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.
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.
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.
The EEG biofeedback training is a painless, non-invasive
procedure. One or more sensors are placed on the scalp, and one
to each ear. The brain waves are monitored by means of an
amplifier and a computer-based instrument that processes the
signal and provides the proper feedback. This is displayed to the
trainee by means of a video game or other video display, along
with audio signals. The trainee is asked to make the video game
go with his brain. As activity in a desirable frequency band
increases, the video game moves faster, or some other reward is
given. As activity in an adverse band increases, the video game
is inhibited. Gradually, the brain responds to the cues that it
is being given, and a "learning" of new brain wave patterns takes
place. The new pattern is one which is closer to what is normally
observed in individuals without such disabilities.
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What disorders may be treated in
this way?
The following disorders have all been treated by EEG biofeedback:
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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. In many
cases ...(old sentence) The dosage of anticonvulsant medication
may ultimately be reduced (if ordered by the referring
neurologist), and side effects of such medication may diminish.
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.
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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.
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).
How frequent should the training sessions
be?
In the initial stages of learning, the sessions should be
regular and frequent, at two, three, or even more sessions per
week. After learning begins to consolidate, the pace can be
reduced. Daily sessions can be very beneficial as well.
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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.
My doctor takes a dim view of biofeedback. What can I
tell her?
Your doctor may not know of this specific type of
biofeedback. He or she will maintain a healthy skepticism about
any new approach claiming numerous benefits. If your doctor is
familiar with EEG biofeedback in general, he may still be
thinking in terms of the more common early experiments with alpha
wave training, rather than with the training we are dealing with
here. Ask your doctor to examine the recent research on the
effectiveness of EEG biofeedback in treating various disorders
such as attention deficit disorder and epilepsy. The following
references are a place where he or she can start:
Lubar, J.F. and Bahler, W.W. (1976). Behavioral management
of epileptic seizures following biofeedback training of the
sensorimotor rhythm. Biofeedback and Self-Regulation,
1,
pp.77-104.
Lubar, J.F. and Shouse, M.N.. (1976). EEG and behavioral
changes in a hyperactive child concurrent training of the
sensorimotor rhythm (SMR): A preliminary report. Biofeedback
and Self-Regulation, 1, pp.293-306.
Lubar, J.O. and Lubar, J.F. (1984). Electroencephalographic
biofeedback of SMR and beta for treatment of attention deficit
disorder in a clinical setting. Biofeedback and
Self-Regulation,
9, pp.1-23.
Shouse, M.N. and Lubar, J.F. (1979). Operant conditioning
of
EEG rhythms and Ritalin in the treatment of hyperkinesis.
Biofeedback and Self-Regulation,4, pp.301-312.
How much does the training cost?
The cost of the training differs among offices depending on
location, the professional status of the person delivering the
service, and on supplementary services offered. Typically,
individual sessions run from $50 to $125. Discounts are often
available for payment in advance.
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DAKaiser@ix.netcom.com - Updated Jan 1996