“Children end up in this line to be tested based on teacher referral, and teacher referral is complicated,” Fenwick said. “Ninety percent of the behavioral referrals come from 10 percent of the teachers, and those teachers tend to be the least effective teachers.”
“Effective teachers tend to have fewer students acting out in their classes,” Fenwick explained, “because they have effective teaching practices.”
Fenwick said the clinical study for the device should have included more than the 275 children studied and had more diversity.
Como said the study met the FDA’s standards and was “fairly well geographically distributed” over 13 testing sites. “In order to be on market, the sponsor had to conduct a pretty rigorous clinical study,” he added.
Seventy-three percent of the 275 children studied were white, and 27 percent were non-white, including 46 African-Americans (17 percent). Yet, black children are diagnosed at nearly the same rate according to 2004-2006 CDC statistics.
In the study, boys accounted for 64 percent of the children studied, with girls making up 36 percent. The average age of the children studied was 10 years old.
How the Device Works
The study was sponsored by NEBA Health, which is based in Augusta, Ga., and developed the Neuropsychiatric EEG-Based Assessment Aid (NEBA) System.
The NEBA System is a non-invasive test that lasts 15 to 20 minutes. It’s based on electroencephalogram (EEG) technology and involves the placement of electrodes and gel on a child’s head. “There’s no risk other than the need to wash your hair afterwards,” Como said.
The test calculates the ratio of the brain’s theta and beta waves, which is higher in children and adolescents with ADHD, according to NEBA and the FDA.
“Without adequate sampling of African-American children in the study population, how do we know that this statement is true of African-American children with ADHD?” Fenwick asked. The accuracy rate for African-American children in the study was 85 percent compared to 90 percent for whites.
Foreman said that the NEBA system “could help with reducing the amount of prescribed medication,” but cautioned that the FDA didn’t have supporting data.
The CDC notes that 66 percent of children diagnosed with ADHD are on medication, a notion that sends chills up the spines of some parents.
“Some people need medication, and some don’t,” Dr. Bailey says reassuringly. “Unrealistic fears block people from treatment.” However, he advocates second opinions if parents aren’t comfortable with their child’s diagnosis and treatment.
“The first thing that people have to be aware of is the normative criteria,” Dr. Bailey says. All five of the following must be present to begin establishing a diagnosis of ADHD and should be confirmed before using the brain-wave test:
- The patient must have at least one of the behavioral symptoms of ADHD — hyperactivity, inattention or impulsiveness
- “Symptoms must have existed prior to age seven,” Dr. Bailey says. “It’s a neurobiological disorder. It starts early. It doesn’t just show up later based on a stressor in life.”
- The individual has “functional impairment,” such as being retained in a grade or having difficulty keeping a job.
- “There must be difficulty in more than one domain in life — home and school for a child; home and work for an adult.” If problems exist in just one environment, it could be a “psycho-social problem between individuals.” This might include Fenwick’s example of a gifted but rambunctious boy and a teacher who doesn’t know how to challenge him intellectually.
- “It cannot be due to a medical problem,” Dr. Bailey explains. “It’s got to stand on its own feet.”
The important thing, Dr. Perrault says, is “what does the diagnosis mean?”
He then zeroes in on a child’s strengths to really tailor treatment and maximize his or her gifts.
In addition to appropriate medical treatment, a creative child might benefit from music lessons or art classes while a linguistically gifted child could learn a new language. The energy of a physically active child might be channeled into sports. “There’s a reason they have all that energy,” Dr. Perrault points out.
He also cited the example of a famous rapper who might have avoided dealing drugs and the ensuing legal issues if he had been properly diagnosed as a child and mentored by an entrepreneur or music producer. “I think ADHD is the entrepreneur gene,” he says.
The bottom line, he adds, is that “treatment should play to the strength of who you are.”
The ADHD Action List
- Trust your gut. To ease your mind about signs and symptoms and try an interactive checklist based on the American Psychiatric Association’s test, and talk to your pediatrician.
- Join a support group. You can also find one in your area through CHADD.
- Know your rights. Learn about Section 504 of the Rehabilitation Act of 1973, and check out the Council of Educators for Students With Disabilities.
- Work with your school to set up an Individualized Education Plan (IEP) for your child.
- Consider tutors outside class and during the summer.
- Keep in mind that just because there are laws in place, your school might not know how to implement them. Many parents have had to educate educators. Karran Harper Royal said that she even drafted some of the plans that were implemented in New Orleans.
Yanick Rice Lamb is an associate professor of journalism at Howard University. Follow her on Twitter: @yrlamb.