Electroencephalographic (eeg) Neurofeedback: Another Approach to Treat Adhd

Author:

Dr. Kamal SeSalem

Neurofeedback: Another

Treatment for ADHD

In just the last 20 years, Attention Deficit & Hyperactive Disorder, (ADHD) has

become America\'s 'leading childhood psychiatric disorder. Approximately 2to 6of school-age children are diagnosed with ADHD (Raz 2004). According to Barkley (1998) the number of children affected by ADHD can vary from 1to 20 depending on how one chooses to define it, the population studies, the geographic locale of the survey, etc. ADHD is characterized by the inability to self-regulate focused attention. Children with hyperactivity are impulsive and behaviorally disinherited. The condition is developmentally disabling which, if left uncontrolled persists into adolescence and adulthood (Edwards, 1995).

Frontal Lobe and ADHD

Research indicates a neurological basis for ADHD, specifically, frontal lobe dysfunction. Frontal lobe functions are executive in nature and are involved in developing plans and organizing resources. They also are critical in mediating inhibitory behaviors such as controlling motor behavior and inhibiting attentional focus on distracter or irrelevant stimuli. The evidence suggesting right frontal lobe dysfunction as the basis of attention deficit disorders is considerable (Chelune, Ferguson, Koon & Dickey, 1986; Gualteri & Hicks, 1985; Hynd, et.al 1990; Lou,et.al., 1989).

There has been increasing interest in the relationship between prefrontal cortex functioning and the ADHD. Children with frontal lobe lesions show impulsive hyperactive behavior (Grattan and Eslinger, 1991), and adolescents with ADHD show decreased anterior frontal lobe activity on positron emission tomography (Zametkin et al., 1993). Performance on neuropsychological tests purported to test frontal cortex functioning is deficient in children with ADHD (Barkley et al., 1992). In study examined frontal lobe functioning in adolescents with ADHD Schandler (2001) found a presence and magnitude reflect frontal lobe dysfunction in children with ADHD ages between 12 and 17. The results of the study conducted by Fredericksen et. al. (2002) was consistent with previous reports of reduced frontal lobe volumes associated with ADHD. Schmidt\'s study (1999) shows that boys with ADHD exhibited a less right-lateralized frontal activation pattern than normal control boys. Halperin (2006) found that the brain activation gradients in ventrolateral prefrontal cortex of ADHD adolescents. Recent research using advanced neuroimaging morphological procedures has shown that ADHD children fail to show the normal right-greater-than-left asymmetry in the mass of the frontal lobes (Hynd, Hem, Voeller & Marshall, 1991). Consistent with this finding, computerized quantitative electroencephalographic (EEG) analysisshows significantly greater slow wave (theta) activity and significantly less fast wave (beta) activity predominantly in the frontal regions for ADHD boys and girls when compared to age-and-sex-matched normal (Mann, et.al.,1992).

Neurofeedback Training for ADHD

The neurofeedback Training, also known as EEG Biofeedback or Neurotherapy, uses an electroencephalograph (EEG), a device that detects and records the electrical activity in the brain, called brainwaves. An EEG can detect brainwaves and discern whether they are strong or weak (amplitude) or fast or slow (frequency). Scientists commonly identify brainwaves in four categories:-

Beta, the fastest brainwaves, 14-32 hertz, focused on day-to-day activities and on attentiveness & thinking activities.

Alpha, a slower brainwave, ranging from 8 to 12 hertz. This rhythm is characteristic of a relaxed yet alert state of awareness.

Theta, the next slower waves range from 4 to 8 hertz. This rhythm is often associated with dreamlike imagery, sleepiness and deep relaxation.

Delta, the slowest waves, from 0 to 4 hertz, predominates during dreamless sleep.

