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Psychological Disorders[ Back to Menu ]
ADD / ADHD
Neurobiofeedback(sm) and ADD / ADHD
Attention Deficit Hyperactivity Disorder
(ADHD) is characterized by inattention, distractibility, and impulsivity.
Three main subtypes have been identified: one is dominated by inattention
(usually referred to as ADDor ADHD without Hyperactivity); another is
characterized mainly by impulsivity and hyperactivity (usually referred
to as ADHD or ADHD with Hyperactivity); and a third that is referred
to as ADHD, combined type.
Often ADHD is accompanied by more severe
behavioral symptoms, such as opposition and poor conduct, as well as
by specific learning disabilities.
Leaders in the field recognize that ADHD
is best addressed by a variety of approaches, including parent training,
psychotherapy, dietary changes and nutritional support, improved quality
of sleep, medication, and now Neurobiofeedback(sm) training. Before
a diagnosis of ADHD is made, specific attention must be paid to medical
factors that could contribute to the disorder, such as allergies or
the presence of toxic metals, and educational factors, such as specific
learning disabilities. Other conditions such as primary depression,
anxiety, and seizure activity can also impact the diagnosis.
Depending on the nature of the underlying
problem, medical management of ADHD may consist of stimulants, anti-depressants,
or anti-convulsant medication. There has been increasing concern by
medical professionals in the field, as well as the educated public,
that resorting quickly to medication for children with ADHD has led
to an over-simplification of this complex condition. This in turn has
led to the over-diagnosis and ultimately the over-medication of many
children and adults.
Neurobiofeedback(sm), has been shown to
reduce and even eliminate the characteristic symptoms of ADHD and the
related conditions, which are the immediate cause of medical referrals.
The training has also been shown to have lasting effects, in contrast
to medication. The effectiveness of medication in even temporarily normalizing
a child's behavior is proof that the child's brain is capable of functioning
normally. Neurobiofeedback(sm) simply allows us to accomlish that task
with objective and measurable data.
What then is the role of stimulant medication?
It is to induce a temporary functional change in the brain. The common
remedy, Ritalin or the new "longer lasting" Concerta for example, does
not supply a missing neurotransmitter. It is not like supplying insulin
to a diabetic (in contrast to what you may have been told). It is also
not like providing glasses to a near-sighted person. Ritalin, like Concerta,
Adderal, and Cylert is not Vitamin R, either. Ritalin, which is a stimulant,
simply speeds the brainwaves up in those children and adults for which
it is appropriate, by impinging on the state of regulation of several
neurotransmitter systems (dopamine and norepinephrine). Once the medication
is metabolized (used up) however, the brainwaves revert back to the
same slower dominating brainwave the existed before, regardless of how
long you have been taking the medication. This is why medication will
only mask the symptoms and never will they "fix" the problem.
Neurobiofeedback(sm) training rewards
the child or adult for changing brainwave activity toward what is more
characteristic of a functional brain. In other words, when the child
learns how to speed their own brainwaves up, without the use of the
medication, they are rewarded. The learning process is much like riding
a bike. However, it can be difficult to explain because it is largly
an unconscious act. (Go ahead and try to explain to someone how to ride
a bike. You will then see what I mean). Neurobiofeedback(sm) challenges
the individuals brain to self-adapt to a more functional state. It is
best considered as mental fitness trainng that over time teaches the
individuals brain improved skills of managing attention, arousal (level
of excitability), and affective or emotional state. The individuals
brain already manages attention, arousal, and affective state to a certain
degree, and the relevant mechanisms are in place to do so. Simply exercising
those mechanisms strengthens them, and allows the individual to have
better control over his or her own behavior automatically, just as these
things are automatic for those of us who don't have ADHD. Basically,
Neurobiofeedback(sm) simply employs learning strategies that heve been
proven effective. For example, we incorporate visual feedback, audio
feedback, and tactile feedback, which are the three best ways to learn.
Although we all learn better with one or the other, if you use all three
at once, you are very likely to learn the information quickly.
If a child exhibits more severe disruptive
behaviors, Neurobiofeedback(sm) will help to deminish and eventually
for many, eliminate those behaviors. The child or adult will likely
also notice an improvement in their quality of sleep, if this is a problem
to begin with, which it usually is with the use of medications. Associated
depression and anxiety will be found to be alleviated as well with the
training. With a more functional brain, the child or adult will exhibit
his or her natural intellectual abilities, and measured IQ scores may
very well increase significantly with the training. This is not because
Neurobiofeedback(sm) will make someone smarter, but rather because it
will make the person more available to reach the potential they already
possessed.
Neurobiofeedback(sm) training can also
be helpful with specific learning disabilities such as dyslexia, dysgraphia,
and dyscalculia, as well as with poor visual and auditory memory. Neurobiofeedback(sm)
should therefore be considered as part of a comprehensive program for
addressing the needs of the child labeled ADHD, learning disabled, or
behaviorally disregulated.
Moreover, a child does not have to meet
specific diagnostic criteria in order to benefit from the training.
