Bring up attention deficit hyperactivity disorder (ADHD) at a soccer game, a school function or even Starbucks, and a chorus of parents are likely to chime in, describing journeys and ordeals in diagnosing and treating the condition. Many children are on medication to enable them to pay attention in school, to organize their thoughts and belongings, and to control impulsive behavior. Some families are also trying alternative treatments, including neurofeedback therapy.
The focus of neurofeedback therapy is to retrain the brain to produce electrical patterns associated with calm and focus. During a typical 30-minute session, a child is seated in front of a computer and electrodes are attached to different points on his head. A neurofeedback practitioner starts a videogame or movie on the child's screen and monitors his brainwaves on another screen. The child then concentrates on sending the kind of brainwaves that will keep virtual hot air balloons floating in the game or allow the movie to continue playing. If attention flags, the balloons descend or the movie stops. The practitioner encourages the child to restart the game or movie by focusing his attention.
Dr. David Mitnick, a founder of The Center for Neurofeedback and Integrative Health in Maywood, treats children, adolescents and adults in his psychiatric practice. He is also affiliated with New York Presbyterian's Weill Cornell Medical Center. When medication isn't an option or isn't working effectively, Mitnick might suggest neurofeedback as an alternative.
Before treatment begins, brain mapping, or a measure of the electrical activity of the brain, is performed by a neuropsychologist. That individual brain map is then compared to a normative database. That information is used to design specific protocols for patients.
Mitnick is optimistic about the potential benefits of neurofeedback for children with ADHD or other disabilities or conditions, such as autism, anxiety, processing issues, and dyslexia and other learning disorders.
"The technique itself is not concerned with what you have," he says. "It's concerned with the regulation of your brain."
There are also cautions. Patients with an underlying predisposition to a seizure disorder should discuss the therapy with their doctors. In addition, patients sometimes suffer headaches or fatigue after the first few sessions.
Mitnick recommends a therapy regimen of twice a week for six to nine months. He likens it to learning a new language.
"If you practice to a certain point, you master it," he says.
For some, that lasting abatement of symptoms is the most tantalizing part of neurofeedback therapy.
Kailan Ottaway was a junior in high school when he was diagnosed with ADHD and learning disorders. Kailan had been unaware of his condition for many years, compensating as best he could, until schoolwork became overwhelming. His mother, Kimberley Ottaway, was looking for an alternative to medication as treatment for Kailan, which brought her to Mitnick. A scientist by training, Ottaway read about neurofeedback and "was intrigued by the fact that it was non-invasive and that it had the potential to help his brain function more efficiently."
Kailan's brain mapping indicated that the right side of his brain had connections that were supposed to be on the left side, forcing the right side to work that much harder and more slowly. Within 10 sessions, his mom says, Kailan was sharper, more engaged and more organized. Ottaway says the effect was "like sharpening a knife.
"When we viewed the second brain mapping after the 20 sessions," she says, "you could actually see the difference."
Kailan, who wants to be a mechanical engineer, was ecstatic to discover he was achieving straight As in his senior year without relying on medication to help him focus. Ottaway says the entire experience was "so profound" that Kailan wrote about it in his college essay. Today, he is a successful college freshman.
One big downside to the treatment is the difficulty in obtaining reimbursement from medical insurance. Dr. Anya Luchow, a psychologist with a private practice in Tenafly, has been providing neurofeedback since 1997. She says some insurance companies are reluctant to cover the procedure, saying there is not enough scientific evidence to prove its effectiveness. In her practice, however, she says she has seen patients go "from failing to top of their class."
• Biofeedback is a technique that trains people to improve their health by controlling certain bodily processes that happen involuntarily, such as heart rate, blood pressure, muscle tension and skin temperature.
• Neurofeedback or EEG Biofeedback measures brain wave activity.