Posts filed under ‘ADD Child’

A Short But Effective Summer Remedy for ADHD

Does any or all of this sound familiar to you?  “My child is struggling in school… the teacher complains that they don’t complete their class work, can’t follow directions, and are frequently daydreaming.  Their grades are below average, yet I know that they are intelligent.  Homework takes forever, and is a constant battle.  If this were not enough, they are frequently getting in trouble at school, and it’s the same at home.  The poor kid can’t get a break, and the family is constantly in an uproar.  We always dread the start of the next school year, and things seem to be getting steadily worse.”

If the academic performance and/or behavioral part of this statement sounds familiar to you, there is a good chance that your child may be suffering from ADHD.  The destruction of the child’s self-esteem, and the conflict and chaos wrought on family dynamics, can be devastating.

Denial is often a further complication to this problem in that many parents, thinking that the side effects and rigors of life-long medication are the only remedy, try to deny the problem and avoid testing and treatment.  Fortunately, medication is definitely not the only form of successful treatment.  We’ll discuss this more in a moment.

The many problems mentioned above and the hectic schedule of school, sports, etc. often make it near impossible to get help during the school year.  However, when the school year ends, and summer is finally here, an opportunity presents itself to make a big change for the better.  Neurofeedback treatment for ADHD requires thirty sessions of only thirty minutes each, with a minimum of one session a week.  During the school year the pace of life can be so hectic that the treatment may take four to seven months to complete. In the summertime, the opportunity presents itself for a “Short Course” treatment, which can be completed in as little as two weeks.

One of the gifts of childhood is an innocence, which (as long as their self-esteem isn’t too damaged) prompts them to believe (without anything actually occurring to bring it about) that next year will always be better.  If the child’s parents actually correct the problem over the summer, then a beautiful thing happens to the child’s belief in his or her self. They discover that, “you know what?… I was right to believe in myself… things are better this year.”  When parents intervene for their children in this way, not only does their performance and/or behavior turn around for the better, but the parents also give their child an incredible boost in self-confidence and self-reliance.  These are wonderful gifts to give your child!

Neurofeedback is a proven, painless, and effective solution to the problem of ADHD, which opens for the person the opportunities they deserve for a lifetime of learning, growing, and relating well with others.

May 16, 2013 at 12:24 am 1 comment

The “End Game” at School- its importance for children with ADHD

If you have a child in your family who has, or you suspect may have ADHD (ADD), and they are not currently getting the proper help with the disorder, there is obviously a problem that needs to be fixed.  It could be that they are on medication and it is not solving all the problems, or that the side effects of the medication are causing their own set of problems, or they are causing a compliance problem, or a combination of the above. It is also possible that no treatment is engaged and parents are employing strategies to help the child cope with the disorder, instead of correcting it, and this is not doing enough for the child to realize their true potential.

Although it may be clear that a solution is needed, what may not be obvious is the importance of the “end game” of the current school year for your child. How this school year ends is of critical importance to how the next school year will start, to both your child and your child’s teacher (both this years’ and next’s). Improvement at the end of the year shapes your child’s current teacher’s decision for advancement and classroom placement for the next year. It also shapes the comments this year’s teacher will make to the new teacher about your child’s perceived (not actual!) personality, intelligence (most children with this disorder actually have a higher than average I.Q., although the disorder can make it seem the opposite), attitude, and in some cases even the parent’s skill at parenting! These comments and reports are very powerful in shaping your child’s school experience next year.

Furthermore, when a child actually experiences that school is really getting better at the end of this year, they will transfer that confidence over onto the start of next year. This makes a tremendous difference in their self-expectations and level of success for the new year to come. Both this year’s teacher’s ending perception of your child, and its effect on next year, and the confidence “carry-over” from this year to the next, is why the “end game” of this school year is so important.

The way to actually make this very important “end game” successful is to actually correct the ADHD (ADD) now at the end of this school year. The most effective way to do this, and at the same time avoid the side effects, stigma, and life-long rigors of medication is through Neurofeedback Treatment.

By utilizing a treatment called Neurofeedback, a child can re-teach the sensory functions of the brain, including processing, to ameliorate the disorder.  Neurofeedback is a painless and effective process, where there is no side effects and no maintenance or re-training is needed after treatment is completed.  It allows for focus, task completion, organization, and a variety of other symptoms to be controlled and become the way they should be.

