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Boston Globe, 5/4/06

AN ALTERNATIVE TO RITALIN PRESCRIBES EXERCISE INSTEAD

by Peter Schworm

Adrienne Albani had tried a number of drugs to treat her son John's attention deficit/ hyperactivity disorder, or ADHD, but all had negative side effects. In frustration, the Dedham mother enrolled her son last spring in the Dore Center, an alternative treatment program in Needham for children with ADHD, dyslexia, and other learning difficulties.

Through daily balance and hand-eye coordination exercises, John, now a seventh-grader, saw his focus sharply improve, along with his writing and reading. He no longer blurted answers in class, and found he could do his homework quietly by himself without being distracted.

Albani said she was doubtful at first of the center's contention that physical exercises like tossing a beanbag and balancing on a wobble board could improve his focus and mental processing. But after just six months in the two-year program, which costs $4,500, her son had shown impressive gains, she said.

''I was skeptical because it's not a proven treatment," she said. ''But it's helped him so much."

The Dore program is based on recent research suggesting that many learning disorders involve a part of the brain, called the cerebellum, increasingly believed to play a role in both movement and mental processing. Some studies have indicated a link between an underdeveloped cerebellum and learning difficulties, raising hope that physical drills specifically stimulating that part of the brain can reduce learning and attention problems.

The Needham center, which has 300 active clients and is one of five Dore Centers in the United States, touts its program as a permanent solution that takes aim at the neurological root of the problem rather than the symptoms.

Just as lifting weights builds muscles, repeating specific exercises can, in time, teach the brain to handle information more efficiently and reflexively, Dore proponents say.

''It's a rewiring of the brain," said Dore's David Pfeil. ''It's dealing directly with the source of the difficulties. If someone has a stone in their shoe, they don't take an Advil."

Pfeil said Dore is ''drug-neutral" but many parents are drawn to the center's drug-free approach. The Centers for Disease Control and Prevention estimates that 4.4 million children ages 4-17 have been diagnosed with ADHD and more than half are receiving medication as treatment.

The center's techniques, however, are not widely accepted by the mainstream medical community.

Jeremy Schmahmann, a neurologist at Massachusetts General Hospital, said there is growing evidence that the cerebellum, long considered purely responsible for motor control, also influences behavior and intellect. But the theories that learning disorders are caused by an underdeveloped cerebellum, and that Dore's exercise program can improve brain development, are unproven, he said.

Nonetheless, the Dore program has attracted parents anxious to help their children and increasingly worried about the side effects of Ritalin and other stimulants used to treat ADHD. Those concerns have escalated in recent weeks as the Food and Drug Administration is considering adding warnings to the drugs about an increased risk of cardiovascular problems.

In 2003, 7.8 percent of school-age children were reported to have an ADHD diagnosis, according to the CDC.

Edward Hallowell, a psychiatrist and founder of a Sudbury center specializing in attention deficit and learning disorders, enrolled his teenage son, Jack, in Dore after tutoring and medication failed to improve his reading skills. Like Albani, Hallowell was dubious at first, but was soon convinced.

''When I first heard about it, I thought, 'There is no way,' " he said. ''Physical exercise isn't going to help someone read."

But after four months in the program, his son was enjoying reading more than he ever had.

Hallowell, a paid consultant for Dore, said that there is a ''plausible link" between targeted exercise and brain development, but that it is unconfirmed.

''Whether or not physical exercise rewires the cerebellum, that's up for grabs," he said. ''We can't recommend it with the same certainty as medication."

The rising number of children labeled with the disorder has stirred criticism of overdiagnosis and overmedication, fueling demand for alternative approaches.

The Dore program was created in England six years ago by Wynford Dore, who was trying to find a cure for his daughter's severe dyslexia.

He assembled a research team of neurologists and instructed them to ''ignore conventional wisdom." They eventually came to believe that, with enough practice, the brain could be altered so that the disorder's symptoms all but disappear.

''The brain is far more elastic than we previously thought," Dore said.

Dore points to a 2002 independent, peer-reviewed study by two British researchers that found that program participants caught up to their peers in reading and shed ADHD symptoms as evidence of the program's success.

There have been no American studies of the program.

At a recent evaluation at the Dore Center, Conor McTavish, an 11-year-old who lives in Dorchester, said he's less interested in the theory than the results.

''I think the exercises have helped," he said. ''I can concentrate better, and I'm better at a lot of things."

Peter Schworm can be reached at schworm@globe.com.
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