In 1992, after over a decade of clinical success treating stress disorders with biofeedback and neurofeedback, the Drake Institute of Behavioral Medicine decided to apply similar technology enhanced by the addition of qEEG brain mapping to develop a highly effective inattentive ADD treatment option without medication.
Today, the Drake Institute’s non-medication treatment for ADD continues to significantly improve the quality of life for patients from around the world, with a clinical success rate of approximately 80%.
For historical accuracy, the diagnostic term ADD (Attention Deficit Disorder) was actually discontinued in 1994 by the American Psychiatric Association's published manual, the DSM-IV, and replaced with the diagnosis of ADHD (Attention Deficit Hyperactivity Disorder) consisting of 3 subtypes:
The DSM is used to classify recognized mental health disorders. In 2013, the new DSM-5 redefined ADHD once again into 3 main subtypes:
However, many families are confused with the diagnostic label of ADHD (Attention DeficitHyperactivity Disorder) when their child or the adult who is experiencing symptoms of the disorder has never been hyperactive nor impulsive.
Many ADHD patients only show "inattentive symptoms", exhibiting no sign of behavioral problems or disruptiveness. In fact, the child with ADHD may be extremely well behaved, but have noticeable difficulty with sustaining concentration effectively on non-preferred tasks, such as academic studies or homework.
Today, the child who would have been diagnosed with ADD (without hyperactivity) before 1994, is now diagnosed as having ADHD-Inattentive Presentation, which again can be confusing.
Accordingly, at the Drake Institute, we still find the former label of ADD to be an accurate description of a distinct or clearly defined group of characteristics in patients diagnosed with ADHD who only exhibit the "inattentive symptoms" of the disorder.
Children with only the inattentive symptoms of ADHD, previously diagnosed with ADD, are less likely to be diagnosed and helped as early as children who are hyperactive and impulsive.
The inattentive type ADHD child is typically well behaved and does not disrupt the classroom. Frustrations with the child failing to complete homework on their own may be the only visible concern until the child reaches third grade when he/she is expected to work more independently; or in 6th grade when the ADD child can become overwhelmed with trying to remain organized and keeping up with multiple teachers.
Kids with ADD have to deal with much more significant challenges when attempting to complete non-preferred tasks. This trouble makes them far more likely to experience the feeling of being overwhelmed by tasks that other kids their age would not have trouble completing.
Girls with ADD are less likely to be hyperactive than boys, and typically do not show the disruptive behaviors frequently exhibited by ADD boys.
Consequently, girls may get diagnosed at a later age. In addition, girls with ADD or ADHD may not show significant inattentive symptoms until middle school or high school, and their symptoms can actually increase with puberty as their estrogen levels rise.
ADHD, including the Inattentive Presentation, is a neurodevelopmental disorder. Brain frontal lobe abnormalities have been found to be different in ADD boys compared to those identified in ADD girls.
These findings provide insight into understanding why ADD often manifests differently in boys versus girls. Research has shown that ADD boys have brain abnormalities in areas involved with inhibition (impulsivity and hyperactivity), whereas girls are more likely to have brain abnormalities in areas involved in executive functioning.
The consequences for failing to treat ADHD-Inattentive Presentation (formerly ADD) as early as possible in a child's or adolescent's life can damage much more than one’s ability to concentrate. In fact, untreated ADHD or ADD can negatively change the trajectory of a person's life and future by increasing their vulnerability to many problems that someone without ADD would not have to face.
As an example, a landmark study from the Mayo Clinic published in the medical journal, Pediatrics, followed ADHD children into adulthood and confirmed that many children do not outgrow ADHD (as was previously thought). The same study showed that these untreated children can face an increased risk as adults for psychiatric disorders such as depression, anxiety, substance abuse or substance dependency.
In addition, untreated ADD children are less likely to graduate high school and college, earn lower incomes, and have an increased incidence of employment problems and marital conflicts.
Incomplete assignments, underachievements, battles with homework, focusing challenges, and forgetfulness can all take a significant toll on the ADD child and his or her parents.
In response to these familial struggles, the Drake Institute developed the FullCare treatment program, which includes reviewing ADD’s impact on the family, providing support for family members in addition to patients.
