What is Neurofeedback?
Neurofeedback is a type of biofeedback. It uses real time displays of brain activity to teach self regulation of brain function. Other types of biofeedback include using skin temperature, heart rate, or blood pressure for self-regulation. Abnormal brain activity has been demonstrated in many problems such as ADHD, depression, anxiety, panic attacks, learning disorders, OCD, head injuries, concussions, and PTSD. Learning self-regulation of brain function can normalize brain activity and decrease, if not eliminate, symptoms associated with those problems.
Inefficient brain function shows up as abnormal brain wave patterns, which can be measured with sensors placed on the scalp. When brain waves move away from the abnormal patterns toward more efficient patterns, then there are rewards, and the brain learns to continue producing the more efficient brain waves. This process is called operant conditioning and occurs on a subconscious level. Over time these efficient patterns become permanent without the need for feedback.
In order to get started with neurofeedback, an assessment needs to be done to evaluate brain function. One of the assessments, the one that documents inefficient brain wave patterns, is called a quantitative electroencephalogram (QEEG) or brain map. A cap embedded with sensors is placed on the head and then measures the electrical signals coming from the brain. Sophisticated computer software analyzes the signals and produces a map of the surface of the brain that illustrates the areas of inefficiency. This map, along with the other assessments, is used to determine the specific areas of the brain to train and the approximate number of sessions that may be needed.
Benefits of Neurofeedback Training
There are a number of benefits of neurofeedback training that have been well documented. Among these are:
- Improved attention/focus
- Decreased hyperactivity
- Decreased irritability
- Better sleep
- Less anxiety
- Increased social interaction
- Improved memory
- Enhanced cognitive performance
Neurofeedback for ADHD
Approximately 11% of children from 4 to 17 years of age in the United States have been diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) as of 2011. That equates to 6.4 million children, and that rate is on the rise, as much as 5% per year. Historically the treatment has been either behavioral therapy, medication, or a combination of the two. However, the results have been less than satisfactory as both types of therapy must continue or else the symptoms return. This means that the child would have to stay medicated or participate in behavioral therapy for the rest of his or her life to control the symptoms. It is estimated that the annual economic cost of ADHD is between $12,000 and $17,000 per individual. (http://www.cdc.gov/ncbddd/adhd/data.html)
While medication can really help with the symptoms, there are always side effects, which can range from minor to very severe, even life-threatening. Some common side effects of ADHD medications are:
- Sleep problems
- Weight loss or gain
- Upset stomach
- Heart palpitations
- Change in appetite
- Skin rashes
- Suicidal thoughts
The good news is that more and more parents are realizing how detrimental medication can be for their child and are looking for alternative therapies. This leads them to neurofeedback, which has several advantages:
- Permanent changes
This therapy targets the abnormal brain waves that are causing the symptoms and seeks to retrain them, allowing the brain to function as it is supposed to function. All of this happens without the use of medication, and the changes are permanent!
The research on neurofeedback is extensive and growing. It has been shown to have the highest levels of efficacy in many conditions such as ADHD and anxiety, and very high levels of efficacy in conditions such as substance abuse and traumatic brain injury. A full list of current and past research is maintained by the International Society for Neurofeedback & Research.
What to Expect
The first visit is the consultation and lasts approximately one hour. During that time Dr. Richards will talk to both the parent and the child about the child’s symptoms and personal history, what their expectations of neurofeedback are, what they know about neurofeedback, and the costs and time associated with the process. If Dr. Richards feels that the child is a good candidate for neurofeedback training, then he will begin the assessment process, which may include both on screen (computer-based) assessments as well as take home written questionnaires. He will also familiarize the child with the office and the equipment used in the sessions.
The second visit also lasts approximately one hour and is the time to finish the assessment process, which includes mapping the brain (the QEEG). Dr. Richards will then take the results of the assessments and correlate them with the child’s symptoms and history to come up with a treatment plan, which will be presented to the parent and child during the third visit.
The third visit again lasts about an hour. Dr. Richards will present the results of the assessments (including the brain map) to the parent and child along with a treatment plan. He will discuss the treatment and answer any questions that either parent or child has. At that point treatment will begin with the first training session.
The training sessions occur at a frequency of two to three times a week and last from 30 to 45 minutes each. Generally a child will need anywhere from 30 to 60 training sessions for the effects to become permanent. Re-assessments will be performed every 10 to 15 sessions, and Dr. Richards will review the results with the parent and child.