EEG accepts the neurological basis of the ADHD (i.e. frontal lobe dysfunction). Recognizing that the ADHD patients produce more theta waves activity and less beta waves activity, compared to non ADHD patients (Barabasz et al, 1993; Mann et al, 1992). The goal of EEG training is to alter these abnormal brain waves by decreasing theta waves, while simultaneously increasing beta waves. Proponents of this technique believe that bringing theta and beta brainwave closer to healthier patterns leads to a reduction of ADHD symptoms.The EEG monitors and records the different brainwaves of the patient, who learns how to increase or reduce certain types of brainwaves. EEG training is intended to teach patients to normalize their brainwave responses to stimuli.

In EEG neurofeedback training, the therapist explains to the patient the connection between what is happening in his/her cortex and what is recorded on the EEG. Then, the therapist helps the patient to learn how to gain control over his/her brain waves. The therapist places the EEG electrodes on the head detect the different types of brainwaves produced by the patient and send the information to a data recorder. Every time the desired brainwave is identified, the neurofeedback apparatus sends a signal to the patient - auditory or visual feedback - to encourage the production of similar brainwaves. The auditory or visual feedbacks vary from simple sounds to elaborate computer graphics made to resemble video games where generating the wanted brainwave adds excitement to the action and brings some kind of rewards. Neurofeedback training typically takes 30-40 sessions depending on the severity of the disorder and other comorbid symptoms present. The first six sessions are completed as quickly as possible and then the frequency of training reduces to two or three times per week. With regular attendance, total training can be completed in four to six months. Each training session lasts approximately 30-45 minutes.

The procedure is based on an early study by Sterman and Friar (1972), who discovered that brainwave feedback made it possible to learn to inhibit epileptic seizures by enhancing low beta (12-16) which is referred to as sensory motor rhythm (SMR). As in current neurofeedback protocols for ADHD, Sterman and Friar\'s patients were also trained to simultaneously minimize theta. The first preliminary case study application of this procedure to hyperkinetic children was by Lubar and Shouse (1977). The effects of neurofeedback appear to provide a change in performance without continual external intervention. Chartier and Kelly (1991) reviewed the effects of neurofeedback for ADHD on over 200 children treated by Dr. Joel Lubar at the University of Tennessee, Dr. John Carter at the University of Texas and Dr. Michael Tansey of Sommerville, New Jersey. Chartier and Kelly found neurofeedback training to provide significant and sometimes 'dramatic' clinical improvements in children with attention deficit disorder. Parents and teachers of children who receive EEG neurofeedback training have reported dramatic behavioral improvements such as: finishing tasks, listening better, less impulsivity, greater motivation and focus, and higher self esteem. In some cases, medications are completely discontinued and in others they have been considerably reduced.

Although the review suggests that EEG neurofeedback approach is an effective intervention for addressing behavioral, listening, impulsivity, and attention problems in patients with ADHD, more research are needed to delineate optimal information for training sessions and follow up procedures Presently, limitations of neurofeedback include: 1) the need for additional controlled experimental studies demonstrating effects which are independent of developmental maturation and the potentially confounding effect of the therapists and parents\' attention during the course of treatments; and 2) the large number of sessions (up to 80; 6-8 months) required for permanent clinical and academic changes to occur. While the field awaits additional research, however, the current EEG training could be used either separately or can be combined with one or more than one of other traditional treatment approaches in order to eliminate or reduce some the possible drawbacks.

References

• Barabasz, A. (1993). Presidential Address: Antarctic isolation and attentional processes: Research implications for practitioners. Presented at the Fifth International Conference on REST, Seattle, WA, Feb. 26-28.
• Barkley, R. A., Anastopoulos, A. D., Guevremont, D. G., & Fletcher, K. F. (1992). Adolescents with attention deficit hyperactivity disorder: Mother–adolescent interactions, family beliefs and conflicts, and maternal psychopathology. Journal of Abnormal Child Psychology, 20, 263–288
• Barkley, R. A. (1998). Attention Deficit Hyperactivity Disorder: A Handbook for Diagnosis and Treatment (2nd ed.). New York: Guilford.
• Chartier, D., & Kelly, N. (1991). Neurofeedback treatment of attention deficit-hyperactivity disorder. Grand Rounds Presentation, Rex Hospital, Raleigh, N.C.
• Chelune, G. J., Ferguson, W., Koon, R., & Dickey, T. 0. (1986). Frontal lobe disinhibition in attention deficit disorder. Child Psychiatry and Human Development, 16, 221-232.
• Edwards, R. (1995). Is the hyperactivity label applied too frequently? American Psychological Association Monitor, 26, 44-45.

