The Hyperactivity Hoax: How to Stop Drugging Your Child and Find Real Medical Help
by Sydney Walker
St Martin's Press, 288 pp, $17
A Monthly Summary of News and Events
Vol. 1 No. 12 - December 1998
This newsletter is sponsored by EEG Spectrum International, Inc.,
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Copyright (C) 1998 by EEG Spectrum International, Inc. All rights reserved.
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Charles Passler, D.C. 80 East 11th Street, Suite 501 New York, NY 10003 (212) 995-5525 Email: cpassler@mindspring.com John McManus, Ph.D. Abilities Center 15100 S.W. Boones Ferry Rd, Suite 700 Lake Oswego, OR 97035 (503)636-0111 Fax: 977-9583 Email: abilitiescenter@inetarena.com Elizabeth Moncrieff, M.A. 180 Washington St. Norwich, CT 06360 (860) 589-7258 Fernando Augusto, Ph.D. Angell Street Wellness Collaborative 469 Angell St. Providence, RI 02906 (508) 677-0493 Mailing: P.O. Box 251 Somerset, MA 02726 Brian Carrico 21707 Hawthorne Blvd, #103 Torrence, CA 90503 (310) 792-6236 | Ladell Lybarger, R.N. 1221 Birch Lane Des Moines, IA 50315-3019 (515) 244-1883 (change of address only) Barry Belt, M.A., Licensed Psychologist A Center for Educational & Personal Development Floral Vale Professional Park 503 Floral Vale Blvd Yardley, PA 19067 (215) 497-0240; F-0259 Email: BABelt@aol.com (not affiliated with EEG Spectrum International) Linda C. Vlay M.S.,R.N., C.S., N.P.P. A.N.P. Snug Harbor Counseling Associates 1212 Route 25A Stony Brook, New York 11790 (516) 751-7474 Fax: (516) 689-7931 Email: colleena@erols.com Attention Disorders Neurofeedback Centre (ADNC) Kimberly Druckman B.A., M.Ed 201-2245 W. Broadway, Vancouver, B.C., V6K 2E4 CANADA 604-730-9600 Email: mikmac@istar.ca |
THX-1138: Coming to a School Near You
by David Kaiser
Which of the following classic science fiction films best reflects our future?
If you chose the third title, Lucas' first feature film from 1971, you are correct... or so the NIH Consensus Conference would have you believe. THX-1138 takes place in the 25th century. By this time the State has taken control of our mental health and everyone is drugged into a continual stupor. Loudspeakers in the home and at work constantly remind individuals to take the appropriate amount of sedatives. Avoiding one's "medication" is a crime. Near the end of the film our fate is tied to one of the men who has fought the system and failed. He's about to be arrested and "re-educated." With nowhere else to go or hide, he sits alone in a lobby, calmly awaiting the authorities. We see a line of children ride up an escalator near him. The children are noticeably subdued, passive, almost without curiousity. The camera focuses on an IV-tube strapped to each of their right arms. One of the children appears frightened and confused and approaches our man for help. His IV tube has come loose. Our man, drained of all his fight, reattaches the IV tube and with a sweet smile sends the child on his way... Perhaps this way is best for all of us, his weak smile conveys...
Last month the National Institutes of Health held an invitation-only conference called the "Consensus Development Conference" from which they "determined" what is known and not known about the diagnosis and treatment of Attention Deficit Hyperactivity Disorder. The Conference was sponsored by the National Institute on Drug Abuse, the National Institute of Mental Health, and the NIH Office of Medical Applications of Research (and assorted co-sponsors). This conference brought together national and international experts in the fields of relevant medical research and health care as well as representatives from the public. EEG Spectrum International was contacted by one of the participants to provide him information about alternative treatments -- although none of this information appears to have trickled into the consensus. A draft of the consensus statement can be found at http://odp.od.nih.gov/consensus/cons/110/110_intro.htm. But here are some of the key points of "agreement":
First, attention deficit hyperactivity disorder (ADHD) is recognized as the most commonly diagnosed behavioral disorder of childhood, affecting 3 to 5 percent of school-age children. This translates to about 3,000,000 children. The core symptoms of ADHD include a "developmentally inappropriate level of attention and concentration and developmentally inappropriate levels of activity, distractibility, and impulsivity. Children with ADHD usually have pronounced difficulties and impairment resulting from the disorder across multiple settings in home, at school, and with peers as well as resultant long-term adverse effects on later academic, vocational, social-emotional, and psychiatric outcomes. "
Some people claim ADHD doesn't exist at all, others that it is overdiagnosed or a catch-basin for other childhood problems. The rate of increase in the number of diagnosed ADHD children would suggest that we are in an ADHD epidemic, one that -- if the rate does not subside -- will include the entire school-age population in the US within 10 to 15 years. Treatment of this condition is most controversial as respectable scientists call for pharmacological solutions to childhood.
