HIGHLAND VILLAGE (CBSDFW.COM) – Nick Van Den Handel, 13, remembers how he felt taking medication for ADHD, and how much better he feels now.

“It feels awesome because I’m not actually controlled by anything else,” Nick said.

“When I had those medications on me I basically did not know who I was some of the time,” his older brother Casey Van Den Handel agreed.

Like millions of other school aged children diagnosed with Attention Deficit Hyperactivity Disorder or ADHD, Nick and Casey followed the most common protocol available: drugs. At the time mom, Kelly Van Den Handel, says she didn’t know there were any options. Side effects of the drugs meant sleepless nights for the boys and lack of appetites. Though their behavior improved, Kelly wanted a change.

Last May, it came in the form of an odd looking cap filled with holes into which therapist Rusty Lozano injects gel.

Q.E.E.G. stands for quantitative electroencephalography. It’s a technology that’s been around since the 70?s that is now commonly called brain mapping.

As Nick sits back and relaxes, each gel filled hole transmits information to a computer screen, and shows brain waves in real time. The pattern is what Lozano says holds the key for treatment.

“The brain mapping is measuring all of the activity in the brain from 19 different sites and we can determine what areas are operating too fast, too slow, and we can target the areas that need work,” explains Lozano who says the fast areas which show up as red on the maps, can be linked to attention and behavioral issues.
Kelly had both boys mapped. A doctor interpreted the results and provided Lozano a specific treatment plan of Neurotherapy.

What looks like a computer game is actually a tool to retrain nick’s brain. After five months of Neurotherapy and the boys no longer on any medication, Kelly VanDenHandel says the differences are clear.

“I’ve had no phone calls from teachers saying your kids are too disruptive in class, they’re driving me crazy in class. I haven’t gotten anything like that,” Kelly said but for her solid proof came in the form of a re-map which showed less red on his scan.

But not everyone agrees that brain scans can show proof of progress. Clinical psychologist Dr. Ray Levy says although Neurotherapy is a tool that works for some children with ADHD, he cautions against using brain map images as proof of success. We showed Dr. Levy nick’s before and after images.

“Looking at these pictures alone does not tell me that the ADHD has improved,” Dr. Levy said. “It tells me that there have been shifts in the brain.”

Kelly VanDenHandel says the remap confirmed for her that the Neurotherapy is working, but her real proof is her children’s behavior.

“It was one of the best decisions we’ve ever made,” she concluded.

Neurofeedback Gains Popularity and Lab Attention
by Katherine Ellison
Published: October 4, 2010

You sit in a chair, facing a computer screen, while a clinician sticks electrodes to your scalp with a viscous goop that takes days to wash out of your hair. Wires from the sensors connect to a computer programmed to respond to your brain’s activity.

Try to relax and focus. If your brain behaves as desired, you’ll be encouraged with soothing sounds and visual treats, like images of exploding stars or a flowering field. If not, you’ll get silence, a darkening screen and wilting flora.

This is neurofeedback, a kind of biofeedback for the brain, which practitioners say can address a host of neurological ills — among them attention deficit hyperactivity disorder, autism, depression and anxiety — by allowing patients to alter their own brain waves through practice and repetition.

The procedure is controversial, expensive and time-consuming. An average course of treatment, with at least 30 sessions, can cost $3,000 or more, and few health insurers will pay for it. Still, it appears to be growing in popularity.

Cynthia Kerson, executive director of the International Society for Neurofeedback and Research, an advocacy group for practitioners, estimates that 7,500 mental health professionals in the United States now offer neurofeedback and that more than 100,000 Americans have tried it over the past decade.

The treatment is also gaining attention from mainstream researchers, including some former skeptics. The National Institute of Mental Health recently sponsored its first study of neurofeedback for A.D.H.D.: a randomized, controlled trial of 36 subjects.

The results are to be announced Oct. 26 at the annual meeting of the American Academy of Child and Adolescent Psychiatry. In an interview in the summer, the study’s director, Dr. L. Eugene Arnold, an emeritus professor of psychiatry at Ohio State, noted that there had been “quite a bit of improvement” in many of the children’s behavior, as reported by parents and teachers.

Dr. Arnold said that if the results bore out that neurofeedback was making the difference, he would seek financing for a broader study, with as many as 100 subjects.

John Kounios, a professor of psychology at Drexel University, published a small study in 2007 suggesting that the treatment speeded cognitive processing in elderly people. “There’s no question that neurofeedback works, that people can change brain activity,” he said. “The big questions we still haven’t answered are precisely how it works and how it can be harnessed to treat disorders.”

