Archive for ADD / ADHD

ADD and ADHD

For those of you who are seeing a clinician utilizing eeg/neurofeedback (NFB) training for targeting ADD and ADHD symptoms realize it takes several visits, oftentimes 30 or more, to see significant gains in brainwave focus. With appointments running $75 per session and higher, our customers are incorporating the DAVID Alert ProAlert Pro mind machine into their NFB training. Most use their Alert Pro as an adjunctive modality at home to the NFB training they are receiving. Results indicate that this method increases their ability to achieve the desired brainwave state more easily, which in turn leads to better, more productive NFB training sessions.

ADD and ADHD affect people of all ages. Many struggle with other issues like depression, insomnia, anxiety and drug abuse. The DAVID Alert Pro by Mind Alive has specific sessions designed for left hemispheric, right hemispheric and whole brain stimulation. These sessions gently guide your brainwaves to a specific brainwave state, editing and reinforcing your neuropathways through pulsed light, sound and cranial-electro-stimulation, with session’s end leaving you relaxed, refreshed and internally invigorated.

Alert Pro

Alert Pro

The DAVID Alert Pro comes complete with: Tru-Vu OmniscreenTM Eyesets and Carry Case, high-quality stereo headphones, stereo patch cord, CES earclip Stim cable, 9v battery, ac adapter, comprehensive owners manual with Symptom Survey Checklist, HRV ready, and Mind States 2 pdf download.

 

Audio-Visual Entrainment as a Treatment Modality for Post-Traumatic Stress Disorder (Part Three)

Audio-Visual Entrainment as a Treatment Modality for Post-Traumatic Stress Disorder (Part Three)

 

By David Siever

 

Abstract: Post-traumatic stress disorder (PTSD) is the aftermath of trauma. Trauma spans a diverse spectrum of unfortunate life experiences such as sexual abuse, assault, car accidents, war, and natural disasters. PTSD occurs when the inflicted can no longer mentally cope with the situation. Following trauma, permanent changes occur within the brain that increases “racy-headedeness,” guardedeness, anxiety, depression, insomnia, plus memory and cognitive impairments. The behavioral aftermath of PTSD also typically involves increased aggression and drug and alcohol abuse. Audio-visual entrainment (AVE) has been shown to reduce anxiety, insomnia and improve coping for police officers and military. AVE has also been shown to reduce depression and anxiety among vets with chronic fatigue syndrome and fibromyalgia.

 

Audio-Visual Entrainment as a Treatment Modality for PTSD

All sensory information, except for smell, must pass through the thalamus in order to gain access into other brain regions. When lights are pulsed into the eyes or tones pulsed into the ears, the nerve pathways from the eyes and ears carry the evoked potentials into the thalamus. When a repetitive stimulus of the proper frequency and sufficient strength to excite the thalamus is present, their frequency signature is shown in the EEG. From there, the entrained electrical activity within the thalamus is amplified and distributed throughout other limbic areas and the cerebral cortexes via the cortical-thalamic loop. This is a signaling loop between the cerebral cortex and the thalamus that generates the alpha rhythm at roughly 10 Hz during neuronal rest (Demos, 2005). This effect of modulating the cortical-thalamic loop with light and sound is known as audio-visual entrainment (AVE). In essence, AVE) is the continuous electrical response of the brain in relation to the frequency of the stimuli plus the mathematical representation (harmonics) of the stimulus wave shape.

The Digital Audio Visual Integration Device (DAVID) AVE devices present pulsed light to the user via a pair of glasses (Tru-Vu Omniscreen™ Eyeset) with an array of flashing LEDs and pulsed tones through a pair of headphones. Because most maladies have an abnormal brain wave signature, the DAVID AVE device can help treat a host of maladies including anxiety, depression, insomnia, impact of trauma, a racy mind, attentional disorders, fibromyalgia and cognitive decline and risk of falling in seniors.

Entrainment occurs best near the natural alpha frequency from 9 to 11Hz (Toman, 1941). The results of a study by Kinney et al, (1973), shown in Figure 3, shows strong and pure entrainment at 12 Hz. The harmonics (small wavelets) seen in the EEG are a reflection of the harmonics produced in the EEG from the Xenon square-wave, strobe-light stimuli.

Entrainment primarily shows itself in the frontal, central and parietal regions. (Siever, 2002). AVE presents itself strongest at a person’s natural alpha frequency, which is close to 10 Hz for the normal population (Toman, 1940). Given that PTSD most commonly causes enhanced beta and suppressed alpha activity, coincident with high arousal (Jokic’-Begic’ & Begic’, 2003), AVE can rapidly reverse the brain wave effects of PTSD as shown in.