One of the major controversies regarding ADHD concerns the use of psychostimulants to treat the condition. Psychostimulants, including amphetamine, methylphenidate, and pemoline, are by far the most widely researched and commonly prescribed treatments for ADHD. The use of methylphenidate and amphetamine nationwide has increased six-fold since 1990, intensifying the concerns about use, overuse, and abuse of this stimulant. According to the federal Drug Enforcement Administration, more than one in every 30 Americans between 5 and 19 years old has a prescription for Ritalin. Of particular concern to parents is that the long-term effects of taking Ritalin are not known. The manufacturers of Ritalin warn: SUFFICIENT DATA ON THE SAFETY AND EFFICACY (EFFECTIVENESS) OF LONG TERM USE OF RITALIN IN CHILDREN ARE NOT YET AVAILABLE." (Quoted from CIBA Pharmaceutical Company in a product information release.)
The consensus statement addressed the following key questions:
In this article I will only address points 1,3, and 4.
"The diagnosis of ADHD can be made reliably using well-tested diagnostic interview methods. However, we do not have an independent, valid test for ADHD, and there are no data to indicate that ADHD is due to a brain malfunction. "
This is the kind of wording which makes me dislike scientists (excluding myself and my friends, that is). It is arrogance dressed up as fact. There are no data..." Unless the statement is purposely unclear or turns on a limited interpretation of malfunction it would appear to say that there is no data showing that ADHD children differ from non-ADHD on any measure of brain function. I know of a dozen papers off the top of my head which refute this point. Doing a search of just the past two years I found the following papers:
How can the Conference dismiss 80 or so papers (since 1996) which find differences between ADHD and non-ADHD brains? Was I reading a scientific report or a nifty propaganda piece? How can they draw firm conclusions about certain points with little evidence (see below) and ignore results wholesale from others? Swanson et al (1998; Current Opinions in Neurobiology, 8(2):263-71) reported that certain regions of the frontal lobes (anterior superior and inferior) and basal ganglia (caudate nucleus and globus pallidus) are about 10% smaller in ADHD groups than in controls. Swanson was a speaker at the conference but still there was "no data" of neurobiological impairment in ADHD. Zametkin and Liotta (1998) of NIMH performed a comprehensive review of the neurobiological basis of attention-deficit/hyperactivity disorder and came to the conclusion that CNS abnormalities are associated with ADHD. How can respected scientists be overlooked and their work dismissed entirely?
They remind us that stimulant treatments do not "normalize" the entire range of behavior problems, and children under treatment still manifest a higher level of some behavior problems than normal children. And, notably, "there is little improvement in academic achievement or social skills" with stimulant treatment. Also, there are no long-term studies testing stimulants or psychosocial treatments nor information on long-term outcomes of medication-treated ADHD individuals in terms of educational and occupational achievements, or other areas of social functioning. Biofeedback is mentioned in passing and at no place do they say that it deems more research. However,one of the most respective and prolific ADHD researchers was prepared to spend five years at the peak of his career to study neurofeedback's effect on ADHD children. Neurofeedback alone! I doubt a respected scientist would have planned such an effort had medications and psychosocial treatments been sufficient or even desirable for the majority of ADHD children.
"Although little information exists concerning the long-term effects of psychostimulants, there is no conclusive evidence that careful therapeutic use is harmful. When adverse drug reactions do occur, they are usually related to dose."
Perhaps this is true (though "no conclusive evidence" is lawyerspeak for my client is guilty but you can't prove it). I think it is true to the extent that people are placing too much burden on stimulant medication to solve their problems. Trying to pass off various conduct and emotional problems as attentional issues underlies the overdiagnosing of ADHD. Dr. Breggin, who also attended the conference, mentions that a multimillion dollar program is now promoting the use of Ritalin for the control of disruptive behavior. THX-1138 is coming...
