ADD/ADHD and NDD

To understand this section it would be best to read the sections “Neuro-Developmental Delay (NDD)” and “Primitive Reflexes”.

ADD is usually much more than simply an attentional problem it usually effects concentration and learning, frequently complicated by emotional and behavioural issue and can also effect energy levels when it is described as ADHD. For some the two conditions of ADD and ADHD are not linked, but two separate conditions. For others the degree of ADD is determined by the association of oppositional behaviour.

This is not meant to be a definitive picture of ADD, it is simply meant to demonstrate how many of the symptoms of both ADD and ADHD can be caused by the retention of Primitive Reflexes and therefore successfully treated by my approach to neuro-developmental therapy.

It is well documented that food additives have an effect upon the responses of the child with ADD/ADHD; those effects will be compounded by any specific deficiency in vital nutrients, especially the fatty acids, the vitamin B group, zinc and magnesium. It is certainly true that retained Primitive Reflexes leaves the individual more susceptible to nutritional deficiencies, to poor immune responses and hence allergies and in consequence to the effects of food additives. But there are also some intrinsic characteristics of the actions of the Primitive Reflexes that can account for the symptoms of ADD/ADHD.

The Moro Reflex has a direct link with alterations in the blood levels of adrenaline and cortisol. Both of these chemicals have an effect upon behaviour. Sudden raised levels of adrenaline results in the fight or flight mechanism. Both can result in aggressive behaviour, oppositional behaviour, and a need to be control the situation and the other individual. Sudden surges of cortisol will cause fluctuations in blood sugar levels. Low blood sugar resulting in irrational behaviour. The Moro Reflex maintains a greater capacity for peripheral vision to the detriment of central vision. The child will inevitably find it difficult to focus upon fine detail, to attend to the specific, the eyes will more naturally focus upon any movement within the peripheral field, be more interested in what is going on around and outside. A similar effect occurs with the ears and hearing so that the child cannot block out the white noise, is easily distracted, hones in on any auditory disturbance but finds it difficult to concentrate on the constant speech of instruction. They are the child that is always being told by the teacher to mind their own business, to attend to their own affairs, to concentrate on their own work and things would be much better.

Co-existence with a retained ATNR certainly adds to the problem for the individual as the ATNR will have prevented the normal maturation of the linkage between the two halves of the brain. This linkage of a bundle of fibres known as the Corpus Collosum does not normally mature until aged 7-8. Children with poor maturity of the linkage between the two halves will retain a preference for right brained activity. The right brain specialisations are a preference for seeing things as a whole, to see the outline and shape in preference to the detail, and to learn by intuition rather than to problem solve. This means that the individual is impulsive, has difficulty seeing cause and effect and hence fails to learn easily from past experience. They have problems with sequencing and memorising sequential detail, both left brained skills. Poor sequential skills results in a poor understanding of time, and like the very young child cannot wait, as they have little concept of next minute, next hour, next day, let alone next month or year. We have a child trapped in the experience of the terrible two’s because the brain development has not enabled them to grow beyond.

A retained TLR in flexion will result in too great a muscle tone. This means that the child is tense, keyed up for action, finds it difficult to relax. The body will be slightly bowed and results ultimately in short muscles and ligaments on the front of the body and long on the back. Breathing may be impeded and hence blood oxygen levels may be low. The brain uses more oxygen and glucose than any other organ.

The continued presence of the STNR will add to these difficulties as the automatic flexion and extension of the arms, hips and knees whenever the head is moved up and down causes sitting at a desk and working a restless experience and attempts to overcome the constant positional change very mind consuming. Concentration upon a piece of reading or written work is difficult. Copying, with it’s constant changes in head position is the most unbearable, creating the most fidgeting. It is not so much that these children have a problem of attention, much more that their attention is constantly being forced upon physical activities that is totally unconscious for the majority. They have to attend to sitting, to maintaining the sitting position, to stay upright in the chair, to frequently remain in the chair, as the head down will inevitably result in straightening of the hips and knees, and head to lower onto the desk.

The Spinal Galant Reflex, with its automatic outward rotation of the hip joint, and hence the leg, every time the small of the back is stimulated causes even more difficulties. Sitting causes the chair back to touch the vulnerable spot on the child’s back. Tight trousers, pants, belts all create the same stimulating effect to the retained Galant. Add to that an inability to fully control the bladder, to only know you want to go as you start to go, to have to hold it back and run; a frequent half crown patch of wet is a tell tale sign. To not be able to hear as sharply as others, to have a delay in processing sound, to lose vital sections of verbal text and still maintain concentration is more than most adults can do, let alone a young child. Frequent doodling, day dreaming, fidgeting, wandering in mind and body are all symptoms of the hearing impaired child. I say hearing impaired for even if they do not show up on a classical medical audiometric assessment it does not mean that they are not hearing impaired. Hearing impairment includes specific frequency sensitivity or loss, neither would be picked up on a routine test. It can be a sensitivity to hearing normally outside human hearing, again not picked up. Over sensitivity in this way can be painful, it is also very distracting to here the plumbing or heating sounds of a school.

Retained Primitive Reflexes is an abnormal development of the nerve networks within the brain stem and in consequence incomplete development of nerve networks above the brain stem. Lying within the brain stem and the mid brain is a specific area of the brain called the Reticular Activating System. All nerves entering and going up into the higher centres of the brain send a branch to the Reticular Activating System, equally all nerves leaving the higher centres to the body also send a branch to the Reticular Activating System. This means that this system is informed of all activity within the brain. It has 3 basic functions: to control the level of stimulation going up to the higher brain so that the brain should never be over stimulated; to control the output from the brain, so that it is to a degree measured; and to regulate the overall activity within the brain. Poor development within the brain stem can cause immaturity within the Reticular Activating System, so that the brain can be easily overloaded resulting in confusion, excitement, inability to focus on specifics. Equally the ability to measure the output, behaviour, is also restricted, so that much of the behaviour is impulsive, excessive, out of control. The brain has several activity levels, measured by brain waves. There are waves of activity for learning, different ones for sleeping. Many children with ADD/ADHD when tested are found to have brain waves more akin to those preceding sleep. This is a surprise, for seeing the behaviour of a child with ADHD it would be expected that they are hyped up, switched on. The suggested reason for the behaviour is to prevent sleep, the only way to feel alive is to keep moving, keep moving, keep moving. Another potential reason for the immature Reticular System, the altered brain waves, and for the retention of the Primitive Reflexes themselves may be an abnormality in specific chemicals within the brain. Altered levels are most likely to have a cause in an enzyme deficiency so that the protein required for the neuro chemical cannot be activated, or there is failure of breakdown of an apposing chemical. It is possible to determine neuro-chemical levels and to provide nutrients to bypass the enzyme deficiencies.

Although some children are diagnosed with ADD/ADHD these conditions frequently coexist with dyslexia and/or dyspraxia. For this reason I suggest that any parent who has a child with ADD/ADHD reads the sections on: “Dyslexia and NDD” and “Dyspraxia and NDD”.

Children with ADD/ADHD, especially if they have symptoms of dyspraxia, are readily identifiable as different from other children; for this reason they are frequently teased, bullied, isolated by other children. The retained Primitive Reflexes and underdeveloped Postural Reflexes not only make rapid adjustments in physical skills difficult, they also impact rapid mental agility. They do not appear street wise, have poor mechanisms to defend themselves physically, mentally and emotionally. For all of these reasons they can frequently be very distressed and unhappy children as they both recognise and are recognised for their difference.