Often it is a breakdown in one or a number of the brain systems critical for the moment to moment processing of information. So while the senses may successfully detect what is going on in the environment, such breakdowns interfere with the brain’s ability to properly evaluate the information provided, leading to difficulties with attention, judgment, knowledge acquisition and behaviour.
The consequences of not resolving these issues can be significant. Early childhood learning and experience provide the social, cognitive and emotional foundations underpinning personal development. And as the construction of the individual gets under way, it becomes increasingly difficult to undo foundational flaws and recover lost ground. Critical aspects of development grind to a halt and the individual is left with poorly formed abilities. So early intervention can potentially lead to more profound positive change.
The medication option: The best known, least expensive and most easily available interventions are psychoactive medications – drugs. Once taken into the body, these drugs pass into the brain to increase or decrease central nervous system activity. This generally changes the way the brain processes information, albeit somewhat indiscriminately. A widely accepted theory of ADHD, for example, is that a number of brain systems are chronically underaroused, with unruly hyperactive behaviour representing the child’s desperate attempt to increase brain stimulation to fulfilling levels. This is used to explain the action of stimulant drugs, such as Ritalin or Dexamphetamine, by attempting to achieve artificially the same outcome.
But as mentioned, such drugs are usually indiscriminate in their action – that is, once released into the brain, they act everywhere and not simply on the systems that are dysfunctional.
And there is usually no attempt prior to medication to identify what brain systems are affected. Thus, by acting everywhere, rather that on just where required, gains can often be at the cost of significant side effects.
Further, the brain’s tolerance to such drugs may require doseage increases even though the changes to function are still only temporary. So while medications can be very important in providing short-term respite, it is important to combine them or replace them with treatment regimes that can work to provide more permanent change.
Recent treatment advances using neurofeedback therapy and QEEG: Fortunately, recent advances in brain functional imaging now make it much easier to identify the dysfunctional systems underlying psychological disorder. One such advance is quantitative EEG (qEEG), which uses age and gender based statistical imaging to identify abnormal brain function. Click here for more information on QEEG and brain mapping.
Another advance is neurofeedback therapy, which non-invasively targets the dysfunctional systems identified by qEEG, often producing lasting, positive change to psychological function without side effects.
Such developments have given rise to a new and more personalised way of assessing and treating disorders. Rather than simply adopting a one size fits all, medication-based approach to the treatment of complex behavioural disorders, it now permits the tailoring of treatment to the individual’s pattern of brain function using a more targeted approach.
Neurofeedback therapy teaches the brain to retrain itself by exploiting natural learning mechanisms and drawing on well established principles of operant conditioning. During treatment, the individual is engaged in computer-based activities – e.g. games – that are driven in real time by activity from their brain. Importantly, the treatment uses activity from the brain systems identified as dysfunctional from QEEG imaging, with success during the game dependent on these systems functioning within normal range.
Over repeated sessions the brain gradually learns and remembers the successful brain activity. Like learning to ride a bike, the brain becomes skilled in identifying and remembering what works well, and gradually releases the need for conscious control of the activity. In this way, the individual is productively engaged in his or her own treatment, with excellent prospects of long lasting change.
Of course such treatments, like drugs, don’t always work as well as one would like. But neurofeedback therapy is being increasingly shown in scientific and clinical studies to be an effective evidence based intervention for children, adolescents and adults.
In ADHD for example, studies uniformly show significant benefit for 70 to 80% of individuals, with gains being maintained years after treatment ends. Numerous studies have shown that neurofeedback results in measurable and replicable improvements in attention, impulsivity, mood, anxiety, memory and learning and clinically significant improvements in addictive disorders and epilepsy in children and adults (e.g. Arns et al, 2009, Heinrich et al, 2007, Hirshberg, 2005, Gevensleben, 2009, Klimesch, 1999, Kropotov, 2009).
Some references about the application of neurotherapy (Check on Google Scholar to see article abstracts. Search using authors names and key words from title. Some articles may be freely downloadable).
- Arns, M. yet al (2009) Efficacy of neurofeedback treatment in ADHD: the effects on inattention, impulsivity and hyperactivity: a meta-analysis. Clinical EEG and Neuroscience 40: 180-189.
- Breteler, MHM, Arns, M, Peter,S Giepmans, I, Verhoeven, L (2010) Improvements in Spelling after QEEG-based Neurofeedback in Dyslexia: A Randomized Controlled Treatment Study. Appl Psychophysiol Biofeedback (2010) 35:5–11
- Cantor DS and Chabot R (2009) QEEG studies in the assessment and treatment of childhood disorders. Clinical EEG and Neuroscience 40: 113-121.
- Chabot, RJ, di Michele, F, Prichep, L and John ER. (2001) The clinical role of computerized EEG in the evaluation and treatment of learning and attention disorders in children and adolescents. The Journal of Neuropsychiatry and Clinical Neurosciences; Spring 2001; 13, 2
- Gevensleben, H (2009) Is neurofeedback an efficacious treatment for ADHD? A randomised controlled clinical trial. Journal of Child Psychology and Psychiatry 50:780–789
- Heinrich, H, Gevensleben, H and Strehl, U (2007) Annotation: Neurofeedback – train your brain to train behaviour. Journal of Child Psychology and Psychiatry 48:3–16 Link
- Hirshberg, LM, Chiu, S, Frazier, JA (2005) Emerging brain-based interventions for children and adolescents: overview and clinical perspective Child Adolesc Psychiatric Clin N Am 14: 1 – 19
- Klimesch, W., 1999. EEG alpha and theta oscillations reflect cognitive and memory performance: a review and analysis. Brain Research Review 29, 169-195.
- Kropotov, J, (2009) Quantitative EEG, event-related potentials and neurotherapy. Elsevier: Amsterdam.