Please feel free to contact Alta Neuro-Imaging for additional information in regards to Neurofeedback, or to set up a consultation with Dr. Ferrari at his Placentia, CA office.

April 16, 2013 at 5:00 pm Leave a comment

Difficulty at the Start of the New School Year?

For most parents, the new school year brings the feeling of accomplishment and pride of seeing their children grow and mature in aptitude, knowledge, and social skills. For some parents, however, it only brings long nights of homework, calls from the teacher, frustrated and discouraged children, and parenting fights about whose fault “all of this” is. There is also the pain of watching your child sink into believing they are not smart, are a “bad boy or girl”, or are not worth much. No parent or child should ever have to experience this.

A typical school year requires sustained attention, sitting quietly, and refined social skills. Some children are not capable of this. A mother recently told me, “I’m worried… Sammy is having such an awful time in school this year.” Sammy is being grounded in the classroom with no recess because he is behind in his work. “We are constantly doing homework and he is still behind,” she continued. To add to his academic problems, Sammy is spending most of his time at school in social isolation; even when he is free from being “grounded” in the classroom, he is the last one picked for teams and the first one to be teased.

A very significant possibility exists that the conditions described above (some or all) are being caused by a disorder called ADD or ADHD (Attention Deficit Disorder). This disorder is caused by a minor neurological imbalance (not parenting style!) and, for the vast majority of those with ADHD, can be corrected relatively easily. What makes the aforementioned tragic self-image even more unacceptable is that fact that the opposite is usually true. Individuals with ADHD (ADD) typically have a higher than average IQ and, although sometimes hidden behind the disorder, a very pleasant disposition.

Whenever such problems are occurring, it is extremely important to determine if ADHD is behind them as soon as possible. Don’t wait until your child’s first report card to initiate testing or treatment. By then, your child is already significantly behind. If there’s one thing harder for a child with ADHD than school, it is the downward sliding struggle to catch up.

Unfortunately, many parents of children with ADHD, or those who suspect it might be present, avoid testing and treatment because of their understandable dread of what they think must be the inevitable “drug” solution. Fortunately, for most individuals, there is a much better alternative.

This treatment is called neurofeedback, an effective, drug-free, painless procedure in which the child learns to re-train the attention mechanisms of the brain, alleviating the condition. Once training is completed, no further treatment is necessary.

October 10, 2012 at 1:58 pm Leave a comment

A Four Week Summer Intensive Program for Children with Difficulties in School

Do any of these complaints sound familiar to you?  “My child is struggling in school… the teacher complains that they don’t complete their class work, can’t follow directions, and are frequently daydreaming.  Their grades are below average, yet I know that they are intelligent.  Homework takes forever, and is a constant battle.  If this were not enough, they are frequently getting in trouble at school, and it’s the same at home.  The poor kid can’t get a break, and the family is constantly in an uproar. We always dread the start of the next school year, and things seem to be getting steadily worse.”

If any of the academic performance and/or behavioral parts of this statement sound familiar to you, there is a good chance that your child may be suffering from ADHD, a learning disorder, or a learning disability.  The destruction of the child’s self-esteem, and the conflict and chaos wrought on the family dynamics can be very difficult to live with.

The problems mentioned above and the hectic schedule of school, sports, etc. often make it near impossible to get help during the school year. However, when the school year ends, and summer is finally here, an opportunity presents itself to make a big change for the better. I think the key part of the word “summertime” is “time”, there is much more of it. With the pressure of school, tests, and homework gone, it is a more relaxed time for kids and parents alike. In the summertime the opportunity presents itself for an easier to do four week Neurofeedback treatment, which is much less stressful on parents and children.

There are three core types of students who benefit the most from the summer intensive programs.  The first type is the student who struggles significantly with homework (which increases in amount and difficulty each year) and tests.  This is usually a problem with attention span, task completion, and/or organization. Problems such as homework taking too long, not being completed, not being turned in, or not being brought home, as well as difficulties taking tests, all fall into this category.

A second type is the child who has to work too hard to get what success they can.  Poor grades and difficulty with testing are typical for this child.  These are children who often can do okay when the work is done “one-on-one”, but are too distracted in group settings such as the classroom or group activities.

The third type is the student who has significant difficulties with his/her behavior. They may be getting into trouble frequently, and as a result may even be getting blamed for things that they don’t do.  This behavior may make it hard to make friends (or the right kind of friends) and lead to feelings of isolation.  They can often be held in or punished at recess (further isolation), and may begin to believe that they are troublemakers, or “bad” kids.  The resulting damage to self-esteem from this, and the other above patterns, can shape self-fulfilling self-images that are very sad to see develop.

If the problems in the beginning of this article sound familiar to you, and you would like to see your child improve their attention and mental processing, think and react faster in school and social situations, be more confident, and improve college readiness, then this type of program is essential for them.

Neurofeedback, a type of biofeedback that utilizes EEG to provide information on brain signaling activity and allows for re-training that lasts for life, is an alternative to medication.  This  form of treatment mitigates the symptoms of ADHD in a beneficial and side-effect-free manner by re-focusing the thought processes of brain.

If your child struggles with these problems, or you know a student that we can make a difference for, please let us know.  We will be happy to follow up.

June 20, 2012 at 12:07 am Leave a comment

Hope is Most Valuable Commodity for Parents of ADHD Children

Hope…not patience, not financial resources, and not perseverance, is the most important thing parents of children with ADHD (ADD) need to have. While the other assets (among several) are valuable, albeit essential to these parents, maintaining hope for their children’s condition to improve is the most essential ingredient for this wish to come true.  The critical thing to remember when considering this asset is that it exists on a sliding scale.  At the bottom of that scale is hopelessness, which means giving up.

The hope parents have for their children’s condition to improve is both fortunately, and unfortunately, not fixed.  This is a good thing if hope is sliding up the scale and increasing, and a bad thing if it is sliding down and a parent is losing hope and in danger of giving it (hope) up completely.  It is also important for parents (and grandparents, etc.) to realize that losing hope is something that one is often not proud of, and so it may be hidden, both from one’s self and/or other concerned persons.  Gaining or losing hope is also contagious, and likewise one needs to be aware of its status and encourage it in the right direction, guarding it carefully.

Hope springs naturally from a happy and healthy heart (as human beings, this can vary according to life’s trials), and from other places such as spirituality, the encouragement of friends and professionals, and faith in one’s resourcefulness, among others.  The reasons for losing hope are often listening to the wrong people (however well intentioned) both professional and non-professional (this can include teachers and doctors), overwork and fatigue (though this seems simple, it’s the culprit in much of our “giving up”), and feeling that you have no options.

Often persons who we figure should know what they are talking about, actually don’t.  Some people with lots of experience working with children and being good at fixing other problems (doctors, teachers, grandparents, friends with children with similar problems) do not actually understand sufficiently this disorder and the treatment options. Unless someone’s specialization is ADHD, you are going to be getting inadequate or inappropriate advice.

As ADHD in frequently hereditary, many parents of children with ADHD who never got the right help, think that nothing can be done, and give up.  Some of the same type of parents go the opposite way and steadfastly refuse to accept this handicap for this children.

A great many parents are afraid (with good reason) of the many side effects that can occur with medication, and seeing no way out, become hopeless too.  This is a big mistake. There is an alternative to accepting the limitations that ADHD forces on their children, and the serious side effects that frequently come with medication. There is a treatment called neurofeedback which is free of side effects and the rigors of medication, and in one set of treatments can free their children of these significant limitations.

Neurofeedback is a type of biofeedback that utilizes EEG to provide information on brain signaling activity and allows for re-training that lasts for life.  This  form of treatment mitigates the symptoms of ADHD in a beneficial and side-effect-free manner by re-focusing the thought processes of brain. 

Timing of the treatment is important too.  If it is possible, it is a good idea to begin the treatment before the end of the school year so the child can experience some of the improvements involved in the school setting.  Once again, it is critical that parents maintain and guard their hope by obtaining the correct (by a specialist in ADHD) consultation and, if necessary, treatment.

May 15, 2012 at 1:01 am Leave a comment

Can we still rescue this school year?

This is the time of year when many parents whose children have struggled with school start to either despair or panic.  Most parents will say: “We’ve done everything we can; we’ve talked to him (or her), we’ve encouraged him, we’ve pushed him as hard as we can, we’ve even tried tutoring and counseling, hoping for the best, and nothing seems to have gotten better.  The school is talking about holding him back and/or putting him in a special class”.

 Most of the time, as I inquire further into the child’s problems, I will hear that he (or she) is having significant problems academically and can’t seem to focus or retain what he’s learned at home, or is having lots of behavior problems at school, lacks confidence, is isolated… or all of the above.  

This question actually has two parts to it.  For the first part: No, it is definitely not too late to get help for this school year.  It is at the end of the school year that the evaluations and decisions are made as to what is best for the child in the coming year and we are definitely not at that point yet.  I have worked with many teachers, and I am consistently told that if they see significant improvement in academics and/or behavior before the end of the year, it can definitely effect their decisions.

Parental attitude toward this question is also critically important to their child.  Your decision to accept these problems as unavoidable and/or to give up on this school year, as opposed to not giving up and continuing to find the solution to your child’s difficulties, makes an indelible impression on how your child sees themselves and their approach to solving problems.  If you take the first option, things will probably get worse for them as they will sense you’re giving up, and they will too.  They will also think less is expected of them and they may put forth less effort.  If you choose the second option, and ground that for them firmly in the fact that the problems do not represent their true self or abilities, and that they are worth these extra efforts to solve the problems, then you have the opposite effect and their self esteem and effort climbs. So does your chances of final success for the school year. 

The second part of the question regards whether or the not the proper underlying cause of the problem is being addressed.  While tutoring and counseling definitely have their place, the problems mentioned here are more likely stemming from ADHD.  Furthermore, the effectiveness of tutoring, counseling, and many other interventions will be significantly reduced if the underlying ADHD is not treated first.  This is a disorder that many parents reject testing for and if present, treating, because they understandably fear what they think is the unavoidable use of medication with its undesirable side-effects and rigors.  There is, however, a much preferable alternative to this scenario, and that is neurofeedback.  

Neurofeedback is an effective, drug and side-effect free procedure in which the individual learns to retrain the attention and/or impulse control mechanisms of the brain, alleviating the condition.  Once training is completed, no further treatment is necessary. 

In conclusion: No, if the parents don’t give up on the school year (or their child), and the true underlying cause of the problem is identified and corrected, it is definitely not too late  to save this school year, and the decision to do so is critical for your child.

April 11, 2012 at 12:08 am Leave a comment

Successful Treatment Planning for Attention Deficit Disorder

If you, your child’s teacher, or someone else significant suspects your child may have Attention Deficit Disorder (ADD or AD/HD), by this time of  the school year you really need to get something going to help them as soon as possible.  What is really needed is to first, find out definitively if it is really there, and secondly, get started immediately with a good plan, before it is too late to salvage the school year.  

Schools vary widely in their ability and willingness to assist the parent in this matter. My brother is an elementary school teacher, and a good one, as are many of his peers.  However, there is a wide range in the ability of teachers, as well as schools, in assessing and working with children with this disorder.  

Some teachers are judgmental in their opinions regarding ADD.  They may believe a child willfully misbehaves.  Everyone knows a “dangerously” little amount about ADD.  School personnel are often more objective than parents, as they can compare the child to hundreds of children in their professional experience.  However, teachers listen to the popular press, have family members with ADD, glean information from other sources, and often base their opinion on what they have heard, and not on the true facts.  With good intentions, school personnel may believe or imply to parents that bad parenting, low ability, and or emotional problems are behind the difficulties.  Some teachers have been known to tell parents not to treat the problem, rather, just to employ harsher punishments, and that indeed is a very bad answer.  Finally, most schools are often very slow to actually do any testing (6 months to a year is not at all uncommon).  Furthermore, the results are frequently too vague, yielding results such as “learning disorders” or “learning disabilities”.

 The proper thing to do, therefore, is to have your child tested by an outside, independent professional.  There are two types of testing, those that based solely on symptoms, observed or reported (the most common form of testing), and those that based on testing the actual source of the problems (a specific brain function), through EEG-analysis.  As there are other problems which can cause ADD like symptoms, it is essential to test right at the source of the problem:  the brain (EEG-analysis).

Medication and Neurofeedback (EEG-analysis and treatment) are the only methods of treatment which actually address the underlying cause of the problem (a minor misalignment in the brain).  Medication is usually effective (unfortunately, teachers will often advise that this is the only answer). However, possible side effects and the necessity of the life long use of these drugs are often understandably very discouraging to parents.  

