Some parents of children with attention deficit hyperactivity disorder say alternatives such as brain exercises or music therapy are better than medication.
It was in 5th grade that Katie Wilhelm realized that the schoolwork that seemed to come so easily to her classmates was much more difficult for her.
Wilhelm, now 16 and a rising sophomore, thought that if she spent hours studying at home, the math and science concepts that eluded her would become clear. But the extra work didn’t help. Nor did it help that during class, her attention would roam to almost anything else in the room.
For 9-year-old Evin Kercher, the problems developed earlier. His parents recall tear-filled nights trying to figure out why their bright, hockey-loving son was so far behind that his teacher suggested holding him back, both in 1st and 2nd grades.
For the two families, their personal friendships with Dr. Linda Williams, the medical director of a company that says it can treat attention deficit hyperactivity disorder without medication, changed their lives. At the Dore Achievement Center in this tidy Denver suburb, both children were evaluated with devices that gauged their balance, eye tracking ability, and reading skills.
Afterwards, the students were given a series of home exercises that Dore contends can strengthen the part of the brain that controls attention and concentration. The results of the 20-minutes-a-day regimen, which costs about $4,000 for 13 months, “are pretty much a miracle,” says Evin, who will start 4th grade in the fall.
His father concurs. “It’s like someone screwed off his head” and fixed whatever seemed to be misfiring inside, Kevin Kercher says.
For years, parents of children with ADHD have sought out treatments other than, or in addition to, stimulant medications such as Ritalin, which are often prescribed to treat the disorder. The Dore method is only one of those alternative treatments. Another method, used at the Center for InnerChange in the Denver suburb of Greenwood Village, promotes the idea that “listening therapy,” or several sessions of listening to music rich in high and low frequencies, can stimulate the brain enough to eliminate ADHD symptoms.
And schools are joining in the search for treatments. Though many nondrug treatments have only anecdotal evidence of success, schools have been referring some of their students to them.
Many doctors and researchers remain skeptical that programs such as Dore and others that promise drug-free treatments offer any long-lasting benefits, saying that they are largely untested and that the people who use them could be imagining their effects.
“What we would have to wonder is if the benefits are truly benefits, or just the expectation of gains,” says Sydney S. Zentall, a professor of special education and psychological sciences at Purdue University in West Lafayette, Ind. Zentall has written a recently published book for educators on how best to teach children with ADHD.
But William Henderson, the principal of Patrick O’Hearn Elementary School, a public school in Boston, says his gut feeling is that there is something in the Dore method that is worth exploring. Some children at his school have been provided free Dore evaluations, and the school has created an after-school program for Dore participants, led by a staff occupational therapist.
“I don’t know if it’s going to work or not,” Henderson says. “But here is a painless exercise which is generally positive. There’s nothing else that the medical doctors have offered us besides the medicine.”
ADHD affects anywhere from 1.46 million to 2.46 million children in this country, according to the U.S. Department of Education, about 3 percent to 5 percent of the school-age population.
Research shows ADHD comes in three forms: hyperactivity, which produces a child who can’t pay attention, who disobeys orders, and who can’t sit still long enough to complete schoolwork; inattentiveness, which produces a “daydreaming” child who may not be disruptive, but may have difficulty paying attention to details; and a combination of both types.
Although ADHD is not in itself a learning disability, children with the disorder often have other difficulties that may make them eligible for the special services provided under the federal Individuals with Disabilities Education Act.
Unlike some other disorders, ADHD has no standard test for diagnosis. The difficulty in identifying the disorder, and the fact that it manifests itself in behavioral problems, lead some to believe that ADHD can be overcome merely by changing a child’s surroundings or upbringing. That is a damaging judgment, some scientists say.
“There is a very deep-seated assumption that children’s behavior is learned,” says Dr. Russell A. Barkley, a research professor in the department of psychiatry at the State University of New York Upstate Medical School in Syracuse. Barkley, a longtime researcher in the field, is also the author of numerous books on attention deficit.
“We’re very fond in this country of parent-bashing,” Barkley says. Many people, he says, believe that treating children with medication for behavioral disorders is “simply papering over the real issue”: bad parenting.
Barkley, who disagrees with that view, is also deeply skeptical of alternative treatments. And the weight of research supports his contention that nonpharmacological treatments, such as modified diets, exercise plans, herbal remedies, and biofeedback training, have little scientifically demonstrated effectiveness.
But alternative treatments remain popular, in part because they say they offer what no pill for ADHD can promise, a cure. Ritalin and other drugs can only treat the symptoms, not eliminate the disorder.
The popularity of drug-free treatments also stems from the existence of conflicting information about the safety of long-term medication. In February, Canadian authorities decided to suspend sales of Adderall, a prescription ADHD drug, after reports of 20 sudden deaths and a dozen strokes in children and adults around the world who had used it. The Food and Drug Administration continues to allow the use of Adderall in the United States, but has required warning labels stating that people with heart abnormalities may be at risk taking the drug.
Many practitioners of alternative therapies agree that more research into their methods is needed.
The Dore treatment program was developed in 2000 in Britain by Wynford Dore, whose daughter struggled with dyslexia. The program maintains that attention problems are caused by an underfunctioning cerebellum, the part of the brain that controls fine motor movement and coordination. Dore has centers in Britain, and in 2002 expanded to the United States.