Neurobiofeedback(sm) training is a challenge to any brain to get it
to function better. In summary, Neurobiofeedback(sm) is a safe, proven,
and non-invasive alternative that should be given a great deal of "attention"
due to the overwhelming success qualified practitioners and researchers
are having. Individuals may say many things about this modality, but
the fact of the matter is that it simply works for about 8 out of 10
people conservatively. With the family support network in place and
minimal compliance, success is very likely to be even higher. The technique
will only get better and better, until their will be no question as
to the efficacy of this powerful intervention.
NOTE: The word Neurobiofeedback(sm) is
a word that was coined by our organization and it simply refers to the
combination of both traditional biofeedback (EMG/muscle feedback) and
neurofeedback (EEG/brainwave feedback). You may see many variations
in the descriptions of this field, i.e. biofeedback, neurofeedback,
EEG-Biofeedback, etc. However, when referring to ADHD, neurofeedback
(brainwave training) is what is being discussed. Because ADHD is in
the brain and not in the foot for example, traditional biofeedback would
simply not be as effective in alleviating the symptoms of ADHD.

- Treatment
of attention deficit hyperactivity disorder with neurotherapy. Nash
JK. Clin Electroencephalogr. 2000 Jan;31(1):30-7. Review.
- The
state of EEG biofeedback therapy (EEG operant conditioning) in 2000:
an editor's opinion. Duffy FH. Clin Electroencephalogr.
2000 Jan;31(1):V-VII.
- Neurofeedback
combined with training in metacognitive strategies: effectiveness
in students with ADD. Thompson L, Thompson M. Appl Psychophysiol
Biofeedback. 1998 Dec;23(4):243-63.
- Neocortical
dynamics: implications for understanding the role of neurofeedback
and related techniques for the enhancement of attention. Lubar
JF Appl Psychophysiol Biofeedback. 1997 Jun;22(2):111-26.
- Attention
and neuro feedback
Dissertation in German with English abstract by Thomas Fuchs
- A
Comparison of EEG Biofeedback and Psychostimulants in Treating Attention
Deficit/Hyperactivity Disorders.
Thomas P. Rossiter, and Theodore J. La Vaque. Journal of Neurotherapy,
1, Summer 1995
- A
Controlled Study of the Effects of EEG Biofeedback on Cognition and
Behavior of Children With Attention Deficit Disorders and Learning
Disabilities
Linden, M., Habib, T., Radojevic, V. (1995). Biofeedback and Self-Regulation,
21, 35-50.
- Quantitative
EEG and Auditory Event-Related Potentials in the Evaluation of Attention-Deficit/Hyperactivity
Disorder: Effects of Methylphenidate and Implications for Neurofeedback
Training
J. F. Lubar, M. O. Swartwood, J. N. Swartwood, D. L. Timmermann
Journal of Psychoeducational Assessment, ADHD Special, 1995, 143-160.
- Ongoing Program Evaluation of EEG Neurofeedback
at New Visions School: 1997-98 * 1996-97
John Anderson
- Efficacy
of SMR-Beta Neurofeedback on Attentional Processes
David A. Kaiser & Siegfried Othmer November 1997
- EEG
Biofeedback Training for Attention Deficit Disorder, Specific Learning
Disabilities, and Associated Conduct Problems
Siegfried Othmer, Susan F. Othmer, & Clifford S. Marks September
1991
- EEG
Biofeedback Training for Attention Deficit Disorder: A Review of Recent
Controlled Studies and Clinical Findings
Siegfried Othmer, Ph.D., David Kaiser, Ph.D., and Susan F. Othmer,
B.A. June, 1995
- EEG
Biofeedback for Attention Deficit Hyperactivity Disorder
Siegfried Othmer, Ph.D., and Susan F. Othmer, B.A. October, 1992
- Evaluation
and Remediation of Attentional Deficits
Susan F. Othmer and Siegfried Othmer, Ph.D.December, 1992
- EEG
Biofeedback Training for Hyperactivity, Attention Deficit Disorder,
Specific Learning Disabilities, and Other Disorders
Siegfried Othmer, Ph.D., and Susan F. Othmer March, 1989
- Efficacy
of Neurofeedback on Adults with Attentional Deficit and Related Disorders
David A. Kaiser December 1997
- Neurotherapy
and Drug Therapy in Combination for Adult ADHD, Personality Disorder,
and Seizure.
Lisa M. Hansen, B.S., David L. Trudeau, M.D., & Dixie L. Grace,
Ph.D .
- Improved
Neuronal Regulation in ADHD: An Application of 15 Sessions of Photic-Driven
EEG Neurotherapy.
Graham J. Patrick, RN, Ph.D .
- Patient-Directed
Neurofeedback For AD/HD.
Thomas R. Rossiter, Ph.D.
- EEG
Biofeedback in the Schools: The Use of EEG Biofeedback to Treat ADHD
in a School Setting.
William D. Boyd, Susan E. Campbell.
