The ADD Centre offers neurofeedback and biofeedback training in combination with strategies that assist the client to achieve success in the workplace or in adult education programs. The goal of the training is to help the client learn to become calm, focused and relaxed. This is done using a computer program that provides very fast feedback about what the brain and the body are doing. Neurofeedback training works by is actually attention span by reading your EEG (brainwave patterns) and letting you know when you are in the zone of an optimal mental state.
See the example Sailboat Race Training Screen below:
When a client is working on the sailboat race screen they will have a small eeg sensor on the top of their head and one on each ear to measure brainwave activity. The EEG sensor picks up brainwave patterns associated with being calm, focused and relaxed. On this screen the yellow boat is associated with inattention or daydreaming and will move if the client is NOT focused. The Green boat will move ahead when the client attains a state of calm alertness and the pink boat will move if the client begins to ruminate or feel anxious. The goal is for the client to get the Green boat to win the race.
At the bottom of the screen you can see a graph of the client’s breathing and heart rate. The client is doing heart rate variability training to achieve a maximum change in heart rate. This type of training helps with stress management.
Sessions also include coaching in strategies to help with stress management, organization, and/or study skills as needed.
The Assessment Interview for Adults
The first step is to complete an initial assessment interview with a professional registered with The College of Psychologists of Ontario. This interview procedure takes 3 ½ hours. During that time the history of the client's strengths and difficulties are reviewed and any available psychological reports are discussed. The client is asked to fill out questionnaires appropriate to the problems they are reporting. The client is also given the TOVA (test of variables of attention) and/or the IVA (Intermediate Visual and Auditory) continuous performance test. These are the most well researched and widely used computerized tests for such factors as attention span, impulsivity and drifting attention, which are among the key factors in Attention Deficit Disorder but are also factors in a number of other problems including learning difficulties, anxiety problems, Tourette’s Syndrome, Asperger’s/High Functioning Autism, depressed mood, Post-concussion syndrome, and even athletic performance. In addition, all clients complete an online neuropsychological evaluation. This test assesses attention, executive function, memory, cognitive flexibility, and motor speed.
Following this the EEG Assessment Protocol developed by Dr. Lubar is administered. This is a simple painless procedure, which involves placing 3 small electrodes (one on the scalp and one on each ear lobe) using EEG paste. Data collection takes only a few minutes. The Client is shown the brainwave patterns and these are discussed. For example, in attention span difficulties one may see a predominance of slow wave activity; with anxiety and ruminations there may be an increase in fast wave activity. Based on this assessment a customized neurofeedback training program can be created. Most often the goal is to achieve an optimal state for learning, working or performing athletics.
With some clients, a 19-channel assessment may be recommended. It is only recommended for more complex cases and is not usually done for ADHD, Tourette’s Syndrome or Mild Anxiety.
It can be very informative about the precise difficulties being experienced by a client who has any of the following symptoms:
Asperger’s Syndrome (High Functioning Autism)
Symptoms Related to Post-Concussion
Difficulties with mood regulation
A stress test may also be done during the initial assessment appointment. This demonstrates to the client how their respiration, heart-rate, skin temperature, skin conduction, and muscle tension varies with even a minor mental stress such as math. This may lead to recommending that biofeedback of some of these variables be recommended to accompany the neurofeedback of brain wave patterns.
Training and Reassessment:
Training usually takes between 40 and 60 sessions, although some adult clients have taken fewer than 20 sessions to reach their goals. Clients experiencing more complex symptoms may take more sessions.
NEUROFEEDBACK AND BIOFEEDBACK TRAINING PROGRAM FOR ADULTS:
The basic training program for adults combines neurofeedback, biofeedback and metacognitive strategies. The program includes steps A to D below:
Neurofeedback (EEG biofeedback):
GOAL: to gain a more flexible brain and learn self-regulation of individual brain states. Be able to remain relaxed, alert, and focused.
COGMED – working memory training program
BRAIN HQ – cognitive training program
19 Channel QEEG Assessments:
The 19 Channel QEEG Assessment, also known as the full cap assessment. This assessment measures the brain at 19 different locations and compares the clients brainwave patterns to a large database. The result is a brain map or a picture of how the brain is functioning:
On the map above, the red and orange areas are outside the normal range as compared to the database. Each area on the brain corresponds to a different function. For example, if we see that an area of the brain that usually corresponds to anxiety is red, we can ask the client if they experience anxiety. If they do, then this is something that we can target in training. With Neuroguide and LORETA we can look at areas of the brain, connections between areas of the brain and networks. This assessment tool is very powerful in helping us determine the best training program for each client.
After this assessment, a program can be created for the client that is tailored specifically for them with a goal of optimizing brain performance. Following the training program, a reassessment is booked and another 19 Channel Assessment is done. The brain maps can then be compared. Below you can see a comparison of a brain map before and after training. This client was training to improve symptoms following a concussion. You can see how the red and orange areas have normalized to a green colour. This change corresponded to reduced in anxiety, improved mood, and better focus.
LORETTA NEUROFEEDBACK TRAINING:
LORETA neurofeedback is an advanced form of neurofeedback training. It involves wearing a cap that measures 19 sites on the head. With this approach we can see what is happening at 47 Brodmann areas in your brain. In addition, the complex mathematics involved in LORETA allow us to train amplitudes, coherence and phase at 47 Brodmann areas. Communication between sites deep in the cortex can also be influenced. This is why some call it Deep Brain Neurofeedback. This program also allows us to train networks in the brain. Networks are areas of the brain that work together to perform a function. There are networks associated with executive function, attention, mood, anxiety, and pain. As we are able to target many locations at once, we are able to see the effects of the training more quickly than traditional neurofeedback.
The training itself involves receiving feedback in the form of a DVD movie or animation. When the client is able to move their brainwave patterns in the right direction (direction toward resolving symptoms) then the DVD movie/animation will play. The client learns what it feels like to be in the desired mental state (often a state of calm, relaxed focus and concentration). They can also learn to regulate brainwave patterns in order to normalize brain functioning in areas where they are having difficulty. A simple example of this would be a person who has difficulty reading. After practice they are able to achieve this state more easily and their brain begins to function in a more optimal way.
We began using LORETA neurofeedback in our centre several years ago. Our preliminary results with clients experiencing head injury, anxiety, depression, learning difficulties, and ADHD have been impressive and we are hoping to publish research in the near future.
Our LORETA neurofeedback training program is based on a complete assessment of the brain (brain map) and is tailored to the client. We collaborate with the client to decide what the best training program will be for them and then we update it after every 10 training sessions.
Improve: Attention, Focus, Organization and Learning through Brain Wave Analysis and Feedback!
Director: Dr. Lynda M. Thompson
416-488-2233 or 905-803-8066