Let’s Talk About Attention Deficit, Part 1

I often see Attention Deficit (AD) with or without hyperactivity in my clinic.  Parents tell me that their child simply cannot stay focused on anything. There seems to be a great issue with the child’s ability to concentrate.   Circle time in the child’s classroom in usually a disaster.  Some of the concerns I hear from parents and teachers include:

•    Child requires many prompts to stay on task
•    Very little toy play, moves from object to object
•    Constant fidgeting
•    Easily frustrated
•    Poor recall of information already learned
•    Slow processing speed
•    Impulsivity
•    Poor social function

There are many theories about the etiology of an inability to focus and concentrate.  There seems to be a general consensus that there are indeed issues that may be attributed to genetics, low oxygen utilization in certain parts of the brain, low glucose metabolism in certain parts of the brain, and dysregulated neurotransmitter functions.

Here are several interventions that may help with ADD/ADHD.   I have also written individual blogs discussing some of these interventions in much greater detail.

Methylation Defect
Genetically speaking, it is very common to find a family history of Attention Deficit disorder, depression, bipolar disease, and anxiety.  This family history points to what is known as a methylation defect and can be improved with Vitamin B12, Di- or Tri- methyl glycine, folinic acid, cysteine, and glutathione.  You can read more about the methylation pathway here.

Thyroid Disorders
Thyroid disorders can manifest as ADD/ADHD and need to be addressed and corrected.

Allergies
Allergies can definitely hamper ones ability to stay tuned in and focused.  Thus, these have to be addressed and treated.  You can read more about allergies here.

Inflammation
Any chronic inflammation must be addressed and treated.

Diet
The diet can have a HUGE influence of focus, concentration and behaviors.  I cannot stress enough how much this has to be evaluated and managed.  Food sensitivities must be addressed and eliminated, removal of sugar and food additives, and each meal must be properly balanced and contain a protein, a carbohydrate, and a fat.   Omega oils are essential!  Good vitamin and mineral supplementation may help as well.  You can read more about supplementation here.

Supplements

Theanine
Theanine is derived from the leaves of Camellia sinesis which is a green tea, as well as 2 other Camellia species.  Studies from Japan confirm this has a generalized calming effect on the brain, which in turn, helps with focus and concentration.  Dosing in our clinic usually starts with 100mg capsules take 1-4 caps twice daily.

Phosphatidylserine
Phosphatidylserine is the amino acid attached to a phosphatidyl fatty acid molecule.  These are derived from soy bean.  Research has been weak demonstrating effectiveness, but use in my clinic seems to be calming, especially when combined with omega 3 fatty acids.  These are thought to help by incorporating themselves into neuron cell membrane and helping with overall normalization of this membrane.  It may really be beneficial for those children who have had severe self-limited diets like cookies or French fries and have an overall nutritional deficit.  These may be used cautiously in those children with soy allergies.  Dosing is usually 100mg capsules, 1-4 caps twice daily.

Hyperbaric Oxygen Therapy (HBOT)
Many studies looking at attention disorder have focused on brain imaging and oxygen utilization/glucose utilization.  Many of these studies note that there are definite areas of the “AD” brain that consistently show decreased oxygen utilization, or what is commonly termed “hypoperfusion.”  Please note, that there are some other areas that have INCREASED perfusion  as well.  The rationale of using HBOT in children with autism and AD would then to increase the oxygen supply to these areas of hypoperfusion.   We generally recommend starting at very modest pressures (this is measured in “atmospheres of pressure”), with 100% oxygen for 60 minutes, once daily.  In about 20-40 sessions, we can generally see if this therapy is helpful.  I will discuss hyperbaric therapy more extensively in a later blog.

Neurofeedback
Neurofeedback ultimately attempts to train the brain to have the most effective brain wave pattern for focus and concentration.  There have been many pioneers in this research who have published impressive clinical results demonstrating marked improvement in the attention deficit.  Briefly, a child’s brainwave pattern is determined by a qEEG (quantitative electroencephalography).  After the therapist has evaluated this qEEG, a program is put into place where a child is usually allowed to play a video game or watch a video on computer.  The trick is that the game or movie only plays if the child brain wave pattern conforms to the protocol set up by the therapist.  Overtime, the brain “learns” what patterns are required to continue the play of the game/movie.  What this translates into, eventually, is the minimizing of attention deficit.

MEDICATIONS
The use of medications will be discussed next week in Attention Deficit Part 2