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Attention Deficit Hyperactivity
Disorder
Inappropriate behavior, including poor attention skills,
impulsivity, and hyperactivity
Attention Deficit Hyperactivity Disorder
• Behavioral disorder emerges before the age of seven
• Symptoms include inattentive, impulsive and hyperactive
behaviors
• ADHD is not a reflection of a child's intelligence nor caused
by poor parenting
• ADHD is more common in people who have a close relative
with the condition
• Twice as many boys are diagnosed with ADHD as girls
What Is The Difference Between ADD
and ADHD
• The current Diagnostic and Statistical Manual of Mental
Disorders (DSM-IV-TR) outlines the diagnostic criteria for
mental conditions.
• Although the terms ADD and ADHD are used
interchangeably, ADHD is the official name used by the
American Psychiatric Association, and it encompasses
hyperactive, impulsive, and/or inattentive behaviors.
• ADD is the older term thus in some older literature you will
find this term as a synonym for ADHD
Attention Deficit Hyperactivity Disorder:
Prevalence
• Affects children, adolescents and adults
• It is one of the most common childhood psychiatric
conditions in the United States.
• The National Institute of Mental Health (NIMH) estimates
that 5 million children in the United States have ADHD – that
is about 5% of all children!
• Studies show that up to 70% of children with ADHD
continue to have symptoms as adults
Attention Deficit Hyperactivity Disorder:
In Children
• Childhood ADHD -- attention-deficit/hyperactivity
disorder -- is diagnosed after a child has shown six
or more specific symptoms of inactivity and/or
hyperactivity on a regular basis for more than six
months in more than two settings.
• There is no single test for ADHD
• Diagnosis is based on questionnaires
Attention Deficit Hyperactivity Disorder:
In Children
• A doctor can diagnose ADHD with the help of
standard guidelines.
• The diagnosis of ADHD involves the gathering of
information from several sources, including school,
caregivers, and parents.
• The doctor will consider how a child's behavior
compares with that of other children the same age.
TYPES OF ADHD
• Combined Type (Inattentive/Hyperactive/Impulsive).
Children with this type of ADHD show all three symptoms.
This is the most common form of ADHD.
• Hyperactive/Impulsive Type. Children show both
hyperactive and impulsive behavior, but are able to pay
attention.
• Inattentive Type. Formerly known as attention deficit
disorder (ADD), these children are not overly active. They
do not disrupt the classroom or other activities, so their
symptoms might not be noticed.
Attention Deficit Hyperactivity Disorder:
In Teens
• Typically diagnosed in childhood, ADHD still affects
many teens.
• The symptoms -- inattention, impulsivity, and
hyperactivity - are intrusive, which means they
interrupt and seriously interfere with a teen's life.
• During teen years, especially as the hormonal
changes of adolescence are going on, symptoms of
ADHD may intensify.
Attention Deficit Hyperactivity Disorder:
In Teens
• It's not uncommon for teens with ADHD to forget
assignments, misplace textbooks, and become
easily bored with their daily class work.
• Teens may become inattentive, or excessively
attentive -- not waiting for their turn before blurting
out answers.
• They may interrupt the teacher and classmates,
and rush through assignments.
Attention Deficit Hyperactivity Disorder:
In Teens
• Teens with ADHD may also be fidgety and have a
difficult time sitting still in class.
• Often, teens with ADHD are so busy focusing on
other things they forget about the task at hand. This
can be seen especially with homework and athletic
skills and in relationships with peers.
• This lack of attention to what they're doing often
leads to poor performance on tests and being
rejected from sports teams, extracurricular
activities, and peer groups.
Attention Deficit Hyperactivity Disorder:
In Teens
• Teens with ADHD are more likely to be heavy
drinkers than teens without ADHD.
• In clinical studies, researchers confirmed that teens
with ADHD were twice as likely to have abused
alcohol within the past 6 months.
Attention Deficit Hyperactivity Disorder:
In Teens
• They also found that teens with ADHD were likely
to abuse drugs and three times more likely to
abuse drugs other than marijuana.
• Getting proper treatment for ADHD in teens may
cut the risk of later alcohol and drug abuse.
Attention Deficit Hyperactivity Disorder:
In Adults
• It is now known that these symptoms continue into
adulthood for about 70% of children with ADHD.
• That translates into 4% of the US adult population,
or 8 million adults.
• However, few adults are identified or treated for
adult ADHD.
Attention Deficit Hyperactivity Disorder:
In Adults
• Adults with ADHD may have difficulty following
directions, remembering information, concentrating,
organizing tasks or completing work within time
limits.
• If these difficulties are not managed appropriately,
they can cause associated behavioral, emotional,
social, vocational and academic problems.
Attention Deficit Hyperactivity Disorder:
In Adults
• The following behaviors and problems may stem
directly from ADHD or may be the result of related
adjustment difficulties:
– Chronic lateness and forgetfulness.
– Anxiety.
