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Neural Feedback Training as Therapy for ADHD?
"If you haven't heard of it, the idea is that by attaching sensors to the head, brainwaves can be measured, and by providing visual feedback, you can actually train your brain to regulate its activity. An ADHD person supposedly has a brain which isn't very good at keeping itself in 'concentration' mode. In a child, the feedback takes the form of a game or in the case of an infant, a pleasing pattern on the screen (an infant would probably be treated for sleep disorders, not ADHD, in case you were wondering). When the brainwaves are in the 'right' state, the game proceeds or the patterns get prettier. When the brainwaves are erratic, it all slows down.
Because it is a trendy new thing, it's been put forward as a possible treatment for many other things including sleeplessness, epilepsy and other disorders, but one of the better successes has been in the treatment of ADHD.
The whole thing sounds quite plausible, but it is also quite expensive. All of the stuff I've read has been either from the suppliers of the treatment, or from people trying to discredit it."
I am borderline ADHD, and I only found out several years ago afte I began having trouble with class and general management of time while in college.
/. to research it.
My mom had a friend who had recently gotten certified in using this type of therapy on her daughter (who was severely ADHD), and they arranged for me to show up at their house knowing that because I was a computer science major and a geek, that I would be extremely interested in the whole setup. I walk in, express interest, and they offer to hook me up, and while they're explaining what's going on, they run a quick diagnostic which shows I could use some work on the machine (and that my brain waves are "sloppy").
To make a long story short, I went through three months of training using the machine, the whole time believing it was a placebo, but my entire family noticed the difference. I also began noticing that I was sleeping better and could work for periods of time longer than 30 minutes without feeling like i HAD to take a break.
To sum up, this is a very groundbreaking type of therapy that does work, and I encourage anyone on
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I am a psychology undergrad, and though I have no serious experience with the study or treatment of ADHD, I can recommend some starting points for gaining the facts on this condition. Where I in your position, I would head to the nearest university, put some cash on a copy card, and start using their online article databases. In particular, MedLine and PsycInfo have the most expansive databases on psychology research. Start simple - run some basic searches using keywords like ADHD and Neural Feedback Training. When you find an article or two that nail the topic you're exploring, move from those databses to the ISI (Web of Science) database. The most powerful feature of this database is its reverse-searching feature, where you can enter in an article, and retrieve a list of articles that have been published citing the one you have. This is a literature search (the first major task in designing a study). Moving back and forth between these databases, narrowing your keywords, following citations, and even searching for authors publishing pertinent studies, is going to return a massive quantity of data.
Unfortunately, links to these databases are going to be useless, because you need a subscription to search them. This is why you need to run your searches from a university library. Once you've got some promising references, start pulling articles, and educating yourself.
I hope this helps. I'm a firm believer in the power of psychology and medicine to improve the human condition. Your daughter doesn't have a disease, but she does have the physiological deck stacked against her. Being a fan of psychology over psychiatry, I'm happy to hear that you're persuing a non-drug-based treatment in addition to her medication regimine. I hope that this is where you'll find true long-term improvement.
Best of luck to you, your family, and your daughter.
First, find out which sub-type she has. There are many different subtypes that each have different treatments. Take the on-line tests at: http://www.amenclinic.com Second, check out the pioneer in non-drug therapies: http://www.drakeinstitute.com If you do have to resort to drugs, try Strattera, which is a new, non-addictive, non-stimulant treatment that looks very promising: http://www.strattera.com/index.jsp
Ritalin is a stimulant. "Speed" is used by people to basically mean anything that stimulates the brain chemicals. In the case of someone who has ADHD, they lack a certain brain chemical. Ritalin replaces that brain chemical to normalize the level in the brain and help with ADHD. In the case of a child without ADHD (they have a normal balance of the chemical) the excess amount causes stimulation in the same way that "speed" causes you to become blitzed. Perhaps you had a low-grade or nonexistant ADHD and the Ritalin was excessive, causing you to be wired when medicated as a kid. I don't know the name of this chemical, and I'm too lazy to Google for it (damn ADD.) Ooh look, a butterfly!
By the way, this is from someone who took Ritalin and Depakote for 10 years, and now takes Lithium and Effexor.
