ADHD, ADD, Inner Ear

 ADHD,ADD, Inner Ear, Dyslexia

from pages 235 - 244 of Smart But Feeling Dumb by Harold N. Levinson, M.D.

 

 

Hyperactivity, Overactivity, and Impulsiveness

 

The body's motor and energy levels are frequently improperly fine-tuned by the inner ear in dyslexia. The result is hyperactive, overactive--or even hypoactive or decreased--activity levels, as well as fluctuations between these different states.

Dyslexic children may initially show abnormal activity levels at an early age, even from birth. Some mothers have been reported feeling hyperactive fetal activity, clearly suggesting that hyperactive or motor racing states may occur prior to birth.

Hyperactivity is frequently distinguished by its onset. When this symptom occurs in the young or during the preschool years, it is frequently referred to as developmental in origin. If this hyperactive, overactive, or restless abnormal motor activity first appears in conjunction with school activity, it may be referred to as acquired.

Developmental activity forms are frequently viewed as being of physiological origin, whereas the acquired forms are thought to be of psychological origin. However, my studies clearly sho that the developmental and acquired forms may both be of physiological origin, although the acquired form is frequently milder in nature and thus requires the frustration and anxiety of school to trigger it so that it becomes belatedly recognizable. Morever, the analysis of the so-called developmental and acquired activity states reveals the presence of still another hidden dyslexic mechanism: the inability of an impaired inner-system to control, regulate, or dampen anxiety buildup. Hence, a dysfunction within this anxiety-regulation may result in greater degrees of frustration in so-called developmental than in acquired activity states. Thus, abnormal activity levels become more apparent earlier in the developmental state than in the acquired state.

My studies further demonstrate that severe hyperactivity is relatively uncommon in dyslexia. These wild states of "runaway" activity or perpetual-motion activity are most commonly observed in brain-injured children and adults. In contrast, mild degrees of hyperactivity and still milder forms of restless, fidgety, overenergetic activity, all of which I call overactivity, are most frequently observed in dyslexics.

High-activity motor levels or energy levels are frequently associated with a poor or lo frustration tolerance and result in impulsive, poorly thought-out behavioral and verbal discharges, such as cursing, temper outbursts, stealing, and truancy. And the need to discharge frustration and anxiety rapidly frequently leads to such negative defensive or maladaptive activities such as alcoholism, drug abuse, and a series of avoidance or phobic mechanisms: cutting school, avoiding work, and son.

Overactivity is frequently associated with the increased stress and frustration of school activities, and was termed acquired to describe this correlation. My research indicates that the added pressure of school does not invariably cause the abnormal regulation of activity (overactivity); it merely triggers and brings to the surface a previously hidden and compensated-for activity disorder. I therefore came to view "mild" hyperactivity, overactivity, and hypoactivity as mere variations on a common theme. As stated earlier, most often the reported distinction between developmental and acquired activity dysfunctions was found by me to be inaccurate--more apparent than real--and denoted the degree of disturbance rather than reflecting a separate causative origin.

There are several reasons justifying my view of hyperactivity, overactivity, and hypoactivity as merely degrees of the same disturbance:

 

Frequently, one state spontaneously slides into another and even back again.

Medications helpful for hyperactive states similarly benefit overactive and even hypoactive states.

These very same medications are helpful regardless of whether the abnormal activity is labeled developmental or acquired.

All three states appear to be similarly compensated for with time.

 

One will often read that hyperactivity or overactivity disappears by puberty and that medications are no longer needed or helpful afterward. Although this assumption is true for some dyslexic individuals, it is by no means valid for all. Many hyperactive dyslexic children will act out their frustrations and develop into explosivve, impulsive, drifting, antisocial, driven young and older adults. They still require active medical and psychological treatment, even as adults.

 

 

Concentration and Distractibility

 

Disturbances of concentration and distractibility are frequently associated with hyperactive and overactive states. The racing motor commonly interferes with normally sustained concentration levels. However, concentration may also be secondarily disturbed, or fragmented, by the drifting sensory imput characterizing the dyslexic disorder. In addition, concentration mechanisms are similarly fine-tuned by the inner-ear system, as are motor mechanisms and the sensory channels. Consequently, a fine-tuning disturbance will result in drifting concentration levels, or a true short attention span, distractibility, daydreaming, and so on.

In other words, many dyslexics who appear to have short attention spans to not. Often the opposite is true. In order to compensate for their drifting sensory input and motor output channels, dyslexics are forced to expend large amounts of concentration and effort over relatively short periods of time. As a result, they "burn out" and create the illusion of ADD.

Normally functioning individuals frequently test their concentration mechanisms while advertently performing many tasks on a "reflex" level. Dyslexics cannot relax or rest their concentration mechanisms without immediately paying the price: a host of typical dyslexic sensorimotor and related cognitive and speech slips and errors. Dyslexics require sustained concentration mechanisms functioning in high gear to control and compensate for their underlying chaotic sensorimotor channels. There is no rest for the weary dyslexic. She must forever be on guard and remain in an overcontrolled state of high alert.

As a result, some dyslexics compensate and developm super-concentration mechanisms and abilities that resist normal degrees of fatigue and diversion. However, the vast majority are not so fortunate. They are forced to struggle constantly to keep their concentration mechanisms going. Many fail in this attempt and forever complain of feeling sleep, tired, foggy, in a trance, or blocked.

The relationship between concentration mechanisms and disturbances of inner-ear functioning is significant and fascinating. Not only do concentration efforts and mechanisms help compensate for the typical sensorimotor dyslexic symptoms, these same mechanisms play a major role in minimizing inner-ear-determined motion sickness and related dysfunctions.

