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2001 First Web Report
The recent boom in remedial methods for Attention Deficit Disorder (A.D.D.) and Attention Deficit Hyperactive Disorder (A.D.H.D.) has come to a standstill at psycho-stimulant medication. A clean, cost-efficient, fast-acting way to "cure" children and adults of learning, concentration and impulsivity difficulties, psych-stimulant drugs such as Ritalin (methylphenidate), Adderoll and Dexedrine (dextroamphetamine) line the shelves as the "hottest" way to minister the disabilities. With a "make everything better" pill, doctors are quick to prescribe, parents are happy and for once, unruly children are behaving; ADD/ADHD troubles are over.
In response to the growth in psycho-stimulant users, reconsideration of alternative remedial interventions for ADD/ADHD occurred. Many have overlooked alternative intervention research out of popularity and public acceptance of the medication. I would like to present four major alternatives to stimulant drug therapy: natural drugs and homeopathy, counseling, assistive technology school support services and EEG biofeedback. How effective are they? Knowledge by the general public of these interventions has been found to be minimal; what is known exist in the form of assumptions of ineffectiveness, safety or trust-worthy. What is the validity of this accusation or the efficiency of the treatments? Are the alternatives as effective for ADD/ADHD?
Today, three to five percent of children in the United States are diagnosed with ADD/ADHD (6). Central behavior characteristics of ADD and ADHD are generally viewed as inattention, hyperactivity and impulsivity (4). Caused by brain irregularities, ADD/ADHD begins with "...anatomic and/or neurotransmitter abnormalities in the cortex of the frontal lobes which are important in attention impulse control and the planning of activity" (5). Neurotransmitters are naturally occurring chemical substances in the brain that transmit information to other regions. Defect in the metabolism of the neurotransmitters leads to the behavioral and attention issues of ADD/ADHD. The cause of the brain region abnormalities of ADD/ADHD is unknown. Many plausible theories have been presented; some say the cause is genetic, others- environmental factors (7). The behaviors are apparent in and out of the classroom; they exist in all aspects of a person's life. Over-diagnosis has become a major issue in recent years. Academics and parents use ADD or ADHD as an excuse for their child's active behavior, imagination or difficulties in school.
The psycho-stimulant medications provide temporary assistance to ADD/ADHD, helping people maintain daily habits, complete basic tasks and increase attention in classroom and social settings (1). Though the psycho-stimulants "...increase concentration and focus while decreasing distractibility and impulsivity", they only provide temporary assistance (2). Short-term enhancement of one's information gathering ability and greater focus, results in enhanced reading comprehension and memory. Psycho-stimulants "...work on correcting neurobiochemestry of the brain which is thought to be the cause of ADHD symptoms. These medications enhance receptor functioning, inhibit the breakdown of certain neurotransmitters in the brain, and themselves act as neurotransmitters (2) ".
Alternatives to psycho-stimulant medication cover a wide range of approaches. Support of their effectiveness is determined by their method. Levels of assistance range on individual scale; geared towards specific disability characteristics and behaviors.
Most similar to the psycho-stimulants, natural drugs and homeopathy operate a natural method to assist the neurotransmitters in the brain. According to specific symptoms the treatment is tailored to needs of the person. Reasonably priced, all-natural, long-term effects and treatment on an individual basis are some of the pros of the intervention. Sample doses could contain a wide range of products, some as unhealthy as the stimulants themselves (9).
Self-confidence in one's capabilities is the central goal of the therapy and counseling method. More psychological than neurological based, therapy guides and reassures ADD/ADHD patients on their abilities and provides daily behavior and attention management. Therapy covers a wide range of treatments from psychosocial and behavioral treatments to routine community care, all helping people cope with their disability. People are treated on individual basis; the personal and intimate style of therapy helps patients become comfortable with their disability and personal management on their own (8).
Similar to therapy, assistive technology focuses on specific and individual abilities. The method works to improve student's self-esteem in the classroom. By working on problem solving skills for youth and adolescents, assistive technology is directed towards where the disability is omnipresent, the classroom. Direct teacher strategic assistance provides students with a clear orientation. The method bases itself on teaching strategies for the classroom and individual products to help the student overcome minor difficulties(12). Products like handheld spell-checks to improve spelling reinforce the student's self-esteem, supporting the motive of the intervention. This method has been shown to work best for college students, though specific strategies such as direct instruction and control of task difficulty have shown efficiency in youth (8).
A non-stimulant, alternative biological method, EEG biofeedback, guides the brain in management of the central nervous system. Brainwaves are measured and controlled through an EEG, electroencephalogram, which regulates a plethora of bodily and psychological functions, an intervention for ADHD. The procedure performance consists of the patient connected to conductor pads, which read the brainwaves, while simultaneously observing the waves that appear as colored bars on a graph. Control of the brainwaves is the goal of the exercise, moving the colored bars move either up or down, producing slow and fast brainwaves. Response to "Brainwave training" has been mixed; studies show that improvement is shown, though the amount of improvement could be minimal (11). Environmental factors, such as social and home setting affect the results along with age and degree of disability of patient (10).
Within each method, smaller research projects have been conducted applying aspects of the method to programs and tools in assisting technology. I find these to be of the greatest assistance. A group of NASA psychologists created a video game to help kids pay attention with their invention of virtual reality biofeedback. Tools for the classroom have been invented as part of assistive technology, such as tape-records, spell checks, note taker machines, and computer programs which assist vocabulary enhancements and typing quality. A Multimodal Treatment Study, where research was conducted using four kinds of treatment on a study of children with ADHD, concluded that a combination of psycho-stimulant medication and behavioral therapy has been proven most effective among the current research (8). From what is known, ADHD is part psychological and part biological, therefore the suggested combination method is most supportive.
No remedial method can ever be proven to be more effective than the other, even psycho-stimulant medication. The major problem is that the causation of ADD/ADHD is unknown. Researchers and institutes present possible explanations on the workings of the disability, which are frequently disproved. Before conducting remedial research one must establish an understanding of the disorder, what is affected in the brain, cause of the occurrence and consequences of the defect. Can applicable information be induced from the plausible causes introduced by neurobiological research?
2)LD Online Website, "Top Ten Things I Wish Students With ADD/ADHD Knew About Their Medication." By, Patricia O. Quinn M.D. April 1998.
3)Attention Deficit Disorder at about.com , explanations of the workings of stimulant medication. By Anthony Law.
4)Attention Deficit Disorders at about.com, From the page of biology of ADD links.By Ruth Mark. 2001.
5) NYSPA website, On the cause of ADHD from NYSPA section on children and adolescents. By Richard Perry M.D.
6)Official Website of Attention Deficit Disorder, interview with Dr. Jakas, 1998. From "what is ADD forum" on ADD.org
7) Official Website of Attention Deficit Disorder , "Basic Information about Attention Deficit Disorders." By Rebecca C. Booth. 1998. ADD.
8)National Insistute of Mental Health website,"NIMH Research on Treatment for Attention Deficit Hyperactivity Disorder (ADHD): The Multimodal Treatment Study" 2000.
9) Homeopathy page at Healthy.com, "An Alternative to Ritalin; Homeopathy as Treatment for ADD". By, Judyth Reichenberg-Ullman M.D. 2000.
10) EEG biofeedback website. , "Evluation and Remediation of Attention Defects." By, Susan F. and Sigfried Othrmer. 1992.
11)Mental health at about.com, "Virtual Reality Feedback". By Leonard Holmes, Ph.D. 2001
. 12)research at LD Online,"Assistive Technology for Post Secondary Students With Learning Disabilities". By, S. Day and B. Edwards. September 1996.
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