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Neurofeedback for Children with ADHD

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Parents, are you fed up?

Every year, it seems as though there is a new statistic showing how ADHD diagnoses are increasing in the United States. Now that we know more about the disorder, it is easier to pinpoint the symptoms and intervene with children experiencing inattention, hyperactivity, and impulsivity.

Medication, mainly stimulants, is recommended as the number one treatment option for ADHD. The best treatments involve a combination of medication, therapy, and behavioral interventions.

Some parents, however, do not want to medicate their child. Medications can cause a whole host of side effects. While they are taken to affect a specific area of the brain, medication can impact other areas of the body as well.

Stimulants increase dopamine stimulation but they can cause side effects that affect other parts of the body.  Children on medication can experience sleep issues, irritability, anxiety, fatigue, and other physical symptoms. 

Hmmm…. have you tried  Neurofeedback for children with ADHD?

Sometimes it seems everything your trying is not working. The medication and behavioral interventions are “fine” but they do not work long term or sometimes do not work at all.

Or maybe, you want to add something new to the mix of treatment that involves “teaching” your child’s brain new tricks.  A new promising intervention that is garnering support is known as Neurofeedback!

Neurofeedback is a treatment which focuses on “training” a brain to focus and pay attention. The goal of this intervention is that the brain should learn on its own how to become more attentive. By learning to stay focused and attend, one can actually teach their brain to “actively listen” and increase fast brain wave activity. 

What happens in session one of Neurofeedback?  

In this intake session, participants have electrodes attached to their heads as they watch a video, play a  game or pay attention to a screen. During this time, an EEG records their brainwave patterns to measure their brain activity and compares it with what a “typical” brain wave pattern should be (of a non-ADHD person). 

Typically, people with attentional issues and ADHD have abnormal brain wave patterns: they are either processing information too slowly or too quickly. This means that their brains are being over-active (fast brain waves) or under-active (slow brain waves).

The EEG recording taken in the first session shows the clinician the mapping of the patient’s brain wave patterns and color codes where activity or inactivity is occurring.

The end goal of all neurofeedback sessions is to match the individual with ADHD’s brain wave patterns to what an attended/focused brain wave pattern looks like. 

Session two and beyond- Neurofeedback Treatment

In the next sessions of neurofeedback,  electrodes are attached to a participants head as they play a computer game, watches a show or pays attention to a picture on a screen.

If they lose focus or stop paying attention to the task, their EEG recording shows this increase in slow brain wave activity and their computer game, show or picture pauses or blurs. 

The only way for a participant to get the video or picture to continue or un-blur is for them to concentrate and focus again (increase brain activity). This is a sign to the participant that their brain needs to focus, once they start to concentrate the brain wave pattern is normal again.

Studies on Neurofeedback :

Neurofeedback has been found to be successful compared to other treatment options in alleviating ADHD symptoms in children. However, being that it is a newer treatment option, there remains far less literature on neurofeedback than on other methodologies such as therapy and medication.

Regardless, there remains a vast amount of people with personal stories of how neurofeedback was extremely effective in improving their child’s ability to focus.  There are examples of parents who did not want to use medication or wanted to try this in combination with other treatments that have boasted of the results. More research definitely needs to be conducted to prove that neurofeedback can be effective without medication in treating children with ADHD. 

Quick……Remember:

  • Neurofeedback requires 20-40 sessions, about half hour to forty minutes each.
  • It can be quite pricey with parents spending up to $3,000 on this treatment option! Definitely, take this into account and be sure to find the most viable treatment option for your child 🙂 

Work Cited

www.aboutneurofeedback.com/conditions/adhd/

http://www.healthline.com/health-news/can-neurofeedback-help-kids-with-adhd-020315

https://www.psychologytoday.com/blog/all-about-addiction/201612/have-child-adhd-neurofeedback-is-great-alternative

