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ADHD

William Stixrud, Ph.D.

William Stixrud, Ph.D., is a clinical neuropsychologist and director of William Stixrud & Associates in Silver Spring, Maryland, a group practice specializing in learning, attention, and social/emotional disorders. Dr. Stixrud is adjunct faculty at the Children’s National Medical Center in Washington, D.C.

Sarina Grosswald, Ed.D.

Sarina Grosswald, Ed.D., is an expert in cognitive learning who recently directed the first-of-its-kind research study on the effects of the Transcendental Meditation program on children with language-based learning disabilities. Dr. Grosswald and her work have been extensively featured in the national media, including PBS and ABC News.

James Krag, M.D.

James Krag, M.D., is a Fellow of the American Psychiatric Association, president of the Psychiatric Society of Virginia, and former president of the Virginia Association of Community Psychiatrists for four years. He is currently Medical Director of Liberty Point, a residential treatment program for adolescents with psychiatric problems.

Here Drs. Stixrud, Grosswald and Krag answer questions
on Attention Deficit Hyperactivity Disorder (ADHD).

Q: It’s common knowledge that children are under more stress than before. Is this contributing to ADHD and other problems? 

Dr. Stixrud: I make my living by evaluating kids who are struggling with classroom achievement, behavioral problems, depression and neurological disorders. Stress plays a significant role in all of these problems. I see many children with learning disorders and ADHD—Attention Deficit Hyperactivity Disorder—and there’s absolutely no question that stress significantly interferes with a child’s ability to learn and perform in school.
Related Scientific Research

Q: How do children experience the stress response in school? 

Dr. Stixrud: The stress response, also called the fight-or-flight response, presumably evolved over millions of years in order to protect us from predators. When that fight-or-flight response is triggered, you aren’t supposed to be able to think clearly. From an evolutionary point of view, if people thought a long time about “What’s the right thing to do?” as a tiger approached, they got eaten, and they didn’t pass on their genes. Nature has protected us from thinking under stress. Consequently, if a kid is under stress, it’s very hard for him to think, to learn, to do school work, to pay attention to the teacher, and to manage his own behavior.

I would say that the main principle that’s been most commonly derived from 20 years of applying brain research to learning is this: a child needs to feel safe in school in order to learn, because you can’t learn when you’re under stress.
Related Scientific Research

Q: Can the Transcendental Meditation technique alleviate this stress? 

Dr. Stixrud: I think that TM can play an extremely important role in alleviating learning and attention problems. In some schools the Transcendental Meditation technique already does play a dramatic role in helping children overcome learning, attentional, and behavioral problems. (See also www.stressfreeschools.org)
Related Scientific Research

Q: I have ADHD and I just can’t sit still, not even for a few minutes. How could I ever practice the Transcendental Meditation technique? 

Dr. Grosswald: That’s a major benefit of the Transcendental Meditation technique. It’s very simple, effortless and easy to do. It actually allows the mind to settle down, and when the mind settles down, the body very naturally follows. You’re able to sit more quietly, easily and comfortably. As a result of practicing the Transcendental Meditation technique, certain aspects of that quiet, settled feeling stay with you after meditation. Over time you begin to feel more calm and settled, and the restlessness begins to subside. That’s why the TM technique is recommended to help adults and children who complain of restlessness. That is the uniqueness of this technique.

Dr. Krag: People with ADHD have attentional variability. In some situations they have trouble focusing and in others they have the ability to hyperfocus. Even with notable ADHD, the Transcendental Meditation technique is not only easy but highly advisable. Although I cannot predict that Transcendental Meditation will eliminate this disorder, I have seen it lessen the symptoms notably.
Related Scientific Research

Q: I had ADHD as a child, and still have trouble focusing on any sort of work. Will practicing the Transcendental Meditation technique help me focus better? 

Dr. Grosswald: Yes, based on our research, it will. The Transcendental Meditation technique works for both adults and for children. It’s easy to learn and to do, and it doesn’t require concentration, or focus, or attention. At the same time, it increases the ability to focus outside of meditation, because it enhances brain functioning. When your eyes are closed and you’re meditating, the brain connections related to attention and focus actually increase. Then when your eyes are open and you are in activity, focus and concentration are better.

Many symptoms of ADHD are actually the result of stress; stress shuts down the prefrontal cortex in the brain, making concentration and focus difficult. Reducing stress increases your attention, focus, and concentration—as well as the ability to act calmly and to feel more relaxed and comfortable in stressful situations.

In our research with children, we found a 20% improvement in attention in just three months after starting the Transcendental Meditation program. There were also significant improvements in working memory and organization, as well as psychosocial measurements of behavior, anxiety, stress, attention, and focus.

