What is ADHD?


Attention Deficit Hyperactivity Disorder (ADHD) is a neurological condition that results in a person displaying a number of behavioural symptoms. The pattern of behaviour differs between individuals because each person has a different combination of symptomsand each symptom varies in severity.
Some of the more common symptoms include:



Distractibility Difficulty in sustaining attention, often getting distracted by other stimuli such as sights and sounds and losing concentration easily.
 
Impulsivity Doing things without thinking, saying things out of turn and appearing impatient.
 
Hyperactivity Not being able to sit still, constantly moving and fidgeting.
 
Insatiability Continuing with a line of conversation, never appearing to be satisfied with an answer.
 
Social Clumsiness Not picking up on subtle social clues, and so appearing tactless and overpowering.
 
Poor Coordination Difficulty in performing multiple tasks, looking uncomfortable in their movements, and being clumsy.
 
Disorganisation Not having structure to their tasks, often flitting between jobs, whilst also being messy.
 
Variability Switching moods very quickly, having good and bad days.



How is ADHD diagnosed in children?


Making a formal diagnosis of ADHD is a complex process and involves a number of health professionals. However, the greatest difficulty is ensuring that symptoms are not just a reflection of other disorders, such as dyslexia, and that the symptoms are not masked by a co-morbid condition, such as asperger’s syndrome.


The official list of symptoms which healthcare professionals use to diagnose ADHD in children (diagnostic criteria DSM-IV1 or ICD-10) state that the child must display 6 symptoms of either inattention or hyperactivity-impulsivity (or both) and symptoms must have been present for at least 6 months.



Inattention


Hyperactivity-Impulsivity

The symptoms must begin before 7 years of age, and be present in at least two places, such as school and home. The disorder must negatively affect functioning in these places, and the symptoms must not occur solely because of a psychotic disorder (e.g. schizophrenia), or be better explained by an alternative disorder (e.g. mood, anxiety or personality disorder.


The above criteria enables three types of ADHD to be diagnosed as follows:

  1. Combined Type: if both inattention and hyperactivity-impulsivity symptoms exist.
  2. Inattentive Type: if only inattention symptoms exist (sometimes referred to as Attention Deficit Disorder)
  3. Hyperactive-Impulsive Type: if only hyperactivity-impulsivity symptoms exist.



How is ADHD diagnosed in adults?


Diagnosing ADHD in adults involves the assessment of the following symptoms:

  1. A sense of underachievement, of not meeting one’s goals (regardless of how much one has actually accomplished).
  2. Difficulty getting organised.
  3. Chronic procrastination or trouble getting started.
  4. Many projects going simultaneously; trouble with follow through.
  5. A tendency to say what comes to mind without necessarily considering the timing or appropriateness of the remark.
  6. A frequent search for high stimulation.
  7. An intolerance of boredom.
  8. Easy distractibility, trouble focusing attention, tendency to tune out or drift away in the middle of a page or a conversation, often coupled with an ability to hyperfocus at times.
  9. Often creative, intuitive, highly intelligent.
  10. Trouble in going through established channels, following “proper” procedure.
  11. Impatient; low tolerance of frustration.
  12. Impulsive, either verbally or in action, as in impulsive spending of money, changing plans, enacting new schemes or career plans, and the like; hot-tempered.
  13. A tendency to worry needlessly, endlessly; a tendency to scan the horizon looking for something to worry about, alternating with inattentiveness to or disregard for actual dangers.
  14. A sense of insecurity.
  15. Mood swings, mood lability, especially when disengaged from a person or a project.
  16. Physical or cognitive restlessness.
  17. A tendency toward addictive behaviour.
  18. Chronic problems with self-esteem.
  19. Inaccurate self-observation.
  20. Family history of ADD or manic-depressive illness or depression or substance abuse or other disorders of impulse control or mood.

Twelve of the symptoms must be present. Other indicators include a history of childhood ADHD (although not necessarily formally diagnosed), and the symptoms not being explained by another medical or psychiatric condition.




What are the effects of ADHD?


ADHD is predominantly diagnosed in children, and has a profound impact on a child’s developmental learning. It is now recognized that children do not grow out of ADHD, indeed it has been estimated that 60% of the child ADHD population retain their symptoms into adulthood. Often people who carry ADHD symptoms into adulthood experience low self-esteem due to constant academic and social failures. This exacerbates the problem of having to cope with ADHD symptoms in adult life and can compromise an individual’s ability to achieve their potential. Other long-term results of untreated ADHD can include relationship problems (both personal and professional), lower income-earning potential, and psychiatric problems. Studies that have evaluated outcome of adults with ADHD have reported a high incidence of anti-social disorders and substance dependent disorders.


Furthermore, the prevalence of ADHD sufferers in a prison population has been found to be 45%. These reports imply that the early treatment of ADHD is essential to provide the best chance for a child or adult to lead as normal a life as possible.


