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Arousal Level and Hyperkinesis: Implications for Biofeedback

Dear Editor: Treatment modalities for hyperkinetic children (approximately 30% to 45% of the learning disabled population) reflect a variety of management strategies, with stimulant medication well established as the treatment of choice (Safer & Allen 1976). A common thought among professionals working with hyperkinetic children is that stimulants such as methylphenidate (Ritalin) have a paradoxical effect on the child. The presented rationale suggests that stimulants have a depressive effect on the prepubescent hyperkinetic child, and physical changes occurring at puberty render this phenomenon inoperative. In recent reviews, however, Barkley (1976) and Satterfield (1975) hypothesized that stimulant drugs have an energizing rather than sedative (paradoxical) effect on the central nervous system (CNS) of hyperkinetic youngsters. Such children apparently benefit from the energizing effect of stimulants due to immature development of the CNS (Satterfield 1973). In one investigation stimulant medication was observed to increase CNS arousal level as measured by increased electrodermal response (Satterfield & Dawson 1971). Shetty (1971) reported significant gains in electroencephalographic alpha following stimulant drug adminis-