OT: Neurofeedback information

[Guest guest]

Hi all

This is a post by the moderator of the autism-nf group. I thought it

was a really helpful introduction to neurofeedback, and thought I'd

pass it along to this group (with permission).

Enjoy!

Rene

-------------------

[autism-nf] Neurofeedback Clinic / Home-Training - for the non-Pros

Ok, you heard about Neurofeedback and it seems like a great

alternative for

whatever condition you need or want to address, and doing it at home

sounds

unbeatable.

Here are some things I believe you should consider:

1. What is Neurofeedback Training (EEG)?

" Neurofeedback training is brainwave biofeedback. During typical

training,

a couple of electrodes are placed on the scalp and one or two are

usually

put on the ear lobe. Then, high-tech electronic equipment provides

you with

real-time, instantaneous audio and visual feedback about your

brainwave

activity. The electrodes measure the electrical patterns coming from

the

brain--much like a physician listens to your heart from the surface

of your

skin. No electrical current is put into your brain. Your brainwave

patterns

are relayed to the computer and recorded.

Ordinarily, we cannot influence our brainwave patterns because we lack

awareness of them. However, when you can see your brainwaves on a

computer

screen a few thousandths of a second after they occur, it gives you

the

ability to influence and change them. The mechanism of action is

operant

conditioning.

We are literally reconditioning and retraining the brain. At first,

the

changes are short-lived, but the changes gradually become more

enduring.

With continuing feedback, coaching, and practice, we can usually

retrain

healthier brainwave patterns in most people. It is a little like

exercising

or doing physical therapy with the brain, enhancing cognitive

flexibility

and control.

Thus, whether the problem stems from ADD/ADHD, a learning disability,

a

stroke, head injury, deficits following neurosurgery, uncontrolled

epilepsy,

cognitive dysfunction associated with aging, depression, anxiety,

obsessive-compulsive disorder, or other brain-related conditions,

neurofeedback training offers additional opportunities for

rehabilitation

through directly retraining the brain. The exciting thing is that

even when

a problem is biological in nature, we now have another treatment

alternative

than just medication. Neurofeedback is also being used increasingly to

facilitate peak performance in " normal " individuals and athletes . "

There is more to it - and I highly recommend reading the entire

article that

can be found at ( <http://www.isnr.org/pubarea/intro-nfb.htm>

http://www.isnr.org/pubarea/intro-nfb.htm) and look for other

articles as

well.

2. What is Neurofeedback Training (HEG)?

There are 2 kinds - nIR and pIR - Hershel's and Jeff Carmen's.

Basically,

nIR is active (injecting a signal into the head, with a narrower

aperture,

and direct measure of oxygenation) and pIR is passive (just measures

what

comes out and a direct measure of cerebral metabolism).

HEG (hemoencephalography) is the study of blood flow in the brain.

More

specifically, it is the study of voluntarily controlled blood flow or

oxygenation in specifically chosen brain modules.

Many major functions occupy clearly defined volumes. Some of these

are well

known. There is a module devoted to making sense of visual objects.

The face

fusiform area recognizes faces. It is located at the lower (inferior)

part

of the right temporal lobe over the right ear. The module used for

working

memory is usually located just above the left eye in the frontal

(anterior)

area of the left frontal lobe. There are obviously many more. Not all

people

have identical areas devoted to a particular function. Any particular

function may call upon the primary module and several helpful modules

to

complete an operation. Location of these modules is a study in itself.

" ...a sophisticated infrared thermometer, passive infrared HEG

(pirHEG),

developed by my esteemed colleague, A. Carmen, or an optical

probe,

near infrared HEG (nirHEG) developed by the originator of HEG Hershel

Toomim, that shines light through the skin and skull to assess the

color of

brain tissue. Oxygenated arterial blood is red, deoxygenated venous

blood is

blue. Increased demand for nutrition results in faster blood flow and

redder

blood in the tissues. "

Again, there is more to it. Google it to find out.

3. Once you have done both of the above and can understand the

difference

EEG and the HEGs, you may be wondering which one you should consider.

One article that explores that question is: EEG or HEG ? Please,

Google or

ask Jeff Carmen, Hershel or your clinician.

4. Bottom Line

Knowing what NF does and its types and such is good. But that alone

will not

even start helping you...

You are the only one who has the answer fot most important piece of

information regarding Neurofeedback - what do you expect it to do for

you ?

This is the basic piece of information that will guide you from now

on to

the rest of the process to the point you can make an informed and

suitable

decision.

Once only you know the answer to the Bottom Line question, all I can

provide

you with is general information.