Russell A. Barkley, a professor of psychiatry at the Medical University of South Carolina and a leading authority on attention problems, has long dismissed claims that neurofeedback can help. But Dr. Barkley says he was persuaded to take another look after Dutch scientists published an analysis of recent international studies finding significant reductions in impulsiveness and inattention.

Still, Dr. Barkley cautioned that he had yet to see credible evidence confirming claims that such benefits can be long lasting, much less permanent.

And another mainstream expert is much more disapproving. William E. Pelham Jr., director of the Center for Children and Families at Florida International University, called neurofeedback “crackpot charlatanism.” He warned that exaggerated claims for it might lead parents to favor it over proven options like behavioral therapy and medication.

Neurofeedback was developed in the 1960s and ’70s, with American researchers leading the way. In 1968, M. Barry Sterman, a neuroscientist at the University of California, Los Angeles, reported that the training helped cats resist epileptic seizures. Dr. Sterman and others later claimed to have achieved similar benefits with humans.

The findings prompted a boomlet of interest in which clinicians of varying degrees of respectability jumped into the field, making many unsupported claims about seeming miracle cures and tainting the treatment’s reputation among academic experts. Meanwhile, researchers in Germany and the Netherlands continued to explore neurofeedback’s potential benefits.

A major attraction of the technique is the hope that it can help patients avoid drugs, which often have side effects. Instead, patients practice routines that seem more like exercising a muscle.

Brain cells communicate with one another, in part, through a constant storm of electrical impulses. Their patterns show up on an electroencephalogram, or EEG, as brain waves with different frequencies.

Neurofeedback practitioners say people have problems when their brain wave frequencies aren’t suited for the task at hand, or when parts of the brain aren’t communicating adequately with other parts. These issues, they say, can be represented on a “brain map,” the initial EEG readings that serve as a guide for treatment. Subsequently, a clinician will help a patient learn to slow down or speed up those brain waves, through a process known as operant conditioning. The brain begins by generating fairly random patterns, while the computer software responds with encouragement whenever the activity meets the target.

Dr. Norman Doidge, a psychiatrist at the Center for Psychoanalytic Training and Research at Columbia and the author of “The Brain That Changes Itself” (Viking, 2007), said he considered neurofeedback “a powerful stabilizer of the brain.” Practitioners make even more enthusiastic claims. Robert Coben, a neuropsychologist in Massapequa Park, N.Y., said he had treated more than 1,000 autistic children over the past seven years and had conducted a clinical study, finding striking reductions in symptoms, as reported by parents.

Maureen and Terrence Magagnos of Lynbrook, N.Y., took their 7-year-old son, Peter, to Dr. Coben after he was given a diagnosis of pervasive developmental disorder in first grade. “He had classic symptoms of autism,” said Mr. Magagnos. “His speech was terrible, he made very little eye contact and he screamed for attention — literally screamed.”

Their exceptionally generous insurance covered neurofeedback, so they decided to give it a try, with sessions twice a week for the next five years.

At the start of the treatment, Dr. Coben said, he discovered that Peter had been suffering tiny, asymptomatic seizures. He says neurofeedback helped stabilize the child’s brain activity, eliminating the seizures. And within three months, said Mr. Magagnos, a retired police officer, Peter’s teachers were calling to report remarkable improvements.

“Today I’d say he has ‘autism light,’ ” he added. “He still has some symptoms, but he is much more manageable.”

Whether such results can be achieved with other children is a matter of debate. Still, as practitioners lobby for broader acceptance, including insurance recognition, a sure sign of neurofeedback’s increasing popularity is the number of companies selling supposedly mind-altering systems to use at home.

With names like SmartBrain Technologies and the Learning Curve Inc., they offer equipment purported, respectively, to “pump the neurons” and “make lasting changes in attention, memory, mood, control, pain, sleep and more.”

The Food and Drug Administration regulates all biofeedback equipment as medical devices. The only approved use, however, is for “relaxation.”

Peter Freer, a former grade-school teacher who is chief executive of a North Carolina firm called Unique Logic and Technology, says that since he began his business in 1994, he has sold several thousand of his “Play Attention” systems, advertised to improve a child’s focus, behavior, academic performance and social behavior.

The equipment, which costs $1,800, is advertised as “a sophisticated advancement of neurofeedback.” Mr. Freer says his clients include more than 600 school districts. (He adds that his system, as distinct from “clinical” neurofeedback, aims not to change brain waves but rather to put the user in an “attentive state” that makes it easier to learn skills.) Neurofeedback in general is a largely unregulated, with practitioners often devising their own protocols about where on the scalp to place electrodes. Results vary widely, and researchers caution that it is extremely important to choose one’s practitioner with care.

When it comes to to the actual devices, Dr. Kerson, at the International Society for Neurofeedback and Research, cautioned that they should never be used without experienced supervision.

