Monday, November 17, 2008

ADHD and Neurofeedback

Here are two good Videos about ADHD. The first is about Diagnosing ADHD in Children. The second is about treatment - specifically Neurofeedback.

1 comment:

Tom said...

I believe that CHADD is not as positive to ADD/HD mental framing as it could be.

DSM and traditional type keep focusing only on the deficits and none of the positives.

This is one person's view, that I agree with.

The Problem With CHADD and "Accommodations"

CHADD (Children and Adults with Attention Deficit Disorder) has undoubtedly helped a great number of people with ADD. The group was started back when no one had heard of ADD and at that time ADD behavior was attributed to shear laziness and lack of character. Since that time, in large part to CHADD, the public now understands that some people have a harder time than others when it comes to paying attention and sitting still. And many people have been helped by medications and other strategies used to help with ADD. If not for CHADD, these people probably would never have known about ADD.

However, now that awareness of ADD has increased to the point where nearly everyone has heard about it, I believe that the group's agenda has become an obstacle for ADDers. The group strongly believes that ADD-type behaviors are caused by brain defects, even though a number of experts in the field believe that such behaviors are often perfectly normal, though different. That is, brain differences vs. brain defects. This is critically important because CHADD is the number one resource for ADD information in the country. All of the information CHADD disseminates to doctors, patients, schools, parents and the government is skewed in a very significant way because of this bias.

CHADD omits the many positive and alternative views of ADD held by researchers and experts in the field of ADD. If you look at their website, you will find no mention of anything at all remotely positive about ADD. Not Dr. Bonnie Cramond's research on the link between ADHD and creativity; the common belief that Thomas Edison and Mozart were ADHD; the similarities between ADD and Gifted/Creative behaviors; positive comments from experts like Ned Hallowell, M.D., or even the slightest acknowledgement that there are respected people in the field of ADD who believe that the syndrome is a natural condition rather than a real disorder.

A while back I wrote a letter to CHADD asking them to post some positive information on their website, or at least link to some other websites with positive information. I never heard back from them.

On the other hand, CHADD has posted a letter by Dr. Barkley in which he describes ADD in the most negative and depressing terms possible, painting a dreary picture of a lifetime of low intelligence, poor performance, and jail time. Dr. Barkley believes that ADD itself lowers a person's intelligence and he brushes aside the fact that many ADDers are quite successful. Dr. Barkley's ideas are just that: his ideas. They are not fact and they should be balanced by information from other ADD experts, creativity and temperament researchers, psychologists and others with ADD experience. CHADD has a duty to let people know there are legitimate opposing factions within the field of ADD.

CHADD is supposed to be an advocacy group. But what CHADD seems to be advocating is not the people who are ADD, but rather the concept of ADD as an severe brain defect. If CHADD was an advocacy group for people who are ADD, then it would spread the news about ADDer's positive attributes far and wide. It would encourage teachers to recognize different temperaments and learning styles and provide creative hands-on opportunities for ADD children, push for smaller class size, advocate alternative schooling, recommend that children be given creativity and IQ tests as part of their ADD assessment, and so on.

Instead, CHADD is pushing for special accommodations by schools and employers under the American's With Disability Act. This issue is particularly dangerous for those of us who are ADD. A backlash has already formed against ADDers because of the special accommodations which a few people have been demanding under the law. For example, prospective ADD attorneys get extra time when taking the bar exam, and employers are now afraid of having ADD employees on their payroll because the law requires them to make "reasonable accommodations". I suspect the majority of people with ADD do not want such special treatment. Moreover, it endangers the careers of ADDers, many of whom are doing just fine. It's a small world, and word of an employee's ADD condition can spread quickly within someone's field, making it hard for them to find a job. I find the law insulting, quite frankly. I don't need extra time to take a test (I have the opposite problem - I rush through tests), or any sort of special accommodations by my employer. I am not disabled, I just think differently.

CHADD has been instrumental in removing responsibility. They are very quick to tell parents "it's not your fault." Parents are never to blame for their children's behavior; schools and teachers are never to blame for a child acting out in school; and ADDers are never to blame for their own behavior. Everything is instead blamed on the brain defect. However, in a study recent reported by Science News, 37 ADHD children were removed from medications while their parents received special training, especially with regard to discipline. After a year, all the children were still off the medications. Obviously how parents act is extremely important and part of the ADD equation. It is simply amazing to me that CHADD can fail to report this side of the story.

Before CHADD existed, everything was blamed on the parents, which was equally wrong. The truth is that ADDers are biologically different from their peers, but parents and teachers DO have profound effects upon their behaviors. Effective, loving discipline is absolutely critical, and I have personally witnessed out-of-control ADHD children whose parents were absolutely clueless about discipline, instead whining, nagging and yelling at their children over and over without enacting consequences. Of course the child was out of control! And regardless of what CHADD insists on telling everyone, the parents ARE partly responsible for that.