- Visual-Motor
Integration and its Relation to EEG Neurofeedback Brain Wave Patterns,
Reading, Spelling, and Arithmetic Achievement in Attention Deficit
Disorders and Learning Disabled Students
T. Nick Fenger, Ph.D.
- Neurological
Basis and Neurofeedback Treatment of ADHD
Joel F. Lubar, Ph.D., & Judith O. Lubar, LCSW, BCD, April, 1995
- Attention
Deficit Hyperactivity Disorder: Neurological Basis and Treatment Alternatives.
Arreed Barabasz and Marianne Barabasz
- Ten-year
stability of EEG biofeedback results for a hyperactive boy who failed
fourth grade perceptually impaired class.
Tansey MA Biofeedback & Self-Regulation 18 (1): 33-44
(Mar 1993)
- Attention-deficit
hyperactivity disorder. Pharmacotherapy and beyond
Tan G, Schneider SC Postgrad Med 101 (5): 201-204 (May 1997)
- A
controlled study of the effects of EEG biofeedback on cognition and
behavior of children with attention deficit disorder and learning
disabilities.
Linden M, Habib T, Radojevic V Biofeedback & Self-Regulation
21 (1): 35-49 (Mar 1996)
- Evaluation
of the effectiveness of EEG neurofeedback training for ADHD in a clinical
setting as measured by changes in T.O.V.A. scores, behavioral ratings,
and WISC-R performance.
Lubar JF, Swartwood MO, Swartwood JN, O'Donnell PH Biofeedback
& Self-Regulation 20 (1): 83-99 (Mar 1995)
- EEG
Biofeedback: A New Treatment Option for ADD/ADHD.
Marabella A. Alhambra, M.D., Timothy R. Fowler, and Antonio A. Alhambra,
M.D.
- Discourse
on the development of EEG diagnostics and biofeedback for attention-deficit/hyperactivity
disorders.
Lubar JF Biofeedback & Self-Regulation 16 (3): 201-225
(Sep 1991)
- Electroencephalographic
biofeedback of SMR and beta for treatment of attention deficit disorders
in a clinical setting.
Lubar JO, Lubar JF Biofeedback & Self-Regulation 9 (1):
1-23 (Mar 1984)
- EMG
and EEG biofeedback training in the treatment of a 10-year-old hyperactive
boy with a developmental reading disorder.
Tansey MA, Bruner RL Biofeedback & Self-Regulation 8
(1): 25-37 (Mar 1983)
- Operant
conditioning of EEG rhythms and ritalin in the treatment of hyperkinesis.
Shouse MN, Lubar JF Biofeedback & Self-Regulation 4 (4):
299-312 (Dec 1979)
- EEG
and behavioral changes in a hyperkinetic child concurrent with training
of the sensorimotor rhythm (SMR): a preliminary report.
Lubar JF, Shouse MN Biofeedback & Self-Regulation 1 (3):
293-306 (Sep 1976)
- Efficacy
of EEG biofeedback for attentional processes.
Kaiser, D.A., & Othmer, S. (1997), Presented at American Psychiatric
Electrophysiological Association, San Diego, 1997.
- Cartozzo, H.A., Jacobs, D., & Gevirtz,
R.N. (1995). EEG biofeedback and the remediation of ADHD symptomatology:
A controlled treatment outcome study. Presentation at AAPB Conference,
1995.
- Fenger, T.N. (1995). Visual-motor integration
and its relation to EEG neurofeedback brain wave patterns, reading,
spelling, and arithmetic achievement in attention deficit disordered
and learning disabled students. Presentation at 1995 Society for the
Study of Neuronal Regulation, Scottsdale, AZ.
- Kade, H.D. (1995). A comparison of
brainwave biofeedback and cognitive rehabilitation for ADHD-inattentive
type with learning disabilities.
Presentation at AAPB Conference, 1995.
- Kaiser, D.A (1998). Effect of neurofeedback
on attentional and cognitive deficits of ADHD children. Presentation
at 29th Annual Association for Applied Psychophysiology and Biofeedback,
April 6-10, Orlando, FL.
- Kotwal, D.B., Burns, W.J., & Montgomery,
D.D. (1996). Computer-assisted cognitive training for ADHD: A case
study. Behavior Modification, 20, 85-96.
- Nash, J.K., & Shakelford, A. (1995).
Neurofeedback and cognitive training in the amelioration of attention
deficit hyperactivity disorder. Presentation at 1995 Society for the
Study of Neuronal Regulation, Scottsdale, AZ.
- Samples, J. (1994). The use of EEG
biofeedback for attention-deficit hyperactivity disorder.
Presentation at AAPB Conference, 1994.
- Scheinbaum, S., Newton, C.J., Zecker,
S., & Rosenfeld, P. (1995). A controlled study of EEG biofeedback
as a treatment for attention-deficit disorders.
Presentation at AAPB Conference, 1995.
- Thompson, L., & Thompson, M. (1997).
Training results with ADD clients: Isneurofeedback training for attention
deficit disorder in adults as effective as similar training carried
out with children. Presentation at 1997 Winter Conference on Brain
Function/EEG, Palm Springs CA.
- Toomim, M., Ibric, V., & Othmer,
Siegfried (1994). EEG biofeedback training for attention deficit disorder
and other behavioral disorders. Presentation at 1994 California Psychological
Association Convention, San Francisco CA.
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