An Alternative to Ritalin

Controversial EEG biofeedback regimen claims to help super-hyperactive children learn to concentrate, but some experts say treatment lacks research

BY ERIC SANDSTROM Beacon Journal medical writer

Not every super-hyperactive child with a concentration problem belongs on Ritalin. Cindy Piszczek realized that fact whenever her son, who has attention deficit disorder, displayed a peculiar form of behavior that she associated with his medication.

For decades, the stimulant Ritalin has been the most-used drug in the treatment of ADD. The disorder afflicts as many as an estimated 5 percent of school-age youngsters, mostly boys like 8-year-old Ben Piszczek of Medina, and doctors have been blamed for over-prescribing Ritalin in many cases. Ben was diagnosed at age 3 with symptoms that include impulsive behavior, hyperactivity and an inability to focus attention.

While Ritalin has been shown to be effective, it also can cause troubling side effects. In Ben's case, his mother said, he would bend over and run into people head-first. Piszczek, a registered nurse, decided to try an alternative treatment for her son called EEG biofeedback Like Ritalin, biofeedback is not without controversy. Also known as neurotherapy, biofeedback is practiced by psychologists, physicians and others who help change brainwave frequencies with a computer and an electroencephalogram - the same device hospitals use to identify abnormalities in the brain.

Ben started biofeedback in September, which required, him to play a Pac-Man-like video game without hand controls. Instead, Ben was hooked up to the computer by electrode plays attached to his head and played the game by carefully focusing his attention on the task at hand.

After 20 sessions with Wadsworth psychologist Glen Martin, Ben has shown improvement that has stunned his parents and teachers. He pays more attention to his parents and Ins five siblings than ever before.

At Ghent Academy for Boys in Copley, the second-grader has shown a sudden desire to read books - an interest that was absent before - as well as a heightened awareness of classroom activities.

"He seems more interested in our conversations and more involved," Piszczek said. "It is really wonderful. And he is medication free." Biofeedback has become an increasingly popular form of ADD treatment, according to its practitioners.

Martin became interested in biofeedback five years ago to help his 14-year-old son control ADD, when only about 125 people offered biofeedback therapy in the nation. Martin said the number of biofeedback practitioners has grown more than tenfold since then.

Martin, who works with a physician, said that about two-thirds of his patients show marked improvement in their social and academic skills. About half of those patients are able to discontinue their medication, and the rest are able to reduce their dosage

"I go along with whatever the Parent likes," Martin said. "My goal is to get the child functioning at his or her peak potential."

Biofeedback has prominent critics.

Dr. Russell Barkley, a nationally recognized expert on ADD and head of psychiatry at the University of Massachusetts Medical School , said biofeedback is an experimental treatment that lacks sufficient research to be considered scientifically effective.

Barkley said that medication has been proven to be the best treatment for people with ADD, though no cure exists.

Biofeedbacks only known risk Barkley said, is "spending your money on something that doesn't work"

Michael Manos, a psychologist and researcher at University Hospitals in Cleveland, said there is only anecdotal evidence to indicate that biofeedback works, but not enough scientific study to prove it.

"The jury is still out," he said.

Peter DiMezza, founder and director of the Center for Creative Learning in Akron, said another problem with biofeedback involves insurance coverage.

The treatment is not cheap, and some practitioners charge $3,000 and up for 40 sessions. Many insurers will not pay for it and expenses run into thousands of dollars.

"Biofeedback may be a very effective treatment for some people, but People need to go "'to it with their eyes Open," DiMezza said. He uses a more traditional form of treatment, which includes Ritalin and also martial arts, that may exceed $1,000 over the course of a school year.

DiMezza said medications, including Ritalin, do help children control ADD.

"The trouble is, many physicians haven't used them properly," DiMezza said. "A lot of kids have been overdosed. It's been given a bad rap because of that."

Ben's mother knew before he started biofeedback that the therapy has detractors. But Piszczek said her son had tried other strategies, including speech and hearing therapy, to no avail.

So she took Ben to see Martin, had him evaluated, and signed him up for 40 sessions - of which he has completed 20. The total cost, $2,500, is not covered by her insurance carrier. But Piszczek said biofeedback has been worth the price.

CHADD, a national nonprofit group of children and adults with ADD, has taken no official position on biofeedback therapy.

But Martin will address CHADD's local chapter at its Tuesday meeting at Cuyahoga Falls General Hospital, 1900 23rd St. The 7:30 p.m. meeting is free to the public.