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Pioneering ADHD treatment with brain exercises

Posted By Batsheva Pomerantz On December 18, 2007 @ 3:02 pm In | No Comments

Dr. Amnon Gimpel: The trouble with Ritalin is that it doesn’t solve the problem.Brawn for the brain is part of a cure to Attention Deficit Hyperactivity Disorder (ADHD), according to Dr. Amnon Gimpel. The Israeli physician has developed a comprehensive proven approach to treat this medical condition suffered by 9.7 percent of American children. According to new studies published in September, only 35% of those diagnosed receive treatment.

Gimpel’s book Brain Exercises to Cure ADHD was published last week by BookSurge Publishing, a subsidiary of Amazon based in North Charleston, South Carolina, and will be followed by Hebrew and Russian translations

“By nature I’m eclectic, not a purist. I’ll use in my approach whatever works for effective treatment,” says Gimpel. ADHD is a neurological condition that causes impulsivity, poor concentration, and hyperactivity beyond the control of the child.

Gimpel’s first-hand knowledge of ADHD comes from his family history, with four generations coping successfully with the condition. “Back in the 1940s my mother realized that certain cognitive tasks were difficult for her. So she learned languages and thus without her realizing it – she increased her brain mass,” Gimpel told ISRAEL21c.

Gimpel tackled his own ADHD with brain exercises which created new pathways. And his son, also an ADHD sufferer, is today a successful businessman, studied in a yeshiva, has a university degree and throughout the years has engaged in sports.

Born in Jerusalem, Gimpel traveled to the US in 1964 after his IDF service. He studied medicine at Oklahoma Medical School and is an Israel and US board certified neurologist and psychiatrist from Emory University in Atlanta, Georgia. Over his years in the US, he has helped many young people, and recently returned to Israel to resume his practice.

Gimpel’s professional interest in ADHD started when he worked with children and adolescents at a time when ADHD generally went undiagnosed. “In the past, these children were labeled as having inappropriate behavior which led to conflict at home and in school,” Gimpel said. “Uncontrolled ADHD leads to agitation which triggers anti-social behavior like alcoholism, drug addiction and delinquency.”

In the 1980s Gimpel established the first out-patient hospital for chemical dependency in the US, approved by the American Hospital Association. Until his revolutionary approach, alcoholics and drug addicts who underwent detoxification treatment in hospitals returned to their addictions upon release.

As director of the adolescent day program at Atlanta’s Brawner Hospital, Gimpel developed a new program to help adolescents deal with the many challenges they were facing. At the afternoon program, they developed coping mechanisms to manage the stresses they encountered during the day. They then returned with new skills to their school and home environments rather than extensive hospitalization. This became the standard popular treatment for chemical dependency. Not surprisingly, many of these adolescents and adults had undiagnosed and untreated ADHD.

Educators, health professionals and parents of ADHD children are familiar with the debate about the use of Ritalin and similar medications to control ADHD. In the brain, when lower levels of the neurotransmitter dopamine are among the causes of ADHD, stimulant medications like Ritalin increase the levels of the dopamine and allow for more efficient use of the brain.

“Ritalin is effective and has a positive impact,” maintains Gimpel. “However, the trouble with Ritalin is that it doesn’t solve the problem. Once the Ritalin wears off, so does its effect on enhancing concentration.”

Gimpel quotes Harvard University researchers who recently reported the finding that the brain’s perifrontal lobe which controls executive functions like attention, judgment, and reflection is 8%-14% smaller in those with ADHD. In addition, the cerebral cortex lining the brain is 6% thinner in ADHD people. The cerebral cortex plays a central role in memory and attention.

“People with ADHD have a normal size brain, but since the perifrontal lobe is smaller, functions are switched to other parts of the brain. That’s why many ADHD people are creative,” notes Gimpel.

The methods used in Gimpel’s approach build the brain’s mass to create new pathways. He also conducts therapy and coaching of parents. “I’ve seen people with ADHD improve tremendously by being involved in physical activities that build up motor skills and balance. These include aerobics, swimming, skating and running. An Israeli daily recently reported on an unmanageable adolescent who joined a boxing club. He completely changed within months, especially his impulsivity,” said Gimpel.

Children are more receptive to a sports coach after school hours, rather than a teacher who can be more demanding. Other brain exercises include playing chess which increases memory and stretches concentration spans. A different form of exercise developed by Gimpel help kids differentiate between their emotions and the actual events that triggered the emotions.

“Children with ADHD have trouble expressing themselves, especially feelings. They become depressed and agitated after a teacher scolds them, carrying negative feelings around for days. They have to be taught social skills,” he said.

Working together with parents, Gimpel’s multi-faceted approach combines training of social, emotional, and cognitive skills which include developing language and solving problems. The parents’ role as coaches is crucial in the success of the treatment. “Coaching parents are in effect therapists – for their children and themselves, too. Research shows that the parents of 80% of ADHD children have the same condition, too. Imagine the explosive situation when a parent with ADHD sees his teenager’s behavior as defiant. The sensitive, frustrated parent becomes rigid, and thus closes the avenue of communication. Parents are taught to think differently,” Gimpel said.

His seminars in Jerusalem, partially funded by one of Israel’s leading health funds, are increasingly popular.

“In addition to saving money on medication, the health fund realizes that ADHD children often end up in emergency rooms since they are more accident prone,” he said.

The goal of the seminar is to empower parents. Parents are given the information, knowledge and skills that will enable them to help the ADHD child improve brain function, by sharpening thinking skills, training in life skills such as problem solving and negotiation, and vigorous mental and physical exercise.

“Before the diagnosis of ADHD, most parents misinterpret their child’s behavior, calling him lazy or undisciplined. Once they recognize what triggers the problem, they can then tackle it. A coaching parent as opposed to an authoritarian parent can react cooperatively and help the child overcome the challenges of ADHD.”