INSIDE THE ADD MIND
By
Mark Goldenberg D.C., DABCN
Chiropractic Neurologist
Picture yourself walking into the lobby of a hotel to wait for a
friend. Music is playing in the back round, a movie is being shown
on a monitor, and there are some people talking. There is a table
with some magazines and today’s newspaper. Let’s throw
in a bird cage in the corner with a cockatiel chirping. The air
conditioning is on and it is quite cold. Bell boys are wheeling
luggage carts back and forth.
At first, you would probably scan the room, and then
proceed to sit down, you would then make a conscious decision to
pick up the newspaper and read. Your friend comes down in a few
minutes and you proceed with your evening. Very non-eventful right?
Well let’s analyze what just happened.
The music in the background was picked up by your
brain as being a low priority and therefore, although you hear it,
any other attention is subconsciously inhibited.
The video which you saw was also briefly noticed
and because it was not of interest to you, your brain automatically
inhibited any further action.
The bird in the corner chirping might be a minor annoyance
but again the stimulus is registered as a non priority and inhibited
or prevented from you taking any action.
As a matter of fact, I’m sitting on the New
Haven Line right now with the sound of the air conditioning blowing
and the temperature approaching 100 degrees. I am still able to
write this article because I am unconsciously inhibiting these stimuli
as being insignificant to my primary goal of writing this article.
The temperature, and the bell boys, is stimuli that your brain is
deciding to ignore, and therefore these stimuli do not even reach
your conscious thought.
You do however; have a desire to pick up some reading
material until your friend comes. This is significant and will cause
hundreds of thousands of neurons in your brain to fire in many different
areas of the brain. The thoughts of your past memories of reading
will be activated and the emotion you felt along with that past
experience will be activated. Memory centers, motor centers, sensory
centers, autonomic centers, visual centers etc. will be activated
due to your goal or desire to walk to that table, pick up the magazine
which has an article on lap tops, and start reading. Nothing else
at this point in time is significant to you except for reading this
magazine; this is why your brain inhibits all that is going on.
Mind you, if there was another stimulus that was more
of a priority, let’s say the sound of someone screaming for
help, your brain due to past learning would bring out from memory
a similar circumstance where that scream or something like it meant
danger. You would then, automatically, without thinking, drop the
magazine and try to help.
If all of this sounds silly, it isn’t. This
happens all day long, every second of every minute of every hour
of every day etc. etc. etc. We take the working of our brain for
granted because it is
such a finely tuned mechanism. More powerful than all the most advanced
computers in the world put together.
Brain dysfunction
Let’s go back to our hotel lobby example. Could
you imagine if your brains ability to inhibit unwanted stimuli was
not functioning correctly? Having to take the time to think about
every stimulus in that room and make a conscious decision which
one to give priority to?
What if they all seemed as though they were of equal
priority? Then you would listen intensely to the music; go over
to the bird cage, run to the luggage cart to see what that was about,
run to the video and watch. You would be uncomfortable with the
temperature and that might interfere with your decisions to do all
of the other things. This would make you feel frustrated maybe even
angry, your heart might start pumping faster, and you might start
sweating.
You have just looked through a small window of what
many children and adults experience whose brain is not functioning
at optimum level. People such as this do not experience all the
presentations that I mentioned. The signs that they manifest depend
on what areas of the brain are not functioning correctly. Notice
that I have not mentioned ADD, ADHD, OCD, PDD, Autism, Dyslexia,
Touretts, NLD, etc.ect.ect. These are all labels given to a constellation
of symptoms that occur frequently enough that they can be classified.
When I talk about children with brain dysfunction
it is important to realize that I am not talking about brain damage.
As a matter of fact, these children are often times extremely bright
and are actually at levels of high normal in many different areas
of cognition and have very high IQ’s.
It does not matter what you call it. All of these
syndromes have one thing in common. The brain is not functioning,
communicating, or processing correctly, or more importantly the
brain is not synchronous.
