EEG Biofeedback Frequently Asked Questions

What is EEG Biofeedback?
EEG Biofeedback is a learning strategy that enables persons to alter their brain waves. When information about a person's own brain wave characteristics is made available to him, he can learn to change them. You can think of it as exercise for the brain.
back to FREQUENTLY ASKED QUESTIONS

What is it used for?
EEG Biofeedback is used for many conditions and disabilities in which the brain is not working as well as it might. These include Attention Deficit Hyperactivity Disorder and more severe conduct problems, specific learning disabilities, and related issues such as sleep problems in children, teeth grinding, and chronic pain such as frequent headaches or stomach pain, or pediatric migraines.

The training is also helpful with the control of mood disorders such as anxiety and depression, as well as for more severe conditions such as medically uncontrolled seizures, minor traumatic brain injury, or cerebral palsy.
back to FREQUENTLY ASKED QUESTIONS

How is it done?
An initial interview is done to obtain a description of symptoms, and to get a picture of the health history and family history. Some testing may be done as well. And the person does the first EEG training session, at which time we get a look at the EEG. This all may take about two hours. (The details may differ among the various affiliate offices. In some offices a full brain map, or quantitative EEG, is routinely obtained, which may require a separate office visit. Or more extensive testing may be done.) Subsequent training sessions last about 40 minutes to an hour, and are conducted from one to five times per week. Some improvement is generally seen within ten sessions. Once learning is consolidated, the benefit appears to be permanent in most cases.

One or more sensors are put on the scalp and one on an earlobe using a washable paste. There is no Pain, it is non-evasive. The brain's own tiny electric signals move through the gold cups into wires and into a computer. The computer changes the electrical impulses from the child's scalp into moving pictures. The child watches the TV movie and by using his mind and not a joystick, the child controls the play of the game. When the child concentrates he scores more points in the game. When the child daydreams his game-piece slows down. Anyone who plays the game quickly learns to strenghthen the positive brain signals and to diminish the negative signals.

After several sessions the child learns how to make strong positive brain waves. The whole process is easily learned and there is no pain or discomfort. Kids love the game. Within three weeks a child's behavior can be dramatically normalized.

The number of sessions needed vary per child. A boy may need 40 to 60 sessions to eliminate ADD and if he is also very hyperactive he may need 60 or more sessions. Severe brain injury responds well, but more slowly. Our most remarkable success was an airline pilot who got rid of his severe pain from Spastic (Irritable) Bowel Syndrome in four sessions! I spoke to him just the other day and it has been several years since his last bowel pain. In 20 years of providing this training I have never had to retrain a child or adult. It's like walking, once you learn how you just keep on walking.
back to FREQUENTLY ASKED QUESTIONS

What disorders have clinical evidence?

All of the following disorders have clinical reports or case histories for EEG biofeedback; many have scientific reports:
	Attention Deficit Disorder (ADD)	Irritable Bowel Syndrome
	Attention Deficit Hyperactivity Disorder (ADHD)	Chronic Pain
	Learning Disabilities	Panic Attacks
	Brain Injury	Post Traumatic Stress Disorder
	Anxiety	Seizure Disorders
	Anger Management	Migraine Headaches
	Compulsiveness	Bedwetting
	Chronic Fatigue Syndrome (CFS)	Stroke Prevention and Rehab
	Depression	Tourette Syndrome
	Alcoholism	Chronic Pain
	Autoimmune Dysfunctions	Sleep Disorders
	Stroke/TBI	Epilepsy
	Conduct Disorder	Post Heart Attack

back to FREQUENTLY ASKED QUESTIONS

What results do we obtain?
In the case of ADHD, impulsivity, distractibility, and hyperactivity may all respond to the training. This may lead to much more successful school performance. Cognitive function may improve as well. In several controlled studies, increases of 10 points in IQ score were found for a representative group of ADHD children. And in two clinical studies, an average increase of 19 and 23 points was demonstrated.

Behavior may improve in other ways as well: If the child has a lot of temper tantrums, is belligerent, and even violent or cruel, these aspects of behavior may come under the child's control.

In the case of depression, there can be a gradual recovery of "affect", or emotional responsiveness, and a reduction of effort fatigue. In the case of anxiety and panic attacks, there is gradual improvement in "regulation", with a dropoff in frequency and severity of anxiety episodes and panic attacks until the condition normalizes.

