Neurofeedback has demonstrated the capacity to improve the brain’s efficiency. By training the brain to more effectivelychange and maintain the appropriate balance of frequencies the individual becomes more capable of responding to daily challenges. The benefits of this process are manifested in the enduring reduction of symptoms of a broad range of issues including anxiety/depression, impulsivity, attention issues, learning disabilities and head injury.
History of Neurofeedback
Research done at UCLA in the mid 1960’s by Dr. Barry Sterman, current Professor Emeritus in the departments of Neurobiology and Biobehavioral Psychiatry at the UCLA Schoolof Medicine, was instrumental in revealingthe ability of the brain to alter the frequencyof cellular activity via a rudimentary neurofeedback process. Using a group of laboratory animals Dr. Sterman’s research team was able to promote an increase in specific frequencies (more brain cells firing at those frequencies) by providing food as an immediate reward. In later research those animals exhibited a significant improvement in stability when exposed to a toxic vapor observed to evoke seizure activity in animals that had not received the training.
Dr. Sterman adapted his technique to work with human volunteers. His first human research population were individuals experiencing epileptic seizures that were not responsive to medication. Many of this group experienced multiple seizures per day and were disabled. The training was successful in reducing seizures in the majority of the participants and in some casesthe seizures were eliminated. Further, the benefits of the training were enduring.
Dr. Sterman’s procedure was replicated in the early 1970’s byDr. Joel Lubar of the University of Tennessee who used the same training to reduce the symptoms exhibited by ‘hyperkinetic’ children. This population would now be diagnosed with Attention Deficit/ Hyperactivity Disorder (AD/HD). Those early investigations of Drs. Sterman and Lubar established the foundation for theprocedure as it is used today.
In the early 1990’s the development of personalized computers and complex software allowed the training process to be manageable, both technically and financially, for treatment providers in small clinics.
In the mid-1980s, Francine Shapiro reported that while walking in a park, she became aware of a decrease in emotional pain connected to some disturbing thoughts she had been having. Serendipitously she noticed that her eyes had been moving back and forth while this was happening. She then brought up some additional disturbing memories and purposefully moved her eyes back and forth. Once again, she noticed a marked decrease in the level of distress associated with these previously painful memories.
Recognizing the potential benefit of this discovery, she conducted her initial research on EMDR with 22 traumatized individuals. Her results suggested that EMDR could reduce the pain associated with traumatic memories. In addition to the desensitization that occurred, EMDR produced a shift in the individual's evaluation of self from negatively held beliefs (I am weak; I am worthless; I deserve to be hurt) to a more realistic, more balanced view of oneself (I did the best I could; I am lovable; I am still a good person even if I make mistakes; I am safe now).
The initial results and claims made by Dr. Shapiro aroused a storm of controversy that has diminished in the decades since the inception of EMDR. Critics questioned the claims she made, the data she reported, and the use of eye movements as part of a therapeutic method. While Shapiro's initial research had several methodological limitations, more methodologically sound replications of her work have supported the positive results she obtained. Today, EMDR is one of the fastest growing methods of psychological treatment with more than 65,000 clinicians trained worldwide. Its primary use is for the treatment of PTSD, but it has also been used to assist clients with a wide variety of other problems, such as phobias, anxiety, and performance difficulties.
Ten Fundamental Principles for Effective Rules and Commands
1. Make the expectation crystal clear to both of you. What exactly do you mean by “clean room", ready to go”, or “don’t act up”?
2. Keep the request simple and brief. (Like this.)
3. Be sure the rule is enforceable (e.g., Do you break the rule? Is your child capable of following the rule? Can you effectively monitor compliance?).
4. It’s generally good to discuss major rules ahead of time with children. However,
5. Do not entertain arguments about requests or commands.
6. Have a set plan for consequences to respond to non-compliance to rules.
7. Handle opposition to requests or commands with the “two simple choices” method.
8. Be persistent. Don’t give in once you’ve drawn the line.
9. Be consistent. We don’t like it when people change the rules.
10. Choose your battles well.
So why isn't this working?