Because ADD disrupts so many different areas of the family’s life, the Drake Institute firmly believes that FullCare is essential to maximize the chances of fully healing the patient and their family.
The inattentive type of ADHD may first manifest as an hour’s worth of homework taking three hours to complete, all with a parent having to be overly involved. Other signs include the child forgetting to turn homework assignments into their teacher even when they’ve been completed, or reports that the child’s teacher frequently has to redirect the child’s attention back onto classroom tasks.
Often the ADD or ADHD-inattentive child exhibits deficits in executive functioning (planning, prioritizing, organizing, time management, self-monitoring, etc.) that becomes increasingly problematic as academic workloads grow heavier, and especially as children move into middle school.
Sometimes, gifted children with the Inattentive Presentation of ADHD are able to compensate for their disorder and get through elementary school on raw intelligence, but when they reach middle school, many of these same children will begin falling behind academically.
The new executive function challenges presented by middle school, where the student will report to 5 or 6 different teachers, rather than their single teacher from elementary school, often overwhelm the ADD or ADHD-inattentive child. Consequently, even though they may be extremely bright, that intelligence alone is no longer enough to allow them to succeed.
The ADD child’s neurophysiologic deficit in executive functioning was an underlying weakness that didn't become symptomatic until they experienced a greater requirement for self-regulation and self-monitoring in middle school.
All of the sudden, the ADD child in middle school becomes overwhelmed by simple organizational tasks, has difficulty prioritizing assignments from multiple teachers, and experiences trouble when faced with the need to adjust to different teaching styles.
As the child begins to fall behind due to the difficulty of completing all of their work, grades begin to drop, self-confidence or self-esteem suffers, and the child may become increasingly frustrated, overwhelmed, and eventually unmotivated. This is why ADD children and adolescents face an elevated risk for new emotional problems, including anxiety and depression.
When the untreated ADHD-inattentive or ADD adolescent goes off to college, their symptoms may noticeably increase since they’re now truly on their own, and working without the advantage of a supportive, structured home environment.
Often times, even very bright children who made it through high school were only able to do so because their home environment helped compensate for their neurophysiologic limitation with executive functioning.
When this individual gets to college, and their parents are no longer close at hand to act as a “safety net”, the ADD adolescent can become quickly overwhelmed since they’re no longer being micromanaged.
Typically, ADD or ADHD-inattention symptoms are caused by dysregulation in the frontal region of the brain (those areas responsible for sustaining attention and focus).
People suffering from this disorder may be unable to sustain focus for an extended period of time on non-preferred tasks such as homework or classwork, even though they may be fully capable of concentrating on preferred tasks like video games or computer games for hours on end.
Even excellent parenting is incapable of normalizing an ADD child’s frontal lobe dysregulation, no matter how hard one tries.
On the surface, while it may appear that the child is willfully lazy or unmotivated, the reality is that they simply do not have the fully-developed and adequately functioning neurobiological capacities to be able to succeed with age-appropriate demands.
Where ADD is present, the brain can be literally stuck in abnormal brain wave patterns, showing imbalances in either slow or fast brain wave patterns, which can be the root cause of ADD symptoms. Either type of disrupted functioning can negatively affect the attentional and executive functioning systems in the brain, even within people who are highly intelligent.
Below is an image showing the “before and after” brain map of a patient who learned to normalize their brain’s frontal lobe brain wave patterns by completing our neurofeedback treatment program. As a result of completing our treatment and normalizing brain functioning, this child’s quality of life was remarkably improved. Our patients report a remarkable improvement in their life experience when their brain is functioning more within normal limits.
In addition to brain wave abnormalities, ADD patients also frequently exhibit abnormal functional connections between different areas of the brain, which results in less efficient and slower processing speed of information. In these cases, the "wirings of the brain" are inadequate, leading to reduced functional brain connections.
An analogy to this situation would be a delivery driver stuck on the freeway in traffic with only 3 functional lanes, so traffic is moving very slow and the delivery driver is unable to make his delivery on time. If the freeway were to create 4 additional lanes for traffic to move through, then traffic would move normally and efficiently, allowing the delivery driver to make his delivery on time. This is one of the core benefits resulting from brain map guided neurofeedback.