Vollebregt, M. A., van Dongen-Boomsma, M., Slaats-Willemse, D., & Buitelaar, J. K. (2014). What future research should bring to help resolving the debate about the efficacy of EEG-neurofeedback in children with ADHD. Frontiers in human neuroscience, 8.

http://www.helpforadd.com/2014/april.htm

http://www.npr.org/templates/story/story.php?storyId=130896102

https://www.additudemag.com/neurofeedback-adhd-brain-training/

CBT for ADHD

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Negative Thought Patterns

Living life as an adult with ADHD can be challenging. As you grow older, one takes on more responsibilities with getting the first career, pursuing higher education, romantic relationships, and personal responsibilities. With all these new obligations, there are more opportunities for symptoms of ADHD to cause impairment: trouble getting to work on-time, forgetting to pick up your prescription, or spacing out on a date.

All these seemingly failures can create patterns of negative thinking and beliefs such as “I mess everything up”, “this is all my fault”, “everything is always wrong”. With these thoughts floating in someone’s brain, the pattern of negativity will ensue.

Medication can help with the main symptoms of ADHD in helping one’s attention, impulsivity and hyperactivity but sometimes that is not enough. To ward off these negative thoughts, a person needs to learn to recognize them and the unwanted behaviors that they cause— this is where CBT comes in.

What is CBT?

Cognitive Behavioral Therapy is a therapeutic approach aimed at changing behavior. The overall goal of this technique is to recognize negative thoughts and change behavioral patterns which will, in turn, change overall cognition.CBT differs from psychotherapy as CBT focuses on the present with current thoughts and current behavioral patterns, rather than exploring past experiences. CBT has primarily been used for anxiety and depression, but with its focus on changing behavior, it can be modified to greatly fit the needs of those with ADHD

Certain negative thought patterns CBT addresses include: all or nothing thinking, selective attention and catastrophizing. Selective attention refers to just focusing on certain details and leaving out the bigger picture. All or nothing thinking refers to the thought pattern that people will either do “everything” and if they cannot, they just do “nothing”. For example, people with this type of pattern who are diets, if they broke the diet, would just continue to binge because it’s “all or nothing”. Either they are healthy the whole day or are eating junk the whole day – no middle ground. 

Catastrophizing, something we are all guilty of at times, refers to the idea that every negative event gets blown out of proportion. For example, someone comes late to work, in his or head, the whole day is ruined, perhaps he or she will get fired and the negative thoughts culminate.

CBT for ADHD

CBT contains an adaptive aspect that stimulant or non-stimulant medications do not: CBT helps an individual learn to plan and organize and better function in society with ADHD. An example of CBT for ADHD would include the idea of breaking down bigger tasks into little parts or learning to better manage one’s time. To put it simply, CBT tackles problems.

CBT focuses on creating positive beliefs and modifying behavior by understanding one’s own cognition. With a CBT approach, a person learns to recognize and pause certain automatic thoughts like “I am a failure” or “This won’t work”.  Instead of thinking “This won’t work”, a person can learn skills and strategies to change the behavior and in doing so, change the distorted thought patterns as well.  An adult with ADHD will focus on changing behaviors of always being tardy or always being unorganized with new behaviors like being on time or keeping a planner. 

Thoughts, behaviors, and emotions work together in ADHD. When someone has low self-esteem and is constantly late or distracted, he or she will feel turmoil emotionally. CBT works with all aspects of this triad– challenging the beliefs, changing the behaviors and in turn enhancing one’s emotional well being.

CBT vs Medication

Medication has been proven to be effective for helping the ADHD brain focus, remain attended and less distracted. In general, it is primarily used as the first line of treatment because of the amount of research and scientific support for its benefits.

Some studies investigating the effects of a CBT intervention for people with ADHD have found that CBT can be effective with and without medication. Even for people with medication, their stimulants are not teaching them to change their habits or master certain skills. Also, there are people who just do not respond well to drugs and get side effects. Thus, CBT can be beneficial in combination with medications or in some cases, on its own. CBT can also help an individual with their low self-esteem and negative beliefs by reducing distorted thought patterns.