1. Read about Neurofeedback, learn how it works, its basic concepts,

its

history. Some links to start with:

<http://www.eegspectrum.com/HealthProfFAQ/>

http://www.eegspectrum.com/HealthProfFAQ/

<http://www.brianothmerfoundation.com/faq.html>

http://www.brianothmerfoundation.com/faq.html

<http://webideas.com/biofeedback/research/dmcdougall.shtml>

http://webideas.com/biofeedback/research/dmcdougall.shtml

The following links are also very valuable:

The International Society for Neuronal Regulation:

<http://www.isnr.org>

http://www.isnr.org

Association for Applied Psychophysiology & Biofeedback:

<http://www.aapb.org> http://www.aapb.org

Dr. Lubar, University of Tennessee: <http://www.eegfeedback.org>

http://www.eegfeedback.org

Neuropathways EEG: <http://www.neuropathways.com/index.html>

http://www.neuropathways.com/index.html

Applied Neuroscience qEEG: <http://www.appliedneuroscience.com>

http://www.appliedneuroscience.com

2. Read

Get these books - you may be able to get from your local library (even

though I would think they are a great buy when you are trying to

learn NF):

A Symphony in the Brain: The Evolution of the New Brain Wave

Biofeedback by

Jim Robbins

3. Learn about the available equipments used for Neurofeedback

training.

Research hardware and software as well.

Some links to start:

<http://www.pocket-neurobics.com/> http://www.pocket-neurobics.com

<http://www.eegspectrum.com> http://www.eegspectrum.com

<http://www.cyberevolution.com> http://www.cyberevolution.com

<http://www.brainmaster.com> http://www.brainmaster.com

<http://www.roshi.com> http://www.roshi.com

<http://www.futurehealth.org/waveride.htm>

http://www.futurehealth.org/waveride.htm

<http://www.thoughttechnology.com/bioinf.htm>

http://www.thoughttechnology.com/bioinf.htm

4. Sign up for web discussion/support groups. Some to start with:

<biofeedback/>

biofeedback/

</>

/

<Nfb-hometrainers/>

Nfb-hometrainers/

When you do that you will notice that you will get an astonishing

amount of

information... Don't be afraid to ASK.

Ask whatever questions you need answers for, until you get them

answered -

even if the answer is actually " it's not known " - which is not

sursprising.

Neurofeedback is still " experimental " .

You will also notice that there are a few " factions " within the

Neurofeedback field and the professionals in the field have their very

strong preferences. This may cause some confusion in the beginning,

but it

is intrinsically enriching.

Do not be afraid to ask, question, discuss. Focus on your particular

needs.

If you get an answer you find inappropriate, or personally

assaulting, take

action, complain to the group owner.

Remember, however, that disagreements, when kept at an acceptable

level, are

very productive to any learning process - use your common sense.

Always

attack the issue, not the person.

Take the time to research the lists archives for information you are

prioritizing.

If you find a post that interests you, write a note asking the author

of

that post for more information. Most professionals and parents in

these

groups are remarkably supportive. Get familiar with the lingo - such

as:

SMR/Beta

Brain waves and Brain states (there is an article by Othmer by

this

name you can find published in the California Biofeddback Society

Newsletter

- Spring 1999 that is very didatic and easy to read)

Locations and the 10/20 system - Frontal, Temporal, Central, Parietal

and

Occipital, as well as Nasion and Inion

Active, reference and ground leads,

One channel/two channels

Montage

Frequencies and their names

Filters

Sensors

Ipsilateral

Rewarding, inhibiting

Protocols

5. By the time you ask all the questions you felt you need, you

should be

familiar with names and specialties, and should be able to ask

questions to

some of them or indications to professionals in your area.

There are a many professionals who will train you - as a non-pro -

and/or

monitor your home-training.

How to choose the right professional or service?

A few things you may want to consider:

- focus on your specific needs.

- you will notice that as soon as you join discussion groups, you

will see a

HUGE amount of people signing as Dr. Joe Doe, PhD.

A note on that: One can obtain a PhD in ANY area or profession... I

have a

PhD, but I can guarantee you it would not help you in your NF

training...

So, what is behind a title ?

Unless of course the person is known and you develop a relationship,

or is

referred by someone you know, Dr. Joe Doe, PhD can be a Civil

Engineer...

)

Now, if you see someone sign as Dr. Joe Doe, PhD, BCIA - it know that

this

Dr. Joe Doe has a PhD and is certified by The Biofeedback

Certification of

America ( <http://www.bcia.org> http://www.bcia.org).

