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Is ADHD Overdiagnosed? Results From a Recent Study

Posted by on Jul 14, 2014 in Articles | 0 comments

Although it is well established that many children with ADHD are never identified or treated, the extent to which children are incorrectly diagnosed with ADHD is not known. There are several reasons to be concerned about over or incorrect diagnosis. First, it can lead to children being inappropriately treated with stimulant medication when they do not need it. Second, it may contribute to children not receiving treatment that would better address another condition they actually have. Third, it could contribute to increased health care costs and health challenges later in life. The possibility of stigma is also an important factor to consider.

Clear diagnostic criteria for ADHD is set out in the DSM-IV-TR. In addition to a minimum number of inattentive and/or hyperactive-impulsive symptoms, children must show impairment from these symptoms in at least two settings, the symptoms must cause clinically significant impairment in social or academic functioning, they must have been associated with some impairment before age 7, and they must not be better explained by another mental disorder such as a mood or anxiety disorder.

Unfortunately, some clinicians who diagnose ADHD in children may not carefully follow the diagnostic guidelines. Instead, clinicians’ may focus on the presence of particular symptoms that they believe are central to the disorder and when these are present, fail to consider whether all the necessary additional criteria are met.

It is possible that this partially explains why many more boys are treated for ADHD than girls. Specifically, boys with ADHD are more likely than girls with ADHD to display disruptive behavior. If clinicians regard disruptive, impulsive, and hyperactive behavior as primary to the disorder it could contribute to boys being overdiagnosed and girls being underdiagnosed. That is because when such behavior is present, clinicians may be less attentive to necessary diagnostic criteria that are not met. And, when it is not evident, clinicians may disregard or at least underemphasize the presence of other ADHD symptoms when making their diagnostic decision.

A very interesting recent study in the Journal of Consulting and Clinical Psychology presents a very interesting look at this issue [Bruchmuller et. al., (2011). Is ADHD overdiagnosed in accord with diagnostic criteria? Overdiagnosis and influence of client gender on diagnosis. Journal of Consulting and Clinical Psychology, 80, 128-138. The study demonstrates that not all clinicians follow DSM-IV criteria “…requirements to base their diagnosis on a thorough evaluation of relevant diagnostic criteria.” Preliminary evidence suggests this may especially be true for male clinicians evaluating male children. Diagnosing children incorrectly can potentially lead to a number of adverse consequences and this research will hopefully contribute to raising awareness of this important issue. Click here to read the entire article.

Why I Recommend Cogmed Working Memory Training

Extensive research has clearly indicated that poor working memory is a significant contributor to learning difficulties for many children especially ADHD children and adults. Cogmed’s program is designed to train and improve working memory and has accumulated substantial research support, with more than a dozen studies published in leading scientific journals.  These include studies that have looked specifically at the impact of working memory training on student achievement and attention. Cogmed Working Memory Training has been widely used in Swedish schools for a number of years and is now being introduced to schools in the US and Canada.

To learn about the potential benefits that Cogmed Working Memory Training may provide your child or students in your school and district, just request information by submitting the form below. The information will be sent to you directly from Cogmed. I believe you will find this information to be of great interest and the training of great benefit.

Please send us an email for more information about Working Memory Training:

Your information will is being requested solely for the purpose of providing you with information on Cogmed Working Memory Training and will not be sold or redistributed to anyone.

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Strong New Support for Neurofeedback Treatment for ADHD

Posted by on Jul 7, 2014 in Articles | 0 comments

Strong New Support for Neurofeedback Treatment for ADHD **

Neurofeedback – also known as EEG Biofeedback – is an ADHD treatment in which individuals learn to alter their typical EEG pattern to one that is consistent with a focused, attentive state. This is accomplished by collecting EEG data from individuals as they focus on stimuli presented on a computer screen. Their ability to control the stimuli, for example, keeping the smile on a smiley face or keeping a video game playing, is contingent on maintaining an EEG state consistent with focused attention. Neurofeedback proponents argue that this ability generalizes to real world situations and results in better attention during academic and related tasks.

Although neurofeedback for ADHD has been controversial for many years, research support for this treatment is growing. In fact, in October, 2012 the American Academy of Pediatrics rated neurofeedback as a Level 1 “Best Support” Intervention for ADHD; this is the highest possible rating and at the same level as medication treatment combined with behavior therapy; you can find the ratings at I have long supported and written about Neurofeedback in both editions of my book, The Gift of ADD: Secrets for Transforming Liabilities Into Possibilities For Parents and Teachers” particularly since medication has never shifted educational gains, changed outcomes for, nor addressed ADD/ADHD students unique brain wave patterns or learning differences.

