A Major Metropolitan Newspaper based in Trenton, New Jersey
October 22, 1998
By: Kelly Beamon

WHEN A CHILD can't sit still long enough to learn, you have to do something. And parents of children with AD/HD (Attention Deficit Hyperactivity Disorder) know how frustrating it can be to search for a permanent, drug-free solution.
      "The school said we had to take him to a psychiatrist. And the psychiatrist prescribed Ritalin after seeing my son for just 15 minutes. I was really annoyed," says Bensalem, Pa., resident Caroline Adiletto. Three years ago, her oldest son - now 10 - was diagnosed with AD/HD.
      "We had heard horrible things about Ritalin. He didn't like taking the medicine. And we felt it was coating the situation, not addressing the problem," she says.
      Ritalin is the brand name for methylphenidate, a central nervous system stimulant used to treat AD/HD. It works by increasing attention and decreasing restlessness in children and adults who are overactive, cannot concentrate for very long or are easily distracted and are impulsive.

      This medicine is used as part of a total treatment program that also includes social, educational and psychological treatment. Loss of appetite, trouble sleeping, stomach pain and weight loss may occur in children, who are usually more sensitive than adults to the effects of the drug. There also have been reports of children's growth rate being slowed when Ritalin was used for a long time. Some doctors recommend drug-free periods during treatment.
      In Moorestown, Holly Crayton, a licensed clinical social worker, was growing just as distraught. She discovered that her 15-year-old daughter Sarah would try to fake more subdued behavior rather than take her prescribed medicine - Sarah hid the medicine under a rug for months before Crayton discovered it.

BUT FIVE YEARS AGO, Attention Deficit Specialists, now in Lower Makefield, PA, started to offer an alternative AD/HD treatment - a $2,000 video-based treatment technique that proponents claim greatly reduces the need for drugs. At the same time, health food stores in the area began to carry the food supplement blue-green algae, which some claimed also could help.
      And in their separate hells of pills and school conferences, Crayton and Adiletto decided to take a chance. Three and four years later, with their children free of Ritalin, both are glad they did - even if they aren't sure their method of what worked.
      And it's no wonder, given the statistics, says John Taylor, a family psychologist and author of "Helping Your Hyperactive/ADD Child." Taylor was in the area earlier this month holding seminars on the subject.
      "Three-quarters of all teenagers and children who have AD/HD are prescribed medications at least once. And one-third of those at any given time are still taking that medication," Taylor says. "I have never been of that camp."

BRAIN GAMES

Barry Belt was not of that camp either.
      "If I hadn't run into Barry Belt, my son would probably still be on Ritalin." Adiletto said.
      When Barry left his post as director of special services and special education for Lawrence public schools 25 years ago to found CEPD, the parent orgnization of Attention Deficit Specialists, it wasn't to promote a non-drug approach to AD/HD. And when Adiletto first visited his office, it wasn't as an adoring fan.
      "I felt like I was going to the quacks. I didn't understand theta and beta (brain waves). I just knew my son had motor problems - holding pencils, cutting with scissors. But I was willing to try anything."
      "Anything" turned out to be a technology called EEG neurofeedback (popularly known as biofeedback) - something the company had used for 22 years to treat disorders originating in the brain, such as epileptic seizures and closed head injuries.
      "Changing (a person's) physiology is the cornerstone of what we do," says Belt, a certified neurofeedback practitioner.

IT TURNED OUT that neurofeedback could be used to affect beta brain waves - the "good" brain waves associated with concentration, while reducing thetas - the "bad" brain waves associated with daydreaming. So practitioners tried teaching the technique to children with AD/HD.
      It seemed to work. Soon, the AD/HD application created a whole new category of health care practitioner: the Attention Deficit Specialist.
      "Now we are treating 30 and 40 children and adults a week, and doing about 80 to 100 sessions," says Belt.
      During a session, electrodes are attached to a child. The electrodes monitor brain waves, as the child plays a video game with built-in rewards for concentration and penalties for becoming distracted.
      Simply put, the kids get to play Pac Man.
      "If your attention begins to wane, Pac Man stops and the screen goes black. The children continue the exercise over and over - it's like physical therapy for the brain. I tell kids they're doing mental weight-lifting," says Attention Deficit Specialists psychologist David Toll. "We strengthen the electrical activity of people's brains."
      They use other games, too. "Sometimes we fly airplanes. And once they get settled in, I have them working on lines on a bar graph. In 30 or 40 sessions that last 45 minutes, you see results," Toll says.

ADILETTO DESPERATELY wanted results after witnessing the impact that some of Ritalin's side-effects had on her 8-year-old son. He'd been on the drug for three months and couldn't sleep or eat much, she says. And because his school said he also needed costly occupational therapy, the family's finances were thinning. We paid $75 per session for occupational therapy, out-of-pocket, for two years," said Adiletto.
      Still, neurofeedback was hardly cheap. The series of roughly 42 sessions costs $2,000 per child, and not all insurers will cover it.
      "I'd say 40 percent to 60 percent of (insurance companies) will pay for it," says Belt.
      But neurofeedback is gaining a reputation as a one-shot treatment that sometimes can greatly reduce or even eliminate the need for drugs in hyperactive children. "We see a 70 percent to 75 percent success rate, which includes people who reduce their medication to a minimal amount," says Toll.
      Adiletto and her son gambled and won. "After 42 sessions, he was off the medication," she said. "Third grade was the last time we went. Now he's in fourth grade. We haven't been back."

DESPITE SUCH SUCCESSES, neurofeedback - first tried in the 1960's as a relaxation technique - is still controversial. And some critics say any good results could be just plain coincidence. Indeed, there is no documented, scientific proof that children's brains are being altered by the technique rather than growing naturally on their own. Even Attention Deficit Specialists is cautious in its claims.
      "We're helping people become amenable to existing therapy, not replacing it," says Toll. "I'm not trashing (drugs). There are some kids we can't treat unless they're on the drug."