Attention Deficit Disorder and A.D.H.D. has been linked to associated negative social ramifications such as increased rates of incarceration,substance abuse, higher pregnancy rates anxiety and depression. This month we had an interesting case present to the office regarding a young adult male with ADHD who was looking at jail time. He was on probation for being in the wrong place at the wrong time. His parents came seeking treatment as the judge had said if he appears before him again he will get five years of jail time. My wife had sent one of her friends an email regarding one of our conferences on Hemispheric Integration Therapy for the treatment of Autism Spectrum Disorders. We view the spectrum as starting with A.D.D. and including A.D.H.D. , Sensory Integration Disorder, Processing Disorders, Asperger's Syndrome, Tourette's Syndrome, O.C.D. and Autism. An over simplified explanation is that these conditions are termed functional disconnect syndromes meaning that different areas of the brain are under functioning or not communicating with each other properly. This timing issue or desynchronization as it is frequently called causes a loss of the higher functions of humanity. There are several common suspects in these cases, the cerebellum, basal ganglia and prefrontal cortex, although the functional lesion can be anywhere and clinically only a detailed functional neurological examination will give the answer as to where the patients problem lies. In this case, we had the benefit of having a SPECT scan available as his parent's had already taken him to the AMEN Clinic when he was younger. A SPECT Scan, single photon computerized tomography is a type of nuclear imaging test that can show blood flows to your brain to determine what areas of the brain are active. The scan showed an under active right prefrontal cortex. The right prefrontal cortex is an area of the brain that among other things is responsible for empathy, judgement and impulse control. Here is the heart of this story. The young man apparently drove of in a car leaving his parole officer's office. The problem is he no longer had a license. Therefore he violated his parole and was now looking at five years in prison for a parole violation. The young man had had an initial consultation with me and had completed one treatment when this occurred. The report of my initial consultation was presented to the patient's lawyer and the judge. In the report I explained how a a patient with an under-active right prefrontal cortex will have limited ability to control his impulses as the area of the brain responsible for regulating those impulses is not working adequately. Thus, it may not be that he doesn't want to listen to the judge's orders, but that he cannot. This is something we go over with parents of young children with A.D.D. and A.D.H.D who are treating at the office. I always advise the parent of these children to consider the fact that it may be that the child can't help it when you are considering punishing him for his actions. Here a similar situation is occurring with the judge. Please consider the fact that he can't help it, yet. His parents are now talking to the judge regarding putting the young man in a half way home - a much better alternative than prison. This would allow the patient to come to the office to receive treatment. The patient's father also said that he would have child rescanned with another SPECT scan after the treatment was completed, in which case further details of this case will be published in a scientific journal. For now, be aware that the children with A.D.D. and A.D.H.D are more likely to get into all sorts of trouble. When punishing them take into account the fact that they may not be capable of controlling their impulses. Realize also that this is a spectrum of disorders that can mix and match. There is much overlap with these neurobehavioral conditions. Your child may have Tourette's syndrome and A.D.D. or O.C.D. and A.D.H.D. Finally, as these children get older their actions may lead to more serious consequences than be not being allowed to participate in recess because they did into behave in class today.

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