October 2003

Neurofeedback: A way to reset the brain
The new method treats learning disabilities
By Deborah Leigh Wood
:::::::::::::::::::::::::::::::::

Evan, 10, of Evanston , trains his brain for about 30 minutes twice a week at the Discovery Clinic in Glenview , the equivalent of a neurological gymnasium. His brain might be getting a strenuous workout, but you'd never know it from looking at him. Evan sits in front of a computer playing video games, which are programmed to help his brain create new neural pathways. In his case, the games are programmed to treat his ADD/ADHD and learning disabilities.

The electrodes, placed at strategic spots on Evan's head, and beeps emanating from the computer are the only giveaways that something deeper is going on.

Evan is one of an increasing number of kids throughout the Chicago area and beyond receiving neurofeedback, also called neurotherapy or EEG biofeedback. Unlike the more well-known biofeedback, which requires the participant to change heart rate or body temperature, neurofeedback relies on the brain's ability to self-correct.

This is such a new field that there are no oversight agencies or licensing requirements yet in place to regulate the treatment. There are only about 15 practitioners in the Chicago area. In fact, the training is offered by manufacturers of the equipment.

It is so new that the medical professional groups have yet to issue a formal opinion.

"An interesting concept and [it] may work for some people, but keep in mind that this is experimental," says Dr. David Fassler, a child and adolescent psychiatrist and a trustee of the American Psychiatric Association member. "It looks like there's some interesting preliminary research, but we still need to see carefully designed and controlled studies before we can really endorse this particular approach."

Fassler says he worries that the claims made may create unrealistic expectations for parents. "There are no easy answers for these kinds of complex conditions," he says. He urges parents to be an advocate for their child and get a comprehensive evaluation from a mental health professional first. "If you decide to include neurofeedback as part of the treatment, check out the practitioner's credentials to make sure they're licensed-i.e., social work, psychology, etc."

Neurofeedback, in effect, "resets" the brain, says Nancy Milnes, a social worker and a practitioner. Milnes, who has offices in Chicago's Hyde Park neighborhood and south suburban Homewood, says the non-invasive procedure targets problems that typically are treated through drug therapy, which parents of these kids are trying to avoid.

"We're looking in a whole different direction than medicine, which hasn't worked for a lot of these problems," says Ann Richman, a speech pathologist who founded the Discovery Clinic with psychologist Marilyn DeBoer.

Neurofeedback is used to treat problems that include ADD/ADHD, autism, learning disabilities, speech and language delays, developmental disorders, bed-wetting, sleep disorders, chronic headaches, and depression, anxiety and other mood disorders.

"A lot of clients come to us after going to doctors, psychologists and neurologists and not getting results. For example, I had a 4-year-old client who barely had a vocabulary and had behavior problems," Richman says. "He was frustrated because he couldn't communicate. Halfway into the program he had gained two new words. The next week he had five new words. Every week after that he increased his vocabulary dramatically and his frustration level dropped significantly."

Evan represents another success, says DeBoer, who has been treating him for several months. "I had a hard time understanding and following directions," says the articulate sixth-grader. "But neurofeedback fixed it. Now I like to read, and things aren't as overwhelming. I have more confidence." Evan's uncle, who drives him to his training sessions, nods in agreement.

The technique, which started gaining popularity in the 1970s, gives the brain the information it needs to relearn and improve functioning, say practitioners, most of whom are professionals in the mental health field.

During a neurofeedback session, a computer measures the brain's electrical impulses as the child plays the computer game. As the right brainwave activity increases, the video game moves faster. It slows down when his brain isn't up to the task. As the brain begins to respond, new neural pathways form, thereby "re-training" the brain. Sometimes practitioners use video games; other times the computer produces beeps and other sounds to reward the brain for going in the right direction.

The procedure, which costs anywhere from $50 to $125 a session and which some insurance companies pay for, may take 40 to 50 sessions to create a lasting effect. However, clients often notice improvements after as few as five sessions, practitioners say. But unlike medication, Milnes says, "it doesn't wear off and put you back to square one. Sometimes you need a ‘tune-up,' but that takes only a session or two."

Because everyone's brain is different, sometimes it takes a practitioner a few sessions to find the right therapeutic frequency for the client, says Michael Cohen, director of education at EEG Spectrum International, a company based in Canoga Park, Calif., that teaches health care providers how to do neurofeedback.

If the client isn't comfortable with a brainwave setting, he may feel a little "off," Cohen says, but "practitioners can, in effect, ‘undo' the results just by changing the frequency. Neurofeedback is safe and easy. We've trained thousands of clinicians from all over the world," he says, "and none have reported that clients have had any long-term adverse effects."

DeBoer says her "fastest and most successful" uses of neurofeedback have been for ADD/ADHD, behavior problems, learning disabilities and depression.

"It's very helpful to do in combination with conventional therapy, tutoring, occupational therapy and academic coaching," she says. "Although some clients are taking medication when they start biofeedback, we often find they need less medication, or it can be discontinued, once the results of the neurofeedback kick in."

Much slower, but ultimately rewarding, DeBoer says, is using neurofeedback for autism. To make it more financially feasible, parents can rent neurofeedback equipment and have a practitioner conduct sessions at their home.

Neurofeedback has its skeptics, practitioners allow.

"Ten years ago you couldn't even mention the word to a doctor," Richman says. "Now doctors are beginning to see how kids respond to it. Some still complain that neurofeedback isn't proven or that it produces a placebo effect. But that's also true for medication, which, unlike neurofeedback, can be unsafe."

Neurofeedback works because "the brain always wants to be rewarded," Milnes says. "It's set up that way."

Deborah Leigh Wood, a writer and editor, lives in Skokie with her husband and three children, 17, 16 and 13.