Articles

How Reorganizing Brain Wave Activity Can Improve Attention Deficits Associated with ADD, ADHD, LD

Author Bio: Bob Gottfried PhD is the clinical director of Advanced Cognitive Enhancement clinics in Toronto. He specializes in the area of Neuro-cognitive treatments for AD/HD, LD, and memory impairment. He can be reached at: bob@aceclinics.com

Article Topics: ADD/ADHD, Memory, Concentration, Acquired Brain Injury, Learning Disabilities,
Article types: General Information,

Background
It is estimated that over 5% of all children in North America are experiencing at least one form of learning disability. ADD/ADHD are characterized by one or more of the following: inattention, hyperactivity, and impulsivity. Learning disabilities are characterized by one or more difficulties associated with attention, reading, writing, oral language, reasoning, memorizing, and problem solving. Further difficulties may include compromised organizational skills and social interaction.

Brain Wave Activity and Attentional Shifting

The brain produces different frequencies for different levels of attention. They include the following:

Delta – sleep state
Theta – between sleep and awake, also a meditative state
Alpha – relaxed state
Beta1 – focused concentration
Beta2 – alert state
Beta3 – very alert, vigilant
Beta4 – Hyper vigilant

The ability to produce the right states, especially those associated with focus and attention is paramount to be able to perform a variety of cognitive tasks. In addition, the ability to shift from one state to another when required, offers tremendous mental flexibility, which results in enhanced performance in every area of life.

The Use of Neurofeedback in Treating Attentional Difficulties:

Neurofeedback, which is a form of biofeedback, has been used for over 20 years to treat concentration related difficulties associated with ADD/ADHD and LD. In general, Neuro-feedback is a modality which uses an EEG recording system along with training software to enhance brain wave activity that is instrumental for improving concentration.

The premise behind Neurofeedback is related to earlier findings that established that individuals with poor concentration lack sufficient levels of Beta1 (this band is also commonly termed SMR - short for sensory motor rhythms) brain waves to sustain attention. The findings also showed that individuals with attentional deficits exhibit excessive amounts of slow brain wave activity, especially Theta waves. Joel Lubar, a pioneer in this field, demonstrated that treatment modalities focusing on enhancing the Beta1/Theta ratio, have been very effective in treating children with attention deficits and learning disabilities, which usually resulted in improved school performance and better behavior control. During Neurofeedback sessions, the person wishing to enhance concentration uses feedback coming through an EEG machine to enhance Beta1 and decrease Theta. After a certain amount of training, typically between 40 and 60 sessions, the individual is able to produce more Beta1 at will. Lubar also proved that all children experiencing any form of learning disabilities demonstrated low amounts of Beta1 waves and that many of the symptoms diminished after a process of brain wave training. Neurofeedback treatment can also result in significant improvement of intellectual functioning, as measured by increases in IQ scores (Linden, Habib & Radojevic, 1996). Such improvement is most likely the result of the treatment’s positive impact on the person's ability to concentrate.

More recently, Monastra (2002) found that Neurofeedback has proven to be successful in long term improvement of ADD/ADHD symptoms. In this study, 100 children, aged six to nineteen years, diagnosed with ADD/ADHD were monitored for one year. All children received parental counseling, academic support, and Ritalin. Half of the children also received Neurofeedback training. After 12 months, all children showed improvement in their attention. However, childrdren who stopped taking Ritalin and did not train with Neurofeedback, lost the gains they had achieved, whereas those who also received brain wave training, kept their gains even after they stopped using Ritalin.

The major limitations of Neurofeedback consist of the cost of treatment (typically, $3000 and up) and the fact that the treatment can only be administered in a clinic by a qualified practitioner. Furthermore, Neurofeedback focuses mainly on reinforcing sustained attention. Different cognitive skills, such as divided attention, visual-auditory processing, multitasking and speed of processing are not part of traditional Neurofeedback protocols. They are, however, incorporated in a new generation of cognitive related software.

New Generation Software

Lately a new generation of programs have been released to the market. The most notable innovation related to these programs is the fact that they are content free. What this means is that the program does not offer any stimulating activities to achieve the desired results. Instead, it offers a series of cognitive tasks that directly work on improving different types of attention. For instance, one such program that is gaining much popularity: Sharper Brain focuses on the following 3 levels:

1. Calm: Allows the mind to relax and get ready for different mental tasks. It is also a state important for contemplation and planning. In terms of brain activity, this is equivalent to Alpha state.
2. Focused: Allows paying attention to a specific task, while offsetting distractions. This is equivalent to Beta1 state.
3. Alert: Allows fast response when the need to react quickly is required. This is equivalent to Beta2 state.

Research indicates that the ability to produce, at will, these specific aspects of attention will result in improvement in a variety of cognitive abilities such as divided attention, multitasking, speed of processing, working memory, visual –auditory processing and coordination as well as higher executive skills such as decision making, organizing and prioritizing. One of the biggest advantages of such program is that it can be practiced at home or in the classroom after a very brief training. In addition, it does not require specialized equipment such as EEG, or any particular computer skills. The program is effective and inexpensive, making it affordable for everyone. It is expected that we will see a wider use of such programs in the near future, as they offer a drug free and a more permanent solution to most cases of attention and cognitive deficits.