Did You Know? The 2016 National Survey of Children's Health (NSCH) found that 9.4% of children between ages 2-17 have been diagnosed with ADHD.
Boys (13.2%) are almost 3 times more likely to be diagnosed with ADHD than girls (5.6%).
Up to 17.5% of the children surveyed by the CDC were not receiving treatment for their diagnosed ADHD.
The rate of emotional development for children with ADHD is as much as 30% slower than it is for children without the condition.
40% of children who have ADHD have at least one parent who has ADHD.
As many as 33% of children diagnosed with ADHD also have a coexisting condition.
* Anxiety disorders also may be present in as many as 10% to 40% of teens with ADHD.
* 20% to 30% of teens with ADHD have a co-existing mood disorder, such as depression.
Is my lack of focus normal? The frontal region of the brain, used for concentration, is typically under-activated (thus under-functioning) for those with ADHD / ADD which makes sustained concentration more difficult. If you or your child has focusing problems, the frontal area of the brain may not be generating enough energy to sustain concentration on routine, mundane tasks, including academic tasks. There can also be focusing problems resulting from the frontal lobe being overstimulated with too many fast brainwaves (beta brainwaves), which can also cause dysregulation of the frontal lobe, resulting in focusing problems and anxiety.
While adults and children with the problems outlined above can exhibit problems focusing on routine and mundane tasks, they may find that stimulating activities (video games, television, Legos, etc.) can sometimes hold their attention for hours, even without the frontal region of the brain functioning normally.
Unfortunately, most “mundane” tasks are not so stimulating, making it extraordinarily difficult for afflicted individuals to effectively sustain concentration. As a result, ADHD and ADD patients can be significantly disadvantaged in school and work, even though they may be very intelligent.
Behavioral Problems May Be Neurologically-Caused ADHD and ADD symptoms are based on neurologic dysregulation, not psychological causes. The frontal region of the brain is responsible for inhibiting motor activity and impulses, but if this region is under-activated or dysregulated, then our motor activity may not be inhibited adequately.
This under-activation or dysregulation also leads adults and children to act out on their impulses (interrupting, blurting out, etc.) without thinking of the consequences. In these cases, the ADHD and ADD patients do not have the neurophysiologic inhibition mechanisms functioning adequately enough to resist some of their impulses.
As a result of ADD or ADHD, their brains are not able to put the impulse "on pause" for a few seconds so they can think about the consequences of acting on the impulse. Instead of being able to think about how to respond appropriately, they act out spontaneously/impulsively.
These individuals are behaving “normally” as far as their brain is concerned because their brain is not inhibiting their impulses. This is the only way their brain has ever worked, so they have no personal history or reference point to understand that their impulsive behavior is inappropriate.
Please keep in mind that the impulsive behavior of a person with ADD or ADHD is not intentional, but is based on the fact that their brain is short-circuiting and failing to filter their impulses appropriately. Because their brain has never consistently filtered impulses efficiently before, and since this is all they have ever experienced, this is their version of “normal”.
ADHD and ADD patients are sometimes unable to fully understand “cause and effect”. They may not understand why they are being criticized for their behavior, and may even feel like they are being criticized unfairly, which can eventually lead to argumentative and oppositional behavior.
Because neurofeedback’s results are produced by the patient’s own self-generated efforts via the learning process known as “operant conditioning”, the treatment addresses the cause of brain dysregulation, fixing the problem itself, rather than masking it.
In contrast, drug-based ADHD / ADD treatments can only produce a short-lived improvement since their results are due to a transient drug effect, rather than an internalized learning process of self-regulation through neurofeedback. Once the drug wears off, so do the improvements. Furthermore, stimulant drugs used to treat ADHD and ADD symptoms have the potential for abuse and dependence, as well as unwanted side effects.
Our brain map-guided neurofeedback treatment empowers our patients by enabling them to develop the neurological resources and skills needed to overcome ADD and ADHD symptoms.
Our clinical staff of therapists also provides much-needed support to our patients, parents, or spouses throughout the treatment process, ensuring that the entire family unit helps facilitate patient improvement, integrating it into their everyday life.
