Question:

What non-medical controversial therapies are effective in treating ADHD?

Answer:

This three-part series on alternative treatments for ADHD concludes with a discussion about the effectiveness of non-medical alternative and controversial treatments such as biofeedback, hypnotherapy, Interactive Metronome Training, Sensory Integration Training and Optometric Vision Training.

Therapies that claim to give children the tools to regulate their own behavior and functions have a special appeal to parents of out-of-control children. Dr. Joel Lubar, biopsychologist, is a leading proponent of the use of biofeedback to treat ADHD. Biofeedback is based on the assumption that children with ADHD have more unalert brain waves than their peers and that they can learn to regulate the type of brainwaves they produce through feedback via charts, graphs, or cartoons. In biofeedback, sensors are placed on the child’s skin to monitor changes in heart rate, muscle tension, and perspiration rate that are associated with specific patterns of brain wave emission. Biofeedback proponents hold the hope that this method can provide a treatment that has more permanent effects than medication or behavioral intervention. Research has indicated that the theory behind biofeedback is consistent with what is known about the nature of ADHD. However, the effectiveness of the treatment has yet to be subjected to the rigorous investigation required to prove efficacy. Although some studies have been done, they have not been controlled for the effects of other treatments accompanying biofeedback such as a close relationship with a therapist and training in academic skills. The American Academy of Pediatrics describes biofeedback as “having potential” but remaining a “unproven therapy.” Parents should be forewarned that biofeedback treatment is time-consuming, generally requiring up to forty sessions, and extremely expensive. Although hypnotherapy can effectively treat tics and sleep disorders that sometimes accompanies ADHD, core symptoms of ADHD were not improved.

Sensory Integration Training (SI), developed by Dr. Jean Ayers, is based on the theory that the brain of the child with ADHD is overloaded by too many sensory messages and is unable to integrate and make sense of these. SI is also used to treat developmental motor coordination problems that sometimes accompany ADHD. SI can be temporarily calming to children with ADHD but studies have not demonstrated effectiveness in improving attention.

Optometric Training, or behavioral optometry claims that faulty eye movements and visual perceptual problems contribute to dyslexia and other learning problems that often occur with ADHD. Skills such as tracking are taught through the use of eye exercises and colored or prismatic lenses. Unfortunately, the effectiveness of this approach to treat learning disabilities has not been proven. The American Academy of Pediatrics, the American Association for Pediatric Ophthalmology and Strabismus, and the American Academy of Ophthalmology issued a joint policy statement in 1984 that no known scientific evidence “ supports the claims for improve the academic abilities of dyslexic or learning disabled children with treatment based on visual training, including muscle exercises, ocular pursuit or tracking exercises or glasses (with or without bifocals or prisms).” The American Academy of Pediatrics has expressed concern that treatment with Optometric Training can delay more effective treatment for learning disabilities.

Auditory integration training is based on the premise that a cause of ADHD is the difficulty attending to and making sense of information while listening. The most well-known of these trainings was developed by Alfred Tomatis, a French physician. Children participating in this training practice listening by being exposed to high frequency modifications of the human voice, classical music, and Gregorian chants through special headphones. One study has shown that boys with ADHD were better able to solve arithmetic problems while listening to music, however, no scientific studies have proven that the Tomatis method improves the symptoms of ADHD.

Interactive Metronome Training (IM) has demonstrated some promise. In this training, the child is taught to keep rhythmic beat with a computerized metronome in order to produce improved motor planning and timing skills. The treatment is based on the theory that motor coordination is related to behavioral inhibition, a theory for which there is no evidence. However, one carefully controlled scientific study has been conducted that supported the effectiveness of IM training for boys with ADHD. More than one study needs to be done to prove that the treatment is effective.

This article concludes the three-part series on alternative treatments for ADHD. Whenever a family is considering an alternative treatment, consultation with the treating physician is recommended. Much money and time can be wasted on unproven, expensive and ineffective treatments.

Sources:

Assessing Complementary and Controversial Interventions: CHADD Fact Sheet #6. available at www.chadd.org

Rickover, Robert. The Tomatis Method and the Alexander Technique. Essay available at www.alexandertechnique.com

Reiff, Michael I, editor. (2004) ADHD: A complete Authoritative Guide. American Academy of Pediatrics.