ADD / ADHD – Neurofeedback and Attention Deficit Disorder

Attention Deficit Hyperactivity Disorder (ADHD) is characterized by inattention, distractibility and impulsivity. Three main subtypes have been identified: one is dominated by inattention (usually referred to as ADD or ADHD without Hyperactivity); another is characterized mainly by impulsivity and hyperactivity (usually referred to as ADHD or ADHD with Hyperactivity); and a third that is referred to as ADHD, combined type.

Often ADHD is accompanied by more severe behavioral symptoms, such as opposition and poor conduct, as well as by specific learning disabilities.

Leaders in the field recognize that ADHD is best addressed by a variety of approaches, including parent training, psychotherapy, dietary changes and nutritional support, improved quality of sleep, medication, and now Neurofeedback training. Before a diagnosis of ADHD is made, specific attention must be paid to medical factors that could contribute to the disorder, such as allergies or the presence of toxic metals, and educational factors, such as specific learning disabilities. Other conditions such as primary depression, anxiety, and seizure activity can also impact the diagnosis.

Depending on the nature of the underlying problem, medical management of ADHD may consist of stimulants, anti-depressants, or anti-convulsant medication. There has been increasing concern by medical professionals in the field, as well as the educated public, that resorting quickly to medication for children with ADHD has led to an over-simplification of this complex condition. This in turn has led to the over-diagnosis and ultimately the over-medication of many children and adults.

In fact Michigan for example is one of the leading states (top 5) for prescription drugs given to children and adults for ADHD. The United States also consumes approximately 97% of all the Ritalin in the world. In a recent publication made by the National Institute of Mental Health (February 4, 2002)it was estimated that an average of up to 15% of the nations children were diagnosed ADHD and were taking stimulant medications, based on a sample size of around 6,000 participants. Is this because there truly is a pandemic problem with the rise of ADHD children, or are we too quick to “diagnose” and medicate? Regardless, there has always been and still remains other options, which are simply not as popular as medications. Interestingly enough, this study also reported that in only 40% of the cases were medications even helpful in reducing any of the symptoms of ADHD.

Neurofeedback, has been shown to reduce and even eliminate the characteristic symptoms of ADHD and the related conditions, which are the immediate cause of medical referrals. The training has also been shown to have lasting effects, in contrast to medication. The effectiveness of medication in even temporarily normalizing a child’s behavior is proof that the child’s brain is capable of functioning normally. Neurofeedback simply allows us to accomplish that task with objective and measurable data.

What then is the role of stimulant medication? It is to induce a temporary functional change in the brain. The common remedy, Ritalin or the new “longer lasting” Concerta for example, does not supply a missing neurotransmitter. It is not like supplying insulin to a diabetic (in contrast to what you may have been told). It is also not like providing glasses to a near-sighted person. Ritalin, like Concerta, Adderal, and Cylert is not Vitamin R, either. Ritalin, which is a controlled stimulant, simply speeds the brainwaves up in those children and adults for which it is appropriate, by impinging on the state of regulation of several neurotransmitter systems (dopamine and norepinephrine). Once the medication is metabolized (used up) however, the brainwaves revert back to the same slower dominating brainwave that existed before, regardless of how long you have been taking the medication. This is why medication will only mask the symptoms and never will they “fix” the problem.

Neurofeedback training rewards the child or adult for changing brainwave activity toward what is more characteristic of a functional brain. In other words, when the child or adult learns how to speed their own brainwaves up, without the use of the medication, they are rewarded. The learning process is much like riding a bike. However, it can be difficult to explain because it is largely an unconscious act. (Go ahead and try to explain to someone how to ride a bike. You will then understand the complexity of this problem). Neurofeedback challenges the individuals brain to self-adapt to a more functional state. It is best considered as mental fitness training that over time teaches the individuals brain improved skills of managing attention, arousal (level of excitability), and affective or emotional state. The individual’s brain already manages attention, arousal, and affective state to a certain degree, and the relevant mechanisms are in place to do so. Simply exercising those mechanisms strengthens them, and allows the individual to have better control over his or her own behavior automatically, just as these things are automatic for those of us who don’t have ADHD. Basically, Neurofeedback simply employs learning strategies that have been proven effective. For example, we incorporate visual feedback, audio feedback, and tactile feedback, which are the three ways in which we learn new tasks. Although we all learn better with one form or the other, if you use all three at once, you are very likely to learn the information quickly. If a child exhibits more severe disruptive behaviors, Neurofeedback will help to diminish and eventually for many, eliminate those troublesome behaviors. The child or adult will likely also notice an improvement in their quality of sleep, if this is a problem to begin with, which it usually is with the use of stimulant medications. Associated depression and anxiety will be found to be alleviated as well with the training.

With a more functional brain, the child or adult will exhibit his or her natural intellectual abilities, and measured IQ scores will likely increase significantly with the training as well. This is not because Neurofeedback will make someone smarter, but rather because it will allow the person to be more available to reach the potential they already possessed.

Neurofeedback training can also be helpful with specific learning disabilities such as dyslexia, dysgraphia, and dyscalculia, as well as with poor visual and auditory memory. Neurofeedback should therefore be considered as part of a comprehensive program for addressing the needs of the ADHD child/adult, learning disabled, or behaviorally disregulated.

Moreover, a child does not have to meet specific diagnostic criteria in order to benefit from the training. Neurofeedback training is a challenge to any brain to get it to function better.

In summary, Neurofeedback is a safe, proven, and non-invasive alternative that should be given a great deal of “attention” due to the overwhelming success qualified practitioners and researchers are having and have had for more than thirty years. Individuals may say many things about this modality, but the fact of the matter is that it simply works for about 8 out of 10 people. With the family support network in place and minimal compliance, success is very likely to be high. The technique will only get better and better with advancements in computers, until their will be no question as to the efficacy of this powerful intervention. With that being said, be cautious about anyone’s claims of success. There is no cure all or silver bullet, so know your options and explore them carefully.

If you would like to learn more about your options, please contact The Institute for additional information at 248-828-2770.

This article was written with excerpts taken from a 1999 publication of Nursing Excellence (June/July), authored by Donald E. Deering, et. al. Send your comments to: info@expertsinmind.com

NeuroHealth Associates

NOTE: The word Neurobiofeedback is a word that was coined by The Institute and it simply refers to the combination of both traditional biofeedback (EMG/muscle feedback) and neurofeedback (EEG/brainwave feedback). You may see many variations in the descriptions of this field, i.e. biofeedback, neurofeedback, EEG-Biofeedback, etc. However, when referring to ADHD, neurofeedback (brainwave training) is what is being discussed. Because ADHD is in the brain and not in the foot for example, traditional biofeedback would simply not be as effective in alleviating the symptoms of ADHD.

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