Hows the results of a 19-channel QEEG (Demos, 2005) as processed through the SKIL (Sterman-Kaiser Imaging Labs) database in 1 Hz bins (sorted into 1 Hz groupings) showing the frequency distribution of AVE at 7.8 Hz. The area within the green circle at 8 Hz shows maximal effects of AVE in central, frontal and parietal regions (at 10 microvolts, in this case) as referenced with the area in the oval on the legend. It is through these effects that AVE has proven effective in treating depression, anxiety and attentional disorders. A 16 Hz., second harmonic is also present (the circled image), which is typical of semi-sine wave (part sine-wave / part square-wave) stimulation. 

Brain map in 1 Hz bins – during 7.8 Hz AVE (SKIL-Eyes Closed) AVE at 18.5 Hz has also been shown to produce dramatic increases in EEG amplitude at the vertex of the head (Frederick, Lubar, Rasey, Brim, & Blackburn, 1999). It was found that: eyes-closed 18.5 Hz. photic entrainment increased 18.5 Hz EEG activity by 49%. eyes-open auditory entrainment increased 18.5 Hz. EEG activity by 27%. eyes-closed auditory entrainment increased 18.5 Hz EEG activity by 21%. eyes-closed AVE increased 18.5 Hz. EEG activity by 38.3%.

Normalizing EEG Activity in Depression

Studies suggest that a significant number of those with PTSD develop depression, characterized by frontal alpha asymmetry with more left frontal alpha activity as compared with right frontal alpha activity (Gordon, et al, 2010; Rabe, et al., 2008).

To help treat depression from an electro-neuro perspective and re-balance the frontal lobes we need to re-excite the left frontal lobe (the happy side) and suppress the right frontal lobe (the fear-based side). So two conditions must be met:

a) we must inhibit the excessive left-frontal alpha (thus “waking” it up).

b) we must simultaneously boost right frontal alpha (calming it down). Therefore, we need a means whereby we can affect both frontal lobes independently of each other.

It has been shown (above) that AVE clearly increases alpha and beta activity, but to treat depression, we also need a way that can suppress alpha in the left frontal lobe. Visual Entrainment has been found to inhibit brain wave activity at the ½ frequency of stimulation, thus satisfying condition a). Shows an ADHD child with aberrantly high theta, in which 14 Hz visual entrainment was used to suppress it at the 30 minute mark. (Collura & Siever, 2009). Notice how rapidly the excessive theta disappears. In the case of depression, we can stimulate with 20 Hz and inhibit the 10 Hz alpha activity.

Suppression of Theta in an ADHD Child Using 14 Hz Photic Stimulation.

Independent hemispheric stimulation is accomplished by utilizing the optic chiasm (Siever, 1995), thus satisfying condition b). Stimulating the right fields of both eyes with a different frequency than the left-fields as shown in Figure 6, can accomplish this. Figure 6 depicts stimulus “A” at 12 Hz and stimulus “B” at 4 Hz. Notice the corresponding frequency evident in the opposite hemisphere of the brain. For treating depression, 18-21 Hz stimulation in the right fields would inhibit the left-frontal alpha from 9–10 Hz, thus boosting activity. Stimulating at 10 Hz in the left fields, will boost right-frontal alpha, thus calming activity.

Patented Technique for Independent Hemispheric Stimulation. Shows the QEEG (also referred to as a brain map) of a happy person as compared to the Sterman-Kaiser Imaging Labe (SKIL) normative database. This person constantly exhibits approach behavior towards socializing and what she considers to be fun activities. Notice that alpha activity is stronger in the right frontal lobe, the EEG signature typically associated with happiness. 

Normative Brain Map of a Happy Person. (SKIL-Eyes-closed).

Shows a fairly typical brain map of a person with depression and anxiety from trauma as shown on the SKIL database. The scale is 2.2 standard deviations (SD) and the pink area in the alpha view is actually 2.6 SD. Activity above 2 SD is considered a clinical abnormality. Notice that alpha activity is higher on the left side coincident with a personality trait based on a focus of withdrawal and avoidance from selfr-perceived negative stimuli. Also, the generalized red colored region is an indicator of generalized cognitive fatigue. The Beta 2 activity is just approaching 2.2 SD (an indication of mild anxiety). Non-clinical persons have greater right frontal alpha associated with an attraction toward positive stimuli (Demos, 2005).

Brain Map of Individual with Depression and Anxiety (SKIL – eyes closed)

Approximately 10 minutes following a 30-minute AVE session designed to reduce the symptoms of depression, both alpha and beta activity is normalized as shown below in Figure 9. Notice that the frontal alpha activity and the Beta 2 activity, has been reduced to roughly 1.2 SD above the norm (non-clinical). The participant was also well aware of his elevated mood and energy. Brain map following depression reduction AVE session (SKIL – eyes closed) Body/Mind Effects of Audio-Visual Entrainment

We conceptualize AVE as achieving its effects through several mechanisms at once (Siever, 2000). These include:

1. dissociation/hypnotic induction

2. increased neurotransmitter production

3. increased cerebral blood flow

4. normalized EEG activity

Dissociation

Dissociation, as a tool in psychotherapy, helps in diminishing the emotional component of disruptive memories. Dissociation, when referring to AVE, is a disconnection of self from thoughts and somatic awareness, as experienced during deep meditation (Figure 10). AVE induced dissociation is rapid, requires only 4 to 10 minutes in most cases and provides an excellent means for clearing a tormented, chattery mind of destructive, fearful thoughts and allowing the person to relax and restabilize (Siever, 2000).

Clearing the mind (dissociating) from negative thoughts using AVE.

Visual entrainment alone, in the lower alpha frequency range (7 to 10 Hz), has been shown to easily induce hypnosis (a form of dissociation). It has been shown that nearly 80% of subjects enter into a hypnotic trance within six minutes during alpha photic entrainment (Kroger & Schneider, 1959).

Photic stimulation induction of hypnotic trance

Inducing dissociation using AVE was found to be more effective than dot staring or stimulus deprivation (Leonard, et al., 1999). AVE also proved to be effective in dissociating people with dissociative anxiety. As expected, subjects experienced increased anxiety during dissociation, but simultaneous relaxation with slowed heart rate was also observed (Leonard, et al, 2000). The DAVID AVE proved to be effective in stopping distressing mental chatter and as an effective desensitization tool for reducing anxiety that is often seen in the PTSD population.

Limbic Stabilization

As mentioned, the amygdala initiates the activation of the fight-or-flight response, which activates the hypothalamus, which in turn controls all autonomic functioning and is responsible for the tensed-up feeling in the body (chest breathing, shortness of breath, racing heart, cold, clammy hands, tense muscles, etc.) that is experienced during a fear response. Anyone who has consumed too much coffee will be familiar with these feelings.

Properly applied AVE produces a calming effect on limbic structures, such as the amygdala and hypothalamus, in which muscles relax (Thomas & Siever, 1989), electrodermal activity settles down, peripheral blood flow stabilizes (hand temperature normalizes to 86 to 90 F), breathing becomes diaphragmatic and slow, and heart rate slows and becomes uniform (Siever 2000). As a result, AVE can re-induce a relaxed state of mind and calm disposition, thus providing some badly needed time away from the distressing thoughts. Figures 12 and 13, show the calming effect of AVE on the somatic functions of forearm EMG (electromyography) and finger temperature (Hawes, 2000). Heart rate and heart-rate variability (HRV) are sensitive measures of stress (Stein, P., Kleiger, R. (1999). Figure 14 shows graphs of the emWave HRV analysis system by Heartmath. It shows dramatic improvements in both heart rate and HRV in a woman with PTSD after discovering that her husband molested two young girls. Within 10 minutes, her heart rate dropped by 22 bpm, and she showed dramatic reductions in both sympathetic and parasympathetic activity (notice the blue mountains). Forearm EMG levels during AVE (Hawes, 2000).

Peripheral temperature levels during AVE (Hawes, 2000).

Pre and post HRV in a woman with adult PTSD

©Mind Alive Inc. (2012) Dave Siever

 

Understanding ADD and ADHD Behavior

 

Understanding ADD and ADHD Behavior

 

by Rayma Ditson-Sommer, Ph.D.

 

The individuals with Attention Deficit Disorder or Attention Deficit Hyperactivity Disorder characteristics were the hunters of old, the warriors whose responsibilities included keeping others safe. The jobs assigned to these individuals included constantly monitoring the environment to keep themselves fully aware of any dangers. Movement was of prime import, flexibility a desired talent.

Quick decisions and the ability to constantly change strategies through bursts of energy coupled with staying power were the marks of leaders. These people were to be envied because of their ability to think visually. They used actions rather than words and were easily bored longing for the hunt. They were praised for their ability to take risks and face dangers others avoided. They cared for those reliant individuals whose brains allowed them to sit around and engage in long range planning in a cautious manner. Some authors refer to this group as farmers, I personally think of them as planners and doers. The people who keep details in view as they plan realistically for the future.

Accordingly, if we subscribe to the description of differing individuals, we must try to understand how the more important people, responsible for keeping others alive, are today those individuals who find themselves in great stress and suffering from mental health problems. How did it happen that the “winners” are now seeing themselves as those needing help? Why are 25 million adults and children taking medications, seeing psychiatrists and suffering from stress related diseases when history portrays them as those responsible for the survival of others?

The question may arise as to the characteristic behavior of the ADD and ADHD individual.

The following are some of these characteristics:

1. Easily distractible.

2. Possess short but intense attention spans.

3. Tend to make impulsive decisions.

4. Disorganized.

5. Distort time and space.

6. Difficulty following verbal directions.

7. Periodic depression or “down moods”.

8. High risk takers.

9. Easily frustrated.

10. Periodic anxieties.

11. Rapid talkers.

The above characteristics are shared by those individuals diagnosed as ADD or ADHD. Added to the above challenges is the fact that these individuals are hard on themselves and those around them.

The challenges of attention deficit and hyperactive behaviors are worldwide. All continents have these individuals. Great Britain has the largest number and Japan the least. It is postulated that those individuals coming to America on the Mayflower brought the characteristics with them to this country. Surely, any explorer could be the possessor of ADD characteristics.

