The ADD Centre® & The Biofeedback Institute of Toronto®

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The Assessment Interview

The Centre's initial interview process may be of interest to you. It will, of course, be somewhat different for an executive or athlete who is here to optimize their performance than it may be for a child who has ADHD.  However, for the most part, this interview procedure takes 3 ½ hours.  During that time the history of the client's strengths and difficulties are reviewed and any available reports are discussed. For children these may include school or psychological reports. Clients or parents are 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 widely used computerized tests for such factors as attention span, impulsivity and variability of response time, which are among the key factors in Attention Deficit Disorder but are also factors in a number of other problems including learning difficulties, Tourette’s, anxiety problems, Asperger’s, dysphoria and even athletic performance. These tests involve pressing a button when a target appears on the screen and inhibiting that response when a non-target appears.
  
Following this the  EEG Assessment Protocol developed by Dr. Lubar is administered to the  client.  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.  Clients and parents are shown the EEG 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. 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 or Tourette’s. It can be very informative about the precise difficulties being experienced by a client who is experiencing difficulties including: anxiety, Asperger’s, dysphoria, learning difficulties, ruminations or clients such as athletes who have had a concussion. The results of all of the procedures are discussed in the context of suitability for training and a demonstration of the training programs is given.
 
With adolescents and adults a ‘stress-test’ may be done. 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.
 
The Second Testing Interview for Clients Who Decide to Enter the Program:
If the child or adult who presents with ADHD or a learning problem has not had psychoeducational testing in the last two years then this will be carried out in a second interview.  This assessment also takes approximately 3 ½ hours.  Intelligence and academic testing is carried out.
 
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. Children who have extreme hyperactivity and/or learning disabilities or Asperger’s in addition to attentional problems take more sessions than those who are simply ADD and inattentive. Progress testing is routinely carried out after at least 40 sessions and there is an additional cost for this to be completed.

At the ADD Centres in Mississauga and Toronto more than 85 children and adults are taking this training at any given time.  For ADHD, for example, the results of training are in line with those obtained at various centres in the United States and Europe: improved behaviour, increases in IQ scores,  increases in scores on academic tests and a decreased need for continuation of stimulant medication.  By the end of training, most clients with ADHD no longer require drugs as their symptoms no longer warrant medication. ADHD clients who are on a stimulant medication when they begin training remain on their medication until the neurofeedback training takes effect. The only time we request that a person be off stimulant medication is for the first assessment interview.