CBT, in a group setting, can be helpful because adults will have a community of other people going through the same thing for support. In this group setting, adults can learn skills like self-management, keeping a planner and being on time for things with a group of other people. This support and level of camaraderie can just enhance the effects of CBT as people are not only learning new skills but also gaining a space where they can open up about their issues to those who truly understand.

Work Cited

http://www.chadd.org/Understanding-ADHD/For-Adults/Treatment/Cognitive-Behavioral-Therapy.aspx

Weiss, M., Murray, C., Wasdell, M., Greenfield, B., Giles, L., & Hechtman, L. (2012). A randomized controlled trial of CBT therapy for adults with ADHD with and without medication. BMC psychiatry, 12(1), 30.

https://www.psychologytoday.com/blog/here-there-and-everywhere/201210/cbt-adhd-interview-mary-solanto-phd

https://www.additudemag.com/cognitive-behavioral-therapy-for-adhd/

Outgrowing ADHD … or growing into it?

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ADHD across the life span:

About 1/3 of children who are diagnosed with ADHD are said to no longer meet criteria for it when they reach adulthood. Still, this leaves a majority of the children diagnosed with ADHD, experiencing the symptoms throughout their life time. Children with more severe impairments or co-morbid conditions (such as anxiety and depression) are less likely to “outgrow” their ADHD.

Outgrowing ADHD refers to the idea that as children mature, they no longer experience their symptoms because they have gained control over them. Also
“growing out of ADHD” is also associated with the idea that ADHD is soley a children’s disorder.

ADHD symptoms do change across the life span and ADHD will look very different in an eight-year-old child compared to a forty-year-old adulthood. As a child, ADHD will be reflected through hyperactivity and impulsivity like constantly running around, blurting out responses or poor conduct in school. As an adult, inattention becomes the more primary symptom and tasks like planning and organizing are challenges. 

One must be careful to understand that a child may not be outgrowing their ADHD but perhaps their ADHD symptoms are changing as they mature. It is possible to stop experiencing ADHD symptoms but then again, this is for the less severe cases with no co-morbidity and still for only 1/3 of cases.

Why is outgrowing ADHD possible?

Studies have been conducted to understand how brain development in ADHD youth compares to development non-ADHD youth. These studies have found that brain development works almost the exact same way in both groups, just that children with ADHD experience delays in development.

When comparing scans of children with ADHD to non-ADHD children, the brains of the children with ADHD matured about three years later than normal. But once their brains matured, it was the same as the non-ADHD children. At around age 7.5,  the cortex of non-ADHD children thicken and this occurs at the age of 10.5 in children with ADHD. This thicker prefrontal cortex is responsible for memory, attention, and suppression of thoughts.

This can explain why children with ADHD are able to outgrow their symptoms: once their brain matures, they have better control over their thoughts and impulses. Interestingly, the primary motor cortex matures faster in ADHD children which can explain why they are more likely to feel restless and fidget. 

Can you be in full remission from ADHD?

Some studies have explored adults in full remission from ADHD and adults in partial remission from ADHD (meaning they experience some symptoms but do not meet criteria). These investigations found that adults who did not meet full criteria for ADHD anymore still experienced difficulties in psychosocial functioning.

While their ADHD symptoms may have been alleviated, they still were having trouble in interpersonal relationships and other types of functioning. It is important to understand that ADHD can affect a range of areas, not just executive functioning.  Psychotherapy or other forms of treatment can always be helpful regardless of age or life stage. 

It is especially important to manage symptoms of ADHD in teenagers and adolescents as impulsivity can be dangerous. Youth with ADHD are more likely to take part in risky behavior like unsafe sex, substance abuse, and dangerous driving. Stimulant medication, therapy or other interventions can curb these impulses and teach a teen strategies to prevent dangerous situations.