There are many survival guides written for the adult ADD and ADHD challenged. It is common sense to realize that if the left side of the brain is not doing its job then it should be awakened and allowed to share the responsibilities. Until this happens the person would do well to adopt the following suggestions for survival:

1. When there is a specific task to be completed, organize your time around the task using short attention times of high quality. This will allow you to use the short bursts of energy you possess in a positive manner. It will be useless for you to plan to spend long periods of time sitting trying to accomplish a task. Use a timer, set it for five minutes to start with.

Work hard during this time and then move the timer on to ten minutes with a short break in between. If the task is sedentary, get up and move around during the short break. This will ensure better concentration.

2. Utilize some sort of relaxation training such as avs before you undertake a difficult task. Meditation is useful but is very difficult for some individuals.

3. Set up all tasks in “little sets” with the same needs and outcomes. This can be thought of as breaking up large assignments into small tasks. You will gain momentum as you accomplish each little task and soon the larger one will be finished.

4. Work within a clean environment keeping yourself free from distractions that will occupy your time. If you are a professional person working outside the home, try to budget your funds to allow you a housekeeper at least a few hours weekly. This will allow you a decrease in frustration and an increase in self-worth as you give yourself the gift.

5. Good eating habits and exercise are essential for good brain power. The person dealing with attention deficit behavior uses up a great deal of energy and it must be replaced.

6. Impulsive decisions are a challenge for these individuals. Any decision should be given a few days for rethinking before becoming final.

7. The wish for certain things is characteristic. This craving can be for anything from food to emotional support. Many times the cravings cannot be satisfied and it is necessary to consider medication until structural changes are apparent in behavior activity.

8. The ADD and ADHD individuals are highly successful and bright. They have good ideas but cannot see them through. If this is the case, hire a good strong “left” brained person who can organize and structure the business. This merger will produce positive results.

9. If depression becomes a problematic challenge, seek help until you can understand and cope with the situation.

10. Above all, it is important to realize that the person with ADD and ADHD characteristics is not a disabled individual. His is not a disorder but a way of life handed down genetically from generation to generation.

Rayma Ditson-Sommer, Ph.D., who has spent years developing programs for sport science, learning styles, sensory stimulation and movement science, is presently immersed in research developing sensory integration-avs programs for athletic enhancement. She currently is working with a range of athletes, including swimmers in all age groups to Olympians, golfers and baseball players.

Visit the Chrishaven Foundation

Copyright Rayma Ditson-Sommer, Ph.D. From the AVS Journal, Fall 2001

Pilot Study Investigation of Auditory and Visual Stimulation . . .

 

 

Pilot Study Investigation of Auditory and Visual Stimulation in the

Reduction of Stimulant Medication Intake of ADHD Subjects

(Part Two)

by Ruth Olmstead, M.A.

Results

The first purpose of this study was to demonstrate improvement in ADHD symptoms using AVS treatment, and investigate whether there would be a significant difference among subjects who reported no progress or decrease in symptomology, those who showed mild progress, those who reported moderate progress, and those who showed significant progress. It was predicted there would be improvement in ADHD symptoms in subjects within the four progress categories.

Table 1 summarizes the age break-down of the age of subjects, and the amount of symptom reduction reported by the subjects.

Table 1

Age Break-Down and Amount of Symptom Reduction Break-Down

0 Mild Moderate Sign Total

6 yrs. 50% (2) 50% (2) 4

7-8 yrs. 42% (5) 33% (4) 25% (3) 12

9-10 yrs. 12% (2) 18% (3) 41% (7) 30%(5) 17

11-12 yrs. 17% (1) 17% (1) 33% (2) 50%(3) 6

13-15 yrs. 7% (1) 20% (3) 53% (8) 20%(3) 12

16-19 yrs. 100% (2) 2

20 yrs.+ 63% (5) 12% (1) 25% (2) 8

A chi-square test (3 df) was statistically significant x^(3) = 13.83, p<.01. It appeared that greater percentages made moderate and significant amounts of progress.

It was noted that of the 65 subjects undergoing AVS treatment, 68% demonstrated moderate to significant progress as a result of treatment. A chi-square test (1 df) was statistically significant x^(1) = 8.14, p<.01. This demonstrates a significant difference from the 32% who made no progress. Table 2 summarizes the results of progress break-down in regards to reduction of stimulant medication using AVS.

Table 2

Progress in Medication Reduction Break-Down (n = 25)

0 change in medication intake: 6 (24%)

Able to reduce medication intake: 11 (44%)

Able to go off medication completely: 8 (32%)

The age break-down indicated in Table 2 demonstrates that 6 subjects experienced no change in medication intake (24%), eleven subjects (44%) were able to reduce medication intake, and eight subjects (32%) were able to discontinue medication completely. A chi-square test (6 df) was not statistically significant x^(6) = 6.45, NS. This demonstrates that there was no relationship between age and the four categories of amount of symptom reduction.