Neurofeedback is a drug and side-effect free, painless procedure in which the child learns to re-train the relevant attention and/or behavioral mechanisms of the brain, alleviating the condition.   Once training is complete, no further treatment is necessary.  It is an excellent alternative to the often dreaded medication scenario.

February 15, 2012 at 1:23 am Leave a comment

ADHD Basics

ADHD (ADD) is an abbreviation for Attention Deficit Hyperactivity Disorder.  There is some confusion with the initials and names used for this disorder.  ADHD actually means Attention Deficit, with or without Hyperactivity, Disorder.  Some people think that attention and hyperactivity (and/or impulsivity) need to be present in order for the disorder to be there, and this is a mistake.  There are actually three sub-types of this disorder: Primarily Inattentive, Hyperactive-Impulsive (either or both), and the Combined Type (all three).  When speaking with true professionals who specialize in this disorder, these misconceptions and misunderstandings should not be a problem.

ADHD is one of the most common childhood behavior disorders.  Of all children referred to mental health professionals, about 35% are referred for ADHD – more than any other condition.  It is estimated that approximately 9% of all children are troubled with this disorder. 

The first step to take in determining if this disorder is present is to do the proper testing, usually, once again, by an independent professional.  Frequently, it is very unfortunate that medication and treatment are prescribed based solely on a parent’s or anothers opinion or observation.  While these may be well intentioned, they are usually not based on the proper criteria or knowledge.  In the cases where testing is actually being done, it is based largely only on symptoms.  While symptoms are important, and indeed are the true “real world” problems, there are other causes than ADHD that can bring about ADHD-like symptoms.  The only way to determine if ADHD is truly present, in conjunction with the symptoms, is to look at the organ in question, which in this case is the brain.  This is done through brain monitoring (EEG analysis), which is a painless non-invasive test.  This is the only objective way to determine if the disorder is present.

There are basically three forms of treatment.  Therapy or cognitive-behavioral treatment: These forms of treatment mostly offer support in learning to live with the disorder.  Since ADHD is a neurological disorder, and not an emotional or psychologically based problem, these treatment options are quite limited in treating the disorder.   Medication: Usually effective in treating the disorder, however, there are frequently unwanted side effects, and, since the medication is only effective while it is in the bloodstream, the medication needs to be taken for life.  Neurofeedback:  An effective, side-effect free treatment in which the child retrains the underlying mechanisms that cause the disorder.  Once treatment is complete, no further sessions are necessary.

Many parents avoid testing and/or treatment for ADHD because they understandably fear the side-effects and need for lifetime use of what they mistakenly think is the only remedy to the problem, medication.  There is, fortunately, an alternative to this scenario.  Neurofeedback is a proven, painless, and effective solution to the problem of ADHD,which opens for the person the opportunities they deserve for a lifetime of learning, growing, and relating well with others.

January 26, 2012 at 1:57 am Leave a comment

Two Distinctly Different Paths for Treatment of ADHD: Neurofeedback or Medication

Neurofeedback (EEG-Biofeedback) and medication are the two most common forms of treatment fo ADHD (ADD).  Both are successful in treating these disorders in a large majority of cases.  There are, however, significant differences in the ways these treatments work, the potential side effects of their use, the length of treatment necessary, and importantly, the lessons learned by the child of how to correct personal problems. 

Most of the most commonly prescribed medications for ADHD are dervied from some form of stimulant or antidepressant.  Most of these medications carry the FDA’s “Black Box Warning” Labels, and should be used with caution.  These warnings refer to the possibility of serious cardiovascular side effets, as well as the possible suppression of children’s growth, and heightened risk for psychosis, bi-polar illness, and aggression. 

In addition to these problems, this class of medications is also associated with the following serious potential side effects: weight loss in children, overstimulation of the central nervous system, dizziness, difficulty sleeping, tremors, headaches, and tics or Tourettes Syndrome.

Now, let us take a look at how these different treatments work.  The medications contain artifical chemicals, which increase neurotransmitter levels in the brain, allowing the brain to function better, thus alleviating the condition.  As these chemicals are artificial, and foreign to the body, they may cause unfavorable reactions in the brain, and therefore brings about the aforementioned negative side effects.

