Understanding and Overcoming ADD and ADHD
by Marilee Nicoll Coots, BA , Certified Neurodevelopmentalist, copyright, 2004

Children of school age are frequently diagnosed with various forms of Attention Deficit Disorder (ADD) and Attention Deficit / Hyperactivity Disorder (ADHD). These diagnoses are often made, without the use of objective medical tests such as brain scans, or blood tests. Rather, they are based on a checklist of symptoms taken from parents and teachers, and the observations of the professional making the diagnosis. If a child has enough of the symptoms on the checklist, he is said to have the disorder.

As a reaction to the high frequency of these diagnoses and to the impulsive behavior and extreme activity level of some of these children, some have suggested that ADD/ADHD is merely a behavioral issue. They may suggest that these are children who are mismanaged, bored by school, too energetic to sit still for long hours in a classroom, or simply normal rambunctious little boys.

Neurodevelopmentalists see many children of these “ADD or ADHD” children, because their parents are often deeply concerned that their child’s lack of focus will be the cause of academic failure. Some children appear to be truly distractible, unfocused, fidgety, impulsive, hyperactive, and easily over-stimulated. For these children, staying on task and focusing enough to learn is extremely difficult. In some cases, the child is quite compliant, but still struggles to focus and stay on task.

I have observed many parents who are skillful managers of behavior, managing their other children easily, and yet the symptomatic child is still hyperactive. These families may have provided high interest materials and may still be dealing with hyperactivity and distractibility.

When a child, exhibiting the symptoms of attention deficit or hyperactivity, comes to an ICAN neurodevelopmentalist, we observe how the child’s brain receives, processes, stores and utilizes information. Using our neurodevelopmental model we go beyond the ADD or ADHD “label” to define and address the underlying root causes of the symptoms that the child exhibits.

By helping the brain to become more efficiently organized, we are able to make positive changes for the child. Children who previously had trouble fitting in with others can now make friends. Those who could not sit still through a lesson can stay focused, follow instructions, and complete their work. Those who were once forgetful, can now remember.

How the brain can change:
The brain has a characteristic called plasticity, the ability to grow and be changed by specific stimulation. It also has redundancy, so when areas usually used for certain functions do not work well, additional areas can be developed to take over lost functions. In other words, the brain has the ability to adapt and change its structure from inefficient organizational patterns to efficient patterns. Function determines structure. As we put the correct function into the brain, we are able to impact, and change its structure as well. Through specific stimulation we are able to develop new pathways into and throughout the brain and the nervous system so that important changes can be made. Even the chemistry of the brain can be changed positively through specific stimulation.

Individualized neurodevelopmental programs put specific stimulation into the brain. The brain is able to organize using this new information and function more typically. The stimulation actually creates new pathways in the brain for improved function.

The following are areas that we are able to improve through the neurodevelopmental approach.

Tactile Issues:
Touch: The children we see who have been called ADD or ADHD often display symptoms of hyposensitivity or hypersensitivity to touch. These children may be overly sensitive to light touch. They are very ticklish, jumpy when touched, or they may dislike being touched. For such a child socks may never feel right and mom may have to cut the labels out of his shirts. During the school day, this child may be seen fidgeting, and squirming, and getting out of his seat. This hypersensitivity can be a source of extreme distraction that carries his focus and attention away from the academic tasks being presented to him.

On the other hand, the same child may not feel deep pressure or pain appropriately. Not being able to feel pressure or not being able to correctly identify where his body is relative to the space around him can affect coordination significantly. This may result in his breaking pencils, hugging too hard, or invading the personal space of others. He may also be late to toilet train and may continue to wet the bed or have daytime toileting accidents.

Not having typical tactile perception with the hands can make the child dislike fine motor activities such as handwriting. This child may have a poor pencil grasp, hold her hand off the paper, or have messy handwriting. She may also have difficulty tying shoes, buttoning, or zipping.

Temperature: Some children do not “know” when they are too hot or too cold, or when they could make themselves more comfortable by adding or removing clothing layers. Being too hot or too cold is distracting.

Tastes: Not being able to distinguish between different tastes or being overwhelmed by tastes can impact dietary choices, causing some children to eat only a restricted selection of foods. Such a limited diet can result in behavioral differences and distractibility.

Odors: Olfactory hypersensitivity can be another significant source of distraction and may also result in a dislike of foods that have a strong smells.

Proprioception: (The brain’s unconscious knowledge of the body’s position in space.) Without well developed proprioception, children can have difficulty with balance, motor planning, orientation, and focus.