Take away points 🙂 

1.Do not assume a child has outgrown ADHD! More than half the cases persist into adulthood

2.Adults face different challenges than children do (so their ADHD symptoms may look different)! 

3. More and more research is showing ADHD can persist over decades

4. Treatment is SO important at all stages of life!!!!!! 

Work Cited

https://psychcentral.com/news/2013/03/05/adhd-can-persist-into-adulthood-with-serious-consequences/52237.html

https://www.verywell.com/do-kids-outgrow-adhd-20509

https://childmind.org/guide/what-parents-should-know-about-adhd/outgrow/

http://content.time.com/time/health/article/0,8599,1683069,00.html

Young, S., & Gudjonsson, G. H. (2008). Growing out of ADHD: the relationship between functioning and symptoms. Journal of Attention Disorders, 12(2), 162-169.

ADHD and Creativity

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What is creativity?

Creativity, according to dictionary.com, is  “the use of the imagination or original ideas, especially in the production of an artistic work”. Creative people are generally described as people who are good at coming up with new ideas, generating novel solutions and in general thinking “outside of the box”. When one thinks of creative, the artists of the world, the inventors and the storytellers and entertainers come to mind.

Are people with ADHD more creative?

A link between ADHD and creativity exists as many studies on children and adults with ADHD have found a relationship between the two. People with ADHD tend to think in more creative ways compared to individuals without ADHD.

One study, with one group of children with ADHD and another group children without ADHD, investigated their ability to problem solve. Children with ADHD were found to score higher across multiple subsets of creativity including coming up with the most number of solutions and coming up with the most original solutions. This means that after being shown a problem, the children with ADHD would have the most ideas on how to solve it and these ideas would be more unconventional and original than the other children’s’ ideas.

Children with ADHD are also found to be more successful at expressing their emotions and story telling (both facets related to creativity)

Why are people with ADHD more creative?

There are several hypotheses still being explored that are trying to piece together this relationship between creativity and individuals with ADHD.

One theory is that in people with ADHD, who experience delayed cognitive functioning, their prefrontal cortexes are more immature. The prefrontal cortex regulates thoughts and executive functioning, so when it is more immature, thoughts are less regulated. This allows people with ADHD to think in more flexible ways with fewer constraints.  People with ADHD have fewer limits and restrictions on their ideas and this is why they can be more creative. 

Another theory looks at genetic markers that people with ADHD tend to share. There are certain genes, which are said to promote novelty, that is found more often amongst individuals with ADHD.

Divergent vs Convergent Thinking

People with ADHD are said to be more divergent thinkers compared to people without ADHD who are better at convergent thinking. Divergent thinking refers to ‘thinking outside the box’ and coming up with creative solutions while convergent thinking refers to coming up with the correct answers.

People with ADHD tend to be effective in producing new ideas while people without ADHD are better able to clarify and expand on ideas.

Convergent thinking can refer to the ability to form associations between concepts and link together unrelated ideas while divergent thinking means altogether producing new concepts. As you may expect, convergent thinkers would be more successful at test taking, responding to teacher’s questions and following instructions in a school setting. 

ADHD and Creativity in an Academic Setting

Many students with ADHD struggle more in academic settings compared to students without ADHD. Statistically, students with ADHD are more likely to fail subjects, feel discouraged when learning and drop out of school altogether compared to students without ADHD.  

This is a pattern that does not need to continue. Children with ADHD are just as capable as any other student and in fact, they hone different strengths. Curriculum and teaching can be flexible to their needs and the creative ways in which their brains work. Many people with ADHD share the traits of high energy and creativity typically associated with gifted individuals without ADHD.

In the box, thinking is usually how teachers and educators look at learning but this leaves out all the out of the box thinkers, who play a necessary role in this world. We need the convergent thinkers but the divergent ones are just as important. Both ways of thinking complement each other extremely well and should be recognized by both parents and teachers.