“Oftentimes what people do is find a way to get one of these machines on eBay and use it at home,” she said, adding that unskilled use could interfere with medications or prompt an anxiety attack or a seizure.

“Neurofeedback is a powerful therapy,” she said, “and should be treated that way.”

Read the full article here.

Read the entire article here.

Here’s the article that talks about Rusty Lozano and his practice:

This Is Your Child’s Brain … Balanced
Brain balancing treatments do what meds do for the ADHD brain—without the medication and with what seem to be long-term results.

Stephanie Rigg knows ADHD. She’s married to it.

Her husband Bryan is a successful, well-adjusted adult. But, in order to manage that, he works out two hours each day and doesn’t eat anything with ingredients he can’t pronounce. So it was no surprise when their second child, Justin, began showing signs of ADHD at age 4. “Once he was independently mobile, he just kept speeding up,” she says. “It’s like somebody pushed the accelerator.”

Because Bryan had a bad reaction to Ritalin, the Riggs wanted to try treatments other than medication for their son, so, on recommendation, when Justin was just 5½, they started with a Quantitative Electroencephalography (qEEG)—a guided map of the brain.

Rigg says the neurologist took one look at a map of Justin’s brain and recognized the problem areas. “He … said here’s attention and impulse control, this is a visual processing challenge, this is processing speech, this is audio processing, over here by his ear, this is short-term memory,” Rigg says. The neurologist assured them that there was nothing really that bad by itself, but there was enough going on that Justin was “a very frustrated kid.” Because of the interplay of all these “glitches,” the neurologist explained, it was difficult for Justin to get anything done at school. The family started a treatment plan to balance Justin’s brain, a plan that included the Interactive Metronome, neurotherapy and close attention to nutrition.

Like the Riggs, many families with young children who are just showing signs of attention/hyperactivity issues, or older children who have been struggling for years, have managed to avoid medicating their child entirely with brain balancing treatments. Others have significantly cut down on the amount of medication given. How? Because balancing the brain does exactly what these meds do. Unlike taking a pill, however, brain-balancing treatments seem to really change the brain, perhaps forever.

The Plastic Brain

The idea that the brain can be changed is not new. But it’s not one that most people understand as it relates to learning differences. Stroke victims and soldiers with head injuries, for example, go through treatments to get their brains back to a more normal realm. But the same can be done with children who have learning differences like ADD/ADHD, dyslexia and autism.

“People don’t understand you can apply the exact same principles to a child who has ADHD,” says Dr. David Clark, an East Dallas functional neurologist.

The concept of brain balancing, a general term for treatments that either increase or decrease the activity in specific sectors of the brain, has popped up in many clinics locally and nationally. But it still isn’t considered mainstream. With technology that has developed over the past decade, trained medical professionals are able to very specifically target a weakened—or overdeveloped—sector of a child’s brain.

But if you’ve never heard of a functional neurologist, brain balancing, or brain mapping, you aren’t alone. To complicate matters further, while data exists, not much is published, which makes people question its validity or, more commonly, they are simply unaware that it’s an option. Proof, however, is in the data that is available. Each day, information is gathered in offices like Clark’s that shows these treatments are effective in addressing the many different ways a child’s brain can be deficient. ADHD behavior may look the same in the classroom or in your car during a long road trip, but the ADHD brain does not look the same from child to child. And while a child with attention issues may always have to do maintenance exercises and be careful of what he exposes his brain to (video games, cartoons, etc., can cause that area of the brain to revert), Clark’s case studies show that the benefits don’t go away with the end of therapy: “The long-term is yet to be seen,” he says. “But there’s good evidence for the short and medium term.”

So how exactly does brain balancing work? Medical professionals often begin by taking a look at the brain. The actual techniques and technologies vary, but they allow medical professionals to visualize how the individual brain is wired.

According to Dr. Todd Clements, a board certified psychiatrist and Medical Director of The Clements Clinic in Plano, brain imaging is a general term that includes various types of brain-scanning techniques that look specifically at the anatomy (CT scans, MRIs) or function of the brain (SPECT, PET, fMRIs). Brain mapping (qEEGs), on the other hand, is a type of functional brain-scanning technique that looks at electrical activity in the brain. SPECT scans measure yet another type of brain function, and Clements is one of just a few doctors using this type of science for the purpose of psychiatry. SPECT scans (a type of nuclear science) examine blood flow and produce 3-D images, which show the areas of the brain that are more or less active.

Once the brain is “mapped,” a specialist accomplishes “brain balancing” through various therapies, including Interactive Metronome, biofeedback (also called neurofeedback and neurotherapy when applied to the brain), home coaches, equine therapy, occupational therapy and even dietary changes. Therapies can be as individual as the patient and vary in length and methods. They can be applied to anyone, children or adults, however, not all types of “mapping” may be used for children. For example, The Clements Clinic does not provide SPECT scans for patients younger than 10. Younger children may have trouble remaining still for long enough to obtain an accurate picture of the brain and Clements prefers his patients to be 12 and older.

