ADD / ADHD

What is ADD / ADHD?

ADD / ADHD as diagnosed by a medical professional is where someone shows a persistent pattern of inattention and/or hyperactivity, or impulsivity, which interferes with their functioning or development.  From a neurofeedback perspective, we focus training on external distractibility and the lack of inhibition giving rise to impulsive or hyperactive behaviour.  Having calmed the brain in general, and trained brain areas involved in attention to the environment, we provide the person with the ability to filter stimuli by relevance, reinstate drive and focus, and establish a more grounded state from which to develop a sense of self.  This enables them to make plans, and act on these; organise their time and the space they inhabit; and ultimately achieve their potential.  Where a client presents with such a diagnosis, we rely on referral from and close collaboration with the respective medical professional, and you should seek medical advice (which Neurofeedback London-Brighton does not provide) if you believe you have relevant symptoms.

Neurofeedback London-Brighton does not provide diagnosis nor medical interventions.  

ADD/ADHD often presents as a comorbidity, that is, an issue in addition to other behavioural problems such as mood regulation, sleep hygiene, anger management, social invasiveness, personal space issues, working memory and sometimes personality or developmental disorders.  With a brain map, we can obtain a holistic view of the person’s mental traits and vulnerabilities.  While not a diagnostic tool, we can observe vulnerabilities and form a training plan as well as structuring a therapeutic approach.  

Neurofeedback London-Brighton does not provide diagnosis nor medical interventions nor medical advice and is not medically trained.  By engaging in neurotherapy, you confirm that you have sought medical advice and are keeping your relevant medical professional informed of therapy progress.  

Daniel Webster has extensive experience working with children and adults with ADD/ADHD.  Contact Daniel on +44 (0)7966 699430 or daniel@neurofeedback.io to arrange sessions.

School is tougher – the likelihood of getting suspended or expelled are 3x higher; 32% drop out before completing school; only 22% enter College / Uni; and only 5% of those graduate from College / Uni

Sustaining interest in interactions with others becomes equally problematic; they often find it difficult to listen to another person and only take in a fraction of what is being communicated to them.  This sets off a negative feedback loop, as it makes it hard for them to relate to others, as much as others find it frustrating to deal with them, triggering secondary effects such as stress and social anxiety.  Frustration leads to anger and impulsive behaviour, and conduct disorders frequently follow. 

 

Sexual activity begins younger; people with ADD will have three times as many lifetime sexual partners; risk of teen pregnancy is 38%, over 9x higher

Sadly, most people around them can’t recognise that the problem setting off this cascade is not a matter of ill will, but rather dysrhythmia of particular brain areas – in a sense, a physical deficiency.  They, and society as a whole, are even less equipped to deal with this appositely.  People with ADD/ADHD are left to feel inadequate about themselves and without support.  Many even remain undiagnosed throughout their entire life.  Denied adequate support and therapy, their affliction can cause immense strain on relationships, their personal development, and career potential. 

Driving is a greater issue – 4x more licence suspensions, 3x more crashes with injuries; 3x more citations for speeding; double the average accident damage; 7x more likely to have 2 or more crashes, and 3x more likely to have 3 or more crashes.  ADD sufferers are more likely to drive before licensing.

For the purpose of applying neurofeedback training to adults and children with ADD / ADHD or attention deficit hyperactivity disorder, we are primarily interested in the symptoms that pose the issues.  These range from learning disabilities to oppositional defiant disorder, and secondary effects may include issues with self-esteem and confidence as a result of ‘not fitting in’.  

Neurofeedback training is non-invasive and drug- or medication free.  

 

Neurofeedback is a form of complementary therapy and should not be seen as a replacement for conventional medicine.  qEEG brain map-based neurofeedback training takes a more holistic approach to brain functioning, rather than just focusing on medical symptoms.  It is not intended as a form of diagnosis nor medical intervention nor medical advice per the disclaimer.

Note:  Statistics quoted above are from MedScape article by Lenard A. Adler, MD; Julie Cohen, BA

Neurofeedback is a Safe, Effective, Non-Invasive Treatment for ADD / ADHD

There are numerous academic studies confirming the efficacy of EEG biofeedback (another name for neurofeedback) with sustained performance gains. 

