Tuning In to Concentrate : Proponents say that EEG biofeedback can benefit children with Attention Deficit Disorder. But critics still have doubts about the treatments.

Susan Callison will never forget how terrified she was when at the beginning of second grade, it took her son, Chad, two hours to complete a simple homework assignment.

“I remember working with him on the word boat. I used pictures, everything, to try to help him recognize the word,” recalls the El Toro mother and former teacher. “But after 20 minutes of working, he still didn’t have a clue. It was frightening.”

Chad’s condition was diagnosed as attention deficit disorder (ADD), a neuropsychiatric condition that leaves a person unable to concentrate or sustain attention. For Chad, it was impossible to focus on his work at home and at school. Even though his teacher said he was a bright, likable boy, he used to just sit at his desk and do nothing.

Today, the Callisons say they have seen significant improvements in Chad’s learning and attention span. Chad’s mother attributes the success to EEG (electroencephalogram) biofeedback treatment, a controversial form of therapy offered at the EEG Spectrum in Encino and at Mission Psychological Consultants in San Juan Capistrano.

Michael Linden and Thomas Habib, clinical psychologists at the Orange County facility, contend that EEG biofeedback trains children to alter their brain waves to improve concentration and behavior.

But many psychiatrists and psychologists are skeptical of the therapy’s effectiveness and the lack of research, and they worry that many parents may embrace it after other remedies have failed.

Chad’s mother, however, insists that after her son completed almost 60 45-minute EEG sessions, she saw a dramatic change in him.

Three to five days a week, Chad sat in front of a computer screen at the San Juan Capistrano office. EEG electrodes were positioned on his scalp to amplify and monitor his brain-wave activity while he played games such as Pac-Man, read or listened to a therapist read.

The goal was for Chad to concentrate as hard as he could on playing the game, reading or listening. If his concentration drops, the game stops. If his mind wanders during the reading, the monitor will reflect his loss of concentration and the therapist will encourage him to pay better attention. He receives high scores for good concentration, and his progress is charted. To further encourage him, Chad was rewarded with baseball cards or movie passes for high scores.

Callison insists that “without the biofeedback, Chad, now 9, would not be where he is today. He is attentive and he is reading.”

Although EEG biofeedback has been around since the late 1970s, Linden and Habib are among about 100 practitioners nationwide using the method to treat children with ADD and hyperactivity.

They admit that the treatment is not for all children and that the successes vary widely. For example, mentally retarded children could not be helped. And the program is expensive. Linden and Habib charge about $3,900, including testing and evaluations. Nationally, the costs range from $3,000-$5,000. Some insurance companies will cover treatment.

The doctors said they are completing the first control-group research to determine the therapy’s effectiveness in training ADD children.

Although more research needs to be done, Habib said, preliminary results indicate EEG biofeedback “looks like a possible cure” for ADD. If it is proven to be effective in controlling the symptoms of ADD, Habib said, it could be a major breakthrough in helping these children live more normal, productive lives. Habib said the psychologists plan to publish their research in professional journals within the next couple months.

Left untreated, ADD becomes a “lifelong problem,” he said. “As they grow older, we see problems with self-esteem, problems with peer adjustment, poor marriages and years of failure.”

ADD children who have learning disabilities or behavioral problems are unable to filter out noises and other distractions and typically have abnormal brain-wave patterns, Linden said. Their EEG patterns generally have an excess of the slower theta waves associated with daydreaming, and a shortage of beta waves associated with alertness and concentration.

Using EEG biofeedback, he said, they are able to train children to alter their brain-wave patterns.

By increasing the beta waves and normalizing the theta waves, the EEG treatment can increase the youngster’s ability to focus and concentrate, which can lead to improvements in classroom performance, achievement test scores, IQs, as well as their social and behavioral skills, they contend.

The drug Ritalin has been used for years to help calm children so they can manage the symptoms of ADD and hyperactivity. But many parents are reluctant to give Ritalin because of its side effects: loss of appetite, sleeplessness and a decrease in growth.

Family therapy, combined with a variety of training and teaching techniques, is also often used to help manage children with ADD.

In fact, therapists say EEG biofeedback is not intended to be an alternative to Ritalin or counseling therapy but can be used in combination with the other methods.

Skeptics question the treatment’s effectiveness, saying the research is too scarce and too flimsy.

Critics such as Russell Barkley, a leading expert on ADD and director of psychology at the University of Massachusetts Medical Center, scoffs at what he calls the “sweeping claims” being made by the biofeedback practitioners.

Barkley, who heads a group of leading scientists and experts on ADD, said the research has not been scientific, and he believes EEG biofeedback is “an unproven treatment at this point.”

Unfortunately, he said, “it will become the fad of the ‘90s” because of all the publicity the therapy has gotten, despite the the lack of data.

Claims that it can permanently elevate IQs or alleviate behavioral problems “border on being unethical,” said Barkley.

Sandy Thomas of Children With Attention Deficit Disorder, an international parent support group, says the organization has not endorsed EEG biofeedback because there is not enough research to substantiate the claims made by its proponents. And reviews from parents whose children tried the therapy have been mixed.

“There were some parents who thought it was a total waste of money . . . and some who became advocates for it,” she said. “We have to be careful because parents of ADD children are very vulnerable. Sometimes they are desperate and they will jump at anything.

“Before our organization backs any kind of treatment, it needs to have the blessing of the scientific communities.”

Countered Habib: “Some criticism is legitimate. The research isn’t up to snuff yet.” Research money is scarce, the cost and availability of computer equipment needed to study the therapy is prohibitive, and the research so far has been generally published in relatively obscure journals, he said.

Joel Lubar, a psychology professor at the University of Tennessee and one of the pioneers in the use of EEG biofeedback since the late 1970s, said that the data is there to prove its effectiveness but that many mental health care professionals just aren’t bothering to review it.

Lubar noted that he has worked with “over 700 children and we estimate there are well over 1,000 children in treatment at any one time around the country. They are reporting success rates above 70%.”

Jacqui Mershon, the mother of twin daughters diagnosed with ADD, said the skeptics won’t knock her confidence in the therapy.

She remembers with frustration the daily battles she once had with her rebellious girls.

“Day in and day out, everything was a battle,” recalls Mershon, of Foothill Ranch near Lake Forest. “They didn’t even look at me as a mother figure. They ignored me. I would tell them something 3,000 times and they wouldn’t get it. Now, we know my little girls just didn’t have the capacity to understand.”

After daughter Rachel received the EEG biofeedback, Mershon said, “it didn’t perform a miracle, but she is much more understanding now. Now 9, Rachel has a longer attention span. She is not as defiant as she once was.” Pleased with the changes she observed in Rachel, Mershon has enrolled Rachel’s twin, Crystal, in the program.

EEG biofeedback has been successful in treating some children with behavioral problems that include aggression behavior and depression, said physicist Siegfried Othmer, who directed the Encino project.

Teachers who worked with students who had the treatment generally said they saw some improvements in attention span and ability to focus and complete work.

But some, like Pam Patterson-McDonald, who teaches first grade at Mary Fay Pendleton School at Camp Pendleton, said she “can’t say wholeheartedly that it was the biofeedback” that was the primary factor in improving one of her students.

Although the child did blossom academically in her class and his behavior improved after the biofeedback, Patterson-McDonald said she believes his achievements were based on a combination of factors, including her teaching methods.

Yet, she says, “the biofeedback did help him get self-control. It gave him the tools to excel in learning.”

“I know it can work,” said Susan Callison, Chad’s mother. “Our pediatrician told us not to waste our money on it. But I’m glad we did.”