Traditional treatments for ADHD


The negative side-effects of stimulant medication such as Ritalin are very common and well-known. Furthermore, medication is not always successful in alleviating the symptoms of ADHD or may only provide a temporary improvement that does not last.


For these reasons, more people are turning to neurofeedback as an alternative treatment for ADHD. In many cases, neurofeedback can eventually replace the need for medication. In fact, recent research suggests that neurofeedback is significantly more effective than stimulant medication in changing ADHD (Monastra,2002)*.


What is neurofeedback?


Neurofeedback* is also known as "EEG Biofeedback" as it is based on the brain's electrical activity, the electroencephalogram (EEG)*. It is a painless, non-invasive method which helps people to modify their brainwave activity to treat deficits in attention and concentration, and reduce hyperactivity and impulsivity.


Research suggests that dysregulation of brain activity or maladaptive brainwave patterns are frequently associated with medical and psychological disorders, including ADHD symptomatology. Neurofeedback directly addresses problems of maladaptive or dysregulatory brain activity by correcting abnormal brain waves, and in turn, reducing or eliminating ADHD symptoms.


Electrodes are applied to your scalp and brainwave activity is transmitted to a computer. Momentary increases or decreases in brain activity are monitored and instantly fed back to you in either a visual or auditory format (e.g. video/games, sounds), so that you see and hear representations of your brain in action. By having an awareness of fluctuating brain activity, you can attempt to influenceŽand change their brain patterns through feedback presented in the form of video-files, DVDs, games or sounds.


An individual gradually learns to gain control over certain brain frequencies, which after a number of sessions, will eventually be reflected in more desirable behaviour, diminished ADHD symptoms, and more regulated performance.


Neurofeedback is an evidence-based treatment for ADHD, which can result in significant long-term improvements in behaviour and performance (see "Support for Neurofeedback as a Treatment for ADHD”


How does neurofeedback treat ADHD?


Children with ADHD

In the case of children with attentional difficulties, e.g. ADHD, brain research has documented an excess amount of slow-wave activity, called theta waves, in the pre-frontal cortex. Theta waves are especially predominant when children with ADHD try to engage in an active concentration task, which makes it very difficult for them to focus and sustain their attention on the task over a prolonged period of time. This is illustrated in the brainmaps below. Through neurofeedback training, children are taught to decrease their amount of theta activity and increase faster beta frequencies which enables them to sustain attention and focus on the task at hand.

An example can be seen to the right from a client with ADD and concentration difficulties. The illustration below shows the obvious visual differences in brainwave amplitude or size compared with normal brain activity.

The brain maps to the right further highlight abnormalities in brain function; the red colour indicates areas of severe over activity within a specific slowwave frequency band called delta. The client performed trained to suppress slowwave activity in the left frontal area of the brain, an area which regulates several executive cognitive functions. An early brainmap performed after only 12 sessions showed significant reductions in the amount of slowwave activity in the left frontal area concomittant with subjective improvements. The training electrode was subsequently moved to another area on the scalp to downtrain activity there.

        

qeeg pre and post 12 sessions only

It is important to note that this pattern of brain activity is not applicable for all  people with ADHD. At PeakMind, we know that each individual is unique and has specialised personal needs. Hence, we adopt a personalised approach gathering numerous data from the individual (e.g., brainmaps, questionnaire data), and subsequently designing a personalised treatment plan tailored to each individual.

Successful neurofeedback training has been shown to:


Adults with ADHD

Successful neurofeedback training can:


Neurofeedback as a treatment for ADHD

If you or your child has been diagnosed with ADHD, PeakMind can offer neurofeedback training* as an alternative form of treatment.This research-supported method is a gradual learning process, but one that does not involve medication. For further information about neurofeedback please go to “Neurofeedback: What is it?”*


At PeakMind, the individual undergoes an extensive initial assessment which isŽnormally conducted at one of our clinics. We gather numerous data from the individual including a quantitative EEG (qEEG) assessment*, clinical interview, standard neuropsychological tests* and questionnaires. We subsequently design a personalised treatment plan tailored to each individual, taking into account their unique issues or problems, and assessment data. We will then use this data to guide the neurofeedback training.Neurofeedback training can be conducted either within one of our clinics or at home*.


The effectiveness of neurofeedback has been well-documented by scientific research. Neurofeedback therapy is completely safe and non-invasive. In fact, many doctors and psychologists have incorporated or consistently recommended neurofeedback as part of the treatment for their patients. Here in the PeakMind works in partnership with a leading assessment centre for ADD/ADHD, providing neurofeedback services for a large number of patients­­.


Click here to read about the support for neurofeedback as a treatment for ADHD.


Support for Neurofeedback as a Treatment for ADHD


Please check our Research section for litterture concerning neurofeedback treatment of ADD/ADHD.


 

 

 


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