The second part of this study was to compare the effectiveness of AVS with that of medication in reducing the symptoms of ADHD. It was predicted there would be a reduction of medication intake in the subjects on stimulant medication after AVS treatment. The hypothesis was confirmed. Analysis of data gathered utilized a chi-square test, with a level of significance of .05. Of the 25 subjects taking stimulant medication prior to beginning AVS treatment, 76 percent reduced or discontinued stimulant medication, and 24 percent did not. A chi-square test (1 df) was significant x^(1) = 13.0, p<.001.

Discussion

This pilot study suggests that an AVS treatment program can lead to significant reduction in ADHD symptoms. Based on DSM-IV criteria checklists that were completed pre and post AVS treatment, it was reported that there was a significant reduction in cognitive and behavioral symptomology. AVS treatment resulted in significant change in the reduction of medication intake within the subjects who were taking stimulant medication prior to treatment.

The results of this pilot study indicates that Audio Visual Stimulation appears to be a viable, non-drug approach to the treatment of ADHD symptoms. AVS intervention is also a cost effective alternative to the long term use of medication, if it results in long term symptom reduction.

This study did not measure specific academic improvements, thus further studies need to be conducted that include the implementation of more varied quantitative testing in many areas, such as standardized academic testing, behaviorrating scales, and measures of social functioning.

There was no control group so between-measures could not be compared in terms of reduction of symptoms between subjects on stimulant medication and those who were not. This study also did not include follow up measures, so the long term efficacy of AVS is unknown.

Current studies in the search to identify the correlates of ADHD such as inattention, impulsivity, and hyperactivity, have been inconclusive in their findings due to many inconsistencies within brain research findings. Further studies utilizing auditory and visual stimulation need to be conducted with more precise measures and larger samples utilizing brain imaging and EEG correlation, as well as neuropsychologic measures and academic and IQ testing to determine the overall effectiveness of AVS for neurological and academic enhancement and treatment.

References

American Psychological Association. (1994). Diagnostic and Statistical

Manual of Mental Disorders (4th ed.). Washington, D.C.: Author

Barkley, R.A. (1990). Attention Deficit Hyperactivity Disorder: A Handbook

for Diagnoses and Treatment. New York: Guilford Press.

Carter, J.L., & Russell, H.L. (1993). A pilot study investigation of

auditory and visual entrainment of brain wave activity in learning disabled

boys. The Texas Researcher, 4, 65-73.

Carter, J.L., & Russell, H.L. (1981). Changes in verbal-performance IQ

discrepancy scores after left hemisphere EEG frequency control training.

American Journal of Clinical Biofeedback, 4, 66-68.

Cunningham, M.D., & Murphy, P.J. (1981). The effects of bilateral EEG

biofeedback on verbal, visual, spatial, and creative skills in learning

disabled male adolescents. Journal of Learning Disabilities, 14, 204-208.

Diamond, M.C. (1988). Enriching Heredity: The impact of the environment on

the anatomy of the brain. New York: The Free Press.

Lubar’s study (as cited in Carter & Russell, 1993).

Rossiter, T.R., & LaVaque, T.J. (1995). A comparison of EEG biofeedback and

Psychostimulants in treating attention deficit hyperactivity disorders.

Journal of Neurotherapy, 2, 48-59.

 Tansey, M.A. (1990). Righting the rhymes of reason: EEG biofeedback training

as a therapeutic modality in a clinical office setting. Medical

Psychotherapy, 3, 57-68.

Copyright: AVS Journal, Michael Landgraf, Publisher and Ruth Olmstead, Author. All rights reserved.

 

Pilot Study Investigation of Auditory and Visual Stimulation in. . .

Pilot Study Investigation of Auditory and Visual Stimulation in the

Reduction of Stimulant Medication Intake of ADHD Subjects

(Part One)

by Ruth Olmstead, M.A.

ABSTRACT: This pilot study compared the effects of auditory and visual stimulation (AVS) produced by light and sound on individuals who were taking stimulant medication for the treatment of attention deficit hyperactivity disorder (ADHD) symptoms. These symptoms include inattention, impulsivity, and the onset of such symptoms often resulting in poor academic performance. Stimulant medications are widely used to treat ADHD symptoms, but have drawbacks. The most serious is that symptom reduction is only temporary unless the medication is taken indefinitely. In addition, stimulants have physical side effects, and long term compliance with taking medication is poor, especially amongst adolescents. Results suggest that AVS treatment demonstrates a reduction of ADHD symptomology as evidenced by the significant number of subjects who were able to reduce or discontinue stimulant medication intake.

Introduction

The purpose of this pilot study was to examine the efficacy Auditory and Visual Stimulation (AVS) in reducing stimulant medication intake in subjects diagnosed with Attention Deficit Hyperactivity Disorder (ADHD). Psychostimulants are the most widely used treatment in the symptomology of ADHD (Barkley, 1990). AVS is hypothesized to effect the brain in a similar manner as neurostimulant medications. This pilot study proposes that AVS, also known as brainwave entrainment and stimulation, appears to be an effective non-drug approach in the treatment of Attention Deficit Hyperactivity Disorder (ADHD) symptoms.

