By BETSY TAYLOR
Bridget Burnor credits neurofeedback — a type of attention training treatment — and counseling for giving her 12-year-old son Nate the skills needed to cope with his attention deficit hyperactivity disorder, dyslexia and anxiety. Through his time in therapy, Nate has strengthened his ability to relax and focus on a task.
For Nate, biofeedback combined with counseling and medication has worked wonders, she said. "He is a completely different child now than he was two years ago. He has so much more self-confidence, and is so much happier now."
Nate Burnor, 12, relaxes with a book at home. His mother says a type of biofeedback was a tool in his counseling sessions at the Sophia Center in Sylvania, Ohio, that helped improve his focus.
About once a week, Nate visits the Sophia Center in Sylvania, Ohio, where he works with clinical counselor Cyd Laurel. She uses cognitive behavioral play and neurofeedback, a type of biofeedback for the brain, to assist Nate and her other clients as they learn to better manage their attention and their focus. She estimates about 80 percent of her clients are children.
Sr. Rachel Nijakowski, OSF, a psychologist, founded the Sophia Center in 1993 to help those struggling with emotional and behavioral issues. The center has a special focus on the needs of women and children. The center is located in a renovated farmhouse on the roughly 90-acre, wooded campus of the Sisters of St. Francis of Sylvania. The farmhouse once served as a residence for the sisters, but now holds offices on the first and second floors where 12 full- and part-time counselors meet with clients. The center offers educational and behavioral testing and consultation — the results of which can help guidance counselors and teachers as they come up with a game plan to assist students. It offers individual, marriage, family and group therapy and counseling. The center is a ministry of the Sisters of St. Francis of Sylvania and a member of Sylvania Franciscan Health of Toledo, Ohio.
Sr. Nijakowski said many insurance providers do cover counseling sessions like those Laurel conducts. (Burnor said Nate's sessions were covered by her family's insurance.) Laurel doesn't just do biofeedback, but combines it with other therapeutic approaches. The center also provides charity care to the uninsured or underinsured as part of its mission. Demand in the region for the Sophia Center's services is high, Sr. Nijakowski said. "It's been 20 years of word of mouth; neighbor tells neighbor," she said. The center also provides counseling for women and children at Bethany House, a residence for battered women and their children. Lourdes University is on the same campus as the center, and staff at the Sophia Center provide the university's psychological counseling services, as well.
Laurel practices neurofeedback, or brain biofeedback. In 2011, an American Academy of Pediatrics subcommittee on ADHD described neurofeedback as an area that should be researched further, noting it was being used clinically but was not approved by the U.S. Food and Drug Administration for ADHD. In February of this year, an independent study funded by an Institute of Education Sciences grant and published in the journal Pediatrics found neurofeedback to be "a promising attention training treatment for children with ADHD."
The study led by Tufts Medical Center researchers examined more than 100 elementary school students in the Boston area who had ADHD, half of whom were taking stimulant medication. Children in the study randomly were assigned to undergo neurofeedback, or another therapy called cognitive training, or no additional therapy. This cognitive training used computerized exercises to build attention and memory through feedback that reinforced correct responses.
The neurofeedback and the cognitive training, conducted at school three times a week for five months, resulted in longer attention spans, the study found. "Neurofeedback participants made more prompt and greater improvements in ADHD symptoms, which were sustained at the 6-month follow-up, than did CT participants or those in the control group," according to the study's conclusions.
Watching the waves
When Laurel conducts a biofeedback session, she places scalp sensors on the child with whom she is working, and uses two laptops to run an operating system by EEG Education and Research. One laptop faces her and allows her to see the EEG, or electroencephalogram. It is a test that measures and records the brain's electrical activity. Certain conditions can be seen by changes in the pattern of the brain's electrical activity.
Laurel monitors the client's brain waves, often looking at delta, alpha and beta wave states on her computer. She says delta is often associated with sleep, alpha is associated with attention and beta is a "more anxious" wave state.
Laurel said, "With kids who have attention impairments, there's a billion reasons why (they) don't pay attention, and not everybody has ADD (attention deficit disorder). Being able to see their EEG really clears that up. Is it anxiety, is it depression, or is it true inattention? And those states have signatures." For example, she said when a person has a true attention impairment, her screen will show poor communication between the front and back of the brain on the person's EEG.
As Laurel monitors one screen, the client sees a video game on the other computer screen. One game involves growing flowers and trees on the screen. The more relaxed and focused the person doing the biofeedback is, the more details will come into the picture. Laurel said she'll ask the child, hooked up to the sensors recording brain waves: "Hey, can you grow me some flowers and get some butterflies to come?" Then she waits as the child tries to make that happen on the screen. Children have different ways of making the images change on the screen. For some, Laurel invites them to settle themselves, perhaps place their arms calmly in their lap. For others, she might offer them imagery, suggesting they picture themselves sitting calmly on a raft in a pond.
When the child is successful, she'll say something like: "Oh, there's the butterflies. Let's check inside. What are you feeling?" And she ties the child's feelings to what they're seeing on-screen, such as the butterflies. "Oh, you feel relaxed, light."
Laurel's work includes cognitive behavioral therapy, often involving cognitive play therapy. Sand tray therapy, for instance, allows children to play with sand and miniatures, where they create scenes allowing them to verbally express how they're feeling or helps them work out a dilemma through play. Even teenagers sometimes open up more if they color while they talk to Laurel, she said, because they don't have to make eye contact as they discuss problems they're trying to resolve. Laurel said sometimes in a therapy session, she'll introduce a task that's a little too hard for a client to tackle, because she's interested in self-talk and helping people change how they talk to themselves while they do something that is difficult.
She said children she works with, on average, require at least 20 sessions, and she asks families to try to keep appointments to see her consistently. Laurel said parents are usually comfortable with having her share information with children's teachers. She recalled a meeting where she reassured a pair of teachers that she expected their student would reap noticeable benefits from the biofeedback and therapy sessions. "You're motivating me to show you," she told them. "Just stay on the ride until it comes to a complete stop. We're going to do a good job." She said that student, who had been struggling to stay in school, made huge improvements. "That kid now is doing fantastic," she said.
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