Sunday, March 1, 2009

ADD-ADHD Alternatives to Medication

Cameron is a sweet, darling boy, who has been suspended from kindergarten and first grade more times than you can believe such a young child could. Cameron suffers from Attention Deficit/Hyperactivity Disorder. It causes impulsive behavior that causes him to do things without thinking of the consequenses. The consequences are that he gets suspended from school.

Attention Deficit Disorder is a biologically based condition causing a persistent pattern of difficulties resulting in one or more of the the following behaviors:

  • inattention
  • hyperactivity
  • impulsivity

Attention Deficit/Hyperactivity Disorder is the name often given when ADD also includes hyperactivity and impulsive behavior.

This definition and the symptoms are very ambiguous. These symptoms can describe most children, especially in their younger years. So the diagnosis is not usually made until a child is seven to nine years old.

ADD is not generally something that is “grown out of.” Children with ADD generally become adults with ADD. It is still difficult to deal with as an adult, but often they do learn how to make adjustments for their disabilities to get on with life.

Diagnosis of ADD-ADHD

There is no conclusive test to prove a child/adult has ADD-ADHD. It is a psychiatric diagnosis based on reported behavior by parents, teachers and self. There are no specific physical signs or symptoms. The behaviors vary in severity and symptoms. It is often difficult to accurately establish. The diagnosis of ADD-ADHD is determined by the clinician, based on the number, severity and duration of symptoms and the degree of impairment in daily activities.

The following are common symptoms of ADD-ADHD:
  • Has difficulty sustaining attention in tasks or play activities.
  • Is often easily distracted by outside stimuli.
  • Often fails to give close attention to details or makes careless mistakes in schoolwork, work or other activities.
  • Often does not seem to listen when directly spoken to
  • Is often forgetful in daily assignments and activities
  • Often fails to finish activities started, such as homework, schoolwork, chores, or duties at work.
  • Often has difficulty following through with instructions.
  • Often has difficulty organizing tasks and activities.
  • Often loses things necessary for tasks.
  • Often avoids or has difficulty completing tasks that require sustained mental effort.

The following are common symptoms of hyperactivity:

  • Finds it hard to be still—fidgets with hands and feet and squirms in seat.
  • Often leaves seat where sitting is expected.
  • Moves around, runs and climbs inappropriately.
  • Often has difficulty playing quietly.
  • Often talks excessively.

The following are common symptoms of impulsivity:

  • Does not give others time to speak; often blurts out answers before the question is out.
  • Has difficulty waiting their turn.
  • Often intrudes on others; has little sense of another's personal space.
  • Acts on what he/she wants in the moment without considering the consequences.
  • Does not seem to learn from negative consequences.

Though brain scans are not done for diagnosis, it has been shown that children/adults with these symptoms have brain changes. Both functional MRIs and Quantitative Electroencephalograms (QEEGs) show that there is under-activity and slower brain wave activity in the frontal cortex of the brain. These areas are often smaller than that of a normal child's brain of the same age.

These scans are not used for diagnosis, but they can be used to monitor treatment.
The brainwaves produced when we are awake and alert are beta waves, which are fast, high voltage type waves. People with symptoms of ADD-ADHD often have excessive slow, low-voltage type waves called theta waves, which are common in the drowsy and daydreaming state. That is why they have trouble focusing and concentrating, and why stimulant drugs help their symptoms, because they speed up the brainwaves.

The pre-frontal cortex is involved with voluntary control of attention, the inhibition of inappropriate and/or unwanted behavior, the planning of actions, executive decision making, maintenance of arousal (or the awake and alert state), and the sequencing of complex activities. When the pre-frontal cortex isn't as active, there will be problems with inattention, poor impulse control, difficulty planning ahead and completing tasks, poor decision making, daydreaming and poor focus, and difficulty carrying out instructions.

At Vanguard Center for Neurological Medicine, we do QEEGs to determine if these problems are present in the brainwave patterns of people with ADD-ADHD symptoms. See

In the next blog we'll talk about other problems that could cause symptoms similar to ADD-ADHD, and deficiencies often found in the ADD-ADHD population.

Until we meet again,

Dr. Judi


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Peggy Ayers said...

Always leading the way to a new way of looking at the real issue. We love all you & neurofeedback has done for our family!! Where would be w/out you & your brilliant look at life?
Thanks for all your time & energy in our behalf to make a better life! We love you!!

Peggy Ayers said...

Always leading the way to a new way of looking at the real issue. We love all you & neurofeedback has done for our family!! Where would be w/out you & your brilliant look at life?
Thanks for all your time & energy in our behalf to make a better life! We love you!!