• Fredericksen, K. A., Cutting, L. E., Kates, W. R., Mostofsky, S. H., Singer, H.S.,

Cooper, K. L., et al. (2002). Disproportionate increases of white mattering right

frontal lobe in Tourette Syndrome. Neurology, 58, 85–89.

• Grattan LM, Eslinger PJ. (1991). Frontal lobe damage in children and adults: a

comparative review. Dev Neuropsychol; 7: 283–326.

• Gualteri, C. T., & Hicks, R. E. (1985). Neuropharmacology of methylphenidate and a neural substitute for childhood hyperactivity. Psychiatric Clinics of North America, 8, 875-892.
• Halperin, J. M & Schulz, K. P. (2006). Revisiting the Role of the Prefrontal Cortex in the

Pathophysiology of Attention-Deficit/Hyperactivity Disorder (ADHD). Psychological

Bulletin, 132, 560-581.

• Hynd, G. W. Hem, K. L., Voeller, K_ K_ & Marshall, R. M. (1991). Neurobiological basis of attention-deficit hyperactivity disorder (ADHD). School Psychological Review, 20,174-186.
• Hynd, G. W., Semrud-Clikeman, M., Lorys, A., Novey, E. S., & Eliopulos, D. (1990). Brain morphology in developmental dyslexia and attention deficit disorder/hyperactivity. Archives of Neurology, 47, 919-926.
• Lou, H. C., Henriksen, L., Bruhn, P., Bomer, H., & Nielsen, J. (1989). Striatal. dysfunction in attention deficit and hyperkinetic disorder. Archives of Neurology, 46, 48-52.
• Lubar, J. F. & Shouse~, M. N. (1977). Use of biofeedback and the treatment of seizure disorders and hyperactivity, Advances in Child Clinical Psychology. N.Y: Plenum, 1, 204-251.
• Mann,C. A., Lubar, J. F., Zimmerman, A. W. Miller, C. A., & Muenchen, R. A. (1992). Quantitative analysis of EEG in boys with attention deficit hyperactivity disorder:Controlled study with clinical implications.Pediatric Neurology, 8, 30-36.
• Raz, A. (August, 2004). Brain Imaging Data of ADHD. Psychiatric Times. Vol. XXI Issue 9.
• Schandler, S. (2001). Frontal lobe functioning in adolescents with attention deficit hyperactivity disorder - Statistical Data Included. Adolescence
• Schaughency, E. A., & Hynd, G. W. (1989). Attention and impulse control in attention deficit disorders (ADD). Learning and Individual Differences, 1, 423-449.
• Sterman, M. B., & Friar, L. (1972). Suppression of seizures in an epileptic following sensorimotor EEG feedback training. Electroencephalography & Clinical Neurophysiology, 33, 89-95.
• Zametkin AJ, Liebenauer LL, Fitzgerald GA, King AC, Minkunas DV, Herscovitch P, Yamada EM, Cohen RM (1993). Brain metabolism in teenagers with attention deficit hyperactivity disorder. Arch Gen Psychiatry 50:333-340.

Article Source: http://www.articlesbase.com/adhd-articles/electroencephalographic-eeg-neurofeedback-another-approach-to-treat-adhd-751914.html

About the Author

Dr. Kamal Sesalem

Professor of Special Education

Dept. of Teacher Education

McNeese State University

Lake Charles, LA 70609

Why Can\'t My Child Sit Still and Pay Attention?