The Neurodevelopmental response: Provide tactile input!
By providing specific tactile input such as deep pressure, light touch, vibration, odors, tastes and temperatures, we give the brain the information it needs to perceive correctly and meaningfully. As the brain is able to correctly organize tactile information, the outward symptoms begin to disappear.

Metabolic Issues:
Allergies, behavior, and good/bad days: Metabolic issues can be a significant source of distractibility and inability to maintain focus. If you notice that your child has a dramatic difference in academic performance, attention, mood, or energy from one day to the next he or she may have significant metabolic problems. This may also be the case if certain foods appear to cause more distractibility, irritability, or out of control behavior. Diet or environment can also affect the level of alertness for many individuals. Some children also may have allergies and food sensitivities where the symptoms do not become apparent for up to 72 hours.

The Neurodevelopmental response: Balance the biochemistry!
We recommend specific resources which have proved helpful to our families. The balance of the child’s biochemistry needs to be maintained so that she can absorb and utilize nutrients correctly

Auditory Issues:
Hypersensitivity to sound: Auditory distractions are common among children identified with “ADD/ADHD.” Some of this distraction comes from being overly sensitive to sound, hearing what others may not hear, or from processing tones incorrectly. These children may overreact to sounds, cover their ears, or report pain at volume levels that seem normal to others.

Auditory sequential processing: The ability to take in sequences of sounds or words and immediately repeat them is called auditory sequential processing. It relates to the number of pieces of auditory information one can hold in short-term memory at the same time. Individuals with auditory processing problems may have great difficulty understanding and following directions, or listening for more than very brief periods of time. Extremely short attention spans and behavior that appears to be rude, such as interruption, can be caused by processing problems. Children displaying symptoms of ADHD are often not able to “process auditorily” at the same level as their peers.

What appears to be significant social immaturity can also be rooted in auditory sequential processing issues. A child who consistently chooses friends younger than herself, may be processing at levels closer to that of younger children than to that of her peers. A ten year old who acts like a five year old may appear to be hyperactive or inattentive; however, he is only behaving at the level of his auditory processing skills. Children with few or no friends may be missing or misinterpreting social cues that are important to maintaining friendships due to their inadequate auditory processing skills.

Auditory tonal processing: Tantrums or misbehavior when in groups, public places, or crowds can arise from not being able to process tones correctly and becoming overwhelmed by the presence of sound.

Vestibular function: Poor vestibular function can result in distraction due to feelings of vertigo.

The Neurodevelopmental response: Address the listening system!
To help with auditory processing, we work with many short processing activities to train the child's brain to hold more pieces of auditory information in its short-term memory. We incorporate sound therapy protocols to help the child distinguish between sounds and to overcome hypersensitivity to sound.

Visual Issues:
Distractions from visual stimuli, especially from the peripheral vision, are common among children who have been diagnosed with ADD, ADHD and similar conditions. These children may be easily distracted by movement, light, or even static visual images in their peripheral vision. This is caused by overdevelopment of peripheral vision and underdevelopment of central detail vision. This causes the child to process visual information incorrectly. He or she may also have difficulty correctly perceiving parts of or the centers of words. If this is your child, you may have noticed that he guesses at words. Words like “house” and “horse” may be confused if the child does not perceive the detail of the central letters of a word accurately.

The Neurodevelopmental response: Remediate visual development, especially central vision!
Children who display these symptoms benefit from therapies that target remediation of visual development. The ND (neurodevelopmental) approach is to implement a program of specific activities that improve central vision and reduce dependence on peripheral vision.

Not having established a dominant hand (i.e. "being" completely right-handed or left-handed) is a symptom of incomplete development and lack of lateral organization of the brain that can result in distraction, lack of focus, forgetfulness, and emotionality.

The Neurodevelopmental response: Remediate the lateral organization of the brain! Children who have not established a dominant hand naturally can develop handedness through activities that relate to sub-cortical areas of the brain. The ND approach is to implement a program of specific activities that relate to subcortical brain levels and build interhemispheric communication.

Intelligence and Attention Deficits:
Often the parents of children labeled ADD are concerned about their child’s level of intelligence. The child may have scored low on standardized tests. Children with neurodevelopmental issues are often not able to provide the “output" required to test well on the type of standardized tests that claim to predict academic success, often called “intelligence tests.”

The Neurodevelopmental response: Unlock potential by correcting dysfunction!
Many of the children we see with these labels are quite intelligent, but they do not have access to their intelligence because of tactile, auditory, and visual sensory distortions, or perceptual dysfunction. As these problem areas are addressed and development progresses, the child will be able to show more of his or her true potential.