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 Ritalin: not the only option for ADD/ADHD

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PosOnderwerp: Ritalin: not the only option for ADD/ADHD    Fri Jul 09, 2010 10:25 pm


07 Jul 2010
Tharuna Devchand


WADE Cramer and his wife Corinne started   their   son   Ryan,  then   in Grade 1, on Ritalin, although not before Wade first tested it on himself. He was not keen on the idea of medicating his son, nor was he comfortable with the side effects.

“The Ritalin made Ryan skinny. He didn’t eat or sleep properly,” Wade says.

Ryan was put on Ritalin despite his parents’ reluctance. “The school puts you in a position where you feel coerced­,” says Wade. “They tell you there’s a chance that your child will end up getting into trouble for criminal­ activity. They scare you into it.”

After two years on medication Wade felt Ritalin was not working for Ryan. “My wife, the school and I didn’t notice any difference in Ryan’s behaviour. He was still disruptive and un-able to concentrate.”

So they stopped the treatment and proceeded to try every other possible remedy, including herbal remedies, neurotherapy, balancing and exercise programmes. Although there was some success in boosting Ryan’s self-confidence, after five years of trying various treatments he was still finding it difficult to concentrate and his behaviour was still disruptive.

“My wife and I were parents who went to every parents’ evening at Ryan­’s school. We would approach the first teacher, who had only bad things to say about Ryan. We would approach the second teacher and they also only had bad things to say. Then we would leave, skipping the rest of Ryan’s teachers.”

Wade then read an article on the Internet about neurofeedback therapy by Dr Timothy Harkness, a colleague of Durban clinical psychologist Kirsten van Heerden, who uses this alternative to medication in treating attention deficit disorder (ADD) and attention deficit hyperactivity disorder (ADHD), called neurofeedback therapy (see box right). This method is unobtrusive with no side effects and can be used in combination with Ritalin.

Wade and Corinne were sympathetic to the theory that you can’t diagnose­ the brain unless you can look at it, and so signed Ryan up for the therapy.

“There are many other things that have the same symptoms as ADD — the child could be a genius or simply he or she could suffer from a lack of nutrients.”

Within two sessions of neurofeedback therapy, the areas of Ryan’s brain that needed to be reprogrammed were worked out and, week after week, Wade was able to see the progress that Ryan was making.

“The first few times that Ryan played the boat race game [see sidebar], the alpha and theta boat moved to the finish line, but the beta boat stayed practically in the same place.”

Van Heerden, who has now taken over Harkness’s practice in Westville, said with regard to neurofeedback therapy: “The process seeks a more permanent solution to ADD-ADHD when compared to Ritalin and other medications. Medicines such as Ritalin work only when in the system and treat the symptoms, whereas neurofeedback therapy seeks to correct brain-wave imbalances that are thought to be one of the underlying causes and so it works even when not hooked up to the machine.”

Ryan finished his last therapy session­ in January.

“Last September my wife and I attended another parents’ evening, Wade says. “Teachers told us how much better he was doing. This year Ryan is getting around 70% in some subjects that he used to fail. He has had great success in subjects that require learning, but he is finding subjects that require understanding a bit more difficult; however he is still passing them.”

Van Heerden notes, however, that as with medication, the therapy does not work for everyone.

The treatment often lasts for 25 to 30 sessions in which progress can be plotted graphically from session to session. One can generally determine whether or not the therapy is working by the 10th session. There are no side effects and the treatment is noninvasive.

Wade’s opinion on treating children­ with ADD is that “parents shouldn’t accept putting their child on Ritalin­ without first exploring neurofeedback and other alternatives.

“ADD children are extremely difficult­, you want to pull your hair out, and putting them on medication is merely the easy way to deal with things.”

History

Neurofeedback therapy is not only used for ADD/ADHD, it was first introduced as a treatment for epilepsy. Scientists, artists and musicians also use the treatment to enhance their talent; NASA has even integrated the treatment into their astronauts’training programme to increase concentration while the Italian national soccer team mentioned neurofeedback therapy as their “secret weapon” after winning the 2006 Fifa World Cup.

How Neurofeedback therapy works:

Brain waves are read through the use of an EEG (electroencephalogram) - a device that reads brainwave activity through the use of electrodes that are attached to the scalp with a conductive gel or paste. This device aids in diagnosing ADD/ADHD by measuring the ratio between theta (drowsy) and beta (alert) brainwaves. An excessive amount of theta brainwaves is generally an indication of ADD/ADHD.

Once a diagnosis is made, the patient is shown different training screens while still attached to the EEG; these display different games for the patient to play, such as puzzles and boat races in which the patient has to produce the desired brainwaves in order to solve the puzzle or make the boat move; as if their brain waves are the ‘joystick’. For example, in the boat race training game, three boats race, one boat represents beta waves, which is associated with alertness, another boat represents alpha waves (relaxed alertness), and the last boat represents theta (daydreaming); the patients brainwaves are therefore displayed on screen, excess theta activity would make the theta boat win.

The patient learns through operant conditioning, or via reward how to use their brain more effectively; how to compare their state of alertness to their state of distractedness; and what strategies can be used to regain a state of alertness.

The therapy aims to reinforce certain pathways and development patterns and correct ‘abnormalities’in brain functioning. Additionally, the therapy involves psychology consultations, helping the patient in overcoming other problems that may be affecting their concentration such as family and emotional problems. For example, many ADD/ADHD children have low self-esteems due to constantly being told and believing that they are unable to do things that other children can do. This added therapy provides the patient with coping skills.

Kirsten van Heerden is currently working on her PHD. She became interested in Neurofeedback therapy via her colleague, Timothy Harkness. She has now taken over Harkness’ neurofeedback practice in Westville as he has relocated to work for Chelsea Football Club. Van Heerden enjoys working with kids, feels that if there is an effective alternative to medication people should be educated about it on order to try to help these children.

For more information, contact her: kirsten.vanheerden@gmail.com.

Attention Deficit Disorder/Attention Deficit Hyperactivity Disorder

The main symptoms of ADD/ADHD are inattention; or hyperactivity and impulsivity. If these symptoms have been evident for at least 6 months to the extent that it is disruptive and and inappropriate for the individual’s developmental level. These symptoms often go unnoticed with a child often being labelled as “unmotivated” or having a “discipline problem”.

Indications of inattention include: not appearing to listen when spoken to directly; becoming easily distracted by irrelevant sights and sounds; and avoiding or disliking things that take a lot of mental effort for a long period of time.

Indications of hyperactivity-impulsivity include: blurting out answers before hearing the whole question; running, climbing or leaving a seat in situations where sitting or quiet behaviour is expected; and feeling restless, fidgeting with hands or feet.

An estimated 3 to 5 percent of children are affected.

ADHD is best diagnosed by a child psychologist or other child specialist in ADHD

Other disorders often linked with ADHD include: anxiety, learning disabilities, speech or hearing problems, obsessive-compulsive disorder, tics or behavioural problems.

- http://psychcentral.com/disorders/adhd
http://www.witness.co.za/index.php?showcontent&global[_id]=43611
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