ADD / ADHD, ADD / ADHD Diagnosis, ADD / ADHD Medication, ADD / ADHD Treatment, Digital Fitness, Dore Achievement Centres, Dyslexia, Dyslexia Testing & Diagnosis, Dyslexia Treatment, Dyspraxia, Medication, Memory, Music, Nintendo DS, Nintendo Wii, Rhythm Games, Wii Fit

One of the reasons I started this blog was because I was interested in creating a cerebellum training program that was quicker, more effective than Dore. Myomancy was my notebook of interesting technology and relevant science. Over the years I’ve examined many different approaches to the treatment of dyslexia and ADHD. Some were simply nonsense, others had promise but were lacking the scientific, technological or business resources to make them viable. Some lacked the ethical honesty necessary when selling products to parents desperately worried about their children.

Slowly overtime I refined my ideas about how cerebellum training should work and how a independent company without much in the way financial resources could develop and sell such a product in an ethical manner. One main stumbling block has been the cost and availability of the technology necessary to track a user’s limb movements and balance. So I’ve been watching the progress of the Wii and latterly the Wii Fit with interest. The technology needed for cerebellum training was finally cheaply and readily available. What’s more many people already own it.

Originally I intended to make an announcement after slowly develop a proof of concept over the next few months but with the collapse of Dore and the shadow that will cast over the cerebellum training field, I’ve decided to move my plans forward. So I’m pleased to announced the creation of WyyMi, a project to create a free, open-source, open-science cerebellum training program.

What is WyyMi?
WyyMi is a project to develop a cerebellum training program to help people with dyslexia, ADHD, dyspraxia and similar educational problems.

Project Goals
To develop a system that cost nothing (or as close to nothing as possible) to use; to do it using open-source software; and to make freely available as much scientific evidence on its effectiveness as possible.

How Will It Work?
The idea is to use cheap and easily available computer hardware that can monitor and assess gross motor movements and balance. At the moment the Wii Remote and Wii Fit Balance Board seem the best candidates but they need to be adapted to work on PCs and Macs because the Wii console itself is difficult to develop for.

Using this hardware and software on the website, users will be perform a series of exercises. The amount of time spent training and the accuracy of the user’s movement will be logged on the server so that the user can track their progress and so the server can inform the user which exercises to do next. This data will also be aggregated, made anonymous and published so that it can be analyzed by any interested 3rd party. Ideally, symptom specific measures (e.g. spelling tests) will also be included so that the training programs effectiveness in treating educational problems can be measured.

Other than a broad statement of goals and the planned route for achieving them, there is nothing else on site at the moment. Progress is likely to slow, not least because I am working on another project at the moment as well maintaining my existing portfolio of web sites. If you wish to help in anyway, please see the announcement for ways you can contribute, not matter what your skills are.

Myomancy will be continuing to report on anything and everything I think is relevant to dyslexia, ADHD and autism. Obviously as I am planning to create my own training program, that might create a conflict of interest when discussing other people’s approach. I will try and be as unbiased as possible and make my conflict of interest clear.

ADD / ADHD Treatment, Digital Fitness, Dore Achievement Centres, Dyslexia Treatment, Nintendo Wii, Wii Fit

With the financial collapse of Dore in Australia, it is inevitable that questions will be because its ask about the long-term future of cerebellum training. The financial problems are Dore will cast a shadow over this approach to dyslexia and ADHD but I don’t believe it will kill it. Why? Partly because it works for some people but mostly because Dore is irrelevant to the future.

One of Dore’s key selling points was a personalised program based on the six weekly check-ups using their hi-tech balance machine. However that advantage has gone or will be gone in the next few months. The worldwide release of the Wii Fit Balance Board put a hi-tect balance machine in people’s living rooms for £69.99.

The balance board is not any use without some software and the Wii Fit software that comes with it, whilst good for general balance training, is nowhere near a replacement for Dore. Unfortunately developing software for a console like the Wii is expensive because of licensing issues and the special tools need to write the software. So its unlikely any company involved in cerebellum training will have enough money to pull it off.

However, the Wii Fit balance board can also be made work with PC’s and Macs. At the moment the software is a hack, a quick & dirty solution, but over the next few months these will stabilize and become easier to work with. Now, any one with a bit of programming skills and a good knowledge of cerebellum training could create a great dyslexia / ADHD orientated training program. One that personalises the training plan every time it is used, not once every six weeks.

Of course, the any training program would need to be tested and validated. Once again, technology can allow the little guy to do this on a budget. Anyone using the training system can sign-up to be part of the trial. Via the internet they can automatically log their usage and fill out regular questionnaires on symptoms or take online reading tests. All this data can then be anonymised and placed online so that anyone, pro or anti cerebellum, can analyse that data. Such a study would have many problems, not least the self-reporting aspect of it, but if the training works there should be a strong signal in the data to warrant more detailed studies.

ADD / ADHD, ADD / ADHD Medication, ADD / ADHD Treatment, Medication

What is Intuniv?

Intuniv is the latest ADHD drug from Shire PLC, the makers of Adderall XR, for tackling ADHD and it marks a big change in potential treatment options. It is not a stimulant like Ritalin or Adderall but instead its a selective alpha-2A receptor agonist. More simply, the active part of the drug helps specific parts of the brain to function more effectively. The key to making it an effective ADD medication is that it targets the area of the brain relating to the central nervous system. This, in theory has a calming effect, suppresses the fight / flight response and allows the normal functioning of the brain.

Secret Ingredient

Intuniv is based on the drug Guanfacine (also known as Tenex) that is used for treating hypertension and blood pressure. In 2006 the makers applied to FDA to allow its approval as a treatment for ADHD and this was granted in June 2007. However Guanfacine is only effective for a few hours before the patient has to take more pills. In the ADHD market, parents want to be able to give their child a tablet in the morning before school and have it working all day. This makes life easier for the school who no longer have to give out medicines at lunch time.

Adderall XR has been very successful for Shire PLC because it proved to be an effective, time release version of the standard stimulant used in Ritalin. Intuniv is very much in the same mold. Taking the existing drug Guanfacine and repackaging it in a time delayed formula. It is not clear exactly how it works but most likely it will use the same system as Adderall XR. The pill effectively consists of two tablets, one of which dissolves quickly in the stomach providing an immediate dose, and the second tablet, protected by a special coating, dissolves a lot slower, delivering its medicine some hours later and at a slower rate. The effect is that the patient receives a continuous level of medication through-out the day.

Intuniv Trial Success

Intuniv has not yet been given full approval by the FDA. In a recent press release, Shire stated that a 25% reduction in ADHD symptoms were seen in children compared with a placebo. This sounds good but remember this against children receiving no treatment. How effective it is versus Adderall XR or non-medical interventions has not been measured. It is also worth remembering that Shire PLC are selling Intuniv and will therefore be putting the best possible spin on their results. Independent researchers often find that real-world results do not match up to the drug company’s trial results.

Side Effects and Other Health Worries

Unlike most other ADHD medications, Intuniv is not stimulant based and is not a controlled substance. This means it has no potential for abuse in the way that Ritalin etc have. This should mean the drug is safer to take for long-periods of time but there has been no research in this area.

Unfortunately the story with side effects is not so good. Over 80% of children using it ireported adverse events (medical problems) during the 20 day trial. Most are unconnected to the drug and represent the normal childhood health problems but only 71% of users on the placebo had adverse effects. This is a significant difference and clearly shows that Intuniv has health risks. Adverse events reported include somnolence (32 percent), headache (26 percent), fatigue (18 percent), upper abdominal pain (14 percent) and sedation (13 percent) plus constipation, dizziness, dry mouth, hypertension and sedation. Shire PLC describe these as non-serious problems and highlight that fractionally less children on the drug developed serious problems compared to the placebo.

ADD / ADHD, ADD / ADHD Medication, ADD / ADHD Treatment

We have looked at Caffeine as a treatment for ADHD before and the science indicated that it could have some benefits. As a footnote to this Wired has a report that regular small doses of caffeine are more effective than one single large dose.

Throughout the day, your noodle fills up with adenosine, a chemical thought to cause mental fatigue. Caffeine blocks the brain’s adenosine receptors, countering the chemical’s dulling effects. To maximize alertness and minimize jitters, keep those receptors covered with frequent small doses — like a mug of low-caf tea or half a cup of joe — rather than a onetime blast. Test subjects reported that periodic small shots made them feel clearheaded and calm, both of which enhance mental performance. Even better, add a lump of sugar or have a carbohydrate-rich snack at the same time for an extra cognitive kick. It seems that glucose and caffeine together do more to enhance cognition than either does alone.

Source: Caffeinate With Care: Small Shots Do a Brain Better Than Big Blasts. Note no reference to the research is given so please take this data with a large pinch of salt.

ADD / ADHD Treatment, Digital Fitness, Dore Achievement Centres, Dore Sport, Dyslexia Treatment, Nintendo Wii, Wii Fit

One of the short comings of the Dore program and all movement based treatments is the low level of feedback you get when doing the exercises. Without someone watching you and checking the instructions for an exercise, its very hard to tell if you are doing them correctly. This is a major problem for people who cannot tell left hand from right and could easy spend ten minutes doing an exercise without noticing they are doing it completely wrong. Of course having someone to help is ideal but for adults doing the course that isn’t always possible and for children, it demands a great deal of time from other members of the family.

Its partly because of this problem that I’m interested in how technology can help deliver training programs like Dore. Computers or games consoles are the perfect way to monitor the exercises and provide feedback so that the exercisers knows they are doing it correctly. This reduces wasted time, improves the rate of progress and most importantly, reduces the demand on the rest of the family. This all adds up to a more effective treatment with a lower drop-out rate.

One technological development that has a lot promise is the slowly emerging 3D cameras. These are not strictly speaking 3D cameras, instead they use a variety of methods to identify depth and distance. This information is then passed back to the computer which can use it to workout if objects are moving towards it or away from it. Something that is very hard to do with a traditional camera.

The best demonstration of this technology I can find is this Second Life demonstration. Second Life (SL) is a virtual reality world shared by many thousands of people. Using a mouse and keyboard the players moves their avatar through the world but in this demo, a 3D camera is used to track the players movements.

It is not hard to make the leap from this demonstration to a computer program that tracks how well the person does does an exercise. We are already seeing this sort of approach in Wii Fit. More demonstrations of the technology are available from the makers of the camera. Here, an on-screen avatar mimics the movement of a real person and in this one, the player is throwing and catching a virtual ball. More are available from 3DVSystems.

ADD / ADHD, ADD / ADHD Treatment, Digital Fitness, Dore Achievement Centres, Dyslexia, Nintendo Wii, Wii Fit

The Wii is showing great potential for physical and mental skills training. The nature of the Wii’s controls plus the add-ons like Wii Fit‘s balance board mean its can be used to track and sense all sorts of movements and actions. Just to show the potential of the Wii, a grad student called Johnny Chung Lee has come up with a way to track your head movements. He’s used this create a prototype virtual reality system which you can see in the video below (skip to 2:45 if you are not interested in the technical stuff).

Virtual reality may be great for games but from neurological training point of view its not that interesting. Its the other potential uses for the head tracker that interests me. A Wii head tracking combine with the balance board allows the Wii to track many of the movements used in the Dore system and other movement based approaches to dyslexia and ADHD. A computerised system will have an advantage over the traditional approaches as it can give feedback on how well the exercise is being done and control its difficulty to reflect the skills of the user.

ADD / ADHD, ADD / ADHD Treatment, Digital Fitness, Nintendo Wii, Rhythm Games, Wii Fit

A couple of days ago I posted about a theoretical iLearn device based on iPhone technology. The main point being that cheap, powerful technology can be used to teach small children basic skills such as rhythm. Today a firm called Emotiv Systems have announced a cheap ($300 is cheap for this technology) headset that monitors brain activity for controlling games.

Biofeedback using devices that monitor brain activity has been tried to treat a number of neurological problems including ADHD. Play Attention are the market leaders in this area with their $1700 dollar system. Good scientific research in this area is thin on the ground (see this for more detail) but the idea is sound in principal. If you can learn to clam your mind, the problems of impulsiveness and hyperactivity should be reduced.

If there is some way combine Emotiv’s headset with the electronic balance board in Wii Fit then you have the basis of a very effective brain and body training system. With well designed games and a gradual progression from easy to hard, such a system should be able teach children to calm their minds and control their bodies at the same time. This would bring the same improvement in control as, say, learning a martial art to a high level but in a form that is easier to learn, with better feedback and generally more convenient. For the company that gets this right, there is a multi-billion dollar market to be taken from the drug firms.

Source: Brain control headset for gamers

ADD / ADHD, ADD / ADHD Diagnosis, ADD / ADHD Treatment, Dyslexia, Dyslexia Testing & Diagnosis, Dyslexia Treatment, Music, Nintendo Wii, Wii Fit

The Corpus Callosum is a large structure in the brain that connects the two hemispheres. Its roll is to pass information from the left hemisphere to the right and vice versa. This is a vital as the two hemispheres perform different tasks and need to communicate efficiently. The Corpus Callosum has been linked by scientists to dyslexia and ADHD for a long time. They theorize that the problems in these conditions may be caused by insufficient information passing between the two halves of the brain.

