Steven T. Padgitt, Ph.D.
As our society becomes more sophisticated, and as we know more about human functioning, previously undefined and undescribed disorders come to our awareness. This is certainly the case with Attention Deficit Disorder, with and without hyperactivity (ADD/ADHD). A decade ago we had roughly identified ADHD as Hyperactivity, without any reference to ADD without hyperactivity. Now we know that a substantial portion of our school aged population, has a neurologically based disorder that is responsible for excessive distractibility, impulsiveness, and oppositional behavior, among other maladaptive social features. These children most frequently fail in school when it comes to staying focused, and attending to the requested classroom tasks. Instead of being able to remain attentive in the classroom, they are ever alert to distraction and are constantly in motion.
These children have a clear and pronounced eeg pattern, with high amplitudes in the slow wave (Theta) part of the eeg spectrum. They have traditionally been treated by physicians with chemical stimulants in the amphetamine family, which increases neuronal firing speed and results in enhanced focus and attentional abilities, in many of these children. In some cases the results are strikingly positive, and have resulted in parents, teachers, and doctors alike, being impressed by the change in behavior and cognitive ability.
The down side of this treatment approach is twofold. While maintaining a child on stimulants for the majority of his or her young years may enhance certain aspects of brain function, learning under the influence of certain stimulants is state dependent, i.e. what is learned under the influence of the drug may not be accessible, absent the presence of the chemical. The second major problem is one of psychological and social dependency production. Specifically, not only does the child learn to depend on chemicals to control his/her behavior and thinking, but the child also receives a message that s/he does not and cannot have self control; these messages are consistent with drug abuse and dependency. In short, we as a society, have subtlely, and without consciousness, promoted the very drug abuse problem we now find rampant in our culture, and desperately seek to eliminate.
Some fifteen years ago Joel Lubar, Ph.D. began conducting EEG Biofeedback research with children, designed to determine the potential for this treatment modality's effectiveness with ADD kids. Since then, he and numerous other researchers throughout the country have effectively demonstrated that children can, in fact, learn to suppress the high amplitude slow wave activity, and enhance the amplitudes of faster neuronal firing patterns. Furthermore, we can now conclude that when ADD children learn these self regulatory skills, their behavior improves, as do their grades and IQ scores.
Just as ADD and ADHD fall on a spectrum of Attentional Disorders, ranging from mild inattention, to Tourettes Disorder, to Autism, so too, there are individual differences in the severity within each of the Attentional Disorders. Likewise, it appears that the number of EEG Biofeedback sessions required to effect significant change in patient performance, varies from as few as five sessions to over forty. Those who are classified as ADHD require more training than those without these extreme motoric symptoms. It is also clear is that children and adults with attentional disorders do respond to the EEG skill building protocols designed to decrease high amplitude Theta activity, and enhance Beta (12-20 Hz) amplitudes. High Theta amplitudes are associated with distractibility, while peaks in low Beta (12 - 15 Hz) are associated with cognitive focus and concentration.
To exemplify the training procedure, we'll turn our attention to Samantha, a twelve year old girl, diagnosed as having moderate ADD without Hyperactivity. Her mother sought assistance through her health insurance company, recognizing that Samantha's behavior appeared to be characteristic of being Attentionally Disordered. After validating historical information was gathered, the patient was assessed by monitoring her eeg activity, and it was established that she portrayed the slow wave dominant eeg pattern typical of ADD patients. This, along with her mother's description of school behavior and her academic performance problems, led to the recommendation of a course of EEG Biofeedback.
Once treatment began, and within the first session, Samantha learned to voluntarily suppress her relatively high amplitude Theta activity. It became clear from her verbal report and observing the computer generated display of her eeg activity, that the instant she decreased the effort required to suppress her slow wave activity, there was a resumption high amplitude Theta activity. Across sessions, she learned to suppress Theta amplitudes with increasing facility and duration. Within the next 7 weeks, her teacher who was unaware of the Neurotherapy, independently reported that Samantha's school performance had improved substantially. Samantha's mother stated that her daughter's behavior at home had improved considerably.
Samantha's level of attentional difficulty was within the mild to moderate range of the attentional deficit spectrum. Hence, it was not surprising that she responded so rapidly to the Theta suppression and Beta enhancement treatment protocol. All the same, her positive response to the EEG Biofeedback treatment is representative of how more severely disordered children and adults tend to do with this treatment modality.
Numerous outcome studies using Neurofeedback in treating Attention Deficit Disordered individuals, have demonstrated both enhanced intellectual and attentional abilities. For example, in a ten year treatment follow-up report, Michael Tansey, Ph.D. substantiates the longevity or permanence of this treatment procedure. Additionally, this learned neurological self regulation skill tends to enhance feelings of self esteem and personal independence, which is increasingly important in our stressful, competitive, and drug encouraging society. In short, Neurofeedback proves to be a valuable treatment modality in overcoming Attention Deficit Disorder and the other Attentional Spectrum Disorders, with the important side effect of enhanced self esteem.