Neurofeedback trains the brain to funciton faster through a highly specialized type of exercise.  As the brain learns to function faster, it naturally increases its production of neurotransmitters, and the brain functions better, thus treating the condition.  The end result is the same in both forms of treatment… with one very big difference.  As neurofeedback does not introduce anything unnatural into the brain, and rather trains the brain to function better through its own natural mechanisms (i.e. it learns or teaches itself to improve), it produces none of these side effects.  As vulnerable as children are, the last thing we want to do is expose them to these unnecessary dangers. 

Finally, length of treatment is another big difference.  Medication is a lifetime process, as it is only effective while it is in the bloodstream.  Therefore, no amount of medication will ever produce a lasting effect.  The medication must be continually taken to treat the condition, with once again, the continuing potential for these serious side effects and health dangers.  Neurofeedback, on the other hand, is a “one time” treatment for this disorder.  It is a far simpler solution, once treatment is complete, no further sessions are necessary.

Finally, there is a subtle lesson being taught to the child about how to deal with life’s problems. It is a lesson that will assume major importance as the child grows older.  The lesson is “Do I take a substance to be smarter, get my work done more quickly, and be more popular- getting along better with others… or do I improve my capacities, performance, and relationships with others through working on and improving myself?”  The abuse of these medications is already growing steadily in schools.  As the child grows older (and, unfortunately, this is happening at a younger and younger age) they will be presented with increasingly more dangerous substances to deal with essentially (if not exactly) the same questions.  In many ways, the stage is already being set by the way in which parents choose for their child to deal with their ADHD.

Once neurofeedback treatment is completed, no further treatment is necessary, and the child learns a healthy lesson about the right way to strengthen their abilities.  With neurofeedback, there are no side effects, the treatment is a one-time process, and the child avoids learning a potentially dangerous lesson, and instead learns a healthy one of self-reliance and self-improvement.  Neurofeedback is an effective, drug free, painless procedure in which the child learns to retain the attention mechanisms of their brain , alleviating the condition. 

If you, or someone you know, is interested in learning more about Neurofeedback or would like to schedule an evaluation, please contact Dr. Ferrari at Alta Neuro-Imaging (Placentia, CA).

December 9, 2011 at 12:20 am Leave a comment

Homework Problems… And Solutions

In my many years of experience helping children and parents with academic and behavioral problems, one of the most common issues is difficulty with homework.  The purpose of homework is to allow the child further opportunities to independently master their coursework, and perhaps allow the parent to become involved in what is happening for their child at school.

If homework is often a problem for a child, several confounding factors may have developed which add significantly to the problem, in a cumulative fashion.  Past assignments that need to be made up (undone or never turned in) and uncompleted class work that is sent home can add much to the burden.  Additionally, with homework being a recurring problem, your child may have developed the behaviors of “hiding” homework or being deceptive about what or when something is due.

A typical “problem homework” scenario may include some or all of these patterns. After much cajoling and struggling, the parent gets the child to begin their homework.  Then ensues in long battles that last multiple hours, involving countless distractions, struggles (and phone calls?) to understand the material and directions which unfortunately, the inattentive child did not get straight in class, and outbursts of frustration and anger occur from both parties.  The outcome of this homework session is (along with hopefully some learning), exhaustion, hurt feelings, distrust, lowered self-esteem, and anger.  Does this sound familiar…?

What’s very important to understand , and to correct this scenario, is that the child may have Attention Deficit Disorder.  With the ADHD child, they cannot stop this from happening; it’s part of the uncorrected disorder.  However, often teachers, other students, and parents lose site of this, and blame the child.  The result is a child who feels very badly about themselves, and gives up, or rebels, or both.

These daily episodes are very damaging to family dynamics.  In addition to the harm done to the parent-child relationship, there are other significant consequences.  Other childrens’ needs go unattended (not to mention the parent’s), important tasks around the house go undone (dinner anyone?), and last, but definitely not least, the parent’s own relationship suffers as blaming, overwork, and loss of quality time together are also casualties.

Remember what we said homework was for and was supposed to be like in the first paragraph? The homework experience with the ADHD child is not any kind of “Building Up”… it is a “Tearing Down” experience.

Fortunately, this can be changed, without the side-effects and rigors of medication.  Neurofeedback is an effective, drug free, painless procedure in which the child learns to retrain the attention mechanisms of their brain, alleviating the condition.  Once training is completed, no further treatment is necessary.

November 28, 2011 at 9:34 pm Leave a comment

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