How do the benefits of neurofeedback for ADHD compare to those provided by stimulant medication? Medication remains the most widely used ADHD intervention and examining this question is thus important. A previous study comparing neurofeedback to medication treatment showed that both treatments yielded significant benefits and did not differ significantly from one another. However, an important limitation of this prior study was that children were not randomly assigned to medication or neurofeedback treatment; instead, parents selected the option they preferred for their child. This limits the conclusions that can be drawn in several important ways. First, without random assignment, preexisting differences between children whose parents preferred neurofeedback and those who preferred medication may have influenced the findings. Second, without random assignment one cannot determine whether neurofeedback is effective for children with ADHD overall, or only for those children whose parents select it.

New Research Comparing Medication to Neurofeedback

Two recently published studies addressed this limitation by randomly assigning children with ADHD to either medication or neurofeedback conditions.

Study 1 – The first study [Duric et al., (2012). Neurofeedback for the treatment of children and adolescents with ADHD: A randomized and controlled clinical trial using parental reports. BMC Psychiatry, 12, 107] was conducted with 91 6 to 18 year olds (mean age of 10.5) in Norway. Participants were randomly assigned to receive neurofeedback, stimulant medication, or both.

Neurofeedback treatment was conducted in 3 40 minute sessions per week over 10 weeks, i.e., 30 sessions total. The primary focus was to decrease theta activity and increasing beta activity. This is consistent with numerous findings that a high theta/beta ratio is a reliably found in individuals with ADHD.

Children in the medication group received treatment with methylphenidate, the generic form of Ritalin. Medication was provided 2X/day at a dose of 1 mg per kg.

Children in the combined group received both treatments.

Results – Parents completing ratings of core ADHD symptoms before treatment began and 1 week after neurofeedback had been completed. Children in all groups – neurofeedback, medication, and combined – were reported to show significant reductions in inattentive and hyperactive-impulsive symptoms. Although between group differences were not significant, the effect on inattentive symptoms appeared largest for the neuorfeedback only group. An unexpected finding was that for all groups, the impact on hyperactive-impulsive symptoms was consistently larger than for inattentive symptoms.

Study 2 – A second study published earlier this year [Meisel et al., (2014). Neurofeedback and standardized pharmacological intervention in ADHD: A randomized controlled trial with six-month follow up. Biological Psychology, 95, 116-125) extends this work by obtaining feedback from teachers in addition to parents – including assessments of educational performance – as well as 2- and 6-month follow up data.

Participants were 23 7-14 year-old children with ADHD – 11 boys and 12 girls; the study was conducted in Spain. Participants were randomly assigned to neurofeedback or medication therapy. Neurofeedback consisted of 40 sessions (approximately 30 minutes/session) provided over 20 weeks. As above, treatment focused on suppressing theta activity and enhancing beta activity.

Medication treatment was with methylphenidate at a dose of 1 mg per kg following Spanish national treatment guidelines for ADHD. Children receiving medication continued to receive it across the 6-month follow up period.

Data was obtained pre-treatment, immediately after neurofeedback ended, and again 2 and 6 months later. Mothers and fathers completed ratings of core ADHD symptoms, oppositional behavior, and functional impairment. Teachers also rated ADHD symptoms, oppositional behavior, and children’s performance in reading, writing, math, and oral expression.

Results – Immediately following neurofeedback treatment, maternal ratings for both groups indicated significant reductions in inattentive and hyperactive-impulsive symptoms; declines in attention difficulties were more pronounced and differences between groups were not significant. Significant reductions in oppositional behavior and reductions in overall functional impairment were also reported. These improvements were generally maintained at the 2- and 6-month follow up.

Reports from fathers were less consistently positive. For neurofeedback, ratings of inattentive symptoms showed significant reductions at each period but were of lesser magnitude than what mothers reported. Declines in hyperactive-impulsive symptoms and oppositional behavior were not significant. Results for the medication group were similar; the only difference was that fathers reported lower oppositional behavior at 6 months, a reduction that was not evident in the neurofeedback group.

Results from teachers were especially interesting. For the neurofeedback group, significant reductions in inattentive symptoms were only marginally significant at the immediate post-test, but were both significant and of large magnitude at the 2- and 6-month follow ups. The same was true for hyperactive-impulsive symptoms and oppositional behavior. At post-test, teachers also reported significant gains in all academic areas, except for math which was marginally significant. These gains generally persisted across the 6-month follow up.

