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alleged "alternatives" for ADHD

alleged "alternatives" for ADHD2010-06-08T15:24:52+00:00

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  • #94259

    Anonymous
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    Post count: 14413

    @TLavonLawrence..it’s too bad that things get confused when money is involved. Especially big money.

    I take everything with a grain of salt.

    @BAM123…I don’t know if this helps but I have been helped immensely by a book about food called ‘The Zone’ by Dr. Barry Sears. I have followed it’s basic principals for over ten years now and it helps me stay on a more ‘even’ keel.

    As an ADHD person, I have a tendancy to get busy, do stuff until I’m so hungry I could eat a horse and then gobble down whatever. And too much of whatever. (but whatever is gooooood)

    This book explains how to keep your blood sugar levels even, and thus helping your mood. All sorts of other good thing happen as well. My doctor keeps marvelling on how healthy my blood levels are, how I dropped weight etc etc…all testing done by my MD.

    The book has been out for a long time and you can get it at libraries. If you are vegetarian, he has a book called (I think) ‘The Soy Zone’.

    Hope this helps!

    ; )

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    #94260

    Anonymous
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    Post count: 14413

    POSITIVE FOLLOW-UP ON NEURO-FEEDBACK RESEARCH:

    Thanks to Sharpbrains.com and Dr. Rabiner (http://www.sharpbrains.com/blog/2010/08/05/long-term-effects-of-neurofeedback-treatment-for-adhd/)

    AUG 5, 2010

    Long-term effects of neurofeedback treatment for ADHD

    By: Dr. David Rabiner

    :::NOTE – Forgive the ‘spaces’ in certain words – I couldn’t get it pasted without them:::

    Neu ro feed back — also known as EEG Biofeed back — is an approach for treat ing ADHD in which indi vid­u als are pro vided real-time feed back on their brain­wave pat terns and taught to pro duce and main tain pat terns con sis tent with a focused, atten tive state. This is often done by col lect ing brain wave, i.e., EEG, data from indi vid u als as they focus on stim uli pre sented on a com puter screen. Their abil ity to con trol the stim uli, for exam ple, keep ing the ‘smile on a smi ley face’, is con tin gent on main tain ing the brain wave pat tern being trained.

    Neu ro feed back sup port ers believe that learn ing this dur ing train ing gen er al­izes to real world sit u a tions and results in improved atten tion and reduced hyperactive/impulsive behav ior. Although a num ber of neu ro feed back stud ies have yielded promis ing results it remains some what con tro ver sial with some researchers argu ing that lim i ta tions of these stud ies pre clude firm con clu­sions about the effec tive ness of neu ro feed back from being drawn.

    Last year I reviewed a par tic u larly well-conducted study of neu ro feed back treat­ment for ADHD — see my review here. The study was con ducted in Ger many and began with 94 chil dren aged 8 to 12. All had been care fully diag nosed with ADHD and over 90% had never received med ica tion treat ment. About 80% were boys.

    Chil dren were ran domly assigned to receive either 36 ses sions of neu ro feed­back train ing or 36 ses sions of com put er ized atten tion train ing. The com put er­ized atten tion train ing task was intended to serve as the con trol inter ven tion and pro vided equal amounts of time work ing on a demand ing cog ni tive task under the super vi sion of an adult; the inclu sion of this con trol con di tion is a real strength of the study.

    The main find ings were as follows:

    1. Par ents of chil dren treated with neu ro feed back reported sig nif i cantly greater reduc tions in inat ten tive and hyperactive-impulsive symp toms than par ents of con trol chil dren, i.e,. those who received com put er ized atten tion train ing. The size of the group dif fer ence was in a range that would be con sid ered mod er­ate, i.e., about .5 stan dard devi a tions. 2. Teach ers of chil dren treated with neu­ro feed back reported sig nif i cantly greater reduc tions in inat ten tive and hyperactive-impulsive symp toms than teach ers of con trol chil dren. The size of the group dif fer ence was sim i lar to that found for par ents, about .5 stan dard deviations.

    The authors also exam ined the per cent age of chil dren in each group that were judged to derive a ‘sig nif i cant’ ben e fit, defined as at least a 25% reduc tion in core ADHD symp toms. Fifty-one per cent of chil dren in the neu ro feed back group met this thresh old com pared to only 26% of chil dren in the atten tion train ing con trol group. This dif fer ence was sta tis ti cally significant.

    – New study presents 6-month follow-up results –

    Recently, the authors of this study pub lished 6-month follow-up data so that the dura tion of neu ro feed back treat ment effects could be exam ined. This is an impor tant issue to study as one of the pur ported ben e fits of neu ro feed back treat ment is that the effects can endure well beyond when treat ment has been completed.

