• An Attention Camp Program for the real world prepared By Allen A. Winebarger, Ph.D.
• Neurofeedback: how it has helped one parent,
• Other resources about Neurofeedback and more information.

Prepared By:
Allen A. Winebarger, Ph.D.
Western Behavioral Consulting, LLC
Sept. 2000
 

Attention Deficit Hyperactivity Disorder (ADHD) is the diagnosis used to describe children with developmentally inappropriate levels of inattentiveness, impulsivity and hyperactivity.  Unfortunately, problems with attention and overactivity often occur with other problems, such as oppositional behaviors.  In fact, the reported rate of  "significant conduct problems" in children with ADHD is as high as 90% (Hinshaw, 1987).

Children with Attention Deficit Hyperactivity Disorder (ADHD) typically suffer more mental disorders, have significantly more difficulty with social adjustment and academic achievement, and are more likely to be a significant source of stress to parents and other family members.  In fact, children with ADHD tend to bring out negative, controlling, directive, coercive and harsh behaviors in most of the significant adults in their lives (such as parents, family members and teachers).  Given that families under significant life stress are more likely to be at risk for a multitude of difficulties, community based interventions targeting these populations are essential. Programs that target skill development in both children and parents are currently viewed as having the most promise in the treatment of ADHD, particularly when these approaches are paired with appropriate medication interventions.  A current focus within the scientific community is on the process of meeting these goals through the use of summer camp programs (Barkley, 1998).

One particularly useful summer camp treatment program format is the summer day camp.

In fact, such a program is a key part of the current National Institute of Mental Health-funded "Multimodal Treatment of Attention Deficit Disorder" study, the largest government-funded child therapy study ever conducted in the United States.  Unfortunately, one of the major criticisms of the NIMH project is that it costs too much to be used anywhere but academia—a place where cost is not usually a factor.  Unlike the NIMH project, our Attention Camp is designed to be used in the “real world” where cost effectiveness and efficiency are central to the provision of services to children  with ADHD and their families.

Western Behavioral Consulting's Attention Camp Program.

Younger Group Arts and Crafts

Western Behavioral Consulting’s Attention Camp Program (ACP) is a state of the art summer day-camp treatment program tailored specifically to the needs of children and families coping with difficulties associated with Attention Deficit Hyperactivity Disorder (AD/HD).  This process involves the entire family, and is based on scientifically supported approaches to managing problems and difficulties related to ADHD that have been found to be effective as "stand alone" approaches, as well as effective additions to medication interventions.

Our particular program is designed to provide intervention and teaching services to children ages 6-11, while simultaneously teaching effective behavior management skills to at least one primary caregiver per family.  As the families move through approximately 70-80 hours of professional contact, they receive services targeted at: 1) improving social problem solving, academic, sports and behavioral skills of the participating children; and 2) improving the supervision/monitoring, problem solving, negotiation, teaching and limit setting skills of the parents.  The child and parent components of the camp are discussed briefly below.

Dr Al helps with social skills building

Child Program:
 

Time out for teachers Olivia and Cherie

Each of the children involved in the program attends our camp from 12 p.m. to 5 pm., Monday through Friday for two weeks.  Each day is broken up into multiple activity periods that are separated by short break/transition periods.  Each of these periods is designed to focus on improving functioning in one or more of the following areas of developmental delay common in children with ADHD: (1) classroom/academic skills, including on task behaviors; (2) social problem solving skills with peers; (3) problem solving skills/negotiation with parents and teachers; (4) self-management of impulsive and inattentive behaviors.  Each one of these skill areas will be continually assessed throughout the summer camp program.

Parent Program:
 

The parent program is designed to compliment and supplement the child program, and contains several key parts.  First, parents are focused on effective strategies for teaching children, with extra emphasis on how children learn, and different ways to reward new behaviors.  Second, parents are provided the opportunity to participate in a stress management class designed to help them moderate and cope with the stresses of parenting a child with ADHD in healthier and more adaptive ways.  Next comes a component designed to help parents learn new strategies to communicate with their children.  This component of the program will also teach parents new strategies to help children enhance their self-esteem.  Finally, our parent program teaches state of the art limit setting, or discipline, skills to parents.  These modules provide parents the opportunity to enhance their parenting behaviors to meet the developing challenges of their ADHD children.

Parenting Skills Group

  ATTENTION CAMP PROGRAM OBJECTIVES
 

One ADHD parent tells her story~
"My son has ADHD and OCD.  He is 10½ years old.  Last year he was on 4 medications:Adderall,Clomipramine,
Luvox, and Risperdol.  The Risperdol caused him to gain 15 lbs which is a great deal of weight for a 10 year old.  He went through the usual social repercussions including being thrown out of schools. I had him thoroughly
evaluated before I would even let them start him on Ritalin.  He was tested by someone who actually wrote a book about proper testing of ADD/ADHD.  My son was a preemie born at 26½weeks and weighing 2lbs 2oz.