From the day my son Ryan was born I have told myself that if he is acting out, his needs are not being met. As his mother, it is my responsibility to figure out what those needs are and to provide for them. Over and over again I have slipped into a habit of exasperation with his behavior, finding him and I Iocked in a cycle of negativity and competition for several weeks. And at these times I have forced myself to stop and think "Who is in charge here? What am I doing wrong?" And each time that I have stopped and done some soul-searching I have found that indeed something was not right. The most common scenario has been Ryan not getting enough positive attention to counterbalance all the negative comments ("Ryan!! Get off of the stove!"). It's so easy for my husband and I to become caught up in our own world of work, chores, and home improvement projects we forget to make time for Ryan. Some other typical sources of problems I've identified with Ryan include poor rule making or discipline techniques on my part, problems with specific teachers, overstimulation, allergy medication and lack of sleep. I have always found a way to improve my son's behavior by changing my behavior or his environment. These improvements have typically been dramatic. If Ryan is acting out, I blame myself and then I figure out what is wrong and try to fix the problem. This has worked. But according to CHADD, this strategy is wrong. I should be telling myself it's not my fault and seek professional help instead for his brain "defect." Then I suppose the doctors can step in to medicate my hopelessly out of control child. Thanks, but no thanks. My strategy of blaming myself (and on occasion his teachers) has worked wonderfully.

Personal responsibility for the ADDer is also removed by CHADD. When I am late for work, I'm not late because of my ADD, I'm late because I didn't leave the house on time. If I forget to do something at work, it's not because of my poor memory, it's because I failed to write it down. Never do I blame ADD. It's my responsibility to recognize my weaknesses and overcome them. Based on what I've heard from other ADDers I think most would agree with me. But CHADD, in their strong support of special accommodations, obviously thinks otherwise.

Certain people have been using this "accommodations" or "defect" strategy wherever they can. Recently a Connecticut man claimed the reason he failed to pay his taxes for several years was because he was ADD. The judge found him guilty anyway, but the case was on the front page of the paper... "MAN SAYS ATTENTION DEFICIT DISORDER CAUSED HIM TO MISS TAX PAYMENTS."

There's a grave danger in this "accommodations" attitude. If you are so defective that you require special accommodations, then you must, by definition be unable to do certain things. Is this what we want the world to think of ADDers? That we are incapable and unable? What will our job prospects be? What hope would ADD children have for their future? We cannot have it both ways. Either we are capable or we are not. CHADD is telling the world that we are not. I would argue the opposite: we ARE capable, we just have to put more effort into organizing and finding an interesting career. Being capable means being responsible. ADDers need to accept responsibility for their own actions, and CHADD is certainly not helping.

Witness how the defect attitude (which goes hand in hand with accommodations) can also be used by "normal" people to try and justify their behavior. A reader wrote to me that her 8-year old granddaughter had been struck and killed by a motorist. The granddaughter, who was being treated with Ritalin, had begun to cross the street and then suddenly doubled back into the path of the oncoming car. The driver was speeding, doing 40 mph in a 25 mph street near a young child. Even so, he refused to take responsibility for his own behavior, saying that the girl had a disorder which caused her to behave unpredictibly.

And "normal" adults can easily use a diagnosis of ADD as an excuse not to change school environments or parenting styles. If a child is seen as different but within the broad range of normal, I believe there is greater pressure for adults to accept responsibility for providing a suitable environment for that child.

Regarding special accommodations in schools: Public schools are required to accommodate ALL learning styles and needs, not just those of ADDers. If a child has problems with fine motor skills so that he has trouble taking tests but knows the subject matter, then a reasonable accommodation would be oral tests or the use of a computer in certain subjects. The student should not have to be identified as ADD, however.

CHADD is big on pushing for schools to provide special education classes for ADD children. They picture "normal" kids in the main class and ADD (defective) kids segregated off to the side in special ed classes. While there is certainly a need for special ed classes, I think we should view ADD kids not as defective kids requiring segregation, but as canaries in the coal mine. They are the ones most sensitive to teaching methods and class size. Based on what I've learned about temperament and learning styles, a slight majority of children learn best using techniques and strategies which ADD kids respond to (lots of hands-on learning, plenty of physical activity, independent projects, small class size, individual attention, extroverted and interesting teachers, etc.) CHADD should be working to change mainstream classes so that most kids learn better and ADD kids can stay in the main classroom.

Smaller class sizes is an issue which is big right now (California recently passed a referendum on class size limits), but there is nothing on CHADD's webpage about that. I suspect that if class sizes were smaller, there would be fewer kids diagnosed with ADD in the first place.

Many ADD children do well in alternative schools or in home schooling. I have heard one psychologist say that homeschooled ADD children almost never need medication. CHADD should support government policies which free parents economically to send their children to private or alternative schools. Many parents have told me they can't afford a private school, although the government is paying all kinds of money for special ed classes in the public school. A voucher system would allow parents to choose an alternative school which might be more compatible with their child's learning style or which might simply have smaller classrooms and better discipline.

CHADD describes certain alternative treatments available and explains why these are ineffective. I agree with CHADD that there is no magical alternative treatment which will "cure" ADD and that there are a lot of scams out there. However, I believe that CHADD should be more open to the idea that ADDers are affected by many things in their lives, including discipline, boring classrooms, diet, stimulation levels, allergies, medications, etc. A predisposition towards ADD may be exacerbated by a combination of environmental factors to generate unacceptable behavior. Parents of ADD children would be wise to examine these factors to see if any are affecting their child. For example, I have spoken to a few parents who had incredible success by removing certain foods from their child's diet. But CHADD would apparently disagree that environmental factors contribute to ADD behavior. They have posted a page which debunks certain "alternative" therapies but is silent about scientific studies on omega-3 fatty acids and parent training, and on the success of alternative schooling.

CHADD is partly funded by the manufacturer of Ritalin, CIBA-GEIGY. They swear their agenda does not reflect this. But when you see how incredibly biased their agenda is towards ADD being a "defect" which requires medication, it's pretty hard to believe they're not being influenced by pharmaceutical companies.