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Friday, May 22, 2009

Neurotherapy for ADHD and Autism

The issues that were identified by the two educators were the increasing number of students displaying symptoms of or being diagnosed with oppositional behaviour, Attention Deficit Hyperactivity Disorder or Autistic Spectrum Disorder and the schools ability or inability to adapt to accommodate the unique needs of today’s children. This paper will define these disorders and explore innovative approaches like neurotherapy and biofeedback to improve various cognitive skills related to attention and memory and to improve the negative behaviours that may be associated with each disorder.

Stanovich and Jordan (1998) have stated that “today’s teachers must deal, as never before, with heterogeneity in their classroom”. Students in the classroom who are severely disruptive may have a variety of mental health issues including Attention Deficit Hyperactivity Disorder, Oppositional Defiance and Conduct Disorder (Cook, 2005) and Autistic Spectrum Disorders. The American Psychiatric Association (1994) estimates that Attention Deficit Hyperactivity Disorder effect between 3-5% of the school aged population. The prevalence for Oppositional Defiance Disorder and Conduct Disorder may lie somewhere between 4 – 15% of the school aged population (Cook, 2005). Children who have been diagnosed ADHD may have a co-morbid diagnosis of Oppositional Defiance Disorder or Conduct Disorder (Jensen, Martin & Cantwell, 1997).

Attention Deficit Hyperactivity Disorder is a neuropsychological disorder that has a strong genetic link within families (Barkley, 1998). Children with ADHD may exhibit behaviour such as a lack of self-control, impulsiveness, inattentiveness and restlessness (Barkley, 1998). They can also be oppositional, disorganized, and verbally or physically abusive to peers and teachers and may have difficulty sitting in their seats (Campbell, 1994). Children with ADHD have difficulty moderating their behaviour in response to certain stimuli (Abikoff, 1985; Barkley, 1998). They are also at a greater risk of school failure and a later diagnosis of a disruptive behaviour disorder (ODD or CD) due to their impulsiveness and actions within a classroom setting (Campbell, 1994).

Evidence is showing that people who have ADHD have difficulties in their frontal lobe which is responsible for executive functioning; attention and impulse control (Chamberlain & Sahakian, 2006). Research using EEG (Electroencephalograph) measurements of brain wave activity in many individuals with ADHD show reduced activity in the prefrontal region and frontal lobes (i.e. cortical slowing) (Gottfried, 2006, Monastra et. al 1999). Niika Quistgard-Devivo (2006) in her article Scatterbrain includes a reference from Dr. Daniel Amen (Assistant Clinical Professor of Psychiatry and Human Behaviour at the University of California) that ADHD may be due to “a lack of blood flow and electrical stimulation to the frontal cortex – the area of the brain involved in prioritizing and focusing. Scans usually show reduced activity in the decision making area of the brain”.

Autism is the most recognized form of a group of disorders referred to as Autistic Spectrum Disorders or Pervasive Development Disorders (Seigal, 1996). According to the Diagnostic and Statistical Manual for Mental Disorders (1994), Autism is diagnosed in reference to three categories: Qualitative Impairments in Reciprocal Social Interaction, Qualitative Impairments in Communication and Restricted, Repetitive and Stereotyped Patterns of Behaviour. Diagnosis can occur as early as 18 months or by the age of three (Seigal, 1996). Claudia Wallis in her article for Time Magazine (May 2006), Inside the Autistic Mind, refers to a statistic from The Center for Disease Control and Prevention that 1 in every 166 children born in the United States will fall “somewhere on the Autistic Spectrum”

The Center for Disease Control and Prevention state that Autism effects the brain in many areas as well as the wiring that connects one part of the brain with another. Autism is a “global disorder that affects reasoning, memory, balance, multi-tasking, and other skills (Center for Disease Control and Prevention, 2006; Williams, Goldstein & Minshew, 2006). Darling (2004) has also noted that children with autism may have problems with gut function that inhibit neurotransmitters to the brain that may effect brainwave activity.

Neurotherapy and biofeedback are innovative treatments being offered to help improve the symptoms of ADHD, Oppositional Behaviour and Autism (Jaruseiwicz, 2002; Perl, 2002). Neurofeedback is a form of biofeedback based on operant conditioning and can be used as a non-pharmacological treatment for ADHD (Butnick, 2005, Alhambra et al, 1995). The client is given information in relation to their state of arousal exactly as it is occurring as measured by the Electroencephalograph (EEG) machine (Gottfried, 2005, Butnick, 2005). The use of EEG feedback has been found to strengthen brain function and regulation of brain wave activity (Robbins, 2000).

Perl (2002) found improvements in impulsiveness, activity level, attention, completing tasks, and fewer aggressive outbursts as shown by the post TOVA (Test of Variables of Attention). Monastra (2002) has also found a decrease in the symptoms of ADHD with neurofeedback as shown by results using the TOVA and the Attention Deficit Disorders Evaluation Scale. Monastra (2002) also notes that children using Ritalin benefited from the Neurofeedback but those who were taken off the medication and had not completed the Neurofeedback sessions showed no retention of improvement. Those that were taken off the medication and completed the Neurofeedback training retained the improvement in symptoms of ADHD (Monastra, 2002).

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One of the biggest issues that I hear about from teachers and caregivers is the behaviour of the children or youth in their school, program ...