One treatment that is gaining popularity in the management of ADD/ADHD patients is neurofeedback.
What is Neurofeedback?
At its simplest neurofeedback is simply brainwave biofeedback. With neurofeedback training, a patient can learn to improve and strengthen brainwave patterns to function more effectively with better focus, organization, follow-through, and basic learning functions. What’s more, the treatment does not have any side effects as do some of the drugs used to treat ADD/ADHD. Neurofeedback works similarly for individuals suffering from autism as well as a number of other disorders.
“Neurofeedback brings down the arousal levels (in the brain) so the patient can get more out of their treatment modalities,” said Dr. Reid Schwartz, Director of Applied Psychophysiology at Neuroheath Associates in Lombard, IL in an interview. “The frequent complaint is that they (ADD/ADHD patients) are non-compliant.”
What Factors Affect Neurofeedback?
First off, it is not a panacea and is generally used in conjunction with other treatments for the disorder. In fact, the Neurohealth staff makes sure they take into account the patient’s entire history to determine the best course of treatment, working in conjunction with pediatricians and other medical professionals that a patient may see. The practice can also be supplemented with phone or in-person consultations with school officials to make EP or 504 plans work more efficiently by giving educators data on how the student’s brain is functioning.
“We take a look at nutrition, medication, is there a family dynamic present to put the brain in emotional overload,” said Dr. Kyle Bonesteel, Neurohealth’s director of clinical neuropsychology.
For example, some patients turn to chelation therapy to augment neurofeedback. Chelation therapy is the process of balancing the presence of heavy metals from the body via a cleansing agent. An overabundance or lack of say, copper or zinc in the brain, can inhibit its receptiveness to information. Thus by changing the brain’s chemistry, neurofeedback therapy becomes more efficient.
Families come to neurofeedback with different goals for the child, Bonesteel continued. Some want the highest level of performance for their child, while others want to wean or significantly reduce the level of medication taken.
How the Brain Learns During a Session
The neurofeedback procedure itself is painless and relatively simple. A technician places sensors on the skull of the patient, targeting areas of the brain to be modified. The sensors are hooked up to a computer program that reads the electrical activity that occurs while the patient watches a screen. A variety of visuals can be used, from computer-generated graphics involving racecars or spaceships to favorite television programs. With the options available, children as young as four years old can benefit from treatment.
What neurofeedback does is challenge the brain in the areas where work is needed. Let’s say a young child with ADD is watching a favorite television character dancing. When the child’s attention begins to wander, the dancing character may slow or even fade to black as the sensors on the skull pick up the electrical information and transmit it back to the computer. When the activity on the screen stops, this forces the patient’s brain to make an adjustment so the character can start moving again.
These tiny adjustments add up over time to help the brain function more efficiently. Patients initially begin with shorter sessions of about 10 minutes in length, then progress to longer ones of a half hour or more as the brain adapts. A general course of treatment averages about 25 sessions, but can be shorter or longer depending on the patient’s response.
Targeting the Correct Areas
Prior to being placed on a course of neurofeedback, a quantitative EEG (QEEG) also known as brain mapping is generally done first to see how the brain is working and to serve as a starting point for treatment and also a measure of progress. Brain function is then normed relative to the child’s age. Cognitive testing is also performed.
The big question for many, however, is how does the brain retain this knowledge when neurofeedback does not affect cognitive learning.
“It’s analogous to learning how to ride a bicycle,” Bonesteel explained. “Once you have acquired the skill, it stays with you for life. The successfully treated child should not be expected to backslide as long as these skills are reinforced.”