In order to get this certification, Dr. Joe Doe must have a

*bachelor's

degree* or *higher* from a regionally accredited academic institution

in the

following BCIA approved health care fields:

medicine

dentistry

psychology

nursing, (including two-year registered nurses with license, not LVNs

or

LPNs)

physical therapy

respiratory therapy

occupational therapy

social work

counseling

rehabilitation

chiropractic

recreational therapy

dental hygiene

physician's assistant (with certification or license)

exercise physiology

speech pathology

sports medicine

Licensed RNs are accepted with an A.A. degree

The following fields require at least a *masters degree*:

music therapy

counseling education (M.Ed. in counseling).

Also, credentialed special education teachers and counselors may also

become

certified to work in school environments. You will need to do more

research

on that if this is ehat you are looking for.

There are a few ways to accomplish this, but it depends on variables

as the

amount of involvement you are willing to have, the amount of money

you can

invest, where you are located, your particular situation and your

child's,

etc.

That said, there is no direct answer to this question.

Based on what I have learned, I have a few thoughts on the process

that

might help you:

- ASD is a complex training condition - and as such, requires a

professional

with experience training ASD kids.

- Look for a professional with experience on *different* Neurofeedback

systems and approaches. The best way of becoming totally uninformed is

becoming totally specialized.

- Look at the professional qualifications and certifications. While

titles

and certifications do not guarantee competence, it does show a desire

to

abide to rules and ethics that can only be beneficial to you.

- Ask the professional questions on how the process works, what

his/her

perspective on Home-Training is for ASD.

- Make sure that the professional you choose *listens* and *does not

discard* any concerns you might have, so you feel comfortable asking

any

questions that might arise, at any time. And make sure you get your

questions answered.

- Consider getting a qEEG done to guide the Neurofeedback training.

(you

will notice this is a point of contention later on). If nothing else,

it's

data you can actually see so when your clinician proposes a given

protocol,

you can understand what " too much Theta means " or why you are

inhibiting a

given frequency and/or rewarding another.

- Become familiar with the Hawthorne Effect and discuss it with your

clinician - I feel this is a point that should be discussed and

agreed upon

prior to the start of any NF training.

(This is the only link I have regarding this issue:

<http://www.cs.unc.edu/~stotts/204/nohawth.html>

http://www.cs.unc.edu/~stotts/204/nohawth.html)

- Once you decide which clinician you will be seeing, it is

recommended you

actually see the clinician at least once.

I know a large number of people who have not done that and have been

doing

very well with Home-Training. I believe it can be done without a

problem.

I like the idea that my clinician knows what my child acts like and

looks

like - and I like the idea I met him as well.

Impressions are very powerful and can reinforce or hinder the trust

you must

have in that clinician. But some people can get those impressions

over the

phone as well.

- At this point you will also be discussing with system you will be

using

for Home-Training.

Whatever system you decide to use, make sure you read ALL the

available

literature you can put your hands on and have a good understanding of

how it

works.(This is when choosing a professional who has experience with

different systems plays a big role, as well).

If possible, get some formal training on that system. Join any

availalble

list that discusses the use of that equipment. Your clinician should

also be

able to answer any questions you might have regarding the usage and

setup of

the chosen equipment also.

- Do not - and I repeat - do not try to use any " out-of-the-box "

protocol

from any NF system to train an ASD child. If your clinician suggests

you do

so, ask why, in detail, and only do it when and if you understand

why. If

the clinician cannot explain why or if you do not get an answer to

your

satisfaction, do *not* train your child and change clinicians.

Never do any blind-training.

- Make sure your clinician is open enough to consider different

training

approaches, second opinions or suggestions. No ONE clinician knows

everything about Neurofeedback or ASD. When a clinician is good

enough and

secure enough, this openess is a natural trait - he/she will consult

others

on a regular basis.

- Never, ever, train your child without knowing what you are doing

and why,

just because the clinician " said so " . If you do not want to spend the

time

learning or asking, take the child to a clinician's office.

- Immediately report any " weird " effect or change in your child

during NF

training to your clinician and make sure your clinician is aware of

your

report and gives his/her opinion about it ASAP.

On this one, I am going to add a personal opinion: follow your

instincts.

No one knows your child better than YOU.

Sometimes, it's even not possible to describe a given strange feeling

or odd

impression to your clinician. Don't be afraid to voice that and

simply say

" I really think something is wrong " .

As discussed before, and your clinician *listens*, you can both

explore this

" feeling " and make any necessary adjustments to the NF training to

acommodate it.

- Maintain a detailed diary of your child's training and maintain

daily

contact with your clinician. One idea is to e-mail the details of your

child's day to your clinician everyday - even if you train only once

a week.

That will make sure your clinician has your daily observations handy

(even

if he/she does not read it everyday) and you create the journal at

the same

time. Remember to add any changes in medication, any major family or

envirnonment changes or school reports/observations.