    Follow-up data was avail able on 61 of the orig i nal par tic i pants includ ing 38 from the neu ro feed back group and 23 from the con trol group. Follow-up data was based on par ents rat ings only as teacher rat ings were not obtained at this time point.

    Of the 32 ‘drop outs’, par ents of 15 did not return the follow-up rat ing scales while the remain ing 17 had started on med ica tion. Chil dren who began med­ica tion were not included because it was not pos si ble to deter mine the extent to which their cur rent func tion ing reflected their ini tial treat ment or their cur rent med ica tion. How ever, it is rea son able to assume that par ents would only start med ica tion if they were not sat is fied with how their child was doing.

    – Results –

    Key find ings were as follows.

    1. Par ents’ rat ings of core ADHD symp toms indi cated that chil dren treated with neu ro feed back were still doing sig nif i cantly bet ter than chil dren who received the ‘con trol treat ment’. The mag ni tude of the dif fer ence was mod er ate to large, i.e., about .7 stan dard devi a tions. Reduc tions in symp toms scores from the ini­tial base line rat ings were in the range of 25–30% for the neu ro feed back group com pared to only 10–15% for the con trol group.

    2.Children in the neu ro feed back tended to receive lower rat ings for delin quent and phys i cally aggres sive behav ior, but these dif fer ences did not quite reach sta tis ti cal significance.

    3. Par ents’ reports of home work dif fi cul ties showed a greater decline over time for the neu ro feed back treated chil dren than for con trol children.

    4. Group dif fer ences in a range of prob lem atic sit u a tions that occur at home were not significant.

    In addi tion to these analy ses, the researchers also com puted the per cent age of chil dren in each group who were con sid ered to show a good treat ment response, defined as at least a 25% reduc tion in par ents’ rat ings of core ADHD symp toms com pared to base line. This was true for 50% of chil dren in the NF group com pared to 30% of those in the con trol group. These dif fer­ences were in the expected direc tion but did not quite reach sta tis ti cal sig nif i­cance given the rel a tive small sam ple size at follow-up, i.e., a total of only 61 children.

    – Sum mary and Implications –

    Results indi cate that the ben e fits of neu ro feed back treat ment were main tained 6 months after treat ment had ended. Thus, com pared to chil dren who received com put er ized atten tion train ing, which served as the con trol treat ment, neu ro­feed back treated chil dren con tin ued to receive sig nif i cantly lower par ent rat ings of core ADHD symp toms and also showed a greater decline in home work dif fi­cul ties over time. These are encour ag ing find ings and high light that neu ro feed­back can be a ben e fi cial treat ment for some chil dren with ADHD.

    Despite these pos i tive find ings, how ever, it is impor tant to empha size that only 50% of chil dren treated with neu ro feed back showed at least a 25% decline in core ADHD symp toms at 6 months, mean ing that the other 50% failed to show this level of clin i cal response. And, if one assumes that many of the chil dren who began med ica tion were also likely to have been non-responders (pre­sum ably par ents would not have started med ica tion oth er wise), this fig ure becomes even higher. In addi tion, no follow-up data from teach ers was avail­able so it is not pos si ble to know the extent to which any ben e fi cial effects were main tained at school.

    In recog ni tion of these treat ment lim i ta tions, the authors con clude that “…the low respon der rate and the por tion of chil dren start ing a med ica tion in our study argue against NF as a stand-alone inter ven tion for ADHD. The results indi cate that not every child with ADHD may improve after NF treat ment. In our opin ion, NF should rather be seen as a treat ment mod ule for chil dren with ADHD which can be embed ded in a mul ti modal treat ment pro gram tai lored to the indi vid ual needs of the child.”

    The authors also noted, how ever, that because they fol lowed a stan dard ized treat ment pro to col for research pur poses, rather than care fully tai lor ing neu ro­feed back treat ment to each child, that their results may under es ti mate what is obtained in actual clin i cal situations.

    In con clu sion, results from this follow-up study pro vide evi dence that neu ro­feed back can yield endur ing ben e fits for some chil dren with ADHD. As sug­gested by the authors, it may be an impor tant com po nent of a mul ti modal treat­ment pro gram but its con sis tent use as a stand alone treat ment does not seem to be sup ported by the find ings reported here.

    – Dr. David Rabiner is a child clin i cal psy chol o gist and Direc tor of Under grad u ate Stud ies in the Depart ment of Psy chol ogy and Neu ro science at Duke Uni ver sity. His research focuses on var i ous issues related to ADHD, the impact of atten tion prob lems on aca d e mic achieve ment, and atten tion train ing. He also pub lishes Atten tion Research Update, a com pli men tary online newslet ter that helps par ents, pro­fes sion als, and edu ca tors keep up with the lat est research on ADHD.

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