Work Cited

Gonzalez-Carpio, G., Serrano, J. P., & Nieto, M. (2017). Creativity in Children with Attention Déficit Hyperactivity Disorder (ADHD). Psychology, 8(03), 319.

https://www.psychologytoday.com/blog/here-there-and-everywhere/201106/is-the-adhd-brain-more-creative

White, H. A., & Shah, P. (2006). Uninhibited imaginations: creativity in adults with attention-deficit/hyperactivity disorder. Personality and Individual Differences, 40(6), 1121-1131.

https://www.psychologytoday.com/blog/freedom-learn/201603/adhd-creativity-and-the-concept-group-intelligence

http://www.healthline.com/health/adhd/benefits-of-adhd

ADHD and Fatigue

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You’re always tired… could it be related to ADHD?

We all get tired every now and then, with work schedules, responsibilities and unexpected life stressors that always seem to get in the way of things. It makes sense to be tired if you slept three hours every night during finals (it makes sense but it’s still unhealthy). However, some people are constantly feeling tired, fatigued and worn out regardless of sleep that they get.

Would you believe me if I said that fatigue or constantly feeling tired can actually be a symptom of ADHD, the disorder known for “hyperactivity” and “impulsivity”?Hyperactivity and Impulsivity are just two facets of ADHD and actually, feeling fatigued and tired is strongly connected to the way ADHD affects your body.

What is Chronic Fatigue Syndrome?

Chronic Fatigue Syndrome (CFS) is a chronic disorder which involves the persistent state of feeling fatigued, tired and with no energy. People with CFS are subject to headaches, concentration issues, pain and cognitive difficulties.

Newer studies are finding that people suffering from CFS can sometimes meet criteria for ADHD as well! Both disorders are marked by inattention, lack of concentration and forgetfulness.  More specifically, people with ADHD-Inattentive are susceptible to this overlap with CFS. 

ADHD and Fatigue (Constant Fatigue Syndrome)

CFS and ADHD can both be caused by the brain being unable to regulate certain neurotransmitters like dopamine or serotonin. This makes it harder for the brain to focus or concentrate, something present in both ADHD and CFS. Understanding ADHD-Inattentive type, better explains how ADHD and fatigue can be closely related!

Sometimes if ADHD goes untreated it can possibly turn into CFS. People shouldn’t just assume they have CFS if they feel tired because perhaps they left their ADHD untreated too long. A lot of times people with inattentive ADHD don’t realize they have ADHD because they may be more quiet and passive which is not quintessential ADHD behavior. Inattentive ADHD type is marked by concentration issues but more day dreaming, sluggish and slow behavior unlike ADHD impulsive/ hyperactive. 

Studies are also showing that ADHD stimulant medication can also be used to treat cognitive deficits caused by CFS. This overlap of medication and diagnosis is further supporting this new theory that ADHD and fatigue are related.

Why is this important?

It is really important for people to be aware that feeling fatigued and tired all the time can actually be related to ADHD. ADHD is associated with attentional issues but other side effects are related. Someone may assume they just have CFS or they are just worn out but really they may have ADHD left untreated.

Tips to feel Rested

  1.  If you are taking medication, remain consistent. Remember to take it every day to give yourself an extra boost. When you don’t take your medication as always you can feel more worn out
  2. Give yourself little “boosts”. Take time to exercise, get a massage or just amp in the day!
  3. Don’t stay up late! set up a bed time routine and remember how important it is
  4. If you feel really fatigued see a doctor and determine what really is going on. Maybe your not the naturally exhausted person you thought you were!

 

Work Cited

https://www.additudemag.com/adhd-fatigue-syndrome-run-down-by-add-symptoms/

http://www.wellwisdom.com/relationship-between-add-and-adhd-and-chronic-fatigue/

https://adhd.newlifeoutlook.com/adhd-fatigue/

https://www.verywell.com/chronic-fatigue-syndrome-adhd-whats-the-link-3972913

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