The following effects of stimulant treatment are thus judged as non-harmful: "decreased appetite and insomnia, negative effects on growth rate, and motor and vocal tics: The growth rate change concerns me the most because they qualify this obviously unusual side effect with the following "but ultimate height appears not to be affected." How do they know this? How arrogant to make a statement like this with little or no data! Rao et al (1998) found a small but significant effect on growth due to stimulant medication in their patient population under study. Spencer et al (1998) reported the small but significant differences in height between children with and without ADHD but concluded this effect appears to be mediated by ADHD and not by its treatment. Six years earlier Spencer concluded that children "treated (chronically) with MPH sustained height deficits that attained statistical significance". So we have conflicting results. Maybe there is no permanent effect -- but the jury is still out and the statement should be qualified accordingly. They say "Further, it is concluded that there is a low probability of long term effects on human body stature when the minimal therapeutic dose is used in clinical practice. " This is the most telling aside as it appears that fewer and fewer children are being prescribed the "minimal dose".
Another issue is abuse and addiction. When children pop psychotropic pills every 90 minutes or so, do you think they are more or less likely to try other mind-altering substances? NIH says no effect -- no more or no less. "There is little evidence that current levels of production have had a substantial effect on abuse. " Then why is methylphenidate one of the most frequently reported controlled pharmaceuticals stolen from licensed handlers. (Source: Dept of Justice) . And what should we make of the increasing reports of Ritalin-abuse on college campuses and secondary schools (see http://www.student.com/article/ritalin , The Ritalin Racket)? In 1994, a national survey indicated that more seniors in the U.S. abused Ritalin than are prescribed it legitimately. Hmmm.... According to the Physician's Desk Reference Guide, the standard text for medical reference, "chronic abuse [of Ritalin] can lead to marked tolerance levels and psychological dependence with varying degrees of abnormal behavior." Hmmm, again.... In the consensus statement, we are cautioned that "there is a need to be vigilant in monitoring the national indices of use and abuse among high school seniors and Drug Abuse Warning Network (DAWN) emergency room reports." According to DAWN statistics, an estimated 2700 emergency room mentions of methylphenidate occurred between 1990 and 1993. And finally, in March of 1995, two deaths in Mississippi and Virginia were associated with students giving and selling their medication to classmates who were crushing and snorting the powder like cocaine (Source: Drug Enforcement Administration press release http://www.usdoj.gov/dea/pubs/pressrel/pr951020.htm. Hmmm, very strange for a non-addictive substance.
Much of the report is clear and reasonable, based on scientific evidence, but here and there a bit of dogma seemed to be dressed up in academic garb.
The Hyperactivity Hoax: How to Stop Drugging Your Child and Find Real Medical Help
by Sydney Walker
St Martin's Press, 288 pp, $17
Sydney Walker III, M.D., a board-certified neurologist and psychiatrist and Director of the Southern Cal Neuropsychiatric Institute, has treated "ADHD" children for more than 30 years. He argues that a wide range of problems -- metabolic and genetic disorders, heart conditions, infections, anemia, hearing and vision problems, and toxic exposure can produce supposed ADHD symptomatology (e.g., hyperactive behavior, inattention) and masquerade as the ADHD. Accordingly, he cautions against the "label-and-drug" fad that has currently swept through U.S. child psychiatry the last decade or so. Children are too often placed on "powerful and potentially harmful mind-altering drugs without the benefit of any real medical diagnosis." He offers step-by-step advice about determining what form of care your child needs.
For more information, see http://www.amazon.com/exec/obidos/ASIN/0312192878/
Last Resort: Psychosurgery and the Limits of Medicine
by Jack D. Pressman
In 1935 Egas Moniz, a Portuguese neurosurgeon and future Nobel laureate, partially destroyed small areas in the frontal lobes on 13 depressed patients and 7 schizophrenic patients, resulting in marked improvement in many of the depressed patients. Removing malfunctioning brain was out of the gate... Some 20,000 psychiatric patients later, today we no longer look so highly on frontal lobotomies. They are no longer done and the entire episode has become an embarrassment to psychiatrists and neurologists who would prefer to dismiss it as a one-time aberration. (Will drugging our active children into sitting still be viewed better in 40 years?)
For more information, see http://www.amazon.com/exec/obidos/ASIN/0521353718/
Drug Addiction and Its Treatment: Nexus of Neuroscience and Behavior
by Bankole A. Johnson & John D. Roache (eds)
The editors examine the behavioral and biological processes involved in drug addiction and suggests ways of integrating behavioral and pharmacological treatments. The book is divided into four sections: behavior, neurobiology, trends in neuroscience, and treatment applications.