“Basically, what brain balance is doing is looking at actual differences in the right and left hemispheres of the brain to better understand any kind of weaknesses a child might have with information crossing from one side of the brain to the other,” explains Josh Cormie, executive director of the Brain Balance Achievement Center in Plano.

For example, an ADD/ADHD brain often shows low activity in the area of the brain called the prefrontal cortex (the front one-third or so of the brain), which has a lot to do with sustaining focus, impulse control, decision-making and distractibility. Medication will increase the activity in that area, making it appear to be a more “normal” brain. But like a muscle, the brain can also be taught to increase its strength in these areas.

After his brain map was complete, Justin began seeing Rusty Lozano, who has his own office, the Center for Biofeedback and Behavior Therapy, and also works at the Shelton School and The Clements Clinic. He’s a licensed professional counselor and is board certified to do biofeedback. One of Lozano’s primary tools is the Interactive Metronome, which tracks kids as they try to clap or tap their foot along with a regular sound. This helps with visual and auditory processing speed and ability—something children need in something as simple as a conversation.

In a classroom, a child with attention issues is constantly processing what is being said, raising his hand, taking notes, answering questions. That requires the brain to run at a certain speed, and the brains of children with ADD/ADHD can run a lot more slowly than they should. When the brain is trying to concentrate, the ADD brain starts to shut down. So the child seeks distraction—stimulus—to keep their brain engaged. It’s not a cycle that’s conducive to learning.

During neurotherapy, Lozano places tiny sensors on the skulls of his patients, targeting the areas of the brain they intend to modify. The sensors are hooked up to a computer program, which reads the electrical activity while the patient is watching a screen, maybe showing racecars or spaceships.

“They [patients] can learn to speed up the signal while interacting with the computer,” Lozano explains. “The cartoon image or animation will speed up or slow down [in response]. What it does is challenge the brain in the areas where work needs to be done. When a child learns to improve focus skills, the neurotherapy machine registers how well that area is functioning or improving.”

But exercising the brain can be accomplished through simpler means, including recreational therapy. For example, with equine therapy, a child has to pay attention to nonverbal cues to get a horse to do what he wants it to do. It forces him to exercise focus.

The Balanced Brain

Nine-year-old Jonathan was diagnosed with ADHD when he was in kindergarten. His mom, Yvonne Tijerina, notes that he had always been different. He had delayed speech and difficulty with socialization. He started medication but couldn’t catch up with the two to three grade levels he’d fallen behind, and the medication made him moody. Tijerina took him to the Brain Balance Achievement Center of Plano, where the right side of his brain got quite a workout. He’s been off his medication for a few months now, she reports.

“We have seen a huge improvement in him,” says Tijerina. “He’s more focused now. He can control his energy more. He’s a happy little boy.”

The Brain Balance Achievement Center of Plano is one of 29 Brain Balance centers nationwide, developed by Dr. Robert J. Melillo. The kids who come through here are between the ages of 3 and 18, with ADD/ADHD the most common reason they come for treatment. While the Center does not get involved in their patients’ medication, 86 percent are taken off medications after treatment.
Dr. Roger Clifford, a board certified chiropractic neurologist at Brain Balance Achievement Center, says, “We get results because we alter the environmental input to the brain.”

But what if the results are too great? Can you balance away creativity?

Clifford assures, “We actually see, in almost all of our kids, increased creativity. As the functional disconnection resolves … the kids are able to think much clearer and are able to get better grades, score much higher on standardized testing, improve their behavioral issues.”

While Clements does work with medication (if the patient requires it), he points out, “One of the biggest complaints we get about meds … is that it flattens out their personality.”

Clifford adds, “We live in a society that is very pharmaceutically based. This does take a little bit more work than that. But you’re actually talking about real, true healing and correction of underlying causes—not a lifelong situation where you have to take this medicine. When parents realize that, then the effort just becomes second nature to the parents and the children.”

For Justin, now 7 and in the second grade at Shelton, it’s working. He recently finished his third session of neurotherapy.

“He’s actually reading now. His confidence is building,” Rigg says. “So many factors have changed in his environment it’s really hard to say exactly which piece the neurotherapy is responsible for. But I feel like things are going well, and I believe this helps. I don’t really care that I can’t quantify it to a level that a scientific panel of experts would approve it. It doesn’t matter because my kid is feeling successful at school and my kid no longer throws tantrums when I say it’s time for school.”

by Dawn McMullan, Dallas Child, Aug 30, 2010

Read the entire article here.