|STILL STANDING: To contend with her son Noah’s hyperactivity, author Dawn McMullen didn’t take the easy route.|
I don’t remember a time when my 9-year-old son’s body, mouth, or brain weren’t in constant motion. Sometimes all three at once. Noah’s tics have in-cluded licking things, twirling his hair until it started to fall out, chewing his hair, darting his eyes. He daydreams at school and can become belligerent after watching TV or playing games on the computer. Although not formally diagnosed, Noah is considered to be on the ADHD spectrum, meaning his ADHD (attention deficit hyperactivity disorder) isn’t severe enough to be a huge problem for him scholastically or socially, but it is enough to make me occasionally want to tie him to a chair.
All that energy, though, is also part of who Noah is. There is no box big enough to contain his imagination and curiosity. While watching the sheepdog show at the State Fair last year, he asked how we knew the dogs were trained and not the sheep. This kind of thinking is why kids with the related problem, ADD (attention deficit disorder) can grow up to be ADD adults such as, it is now thought, Albert Einstein, F. Scott Fitzgerald, Robert Frost, and, more recently, Steven Spielberg.
So we’ve worked hard to find a treatment that works for Noah—something other than a pill. Twenty minutes wearing glasses with red-tinted lenses each day. Standing on his right leg for 60 seconds. Holding his body in a bridge form, one leg straight out, for 60 seconds. Repeat with other leg. One hour a day, three days a week, clapping along with a cowbell piped into headphones. Smelling a rotten onion five times a day with just his right nostril.
It’s a regimen based on research into how the brain works. ADD and ADHD—the most common childhood psychiatric disorders—are all about how the brain is wired. And that wiring, some specialists insist, can be changed with targeted stimulation by simple exercises and tasks. It’s a new way to treat the disorders, an approach that in some respects is a backlash to a time when the first and only option would have been a pill.
Ten years ago, ADD and ADHD medications were all the rage. Between 1990 and 1995, office visits for ADHD more than doubled. For that same time period, prescriptions for drugs such as Ritalin tripled for kids between the ages of 5 and 18. The most common drugs prescribed are Ritalin, Dexedrine, Cylert, and Adderall. Now, many parents are questioning their effectiveness, searching out other treatment options—hemispheric integration therapy (what we’re doing with Noah), behavior modification, neurofeedback, biofeedback, sensory integration therapy, and occupational therapy.
“There’s more awareness of the complexity of the problem and the fact that there are other treatments,” says Dr. Harvey Oshman, a Dallas clinical psychologist who is ADHD himself and a founder of ADD Associates. “I haven’t seen a complete pendulum [away from medication], but you have a more sophisticated population. ADD is a very complex disorder. Sometimes we make it too simple.”
When Vicki Brooks brought her then 7-year-old son Jonathan to Dr. David Clark’s office, he was on his second ADHD medication as well as medication for depression. Clark, an East Dallas chiropractor trained as a chiropractic neurologist, did two things: noticed Jonathan’s heart rate was 189 (twice what it should be) and changed the diagnosis to Asperger Syndrome, which is on the autism spectrum.
Clark placed Jonathan on a therapy schedule including daily exercises such as throwing a ball back and forth with his mom and catching it only with his left hand. The idea was to stimulate the right side of his brain, which wasn’t functioning as well as his left. Jonathan also listened to music to stimulate the right brain. One day, he forgot to take his medication. His heart rate was normal. Off medication and with therapy, Jonathan’s meltdowns in school stopped. His anxiety lessened. Now, he’s a normal teenager who actually gets in trouble sometimes for goofing off, something unthinkable previously.
One of the better-known advocates of behavioral therapy for the treatment of these brain disorders is Wynford Dore, a U.K. native who founded a chain of clinics based on research spurred by the suicide attempt of his daughter Susie, who suffered from severe dyslexia. What was known when Dore organized his research team in 1999 was that in dyslexics (he hadn’t yet gotten into ADD/ADHD), the cerebellum part of the brain was underdeveloped. Research with targeted exercises and tasks allowed Dore’s team to measure cerebellum function as it generally caught up with the rest of the brain over the course of a year.