The third section in particular may be of interest to neurofeedback clinicians as they describe state-of-the-art research techniques for studying the neurobiology of drug
addiction including topographical brain mapping.
For more information, see http://www.amazon.com/exec/obidos/ASIN/0397517645/
Discoveries in the Human Brain: Neuroscience Prehistory, Brain Structure, & Function
by Louise H. Marshall & Horace W. Magoun
Humana Press, 336 pp., $60
The history of the brain research and the emergence of modern neuroscience are chronicled from the first findings of gross neuroanatomy in the ancient world to present-day neural networks and brain modeling. Along the way the people and events which gradually produced today's understanding of brain anatomy and physiology are presented, often with quotations from primary sources.
For more information, see http://www.amazon.com/exec/obidos/ASIN/0896034356/
Neurofeedback treatment of pseudoseizure disorder.
Swingle PG
[ Dept of Psychiatry, Harvard Medical School, USA.
]
Biol Psychiatry 1998 Dec 1;44(11):1196-9
The functional neuroanatomy of major depression: an fMRI study using an emotional activation paradigm.
Beauregard M, Leroux JM, Bergman S, Arzoumanian Y, Beaudoin G, Bourgouin P, Stip E
[ Dept de Radiologie, Faculte de Medecine, Universite de Montreal, Quebec, Canada.
]
Neuroreport 1998 Oct 5;9(14):3253-8
EEG analysis in ADHD: a comparative study of two subtypes.
Clarke AR, Barry RJ, McCarthy R, Selikowitz M
[ Dept of Psychology, University of Wollongong, NSW, Australia
]
Psychiatry Res 1998 Oct 19;81(1):19-29
Attention deficit diagnosis and care uncertain
Various
NIH Consensus Conference
Five Top Warning Signals Of Depression Identified
Cheryl Carmin & John Klocek
[ University of Illinois at Chicago,
]
The International Journal of Psychiatry in Medicine, Fall 1998
Brain's Ability To "Rewire" Itself After Strokes Or Injuries
(Large-scale sprouting of cortical connections after peripheral injury in adult macaque monkeys.)
Florence SL, Taub HB, Kaas JH
[ Dept of Psychology, Vanderbilt University, 301 Wilson Hall, Nashville, TN 37240 sherre.l.florence@vanderbilt.edu
]
Science 1998 Nov 6;282(5391):1117-21
The training also includes the all-important practicum section which focuses on actual operation and use of instrumentation. Additionally, opportunity is provided outside the formal curriculum for practitioners to experience training on themselves as well as discussing professional issues, marketing, and the particulars of establishing a financially successful practice based on this modality.
Faculty: Siegfried Othmer, Ph.D., BCIAC; Susan Othmer, BCIAC; M. Barry Sterman, Ph.D.; Nancy White, Ph.D. ; Pat Fields, Psy.D.; Martin Wuttke, BCIAC; William Scott, BSW, CCDP
| LOCATION | DATES |
|---|---|
| Encino, CA | (Adv. Practicum) Dec 12-13, 1998
|
| Encino, CA | (Specialty Course) Jan 7-11, 1999
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| San Diego, CA | Jan 21-25, 1999
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| Orlando, FL | Feb 18-22, 1999 |
| TOPICS COVERED |
|---|
| EEG Biofeedback Theory: Neurophysiological Basis; Research History |
| Clinical Applications: Assessment, Protocol Selection, Practicum & Case Review |
| Specialty Applications: For Behavior Modification & Performance Enhancement |
| COST (5-Day Course): $995.00 (** excluding Specialty courses)
Additional Attendees from Same Facility: 30% discount Reattendees: $200.00 |
To enroll, contact Dennis Campbell or call EEG Spectrum International at 800-789-3456 or (818) 788-2083. Or email denniscampbell@eegspectrum.com Please include your name and phone number in all email messages.
Conferences for Neurofeedback Clinicians & Researchers | ||
|---|---|---|
| CONFERENCE | LOCATION | DATES |
| FutureHealth 1999 (see below) | Palm Springs, CA | February 5-9, 1999
|
| AAPB 1999 | Vancouver, BC | April 7-11, 1999 |
For additional information and updates: bio@Futurehealth.org
In a related note, the FutureHealth 1998 abstracts are online at http://www.futurehealth.org/97eegab1.htm
-Siegfried Othmer, Ph.D.
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