Daniel Money, 8, receives bio-feedback and neuro-feedback treatment at Neurocore in Okemos, MI. Daniel was diagnosed with ADHD and has had more than 30 treatments so far. (Dale G. Young / The Detroit News)
A growing west Michigan-based neuropsychology practice claims that up to 60 percent of its clients previously diagnosed with attention deficit hyperactivity disorder — ADHD — are missing the telltale brain wave patterns characteristic of the disorder.
More often than not, their lack of mental concentration is due to allergies, sleep disorders, anxiety or other problems — but not ADHD, according to neuropscyhologist Tim Royer, founder of the Grand Rapids-based Neurocore, whose clients also include members of major sports teams.
But doctors and therapists who rely on traditional diagnostic and treatment methods are skeptical. Critics note that the use of electroencephalography (EEG) findings for diagnosis has only recently been approved by the federal Food and Drug Administration, and they say bio- and neuro-feedback require further testing to determine their effectiveness.
Royer said his clinical experience, though not universally accepted, has been validated in studies such as one published in the August Annals of Allergy, Asthma & Immunology. In that study, a third of children diagnosed with ADHD were found to have asthma.
Royer said it’s not uncommon for kids as young as 6 to come into his clinic on three psychotropic drugs for a condition they don’t have.
“I see over and over again kids who are misdiagnosed and over medicated,” he said. “Many times, you find out the child never had ADHD.”
ADHD is the most common neurobehavioral disorder of childhood. It can profoundly affect the academic achievement, well-being and social interactions of children, according to the American Academy of Pediatrics. Roughly 8-10 percent of children are affected, including about three boys to every girl. Scientists aren’t sure what causes ADHD, although studies suggest genetics plays a role. Researchers also are looking at environmental factors, as well as brain injuries, nutrition and the social environment as possible causes.
In a recent article in the American Academy of Pediatrics News, Dr. Michael Reiff, a professor of pediatrics at the University of Minnesota, urged caution. The current standard of care calls for evaluations that take into account the individual’s environment, peer relationships and school behaviors, as well as the observations of parents and teachers.
“There is no psychological, blood test, lab test, EEG test, brain wave pattern that diagnoses ADHD,” Reiff said in an email to The Detroit News.
The use of EEG technology, and bio- and neuro-feedback, for the treatment of attention disorders is increasing nationwide, with about 1,500 such clinics across the country, Royer said. Neurocore has expanded to eight clinics in Michigan, including one that opened this fall in Sterling Heights. Another is to open this week in Livonia.
At Neurocore, all clients are given an EEG exam, in which electrodes are placed on the head to measure brain activity, including the ratio between restful “theta” brainwaves, and “beta” brainwaves, which are produced in response to stress. Royer said an abundance of theta brainwaves is an indicator of ADHD, but clients with too many beta brain waves — due to anxiety, allergies or lack of sleep — also can have trouble focusing.
Dr. Bruno Giordani, chief psychologist in the Department of Psychiatry at the University of Michigan, is skeptical of too much reliance on EEG results.
“In and of itself, it’s certainly not a diagnostic test. ,” Giordani said. “I’m not sure everybody needs an EEG. There’s not been enough research to say that if your theta isn’t high enough and your beta isn’t low enough you don’t have ADHD.”
Neurocore treats people with bio-feedback and neuro-feedback, therapies that use computer games and other technology-based exercises to train the mind to focus. Its clientele includes the Orlando Magic. The teams believe Neurocore’s treatments improve their athletes’ ability to keep focus on the game.
Two kinds of therapy
Eight-year-old Daniel Money of Brighton was “antsy” and couldn’t pay attention in school, so his parents took him to a psychiatrist who gave Daniel a prescription for ADHD medicine, said Shannon Money, his mother. An EEG exam at Neurocore did not show the tell-tale “theta” brain waves associated with ADHD. Instead, he showed too many of the “beta” brain waves that are symptomatic of anxiety.
Twice a week for more than four months, technicians at Neurocore in Okemos wrapped a sensor belt around Daniel’s stomach to track his breathing and clipped another sensor onto his finger to track his pulse. Then, monitoring his own progress on a computer screen, Daniel practiced timing his breathing to his heart beat, a therapy called bio-feedback.
In another exercise, grounding wires were attached to Daniel’s earlobes, and an electrode was fastened to his head to record his brain waves. The third-grader popped a movie into a DVD player and settled down to watch. But if he let his mind wander, even for a minute, the movie would shut off, a therapy called neuro-feedback.
“Within six weeks we noticed some small changes at school,” Shannon Money said. “Twenty weeks in we had a very good routine of behavior at school. He was able to focus longer. He could listen to instruction and apply it. That was a big difference.”
Changing brains, lives
Los Angeles Lakers Center Chris Kaman went to Neurocore when he played for Central Michigan University’s Chippewas and found out he’d been misdiagnosed since the age of two and a half. He publicly revealed his ADHD misdiagnosis in 2008.
Kaman, 31, said he underwent bio-feedback and neuro-feedback therapy at Neurocore for two and a half summers before going professional.
“On the court, my impulse control is slower,” Kaman said. “I can take my time and think things through, but think them through at a fast pace.
“(It’s helped) my offensive production, timing, free throws. After my fourth season I trained with Dr. Royer that summer, I improved steadily in my fifth season, sixth season, seventh season. The biggest thing that helped me is the neuro-feedback; it changed my life.”
Royer, formerly division chief of psychology at Helen DeVos Children’s Hospital in Grand Rapids, said when he started using bio-feedback and neuro-feedback for treatment of ADHD, he combined it with cognitive therapy. Now, only about 3 percent of patients get psychotherapy at Neurocore.
“What started happening is I’d get to the 30-day mark and the patients would say they don’t need it,” Royer said of the cognitive therapy sessions. “I found out I was moving three to four times faster in progression with my patients when I was just focusing on the bio-feedback and the neurological, and not getting in the way with all the talking.
“It’s far more productive and long lasting when you change the brain.”