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Biofeedback Offers Help To Hyperactive Children

By JIM ROBBINS

Published: Tuesday, November 11, 1997

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IN May 1987 Mary Obringer and her husband adopted a 5-month-old South Korean infant. But there were problems with the baby they named Max. ''He had speech disabilities, motor skill problems, was hyperactive and had trouble concentrating,'' Ms. Obringer said. He could not be in a large group of people without hitting, kicking and screaming.

When he was 5, they started him in school in their hometown, Jackson, Wyo., ''and it was clear right away he wasn't going to be able to stay,'' Ms. Obringer said. Doctors diagnosed his condition as attention deficit disorder, and put him on the drug Ritalin, which helped. But he still had numerous problems and stayed in a classroom for special students.

Ms. Obringer met a psychologist, Michael Enright, who urged her to let Max try a new kind of biofeedback technique in combination with the Ritalin.

''We started seeing immediate results,'' Ms. Obringer said. ''Within a couple of weeks he could sit in a chair and not fidget. Two years later, he was like every other kid. No kicking, no hitting, no fighting.''

Max, now 11, has been in regular classes for several years and does well in school, though he still takes Ritalin, at a much lower dose.

The Obringers are among a growing number of people who, concerned about the amount of drugs their children are taking, are turning to a new kind of treatment called EEG biofeedback or neurofeedback, a technique that reads a patient's brain waves with standard electroencephalogram (EEG) equipment, and displays them on a computer. Being able to see their brain waves, combined with video games that they perform based on brainwave states, allows patients and their doctors to exert a new level of control over brain waves. And that, some researchers say, improves and sometimes cures problems that have a physical component in the brain.

Prononents of the technique say some controlled studies and a large number of positive clinical results show that neurofeedback is very effective for patients with attention deficit disorder, attention deficit hyperactivity disorder or hyperactivity, epilepsy and closed head injuries.

Other scientists have a different view of the technique. ''It's highly experimental'' as a treatment for attention deficit disorder, said Russell Barkley, director of psychiatry and a professor of psychiatry and neurology at the University of Massachusetts Medical School, and an expert on attention deficit disorder, which is known as A.D.D.

''There's a tremendous placebo effect in a situation like this,'' Dr. Barkley said. ''Case studies prove nothing because they're totally uncontrolled.''

On the other hand, Dr. Barkley said, ''we don't have any studies that say it's bad for you,'' adding: ''I don't think it will do harm. But I don't think it should replace treatments that are cheaper. Basically, it's buyer beware.''

The first part of treatment with neurofeedback is a diagnosis by a doctor or mental health professional. In a typical neurofeedback session, the user wears two sensing electrodes. The brain waves are amplified and displayed on one computer screen, while on the other a video game is displayed. The computer is programmed to help the patient do well on a video game similar to Pac-Man, when he or she is creating the right brain waves. Sessions take 30 to 60 minutes and vary in cost from about $60 to $100. Some health insurance companies pay for sessions, and some do not. In Ms. Obringer's case, the school system paid.

Biofeedback is based on a certain sort of electrical activity in the brain, which produces what are called alpha waves. The technique has been widely used since the 1970's to treat stress and migraines, and to help manage pain, but some doctors are skeptical about the wide range of claims attributed to biofeedback. In the 1970's researchers like Elmer and Alyce Green at the Menninger Clinic in Topeka, Kan., found that biofeedback users could get into a deeply relaxed alpha state in just a session or two.

But alpha waves are only part of the brain's frequencies. There are several basic brain waves. Delta is the sleep state. Between sleep and wakefulness is theta. Next is alpha, a relaxed and mentally unfocused state. Beta brain waves indicate normal waking consciousness. There is also something called sensory motor rhythm, or S.M.R., which is a similar frequency to beta waves. Sensory motor rhythm governs body sensations and voluntary movement.

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A version of this article appeared in print on Tuesday, November 11, 1997, on section F page 7 of the New York edition.

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