Although I sympathize with your bad experience, I tend to want to stay away from generalizations. My wife was diagnosed with ADHD about 12 years ago. She took ritalin in college and she went from a c-d student to a b student. Much of this has to do with concentration and focus. She describes her thoughts as a flashing from one subject to another all with equal/high priority, and she is able to focus on one task, one though with the help of ritalin. She does not take it currently, because she is nursing our third daughter, but she wishes she could because of the focus and clarity if gives to her. Our oldest daughter likely has ADHD. She is struggling in school. We remind her that school is not the most important thing in life. I agree that mindless conformity is bad. It reminds me of how some Native American tribes "honored" androgenous people as a special type of person. Where our society has in the past and currently doesn't know what to do with such people. We tried to "make" them one sex or another just so they could conform. I think ritalin can help some people. As with any narcotic substance, caution surely is advised.
It is dangerous to be right on a subject on which the established authorities are wrong. - Voltaire
Let me begin by pointing out that there is a correlation between ADD/ADHD and Tourette's. In other words, having one increases your chances of having the other.
... we'll never get a chance to perform that experiment, since now I'm all grown up. But I know from firsthand experience that it's possible to reign one's body in using only the power of one's concentration. So give it a shot. If it doesn't work, there's always the drugs.
I was diagnosed with mild Tourette's Syndrome when I was in sixth grade. It manifested itself similarly to your daughter's symptoms -- minor vocal and muscular tics. It wasn't a significant bother, but it impaired me enough that I sought medication for it. I began taking Clonidine transdermally (through a skin patch) to help ease my Tourette's symptoms.
A year after starting the Tourette's medication, I was diagnosed with ADD. This was ~1990, before ADD was a "trendy" disease. At the time, none of my family had ever heard of it before. So I began a regimen of Dexedrine, to help with the ADD.
I stayed on both medications for a further year, until I developed an allergy to the skin patch. At that time, my doctor recommended I try neural feedback therapy to help control the Tourette's. I went in for an hour of therapy every two weeks for a year. Over the course of the year I became better able to control my tics, but only with great concentration. If I became flustered or anxious or nervous or just plain stopped paying attention, I would lose control and the tics would come back. But, at the end of the year, I decided I was able to control the Tourette's well enough to stop therapy and medication.
I continued with Dexedrine throughout my junior-high and high school years, and gradually stopped taking it when I got to college. I firmly believe that the Dexedrine was a great help in high school; even though it exacerbated my Tourette's symptoms, it allowed me to finish high school having learned what I needed in order to get into college. Could I have used some other means to achieve the same ends? Probably. But the medication worked.
Today I'm a slightly disorganized, nervous and fidgety young man living a normal life and working a full-time job in software development. My duties expand every day and I find myself diverting more and more of my attention toward organization and self-management. But I can manage.
Will neural feedback therapy help your daughter? I'd say, give it a try. It could be that the techniques I learned to help control my Tourette's also gave me an edge in studying
P.S. I would recommend looking at alternatives to Ritalin. Dexedrine and Desoxyn , AFAIK, achieve the same thing but with fewer side effects (less of a methamphetamine-like effect on the human body).
As a previous poster mentioned, this kind of stuff works by "training" your brain. It does this through biofeedback.
Biofeedback works by presenting data of interest from some sort of sensor array (EKG, or in this case an EEG) in a way your brain interprets on various levels (ex: colors, shapes, etc).
These guys usually do it (afaik) in the context of some sort of non-interactive game (well, it is interactive in that it's driven by your brain, not by a joystick/keyboard/mouse, etc).
Anyways, I don't want to say too much because I'm sure most of it was under some sort of NDA, but here's their sites:
- EEG Spectrum International
- NeuroCybernetics
This stuff is pretty amazing, you can actually feel it working, as potent (or more) than any medication I've ever popped. But it should only be done by a trained therapist (I tried it on myself a few times because I was sick of playing back the same old recordings and it gave me a bit of a headache, but under the control of a trained tech it doesn't cause much (any afaik) discomfort. Also, unlike another poster mentioned, I was never irritated by the connections, maybe they've improved over time).It's pretty cool stuff and I hope I have an opportunity to contribute more in the near future.
