WHAT IS EEG NEUROFEEDBACK?

EEG neurofeedback is a learning strategy that enables a person to alter his or her brain waves to reduce or eliminate those patterns associated with certain disorders, illnesses or injuries.  Information about the person’s own EEG brain wave characteristics are made available to the patient via colorful computer displays, and can therefore be voluntarily changed through the use of gentle mental techniques.

HAS A MEDICAL BASIS BEEN ESTABLISHED FOR UTILIZING EEG NEUROFEEDBACK?

Yes.  A recent study in the New England Journal of Medicine (N Engl J Med 1990;323; 1361-6. ) found neurological deficits to be present in those areas of the brain involved in the control of attention and motor activity in adults with Attention Deficit/Hyperactivity Disorder (ADHD) from childhood onset.  Numerous other studies have shown that distinctly identifiable EEG abnormalities are present in children with learning disabilities and/or hyperactivity.  More recently, oxygen deficits in the frontal lobes of the brain have been targeted as one of the primary areas of abnormality in ADHD.  EEG neurofeedback training can be used to correct these EEG abnormalities and normalize oxygenation deficits.

ARE THERE ANY ADVERSE SIDE EFFECTS FROM THIS TYPE OF TREATMENT?

No.  Unlike commonly prescribed drugs for ADHD (Ritalin, Adderall, Cylert), which may produce loss of appetite, sleeplessness, addiction, decrease in growth, greater risks of future recreational drug use and attraction to others with alcoholism and/or drug addiction (see the work of Judith Lubar), EEG neurofeedback training has no adverse side effects.

HOW IS IT DONE?

EEG neurofeedback training is a drug-free, painless, non-invasive procedure.  Small sensors are attached to each ear and one to the scalp.  EEG brain waves are monitored by means of an amplifier and a computer-based instrument that processes the EEG signal and provides the proper feedback. Brain wave feedback is displayed to the trainee by means of sounds and colorful light displays on a computer screen.  Like a computer game, the individual is asked to turn the light or sound on (or make certain changes in the screen).  However, this requires the production of brain wave activity in a desired high frequency band (e.g., beta or SMR), along with the simultaneous suppression of undesired low frequency brain wave activity (e.g., theta or delta).  The brain sorts out what is necessary to perform the learning task and acquire the new brain wave pattern.  Eventually, the brain “knows” to continue to produce more of the desired beta/SMR brain waves and less of the undesired theta/delta.

Most interesting is the fact that EEG neurofeedback teaches the child to sustain the same brain wave patterns that are produced by the drugs Ritalin, Adderall, Cylert, etc.   Therefore, in most cases, these drugs are no longer needed after EEG neurofeedback. 

EEG Neurofeedback Graph

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WHY DOES THIS TRAINING PROCEDURE WORK?

The common element in all of the conditions treated appears to be that they are associated with anomalous activity of the brain.  In addition to being the center of our thinking processes and regulating various bodily functions, the brain also manages itself.  When the mature brain is well regulated, the EEG in the awake and focused state shows a very stable baseline.  When this is not the case, there may be adverse impacts on behavior, moods, sleep, and on cognitive function.  We therefore see the EEG neurofeedback process as improving the brain’s own mechanism for regulating itself.  In our view it treats one underlying condition, rather than many different conditions.

In particular, it is currently believed that we are facilitating inhibitory pathways between non-specific subcortical nuclei and the cerebral cortex.  The process is likely to be very analogous to normal learning, which also involves the facilitation of new neuronal firing patterns.  Three key analogies to the learning process encourage this view:  (1) the learning appears to be permanent in most cases;  (2) if we train one hemisphere the other learns as well; and (3) one cannot learn “too much.”  That is, the learning process reaches completion; it cannot overshoot.

HOW LONG DOES THE TRAINING NORMALLY TAKE?   WHEN WILL PROGRESS BE NOTICED?

EEG neurofeedback is a learning process and therefore results are seen gradually over time.  For most conditions, initial progress should be seen within 10-15 sessions.  In more severe cases of ADHD, progress is usually seen within 20-25 sessions and total length of treatment usually averages 40-45 sessions.  However, these numbers are just guidelines; every child is different.  Changes in behavior in the classroom are usually noticed after 1-3 months of training.  Frequency of training varies from 2-5 times per week for a period of 2-5 months, depending upon the frequency of visits and the severity of the problem.  Each training session lasts approximately 45 minutes.

IS PERSONALITY CHANGED BY THE EEG TRAINING?

An ADHD child may well be described sympathetically as “lively, stubborn, rambunctious, scattered, independent”, etc.  When the hyperactivity is no longer evident, s/he will be described differently.  The descriptors that change are those related to hyperactivity and focus of attention.  The implication is that the underlying personality will not have changed.  However, it is more accurate to say that the underlying personality was always there- it was simply not permitted to surface as long as the child’s brain was interfering.  Similar considerations apply to mood swings, irritability, OCD/ODD behavior or even violence.  In cases where irregular brain wave patterns are found to be associated with these disorders, they can be distinguished from the person’s intrinsic personality, and may be modified by EEG neurofeedback training.

HOW WILL THE CHILD BENEFIT FROM EEG TRAINING?

EEG training has been shown to be a powerful modality for helping children increase their focusing and concentration which leads to significant improvements in classroom performance and achievement test scores.  In terms of behavior, successful training decreases symptoms of hyperactivity and improves the child’s socialization skills both at school and home.  These children clearly become more responsive to the parenting and teaching efforts to which they were previously unresponsive. 

CAN A SUCCESSFUL OUTCOME BE PREDICTED?

It is not possible to predict with certainty that neurofeedback training will be successful for a particular condition.  However, research has repeatedly pointed to an 80-85% success rate for neurofeedback with ADHD and similar disorders.  Certainly, there are no grounds for believing that the procedure can be harmful in any way, so long as it is performed by a professional who is board-certified in EEG neurofeedback by the Biofeedback Certification Institute of America (BCIA). 

HOW MUCH DOES THE TRAINING COST AND IS IT COVERED BY INSURANCE?

The cost of each session ranges from $90-$110, depending on the length of each session and the specific nature of the treatment.  Many medical insurance plans now cover biofeedback.  The coverage varies a great deal by company and by plan.  Some plans will reimburse a large percentage of the cost and others will cover only a fraction of the cost.  Our staff will make every effort to pre-determine insurance coverage and to assist with reimbursement (including submitting computerized bills).  A prescription for the training, along with a diagnosis, is required from a physician if you would like your insurance to be billed.

HOW LONG DO THE RESULTS OF TRAINING LAST?

Long term follow-up with adults who, as children, received EEG neurofeedback training for ADHD and similar disorders, indicates that the improvement appears to be permanent in most cases. 

WHERE CAN I LEARN MORE?

Some of the best resources for EEG neurofeedback in the treatment of ADHD and similar disorders (including research and follow-up studies) can be found on the Internet at: