ADD / ADHD

Attention Deficit and Attention Deficit Hyperactivity Disorder is the most common psychiatric disorder in children (2%-5%) (American Psychiatric Association 1994).

ADD/ADHD is caused by a disruption to the functioning of certain neural networks in the brain. It is hereditary in more than half of the cases; 30%% of those affected have at least one parents with ADD/ADHD; 30% to 50% of children with this disorder have significant difficulties that persist into adulthood and they also have an 80% chance of having at least one child with ADD/ADHD. This disorder is neurological in origin and does not develop because of any environmental demands or difficulties.

ADHD is frequently co-morbid or occurring with other behavioral disorders (Barkley, 2006), including Sleep Disorders (30-56%), Oppositional Defiant Disorder (40%-80%), Conduct Disorder (20-56%), Anxiety Disorder (10-40%), Depression (30%), Tic Disorders (10-15% for simple tics) and Dyslexia (20%). It is also seen in Autism Spectrum Disorder and non-verbal Learning Disorders.

Typically, ADD/ADHD is diagnosed using a number of subjective behavioral ratings. However, this can lead to persistent doubts about whether this is in fact an accurate diagnosis. Over the last ten years, independent research groups have published a large number of articles on the value of using QEEG or Quantitative Electroencephalogram in the diagnosis of ADD/ADHD. As a result, the American Academy of Pediatrics, in their guidelines on ADHD, have described the QEEG as a valuable diagnostic assessment. At our clinic, we have the QEEG available to direct our Neurofeedback approach but also use other standardized measures to diagnose this condition, including Continuous Performance Tests which are also helpful as a re-assessment tool in order to document changes with therapy. In addition to using EEG Neurofeedback, we also utilize Biofeedback, Listening Therapy, Sensory Integration and Cognitive strategies which we will be happy to discuss with you in more detail during the initial consult.

Getting Rid of RitalinNeurofeedback is probably the most interesting and promising treatment modality for Attention Deficit Disorder in use today and this is an area of specialization at our clinic. The goal of treatment is to teach a child or adult how to change the way one's brain works, so that they can better cope and function with this neurological based disorder. EEG Neurofeedback or Biofeedback is not a "cure" for ADD/ADHD. Nonetheless, there is an increasing body of evidence that it leads to "normalization" of behavior and can enhance the long-term academic performance, social functioning, and overall life adjustment. An additional area that we have found to be present in a large number of children and even adults who present to our office with ADD/ADHD is Sensory Processing Disorder. It appears this is a foundational issue that greatly impacts on behavioral organization and is often seen by Linda Marshall-Kramer OTR/L in the initial assessment. This Disorder can be diagnosed by Linda Marshall-Kramer as she is an experienced and Certified Sensory Integration clinician with over 30 years of experience working with children having sensory based behavioral issues.

We also have Research studies available at our office on a number of topics, but especially on this disorder which we will be happy to share with you. In addition, there are links on this website which can direct you to more research based information.

Ritalin Gone Wrong by L. ALAN SROUFE - Published: January 28, 2012 »

SYMPTOMS AND CATEGORIES OF DISORDERS IN ATTENTION

The principle characteristics of ADHD are inattention, hyperactivity, and impulsivity. This disorder used to be known as attention deficit disorder (ADD) but was renamed attention-deficit/hyperactivity disorder (ADHD) in 1994 and broken down into three subtypes, each with its own pattern of behaviors. However, the use of ADD/ADHD is often seen in literature; the below gives more specific information on the breakdown of the different types.

ADHD – Predominantly Hyperactive-Impulsive Type that does not show significant inattention, but with signs that include:

  • fidgeting or squirming
  • difficulty remaining seated
  • excessive running or climbing
  • difficulty playing quietly
  • always seeming to be "on the go"
  • excessive talking
  • blurting out answers before hearing the full question
  • difficulty waiting for a turn or in line
  • problems with interrupting or intruding
QEEG/ERP Report by Dr. Otto Kramer

ADHD - Predominantly Inattentive Type that does not show significant hyperactive-impulsive behavior, but may include the following:

  • inability to pay attention to details or a tendency to make careless errors in schoolwork or other activities
  • difficulty with sustained attention in tasks or play activities
  • apparent listening problems
  • difficulty following instructions
  • avoidance or dislike of tasks that require mental effort
  • tendency to lose things like toys, notebooks, or homework
  • distractibility
  • forgetfulness in daily activities

ADHD - Combined Type which involves a combination of the other two types and is the most common. To be considered for a diagnosis of ADHD:

  • child must display behaviors from one of the three subtypes before age 7
  • behaviors must be more severe than in other children the same age
  • behaviors must last for at least 6 months
  • behaviors must occur in and negatively affect at least two areas of a child's life (such as school, home, day-care settings, or friendships)

The behaviors must also not be linked to stress at home. Children who have experienced a divorce, a move, an illness, a change in school, or other significant life event may suddenly begin to act out or become forgetful. To avoid a misdiagnosis, it's important to consider whether these factors played a role in the onset of symptoms.

Client Testimonial:

We started out with a very active little boy, who got into everything. Then we progressed into more and more behavior problems. At the time, we couldn't understand why he was doing these things. By first grade, we were really having a hard time. It was really taking a toll on the whole family. I dreaded the thought of birthday parties or any kind of social gathering. Everything we did was a struggle. He really had a hard time in school. We had problems with not paying attention, talking out of turn, non-stop talking, starting fights, not getting along with other kids, stealing, temper tantrums that could get out of control. He also fought me on shoes, socks, coats, and shirts.

When the school social worker told me about sensory disorder, I had never heard of it. I researched it and thought that this sounds like the problem and now we can understand him and help him. Then we got him diagnosed and started with OT. We also joined a social thinking group, started seeing a psychologist and started taekwondo. He was also tested for ADHD and we were told he had that too. I did not want to start him on medicine, but eventually when the problems at school continued, we did. One thing that made is so hard was that I saw both sides of him. He is funny, kind, affectionate and loving. He always tries so hard to make good choices and do the right thing. I could tell how hard he was trying and he still struggled everyday. Even with everything we were doing to help him, I still saw very little improvement. He had no friends and he was unhappy with himself.

When one of the mom's at taekwondo told me about Neurofeedback I thought it sounded crazy. We were doing all these other things and I wasn't about to try something like that. Then about a year later another mom told me that she saw something in the waiting room of Children's Therapy Services, and it was called Neurofeedback. I'd been researching treatments for ADHD and sensory disorder and still really didn't know anything about Neurofeedback. Then I really started to read about it. I ordered books, searched on-line and I was amazed at what I was reading. This sounded like it was really helping people, and the more I found out about it and how it works, it made sense to me. I couldn't wait to try it. Then I made a mistake. I was in such a hurry to start that I went somewhere that didn't have people that were trained properly. After about 10 sessions I knew from what I had read that something wasn't right. I called Linda at CTS and told her what was going on and she explained to me how it really should be done. We started coming to CTS in April 2011 - I was so excited! My son was so excited, he finally felt that something was going to help him. Right away he connected with Linda. He felt like she 'got' him and he knew she was going to make his life easier. I wanted to do things right, so we had Dr. Otto Kramer do a QEEG and it felt so good to see it on paper. It also showed that we had a more severe case of ADHD to deal with. I wanted to see a change right away, but that's not how it happened.

There were times when I was discouraged because I didn't think I was seeing any improvements and we were over 40 sessions. I was afraid we were going to start fifth grade with all the problems we had before. Then it started to happen, I'd notice little things. He started playing better with his cousins and with friends. They would even look forward to playing with him. They would play for hours and there would be no fighting, I couldn't believe it. I wasn't holding my breath any more waiting for things to go bad. When I talked to his teacher, I told her that he struggled with his peers and she said that she didn't notice that. Did she really just say that! He came home from school and said that a boy who has been in his class before told him that he wasn't as weird. Most people would think that was not a nice thing to say, but it was amazing for us to hear it. We can enjoy spending time with him. He's happy with who he is. He's still a 10 year old boy and I know he'll still have issues from time to time, but what a difference this has made. We're not done yet, we've decreased the medicine and over time will eliminate it. I can't say enough good things about Childrens Therapy Services and Neurofeedback - this thing turned out to be not so crazy after all!

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