Disclaimer: I'm just a code monkey that developed some "front-end" stuff (the game side shown to the patient, not the nuts & bolts on the therapist's side). So, take my info in context of just a guy who coded from a spec and attended one of their conferences.
DONT PANIC
I spent three years in my graduate school days (which was now a decade ago... yikes!) administering the hardware/software for the Autogenics system in our community mental health center at Nova Southeastern University under Doil Montgomery, Ph.D. Neural feedback is also referred to as EEG biofeedback. Not only is there some good research in this area, but it's a nice, non-invasive and non-drug way to treat this disorder (which should be especially interesting to teens and children, where medications are less tested and proven).
Some basic positive empricial results supporting the use of EEG biofeedback in the treatment of ADHD from MEDLINE:
Neurofeedback treatment for attention-deficit/hyperactivity disorder in children: a comparison with methylphenidate. in Appl Psychophysiol Biofeedback. 2003 Mar;28(1):1-12.
Fuchs T, Birbaumer N, Lutzenberger W, Gruzelier JH, Kaiser J.
Institute of Medical Psychology and Behavioral Neurobiology, Eberhard-Karls-University, Gartenstr. 29, 72074 Tubingen, Germany.
Clinical trials have suggested that neurofeedback may be efficient in treating attention-deficit/hyperactivity disorder (ADHD). We compared the effects of a 3-month electroencephalographic feedback program providing reinforcement contingent on the production of cortical sensorimotor rhythm (12-15 Hz) and betal activity (15-18 Hz) with stimulant medication. Participants were N = 34 children aged 8-12 years, 22 of which were assigned to the neurofeedback group and 12 to the methylphenidate group according to their parents' preference. Both neurofeedback and methylphenidate were associated with improvements on all subscales of the Test of Variables of Attention, and on the speed and accuracy measures of the d2 Attention Endurance Test. Furthermore, behaviors related to the disorder were rated as significantly reduced in both groups by both teachers and parents on the IOWA-Conners Behavior Rating Scale. These findings suggest that neurofeedback was efficient in improving some of the behavioral concomitants of ADHD in children whose parents favored a nonpharmacological treatment.
The effects of stimulant therapy, EEG biofeedback, and parenting style on the primary symptoms of attention-deficit/hyperactivity disorder. in Appl Psychophysiol Biofeedback. 2002 Dec;27(4):231-49.
Monastra VJ, Monastra DM, George S.
FPI Attention Disorders Clinic, 2102 E. Main Street, Endicott, New York 13760, USA. poppidoc@aol.com
One hundred children, ages 6-19, who were diagnosed with attention-deficit/hyperactivity disorder (ADHD), either inattentive or combined types, participated in a study examining the effects of Ritalin, EEG biofeedback, and parenting style on the primary symptoms of ADHD. All of the patients participated in a 1-year, multimodal, outpatient program that included Ritalin, parent counseling, and academic support at school (either a 504 Plan or an IEP). Fifty-one of the participants also received EEG biofeedback therapy. Posttreatment assessments were conducted both with and without stimulant therapy. Significant improvement was noted on the Test of Variables of Attention (TOVA; L. M. Greenberg, 1996) and the Attention Deficit Disorders Evaluation Scale (ADDES; S. B. McCarney, 1995) when participants were tested while using Ritalin. However, only those who had received EEG biofeedback sustained these gains when tested without Ritalin. The results of a Quantitative Electroencephalographic Scanning Process (QEEG-Scan; V. J. Monastra et al., 1999) revealed significant reduction in cortical slowing only in patients who had received EEG biofeedback. Behavioral measures indicated that parenting style exerted a significant moderating effect on the expression of behavioral symptoms at home but not at school.
Treatment of attention deficit hyperactivity disorder with neurotherapy. in Clin Electroencephalogr. 2000 Jan;31(1):30-7.
Nash JK.
Behavioral Medicine Associates,
As another person who could also be considered a 'poster child for ADHD' let me disagree with you. My personal experience has been that there are times that no matter how hard I try or attempt to work around it, there are times where my brain simply refuses to focus on any single task long enough to accomplish anything - even the things I want to do. I also occassionally fall into another classic symptom - hyperfocusing on a single task to the extreme detriment of others.
I've been on adderall on and off since middle school, and it has had a definite, positive effect on these symptoms when I take it. That said, I will agree that I'm strongly opposed to what I'd call routine prescription of stimulants. IE: Take one daily, 'just in case.' The thing I feel is often overlooked is these drugs do have definite side effects. For example, while I usually have a good appetite and admittedly eat a bit more than I probably should, if I'm on a 'routine' adderall dosage, I have to force myself to eat - it's not totally unusual for me to go a day or two without eating simply because I forget otherwise.
The bigger reason why I oppose it, however, are the emotional side effects; which is the primary reason why I don't take it daily as I'm prescribed to. Not only does the medication tend to cause you to focus better, but it also tends to cause emotional swings to become more extreme. While I tend to have slight swings anyway, the medication tends to turn what might be a slightly down mood into full blown depression - especially on the off end of the drug. Having dealt with that for several years and realizing the drastic improvement in my attitude when I took myself off medication for a couple of years, I'd never put a child on medication full time.
As it stands today, for the most part I avoid medication and try my best to work around the condition on my own, but do keep my prescription filled for times when I feel it would help me. I've found it to be a fairly good compromise, allowing me to work effectively and avoid the side effects on being constantly medicated.
So I guess what I'm saying is I don't totally disagree with you, but I still feel that ADHD isn't just something that you deal with or drastically change the environment of the kid for. I know that if anything, all years of guidance counsellors giving me things 'that will help' did is piss me off. You just have to give the kid a chance to figure things out for themselves and allow them to decide when and if they need medication, accomodations, etc. I'd force neither medication nor a special environment on a kid, but feel it'd be better to give them the tools to figure it out for themselves.
I am of exactly the opposite opinion, ADD/ADHD is a disorder and not treating it (when properly diagnosed) is just cruelty plain and simple.
I have ADD and went from being last in my class in High School and failing out of college to graduating with Honors and going on to graduate school at the finest university in the country, after being prescribed Ritalin.
I hold more than a dozen patents and have had research papers published at world class conferences, so as the poster says, I am a very insightful, creative, and interesting folk. And this is only enhanced not suppressed by medication.
I still suffer the effects of going so late in life before being diagnosed, I can't spell for beans having learned all the wrong spellings when I was young. Its all very nice to talk about not trying to harm her "very special mind", but failing to treat her WILL damage her intellect forever, while treating her will allow her intellect to develop.
-jon
The last four months of my life have been, literally, a living hell. Panic attacks to the point of screaming and shaking in fear, tranquilizers by the tubfull. Welcome to the world of [what was diagnosed as] Generalized Anxiety Disorder and it's fun big brother, Acute Panic Disorder.
The reason I mention them is because they have many of the same physical symptoms as ADHD: Trouble sleeping, racing thoughts, inability to focus, irritability/easy to upset, etc.
It was only when that connection was made, in the last week or so, that I appear to be finding my way out of it...
You see, I had what most people would call ADHD when I was a kid. Pretty much every symptom, which are pretty much the same symptoms as anxiety disorder and panic disorder in adults, I had.
Then, it being the 70s in England and Ritalin not being as popular, my mother looked around for other remedies and found the reports on Yellow 5 allergies. She took me off Yellow 5 (tartrazine) and I started to chill out. The scientists may be divided on whether it's a factor but the emprical evidence suggests it was for me at least.
It's only been in the last week or so that we put two and two together. I was ordered off caffeine the moment I got ill. I swapped to Minute Maid lemonade from diet Coke. The stuff is full of Yellow 5 - the problems snowballed.
Since Sunday I've been off anything with Yellow 5 (or Blue 1). What do you know? The physical symptoms are getting better by the day.
The point of all of this is that Yellow 5 and ADHD may or may not be related, who cares. What does seem to be the case though is that a Yellow 5 allergy can manifest with the same symptoms as ADHD or Anxiety Disorder.
All the tranquilizers in the world, SSRIs, you name it, weren't going to help when I had the equivalent of someone slipping me speed or an acid tab in every can of soda. Ditching the soda (and other things that have Yellow 5) has already had a profound affect in, what, 72 hours?
My advice would be - try cutting out Yellow 5. It might not make a difference but it will only take two weeks to find out so it doesn't really cost you anything much and you can try it in conjunction with her other treatments. But can you really afford not to try it? Imagine if the ADHD was a misdiagnosis and you'd put her through all the Ritalin and everything else when just changing out the lemonade and Sunny Delight she drinks could cure it?
Yeah, it's an unproven theory at the moment (then again, people once argued smoking wasn't bad for you too). But it risks nothing to try it and there's one person who'll serve as empirical evidence right here.
Most modern thinking in ADHD is that AAD ( Attention Abnormality Disorder ) would have been a better term. The point is that people with ADHD ( myself being one of them ) can't choose for themselves what they will concentrate on. In fact, when something like a video-game gets my concentration it is almost impossible for me to let it go. Even if I shut the game off my brain will keep trying to play. It's hard to describe and very frustrating. At least ADHD is better than MBD ( Minimal Brain Dysfunction ) which is what they used to call it.
XML is the best data format; unless your data needs to be read or written by a human or a computer.
With my daughter, it's not just the schooling. It's everything. There is no planning going on in her brain, and without Ritalin, almost no independant thought.
The morning routine is a bit like this:
Daughter wakes up.
daughter: Can I get dressed now.
me: yes, of course you can.
daughter: what can I wear?
me: there's a dress on the couch there for you, and some knickers in your drawers.
daughter: (picks up dress) this dress?
me: yes.
daughter: is it going to be warm today?
me: i think so. it should be just right for wearing that dress.
daughter: so can I wear this dress?
me: yes (I won't pretend not to be frustrated at this point)
daughter: where are my knickers?
me: in your drawers. (if, in fact, they are none in there afterall a major panic attack is had by daughter).
breakfast also is along the same lines:
me: (puts daughters bowl of cereal at the dining table, in exactly the same place as it has been put every morning since we moved into this house 2 years ago) , come and eat your breakfast
daughter: which one is mine? (hers is often only bowl at the table at that point)
me: (points to bowl) that one.
daughter: (sits down at table in her normal spot) so is this one mine?
and so on.
Up until she was 3 or 4, she would never get out of bed in the morning by herself. If she woke up early she would lie in bed and chat to herself until she heard one of us moving around and could ask us if it was okay to get up now. She had been told repeatedly that it was okay to get up at any time past 7 o'clock but just couldn't think for herself. (and yes, she could tell the time enough to know when 7 o'clock was)
Diary writing is the whole thing over again. 'What do I write?'.
With ritalin, it's a whole lot better. She actually thinks for herself rather than being a robot that needs constant instruction.
The schooling thing was (before ritalin) a problem with things like the diary writing. She would not be able to think about what to do next, and would just start annoying the other kids, or if the teacher was lucky, just hide under the table out of the way.
We have (at home) learnt to cope with this to some extent, although I can't imagine it's a good way to conduct home life. But no teacher can be expected to devote almost all their time to one child. It's not fair on anyone else.
On the one hand, i agree with you that it's just a way of thinking that's different to 'normal', but so is autism, and to stretch your line of reasoning way beyond breaking point, so was the way of thinking of anyone whose grabbed a gun and started putting holes in anyone who's ever pissed them off. At some point you have to say 'this is a problem, either for this person or for everyone around them', and i believe that is where we are at with my daughter.
I find myself tuning out people at times. It's like they talk too slow. I've noticed this problem especially with the older generation. They feel they must talk in very precise terms and verbally illustrate their ideas. Problem is, I often get their point long before they've finished babbling. So I find myself drifting in and out of attentiveness with them.
That isn't ADD/ADHD. That's getting bored with someone who belabours a point. ADD/ADHD is when you CANNOT, despite your best efforts, concentrate on anything for a long period of time. This is really bad in a classroom environment when you need to pay attention to new material (especially in Calculus courses) and you keep drifting out every five minutes regardless of the effort that you put into paying attention.
I have to deal with ADHD. I know what it's like to suddenly get distracted by the smallest thing, and I know that -- in my case -- Ritalin helps with the concentration problems. I can't stand it when someone who does not have to deal with what I live with comes forth with an "authoratitive" position on ADHD, calling it a myth.
STOP MISUSING APOSTROPHES, YOU MORONS!!!