Author:

Jennifer K. Gray

The American Academy of Pediatrics and the American Academy of Child Adolescent Psychiatry have published specific criteria and guidelines for diagnosing ADHD. If ADHD is suspected, the child should have a clinical evaluation, which may include:2. Often gets up from seat when remaining in seat is expected.Attention Deficit/Hyperactivity Disorder affects an estimated 3 to 5 percent of children of school age. ADHD frequently gets identified when a child is consistently having trouble in school, whether he (significantly more boys than girls are diagnosed with this disorder) is home-schooled or attends public school. The necessity of sitting still, focusing for relatively long periods of time, performing in spite of distractions, and/or getting along with a number of other children can bring ADHD symptoms to the fore and make very obvious what may have been only suspected before.

ADHD affects a child’s performance in school and his relationships with other people. Parents of an ADHD child can feel exhausted and frustrated. The child may feel like he is stupid or bad. It can be a heart-breaking situation. The disorder involves problems with being inattentive, over-active, and impulsive--all three together, or in varying combinations.

The following criteria have been specified by the American Psychiatric Association as diagnostic for Attention Deficit/Hyperactive Disorder:

DSM-IV Criteria for ADHD

I. Either A or B:

A. Six or more of the following symptoms of inattention have been present for at least 6 months to a point that is disruptive and inappropriate for developmental level:

Inattention

1. Often does not give close attention to details or makes careless mistakes in schoolwork, work, or other activities.

2. Often has trouble keeping attention on tasks or play activities.

3. Often does not seem to listen when spoken to directly.

4. Often does not follow instructions and fails to finish schoolwork, chores, or duties in the workplace (not due to oppositional behavior or failure to understand instructions).

5. Often has trouble organizing activities.

6. Often avoids, dislikes, or doesn\'t want to do things that take a lot of mental effort for a long period of time (such as schoolwork or homework).

7. Often loses things needed for tasks and activities (e.g. toys, school assignments, pencils, books, or tools).

8. Is often easily distracted.

9. Is often forgetful in daily activities.

B. Six or more of the following symptoms of hyperactivity-impulsivity have been present for at least 6 months to an extent that is disruptive and inappropriate for developmental level:

Hyperactivity

1. Often fidgets with hands or feet or squirms in seat.

2. Often gets up from seat when remaining in seat is expected.

3. Often runs about or climbs when and where it is not appropriate (adolescents or adults may feel very restless).

4. Often has trouble playing or enjoying leisure activities quietly.

5. Is often 'on the go' or often acts as if 'driven by a motor'.

6. Often talks excessively.

Impulsivity

1. Often blurts out answers before questions have been finished.

2. Often has trouble waiting one\'s turn.

3. Often interrupts or intrudes on others (e.g., butts into conversations or games).

A diagnosis of ADHD means that the child has at least six symptoms in the inattentiveness category, or six symptoms in the hyperactivity and impulsivity categories. According to the American Academy of Child Adolescent Psychiatry, the symptoms must have been present for at least six months, and there must be clear evidence of severe impairment in at least two of these major areas of the child’s life:

• in the classroom
• on the playground
• at home
• in the community
• in social settings

Some symptoms must have been present since before the age of seven. Symptoms cannot be present only during the course of another disorder, or better accounted for by another diagnosis. Three major subtypes of the disorder have been identified: 1) Predominantly Inattentive Type a)Criterion 1A is met but Criterion 1B is not met for the past six months b) Most symptoms are in the inattention category c)Fewer than 6 symptoms of hyperactivity-impulsivity are present i)Children with this subtype are less likely to have problems getting along with other children. ii)They may sit quietly, but are having trouble paying attention to what they are doing; symptoms of ADHD may therefore not be noticed. 2) Predominantly Hyperactive-Impulsive Type a)Criterion 1B is met but Criterion 1A is not met for the past six months. b)Most symptoms (6 or more) are in the hyperactivity-impulsivity categories. c)Fewer than 6 symptoms of inattentiveness are present 3)Combined Type: hyperactive-impulsive and inattentive a) Both Criteria 1A and 1B are met for the past 6 months b)Six or more symptoms of inattention and six or more symptoms of hyperactivity-impulsivity are present. c)Most children have this type of ADHD. If a child is having problems in one situation only—maybe is too active at play, but not in the classroom—the problem might be something other than ADHD. There are other conditions that can elicit behaviors resembling ADHD behaviors, such as:

• A loss, such as the death of a pet, a family member
• A sudden stressful change, like parents divorcing, or a parent’s job loss
• An exposure to violence or emotional stress
• An undetected illness
• An undetected hearing or vision loss
• A learning disability
• Anxiety or depression
• Lack of sleep
• Undetected seizures

ADHD has come to be a popular diagnosis when a child is difficult to handle, and an incorrect label is easy. There are a number of other disorders that can look like ADHD, and children with ADHD may have an accompanying mood disorder, such as anxiety, depression, or bipolar disorder.

The American Academy of Pediatrics and the American Academy of Child Adolescent Psychiatry have published specific criteria and guidelines for diagnosing ADHD. If ADHD is suspected, the child should have a clinical evaluation, which may include:

Parent and teacher questionnaires

• Psychological evaluation of the child and family
• A complete work-up, including developmental, mental, nutritional, physical, and psychosocial evaluations

ADHD can be difficult to pin down, and doubly difficult to live with, for both the parents and the child in question. The first step in dealing with the problem is correct diagnosis.

Article Source: http://www.articlesbase.com/adhd-articles/why-cant-my-child-sit-still-and-pay-attention-1312578.html

About the Author

Jennifer K. Gray is the Director of Operations for LessonPathways.com.

Lesson Pathways is an innovative online curriculum created entirely from INTERNET RESOURCES, making it easy for educators to use educational resources and links, with limited pre-planning time!

Forms Of Autism In Children - What Are The Types And Forms Of Autism?

Author:

Autism Advisor

Forms Of Autism In Children

There hold continued a good amount of sorts of autism noted along the spectrum. Each differs by severity. Some kinds are classic autism, autistic disorder or Kanner\'s syndrome, Rett\'s Syndrome, and Asperger\'s Disorder. Forms Of Autism In Children

Kanner\'s syndrome was named for psychiatrist Leo Kanner who is credited with discovering this syndrome based off of research done on 11 child patients between 1932 and 1943. This is the most severe form of autism. All the children studied demonstrated the same characteristics. There was a lack of emotional contact with others, a desire for sameness and routine, abnormality in speech or muteness, fascination with manipulating objects, and learning difficulties despite an intelligent appearance. Certain sounds or colors can upset people with classic autism.

Hans Asperger of Vienna discovered Asperger\'s disorder in 1944, around the same time as Kanner. However, many until the 1980s when his work was translated to English did not know his studies. Asperger\'s studies concluded some similar findings as Kanner, with one major distinguishing feature, the subjects of Asperger\'s studies were vocal. People with Asperger\'s are not found to have language delays. Nor do they have delays in cognition. Forms Of Autism In Children

Childhood Disintegrative Disorder is a type of autism that has developed in children later on between the ages of 2 and 4. Children who suffer with this condition once appeared normal. However, somewhere down the road they stopped talking, lost potty-training skills and stopped socializing with others. Oftentimes they fail to make friends and lose motor skills. Forms Of Autism In Children

Dr. Andreas Rett identified Rett\'s syndrome in 1965. Rett\'s syndrome is established as being a neurological degenerative disorder that affects only girls. Rett\'s syndrome is marked with poor head growth. Many times girls with this disorder repeat hand motions like hand washing and clapping. The discovery of the gene responsible for the onset of Rett\'s syndrome was found late in 1999. Don\'t let your love ones suffer anymore! Lead them out through Forms Of Autism In Children program now!

Article Source: http://www.articlesbase.com/adhd-articles/forms-of-autism-in-children-what-are-the-types-and-forms-of-autism-1872549.html

About the Author

Feeling lost without solutions? Forms Of Autism In Children is a proven Autism Solution for your Child.

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