Tom and Tim and other readers of the list,
There ARE known anatomical, electrophysiological and biochemical differences
for ADHD and Dyslexic children. We probably know more about these conditions
than most other DSM-IV categories believed to have some biological basis
such as Schizophrenia or Bipolar Disorder. When I have the time and energy,
I will compile a list of the known differences. Not now.
I don't put the DSM-IV cateogories in some God-given status. They are simply
non-theoretical descriptions of problems which people develop. No doubt that
someone with a PCT perspective could come up with alternative descriptions
in terms of PCT.
I suspect that ADHD children have more difficulty going up levels. I will
find out when I do the MOL research project I mentioned on this list. I will
be giving them the tracking tasks and will be able to say something about
how they differ in terms of the parameters of that task. Any other
suggestions are welcome.
Do you take any kind of medication or supplements? I do. For example,
Tylenol for headaches. Vitamin C? Vitamen E? Are you always sure of the
mechanism of these substances?
Some of the children are aware that they are not able to behave or learn
like other children. They become aware through parent and teacher reactions
and observing other children. Some of the children think there is nothing
wrong.
There has been some genetic research with tests of phonemic awareness which
has localized it on specific chromosomes. I suspect that as we learn more
from the Human Genome Project, more and more complicated characteristics
will be found to have a genetic basis.
Thanks for your inputs on these matters. Let's simple agree to disagree for
now.
···
From: David M. Goldstein, Ph.D.
Subject: How about this one?
Date: 3/12/2000
David,
I see you have included the CSGNet in this discussion. Perhaps my
reply will make it through their network filters. If it happens
to bounce back, please post it there for me.
There ARE known anatomical, electrophysiological and biochemical differences
for ADHD and Dyslexic children.
If there are known anatomical, electrophysiological and
biochemical measures that identify a child as "having" ADHD, then
why is it the case that *every* diagnosis of ADHD is made by a
procedure that relies entirely on perceived behaviors? In that
procedure, if a child is judged to "exhibit" a specified number
of "behaviors," from a list of potentially "pathological"
behaviors, then the child earns the label. Several children who
wear the same psychiatric label can "demonstrate" different lists
of "pathological behaviors."
Assuming that you are correct, then why is it the case that no
anatomical, electrophysiological and biochemical measures are
employed by those who diagnose a child as "being" ADHD?
Tom
Hi Tom and other readers of these lists,
Tom asks: why is it the case that *every* diagnosis of ADHD is made by a
procedure that relies entirely on perceived behaviors?
David: I am glad you put every in quotes. The DSM-IV is the official
dictionary. A person must at least meet the definition in this book. As you
indicate, it lacks preciseness. I have been sick for the last few months.
When I have energy and time, I will post a list of what the research is
saying.
Tom said: Assuming that you are correct, then why is it the case that no
anatomical, electrophysiological and biochemical measures are
employed by those who diagnose a child as "being" ADHD?
David: Most of the data are new and follow-up studies are being done. The
people at NYU, who have a QEEG software package called Nxlink which has been
FDA approved, have developed discriminant functions for ADHD and Learning
Disabilities.
The anatomical and biochemical differences which have been found are
observable only through expensive and not widely available testing.
If you take the position that there are no differences, then you will not
look for them.
Even if there are biological differences, it doesn't means that biological
treatments such as medication are the best and only choice. For example, PKU
is a genetic disorder which can lead to retardation. The best treatment is
to avoid a diet which contains phenylalanine.
Schools have a hard time adjusting to children who are different in any way.
In the case of ADHD, home schooling may be the best answer for the first few
years of school. This is based on the assumption that parents have more
flexibility than the typical school and that parents are able and willing to
carry out such a program. In the case of Dyslexia, I advocate the use of a
parent run program called Ball-Stick-Bird. Parents give their child a
10-minute lesson for five days a week.
This could start as young as four years old in a child who is at high risk
of Dyslexia.
David,
Tom asks: why is it the case that *every* diagnosis of ADHD is made by a
procedure that relies entirely on perceived behaviors?