Plenty of research has been done on the size of the Corpus Callosum in dyslexics and in children with ADHD and the results have generally found a correlation. Its seems that the anterior region of the Corpus Callosum was significantly smaller in the dyslexic children. However the results are not clear cut with at least one study has found no difference in dyslexic versus non-dyslexic children and another study on adult, male dyslexics found areas of the Corpus Callosum were larger that normal.

These variation in results may have several causes. How the study defines dyslexia when selecting there sample population may make an impact. The sophistication of the equipment used is important. Some of these studies date back to the early 1990’s when fMRI technology was still new so the ability to accurately measure the Corpus Callosum may of been poorer. Our knowledge of the brains structure has also improved and later studies have tended to focus on specific areas of the Corpus Callosum, partially areas linked to the processing of sounds. However, with a lot of maybes and provisos it does look like the Corpus Callosum in dyslexic and ADHD children is subtly different.

Being able to efficiently pass information from one half of the brain to the other is vital. Much like a road between to busy cities. The better the road, the more information, wealth and trade will flow between the cities. So in dyslexic and ADHD children this road may be poor and restricting vital traffic. But there is hope that this roadway can be improved.

Its has been found that the Corpus Callosum was larger in professional musicians than in non-musicians. Playing instruments involves a lot of cross hemisphere processing to keep both hand’s movements in time with each other. This suggest that by regular practice the Corpus Callosum can be strengthen. The Dore Program, Interactive Metronome and primitive reflex based treatments such as INPP all involve cross-lateral movements designed to train this area of the brain. Other activities may also help. Such as computer games like Wii Drums and some aspects of Wii Fit may also help.

If you would like to try out your Corpus Callosum, have a look at this test on Mind Hacks. You will need a friend to help you but otherwise it is an extremely simple demonstration of what the Corpus Callosum does.

Studies

Dyslexia and corpus callosum morphology
Magnetic resonance imaging of the corpus callosum in developmental dyslexia
Corpus callosum morphology, as measured with MRI, in dyslexic men
Developmental Dyslexia: Re-Evaluation of the Corpus callosum in Male Adults
Less developed corpus callosum in dyslexic subjects—a structural MRI study
Increased corpus callosum size in musicians

ADD / ADHD, ADD / ADHD Treatment, Balance & Coordination, Brain & Body, Digital Fitness, Dyslexia, Dyslexia Treatment, Music, Nintendo Wii

Doing the post on the Wii Drums remindered me of a book I wanted to write about. Its 4-Way Coordination: A Method Book for the Development of Complete Independence on the Drum Set . I forget how I found it but it immediately got my attention as a way of learning cross-lateral and limb-independent movements. Drummers need to be able to use each of their four limbs independently from each other and this takes a lot of time to learn. Education problems such as dyslexia and ADHD are linked to a poorly developed cerebellum, the part of the brain that controls the limbs, and retained primitive reflexes which restrict limb movements. Training regimes such as the Dore Programme teach children (and adults like myself) how to use their bodies. If this book has a good training method for limb independence that doesn’t focus on drumming it could be and effective resource of parents.

Here is what one of its reviews says:

You don’t need a drumset to work it — all you need are hands and feet to
get better. the “score” is set out in various patterns of LH,RH, LF, RF
(left hand, right hand, left foot, right foot). So if you can’t get
enough of drumming, take this on the road with you for vacations, work
trips, whatever and work on breaking the mold. The floor, your knees
and any flat surface in front of you will do for practice.

This is one of the few drum books you can literally practice from
anywhere at anytime with nothing but the book and you.

I’ve ordered a copy and will be reviewing it soon.

ADD / ADHD, ADD / ADHD Medication, ADD / ADHD Treatment, Autism, Autism and Mercury, Autism Treatment, Dore Achievement Centres, Dyslexia

Are we too quick to medicate children?, a good round-up of the issue from the Las Angeles Times. Whilst The Guardian has a piece on the rise of students using brain boosting drugs such as Ritalin

The Spoof! has a short piece on PHADD (Pseudo Hyperactivity Attention Deficit Disorder)

Questionable Study Claims ADHD is Under-Diagnosed

Good Vibrations, a new, drug-free treatment for ADHD?

Understanding Chelation therapy, a brief round-up of this dubious autism therapy.

National Institutes of Health will intensify its efforts to find the causes of autism.

No explanation for ‘scary’ rise in autism in New Zealand

A Dore Program presentation at the Hallowell Center in Sudbury, MA.

Experts Demand End to Child Drugging in the US.

Shire reveals the effect size for it ADHD medication, Vyvanse.

Study on Concerta shows significant effect on ADHD sufferers.