Auditory and visual brain stimulation is induced through the rate of flickering lights that are applied at varying frequencies to the brain through the use of white light emitting diode (LED) glasses. The rate of the flickering lights within the goggles worn over the eyes, causes the brain to “entrain” or match the set rate of flickering to a desired frequency, depending on the preferred outcome. Increased brain activity is theorized to be produced by the light stimulus as it enters the brain through the optic nerve into the visual cortex. AVS is thought to produce new neuropathways and increase high arousal brainwave states.

In a related series of studies, Diamond (1988) demonstrated that environmental stimulation in rats increased dendritic growth and brain weight, which resulted in improved performance on tasks such as maze learning and memory.

The induction into certain brainwave states has been found to increase brain activity and reduce hyperactivity and feelings of anxiety through the decrease of high-arousal brainwave states, or the increase of under-aroused brainwave states. For example, brainwave entrainment within alpha states allows for relaxation, and a decreased stress response to occur by providing a slower and more relaxed brainwave state. A faster brainwave state, produced by faster flickering of the LED lights, induces a higher brainwave state, and is theorized to provide enhanced brain stimulation, resulting in a decrease in hyperactivity much like the paradoxical application of neurostimulant’s, increases in memory, problem solving, and information processing abilities.

Cunningham (1981) reported improved reading and math scores as well as increases in selfcontrol in children following Electroencephalograph (EEG) biofeedback training. EEG biofeedback training also demonstrates effective alterations in brainwave frequency through the process of focusing, learning, and practice of increasing or decreasing brainwave activity. Lubar (1985) demonstrated significant improvement in overall academic performance in learning disabled (LD) students using EEG biofeedback. Additional studies by Tansey (1990) and Carter and Russell (1981) investigated the effects of biofeedback training on LD boys, and noticed significant gains in intelligence quota (IQ) scores. All of these EEG studies have demonstrated that brainwave entrainment within higher or lower arousal states, depending upon the target symptoms, result in increases in overall cognitive abilities and IQ, as well as increased self- control of negative behaviors.

There is some evidence that auditory and visual stimulation, which includes brainwave entrainment, can be duplicated in terms of physical phenomenon such as dendritic enhancement or neurodevelopmental growth. Carter and Russell (1993) conducted a pilot study using AVS and measured changes in academic performance and behavioral functioning of learning disabled (LD) boys. This study outcome suggests that AVS brought about neurodevelopmental changes as reflected in significant increases in IQ scores, achievement test scores, and self-control measures in LD boys.

Rossiter and LaVaque (1995) conducted a study comparing the effects of EEG biofeedback and stimulant medication in reducing ADD symptoms. The study compared treatment programs with 20 sessions of EEG biofeedback or stimulants as their primary components. An EEG group of 23 students (EEG) was matched to a stimulant medication group (MED) by age, gender, diagnoses and IQ. The Test of Variables of Attention (TOVA) was administered pre and post treatment. Both EEG and MED groups demonstrated improvement (p<.05) on TOVA change scores in measures of inattention, information processing, and variability, but did not differ from each other (p>.03) on TOVA change scores. These results indicate that EEG biofeedback is an effective alternative to stimulants, and may be a preferred treatment of choice if stimulant medication is ineffective, has negative side effects, or if compliance is problematic.

These studies indicate that brainwave entrainment such as EEG biofeedback, and entrainment and auditory and visual brain stimulation (AVS) can affect cognitive functioning and aid in behavior control. The purpose of this pilot study was to: (1) demonstrate the effectiveness of AVS treatment in significantly reducing the cognitive and behavioral symptoms of ADHD; (2) demonstrate that a significant number of subjects who were taking medication prior to AVS, to reduce or discontinue stimulant medication as a result of AVS treatment. Symptom reduction was based on post-AVS evaluation of the ADHD symptom criteria checklist in accordance with DSM-IV (American Psychological Association, 1994) diagnostic criteria.

Methods

The participants in this pilot study were 65 clients (n=65) from the Research Center for Alternative Medicine in Calgary. They were referred by their parents, physician, or were self referred. The subjects were evaluated by a physician prior to beginning AVS, and received a primary DSM-IV diagnosis of Attention Deficit Hyperactivity Disorder (ADHD). Subjects consisted of 55 males and 10 females, and were between the ages of 6 and 45 years of age. Twenty-five subjects were on stimulant medication when beginning treatment.

Procedure

Each subject was administered a DSM-IV criteria checklist prior to undergoing AVS treatment, and again after treatment sessions commenced. AVS protocols were provided by the author, and are varied dependent on the age, presenting symptoms, and visual baseline test results obtained from each subject. AVS protocols were sometimes changed during the course of treatment as targets for intervention changed, e.g., from improving attention span to reducing impulsivity.