In the case of epilepsy, we observe a reduction in severity and incidence (frequency of occurrence) of seizures. The dosage of anticonvulsant medication may ultimately be reduced, and side effects of such medication may diminish.
back to FREQUENTLY ASKED QUESTIONS

Can a successful outcome be predicted?
It is not possible to predict with certainty that training will be successful for a particular condition. But for the more common conditions we see, a reasonable prediction of outcome is usually possible. More important, however, the effectiveness of the training can usually be assessed early in the course of training. For most conditions, there are no known adverse side effects of the training, provided that it is conducted under professional guidance.
back to FREQUENTLY ASKED QUESTIONS

Why does this training procedure work?
The brain is amazingly adaptable, and capable of learning. It can also learn to improve its own performance, if only it is given cues about what to change. By making information available to the brain about how it is functioning, and asking it to make adjustments, it can do so. When the mature brain is doing a good job of regulating itself, and the person is alert and attentive, the brain waves (EEG) show a particular pattern. We challenge the person to maintain this "high-performance", alert and attentive state. Gradually, the brain learns, just like it learns anything else. And like with other learning, the brain tends to retain the new skill.

We observe that if the EEG is not well-behaved under these circumstances, there may be adverse impacts on learning ability, on moods, on sleep, and on behavior. With training, these may be gradually brought under control, along with normalization of the EEG.
back to FREQUENTLY ASKED QUESTIONS

What does EEG Biofeedback look like?


The therapist computer is usually positioned behind the client. This enables the therapist to monitor the client's EEG at any time during the session without disturbing the biofeedback.	A single electrode is placed on the scalp (above the motor strip, typically) using gel or paste and two other electrodes are attached to the earlobes. Most clients recline during training.	The game computer is placed a few feet away, directly in front of the client. The client interacts (only using her EEG) with the game computer for the next 30 minutes.

Each display contains four EEG data streams (below each stream are text and average data values). The top line, slightly squiggly, is the person's entire EEG recorded from the scalp by the single active electrode. The three wavy lines below show activity in three separate EEG frequency bands or rhythms -- here, theta, SMR, and high beta bands. The client's goal is to increase certain EEG frequency bands (e.g., SMR) while decreasing others (e.g., theta & high beta).The patient monitors her EEG frequency band activity NOT as wavy lines on the therapist machine, but as elements of a game on the game computer. Each frequency band appears as a colored rectangle which grows larger or smaller in response to her brain wave activity.

With her brainwaves she is playing the game called "Islands." Frequency band activity is displayed at the bottom of the screen -- two square "inhibit" boxes on either side on a large "enhance" rectangle. At this instant, she is doing quite well, inhibiting or reducing the activity of the bands represented by purple & yellow (at the moment, mere dots in each corner of the screen). She has increased her SMR activity to a point where it overflows the middle (blue) rectangle. As long as she keeps this up, she is rewarded in the game with visual and auditory stimuli. During the 30 minute session, she will work to keep purple and yellow small and make blue large as long as possible. A hundreds of times she may need to alter her brain activity in order to achieve a brain state which scores the most points. For every half second that her brainwaves stay in the desired state or "zone", she scores another point, an additional seagull appears in the sky (top of screen, barely visible), a new stripe segment is drawn on the highway (middle of screen), and a beep sounds to announce it all. If or when she attains 500 points, the volcano (middle left) will erupt!

back to FREQUENTLY ASKED QUESTIONS

How long does training normally take?

EEG training is a learning process, and therefore results are seen gradually over time. For most conditions, initial progress can be seen within about ten sessions. Initial training goals may be met by twenty sessions, at which time the initial retests are usually performed. In the case of hyperactivity and attention deficit disorder, training is expected to take about forty sessions, or even more in severe cases. Teeth grinding usually responds in twenty sessions. Some symptoms of head injury often respond in less than twenty sessions (quality of sleep; fatigue; chronic pain), whereas others may require longer training before they show an initial response (memory function, for example).
back to FREQUENTLY ASKED QUESTIONS

How frequent should the training sessions be?
The sessions should be regular and frequent. Daily sessions can be very beneficial as well. I find doing up to 4 sessions a day for 3 weeks is the best way. You can have a normal child in 3 weeks. If this is not possible, then doing at least 2 sessions a week will still provide good results just over a longer period of time.

Sessions are generally done in 20 session increments. After each 20 session increment a TOVA (Test of Variable Attention) may be given to see the benefits of training to that point.
back to FREQUENTLY ASKED QUESTIONS

Is EEG biofeedback covered by insurance?
Many medical and psychological insurance plans now cover biofeedback for various conditions. Some require co-payments. Other plans have annual caps. A prescription for the training, along with a diagnosis, may be required from a physician under the medical part of the plan, or from a licensed psychologist under the mental health services part of the plan. Medicare pays for EEG biofeedback for some conditions.
back to FREQUENTLY ASKED QUESTIONS

My doctor takes a dim view of biofeedback. What can I tell her?
Dr. Von will be glad to send your Dr. information on biofeedback and some websites that offer a lot of good information. If requested, Dr. Von will call your Dr. to discuss. We are finding more MDs are being receptive to parents trying biofeedback rather than putting their children on drugs.

Some will cover biofeedback with a prescription from and MD, along with a diagnosis.