There are now 33 DORE Achievement Centers across the world, including a clinic in Grapevine, where Joe Stephens is DORE’s co-chair and regional director of the southern United States. He says a recent study supports the success of behavioral therapy. Assessing 895 participants, of which about 73 percent had ADHD symptoms, the study showed that only 19 percent exhibited the symptoms after a year of treatment. “In the six years we’ve been doing this in the U.K., the patients don’t come back,” Stephens says. “There is no material regression.”
In Clark’s work with my son Noah, the scope of the therapy gets more specific. Clark, who says Noah is on the ADHD spectrum, wants to know what parts of the brain need help. Unlike DORE, which uses sophisticated equipment that was developed based on similar technology used by NASA to plot graphs of brain activity and eye movement, Clark employs a multistriped piece of cloth and the follow-my-finger game. He thinks Noah has issues with his orbitofrontal cortex and dorsolateral prefrontal cortex and their connections with an area known as the basal ganglia. Noah’s red lenses, left leg balancing exercises, and time with the Interactive Metronome (the cowbell sound) stimulate the specific areas of his brain that need development.
For another patient, 11-year-old Daniel, the results are not yet clear. He sees the psychologist Oshman for behavior modification therapy but recently started seeing Clark, too. While skeptical of some of the behavioral approaches, Daniel’s parents, Gail and Wayne, are willing to try. But they haven’t given up on medication. When Daniel first started medication, it helped tremendously. “It took less than an hour,” Gail says. “I could say to him, ‘Put these socks in the dirty clothes,’ and he could walk from here to the dirty clothes and not be distracted by 500 other things he wanted to do.”
Wayne has been treated for depression for years before his ADD diagnosis and is also seeing Oshman. Wayne says that since he started medication, his memory is better, he’s more motivated, and he’s able to follow through on projects. “I’ve always kind of felt like I never quite lived up to my potential,” he says. “With the medication, it’s like I can steer now in my life. I just feel like I can keep up with a list and I can knock things out. It’s like the difference between feeling like you’re coming off the day or you’re on a roll and just starting. I’m just on track.”
Oshman doesn’t at all discount alternative behavioral treatments, nor homeopathic remedies, nutritional changes, biofeedback, or neurofeedback. He says the problem with these treatments is a lack of formal research, not necessarily a lack of results. The main reason is money.
“There’s not a great database of research to give support to those things,” Oshman says. “One needs to understand drug companies are the ones who fund a lot of the research.”
That helps explain why treatment of ADD/ADHD has, thus far, leaned to pharmaceutical approaches. “The pill is a very seductive and useful treatment,” Oshman says. “It’s a very good start. I don’t want to dismiss it. But it’s also extremely easy and needs to be combined with other treatments.”
That’s why it’s important for parents to consider all the options. “There is such a huge gap in people who were willing to work with those kids and such a huge need for different treatment plans,” Clark says. “People need to realize there are parts of the brain that are responsible for allowing your child to maintain focus, not be distracted, not be compulsive, not be impulsive.”
With the right treatment, by stimulating and retraining targeted parts of the brain, Clark has seen patients with ADD, dyslexia, and autism do more than just live with their problems—they’ve overcome them. “There are so many people who have learned to cope because that’s all they could do,” Stephens says. “But they live a life that’s less than their potential. The whole picture of the treatment paradigm has got to change.”
There’s nothing easy about this “other treatment” road. Several years into it, I can tell you that it’s long, expensive, and time-consuming. Would it be easier to give my son a pill every morning than nag him about balancing exercises and cowbells? Sure. If his ADHD were more severe, would I medicate him? Maybe. Like everything else about parenting, there is no quick fix.