– Low self-esteem.
– Employment problems.
– Difficulty controlling anger.
– Impulsiveness.
Attention Deficit Hyperactivity Disorder:
In Adults
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Substance abuse or addiction.
Poor organization skills.
Procrastination.
Low frustration tolerance.
Chronic boredom.
Difficulty concentrating when reading.
Mood swings.
Depression.
Relationship problems.
Attention Deficit Hyperactivity Disorder:
In Adults
• These behaviors may be mild to severe and can
vary with the situation or be present all of the time.
• Some adults with ADHD may be able to
concentrate if they are interested in or excited
about what they are doing. Others may have
difficulty focusing under any circumstances.
• Some adults look for stimulation, but others avoid it.
Attention Deficit Hyperactivity Disorder:
Interesting Facts
• Adults with ADHD are more likely to:
– Change employers frequently and perform poorly.
– Have had fewer occupational achievements
– Have a lower socioeconomic status.
– Have driving violations such as: be cited for
speeding; have their licenses suspended; be
involved in more crashes; rate themselves and
others as using poorer driving habits.
Attention Deficit Hyperactivity Disorder:
Interesting Facts
• Adults with ADHD are more likely to:
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Use illegal substances more frequently.
Smoke cigarettes.
Self-report psychological maladjustment more often
Have more marital problems and multiple marriages.
Have higher incidence of separation and divorce.
• Much of this functional impairment diminishes with
remission of the disorder and can be mitigated by
appropriate treatment.
Common Conditions That Coexist With
ADHD
COMORBIDITY
Learning Disorders
Anxiety & Depression
Bipolar Disorder
Oppositional Defiance Disorder
Conduct Disorder
Tourette’s Syndrome
Substance Abuse
Obsessive Compulsive Disorder
Intermittent Explosive Disorder
Panic Disorder
Specific Phobia
CHILDREN ADOLESCENT
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ADULT
X
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Attention Deficit Hyperactivity Disorder
The Medical Approach
Medication for ADHD
• A class of drugs called
psycho-stimulants or
stimulants have been used to
effectively treat ADHD for
years.
• They work by increasing the
production of two
neurotransmitters – dopamine
and norepinephrine
Medication for ADHD
• These medicines help users to focus their thoughts
and ignore distractions.
• Stimulant medications are effective in 70% to 80% of
patients.
• However there are short and long term effects
related to these drugs
Medication for ADHD
• Stimulant drugs to treat ADHD include:
– Adderall and Adderall XR
– Concerta
– Dexedrine
– Focalin and Focalin XR
– Metadate CD and Metadate ER
– Methylin
– Ritalin, Ritalin LA
– Vyvanse
– Desoxyn
Side Effects of ADHD Drugs
• ADHD drugs sometimes have side effects
• The most common side effects of ADHD drugs
include:
– Decreased appetite/weight loss
– Sleep problems
– Headaches
– Jitteriness
– Social withdrawal
– Stomach aches
Side Effects of ADHD Drugs
• Rarely, medications for ADHD can cause more
serious side effects.
• For instance, some stimulants are associated with
an increased risk of cardiovascular problems and
sudden death.
• They may also exacerbate psychiatric conditions
like depression or anxiety.
Stimulant Safety Concerns
Effect On The Developing Brain
• The long-term impact of ADD / ADHD medication
on the youthful, developing brain is not yet known.
• Some researchers are concerned that the use of
drugs such as Ritalin in children and teens might
interfere with normal brain development.
Stimulant Safety Concerns
Heart Related Problems
• ADHD stimulant medications have been found to
cause sudden death in children and adults with
heart conditions.
• The American Heart Association recommends that
all individuals, including children, have a cardiac
evaluation prior to starting a stimulant.
• An electrocardiogram is recommended if the
person has a history of heart problems.
Stimulant Safety Concerns
Psychiatric Problems
• Stimulants for ADD / ADHD can trigger or
exacerbate symptoms of hostility, aggression,
anxiety, depression, and paranoia.
• People with a personal or family history of suicide,
depression, or bipolar disorder are at a particularly
high risk, and should be carefully monitored when
taking stimulants.
Stimulant Safety Concerns
Potential for Abuse
• Stimulant abuse is a growing problem, particularly
among teens and young adults.
• College students take them for a boost when
cramming for exams or pulling all-nighters.
• Others abuse stimulant meds for their weight-loss
properties.
• If your child is taking stimulants, make sure he or
she isn’t sharing the pills or selling them.