The Digital, Audio, Visual, Integration Device (DAVID) was the instrument used to induce AVS. This instrument comprises headphones for gaining audio stimulus, and eye goggles inset with full-spectrum, white LEDs for inducing brainwave entrainment and stimulation. To undergo AVS, subjects got into a comfortable position while reclining, and donned headphones and eye goggles. Systematic AVS treatment was administered in a designated room one day per week for a duration of 35 minutes.

End of Part One.

 

Copyright AVS Journal, Michael Landgraf, Publisher and Ruth Olmstead, M.A., Author. All rights reserved.

 

Therapeutic Use of Auditory and Visual Stimulation in the Treatment of Attention Deficit Hyperactivity Disorder

 

Therapeutic Use of Auditory and Visual Stimulation in the Treatment of Attention Deficit Hyperactivity Disorder

 

Ruth Olmstead, Ph.D.              

Abstract

Attention deficit hyperactivity disorder (ADHD) is a learning disorder that is becoming increasingly prevalent amongst school-aged children. Scientific studies have implicated brainwave irregularities and various neurobiological abnormalities within the prefrontal cortex of the brain in those exhibiting symptomology of this disorder. Treatment strategies for ADHD are typically behavioral approaches to address the problem behaviors associated with the disorder, and a pharmacological approach to treat the hyperactive and impulsive symptoms. The use of auditory and visual stimulation (AVS) has been found to have efficacy not only addressing the symptoms of this disorder, but may be a method of treatment that directly regulates brainwave activity and affects the physiology of the brain. Though current research is limited, studies utilizing AVS on children have demonstrated significant changes in academic performance, and in the reduction of the behavioral symptomology and cognitive deficits associated with ADHD and other disorders that are neurologically based. There is also some promising evidence that AVS may be an effective substitute for neurostimulant medication.

Attention Deficit Hyperactivity Disorder

Attention Deficit Hyperactivity Disorder (ADHD) is one of the most prevalent and intensely studiedsyndromes in child psychology and is characterized by deficits of poor attention, impulsivity, and hyperactivity (American Psychological Association, 1994). Children who demonstrate ADHD characteristics generally score seven to 15 points lower than peers on standardized intelligence tests (Barkley, Anastopoloulos, Guevermont, & Fletcher, 1991). Common treatment interventions are behavioral modification techniques to address the problem behaviors of hyperactivity and impulsivity, and pharmacology to address the attentional deficits in the in the form of stimulant medications. Due to medication cost, possible psychostimulant side effects, and compliance, many individuals are interested in a safe, effective, and less costly alternative treatments for this disorder.

Auditory and visual stimulation (AVS) therapy has been used to alter brainwave irregularities and increase brain activation in those with ADHD characteristics. Research is being conducted using this technique as a non-drug approach to aid in regulating brainwave function, decreasing medication intake, increasing concentration and academic performance, and decreasing problematic behavior.

Neurobiological Aspects of ADHD

Neuroimaging studies have implicated deficits in frontal lobe functioning, differences in corpus callosum measures (Giedd et al., 1994), decreased brain volume (Castellanos et al., 1996; Filpatrick et al., 1997; Hynde et al., 1991), impaired cognitive and behavioral functioning, and other brain abnormalities in those with ADHD. Although none of the current findings result in locating a primary cause of the pathophysiology of ADHD, many studies do contend that there are fundamental neuroanatomical abnormalities within the developing brain of those individuals with ADHD that effect cognitive functioning. The use of auditory and visual stimulation has been found to be effective in aiding in brainwave irregularities in those with ADHD (Lubar, 1991; Othmer, 1992), and findings suggest that AVS initiates dendritic enhancement as evidenced by cognitive increases and higher scores on standardized testing (Carter & Russell, 1981, 1993, 1994; Micheletti, 1999; Patrick, 1994).

Earlier studies found that electrical stimulation administered to the frontal cortex in animals demonstrate significant enhanced recovery of neurons in the visual cortex, suggesting increases in visual input processing and improved attention paid to external stimuli (Spinelli & Pilbram, 1967). Diamond (1988) discovered that challenging environmental stimulus result in increases in dendritic growth, brain weight and density, as well as changes in molecular, synaptic, and behavior in animal studies resulting in increased memory and maze learning. Later, Diamond, Kolb & Whilshaw (1990) found greater dendritic length and structural changes in the cortex of postmortem humans who had lead more challenging lives. These physiological brain studies demonstrate that various forms of stimulation produce increases in dendritic growth and length which can be associated with enhanced cognitive abilities and functioning. Auditory and visual stimulation appears to be another promising method that can effect changes within the brain’s physiology.