We use evidence-based, safe, natural methods to treat ADHD and ADD without medication. Instead of subjecting a child's developing brain to the side effects of psychiatric medication such as addiction, mood swings, sleep difficulties, depression, irritability, paranoia, and panic attacks, we rely on the safe and clinically effective technologies of Neurofeedback, Biofeedback and evidence-based family and child therapy.
Utilizing the latest developments in Q EEG Brain Mapping, neurofeedback, and evidence-based therapy technology, our non-drug ADHD & ADD treatment protocols enable patients to receive much-needed therapeutic relief from their ADHD and ADD symptoms faster than ever before without the use of traditional pharmaceutical drugs.
In addition, our neurofeedback treatment process can produce long-term improvement for our patients, unlike the temporary improvement offered by drug-based treatment. Our non-medication treatment for ADHD and ADD continues to significantly improve the quality of life for patients from around the world. The Importance Of Accurate Diagnostic Testing Historically, the diagnosis of Attention Deficit Hyperactive Disorder has been based on a cluster of clinical symptoms, but this diagnosis has failed to include testing actual brain functioning. It is now known that ADHD symptoms are neurologically based, and it is over-simplistic to view ADHD as a single disorder since similar symptoms in various patients can manifest in unique ways, leading to different sets of problems. Also, the traditional ADHD diagnosis itself does not provide answers to the origin and cause of the unwanted symptoms. It is only by analyzing brain functioning that we can fully understand the neurophysiologic origin of ADD and ADHD symptoms, which is needed to design the most effective treatment approach, customized to focus on the specific dysregulation that each patient is experiencing.
We believe that the historical ADHD diagnosis has been too subjectively based on observations, without looking at biological or neurophysiological markers. That is why we utilize quantitative EEG brain mapping technology, which can correlate ADHD symptoms to dysregulated networks or regions in the brain. Similar symptoms in different patients may even show different abnormal brainwave patterns, requiring individualized brain map-based neurofeedback treatment protocols.
Compared to drug-based treatment, which is mostly trial and error, our brain map-guided neurofeedback protocols are scientifically targeted to improve performance for specific networks and regions in the brain.
How Does Treatment Without Drugs Work? We believe that ADHD and ADD treatment should focus on the root of the problem: the patient’s dysregulated brain. Once the dysregulation has been mapped via qEEG brain mapping, we can then create individualized treatment plans for our patients and help them achieve symptom reduction through Neurofeedback.
Treating Brain Wave Abnormalities A key component of our treatment protocols is the use of qEEG (Quantitative Electroencephalogram) brain mapping, which helps us obtain a clearer picture of the dysregulation occurring in the brain.
Creating a brain map for an ADD/ADHD patient is every bit as important as running an EKG (electrocardiogram) for a heart patient. The more information the physician has about what’s causing the patient’s symptoms, the more effective their treatment can be. As is true with any medical test, brain map findings must be correlated with the patient’s clinical symptoms and evaluated to determine optimal EEG biofeedback (neurofeedback) protocols. When ADHD and ADD are present, the brain can be literally stuck in abnormal brain wave patterns, showing imbalances in either fast or slow brain wave activities, which is often the root cause of ADHD and ADD symptoms.
Either type of disrupted functioning can negatively affect the attentional and executive functioning systems in the brain, even in highly intelligent people. Below is an image showing the "before and after" brain map of a patient who learned to normalize their frontal lobe brainwave patterns by completing our brain map guided neurofeedback treatment:
The American Academy of Pediatrics has classified neurofeedback as a Level 1 Best Support for treating ADHD*. This means that neurofeedback consistently shows superiority to placebo treatments and yields at least equivalent outcomes when compared to credible and well researched ADHD treatments.
* American Academy of Pediatrics Strength of Evidence Definitions: I. At least 2 randomized trials demonstrating efficacy in one or more of the following ways:A. Superior to pill placebo, psychological placebo, or another treatment;
B. Equivalent to all other groups representing at least one level 1 or level 2 treatment in a study with adequate statistical power (30 participants per group on average) that showed significant pre-study to post-study change in the index group as well as the group(s) being tied. Ties of treatments that have previously qualified only through ties are ineligible.II. Experiments must be conducted with treatment manuals.
!!!. Effects must have been demonstrated by at least 2 different investigator teams.
