What Is ADHD?
ADHD (attention deficit/ hyperactivity disorder) is a problem in children and adults that is typified by an inability to focus, stay alert, and maintain attention on tasks requiring some level of sustained concentration. Somewhere between 5-12% of children and adults are afflicted with ADD. Down through the years there have been many ideas posed as to what causes ADD.

The prevailing theory to date is that ADHD is a congenital disorder with a sizeable genetic link that causes cortical underarousal, thus causing some level of brain “deactivation” or under-stimulation in the frontal and parietal lobes. This “brain dampening” or underarousal disables normal functioning for the frontal lobes, impairing the executive functions of the frontal lobes. [Below is a chart portraying the lobes of the brain.]
                                             

                        
The executive functions of the frontal lobes allow the person to focus, pay attention, concentrate, control their impulses and emotions, exercise judgment, plan, organize, and regulate motor behavior (i.e. inhibit their impulses and sit still). Cortical underarousal disables the executive functions, severely compromising the ADD person s ability to pay attention, focus, and inhibit their impulses. Research (e.g. brain imaging, EEG studies) has demonstrated that the brains of ADD children and adults can best be described as “sleepy brains”, as their brains are typically like the brains of sleepy “normals”, with a preponderance of the drowsy brain wave frequency.


An EEG (i.e. electroencephalogram) is an instrument that measures the electrical activity of the brain by recording residual electrical activity from electrodes (or sensors) on the scalp. The wave forms on an EEG  graph corresponding to the different brain waves are illustrated below. Research indicates that the conscious but "sleepy" brain wave patterns (i.e. theta wave and “low” alpha wave) occur much more often in ADD children and adults, causing cognitive lethargy that has been identified in studies as sluggish cognitive tempo. Treatment for ADHD increases the frequency (or "cycles per second") of the electrical brain wave signature to increase cognitive alertness and focus.

         

Treatment for ADD and ADHD in children and adults may take a more biological form as in the prescribing of stimulant medication (e.g. Adderall, Concerta, Metadate, Strattera), or a non-medication approach, as in behavioral treatments and attention training. Stimulating medications perk the brain up by increasing levels of the more excitatory neurotransmitters in the brain (e.g. norepinephrine, dopamine), and with the stimulating effects, boosting the brain wave frequency into a higher prevalence of beta waves - a more alert brain wave frequency.

One of the more novel approaches in recent years is an approach that combines the advantages of sophisticated EEG technology and a behavioral learning model. This new tool in the treatment of ADHD is an approach called EEG biofeedback, or neurofeedback.  Neurofeedback uses an EEG technology wedded to sophisticated computer software to provide gamelike reinforcement to the ADD subject, training them to develop increasing levels of beta wave activity (the alert, focus waves) and decreasing levels of theta wave activity (the drowsy, sleepy waves). Below is a closer look at a young woman training on the neurofeedback machine.


          


EEG biofeedback training has become in recent years a powerful tool and a very effective non-medicinal alternative for the treatment of ADD and ADHD. Neurofeedback training requires an average of 40-60 training sessions of at least 30 min. each session. Research studies indicate that EEG biofeedback is equal in effectiveness to stimulant medication. Below is a table comparing the strengths and weaknesses of medication versus EEG biofeedback. [The number of plusses or minuses indicates a strength or weakness.]

                              Comparison of Medication vs. EEG
      MedsEEG Training
Efficacy in treating ADD/ ADHD       ++      ++
Speed of therapeutic onset (how fast does it work)       ++       -
Side effects and "adverse drug events"        -      ++
Cost of therapy
        +

(0-2 yrs. of treatment)


       +

(2+ yrs.after treatment)


Long term cost vs. benefit of treatment        +       ++
Sense of personal "empowerment" and control over one s ADD        -       ++
 
Might it help your child?

Here is a comparison of the effectiveness of EEG Biofeedback training vs. Stimulant Medication (Ritalin, Adderall, or Dexedrine) vs. ATTEND. These results are from two studies using the computerized TOVA test. Read more on the studies.



EEG biofeedback training works best with subjects who have average to high IQ, are seven years old or older, can sit still for a few minutes if interested in what he s doing, and are motivated people. It works much less well for those with low IQ, or are very young, or who couldn t sit still under any circumstances, or those who "don t want to be here." The worst results are with 14 to 17 year olds who have been dragged to treatment by their mothers and don t want to be there.