New To Newtown, Neurological Specialist May Have Answers To ADD

By Kendra Bobowick

“Mommy says, ‘Billy, why did you do that?’ And the child looks her in the eyes and says, ‘Mom, I don’t know.”

“‘How could you not know, we just talked about this.’”

—Clinical Neuropsychologist Jonathan Michaelis, PhD

The dialogue is familiar, Dr Michaelis said.

Co-founder of AMS Solutions (Attention Modification System) LLC Neurotherapy Center, Dr Michaelis treats ADD (attention deficit disorder) and ADHD (attention deficit hyperactive disorder) among other conditions in children, adolescents, and adults, he explained. AMS brings together interventions from social psychology theory, psychotherapy, family therapy and behavior modification.

Making an example of the narrative between the parent and child plagued with ADD, he said a parent becomes frustrated with the child’s lack of understanding.

The child is not able to foresee consequences to actions, he said.

“Billy, why did you do that?”

“In [the child’s] mind there was no chance to think about it,” Dr Michaelis said. “It’s not a choice, but how [the child’s] brain works.”

Explaining an occurrence often associated with oppositional or defiant behaviors he said, “The children aren’t capable of thinking about consequences of behavior before an action…they don’t make choices ‘not to.’”

“Mom, I don’t know.”

The child is answering truthfully because the child’s mind never provided an opportunity to obey a parent’s wishes, he explained.

“How could you not know? We just talked about this.”

Dr Michaelis has an answer.

He explained that the child’s brain prompts the child from impulse to action, without considerations of consequences in between.

“Normally, there is impulse, then we think about it and choose to do or not to do something, but ADD doesn’t get that choice,” he said.

AMS Executive Director Ann Scalisi, MSW, explained that ADD children might be too “touchy” and not realize that their behavior is inappropriate, for example.

Mom may ask “Billy” to stop it, over and over, but the repetition does not help, Dr Michaelis explained.

How does Dr Michaelis approach this problem?

“Helping a child change the way that child thinks and the way the brain works.” Neurotherapy is a large part of his treatment where he aims to “retrain the brain,” he said. He provides a glimpse into his therapy.

“Actually, they play video games and their brain wave activity controls the game activity. A rebalancing and reregulating in the brain occurs,” he said.

He addresses the mind, he said, rather than focusing on behavior. “A common belief is that this is a behavioral disease, but it’s not. It’s neurological.”

Dr Michaelis said a consistently “huge” problem with ADD is an “excess of slow activity in the front of the brain — that’s our decisionmaking area and the frontal lobes also modulate response.”

Regarding “Billy” who cannot explain why he did something his mother asked him not to, Dr Michaelis said the neurotherapy “reintroduces that extra step” of thinking about the consequences of an action.

A list of conditions he treats includes OCD (obsessive compulsive disorder), conduct disorder, addictive behaviors, depression, anxiety, and panic attacks. He works with all ages.

Offering an overview of his methods to a group recently gathered during an informational seminar, he noted the frustrations that often bring parents to his door.

“Often parents seek us out because they’re not getting full satisfaction,” Dr Michaelis said. Traditional behavioral therapy combined with medications can often address symptoms that show up in a child’s behavior. Some parents, however, may not be satisfied with this approach, or may not want to medicate their children as an answer to problems.

Dr Michaelis outlines his perceptions of the good and bad sides to traditional treatments saying, “Meds are not designed to heal but handle the symptoms, and they work well there…”

He treats the direct cause of symptoms he said.

Not to be confused with non-medicinal alternative treatments, he said, “Sometimes you need meds so you can get [a child] to function better and receive treatment, and ultimately get them off the meds,” he said.

Classic struggles accompanying ADD include difficulty with school, homework assignments, and simply following directions, Dr Michaelis explained.

“Even with the best management and counseling the child is still working two times as hard as the child in the next seat,” he said.

Explaining the mechanics of how the ADD affects the mind, Dr Michaelis said, “It’s an underlying foundation of vulnerability.”

Referring to a child who may be criticized as disobedient, he said, “It’s not about being unable to sit down in class; it’s about the emotional life and makeup of an individual.”

A child with ADD carries the condition into adulthood.

Dr Michaelis said, “ADD kids grow up to be ADD adults; it just looks different.”

Clearing up a common misunderstanding he explained, “We used to think they outgrew it.”

A child matures past hyperactivity but does not leave the attention deficit behind, explained Dr Michaelis. “The cause and effect thinking persist,” he said.

Speaking from experience, he said, “Children grow up into adults with problems.”

Essentially, the adults would have the same concentration problems and inability to finish work as the ADD child, he said.

Offering one scenario, Dr Michaelis said, “[Adults with ADD] can’t find a job for the same pay for half the work done in twice the time. It’s the kid with trouble in the classroom who has to work twice as hard and this persists.”

He also shared his concern that ADD children might be misdiagnosed and improperly treated for low self-esteem.

“They’re struggling,” he said. “A vast amount of children have anxiety problems because they are not succeeding at what they are trying to do.

“At the core they’re unhappy because they try and they fail. They are not unhappy because they’re depressed, they’re unhappy because they’re not doing well at what they are trying to do — so we call it low self-esteem.”

Continuing with the scenario, he said, “In therapy they tell you that you should not have low self-esteem.” He does not believe this conversation works for a patient, but feels that the best method is to provide the child with the ability to succeed, he said.

He and Ms Scalisi agree that seeing a pattern of success boosts the child’s self-esteem.

Approaching ADD and other problems in children, adolescents, and adults from a neurological rather than behavioral standpoint is not as common as behavioral counseling. Dr Michaelis is closely linked with neurotherapy, however.

“I am kind of the second generation,” he said. Leading up to the neurotherapeutic approach, he said, “I go far enough back that I learned from the originals.” By original, he refers to pioneers in the field who studied at Yale. Referring to one doctor who used neurotherapy more than 40 years ago and under whom Dr Michaelis trained, he said, “This is not so different that we invented it, it just combines an array of treatments including neurotherapy to retrain the brain and work more effectively.”

His mentor moved his career from Yale to UCLA, the University of California, Los Angeles. “That’s why this has been mostly a West Coast phenomenon,” he said.

Dr Michaelis has, however, been working with neurotherapy for more than a decade.

With an established practice in Newington, Dr Michaelis opened a Newtown office two months ago, and last week held an open house and information sessions discussing his process of managing and improving the lives of patients and family members living with ADD and other disorders.

Dr Michaelis has served as a neuropsychology director for several clinics and hospitals in Connecticut and other states. He received his doctorate from Columbia University and postdoctoral training at Yale University in New Haven. He has been in private practice since 1988.

Ann Scalisi earned her master of social work at Sacred Heart University.