Using the four-level scale of the American Academy of Child and Adolescent Psychiatry (AACAP), Hirshberg et al, editors of the special EEG issue of Child and Adolescent Psychiatric Clinics of North America, in which Monastra’s review appeared, were even more enthusiastic than he was. They stated “EBF [EEG biofeedback] meets the AACAP criteria for ‘Clinical Guidelines’ for treatment of ADHD.
A March 2020 meta-analysis of neurofeedback for ADHD found it to be effective "Therefore, standard neurofeedback protocols in the treatment of ADHD can be concluded to be a well-established treatment, or ‘efficacious and specific’ in line with the APA guidelines. Effectiveness in open-label studies was confirmed, no signs of publication bias were found and no significant neurofeedback-specific side effects have been reported. Standard neurofeedback protocols in the treatment of ADHD can be concluded to be a well-established treatment with medium to large effect sizes and 32–47% remission rates and sustained effects as assessed after 6–12 months."
The History Of ADHD & ADD For historical accuracy, the diagnostic term ADD (Attention Deficit Disorder) was actually discontinued in 1994 by the American Psychiatric Association's published manual, the DSM-IV, and replaced with the diagnosis of ADHD (Attention Deficit Hyperactivity Disorder) consisting of 3 subtypes:
Predominantly Inattentive Type
Predominantly Hyperactive-Impulsive Type
The DSM is used to classify recognized mental health disorders. In 2013, the new DSM-5 redefined ADHD once again into 3 main subtypes:
Predominantly Inattentive Presentation
Predominantly Hyperactive-Impulsive Presentation
Many families are confused with the diagnostic label of ADHD (Attention Deficit/Hyperactivity Disorder) when their child or the adult who is experiencing symptoms of the disorder has never been hyperactive nor impulsive, but to be clear, it’s entirely possible to be diagnosed with ADHD, even without the presence of hyperactivity.
What Causes ADHD & ADD? Most commonly, ADHD and ADD symptoms are caused by dysregulation in the frontal region of the brain (those areas responsible for sustaining attention and focus). It often has a genetic basis. People suffering from this disorder may be unable to sustain focus for an extended period of time on non-preferred tasks such as homework or classwork, even though they may be fully capable of concentrating on preferred tasks like video games or computer games for hours on end. Even excellent parenting cannot normalize an ADHD child’s frontal lobe dysregulation. No matter how much effort the child puts forth, they may not be able to fix the problem either, as simply trying harder won’t correct the dysregulation in their brain. On the surface, while it may appear that the child is willfully lazy or unmotivated, the reality is that they simply do not have the fully-developed and adequately functioning neurobiological capacities to be able to succeed with age-appropriate demands.
BEFORE TREATMENT: Red areas represent abnormal brain wave balance.
AFTER TREATMENT: Improved brain wave balance after 11 weeks of treatment.
ADD / ADHD Evaluation
We use the most current, state-of-the-art technology in each of our highly successful non-drug treatment programs. Our ADHD testing and ADD evaluation processes are performed with a more in-depth level of knowledge, improving the accuracy of each patient’s evaluation and the efficiency of each patient’s treatment plan. Our ADHD / ADD evaluation isis a 2 hour procedure which allows time for a complete clinical overview of our prospective patients and includes an extensive diagnostic interview. A key part of our ADD evaluation is a battery of standard assessments along with brain mapping that help us to better understand linkages between behavior patterns and brain activity.
Because many of our patients have additional overlapping disorders in addition to their ADD/ADHD, we know the importance of thoroughly assessing the difficulties that they face. This allows us to develop the most efficient, effective, andcomprehensive treatment plan possible.
By evaluating all of these elements, as well as the negative impact the patient’s ADD/ADHD has had on family dynamics, we’re able to determine the degree to which the family will require support from our staff during the patient’s treatment process, maximizing their clinical improvement.
Since approximately 70% of patients with ADD or ADHD may have a coexisting learning disorder, additional psychoeducational or auditory/language testing may be warranted (depending on patient symptoms).
ADHD Testing for Kids: Our test for ADHD in kids is different than the typical adult ADHD test. In our children’s ADD/ADHD evaluation, we include an extensive diagnostic interview with their parents.
During this interview, we cover the child’s medical history, along with their medication history, possible drug side effects or interactions, family history, pregnancy, labor and delivery, infancy and other developmental milestones, childhood illnesses, school history, social history and behavioral concerns.