Recently a social worker at the hospital I work at told me about Neurofeedback and I found a clinic in Scottsdale called "the ADD clinic" where they exclusively deal with this problem.  He had a brain map EEG which is a computer brain map that picks up typical brainwave patterns in ADD/ADHD.  He had afairly serious case with obvious OCD and also a pattern commonly seen in depression.  There is a fairly large incidence of OCD with ADHD (I think maybe 30%) and it is more difficult to treat.  He has had at least 20 -23 treatments so far and is doing well.  We also have him on a behavior modification program started by the clinic that is fairly detailed, but he is
gaining many points since he has a goal of buying the Nintendo playstation which is now going for $99 until the third version comes out ($250).  Each point is worth a penny and he is over $30 at present, in fact he is waiting
for me to come home to add up some more accumulated points.  Also, I had to put him back on Adderal, Clomipramine and Risperdol (I had taken him off when we hit a plateau and that was when I was told about neurofeedback), but they are in lower doses than last year and as soon as possible I will get him off them.

I have seen very good results with the neurofeedback.  He now gets up, fixes his bed, gets dressed and is eating breakfast and doing chores with one command.  If you know about behavior mod, with two commands you miss the potential points.  Everyone responds differently with neurofeedback, some just need 15 treatments, some need40.  I want to get him as many as possible to get him off the meds as much as I can and then we will go to the monthly maintenance plan.  I am very happy with it; my only regret is that no one told me sooner!!!

Neurofeedback has been around for 20 years and his doctor who is well known didn't mention it.  I am also a doctor and regularly read up on this and also didn't find info until the social worker told me about it.  This disturbed me a great deal and I worry about parents who have no info on it and are going through what we went through.  It also disturbs me that insurance doesn't pay for it."

Carol

A Symphony in the Brain : The Evolution of the New Brain  Wave Biofeedback click here for USA and the Pacific, US$19.20 and and herefor Europe 15.33 pounds

Reviewer: Donald W. Mitchell   coauthor of The Irresistible Growth Enterprise and The 2,000 Percent Solution from Boston   A Symphony in the Brain : The Evolution of the New Brain  Wave Biofeedback  "I became interested in this book from the perspective of a long-term   meditator. I have read many many studies of how meditation improves brain wave patterns, and provides many psychological and physiological benefits. So I was curious about what neurofeedback could do. This book provided an excellent, complete review of the subject. I highly recommend that you study it.

How neurofeedback treatment is administered depends on the practitioner. There is no government licensing or certification in the field. Many types of equipment are used. Some even allow you to do the treatment on your own at home, with an investment as low as $950. The experience and skill of the practitioner seem to add value though.

This field should be distinguished from biofeedback. That process (which is also unlicensed and unregulated for practitioners) focuses on giving patients feedback on things like how warm their hands are, primarily as a mechanism to help people reduce stress. Cold hands can be one sign of stress. By learning to induce more relaxed states, many patients improve from various psychological ailments that involve excess stress. Neurofeedback measures the brain waves themselves (that which directs the body) rather than the outcome of the brain waves (what the body is doing).

The book details many interesting cases of great improvement in Attention Deficit Disorder and its near cousin, AHDH (which includes hyperactivity), alcoholism, epilepsy, depression, autism, and high performance (such as opera singing). Each one seems to require a different application of neurofeedback, and is specialized in by different practitioners. One of the encouraging things about the book is a complete list of research reports, descriptions of which practitioners treat which areas, and ways to get more information from web sites and manufacturers. The author also tried neurofeedback and reports his positive and negative experiences. He also looked for failures, and describes those.

The main drawback of neurofeedback is that it developed outside of the medical community, so a full set of definitive studies of it remain to be done. So far, NIH has not  sponsored any research in this area although it has received grant applications. My own impression is that this would be a good area for NIH to sponsor research in. If efficacy is established, many more researchers would become involved and the field would improve more rapidly. If the process cannot be proven to be effective in double-blind tests (properly designed), then people should stop wasting their time and money and move on to something that works better. To me, the combination of promising results of flawed research and the anecdotal evidence suggests that the $10 million to find out more
 would be well worth the price. For this therapy is relatively inexpensive, and shows promise even in reducing recurrence of criminal behavior among inmates. If this therapy works, we will save a whole lot on drugs, incarceration, education, and wasted lives.

Read this book and see what you think. I certainly identified two people who I think might be good candidates for neurofeedback who aren't doing well with medication and psychiatric help. Perhaps this is what they need. It's certainly worth the money to me to find out.

  While you are reading this book, also think about our disbelief stall about the way things work. For decades, we treated stomach ulcers with surgery, stomach lining drinks, andacid-production inhibitors. All helped. For the same decades, some scientists believed that these ulcers were caused by stomach infections of the lining. These scientists were right, and now that's the way most ulcers are treated, and quickly and inexpensively cured. Can it be that we have been discouraging another way of thinking that could help us again? It's certainly possible."
 

Introduction to Quantitative EEG and Neurofeedback  click here for USA, The Pacific and Canada, US$79.97 and here in Europe £49.95

Introduction to Quantitative EEG and Neurofeedback  This is the first clinical textbook on Neurofeedback (NFB) to be published, and if you are a professional seriously interested in neurofeedback, it will give you more detail than the one above.   It provides an introduction to neurofeedback/neurotherapy techniques,for clinicians and clinical psychologists.  Discusses techniques used in treating attention deficit disorder, dissociative identity  disorder, depression, drug and alcohol abuse, and brain injury.

 

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