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Using common sense to help manage attention deficit disorder

Tue, 01 Apr 2014 16:47:00
5 / 5 (2 Votes)
Article by:
By Erik Peper, Ph.D.
Child and father. Photo via Erik Peper, Ph.D.
In class, he fidgets, every auditory and visual stimulus distracts him-- he gets up, talks to other students and disrupts the class. Nothing seems to hold his attention; he looks at the page, and moments later turns around and disturbs the boy behind him. At home, he grabs his food and leaves the table. He is continuously distracted. The only thing that seems to capture his attention is his computer games.
   
Health is optimized when we live in harmony with our biological and evolutionary background.
  
These behaviors allowed survival for thousands of generation. Disorders often occur when we neglect our evolutionary background during infant, toddler and childhood stages of development. Diabetes, obesity, allergies, asthma, attention deficit disorder —ADD — and attention deficit and hyperactivity disorder — ADHD — and other illnesses are more common in our modern life style. ADD/ADHD disorder is only a disorder if the behavior is too dysfunctional in the cultural setting, or if the learning style is not supported by the prevailing culture.
  
Drs. Lynda and Michael Thompson — directors of the ADD Centre & Biofeedback Institute of Toronto — observed that in running a boys’ camp, and ADHD boys are often sent off to camp, that ADHD children were the best on really difficult canoe trips. They were far faster learners of difficult mathematical concepts concerning the relationship of sails and wind if they were taught in those conditions — such as wild approaching hurricane winds. However, they were terrible if it were insisted that they just sit on a dock and listen.
  
ADD/ADHD disorders have become epidemical during the last 30 years. Now one in seven boys has received this diagnosis by the time of reaching age 18, according to the Centers of Disease Control and Prevention as shown in the following graph.
   
The increase in ADD/ADHD or diabetes, obesity and allergies cannot be explained by genetics alone. It may depend upon the interaction of genetics and the environment. Diabetes and obesity have increased because sugar intake has increased from about 10 pounds in the 19th century to 150 pounds per year today. Similarly, allergies previously were rare; however, during the past 20 years they have tripled. This spring I was shocked when I asked my students at San Francisco State University how many had allergies and more than 25% of the students said they did. When these illnesses occur, we attempt to remedy them with medications.
   
Medications such as Adderall, Concerta and Ritalin are prescribed for ADD/ADHD and provide an $8 billion revenue stream for pharmaceutical companies. Yet, there is little or no evidence of long term benefits.
   
Self-mastery approaches such as neurofeedback have demonstrated long-term benefits in improving reading, writing, and mathematical scores as well as decreasing impulsive behavior. Neurofeedback training teaches children how to control their brain function. It is similar to learning a new language, mastering a musical instrument, or becoming proficient in a sport. It takes time and practice to retrain and rewire the brain. Medications often mask the symptoms.
   
It also means respecting different learning styles; since numerous people with diagnosed or undiagnosed ADD/ADHD are highly successful. They have learned how to use their brain in a style to make them perform even better.
   
Public health education needs to focus on prevention and supporting optimum brain development from birth through early childhood and encourage the following factors which are in our control.

- Breastfeed children for up to two years and concurrently introduce new foods slowly after the 6 or 8 months.
- Respect the importance of face-to-face contact to provide safety, develop empathy and nurture social connection.
- Encourage motor development such as crawling, playing in nature, and physical movement to support brain development instead of sitting and being entertained by smart phones, computers, tablets or TV screens. Physical movement during play — without being distracted by the overwhelming rapid changing stimuli shown on LED and TV screens — is necessary for brain development.
- Provide constancy and reduce novelty

A cacophony of sounds, I could not make any sense of it. I finally comprehended one word when it accompanied the action a polite bow and words were repeated time and time again. All of a sudden I could recognize and even say “Konnichiwa” – good afternoon in Japanese. My hosts wanted to help me learn some more words; however, they said one Japanese word after another. I could not remember any of them. Only when a few words with appropriate action were repeated time and time again could I remember them.
   
When reading a bedtime story, the child wants to hear the same story again and again. If part of the story is skipped, the child interrupts and reminds us to read correctly. When the child is stressed, it wants to hear a previous story for comfort and safety. Repetition while feeling safe allows memory to create appropriate neural connections.
   
Having too few stimuli hinders brain development. Rumanian orphans who were warehoused with limited stimuli had brains with less grey and white matter than children who were brought up in an enriched environment. These Romanian children had difficulty keeping focused attention and making social connections.
   
Having too many novel stimuli also decreases brain development. A sensory overload environment — such as too many toys to play with and too many choices to make. The more hours children watch TV, the higher is the incidence of ADD/ADHD. Babies and toddlers are now entertained by watching smart phone screens and monitors instead of kinesthetically exploring the world and integrating/connecting visual and auditory stimuli with touch and movement.
   
This lack of interconnection is seen in some people with learning disabilities. Some have incomplete motor development — when skipping, they tend to lift the arm and leg on the same side of the body instead of lifting their opposite arm and leg. This incomplete coordination may have been caused by the repeated triggering of the defense (fight/flight) reaction to excessive auditory and visual stimuli.
   
Children need more time crawling, walking and playing in nature to develop an integrated motor pattern. Researchers Taylor and Kuo showed in 2011 that ADD/ADHD children re-exposed to nature and play in nature children have decreased ADD/ADHD symptoms.
   
Rapidly changing visual stimuli from the screens and monitors evoke biological reflexes to attend —which is something new, and it could be dangerous. The stimuli do not train self-control or internally generated attention. The flood of novel visual and auditory stimuli trains the brain to react — to react again, and again. The ongoing external novelty captures a child’s attention, instead of directing attention from within.
  
A similarity is also observed in college students. Professor Andrew Lepp and colleagues at Kent State University discovered that the more the students use their cell phones and texted, especially while studying, the lower were their grade point averages, and the higher their anxiety levels. Their attention was continuously interrupted instead of staying focused. Adults also experience the paralysis of too many choices and stimuli. If you have only one or two choices, you become happier and content. With too many choices, you keep thinking, “May be the other one would have been better.”
  
Infants are often bombarded with visual and auditory stimuli without the opportunity to feel safe through face-to-face contact with mother/caretaker familiar faces. Until the 19th century babies were commonly carried facing the mother’s chest. Babies also faced their mothers in 19th century baby carriages. Now babies are often carried facing outward on the chest or in baby carriages/strollers facing forward — where they lead the charge into the unknown — instead of facing the parent, touching the parent or hiding behind the parent for safety.
   
Let us create an environment that is in harmony with our evolutionary background instead of being parked in front of smart phones, tablets, GameBoys, computers and television screens. Such an environment would be one where infants play interactively with objects, explore nature and have face-to-face contacts with their caregivers.
 
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