The American Academy of Pediatrics bases its conclusion that there are “no significant contraindications” to its use on these studies. 

ILF / Othmer Method neurofeedback training was shown to reduce ADHD symptoms, specifically distractibility and impulsiveness, in a study involving 251 children over a course of 30 neurofeedback sessions. 

Training specific brain areas successfully activated error monitoring networks in ADHD patients, associated with symptom improvements.  Dynamic functional connectivity was found to be maintained in a follow-up 11 months later.

Neurofeedback “appears to have more durable treatment effects, for at least 6 months following treatment.” 

Neurofeedback was shown to be an effective method to enhance cognitive deficits, reduce ADHD symptoms and behaviour problems in children.  The effect was maintained in a follow-up six months later. 

Another study attested improved response control and attention in ADHD post Neurofeedback.  

In line with AAPB and ISNR guidelines for rating clinical efficacy, neurofeedback can be considered “Efficacious and Specific”, the highest level (5), with a large effect size for inattention and impulsivity in this study.

A large-scale study showed that neurofeedback is effective in remediating attentional dysfunction.  Significant clinical improvement in one or more of attentiveness, impulse control, and response variability was observed in 85% of participants after 20-40 training sessions.

Neurofeedback training has the relevant goals of:

  • restoring emotional regulation – dampening erratic mood swings, oppositional, defiant and aggressive behaviour;
  • improving focus and concentration including working memory, ability to plan and organise, attention to detail and dominant hand awareness
  • physical calming – reducing hyperactivity and hyper-vigilance as well as headaches from stimulant medication; improving awareness of body and environment
  • addressing disinhibition by calming the mind for improved impulse control
  • establishing a healthy sense of self-worth as self-esteem and confidence are often compromised by repeated criticism of their behaviour and achievements.

It is described as a fun to use process for all ages.

 

 Good self-regulation by the brain is key.  The neurofeedback approach focuses on symptoms rather than a simple diagnosis of “ADHD”; as Dr. Amen explains in the video below, there are multiple types of this disorder, and a classical approach of prescription stimulant medication could prove toxic for many of these, aside from having substantial adverse side effects in many cases.

 

Modern Thinking on ADD / ADHD

There are various schools of thought as to how to deal with ADD / ADHD.  The first, and most important step, is to acknowledge that it is a real condition.  When seeking medical advice, which this website does not provide, you can ask about forms of treatments, and whether supplementary actions might be beneficial, such as behavioral training as suggested by the AAP or dietary supplements.  

The Contrarians – Denial is merely a Rebellion against Drugs

Note that contrarian views exist.  Dr. Richard Saul, in his book  “ADHD Does Not Exist:  The Truth About Attention Deficit and Hyperactivity Disorder” takes aim at the pharma industry, medical practitioners, the media and patients themselves and believes it is actually a conglomeration of conditions.  Nevertheless, he seems to acknowledge the ‘it’ – being distractibility and impulsivity.  Focus and disinhibition and the symptoms we are interested in from a neurofeedback perspective.

Harvard professor Jerome Kagan, considered the 22nd most eminent psychologist of the 20th century (ahead of Carl Jung, who ranks 23rd), similarly takes aim at the establishment for overprescribing pills, and suggests a bevarioral therapeutic approach instead:

“Who’s being diagnosed with ADHD? Children who aren’t doing well in school. It never happens to children who are doing well in school. So what about tutoring instead of pills?”

(SpiegelOnline, 2 August 2012)

Again, he acknowledges an issue, and suggests a targeted approach, while reprimanding an over-reliance on drugs. 

 

The Issue is Self Regulation 

Dr. Russell Barkley points out that Will Power is a Limited Resource Pool, that is, when conceptualised as a fuel tank, is particularly prone to depletion in sufferers of ADD / ADHD.  This finite source of conscious discipline has to provide the following functions, and the more is needed, the quicker it empties:

  • Inhibition and Self-Restraint
  • Self-Management to Time
  • Self-Organisation and Problem Solving
  • Emotional Self-Regulation
  • Self-Motivation

 

Neurofeedback helps Restore the Brains Ability to Self Regulate

From a neurofeedback perspective, we view ADD as a brain dysregulation, in particular, an instability.  It is less able to perform the above tasks automatically, without conscious effort.  Instead, the more strain it is put under, the quicker its fuel tank of willpower depletes, and as this continues, and it becomes less and less able to handle organisational tasks, emotional regulation and maintain focus.  In that sense, the more self-discipline is demanded from someone with ADD, the more difficult a task becomes.  This means that a traditional approach to invoke concentration through threats and remonstration will only worsen the situation. 