For the medication group, significant reductions were also reported for core ADHD symptoms and oppositional behavior. The magnitude of these improvements tended to be larger than for the neurofeedback group, but not significantly so. However, no improvements were evident for any academic area at any time point.

Summary and Implications

Across both studies, neurofeedback and stimulant medication treatment yielded significant and generally consistent benefits for children with ADHD. In contrast to prior studies comparing neurofeedback and medication, both employed random assignment. The second study had several additional strengths including collecting data from multiple informants – including teachers – and following children up to 6 months after neurofeedback treatment ended. It is thus especially promising that benefits evident for neurofeedback when treatment first ended were generally retained over this period. Medication related gains also persisted, which is not surprising given that children continued on medication.

Both studies have limitations that need to be recognized. The sample sizes were small which makes finding significant differences between treatments more difficult. Neither study was conducted in the US and one must be cautious about assuming the findings would apply to US children. However, there is no reason I know of why a different pattern of findings would be expected here.

Obviously, parents were not blind to their child’s treatment; in the second study, there is no indication that teachers were kept ‘blind’. The inclusion of data from ‘blind’ observers and/or objective measures of attention that are less susceptible to expectancy effects would have made for a stronger study. Apparently, objective assessments were collected in study 2 and will be published separately; I will be eager to learn what was found.

No mention is made in either study as to whether children actually showed improvement in producing and maintaining the EEG states that were targeted in training. This, as well as the absence of a ‘sham’ feedback condition makes it impossible to conclude that it was feedback on EEG states, as opposed to non-specific factors linked to neurofeedback treatment (e.g., therapist attention) that are responsible for the gains.

I would also note that in both studies, children received a standard medication dose based on body weight rather than determining the optimal dose for each child via a titration trial. Standard dosing is not the best way to optimize medication benefits, and gains may have been greater if titration procedures were employed.

These limitations not withstanding, results from these studies suggest that the benefits of neurofeedback for ADHD may approximate those provided by stimulant medication. Study 2 also suggests that neurofeedback may produce academic gains that medication does not. Thus, while neither study is perfect (then again, no single study ever is) both point towards the value of neurofeedback treatment for many children with ADHD. There is also much clinical evidence for the support of neurofeedback.

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Parenting ADD/ADHD Children

Posted by on Jul 2, 2014 in Articles | 0 comments

Parenting is the most complex and difficult job we ever do as adults and few of us have any real training in what works and what doesn’t. Most of us rely on what our parents and significant adults taught us even though these strategies are scientifically proven to fail. Parenting is even more challenging when we have children who have more difficult temperaments or are impulsive. What we know from scientific studies is yelling and reasoning with your children is equally ineffective.

Sadly, many family therapists and parenting educators aren’t aware of the best research, either, which means that even when parents do seek professional help they often won’t get the advice that is most proven. In fact in a review led by Sheila Eyberg at the University of Florida and published in the January Journal of Clinical Child and Adolescent Psychology, only 16 programs designed to treat children with disruptive behavior have been shown to be “well established” in randomized clinical trials.

