Drug Free Therapy for ADD and ADHD

     Most children and adults can focus and pay attention to a particular task or subject when called on to do so. While playing or socializing with friends, there is sharing and peaceful interchange; when interacting with family members, there is rational behavior; when taking an exam, most can concentrate on the questions, recall the studied information, and write the correct answer.
     For about one in ten, however, the ability to focus is blunted to a point of negatively affecting life. School or work is catastrophic, with failure the rule; family life is chaotic, with upheaval common; peer group and sibling relationships are "war."
     Such a major, life-disrupting problem with focus and attention may be what the medical, psychological and educational community call Attention Deficit Disorder (ADD). If the person also has a serious problem with impulsive behavior, with excessive, socially inappropriate physical movement, the diagnosis is likely to be Attention Deficit Disorder with Hyperactivity (ADHD).

     It is Dr. Marvin Sams', Director of Neurofeedback Centers of America, opinion that the severe focus and attention problem commonly called Attention Deficit Disorder is misnamed. Based on his experience of working with hundreds of children and adults with a diagnosis of ADD/ADHD, he is convinced that a more accurate designator is Intention Deficit Syndrome.
     Attention, defined as the act of mentally concentrating on a single object, thought, or event, is not the real problem in Attention Deficit Disorder. Virtually all with a "pure" diagnosis of ADD (that is, without co-existing learning disabilities) are able to focus, often in a very intense way, on a task or project that is of high interest to him or her. It is not uncommon, for example, for children who do poorly in the classroom to play video games for hours on end, without eating or even going to the bathroom.
     Adults, particularly men, may be unable to keep a job due to poor ability to focus and perform required tasks. Yet, the same people are able to spend hours in front of the TV, watching and being emotionally engaged in one sporting events after the other. Attention is only interrupted during commercials - - to get a snack, or to yell for someone else to get it for them.
     The inability to do undesirable tasks or jobs is in and of itself not a malicious act; most children and adults diagnosed as ADD are unusually bright, uniquely insightful, and fun loving people. It's just that brain wave patterning prohibits intentional and deliberate focusing on a task that is low or no interest.
     Intention, that is, purposely focusing and concentrating our mental powers on a single task or subject, whether it is of particular interest or not, is not easy (and sometimes is apparently impossible) for the person seriously affected with ADD. The problem is not one of attention. Rather, it is a problem with intention -- an inability to focus on purpose.

     The PET scan (positron emission tomography) is a special imaging technique used to reveal where in the brain a task is being performed. In this procedure, a glucose-based substance with a radioactive marker is injected into the blood stream. As the brain uses its various specialized areas to process and execute the assigned task, active cells "take up" the glucose/radioactive substance. A special scan (picture) is then taken.
     Brain areas working on the task, show as colors on the image, making for a dramatic display of where the brain is doing its work.
In those with a clinical diagnosis of ADHD, the brain does not take up as much glucose in certain brain areas as people who attend normally. The ADHD brain is thus blocked from processing incoming sensory information in the same way as a normal brain does. (See Zemetkin, et al (1990) New England Journal of Medicine 323:1361 for details.)
     Additional evidence for the biological basis of ADD/ADHD is in the brain wave patterning. A recent study found 80% of children with ADHD had a specific EEG signature of an excessive slow waves/deficient fast waves ratio, while 75% of non-ADD (normally attending) children did not. (See Mann, C. A., et al, (1992), Pediatric Neurology, 8:30.)
     The Mann and associate's study shows the EEG patterning of most ADD/ADHD children to be similar to the drowsing pattern of normal children. The implication is the brain is under aroused ("sleepy", and not able to sufficiently focus itself in the classroom and work place.
     There are exceptions to the Drowsy Brain Syndrome: In some, Alpha waves are excessively abundant and unyielding. Since the brain uses Alpha activity to idle non-working parts of itself, the person is unable to successfully participate in the world when Alpha activity does not downshift to let faster frequencies take over.
     The evidence is conclusive: there is overwhelming evidence of a biological brain dysfunction in those with significant and serious attentional impairment.

     Excessive slow/deficient fast waves, and unyielding Alpha brain waves, may cause:
          * Reduced applied intelligence
          * Poor recall of studied material
          * Diminished, or exaggerated, emotions
          * Poor impulse control
          * A distorted sense of time

     As demonstrated by recording brain waves during common classroom tasks, strong discipline is not the answer to correcting unfocused, unruly or inappropriate behavior in those with ADHD. The more pressure to perform and comply, the more abnormal the EEG becomes. Forcing or pushing a child or adult to "do better" causes performance to become worse...sometimes much worse. It's a physical brain problem, not an attitude problem.
     Especially sad is the ADD/ADHD child who wants to please his or her teacher or parent by doing a "great job." Often as not, the harder the child tries, the worse the outcome. Instead of the sought after praise, the only "reward" is increased criticism from parents and teachers. The disappointment often turns to frustration, then anger or depression as self esteem spirals down. In the end, there is commonly extreme rage and acting out.
     Disciplining an ADHD child requires patience and creativity. But considering the biological origin of the behavior, it is the only choice that is fair to the afflicted child.
     In most ADD/ADHD children and adults, Neurofeedback teaches the brain to perform at peer group levels, sometimes better. The enhanced attentional performance and flexibility builds self esteem, creating stable relationships among parents, teachers, fellow students and workers, and bosses.