At the Dore center in Colorado and at five other centers around the country, patients are evaluated on their ability to maintain their balance with their eyes open and closed. Their eye tracking abilities are also measured, and they are given a dyslexia screening test. The regimen of physical exercises, which are done at home, is intended to improve cerebellar function.
Williams, the company’s medical director, has applied for a National Institutes of Health grant to pay for research on the program and is awaiting the results of a review of her proposal.
An energetic woman who lights up when showing magnetic resonance imaging, or MRI, scans and microscope pictures of neurons, Williams says she wants to put the exercise treatment up against the more widely accepted drug therapies.
She says she appreciates that the medical profession demands a high scientific standard before a treatment is widely accepted. But “sometimes we are so hung up in the maintenance of the status quo that we often deny people the opportunity to be treated with some of these alternative treatments,” she argues.
At the Center for InnerChange, the founder, Dr. Ron B. Minson has based his program on the research of French physician Alfred Tomatis, who believed that listening problems were the root cause of learning disabilities.
The program costs about $3,000 for 23 sessions. At least two elementary schools, in Missouri and New Mexico, are using center-trained volunteers to administer the method to some of their students.
At Minson’s center, about 30 minutes from the Dore headquarters in Westminster, children with ADHD and other learning difficulties file into the colorful offices and plug headphones into a wall of audio equipment. They listen to Mozart while playing board games or making craft projects out of pipe cleaners and construction paper.
Over the course of treatment at the center, certain musical pitches are dropped out from the orchestral selections, until eventually all the children hear are the very highest notes of the violins. Other therapeutic sessions include Gregorian chant or recordings of the voice of a child’s mother.
“The ears are the batteries to the brain,” Minson says. By stimulating the brain through the music, mental processing is improved, he adds. His daughter went through struggles with learning disabilities and depression before treatment with the Tomatis method.
Minson, a psychiatrist, says that when he first got involved in the therapy, he was skeptical. He was also disappointed to find that most of the papers on Tomatis’ method were anecdotal reports of success, not peer-reviewed research.
But, he adds, “we wouldn’t be in business 15 years later if there was nothing to this.”
Those who have gone through the alternative programs for ADHD and their parents believe strongly that at least some improvement has occurred.
Julie Fuller, who lives in the Denver suburb of Littleton, Colo., had all three of her children evaluated and treated at the Center for InnerChange after hearing a positive report from a neighbor. Fuller says she has seen dramatic benefits with her son Joshua, 10, who is diagnosed with ADHD. “After Josh started doing this, he said, ‘Mom, I can sleep better now because I don’t have to move so much,’ ” she says. Her son Ben, 12, has also shown some improvement in concentration, she says.
Lynne Beachner, the executive director of Gordon Parks Elementary School, a 200-student charter school in Kansas City, Mo., had a volunteer trained at the Center for InnerChange offer free treatments to some of her students last school year.
“I just hate the fact that we give children drugs. It doesn’t seem right,” Beachner says.
She does not say that every student using the method has improved. But she says that one child in the program, who has behavioral problems and would not make eye contact with others, has seemed to come out of his shell.
“When you asked him what’s different, he said he’s not as shy,” Beachner says.
The music method is just one of several that Gordon Parks Elementary is using to raise achievement among its students with learning disabilities, she says.
“We’re coming at this from a lot of different directions, with a combination of things,” Beachner says. “These kids are smart kids, and I’ve never understood why it’s so difficult for them.”
With the Dore program, Katie Wilhelm started therapy before her recently completed freshman year at Wheat Ridge High School in Lakewood, Colo., which she recently completed. Though she’s been deeply involved in theater since grade school, she says she was shy and had problems holding conversations with strangers. And then, there was the distraction that was hurting her in school.
Wilhelm was never formally diagnosed with any attention disorder. But “something else was always catching my eyes,” she says. “It seemed that everyone else around me was getting it.”
Wilhelm says her math grade rose from a D in 8th grade to an A average by the end of 9th grade. Science is still a struggle, she says, but she was able to concentrate better in class. Plus, her confidence has improved.
Evin Kercher recalls that “in first grade, I didn’t do what the teacher told me to do. I wanted to talk, and I’d get detentions.”
“Now, I make better choices than talking to my friends” during class time, he says.
Zentall, the Purdue researcher, has written ADHD and Education: Foundations, Characteristics, Methods and Collaboration, which is intended to help administrators and teachers wade through the research on attention deficit hyperactivity disorder. Though she has researched the disorder for the past 30 years, she says she hasn’t found much that is written for the educators who teach children with ADHD.
Zentall says that medication works, but that in the school setting, it helps only with lower-level skills, such as rote mathematics, handwriting, or memorization. Creativity and higher-level problem-solving are not improved by taking medication, she says, so children with ADHD, even those on medication, still need a lot of help.
“Even if we know the genetics of the disease, it still doesn’t help us as educators to know what to do,” Zentall says.
For example, she says that children with ADHD crave stimulation and novelty. “If we can guide the attention of the children with ADD, we’ve got the rest of the class,” she says.
But in a quest for the novel, some schools may be drawn to the untested, Zentall says. “Fads and ‘how-to lists’ are more prevalent than methods based on educational research,” she says.
But educators who support the alternative methods don’t feel they’re falling for fads.
“Medicine hasn’t been the answer for every child,” says Henderson of O’Hearn Elementary School in Boston. “This is another avenue. I’m for whatever helps that’s humane.”
Vol. 24, Issue 43, Pages 36-39Published in Print: July 27, 2005, as Attention Seekers