My clinician told me something I found VERY interesting during our

first

meeting and that I think it's worth mentioning: he said he does not

care as

much about what the brain waves look like in the recorded training

sessions

I send him - as long as the child is progressing and we are

addressing all

emerging issues.

That said, data alone won't do it. I and absolutely agree with him.

I suggest you have a custom symptom tracking form that you fill out

everyday

with Better, Worse, New or No Change as well. These notes may help

you link

a given protocol, lenght or even time of training to different

outcomes.

- In my experience, Location DOES matter.

You will also notice there is the " Location matters crowd " and

the " Location

does not matter crowd " within the professionals.

When training ASD kids it is KNOWN and REPORTED that C3 training may

cause

problems.

If you are uncertain, I would advise you to contact:

Coben, PhD, BCIA-EEG, QEEG-D - 1035 Park Blvd, Suite 1C ,

Massapequa

Park, New York 11762

or

Sig Othmer at <http://www.brianothmerfoundation.com/>

http://www.brianothmerfoundation.com/

It may very well be that in your case this turns out not to be true -

but I

think this is a very important piece of information I wish I had

about 6

weeks ago, so I am passing it along, so you can make an informed

decision as

to which crowd to join.

6. When training ASD children, CONSERVATIVE is a good word. You are

much

better safe than sorry - and so is your child.

7. You will most definitely get to know the most wonderful and the

nastiest

people on the web. Do *not* attempt any change in protocol or training

unless you know exactly what you are doing or/and you consult your

clinician

first. Most people will never suggest you do anything to hurt your

child,

but again, this is not the same as training a migraine episode, and

every

(as much as I don't like to be repetitive) child is unique.

8. Try to learn a little about Brain Physiology. You don't need to

get a

degree on it - just remember that information is power and you are

empowering yourself to help your child. (

<http://brain.web-us.com/brain/aboutthebrain.htm>

http://brain.web-us.com/brain/aboutthebrain.htm is a good simple link

to

start).

9. NF is one approach. I don't think it's a good idea to abandon other

ongoing treatments or supplements in lieu of NF. Always consult your

physician and your clinician before making any changes.

10. Try not to introduce other " treatments " at the same time as you

start

Neurofeedback - such as Epsom Salts in the bath, or B6+Magnesium or

GFCF

diet. Not because they are not good or I have anything against any of

them -

but because if you start more than one approach at the same time, it

will be

virtually impossible to tell what is working, what is not - or if any

is not

making any difference.

11. Be aware that NF may not work as you expected. NF may not work at

all.

It is a real possibility, even though the percentage seems low.

12. My dad always told me - " Never believe in everything you read " .

So,

including this message, you have built-in filters, you might as well

use

them ! )

Most important of all, is to listen and love your wonderful child.

Listen with your ears and with your heart.

We wanted to be parents and have become more - we are very *special*

parents.

I am sure you have forgotten *something* while writing this - but

consider

it a live document.

If you are a Home-Trainer and would like to have something added to

it, let

me know.

If you are a professional and would like to see something else also

let me

know.

I hope this somehow helps parents of ASD children start the

Neurofeedback

journey.

Some of it applies to NF training in general - but I am biased about

ASD for

obvious reasons - but mostly because I would have loved to find such

instructions when I started.

I have no issues with Home Training and/or self training for other

reasons,

but ASD is not something you can do on your own without assistance...

but

that being the case, INSIST on home training, otherwise chances are

you will

not be able to afford the treatment for as long as your child needs

it.

I wish you and your child much success with Neurofeedback.

Ariane

[Guest guest]

Hi Rene

Thanks for posting that NF FAQ piece. Can you tell me how

I can subscribe to that group & if it is a mailing list like this

list?

I'm embarking on a couple of sessions first & the practitioner

here in my country is suggesting my ASD son will need about

60-70 sessions to be able to 'graduate' from it. That's a lot.

When it was first publicized in our local paper, about 20

sessions were suggested, a far cry from the 60-70.

Terms like T3, T4 & C... (points on the head) sounds alien to me

Thanks

G

[Guest guest]

G, here is the link to the autism-nf group.

autism-nf/

It is a group, just like Autism Mercury.

Take care

Rene

>

> Hi Rene

>

>

> Thanks for posting that NF FAQ piece. Can you tell me how

> I can subscribe to that group & if it is a mailing list like this

> list?

>

> I'm embarking on a couple of sessions first & the practitioner

> here in my country is suggesting my ASD son will need about

> 60-70 sessions to be able to 'graduate' from it. That's a lot.

> When it was first publicized in our local paper, about 20

> sessions were suggested, a far cry from the 60-70.

>

> Terms like T3, T4 & C... (points on the head) sounds alien to me

>

>

> Thanks

> G

>

>

>