Our clinical staff, under the supervision of our director, also assesses the added stress of the child’s ADHD on family dynamics, helping them to come up with the best recommendations for providing family support.. This process has proven to help optimize clinical improvement for the ADHD child, but it also provides much-needed support for parents.
During ADD/ADHD diagnostic testing we have the child undergo a baseline neurofeedback training session to start them down the path of beginning to learn how they can effectively self-regulate and improve optimal brain functioning.
Many of our patients come to the MindBrain Institute with additional overlapping disorders along with ADD/ADHD, including:
Scientific research has shown that up to 70% of patients with ADD and ADHD may have a coexisting learning disorder.
Further testing and/or treatment of these comorbid or secondary disorders is included in the treatment plan for each child.
ADHD symptoms in children manifest differently than they do in adults, with approximately half of children with ADHD presenting hyperactivity and impulsivity as core symptoms, which produce overt behavioral difficulties. Hyperactivity and impulsivity are much less common in ADHD adults.
Struggles with homework and academics are especially problematic in ADHD children and adolescents, whereas typical adults with ADHD struggle primarily with the inattentive symptoms that produce problems with executive functioning (time management, organization, procrastination, prioritization, etc.), job performance, relationships, anxiety, depression, and substance abuse.
One essential part of our diagnostic evaluation is that every child undergoes a quantitative EEG brain map analysis to identify the abnormal patterns and regions of brain activity linked to the child's symptoms and behavioral difficulties.
Many clinics do not offer this service, but it is an extremely important test. We use the results of this test to determine the proper course of action for achieving an effective, long-term reduction of ADD/ADHD symptoms.
Brain mapping is no different from a physician performing an EKG (electrocardiogram) on an adult patient with chest pain and a shortness of breath. The more information that the physician has at their disposal, the better they are able to treat the patient, improving the prognosis for the child with ADD/ADHD.
The Drug-Free Solution:
Brain mapping and testing can illustrate what neural networks are not working as well as they should. Neurofeedback treatment can then be implemented specifically to strengthen the patient’s brain weaknesses.
Treatment response can then be compared to baseline to determine rate of progress.
Studies that have explored neurofeedback as a treatment for ADHD/ADD symptoms have generally been very positive which has lead the International Society for Neuronal Regulation to classify EEG Neurofeedback as a Level 1 treatment (most effective) for ADD and ADHD.
Neuroscience research has clearly demonstrated that ADD/ADHD is a brain related issue, not merely a problem with “not trying hard enough.” The frontal lobes are most often related to symptoms of ADD and the ADD brain tends to produce too much slow frequency, though not all individuals with ADD have the same exact pattern.
Attention Deficit Hyperactivity Disorder (ADHD) - Neurofeedback Publications PracticeWise - Level 1: Best Support EEG and Clinical Neuroscience - Level 5: Efficacious and Specific BCIA - Level 4: Efficacious (description of efficacy levels here)
Efficacy of Neurofeedback Treatment in ADHD: the Effects on Inattention, Impulsivity and Hyperactivity: a Meta-Analysis Arns M, de Ridder S, Strehl U, Breteler M and Coenen A Journal of Clinical EEG & Neuroscience, July, 2009 reported that Neurofeedback should be regarded as an evidence-based treatment for Attention Deficit / Hyperactivity Disorder (ADHD) based on accepted scientific standards of clinical medicine. Neurofeedback has steadily gained acceptance as a mainstream medical technique for the treatment of several disorders; however critics persist in questioning the efficacy of neurofeedback and the quantity and quality of the clinical studies that support its use. The study was a so-called meta-analysis which examined the caliber of the scientific and statistical techniques and robustness of all recently published research about neurofeedback treatment for ADHD. This meta-analysis included 15 studies and 1194 ADHD patients. Based on this study, the research team concluded that neurofeedback should be regarded as an “Evidence-Based treatment for ADHD”. The results show that neurofeedback treatment has large and clinically significant effects on Impulsivity and Inattention and a modest improvement of Hyperactivity.