David: I am glad you put every in quotes. The DSM-IV is the official
dictionary. A person must at least meet the definition in this book. As you
indicate, it lacks preciseness. I have been sick for the last few months.
When I have energy and time, I will post a list of what the research is
saying.
Those were not quotes. They were asterisks, to emphasize the
word, as would be done by italics.
Please do not think you must post the research that reports
"differences" between children diagnosed as ADHD and those who
are not. I know that literature. I have worked with many kinds of
equipment used to "image" brain activity. I know the research
designs, the technical procedures, and the artistic methods, by
which people create colored pictures that purportedly reveal
differences between normal brains and pathological ones. Much of
the literature on differences in brain activity is as deeply
flawed as is the literature on behavioral research.
If you take the position that there are no differences, then you will not
look for them.
I do not take the position that there are no biological
differences. Please see my comments above.
David, I am sorry to learn that you were ill. I hope you are
recovering. (For those who do not know our history, David and I
were colleagues in a psychology department, way back when. Could
it really have been as long ago as the 1970s?)
Tom
Hi Tom and other readers of these lists,
No insult meant Tom. I know that you were into this area way before me.
For others who might be interested in pursuing the topic of QEEG, there is a
good website by Frank Duffy, MD who is one of the pioneers in this area.
http://fhdno2.tch.harvard.edu/www/qeeg/index.shtml
I was at SFASU from 1975 to 1980. I sure wish my interest in
electrophysiology had been present at that time. We could have had some fun
in this area.
Do you still work in this area?
I have learned to do QEEGs and Neurofeedback. As you say, this area is not
immune to people who do poor research and make all kinds of claims.
Thanks for your well wishes. I feel as though I see "light at the end of the
tunnel." The tunnel started in August 1999.
Best regards,
David
Tom and all:
In a letter published in the Wall Street Journal dated March 13, 2000,
Ruthmary Deuel, M.D., Professor of Neurology and Pediatrics at Washington
University, agrees that mood-altering drugs for toddlers "should be used with
much, much more restraint than seems to be the current vogue." She claims
that "few medications of any kind are given anything like adequate
preclinical trials in infants and children." "This is most particularly the
case with anticonvulsants and psychoactive medications."
She also believes that physicians are facing a cultural and economic bias
where "parents think that there is a specific medicine for everything,
including two-year-olds throwing normal two-year-old tantrums." The aphorism
seems to be "Spare the rod, and drug the child."
Despite not having accurate medical diagnoses, and with drugs that aren't
well enough tested and understood, these little brats still need to be
controlled to behave properly in schools. Right? 
The medicine of proven form used by loving parents to teach civility to their
offspring was the rod. Such old fashioned and brutal ways are not allowed
now in our public schools. I suppose most PCTers would object too, because
it looks like punishment of the rascals. I, of course, have no problem with
the use of discipline for a child by a caring adult whether at home or at
school (RTP or otherwise).
Kenny
I forgot to include a brief explanation in my earlier reply to
David's message.
David Goldstein wrote:
Tom said: Assuming that you are correct, then why is it the case that no
anatomical, electrophysiological and biochemical measures are
employed by those who diagnose a child as "being" ADHD?
David: Most of the data are new and follow-up studies are being done. The
people at NYU, who have a QEEG software package called Nxlink which has been
FDA approved, have developed discriminant functions for ADHD and Learning
Disabilities.
For those who are not familiar with the jargon of brain activity
measurement, "QEEG" refers to Quantitative Electroencephalography
-- Quantitative EEG. I am familiar with various software packages
that produce QEEG analyses. ELectrodes are placed at several, or
many, locations on a person's scalp and scalp electrical activity
is recorded under various conditions that are imposed on the
person. Using proprietary software routines, the data are
analyzed and subjected to mathematical modeling. The idea is that
the final result reveals the origins of electrical activity
coming from inside the skull, presumably from inside the brain.
I have worked with several QEEG programs. Sometimes the results
of their modeling are interesting. Sometimes they are ludicrous.
