The following is from my wife's clinic, and is posted in response to requests for information on biofeedback. Two videotapes are noted at the end. Insurance rarely reimburses in the northeast US, but is more likely the further west you go.
From
Neurodevelopment Associates, Inc.
Lexington, Massachusetts
- An attention deficit disorder (ADD) may occur with or without hyperactivity (ADHD) or learning disability (LD). EEG brainwaves in individuals with ADD contain a high ratio of slow waves (theta EEG, 4-8 Hz) to fast activity waves (beta EEG, 16-20 Hz) as compared to persons without ADD.
- EEG biofeedback trains a subject to increase the amount of beta EEG activity that is generated during times when the subject needs to concentrate, and to reduce the amount of theta EEG associated with day dreaming.
- EEG biofeedback uses a single or multiple channel EEG instrument coupled with a computer system. Sensors placed on the head record EEG waves, which are represented on the computer screen as a spectrum of frequencies, which are used by the clinician to calibrate the training exercises to follow. During training sessions, the subject is presented with a series of tasks (reading, listening to stories, etc.) and is rewarded by changes in the game on the computer screen when he or she produces a certain level of beta wave activity. Each session lasts approximately an hour.
- Teachers and parents report that children who successfully complete EEG training significantly improve their ability to complete homework accurately, to concentrate in class, to listen effectively, and to maintain their attention to tasks. There is an improvement in self-esteem and a decrease in impulsive behaviors. There is also an associated increase in scores on IQ tests that will vary for each subject, primarily as a result of improved concentration.
- The research indicates that subjects who respond well to Ritalin and similar medication are likely to respond well to EEG Biofeedback and vice versa. Clinical experience indicates that approximately 4 out of 5 likely subjects will respond well to the training and successfully complete.
- Children receiving medication for ADD are often able to decrease or eliminate the need for medication as EEG training progresses. The medication does not interfere with EEG training, and may be maintained as long as it is still necessary.
- No side effects have been observed from this type of treatment.
- The beneficial effects are cumulative with treatment, and there is no evidence that the effects fade over time.
- While EEG biofeedback training is specifically targeted to the child or adult with ADD, it offers improvements in concentration to persons with normal EEG as well.
- EEG biofeedback training typically takes 40-60 sessions for children, more for adults.
- Sessions are typically scheduled twice a week for the first 20-30 sessions, once a week for the next 10-20 sessions, and then with progressively decreasing frequency for the remainder of the training. Follow up evaluations are typically scheduled for six months and one year after completion, and parents are encouraged to continue subsequent annual follow up sessions.
- The training can be given on an accelerated schedule with a small improvement in the number of sessions required and without reducing its effectiveness.
- The first step is a one to two hour initial consultation with parents only. At this time, family history will be reviewed. The subject's medical, developmental, social and educational histories will be discussed, and previous testing will be reviewed and discussed with parents.
- The next session will include the subject and one or both parents. At that time, the biofeedback training procedures will be explained and demonstrated, and a topological brain mapping will be conducted with the EEG biofeedback equipment. This procedure provides a detailed analysis of the subject's unique brain wave patterns, and is important to confirm a diagnosis of attention deficit disorder (ADD) that will respond to EEG biofeedback. This also allows custom training protocols to be derived.
- At this point, candidates who are felt to be appropriate for EEG biofeedback training will be scheduled for regular training sessions.
- EEG progress can generally be observed after 10-15 sessions. Changes in behavior (increased attention span, greater concentration, decreased impulsivity, improved socialization skills, etc.) are usually noticed after 20-30 sessions. These changes will be increasingly noticed as the training progresses.
1. It is helpful if the subject has recently had their hair washed thoroughly, as skin oils can increase the background noise in the EEG.
2. It is recommended that use of hair spray, styling gels or other hair additives be avoided between hair wash and EEG session.
3. Subject should be well rested as biofeedback requires concentration.
4. Please notify the clinician if the subject has a history of skin allergies to cosmetics and lotions.
Note: These are hand assembled references. A complete, up to date bibliography of EEG neurotherapy is available for a fee from Lexicor at (303) 443-3915.
Gillberg, C., Matousek, M., Peterson, I., and Rasmussen, P. Perceptual, motor and attentional deficits in seven year old children: Electrophysiologic aspects. Acta Paedopsychologica
Hughes, J. R., and Myklebust, H. R. (1971). The EEG in a controlled study of minimal brain dysfunction. Electroencephalography and Clinical Neurophysiology, 31, 292.
Jasper, H. H., Solomon, P., and Bradley, C. (1938). Electroencephalographic analysis of behavior problems in children. American Journal of Psychiatry, 95, 641-658.
Klinkerfuss, G. H., Lange, P. H., Weinberg, W.A., and O'Leary, J. L. (1965). Electroencephalographic abnormalities of children with hyperkinetic behavior. Neurology, 15, 883-891.
Knott, J. P., Platt, E. B., Ashby, M. C., and Gottlieb, J. S. (1953). A familial evaluation of the electroencephalogram of patients with primary behavior disorder and psychopathic personality. EEG and Clinical Neurophysiology, 5, 363-370.
Lubar, J. F., Bianchini, K. I., Calhoun, W. H., Lambert, E. W., Brody, Z. H., and Shabsin, H. S. (1985). Spectral analysis of EEG differences between children with and without learning disabilities. Journal of Learning Disabilities, 18(7), 403-408.
Matousek, M., Rasmussen, P., and Gillberg, C. (1984). EEG frequency analysis in children with so-called minimal brain dysfunction and related disorders. Advances in Biological Psychiatry, 15, 102-108.
Satterfield, D. H., Lesser, L. I., Sand, R. E., and Cantwell, D. P. (1973). EEG aspects of the diagnosis and treatment of minimal brain dysfunctions. Annals of the New York Academy of Sciences, 205, 273-282.
Werry, J. M., Delano, J. G., and Douglas, V. (1984). Studies on the hyperactive child. I: Some preliminary findings. Canadian Psychiatric Association Journal, 9, 120-130.
Winkler, A. W., Dixon, J. F., and Parker, J. B. (1970). Brain function in problem children and controls: Psychometric, neurological and electroencephalographic comparisons. American Journal of Psychiatry, 127, 634-645.
Ahw, H., Prichep, L., John, E. R., Haird, H., Treptin, M., and Kaye, H. (1980). Developmental equasions reflect brain dysfunction. Science, 210, 1259-1262.
Cohn, R., and Nardini, J. (1958). The correlation of bilateral occipital slow activity in the human EEG with certain disorders of behavior. American Journal of Psychiatry, 115, 44-54.
Flynn, J. M. Topographic brain mapping and evaluation of dyslexic children: Clinical and research considerations. Learning Disabilities Section, Gunderson Medical Foundation, 1836 South Avenue, La Crosse, Wisconsin, 54601.
Kinsbourne, M. (1973) Minimal brain dysfunction as a neurodevelopmental lag. In F. de la Cruz, B. H. Fox, and R. H. Roberts, (Eds.), Minimal Brain Dysfunction. Annals of the New York Academy of Sciences, 205.
Spiel, G. (1987). Is there a possibility of differentiating between children with minimal cerebral dysfunction by means of computer- assisted automatic EEG analysis? Advances in Biological Psychiatry, 16, 171-177.
Torello, M. W., and Duffy, F. H. (1985). Topographic mapping of brain electrical activity: Utility in the diagnosis of learning disabilities. In M. Languis (Ed.), Brain and Learning: An Emerging Synthesis, Theory into Practice.
Lubar, J. F., and Deering, W. M. (1981). Behavioral Approaches to Neurology, Academic Press.
Lubar, J. F., and Shouse, M. N. (1976). EEG and behavioral changes in a hyperkinetic child concurrent with training of the sensorimotor rhythm (SMR): A preliminary report. Biofeedback and Self Regulation, 3, 293-306.
Lubar, J. F., and Shouse, M. N. (1977). Use of biofeedback in the treatment of seizure disorders and hyperactivity. Advances in Child Clinical Psychology, Plenum Publishing Company, 1, 204-251.
Shouse, M. N., and Lubar, J. F. (1978). Physiological bases of hyperkinesis treated with methylphenidate. Pediatrics, 62, 343-351.
Shouse, M. N., and Lubar, J. F. (1979). Sensorimotor rhythm (SMR) operant conditioning and methylphenidate in the treatment of hyperkinesis. Biofeedback and Self Regulation, 4, 299-311.
Lubar, J. O. and Lubar, J. F. (1984). Electroencephalographic biofeedback of SMR and beta for treatment of Attention Deficit Disorders in a clinical setting. Biofeedback and Self Regulation, 9, 1-23.
Lubar, J. F. (1985). Changing EEG activity through biofeedback applications for the diagnosis and treatment of learning disabled children. Theory into Practice, Ohio State University, 24, 106-111.
Lubar, J. F., Bianchini, K. I., Calhoun, W. H., Lambert, E. W., Brody, Z. H., and Shabsin, H. S. (1985). Spectral analysis of EEG differences between children with and without learning disabilities. Journal of Learning Disabilities, 18(7), 403-408.
Lubar, J. F. (1989). Electroencephalographic Biofeedback and Neurological Applications. Chapter in J. V. Basmajian (Ed.), Biofeedback: Principles and Practice, 3rd Edition, Williams and Wilkins Publishers, 67-90. [Note: good technical overview.]
Lubar, J. F., Gross, D. M., Shively, M. S., and Mann, C. A. (1990). Differences between normal, learning disabled, and gifted children based upon an auditory evoked potential task. Journal of Psychophysiology, 4, 470-481.
Lubar, J. F. (1991). Discourse on the Development of EEG Diagnostics and Biofeedback Treatment for Attention-Deficit/Hyperactivity Disorder. Accepted for publication, Biofeedback and Self- Regulation.
Lubar, J. F. (1991). Differences in semantic event related potentials in learning disabled, normal, and gifted children. Accepted for publication, Biofeedback and Self-Regulation.
Mann, C. A., Lubar, J. F., Zimmerman, A. W., Miller, B. A., and Muenchen, R. A. (1991). Quantitative analysis of EEG in boys with Attention-Deficit/Hyperactivity Disorder (ADHD). A controlled study with clinical implications. Accepted for publication, Pediatric Neurology.
The Connie Chung Eye to Eye broadcast from June 30, 1994 is available for $29.95 plus shipping by calling (800) 762-9990.
"EEG Biofeedback for Learning Disabled Children" is available from
Instructional Technology Center
B-117 Education North
University of Alberta
Edmonton, Alberta T6G 2G5
Canada
Charge was about C$95 last time we inquiried, about US$80. A reasonably good technical overview for people with no background in the field.