For most children, a typical Tuesday morning begins with an abrupt tone or monotonous buzz from an alarm clock followed quickly by a pleasant “good morning” from their parents. What soon follows is the typical routine of brushing teeth, getting dressed, eating breakfast, and organizing materials for yet another school day. The routine is fixed and automatic, and executed with precision. However, children with disabilities impacting basic levels of arousal and self-regulation (such as autism, attention deficit disorder, anxiety or depression) have a much different morning experience. Billy is 9-year-old with an attention-deficit-disorder. His morning routine is characterized by difficulty transitioning from a sleep state to wakefulness, inefficient time management, forgetfulness, and moodiness as his parents constantly bellow to “hurry up” and not be “late again” for school. Billy often begins his day frustrated and confused, agitated and tired, and certainly not in an ideal emotional or psychological state to handle the academic rigors of 4th grade.
Students who have difficulty regulating their own internal states of arousal are often diagnosed with an attention deficit disorder. Children who have difficulty regulating their moods and emotions often have a mood disorder diagnosis. Those with difficulty managing and organizing their time effectively, and sustaining their attention to a goal directed task are often labeled as having difficulty with executive functions. The common thread among all of these children are difficulties with self-regulation skills; including self-regulation of attention, self regulation of moods, and self-regulation of cognition. In other words, there is a dysregulation of brain functioning. Billy does not want to begin each day so frustrated, tired, and emotionally on edge, but feels little control over his behavior. Parents want, and deserve, a greater range of treatment options besides a quick pill, or new behavior management plan at home.
Over the last four decades, neurofeedback has evolved as a scientifically based alternative to treat most childhood conditions involving poor self-regulation skills. It is a totally painless, non-invasive approach to reset the brain to more optimal levels of arousal. Neurofeedback involves a learning paradigm, meaning that the child learns how to exercise, enhance, and strengthen desired brainwave activity. For instance, like most children with attention deficit disorder, Billy’s frontal lobes are most likely functioning at a less than optimal level. Simply put, the brain wave activity in the frontal regions of his brain are operating too slowly. While stimulant medication acts quickly to speed up this brain region, it also ends quickly, meaning that the child will return to their dysfunctional brainwave state once the medication wears off because there is no learning involved with the treatment. On the other hand, neurofeedback works more slowly, often requiring 20-25 sessions, leading to incremental changes to optimize brain wave activity that generalizes to most settings.
A typical neurofeedback session lasts approximately 45 minutes, and is both relaxing and fun. The child puts on a special cap with electrodes placed on various parts of the scalp to record brain wave activity at desired locations. In Billy’s case, while he is engaged in a simple task, the neurofeedback clinician carefully monitors the electrical activity of his brain on a computer, choosing a more optimal range for the child to be functioning. Billy is then rewarded for increasing or speeding up brain wave activity in the frontal lobes, an area of the brain critical in helping him establish more focused attention and better self-regulation skills.
The American Psychological Association (APA), the governing body of professional psychology, has recognized neurofeedback as an efficacious treatment for most arousal types of disorders. Neurofeedback has also been used to treat headaches, pain, and sleep disturbances as well. In fact, many parents will report that after just a few sessions, their child was able to fall asleep quicker, sleep more soundly, and transition more efficiently from a sleep state to an awake state in the morning. It is important to note that neurofeedback does not “cure” developmental disorders, but rather minimizes the symptomology from disrupting everyday life and activities.
Persons of all ages can benefit from neurofeedback, though it is important to note that like any treatment, the effects will vary among all individuals. Neurofeedback is designed to tackle the problem right where it lies…in the brain. The field is regulated by the Biofeedback Certification Institute of America (BCIA). In addition, peer reviewed clinical studies demonstrating the efficacious treatment of neurofeedback with a variety of disorders can be found by going to the website for the International Society for Neuronal Regulation (ISNR), or subscribing to their journal. With respect to attention-deficit-disorder, there have been ten peer reviewed randomized clinical trials published in the literature showing a mean effect size of .66 for using neurofeedback to reduce the symptomology of ADHD. In clinical terms, this is excellent! Billy’s morning routine is looking much brighter indeed.
Steven G. Feifer, D. Ed., NCSP, ABSNP is a nationally renowned speaker and author in the field of learning disabilities, and has authored six books on learning and emotional disorders in children. He currently works at the Monocacy Neurodevelopmental Center in Frederick, Maryland, where he conducts school neuropsychological evaluations and is the director of neurofeedback. Dr. Feifer is also an adjunct professor at both George Washington University and Philadelphia College of Osteopathic Medicine, as well as a clinical supervisor in the ABSNP school neuropsychology training program. He was voted the Maryland School Psychologist of the Year in 2008, and awarded the 2009 National School Psychologist of the Year.