Attention Deficit Disorder (ADD)

Even after all these years, Attention Deficit Disorder is still only poorly understood. Attention is so central to how we function that one can have a different view of the matter of attention deficits depending on one's perspective. These different perspectives each have some degree of validity, but they may be difficult to bring under one hat. It may even be necessary to see the subject from various perspectives in order to encompass it. So in the following, we add one more perspective. Read on for a fascinating journey.

One can start from the vantage point that it is the business of the brain to pay attention. It must be vigilant to threats to our existence; it must organize our response to the world; and it must look to its own affairs. In that regard, the brain appears to be very self-absorbed. Most of its resources are spent paying attention to itself. Only a very small percentage, on the order of one percent, is spent paying attention to the outside world.

So if we observe a child that is highly distractible, impulsive, and hyperactive, does the problem lie only in what we can observe? No. The problem lies more broadly in the issue of how the brain organizes its attentional and regulatory faculties. What we observe is analogous to the part of the iceberg that sticks out of the water. There is a lot more of the iceberg that we cannot see. Similarly, in the ADHD child we observe "disregulation" in a variety of functions where it may be less obvious: in the organization of sleep; perhaps in immune or endocrine function; perhaps in auditory processing; perhaps in emotional regulation; and perhaps even in the regulation of blood glucose levels.

The operative word in Attention Deficit Hyperactivity Disorder is "Disorder," and it can affect a variety of functions. In other words, we see ADHD as a Disorder of Disregulation, and the extent of that disregulation is a function of how carefully we look.

And if that is the case (we agree that we need lots of evidence on this point!), then the remedy is to be found in any technique that restores more ordered regulation. We know the endpoint: managing attention and behavior is the outcome of a self-regulatory process. We don't have any kind of prosthesis in our medical armamentarium that can prop up our attentional faculties. The brain has to do it all. So whatever we undertake has to serve the cause of better self-regulation of attention and behavior.

Now as we know, a common remedy for ADHD is the stimulant medications. These clearly can support brain function in its regulatory tasks. But the objective is kind of minimal: it is to rescue the child (or adult) from what may be a burdensome dysfunction. We'd like to think, however, that good brain function is more than a matter of being above the threshold of obvious deficits. We can describe the quality of cortical function in a variety of ways that are not just pass/fail criteria but range across the entire realm of human function.

A concert pianist, for example, needs to maintain good brain nutrition as a minimum. But having good brain nutritional status does not make one a concert pianist. So let us ask the more subtle question, is the child functioning as well he or she can with the brain God gave him. Let's go beyond the issue of pass/fail. Here is turns out that modern science has handed us the capacity to appeal to the functional plasticity that is available in our brains to obtain better function. We can take a child medicated for ADHD and considerably improve their academic performance and their level of functioning in the world.

This involves a learning technique much like learning the skill of playing the piano. Only in this case the learning is so fundamental that once it has taken place the brain remembers it and continues to practice it. Life itself can be looked at as a continuing lesson in the learning and practice of self-regulation. And so we don't forget what we once learned because the skills continue to get used.

More good news: When ADHD children learn this skill they find that the stimulant medication that may have helped them earlier is no longer necessary. This is true for at least 85% of them, according to published research. What does this tell us? It tells us that the entire problem of ADHD may simply be one of disregulation, and that once good self-regulation is learned, the problem disappears. It can no longer be identified within the child. It no longer exists. This in turn means that ADHD is not a concrete condition like cerebral palsy, but actually a much more wimpy kind of failure to self-regulate that is easily remedied. Train the brain to pay attention and voila, no more attention deficit. Some children will have to expend a little more effort to get there, but that's true in all of education. Paying attention is a skill, only it happens to be one that is rather more central to our good function than some others.

Now we get to the heart of the matter: It's not just about attention. It's really about behavior-impulsivity, oppositionality, defiance, etc. It turns out that these just involve different aspects of the brain's attentional repertoire. Emotional regulation occurs when we pay attention with our emotional faculties on-line and intact. The brain that can regulate its attention can also regulate its behavior.

It's one story, not two or more.

So a single kind of brain training, targeting our attentional mechanisms, can effect normalization of behavior of the most intractable ADHD child. This is simply breath-taking. Now again, one wants some evidence at this point. You can find it at our research site, eeginfo.com/research.

Neurofeedback is now being used with the most difficult children in the custody of the State of California. It is being used in a Federal penitentiary, and in the California prison system. It is being used in the Minnesota school systems and elsewhere. There are some 8,000 or more professionals providing Neurofeedback to ADHD kids around the US. Probably some 100,000 children per year are being helped. This is only a fraction of those who are on stimulant medication, but then the effect of Neurofeedback is cumulative. Next year, it will be another 100,000, and within a decade most children will no longer be on stimulants.
- Siegfried Othmer, PhD

Case Report:
The following report came from a parent of a Neurofeedback client:
Our son continues to be incredibly successful, thanks significantly to the Neurofeedback that Sue Othmer guided. We were told by a neuropsychologist at a Ritalin mill that he had an IQ of 107, and would never do well at math. After 100 Neurofeedback sesssions, he's a straight-A college sophomore, majoring in math and physics. Thank God we didn't listen to the "experts"!

Case Vignette:
From a long-time Neurofeedback Clinician, a nurse:
March 2008
I was at the grocery store the other day when a mother of a former young client rushed up to me and began to hug me, thanking me over and over. At first I didn't recognize her! She told me (in her broken English) that her son was tested last month and no longer met ADD criteria. She told them about Neurofeedback, and they didn't want to believe her, saying that ADD had probably been wrongly diagnosed in the first place. But they could not dispute the before and after TOVA results I printed off for her.

At the same time the 9-year-old boy was on one instrument, I put his 3-year-old brother on the other one. He was unable to speak at the time and had been diagnosed "developmentally delayed." His status was extremely disturbing to the parents. Now he is 5. He's talking a blue streak and finding himself at the head of his kindergarten class. He is no longer developmentally delayed in any way.

Parent Testimonial:
By the time we arrived at Neurofeedback Centers for Success in May 2006, we were at the end of our rope as far as ideas for dealing with and helping treat our then 9 year old son. He had been diagnosed with ADD about 2 years prior but had behavioral issues that began in earnest about the time he entered kindergarten. Although we all struggled and tried various therapies and behavior modification techniques, we eventually ended up on the medication pathway that included Ritalin, Risperdal, and other mood altering drugs. For a child our son's age it was a path we were reluctant to journey but felt compelled to do so for lack of other viable alternatives.

Just prior to our initial evaluation at NCFS, our son began experiencing very disturbing panic/anxiety attacks. What started as somewhat clingy and fearful behavior snowballed into attacks that included the inability to breathe, inconsolability, and physical aggression that was direct both away from him and towards himself. At that point we knew that medication would not continue to be our answer. Not only were the new side effects frightening but we found that over time the effectiveness of the medications was dwindling. It was at that point that an acquaintance who specializes in holistic and homeopathic treatments suggested neurofeedback. She had not experienced it herself, but knew from research and others in her field that it was a more viable and long-term solution for our son’s issues.

We did our own research and found numerous articles in various publications that detailed the neurofeedback process and the benefits that could be derived from it. We were very heartened by the research that supported its use for children like our son and many who were more developmentally and behaviorally challenged than him. We knew then that we had nothing to lose and possibly so much to gain by giving this new treatment a chance. We also continued counseling sessions that our son had been involved with both at school and independently. We hoped that the combination of therapies would offer the most benefit and were encouraged to do so by both our son's counselors and the clinicians at NCFS.

Our son was very resistant to the sessions when we first began and each visit was a struggle. We began with 3 sessions per week and within a very short period of time the first change we noticed was a change in his sleep pattern. He had dealt with fitful and limited sleep, difficulty getting to sleep, and even more difficulty waking. After just a few sessions and the nightly playing at bedtime of one of the CD's offered by NCFS, De-Stress, we found that our son was falling to sleep more quickly and staying asleep all night.

When our son went off-track at the end of summer, we decided to increase the number of sessions to five a week. At that point we began to see even more rapid change in many of his behavior issues, first at home and then at school once he returned. With constant dialogue and feedback from us, his teachers, and our son as well, the clinicians at NCFS were able to modify the treatment areas to effect the most appropriate results for our son. The addition of The Listening Program also brought about more calm and concentration for our son and we also began to see considerably less resistance to the entire treatment program on his part.

Although we continue to deal with our son's various behavior issues, those issues have become less about a child with ADD and more about those of a "normal" 11 year-old. Our son continues visits with an independent counselor and has dramatically increased his ability to talk candidly with the counselor. He continues neurofeedback sessions twice a week and is now disappointed if we have to miss a session. Most importantly, our son is no longer on any medication, he consistently sleeps well, he is always lucid and rational, he carries on normal conversations with both peers and adults, and everyone who interacts with him who has known him from before beginning neurofeedback has taken note of the positive changes in him.

We are very grateful that we were referred to NCFS and we tell everyone we can about the positive change they can bring about. We are also grateful for the other families we have met there who have similar success stories and have enabled us to be part of a pseudo support group – one that has given us hope and inspiration for the future.