Pilot Study Investigation of Auditory and Visual Stimulation in the
Reduction of Stimulant Medication Intake of ADHD Subjects
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.
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.
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.
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.