The effect of hemisphere specific remediation strategies on the academic performance outcome of children with ADD/ADHD.

The development and normal function of the cerebrum is largely dependent on sub-cortical structures, such as the cerebellum and basal ganglia. Dysfunction in these areas can affect both the nonspecific arousal system and information transfer in the brain. Dysfunction of this sort often results in motor and sensory symptoms commonly seen in children with ADD/ADHD. These brain regions have been reported to be underactive, with that underactivity restricted to the right or left side of the sub-cortical and cortical regions. An imbalance of activity or arousal of one side of the cortex can result in a functional disconnection similar to that seen in split-brain patients. Since ADD/ADHD children exhibit deficient performance on tests thought to measure perceptual laterality, evidence of weak laterality or failure to develop laterality has been found across various modalities (auditory, visual, tactile) resulting in abnormal cerebral organization and associated dysfunctional specialization needed for lateralized processing of language and non-language function. This study examines groups of ADD/ADHD elementary school children from first through sixth grade. All participants were administered all the subtests of the Wechsler Individual Achievement Tests, the Brown Parent Questionnaire, and given objective performance measures on tests of motor and sensory coordinative abilities (interactive metronome). Results measured after a 12-week remediation program aimed at increasing the activity of the hypothesized underactive right hemisphere function, yielded significant improvement of greater than two years in grade level in all domains except in mathematical reasoning. Results are discussed in the context of the concept of functional disconnectivity in ADD/ADHD children.