Nothing is guaranteed.
QEEG software packages are used in some research programs, and in
many "popular" applications, like "consciousness expansion." Some
QEEG packages date back to the 1970s. Often, new QEEG packages
are touted as just the thing to bring about a revolution in brain
science, especially in clinical applications of brain science.
For decades, that has been the unrealized promise and hope, for
QEEG. I have little confidence in many of the results produced by
QEEG analyses, for reasons I will explain in the book I am
writing.
Tom
David,
(I realize that people on CSGNet might not know what this is all
about. David included you when he replied to me in a conversation
on respthink. I felt obligated to include you when I replied to
him. If you don't want this conversation to appear on CSGNet,
just let me know.)
In our discussion about techniques that are alleged to identify
the biological causes of ADHD, I want to be sure we are talking
about the same animal.
For example, we had the following exchange.
Tom said: Assuming that you are correct, then why is it the case that no
anatomical, electrophysiological and biochemical measures are
employed by those who diagnose a child as "being" ADHD?
David: Most of the data are new and follow-up studies are being done. The
people at NYU, who have a QEEG software package called Nxlink which has been
FDA approved, have developed discriminant functions for ADHD and Learning
Disabilities.
The anatomical and biochemical differences which have been found are
observable only through expensive and not widely available testing.
Here are the citation and abstract for an article about the
ability of QEEG to differentiate boys who are diagnosed with ADHD
from boys who are not. Is this the kind of research you had in
mind?
···
=====================================
Pediatr Neurol 1992 Jan-Feb;8(1):30-6
Quantitative analysis of EEG in boys with
attention-deficit-hyperactivity
disorder: controlled study with clinical implications.
Mann CA, Lubar JF, Zimmerman AW, Miller CA, Muenchen RA
Department of Psychology, University of Tennessee, Knoxville
37996-0900.
Sixteen-channel topographic brain mapping of
electroencephalograms of 25 right-handed males, 9-12 years of
age, with
attention-deficit-hyperactivity disorder revealed increased theta
(4-7.75 Hz) and decreased beta 1 (12.75-21 Hz) when compared
with 27 controls matched for age and grade level. The differences
were greater when patients were tested for reading and drawing
skills, but were decreased when they were at rest during visual
fixation. Although the differences in patients with
attention-deficit-hyperactivity disorder were generalized,
increased theta was more prominent in frontal regions, while beta
1 was
significantly decreased in temporal regions. Principal component
analysis was used to combine the variables into 2 components
which
accounted for 82% of the total variance. A discriminant function
analysis using these components was able to predict group
membership for attention-deficit-hyperactivity disorder patients
80% of the time and 74% for controls. These findings support the
use
of topographic electroencephalography for further elucidation of
the neurophysiology of attention-deficit-hyperactivity disorder.
PMID: 1558573, UI: 92215288
Cheers,
Tom
Hello Tom and readers of these lists,
Yes, I would consider this to be the sort of article I was referring to for
the electrophysiological differences.
It is older, 1992.
The support of biochemical and anatomical differences is more recent. The
NYU group has a larger data base.
David
from Tom Bourbon
David Goldstein wrote:
Yes, I would consider this to be the sort of article I was referring to for
the electrophysiological differences.
It is older, 1992.
Do you think that the data from more recent studies are different
from the ones in this article? If so, in what way(s) are they
different?
The support of biochemical and anatomical differences is more recent. The
NYU group has a larger data base.
Can you direct your readers to some of the newer data?
Tom
Hi Tom and readers of these lists,
Tom asked me to direct the readers of these lists to a souce where they
could learn of the newer biochemical tests.
Here is one: http://www.bostonlifesciences.com/new2.htm
He also asked about studies involving electrophysiological differences: Do
you think that the data from more recent studies are different from the ones
in this article? If so, in what way(s) are they
different?
David: They are the same in pointing to electrophysiological differences.
They are different in specifics. I will find some internet references.
Tom, are you familiar with the Neurorep Report by Bill Hudspeth, Ph.D.? This
is the one I use.
Best,
David