The Eight Biggest Mistakes Parents Make

  1. Parents Don’t Consistently and Powerfully Set Limits Not setting limits has been shown to create more rebellious and defiant children. This because they feel unsafe without limits and the push the envelope to get their parents to respond.
  2. Parents Nag, Lecture, Nag, Lecture, Then Yell Studies show that humans tune out when commands or requests are repeated. Nagging is actually a form of “negative reinforcement” and children often continue misbehaving to get parental attention. We tend to ignore good behavior and focus on the negative because it creates discomfort which we naturally try to avoid. Praise on the other hand is one of the most powerful tools we have to influence a child’s actions. Typically praise is used poorly by not being specific enough with our praise so that children understand what you want repeated. Using positive reinforcement—to praise your child immediately, specifically and enthusiastically works and creates a happy home. Encouragement is more powerful than praise because it leads to children to self validate rather than needing someone else to recognize their worth.
  3. Parents Overprotect it’s difficult to see your child struggle or experience disappointment. Parents often jump in too quickly which doesn’t allow the child to learn resiliency. We have to show kids we believe that they are capable and allow them to face the consequences of their behaviors as well.
  4. Parents Aren’t Specific with Their Praise and Praise Too Frequently Most praise children get from parents and teachers is far too generic (i.e. great job, You’re a good boy) and the praise is far less frequent than we think. In fact, children receive 45% more negative feedback in a day than positive. Praise that is non specific make children less motivated, less self-confident and they will have a harder time dealing with failure.
  5. Punishment is Too Severe 90% of parents believe spanking young children is acceptable. Discipline is about teaching; not punishment. The goal is to help the child to develop the inner voice of discernment and make choices based on that voice rather than the threat of punishment or the need to have adult supervision to make the correct choices. Harsh punishments (i.e.. grounding for a month or spanking) work only in the short term but teach children to be unfair or to use physical violence to solve problems. Discipline works best when it is immediate, fair, logical or natural (or set up in advance such as through an early warning to shift behavior). When discipline is too severe it breeds anger and resentment and a desire to get back at the parent. Punishment erodes the relationship with the parent.
  6. Place Attention On Changing Behaviors Rather Than Teaching Compassion Research shows that the most important quality to develop for success in managing relationships at work, in school or in our families is compassion. Children need to learn to be aware of how their actions and words will affect the feelings of others and themselves. We help children to learn empathy through being empathized with. Modeling this behavior for children and discussing feelings in different situations is critical to this development.
  7. Grades Take Precedence Over Creativity and Results Trumps Effort Too much emphasis is placed on learning facts and rules. Those who learn to read early and parrot back information while sitting quietly impress us more than those who are creative and learn and process differently. Yet creative thinkers are more likely to be resilient when the first idea doesn’t work. When we reward “getting the answers right and right away” children who struggle or take longer to learn something lose he will to keep trying. Effort is more important to success than knowing facts. Using open-ended questions or having children explore more than one way to solve problems helps them become independent thinkers and life-long learners.
  8. Parent’s Don’t Focus Enough on Fun Life is serious enough. Laughing and playing together are key to a healthy family and to raising emotionally healthy children. Planning regular outings and things like family game night strengthen your relationships and build trust and love.

The Gift of ADD – Transforming Liabilities into Possibilities

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Chronic Reversed Polarity

Posted by on Apr 5, 2014 in Articles | 0 comments

Chronic Reversed Polarity 


The human body is a self-contained, self-generating electrical system. Our mental processes, the immune system, and the heart are  all part of a vast system that runs electrically. Whenever electricity 

is in operation, magnetic fields are created and these fields have polarity. This means they have a north and south pole. If you put a magnet under stress, it will reverse its polarity; in essence, the north and south poles change positions. 


Since the human body is electrical and has a subtle magnetic field, certain conditions such as stress will reverse the body’s polarity. This condition can be temporary, yet it is often is often long-lasting and chronic. Keith R. Smith discovered that chronic polarity reversal appears to be a major factor in the cause of chronic 

fatigue syndrome, depression, anxiety, fibromyalgia, auto immune diseases, cancer, ADHD, and many other conditions. 


Some potential signs of Chronic Reversed Polarity are: 


➤ Chronic stress or an Inability to Relax, Depression or Anxiety


➤ Headaches or Migraines 


➤ Difficulty concentrating, Feeling Brain Fog. or Poor Short Term Memory


➤ Insomnia, difficulty sleeping 


➤ Clumsiness or Being Accident Prone 


➤ Chronic Fatigue 


➤ Pain 


➤ Chronic health problems including Constipation, digestive problems or Irritable Bowel 


Stress plays an important role in ADD and the ability to learn. One form of stress that has greatly increased in recent years is exposure to Electromagnetic Frequency waves (EMF) from cell 

phones, Wifi and other electrical devises. Younger people are more vulnerable to EMF waves due to skull-thickness, which is maturing and growing. Evidence now suggests that fetal or neo-natal exposures to radiofrequency radiation may be associated with an increased incidence of autism. One way to protect yourself and your child against the stresses due to EMF exposure is wearing the GIALife Pendant. (For more information visit and look for the Biological treatments in the drop-down menu). Treatment with Biomagnetism can return the body to balance. 

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Did you know that if your ADD/ADHD child finds something to shine in they are more likely to succeed and show fewer symptoms?

Posted by on Mar 2, 2014 in Articles | 0 comments

Because of their symptoms ADD/ADHD children are more likely to receive a higher percentage of negative feedback than other children. Because of neurological differences they are already more attuned to tonal messages and negative signals than other children so this only heightens their poor self-esteem. By finding creative outlets of expression that a child can get passionate about there are more opportunities for them to not only feel good about themselves but also set up situations where they receive encouragement. Outlets like sports, music, building things, and the arts also allow for increased opportunities for hyper focus. This allows your child (especially when you bring attention to it)  to realize they are capable of focus and attention (in fact to higher degrees than non-ADD/ADHD children). Focus on the positive by parents and teachers reduces stress and increases the child’s ability to follow through on tasks of less interest and reduces symptoms. 

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