EEG Biofeedback in the Treatment of Attention Deficit Hyperactivity Disorder (abs.) Friel PN Alternative Medicine Review, Volume 12, #2, June, 2007, pp146-151 Electroencephalogram (EEG) biofeedback, also known as neurofeedback, is a promising alternative treatment for patients with attention deficit/hyperactivity disorder (AD/HD). EEG biofeedback therapy rewards scalp EEG frequencies that are associated with relaxed attention, and suppresses frequencies associated with under- or over-arousal. Electroencephalographic Biofeedback in the Treatment of Attention-Deficit/Hyperactivity Disorder Monastra VJ, Lynn S, Linden M, Lubar JF, Gruzelier J, LaVaque TJ Historically, pharmacological treatments for attention-deficit/hyperactivity disorder (ADHD) have been considered to be the only type of interventions effective for reducing the core symptoms of this condition. However, during the past three decades, a series of case and controlled group studies examining the effects of EEG biofeedback have reported improved attention and behavioral control, increased cortical activation on quantitative electroencephalographic examination, and gains on tests of intelligence and academic achievement in response to this type of treatment. Deficit Hyperactivity Disorder: Rationale and Empirical Foundation (abs.) Monastra VJ During the past three decades, electroencephalographic (EEG) biofeedback has emerged as a nonpharmacologic treatment for attention-deficit/hyperactivity disorder (ADHD). This intervention was derived from operant conditioning studies that demonstrated capacity for neurophysiologic training in humans and other mammals and targets atypical patterns of cortical activation that have been identified consistently in neuroimaging and quantitative EEG studies of patients diagnosed with ADHD. Treatment of Attention Deficit Hyperactivity Disorder with Neurotherapy (abs.) Nash JK Significant public health concerns exist regarding our current level of success in treating ADHD. Medication management is very helpful in 60-70% of patients. Side effects, lack of compliance and the fact that stimulant medications cannot be given late in the day limit the benefits largely to school hours. Review of the Literature Regarding the Efficacy of Neurofeedback in the Treatment of Attention Deficit Hyperactivity Disorder Lingenfelter JE The following is a review of the most recent literature regarding the efficacy of EEG Neurofeedback in the treatment of attention deficit hyperactivity disorders. Update on Attention-Deficit/Hyperactivity Disorder (abs.) Campbell Daley K In her recent paper, Update on Attention-Deficit/Hyperactivity Disorder, published in Current Opinion in Pediatrics, Katie Campbell Daley reviewed the research and practice standards on treatment of ADHD.
Dr. Campbell is on the staff of the Department of Medicine, Children's Hospital Boston and in the Department of Pediatrics of the Harvard Medical School. Her conclusion:
"Overall, these findings support the use of multi-modal treatment, including medication, parent/school counselling, and EEG biofeedback, in the long term management of ADHD, with EEG biofeedback in particular providing a sustained effect even without stimulant treatment... Parents interested in non-psychopharmacologic treatment can pursue the use of complementary and alternative therapy. The therapy most promising by recent clinical trials appears to be EEG biofeedback." full text In-School Neurofeedback Training for ADHD: Sustained Improvements From a Randomized Control Trial Naomi J. Steiner, MDa, Elizabeth C. Frenette, MPHa, Kirsten M. Rene, MAa, Robert T. Brennan, EdDb, and Ellen C. Perrin, MDa (104 participants) Response rates were 90% at the 6-month follow-up. Six months postintervention, neurofeedback participants maintained significant gains on Conners 3-P (Inattention effect size [ES] = 0.34, Executive Functioning ES = 0.25, Hyperactivity/Impulsivity ES = 0.23) and BRIEF subscales including the Global Executive Composite (ES = 0.31), which remained significantly greater than gains found among children in CT and control conditions. A Comparison of EEG Biofeedback and Psychostimulants in Treating Attention Deficit Hyperactivity Disorder Tom Rossiter, PhD and Theodore LeVaque, PhD. Reprinted with permission: Journal of Neurotherapy, Summr, 10995, 48-59 Quantitative QEEG and Auditory Event-Related Potentials in the Evaluation of Attention Deficit/Hyperactivity Disorder: Effects of Methylphenidate and Implications for Nerofeedback Training J.F. Lubar, PhD, M.O. Swartwood, PhD, J.N. Swartwood, PhD and D.L. Timmerman, PhD. 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