1. We use good encouragement with a negative twist.(e.g., “So why can’t you do it all the time?”)
2. We ask for compliance to a command or request.("Are you ready to go home now?")
3. We end a command with “OK?”.("Come take the trash out, OK?")
4. We use the “two simple choices” method with threat of a consequence we won’t or can’t follow through.
5. We get bogged down by rationalizing, pleading, nagging, or arguing.
6. We send a non-verbal message that doesn’t match the verbal message.
7. We forget that silence is sometimes the best response.
8. We overlook the child’s non-verbal message.
9. We model an undesirable behavior.
10. We give up on a new method too soon.
The 1-2-3 Method
For frequent and relatively minor behaviors like arguing, whining, being demanding, disrespect, pouting, etc.
1. Calmly give a warning that is both verbal and visual. Hold up one finger and say, “That’s one.” DO NOT explain, plead, argue or get emotional.
2. If he or she stops, fine. Move on. If the behavior continues, give a second warning: hold up two fingers and say, “That’s two.”
3. If he or she stops, fine. Move on. If the behavior continues, immediately hold up three fingers and say, “That’s three, take five.” (The child goes to their bedroom or other time-outspot you choose for five minutes.) When five minutes are up, act as if nothing has happened -- no lectures or apologies --and repeat the process as often as necessary.
Managing Behavior in Public Places
1. Set up the rules before entering the place. Pick three very specific rules you want your child to follow. Choose the three you most frequently have trouble with (e.g., “stay beside me, no running, don’t beg for a toy”, etc.). Have your child repeat the rules back to you before leaving the car.
2. Briefly remind the child that there will be a time-out for breaking the rules.
3. Have a time-out plan for the place you’re in (e.g., restroom, quiet aisle, car, etc.).
4. When your child breaks a rule, tell them, “that’s one” (or “two” or “three”). For each count, place a small pen mark on the child’s hand. If they get to “three”, immediately go to a time-out. In public places, one minute (or less) for each year of their age is usually adequate. If you absolutely cannot use a time-out in the public place, the marks will be a clear reminder of why they must serve a time-out in the car or at home.
The Marble Jar
This is an effective method for managing typical misbehavior on a daily basis. The Marble Jar method is based on a simple idea -- people will work harder to keep something they already have than they will to get something that seems impossible to earn. This is especially true with AD/HD kids because they often feel like they can never be “good” long enough or often enough to earn typical rewards.
You will need a clear (glass or plastic) container and twelve marbles (or any twelve identical objects). Neon ping-pong balls are terrific for this. The bigger and more obvious, the better. Keep the jar where it is easy to see -- on top of the fridge is perfect.
First, identify your kid’s misbehaviors that typically occur every day. Pick about five behaviors (less for very young kids) that are relatively minor, but normally create the most frustration for the family (arguing, yelling, running in the house, name-calling, etc.). Be very specific about what you expect regarding a behavior. Post this list in big letters on the fridge below the jar.
Next, pick one activity that your kid really enjoys. Make sure that this activity is available in your home, and one that you wouldn’t mind letting him or her do for up to an hour every day. (Video games work well for most younger kids, while time on the phone or internet is effective with older kids.) Set a scheduled time (ideally the same time every day) when this activity begins.
The new rule is that your kid automatically starts every day with one hour of this activity earned. The catch is that they have to work to keep it. Make it clear that this is the only way to earn time doing the activity.
Each marble is worth five minutes of the activity. Every time your kid does one of the behaviors on the list, remove one marble from the jar. It is not necessary to comment on the behavior. At the time scheduled for the activity, sit down with your child and count the marbles left in the jar. This determines how many minutes of the hour remain. Set a timer and do not allow any extra time. Handle disappointment on “less successful” days with a brief reminder that there will be another chanceto earn more time again tomorrow.
For a quick alternative to a jar, use a large piece of neon paper marked with twelve squares. Each square is worth five minutes of the activity. Post this on the fridge. When your kid does one of the behaviors on the list, cross one square off. Count the remaining squares to determine how many minutes of the activity are left. A big, bright, three-dimensional reminder is effective with younger kids, while a chart on paper works well with older kids.
The ADHD assessment can be used to expedite access to accommodations in the school setting, to complement a psychiatric consultation, or to detail specific functional deficits to enhance intervention.
As there is no definitive 'test' for ADHD, a proper assessment incorporates a variety of resources detailing the historical and current symptom presentation. The evaluation is based upon the guidelines developed by Dr. Russell Barkley, a recognized authority on the assessment and diagnosis of ADHD. Midwest Neurofitness is unique in the integration of the TOVA (Test of Variables of Attention) and the Mini-Map. These are objective measures of function and neurological activity respectively.