Recent Studies Utilizing AVS to Enhance Cognitive Abilities and Behavioral Functioning

In a recent study by Micheletti (1999) utilizing AVS with ADHD children demonstrated both enhanced cognitive and behavioral changes. Micheletti (1999) compared four treatment groups of 99 ADHD children ranging from seven to 13 years of age. The treatment groups consisted of an AVS Group, an AVS and Stimulant Medication Group, a Stimulant Medication Group, and a Self-Selected Comparison Group. All groups were tested off medication to evaluate differences at baseline. Cognitive functioning was evaluated using achievement tests in Reading, Spelling, and Arithmatic from the Wide Range Achievement Test-Revised (WRATR). Listening comprehension and verbal ability was measured using the Peabody Picture Vocabulary Test (PPVT). The Raven Progressive Matrices (Raven’s) was used to measure reasoning ability and the ability to organize spacial perceptions into systematically related wholes. Behavioral changes were changes were noted using the Intermediate Visual and Auditory Continuous Test (IVAC) and the Attention Deficit Disorder Evaluation Scale (ADDES).

The study also evaluated the effectiveness of the stimulant medication (Ritalin and Adderall) and the efficacy of combining AVS and medication. Both the AVS and the AVS/Stimulant Medication Group demonstrated significant statistical cognitive and behavioral changes at p < .05, p < .01, and p < .001 level. The AVS training Group demonstrated statistical changes in five out of nine tests or 55.6 % of the time. The AVS/Stimulant Group demonstrated changes on eight out of nine tests or 88.9 % of the time. The Stimulant Only Group demonstrated less change when compared to the AVS and AVS/Stimulant Groups. This group showed only change in three out of nine tests or 33.0 % of the time. The Self Selected Comparison Group indicated no statistical change on cognitive or behavioral defendant measures over time.

This study findings indicate that the use of AVS appeared to impact the neurological functioning of the ADHD individual as evidenced by increases in cognitive functioning levels as demonstrated by increased performance in Reading, Spelling, and Arithmatic as evidenced by WRAT-R scores and improved behavioral functioning as evidenced by behavior rating scales (ADDES; IVAC).

An earlier Canadian study investigated the efficacy of AVS in decreasing stimulant medication intake and ADHD symptomology in subjects diagnosed with ADHD (Olmstead, 1997). The study consisted of 65 participants, 55 males and 10 females between the ages of six and 45 years of age who met the DSM-IV (APA, 1994) criteria diagnosis of ADHD. Twenty five of the subjects were on stimulant medication when beginning AVS treatment. Results demonstrated that of the 65 subjects undergoing AVS treatment, 68% noted moderate to significant reduction in negative behavioral symptomology according to ADHD diagnostic criteria checklists.

A chi-square test (1 df) was statistically significant x^ (1) = 8.14, p<.01. indicating a sig nificant difference from the 32% who noted no reduction in symptomology. The significant effectiveness of AVS on those subjects taking stimulant medication was concluded due to decrease in medication intake as correlated to the reduction of ADHD symptomology. Analysis of data gathered using a chi-square test (1 df) was significant x^ (1) = 13.0 p<.001.

Of the 25 subjects taking stimulant medication prior to beginning AVS treatment, 76% of the subjects were able to reduce or completely discontinue medication and 24% did not. Though this study did not conduct a formal follow up to measure sustained results, these findings suggest that an AVS treatment program can lead to significant reduction in ADHD symptoms and may be a viable non-drug approach to treating this disorder as evidenced by the significant decrease in medication intake.

Both of these studies indicate that auditory and visual stimulation is effective in producing academic enhancement (WRAT-R), as well as increases in verbal ability and non-verbal reasoning ( Raven’s, and PPVT). AVS was found to decrease problem behaviors such as impulsivity and hyperactivity as noted on parent and teacher behavior rating scales (ADDES, IVAC), and the ADHD diagnostic checklist (DSM-IV).

The above findings suggest that auditory and visual stimulation may be a viable replicable physical phenomenon that increases brainwave activity, resulting in neuronal changes and dendritic growth. Such findings are important and have significant application to the intervention of individuals diagnosed with ADHD and other learning and neurological disorders. Due to the promise of increased cognitive functioning, research studies have begun to investigate the efficacy of AVS, thus the use of such devices in clinical settings is broadening.

Additionally, compact, portable, low-cost devices are now available with specific programs and instructions for use as an intervention for specific symptom reduction. These are important developments for the ADHD individual who can now utilize this technique safely and relatively inexpensively at home.

Ruth Olmstead Ph.D. has developed a number of intervention programs for ADHD that have been duplicated for use with various light and sound devices. She has utilized AVS for many years in a medical setting as a method of intervention for a number of psychological and neurological disorders such as brain trauma, migraine, learning disabilities, and stress related disorders. She currently uses AVS in conjunction with psychotherapy in a clinical setting as an adjunct intervention for learning disabilities, anxiety, trauma, and depression. She is currently completing her Doctorate degree in Clinical Psychology, and trains licensed therapists in the clinical application of AVS stimulation and brainwave entrainment.

Copyright AVS Journal / Michael Landgraf, Publisher and Ruth Olmstead, Ph.D., Author. All rights reserved.

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