 

Neurofeedback is a form of complementary therapy and should not be seen as a replacement for conventional medicine.  qEEG brain map-based neurofeedback training takes a more holistic approach to brain functioning, rather than just focusing on medical symptoms.  It is not intended as a form of diagnosis nor medical intervention nor medical advice per the disclaimer.

Personalised Brain Training and ADD / ADHD

Brain Maps and Personalised Brain Training

Personalised Brain Training is a neurofeedback training method devised by founders of the field, Barry Sterman and David Kaiser.  

 

Every Brain is individual and different, therefore Personalised Brain Training neurofeedback

We take a holistic approach to healthy brain self-regulation, rather than categorisation or diagnosis.  In our view, and experience, symptoms resolve when our system is balanced.

Neurofeedback Training calms the mind and restores functionality

A brain map is an analysis of brain wave behaviour as measured by a qEEG recording.  We record 20 minutes of the brain activities with a 19-sensor qEEG recorder.  There is no stimulation, and contact between the sensors and the head is via an easily removable gel applied to specific points.  From this recording, we can generate a brain map using Kaiser Neuromap software.  

qEEG recording of brain waves is analysed to generate a brain map in form of a Kaiser Neuromap

The functional connectivity between various brain areas allows us to see vulnerabilities to character traits or behaviour patterns.  

Kaiser Neuromap brain maps show character traits for neurofeedback

Neurofeedback training is a process where we give the brain feedback about its own activity at a particular cortical site in real time, via visual, auditory or tactile means.  There is no direct stimulus to the brain and the sensors attached are for measurement of cortical EEG, or tiny electrical currents detectable on the surface of our head.  This signal is then amplified and analysed by software in real-time, and this information is used to provide feedback to our brain.  

Neurofeedback process illustrated by electrode measurement analysed and transformed into feedback via a movie in visual and auditory form for the preconscious mind to process and adapt its behaviour to in a learning process.

 We use a movie of choice as the feedback mechanism – our conscious mind engages with the film, and feedback is delivered by small changes in volume or picture size.  Our pre-conscious mind adapts its behaviour to preserve the more comfortable volume and picture size, and learning occurs.

Neurofeedback helps restore functional connectivity in key neural networks

Neurofeedback training is safe, effective and non-invasive. 

Neurofeedback training is safe and non-invasive shown in a picture using Othmer Method

Neurofeedback is evidence-based. 

Neurofeedback is evidence based therapy with a wealth of over 3,500 peer-reviewed research reports per PubMed neurofeedback

 

Guided by a Kaiser Neuromap, our neurofeedback training targets specific brain areas, neural hubs and networksThis improves integration of the  brain area we are training, as well as its network and sub-cortical connections.

Developed by a founder of the field of neurofeedback, and with a wealth of over 3,000 brain maps and thirty years’ of experience, Personalised Brain Training uses advanced neurofeedback protocols.

qEEG-brainmap takes under an hour to obtain and is a non-invasive process.  A nineteen-sensor cap is comfortably fitted and we record about twenty minutes of brain activity.  Using specialised software, we obtain a visual analysis which we will communicate verbally.  This also forms the basis of our training plan.  Note that we do not provide diagnosis.

qEEG brain map for personalised brain training in neurofeedback

This brain map approach is unique in that it analyses the connectivity of a functional brain area, rather than simply geographic areas of the brain.  

