contrast, children in the EFA group made three times the expected improvement in reading and twice the expected improvement in spelling, bringing their values close to normal values! Equally interesting is the fact that continued EFA treatment led to either maintained or improved progress.
It's important to note that children who meet the criteria for DCD and ADHD by age 7 show a particularly poor prognosis on both academic achievement and psychosocial adjustment when evaluated at age 22. Hopefully, future clinical trials will be funded to compare different EFA combinations and dosages as well as delivery forms that will be lead to greater compliance with this pediatric population
Last modified on 01.13.10
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