EEG Biofeedback Training as a Treatment Option for ADHD
The popularity of EEG Biofeedback Training continues to grow both in the USA and around the world. Many parents are searching for treatment options for ADHD other than medications, and as a results are exploring this high tech approach to treatment. Here are some things that I think you should know about Neurofeedback or EEG Biofeedback training if you are considering it for your ADDer:
First, I believe it to be a good option for treatment. This is based on my ten years of personal experience as a provider of this option in my practice. I have treated over 300 ADHD kids and adults using excellent equipment from EEG Spectrum in Encino, CA. I have found that about 70% of my clients have received either "good" or "excellent" results from the training.
I am often surprised by the results, and sometimes disappointed by the results. For example, I am just completing treatment with a 20 year old college student with ADD (space-cadet type) who is very bright and highly motivated. His brother had been through treatment in the past and had done remarkably well, as had his step-sister. Yet he has had only fair improvement at best. He has received most of his benefit from taking the nutraceutical Attend on a regular basis, and at much less cost.
Yet I am also treating a 13 year old girl with ADHD, panic disorder, obsessive-compulsive disorder, and HUGE temper tantrums. This young person has been on several medications with little or no benefit. We have done only three sessions and there have been zero tantrums (used to be one per day on average) and the parents are so excited they can hardly contain themselves. I cannot explain why some do so well, and sometimes quickly, while others barely benefit. But I also cannot explain why some benefit from medications, diet, Attend, therapy, essential fatty acids, pycnogenol, or whatever, and others do not.
Treatment: Following diagnosis and baseline testing. Typically the subject wears one or two electrodes on the scalp to monitor the EEG activity of the brain. The brainwaves are amplified and displayed on the therapist*s computer screen, both in raw wave-form and broken into various frequency bands. The subject sees a representation of this electrical activity in the form of animation on his computer monitor. The training involves learning to increase the activity in specific frequency bands and decreasing the activity in other specific frequency bands. Various computer animation and games are used for the feedback to the subject. Yes, subjects can learn to change and control their brainwave activity.
Realistic Expectations for treatment: If your child has never been on medication, you might be able to get good enough results to never have to use meds. If your child is currently using medications, you might be able to discontinue meds altogether. Maybe. Mostly what we see, however, is that kids will use both the training and a small dose of medication. I am usually happy if we can cut the dosage of the medication by half or more and still get the same level of performance from the child.
Controversy: The mainline ADDers tend to be opposed to EEG training on the grounds that there are only clinical studies, no -double-blind- studies on the effectiveness of the treatment. Yes, this is true. And there will not be any either.
Why? Because a double-blind study means that the subject does not know whether he is using the experimental treatment or just a placebo treatment which is assumed to have no effect on the subject. Double-blind studies are great when you are talking about pills, but they are not useful for much of anything else. For example think of weight-lifting.
Could you prove that weight- lifting made subject stronger with a double-blind study? Never.
Could you prove that reading a book increased the reader's knowledge with a double-blind study. Never.
Most things cannot be tested with double-blind studies because the subject has to participate in the treatment actively. So the criticism about biofeedback lacking double-blind studies is a hallow argument, and they know it, but the press always prints it without question and many people assume it is a valid criticism.
Are there clinical studies? Yes, dozens, maybe hundreds at this point. EEG Spectrum has collected data on over 2,000 subject to date. That is just one provider. There are about 800 providers in the USA at this time. However, choose only providers who know what they are doing. There is no substitute for experience or for good equipment. Slow feedback from the equipment is not helpful. Typically the more expensive the equipment the better, because the software is able to deliver the feedback to the subject very very quickly. Ask around for a good provider. And avoid people who treat this like a religion. It is a very good tool, but there are several good tools available. For more information visit the ADHD Information Library at newideas.net.
Douglas Cowan, Psy.D., is a family therapist who has been working with ADHD children and their families since 1986. He is the clinical director of the ADHD Information Library's family of seven web sites, including http://www.newideas.net, helping over 350,000 parents and teachers learn more about ADHD each year. Dr. Cowan also serves on the Medical Advisory Board of VAXA International of Tampa, FL., is President of the Board of Directors for KAXL 88.3 FM in central California, and is President of NewIdeas.net Incorporated.
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