Stimulant Contraindications
• ADD / ADHD stimulants are not recommended for
those with:
– Any type of heart defect or diseases
– High blood pressure
– Hyperthyroidism
– Glaucoma
– High levels of anxiety
– A history of drug abuse
Attention Deficit Hyperactivity Disorder
The Brain
ADHD AND BIOLOGICAL FACTORS
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First identified in 1902
Initially classified as serious brain damage
Precise causes still unknown
New research proves that ADD/ADHD is closely
tied to:
– Brain size
– Brain density
– The way brainwaves are produced
PREFRONTAL CORTEX
• Smaller Prefrontal Cortex
• Key functions include impulse
control, socialization, reason
and judgment
• ADHD children are more prone
to drifting off, making sudden
outbursts or using poor
judgment
NERVE TISSUE
• Nerve tissue is smaller and
thinner
• Less connections
• Scientists believe that
these variations can affect
a child's attention and
impulse control.
NEUROLOGICAL DYSREGULATION
• Brainwave Imbalance
• May be caused by:
– Variations in brain structure
– Drugs
– Toxins
– Poor Nutrition
– Subluxation
– Trauma
– Stress – both physical and emotional
NEUROLOGICAL REGULATION
• The ability of the brain to regulate itself
• Mental states are associated with specific brainwaves
• These brainwaves include:
– Delta
– Theta
– Alpha
– Beta
DELTA BRAIN WAVES
• Produced during deep sleep
• Associated with the release of
Human Growth Hormone
THETA BRAIN WAVES
• This is the predominant brainwave that your brain
produces when you are just about to fall asleep
• It is associated with creativity and memory retrieval
• This is why you seem to get your best ideas just as
you are falling asleep. It is also why you typically
remember things when you are just about to fall
asleep.
THETA BRAIN WAVES
• When the brain is dysregulated it sometimes
produces high levels of Theta in the waking state
• In these cases it is associated with:
– Distractibility
– Inattention
– Daydreaming
• Excessive amounts of Theta are typical in
individuals with ADD
ALPHA BRAIN WAVES
• Associated with meditation and a sense of inner
calm or peacefulness
• They are produced when the brain is in an idle
state
• This mental state is sometimes described as a
quiet alertness
BETA BRAIN WAVES
• The brain produces brain waves when we are:
– Awake
– Alert
– Externally focused
– Logical
– Problem solving
– Attentive
BETA BRAIN WAVES
• Beta Waves are produced in the cortex
• Children with ADHD typically have a smaller cortex
so they very often produce less Beta Waves than
normal
THETA BETA RATIO
A Key Diagnostic Finding in ADHD
THETA BETA RATIO
• Normal Theta / Beta ratios are
– 2:1 in adults and
– 2.5:1 in children
• Ratios higher than 3:1 suggest ADD/ADHD
• In several different studies it was demonstrated that
86% of the children diagnosed with ADHD using
traditional criteria had a T/B ratio higher than 3:1
BRAINCORE THERAPY
BRAINCORE THERAPY AND ADHD
• Neurofeedback is a training procedure designed to
teach children with ADHD how to control their own
brainwaves bringing balance, harmony and
regulation to the brain
• The goal of neurofeedback is to transform an
unhealthy brainwave pattern into a healthy one
THE BRAINCORE APPROACH
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Painless
Drugless
Non-Invasive
And Has No Side
Effects
THE BRAINCORE EVALUATION
A Window To the Brain
• The EEG evaluation begins
by placing surface sensors at
specific sites on the scalp
• These sensors detect brain
waves and display them on
the computer screen
THE BRAINCORE EVALUATION
A Window To the Brain
• During the course of the next 10
minutes the patient is asked to
perform several tasks while the
BRAINCORE software monitors
the brainwaves
• A report is generated
demonstrating imbalances
associated with ADHD such as a
high Theta Beta Ratio
THE BRAINCORE TRAINING
• Based on the patient history and the BRAINCORE
EEG Evaluation results, a customized training
program is designed for the patient
• The training program is different for each individual
case but typically it involves either training the
patient to produce more of a certain brainwave or
less of a certain brainwave
THE BRAINCORE TRAINING
• During the training session the patient is connected
to the EEG using the surface sensors and the
patient’s brainwaves are displayed on the computer
• On a separate monitor the patient is watching a
movie that is being controlled by the patient’s own
brainwaves
THE BRAINCORE TRAINING
• The movie will only play if the patient’s brain is
producing the desired brainwave
• During the course of 20 training sessions, the
patient’s brain learns how to produce the desired
brainwave
• This new ability is associated with the alleviation of
the ADHD symptoms
THE BRAINCORE TRAINING
• The best part is that the changes experienced by
the patient are permanent!
• It has been demonstrated that after 20 or more
BRAINCORE training sessions, the brain actually
remodels itself – a process known as
Neuroplasticity
BRAINCORE THERAPY
30 Years of University Based Research
Demonstrates a 76% Success Rate
THE EFFICACY OF NEUROFEEDBACK
• Dr Frank H. Duffy, a Professor and Pediatric Neurologist at
Harvard Medical School, was asked about the effectiveness
of neurofeedback – this was his response:
“In my opinion, if any medication had demonstrated such a
wide spectrum of efficacy it would be universally accepted
and widely used”
BRAINCORE THERAPY
QUESTIONS
A GIFT