008 - ADHD

Post date: Nov 10, 2015 9:10:48 PM

Counselor Notes 8

December 2012


A few "housekeeping items":

Attention Problems In Children

For the rest of this letter and the next few I want to address attention problems in children. This gets controversial as I know some say it is just the doctors doling out medication or teachers expecting too much too soon, but as a collective whole, children really are having more attention problems than in the past.

When you work in a school system you get to see an awful lot of kids. The children with some type of attention problem are really standing out. The hyperactive ones are going to be blatantly obvious. The inattentive ones aren't going to show up as much until there are tasks/demands placed upon them.

There may be a multitude of causes (diet, toxins, anxiety, home life, sleep disorders, food allergies, too many immunizations too soon, genetics, etc.) but it does seem to me that there is something going on.

Let me make the case for ADHD actually existing:

Dr. Daniel Amen did single photon emission computed tomography (SPECT) on people with ADHD. (SPECT is a “nuclear medicine study that evaluates brain blood flow and activity patterns.” Amen, p. 44) Amen found that there were six distinct types of brain scans (Healing ADD by Daniel Amen, M.D. p. 61 – 66):

1. Classic ADD – normal brain at rest, but when concentrating, there is “decreased activity in the underside and lateral prefrontal cortex.”

2. Inattentive ADD – normal brain at rest, but there is “decreased activity in the lateral prefrontal cortex” during periods of concentration.

3. Overfocused ADD (“trouble shifting attention, frequently gets stuck in “loops of negative thoughts or behaviors, obsessiveness, excessive worrying, inflexibility, frequent oppositional and argumentative behavior.”) - “at rest and during concentration there is increased activity in the anterior cingulate gyrus. During concentration there is also decreased activity in the underside and lateral prefrontal cortex.”

4. Temporal Lobe ADD ('inattentiveness, irritability, aggressiveness, dark thoughts, mood instability, learning problems, inattention and impulsivity.”) - “at rest and during concentration, there is decreased and infrequently increased) activity in the temporal lobes. During concentration there is also decreased activity in the underside and lateral prefrontal cortex.”

5. Limbic ADD (inattentiveness, chronic low-grade depression, negativity, 'glass-half-empty' syndrome, low energy, and frequent feelings of hopelessness and worthlessness.”) - “at rest there is increased deep limbic activity (thalamus and hypothalamus) and decreased activity in the underside and lateral prefrontal cortex. During concentration there remains increased deep limbic activity and decreased prefrontal cortex activity.”

6. Ring Of Fire ADD (Inattentiveness, extreme distractibility, anger, irritability, oversensitivity, moodiness, hyperverbal, and extreme opposition) - “at rest and during concentration (often worse during concentration) there is patchy increased uptake across the cerebal cortex with focal areas of increased activity, especially in the left and right partial lobes, left and right temporal lobes, and left and right prefrontal cortex. In addition there is often increased activity in the cingulate gyrus.”

Harvard Medical School’s Edward Hallowell M.D. and John Ratey, M.D. write in Delivered From Distraction:

• “…ADD is associated with slight but significant differences in specific regions of the brain.” (p. xxxv)

• “Four different studies done in the past decade using MRI (magnetic resonance imaging) all found a slight reduction in the size of four regions of the brain: the corpus callosum, the basal ganglia, the frontal lobes, and the cerebellar vemis…. The frontal lobes help with organization, time management, and decision making, all areas that people with ADD struggle with. The basal ganglia help to regulate moods and control impulsive outbursts, which people with ADD also struggle with. And the cerebellum helps with balance, rhythm, coordinated movements, language and other as yet to be proven functions.” (p. 8)

• “…PET (positron emission tomography) scan study published in The New England Journal of Medicine showed differences in glucose metabolism in the brains of adults who had ADD compared to adults who did not.” (p. 55)

• “In patients with ADHD, parts of the cerebellum are smaller in volume and don’t function properly, so it makes sense that this could cause disjointed attention.” (p. 151)

• “The molecule that transports dopamine is called DAT, which stands for dopamine transporter…. Using a brain scan and a radioactively labeled molecule called altropane, scientists have measured the concentration of DAT in adults who have ADD and adults who do not.” (p. 154)

• “DAT turned out to be 70% higher in adults who have ADD than in those who did not.” (p. 154) Note: “High levels of DAT are also associated with a high risk for developing addictions of various kinds.” (p. 154

Carla Hannaford Ph.D. writes in Smart Moves that:

“PET scans of children who were labeled ADD and ADHD showed substantially lower dopamine levels and smaller brain volumes than normal children, particularly in the gray matter in the right front area having to do with movement and integration of ideas. Also, two regions in the front of the corpus callosum were found to be smaller in these children: one region connects to the part of the brain involved in suppressing the impulse to fidget, the other activates the proper production of dopamine.” (p. 220 – 221)

I also once went to a conference on ADHD where the presenter (Marilyn Thatcher Ph.D.) noted that a true ADHD person has:

    • an average of 10% less total brain volume than normal (Note: the brain volume difference doesn't mean that they are unintelligent though - remember Einstein had a rather small brain.)

    • right hemisphere differences

    • a reduced hippocampus volume

    • atypical development of cerebella vermis.

I found this interesting as well: