On The Track With Neurofeedback

I used to think of bio-feedback as a relic of the flaky 1970s. That was before I met Jake Flaherty. Born in 1990, Jake was an infant in crisis: he arrived more than three months before his due date and weighed just over a pound. At 3 days he required open-heart surgery. He spent the first two months of his life in intensive care. He survived, but with serious damage to his brain. At the age of 7, when I met him, he was taking Depakote and Tegretol to control his epileptic seizures and lacked the coordination to tie his shoes. He had speech and attention problems, ground his teeth incessantly and often woke up 10 or 11 times during the night.

Three years ago Jake's parents sought out a clinic offering neurofeedback, a form of biofeedback that involves displaying a person's brain waves on a computer screen and helping him control them. Jake would sit at a monitor with a sensor on his scalp, and whenever his brain achieved the calm, steady rhythms that normally eluded him, a Pac-Man would start gobbling black dots and beeping. Soon he was controlling the screen action at will, by recognizing the way it feels when the Pac-Man goes to work--and his brain was growing more stable. "It took care of his teeth grinding in two sessions," says his mother. "It took care of his sleep problems right away." Within a week Jake was using scissors and developing a range of other fine motor skills. The number of seizures dropped. His schoolwork improved dramatically. Several years later he still has some problems, but his parents say he has gained far more than they dared to dream.

Though biofeedback is best known as a stress-reduction exercise, researchers in private clinics, universities and even NASA are now working to refine the type that deals with brain waves. The technology is still in its infancy, but it's emerging as a tool to treat everything from epilepsy and attention-deficit disorder to migraines, anxiety, depression, head injuries, sleep disorders and even addiction. In the last few years, neurofeedback has made its way into the offices of hundreds of reputable doctors, psychologists and counselors. No one knows exactly how the technique helps people, but recent research shows the brain is far more "plastic," or changeable, than previously imagined. Some experts believe that regular brain-wave training improves blood flow to particular brain regions, fostering stronger connections between cells. And after 20 or 30 sessions, the changes seem to last.

Some health experts dismiss the treatment as a fad, suspecting it's just a high-tech placebo. They question the wisdom of spending thousands of dollars to try something so unproven. "Parents need to be fully informed about the lack of research," says Russell Barkley, a researcher at the University of Massachusetts Medical School and a leading expert on attention-deficit disorder. "Basically, it's buyer beware." Proponents counter that since neurofeedback carries no risks--and has been used successfully by thousands of people--there is no reason to suppress it until costly clinical trials can be performed. Joel Lubar, a University of Tennessee psychologist who has spent three decades studying ADD and treating it with neurofeedback, claims that more than 90 percent of his patients have benefited. Combined with family therapy and a supportive school environment, the technique has reduced and in many cases eliminated the need for medications such as Ritalin.

Though neurofeedback appears to be very safe, it isn't cheap; evaluation and 20 or more sessions can cost anywhere from $2,000 to $5,000. And while that's about the same as several years of medication, insurance reimbursement is spotty. As schools begin to offer the technique to students, and the cost of the equipment comes down, the cost should decline. The systems are simple to use, and a few practitioners lease units to patients, who can, with an office visit and phone counseling, take them home and do the training at a fraction of the usual cost. But for now, the challenge is to find a practitioner who is well trained and experienced. Start your search with a licensed professional, such as a psychologist or pediatrician, who is familiar with the technique and can give you a referral. If you find a practitioner by some other route, ask the practitioner for references from doctors or psychologists. You should also find out how long the person has been in business. And search the Web. Lubar's site, brainwavebiofeedback.org, is a good place to start. EEG Spectrum (eegspectrum.com), a company that makes neurofeedback equipment and trains people to use it, has several hundred affiliates around the country. And ct-ed.com and biofeedbacksolutions.com offer state-of-the-art brain-wave training for learning disabilities and brain injuries.

Understanding neurofeedback, and maximizing its benefits, will require years of research, but the future looks bright. "I feel like someone has given us a piano and we've learned to play a couple of keys," says Sue Othmer, executive director of EEG Spectrum.