Some consider the Drake Institute’s non-drug treatment regimen as a “natural treatment for ADD”, simply because it does not rely on medication, but we do want to make it clear that our treatment process is scientifically-based and supported by both FDA-approved technology and qEEG brain map analysis.
Our ADD patients learn to use their own brain’s resources to develop healthier connections and more normalized brain wave activity, which reduces or resolves their ADD symptoms. Compared to drug-based ADD treatments, which only temporarily suppress symptoms, our treatment process can lead to long-term improvement.
Our medical director, David Velkoff, M.D., develops and prescribes each patient's neurofeedback protocols on an individual basis, ensuring that treatment will target the specific dysfunctional areas and connections responsible for creating the patient’s symptoms.
Through neurofeedback, our patients can learn to strengthen connections involved in focus, concentration, and executive functioning, leading to a reduction or resolution of their ADD symptoms.
Research completed at the University of Montreal's Mind/Brain research lab, published in the scientific journal, Clinical EEG and Neurosciences, has shown that neurofeedback training/treatment increased both brain volume and brain connections in areas involved in "attention", which correlated with improved auditory and visual sustained attention.
This study was a milestone in proving that neurofeedback training can lead to structural changes in the brain that lead to improved brain functioning. Sometimes, it is helpful to think of neurofeedback for ADD or ADHD as analogous to "physical therapy" for the brain, with the results being self-generated by patients’ activity.
A child with ADD or ADHD-inattentive presentation can be successfully treated without drugs, leading to successful development and an improved quality of life. The Drake Institute's treatment process can improve the trajectory of the child's brain maturation and development to help optimize brain functioning, resulting in reduction or resolution of ADD symptoms.
While it’s better to start the treatment process as early as possible, it is never too late to treat ADD, even in adults. The sooner treatment is offered, the less likely a patient is to face cumulative struggles, under-achievements, frustrations, development of unhealthy defense mechanisms and emotional problems, damaged self-esteem and loss of motivation, but our ADD treatment process can dramatically improve quality of life for people facing ADD challenges at any age.
Get help for you or your loved ones by contacting us to arrange a screening consultation at no charge.
Interview with Dr. David Velkoff
Interview with Dr. David Velkoff
Spanish News Feature
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“David F. Velkoff, M.D., our Medical Director and co-founder, supervises all evaluation procedures and treatment programs. He is recognized as a physician pioneer in using biofeedback, qEEG brain mapping, neurofeedback, and neuromodulation in the treatment of ADHD, Autism Spectrum Disorders, and stress related illnesses including anxiety, depression, insomnia, and high blood pressure. Dr. David Velkoff earned his Master’s degree in Psychology from the California State University at Los Angeles in 1975, and his Doctor of Medicine degree from Emory University School of Medicine in Atlanta in 1976. This was followed by Dr. Velkoff completing his internship in Obstetrics and Gynecology with an elective in Neurology at the University of California Medical Center in Irvine. He then shifted his specialty to Behavioral Medicine and received his initial training in biofeedback/neurofeedback in Behavioral Medicine from the leading doctors in the world in biofeedback at the renown Menninger Clinic in Topeka, Kansas. In 1980, he co-founded the Drake Institute of Behavioral Medicine. Seeking to better understand the link between illness and the mind, Dr. Velkoff served as the clinical director of an international research study on psychoneuroimmunology with the UCLA School of Medicine, Department of Microbiology and Immunology, and the Pasteur Institute in Paris. This was a follow-up study to an earlier clinical collaborative effort with UCLA School of Medicine demonstrating how the Drake Institute's stress treatment resulted in improved immune functioning of natural killer cell activity. Dr. Velkoff served as one of the founding associate editors of the scientific publication, Journal of Neurotherapy. He has been an invited guest lecturer at Los Angeles Children's Hospital, UCLA, Cedars Sinai Medical Center-Thalians Mental Health Center, St. John's Hospital in Santa Monica, California, and CHADD. He has been a medical consultant in Behavioral Medicine to CNN, National Geographic Channel, Discovery Channel, Univision, and PBS.”