Diagnosing ADHD with Brain Imaging

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In a related field, autism research, new findings show a brain-scanning measurement of “grey matter (GM) volumetric data, to assess whether individual ADHD adolescents can be accurately differentiated from healthy controls based on objective, brain structure measures…”

from Autism Speaks, http://asdresearchinitiative.wordpress.com/2013/05/24/grey-matter-adhd-autism/ 

While this study is looking for biological measurements to identify people with autism spectrum disorders AND ADHD, it explains that the screening mechanism is a good way to detect ADHD. Rather than compare brain waves (see my blog post here), it looks at actual structures of different parts of the brain.

Many doctors and psychologists say that there are usually enough (subjective) behavioral reports from parents and teachers to determine if a person suffers from ADHD. However, these objective biometric tests may be useful in deciding on medication/s, which could be enormously helpful.

 

Twice Exceptional Learners Are “2E”

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The term “2E” refers to being Exceptional, as in gifted, and Exceptional, as in having special learning needs. Many children who have learning differences/disabilities are also gifted, perhaps in math, the arts, or other areas.

A thought-provoking theory about giftedness is that these special traits or talents are “intensities”.  I like this description for many reasons, one being that it honors the basic abilities that most people have to create, to think mathematically, to understand literature, to relate on some level to the creation they are witnessing. For example, most people shudder at the thought of public performance, but they still love to hear music performed because they can appreciate the melodies, the interplay between the musicians, or some other aspect of the performance.

If you or your child has ADHD, and yet you can see areas of unexpressed talent, it may very well be that they are functioning at two different extremes. Because a lack of executive functions can impede productivity and follow-through, you or your child may not believe that you or he could be “gifted”. The common belief is that gifted only applies to academic subjects; people forget that dancers, designers, engineers, architects and so many other professions require creativity, novel approaches to problem solving, and a willingness to try many options (perseverance) until the most suitable solution is found.

Kazimierz Dabrowski, a Polish psychiatrist, developed this theory of human development, or “theory of personality.” One very nice book that details various aspects of intensities is Living with Intensity, edited by Susan Daniels & Michael M. Piechowski, Great Potential Press, 2009. Dabrowski’s theory has many fascinating insights into human development and what educational therapists call “temperament”. The most widely-known concept from his work is called “Over-Excitabilities,” or OEs. This term is an unfortunate translation of the Polish term nadpodbudliwos’c’ “superstimulatability” or “superexcitability” (p. 8). Dabrowski identifies five areas where a person might be intensely sensitive: psychomotor, sensual, intellectual, imaginational and/or emotional.

This book is a collection of works by psychologists, therapists and educators who apply Dabrowski’s concepts to behaviors in children, adolescents and adults. The articles range from the theoretical to the practical to the spiritual. Most of the authors imbue their texts with hopeful outcomes once their clients are liberated with the idea that they are gifted and worthy of appreciation. Many of their clients have experienced only the awkward parts of being gifted: being rejected for being “too intense”; not having peers to match their interests; feeling different but not knowing why; being depressed or anxious; and many other scenarios.

Seeing a person’s gift(s) in a more specific way can also be helpful in understanding his or her temperament. A person with an OE in the sensual realm, for example, may “catch details and may, for example, be captivated by the beauty of a glistening drop of oil floating and swirling across a rain puddle” (p. 40). Someone with a psychomotor OE may appear to be hyperactive, because they may like to move around a lot or use rapid speech. Chapter 3 of this book has wonderful suggestions on how to talk with a child about his or her gift, such as “You have wonderful enthusiasm and energy” or “Your curiosity fuels your intelligence.” There are also strategies listed for each type of OE.

Brain Screening Can Help Diagnose ADHD

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This technology, called electroencephalogram (EEG) or quantitative electroencephalogram (qEEG), has been around for many years. It can help diagnose ADHD by detecting brain-wave patterns that are distinctive to people with ADHD. People with ADHD have areas of their brains that are *under-aroused* or hypoaroused. When the ratio of under-aroused brainwaves is greater to active brain waves, it may indicate a disorder that responds well to stimulant medication. As stated by Edward Hallowell and John Ratey in Delivered from Distraction(2006), “New studies have shown that people who show the characteristic pattern of cortical hypoarousal are likely to respond well to stimulant medication. This provides an elegant physiological link between diagnosis and treatment” (p. 124).

Very recently — July, 2013 (9 years after Delivered from Distraction was published!), the NY Times reported that this method has finally been approved by the Food & Drug Administration. So, if you are unsure whether you or your child has ADHD, this non-intrusive test can help you determine the diagnosis.

From the New York Timeshttp://www.nytimes.com/2013/07/16/health/brain-test-to-diagnose-adhd-is-approved.html: “The test uses an electroencephalogram, or EEG, with sensors attached to a child’s head and hooked by wires to a computer to measure brain waves. … The test takes 15 to 20 minutes, and measures two kinds of brain waves — theta and beta. Certain combinations of those waves tend to be more prevalent in children with A.D.H.D.”