Connectivity is a measure of regional integration of specific brain areas with other areas and key networks.  This is a relative measure – to be meaningful, it has to be referenced to a baseline.  Rather than use an average as a reference, we compare results to a set of hand-picked individuals who are both high-performing professionals and well-balanced individuals.  Our ability to engage with others, form friends and alliances, and make consensual decisions is deemed as important for success as professional specialisation and technical performance.

functional brain area, as first delineated by Korbinian Brodmann in 1909, was first defined by variations in the number of layers in its grey matter.  This difference in physical property still holds as a valid way to separate brain regions, and each has its own function while being connected to other areas of the cortex via white matter, as well as to the brainstem, in particular, the thalamus.  With a brain map, we gain insights into both cortical integration (how well the area connects with its surrounding areas), as well as its thalamo-cortical integration. 

Neurofeedback training relies on real-time EEG measurement, analysis and translation into feedback

Neurofeedback Training Sessions

Personalised Brain Training aims to optimise the cortical connectivity, as well as promoting improved thalamo-cortical connection.  Neuroplasticity, the ability of neural networks in the brain to make new connections, is an essential and continuous process that underpins our ability to learn.  With brain training, we can promote this process.  

Protocols are generally around 30-45 minutes per brain area that we train; as such, training sessions are ideally around 90-120 minutes.  This corresponds to the average length of a movie.  This is also the length of our ultradian rhythms – attention cycles that govern our day, letting us perform at more than 100% at peak, and less than this at trough – think of the lull we experience around lunchtime.  By training the brain throughout a complete cycle, we are more likely to provide the brain with a challenge at different points in its attention cycle for a more comprehensive training. 

The primary feedback mechanism in Personalised Brain Training is auditory, that is, a subtle change in volume.  The brain recognises this, preconsciously, while our conscious mind is focused on the movie, and corrects its behaviour to preserve the continuity of the watching (or listening) experience.  A secondary, visual feedback mechanism can be activated, whereby the picture size changes too, though this is optional in cases of high visual sensitivity (e.g. migraines).   

We can track progress by remapping the brain at intervals, usually after every 20 hours of training.  Ten sessions will give a good indication of responsiveness, which besides subjective feedback we can ascertain with a further remap.  With neurofeedback training, we are showing the brain a more efficient state during a session.  Upon repetition, the brain learns to adopt this new state.  The person has to then implement this new learning in their life.  Internal changes have to be externalised.  Training success depends on this ability thus results can vary.  

Neurofeedback training begins with two to three sessions per week and the frequency of training can then be adjusted to need and symptom improvements.  Intensive courses involving two or more sessions per day can also be accommodated.

Contact Daniel on +44 (0)7966 699430 or daniel@neurofeedback.io to arrange sessions.

The Process

Brain Map

We record qEEG brain activity for about 15-20 minutes.  This process takes about 30-45 minutes overall and we discuss results a few days later via call or in person.  This provides the basis for the Personalised Brain Training Plan. 

Neurofeedback Sessions

 Comfortably watching a movie of choice, we train specific brain areas per our Personalised Brain Training Plan.  Sessions are two hours (shorter if necessary), and ideally we aim to do two or three per week.  Alternatively, intensive courses can accommodate two sessions per day.  Generally, we would look to do 40 hours or 20 sessions.

Contact Daniel on +44 (0)7966 699430 or daniel@neurofeedback.io to arrange sessions.

Complementary Measures to Help the Dysregulated Brain

Needless to say that stress and any other physical debilitation will negatively affect the Will Power fuel tank.  This includes the use of alcohol and recreational drugs, and of course illness.  It therefore seems logical that a ‘clean’, healthy lifestyle helps preserve powers indeed increase the resource pool.  Diet plays a role as much as exercise.  De-stressing activities such as yoga and meditation (though often seen as boring by ADD sufferers!) can help.  

To preserve willpower and indeed apply the available pool as efficiently as possible, it is useful to establish routines.  A key issue is that the ADD brain is structurally reward deficient due to its lower dopamine production.  It’s often observed that homework or housework tasks seem impossible to attract the attention of an ADD sufferer, while they have no problem playing computer games for hours on end.  Tasks they can hyperfocus on are typically ones that provide immediate reward, which indeed computer games do.  The trick in capturing focus therefore is to closely link reward with actions, in a sense, increasing accountability in the moment.  

Breaking projects down into smaller tasks, with clear hurdles to clear and consequences if achieved (or not), achieve this mimicking of a computer game ‘flow’.  This is where external help is beneficial – dividing up the task, relating the timing, and administering the reward.