Perhaps a few clinicial examples will prove helpful here. During special inner-ear testing (electronystagmography, or ENG), the inner ear is stimulated using warm and cool water as well as rotation. These stimuli frequently trigger dizziness, nausea, even vomiting , as well as a reflex pattern of rapid eye movements called nystagmus, especially if individuals are tested with their eyes closed. The above symptoms can be rapidly reveresed if:

 

1. The subjects are asked to open their eyes.

2. The subjects are asked to calculate or perform tasks requiring concentration.

3. The subjects are asked to fixate and concentrate upon a specific object. This task best and most rapidly serves to eliminate the induced symptoms.

 

 

These observations led me to recognize that eye fixation and/or concentration mechanisms inhibit or dampen motion sickness responses. Similar observations were spontaneously made by dyslexics with motion-sickness tendencies when riding in a car. They are most prone to car sickness when seated in the back: If they sit next to the driver and look out the front window, their car sickness decreases or disappears. Without question, they feel best when they are driving, an activity requiring maximum concentration and fixation efforts; and many individuals with motion sickness tendencies refuse to ride in a car unless they drive.

Psychologists have assumed that individuals who must drive have a need to control others or to avoid being controlled by others. Not so! They merely wish to avoid motion sickness. They wish to control only their own inner-ear systems!

Upon analysis it became apparent that concentration and eye-fixation mechanisms tend to improve inner-ear functioning and thus result in a decrease in corresponding symptoms. A series of animal experiments demonstrated that visual stimulation results in decreased inner-ear reactivity or sensitivity, corroborating the findings that I observed while studying dyslexics.

Repeated observations demonstrated that improved concentration results in a corresponding improvement in sensorimotor functioning. As a result, I began treating dyslexics with concentration-stimulating medications while simultaneously utilizing anti-motion sickness agents. Accordingly, there resulted higher yields and degrees of improvement among my dyslexic patients than when they are treated with only antihistamines. No doubt for similar reasons, astronauts were treated with a combination of anti-motion sickness and concentration-improving medications. And no doubt the failure of these medications in some astronauts helps explain their developing what I call "space dyslexia."

Distractibility is frequently reported by dyslexics with concentration difficulties, despite the fact that this symptom may occur in the presence of intact concentration mechanisms. My research has show that the inner-ear system acts as a filter separating unwanted background stimuli or noise from important foreground events.

A dysfunctioning inner ear frequently results in impaired filter funtioning. In this case visual and/or auditory overloading may occur and give rise to such symptoms as light sensitivity or sound sensitivity. Moreover, the visual and/or auditory input may be scrambled by the incompletely separated background and foreground inputs, resulting in variations of visual and/or auditory blurring.

Dyslexics with a dysfunctioning filter will often become fearful of crowds, or demophobic. The crowd represents a situation in which there is either too much visual and/or too much auditory stimulation. The overloading triggers anxiety responses, and the latter in turn trigger avoidance or phobic mechanisms.

Fortunately, the same medications that improve concentration mechanisms also result in improvement of the inner ear's filter functioning, thus minimizing or eliminating distractibility. Improvement in concentration by any means will frequently diminish the distractibility resulting from impaired inner-ear functioning. Interesting material presented to dyslexics in a manner that stimulates their concentration invariably results in decreased distractibility and increased inner ear functioning.

All too often interest and its beneficial effects on learning have been viewed only in psychological or educational terms. My concepts have added a fascinating physiological dimension to the various psychological explanations of motivational learning. More specifically, by stimulating one's adrenaline, interest neurochemically enhances concentration and cognitive functioning while inhibiting distractibility, dizziness, and related inner-ear symptoms--as do the stimulant medications. Moreover, the use of medications and various physiological conditioning techniques has provided a new medical dimension to the learning-teaching experience.

Before concluding this topic, I would like to leave the reader with a question to ponder: Is it not possible that a series of sleep disturbances, such as insomnia, nightmares, and the inability to wake up in the morning; states of fluctuating consciousness, such as dream states, split personality, etc; and mood disturbances previously thought to be of psychological origin may be in fact also physiologically determined by mechanisms affecting concentration or alertness?

 

Attention Deficit Disorder (ADD) or Attention Defict Hyperactivity (ADHD)

 

Since attention deficit disorder (ADD) and attention deficit hyperactivity disorder (ADHD) have recently come into the forefront in diagnostic circles, it seems that a word of explanation is indeed warranted.

In studies I've conducted over the past twenty years, just about 90 percent of the children diagnosed as dyslexic have had related ADHD symptoms. Ninety percent of children diagnosed with ADHD or ADD have some dyslexic-related symptoms and inner-ear-related balance and coordination signs similar to those previously described.

If 90 percent of both dyslexics and ADHD- (or ADD-) diagnosed children share overlapping symptoms and over 96 percent have diagnostic inner-ear signs, are not both named disorders reflections of one and the same inner-ear dysfunction? Obviously! But to date, this commonsense observation has not been officially recognized.

Additionally, the combined use of anti-motion sickness antihistamines and stimulants offers those patients the best chance of improvement.

 

The anti-motion sickness antihistamines improve the "typical" dyslexic aspects of the inner-ear syndrome more than the ADD or ADHD aspects, and

 

The anti-motion sickness stimulants or antidepressants improve the ADD or ADHD aspects of the inner-ear syndrome more than the dyslexic part.

 

 

For this very reason, combining these medications where possible triggers the widest and highest degree of improvement while allowing stimulant doses to be minimized.

Also the fact that the anti-motion sickness stimulants were shown to be as effective as the antihistamines in controlling or preventing motion sickness--and thus enhancing inner-ear functioning--further supports my hypothesis that the inner ear is responsible for both dyslexia and ADHD or ADD.