Dr. Krag: Anyone with longstanding problems with ADHD knows that when they are rested and calm they have fewer ADHD symptoms than when they are tired and anxious. Since TM helps create a calm and stable state, it clearly can help reduce the problems of ADHD.
Related Scientific Research

Q: One of the really crushing parts of ADHD is lack of impulse control, where a child is constantly interrupting people, saying things impulsively—and that gets people upset. Can the Transcendental Meditation technique help? 

Dr. Stixrud: Absolutely. Many researchers think that a lack of impulse control, or a lack of inhibition, is the primary deficit in people who have ADHD. One of my favorite patients with ADHD is a tall kid; he’s 14 or 15 years old and he speaks loudly. I always know when he’s in the building. Once he was talking in the waiting room, and a woman from another practice came out and said, “When you come here, you’re going to have to be quiet.” And he snapped back, “If I could be quiet, I wouldn’t have to be here.” Which is absolutely true.

With the practice of Transcendental Meditation, the nervous system becomes settled and quiet. And when the stress response starts operating normally, you’re simply less impulsive. I think there’s reason to believe that the process of quieting the mind and body through the Transcendental Meditation technique—which results in increased integration in the electrical activity of the brain, seen through increased coherence between the two hemispheres and the front and the back part of the brain—allows children much improved ability to control their impulses. They get in trouble less; they think before they act; they can inhibit the tendency to get distracted better.
Related Scientific Research

Q: It sounds like you’ve experienced this firsthand. 

Dr. Stixrud: In a pilot study on middle school students with ADHD practicing Transcendental Meditation, we interviewed the students after three months of meditating. We asked, “What do you notice after meditating for a few months?”

Virtually all the kids said things like, “I feel much less stressed, and I feel more relaxed.” Most of them said, “I feel more organized. I feel I can do my homework better. My parents don’t need to help me.”

One strikingly impulsive boy said, “Before I started meditating, if I was walking in the hallway and another middle school kid bumped into me, I’d turn around and hit him. Now that I’ve been meditating for three months, if somebody bumps into me, I stop and think, “Should I hit him or not?”

To some that may not sound like much, but from my experience in working with impulsive kids and teenagers, this delay in reacting is very hard to achieve. If the Transcendental Meditation technique gives this child a little bit of time between a stimulus and a response—which then allows him to think, to plan, to ask what’s the right thing to do in this situation—that’s a capacity that he didn’t have before he started meditating.
Related Scientific Research

Q: Is there other research indicating that the Transcendental Meditation technique can help with ADHD? 

Dr. Stixrud: Most researchers think ADHD is a disorder of multiple executive functions. “Executive functions” refers to the functions of the front part of the brain: the mental control and the mental organizational skills that you need to carry out purposeful behavior. When you have to get something done, for instance, you need to be able to plan, to organize, and to hold relevant information in your memory. You also need to self-monitor, to ask yourself, “How’s it going?”

And there’s good evidence in several hundred studies on Transcendental Meditation that it improves every one of these executive functions. This is probably, at least in part, because the Transcendental Meditation technique increases the coherence of brain functioning, and in part because it reduces stress, which makes all these other things worse.
Related Scientific Research

Q: I think meditation’s great, but I want my child to be focused. I don’t want him to get too passive. 

Dr. Stixrud: Sometimes parents are concerned that if their kids get too chilled out from meditation, they’ll lose their drive. The common experience is actually the opposite.

While it’s true that the Transcendental Meditation technique produces deep relaxation, on the other hand, it’s also activating. It’s that unique combination of activated brain and deeply relaxed physiology that produces so many of the positive benefits of meditation. The common experience of people who meditate is not that they lose their drive, it’s that they find it easier to channel their drive in an effective manner.

They don’t waste energy in worrying and excessive anxiety. They become better at planning and become more goal oriented. If you look at the schools where the kids have practiced TM on a regular basis, you’ll see that the children are ridiculously successful. They’re exceptionally high achieving, in academics, sports, arts, everything. That’s why I think there’s absolutely no merit to the idea that the Transcendental Meditation technique could make children passive or lose their drive or their interest. It’s completely the opposite.
Related Scientific Research

Q: How will I ever be able to meditate when I have young children, including one with ADHD? 

Dr. Krag: Obviously, you will need some help to accomplish this. But keep in mind that the Transcendental Meditation program is not done for the sake of meditating itself (although it is a very peaceful and pleasant state—a 20-minute vacation), but rather it is rest for the sake of enhanced daily activity. As a parent of a child with ADHD, you need all the energy and clarity you can muster. Transcendental Meditation will help you develop the calm state of mind that will help your child respond to you more effectively.
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