The cause
The question now becomes;
Why isn’t the brain functioning correctly?, Where in the brain
is the malfunction?, Is it an anatomical problem such that if we
take an MRI we would see an abnormality?, Is it a chemical problem
such that if we take a chemical test it will reveal a decrease of
some chemical, a neurotransmitter perhaps?. The answer to these
questions for the great majority of these syndromes are that it
is not an anatomical abnormality, it is not a chemical problem per
say.
Is poor parenting the cause? Usually not, although
the home environment does have a great deal to do with the way the
child will progress and improve.
Is genetics the cause? Genetics obviously plays a
role but not totally. Is environment the cause? Environment does
play a critical role as well.
Let’s get back to our first question. Why isn’t
the brain functioning properly? Studies and current research have
shown that many of the brains of children and adults with these
challenges have a decreased activity or hypo-functioning of certain
brain regions.
This has been shown through PET (positron emission
tomography) scans, fMRI (functional MRI), SPECT (single photon emission
computerized tomography). These scans pick up the metabolic rate
of cells in various areas of the brain, and look at the brain as
a whole and compare different regions from side to side.(1)
These scans have shown that kids with ADD/ADHD, Bipolar disease,
and other types of processing problems, exhibit areas of the brain
that seem to be colder or less metabolically active. The cells in
these areas are not as active as they are supposed to be. Not because
of any type of specific damage per say, but just because the cells
are functioning at a lower level. In the case of ADHD the problem
is usually in the right frontal lobe.
Recent functional MRI scans have shown that children who fit the
classification of ADD/ADHD, Bipolar disease, Autism and many other
learning disabilities and processing problems have decreased activity
in the right frontal lobe of the brain and the cerebellum. (1)
Synchronicity
A great many children with ADD/ADHD and other disorders,
have processing problems in the areas of motor planning and sequencing.
The front part of the brain is responsible for taking all the environmental
stimulation from different areas of the brain and putting it together
so that it can be acted upon. Therefore, the different sensory areas
must send the information to the front of the brain so that it arrives
there at the same time. If it does not, then the thought or action
will be asynchronous. If synchronicity can be improved, this will
improve focus, timing, and synchronicity of the brain as a whole.
Improving Synchronicity and Processing speed
There is a protocol which has shown to be extremely
effective in increasing processing speeds and brain synchrony. It
is known as the Interactive Metronome.
The Interactive Metronome objectively measures an
individual’s timing, rhythm, coordination, and capacity to
plan actions. Based on this measurement, timing deficiencies and
challenges in planning actions such as those commonly found in people
with ADHD, and other learning and processing problems can be identified.
This measurement has been shown to correlate to academic performance
and the ability to pay attention. The initial Interactive Metronome
session gives us a wealth of information concerning a child or adults
ability to synchronize sensory and motor activity.
The process involves having the individual tap his/her
hands and feet in synchrony with a target sound. The program takes
the child through app. thirteen different coordinated movements
increasing repetitions as the child progresses.
A recent study published in the March /April 2001
issue of The American Journal of Occupational Therapy found that
by following the protocols of the Interactive Metronome, significant
increases in attention, coordination, control of aggression, motor
control, language and reading processing were found.
With the use of this protocol and other physical activities, patients
have demonstrated a 2 grade level increase in reading fluency and
a 1.7 grade level increase in math fluency.
Any therapy geared towards dealing with these types
of problems should also include exercises that will stimulate specific
areas of the child’s brain therefore improving the brains
function, hopefully on a long-term basis. The exercises should address
a number of different areas. The exercises that we use include breathing,
eye exercises, strength, endurance, balance, coordination, fine
motor activity, gross motor activity, auditory stimulation and visual
stimulation. Emphasis is placed on making sure that the proper signals
from the spinal muscles and joints are being transmitted since it
is here that the largest percentage of stimulation to the cerebellum
occurs.
Obviously, these are complex issues. New research
is being done as we speak on how the brain functions. The information
in this article is based in part on the most current thoughts on
brain function.
This article has been written to give hope to any parent with a
child who is challenged. To understand that your child too, can
increase their brain function through certain types of activities,
and that genetics need not be the only dictate of a child’s
potential, that there might be another approach to these problems
other than medication.
Every child has unlimited potential, every child
is an angel and can fly!
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