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The efficacy of neurofeedback with children and adolescents.

Susan Denny

on 8 January 2015

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Transcript of Neurofeedback

What do we know about the brain
Statement developed by committee of International Society for Neurofeedback and Research (ISNR)
How to refer or get started
Supportive Research
Neurofeedback Loop
1. Clinician determines which brainwaves are not functioning properly or are not connecting efficiently.

2. Electrodes are placed on the scalp to read the EEG from that single or dual points, depending on what the client is working on training.

3.Clinician sets the thresholds for rewards and inhibits on the clinician computer.

4. Client watches a video game, which gives feedback. The game will go when brainwaves meet criteria, and will stop if they do not.

5. Once the brain learns the correct pattern, and continues to be rewarded for this pattern, then Classic Conditioning kicks in, and the brainwaves will permanently keep the more productive brainwave pattern.
Brainwaves need to change their pattern depending on the task at hand.
Arousal Level
DisOrGanizEd Arousal
Unstable arousal

Sleep Onset
Muscle tension/headaches
Autism Spectrum/Aspergers
Low motivation
Attention problems (ADHD)
Poor concentration
Early Morning awakenings
Difficulty maintaining state.
Difficulty with control over shifting.
Doesn't seem related to arousal shifts.
Examples: seizures, migraines, frequent waking from sleep, nightmares, emotion regulation
Under and Over aroused at the same time:
Developmental problems
examples: autism, early abuse and trauma, developmental disabilities

Explosive anger

Dysregulated attachment
examples:Axis II

75% of people with disordered arousal have substance abuse.
Symptoms/Diagnoses Reported
Some clients get stuck in a pattern, and struggle to function except how that pattern manifests into behavior.
Problem solving- analysis paralysis,
Brainwave pattern may look like - Excessive high beta (22-36Hz)
hijacks the ability for beta (focus), and theta (creativity) to function properly, and make a decision.

If someone is not able to move from one pattern to the next that person is stuck. This is when flexibility training is utilized. Also called coherence training - getting two areas of the brain to work together.
Brainwaves need to change their pattern depending on the task at hand.
Emotion disregulation
Chronic Pain
Some Anxiety Disorders (Panic)
Neurologists look for abnormalities in each brainwave in the EEG
Neurofeedback Clinicians look for abnormal brainwave patterns at different areas in the EEG
brainwave patterns
BAT Triangle
post dominant rhythm in CHildren and Adolescents
Common brainwave patterns assessed:
Normal T:B for children- 2.5:1;
adolescents- 2:1;
adults 1.5:1
3:1 T:B Ratio at CZ, FZ, C3, C4= slow wave disorder
High T:B in the frontal lobes is indicator of inattention and other executive functions

Anterior to Posterior Ratios

LH : RH Asymmetries
Anterior Beta > Posterior Beta Fz > Cz > Pz
Posterior Alpha > Anterior Alpha Pz > Cz > Fz(EC)
Anterior Theta > Posterior Theta Fz > Pz
Normal LH : RH Asymmetries
LH Beta > RH Beta
RH Alpha > LH Alpha
RH Theta = LH Theta

LH alpha > RH alpha = depression
RH beta > LH beta = anxiety or anxiety/depression mix

Theta:Beta Ratios
BAT Triangle

Alpha is the dominant brainwave in the posterior.
Because everyone's brain is different, especially children whose brains are still maturing, their specific dominant rhythm is also different.
Adults and adolescents (11yrs. +) PDR should be around 10Hz (+/- 2) = 8-12Hz bandwidth
PDR matures and stays the same by about 10/11 years old, normally.
Children under 11 will most likely have a lower PDR.
Measure alpha at PZ with eyes open and this is the client's PDR

0 4 8 10* 12 15 18 22 36

Adult with PDR of 10Hz

Delta Theta Alpha SMR/Beta Beta High Beta/Gamma
Low PDR in adults/children = Lower IQ, DD, TBI, Dementia

Before 10/11 yrs., children will have a separate dominant frequency in the Frontal lobe.
If this is still the case over 11yrs., sign of immature brain development.
Clinically Researched and Proven Protocols
How does it look?
Consultation with Clinician:
Is the clinician certified? (BCIA)
Does the clinician have experience
in the area you want help?
Assessment required
EEG Assessment and Intake
Training Plan Developed

Child with PDR of 7Hz

Delta Theta Alpha SMR/Beta Beta High Beta/Gamma

0 4 7* 8 12 15 18 22 36
EEG Information

"EEG biofeedback meets the AACAP criteria for clinical guideline (CG) for treatment of ADHD, seizure disorder, anxiety (OCD, GAD, PTSD, phobias, depression, reading disabilities and addictive disorders."
(Child and Adolescent Psychiatric Clinics of North America, 2005)
How Does it Work?
What is Neurofeedback?
Controls your life
Why Neurofeedback?
Addresses the underlying cause, not just the symptoms.
Repetition of the more efficient brainwave patterns, creates a well oiled machine.

Non invasive and simple
Can help almost anyone become more calm and focused
Train for calm and focus before and during competition
Train for relaxed and focus during performance
Train for creativity - artistic, or business creativity to help develop new ideas for growth
Train to be in the ZONE when you need it.

Athletes, executives, musicians, anyone who wants a mental edge on the competition
Peak Performance
Neurofeedback Bibliography
Hundreds of Articles on various topics can be found here:

Determine if QEEG or minimap assessment will give enough information.
20-40+ sessions are required for the brain to hold new, efficient pattern.
Twice a week is recommended for maximum change.
Most clinicians will not bill directly to insurance for reimbursement. Client can check with insurance company first.
$70-$100 per session depending on clinician.
Time and monetary commitment.
Neurofeedback has only had positive and neutral results.
Due to the individualization of neurofeedback, and lack of funding, there is not as much research to show the profound effects neurofeedback has on clients.
Biofeedback +EEG
Changes your brain for the better
Does not change the chemicals in your whole body.
Client does the work mostly subconsciously.
Side effects are rare, but include a slight headache and tiredness. Measures can be made quickly to eliminate these side effects.
Anything that can
be measured,
can be changed.

EMG - muscle tension

Skin Conductance

Heart Rate Variability

What can Neurofeedback treat/train?
Susan Denny, LPC
The Neurofeedback Center
September 11, 2014
University of the Incarnate Word
Arousal (under, over, unstable, disorganized)
Flexibility (loose, or rigid)-cingulate
Phase/Processing issue (speed)
Frequency (HZ/speed) and Amplitude (uv's/power)
Example: normative EEG vs.ADHD
How are the limbic system and cortex working together?
Full transcript