"Neurofeedback should play a major therapeutic
role in many difficult areas. In my opinion, if any
medication had demonstrated such a wide spectrum
of efficacy, it would be universally accepted and
widely used. It is a field to be taken seriously by
all.’’

Dr. Frank H. Duffy, M.D.
Pediatric Neurologist & Professor
Harvard Medical School

               What is Neurofeedback?

With individualized coaching, clients navigate games and
exercises with their mind to promote healthy brain function.
Neurofeedback can act as a drug-free solution for attention
deficits, learning difficulties, executive functioning weaknesses,
anxiety, neurological disorders (e.g., traumatic brain injury), and
various other issues by improving mental performance, emotional
control, information processing, and memory in people of all
ages (e.g., children 3+ years old through adults). Neurofeedback
can also be used by individuals already taking medication, if
desired. We use top of the line amplifiers, combined with
Neuroguide Quantitative EEG (i.e., qEEG) and Neurofeedback
systems. This includes 19-Channel Z-Score Neurofeedback
(both Loreta and Surface), which has demonstrated strong
efficacy in the treatment of a wide variety of conditions. We are
also one of only a few NeuroField providers in Arizona.  

How Did Dr. Baker Become Involved in
Neurofeedback??? A Tale of Confronting Skepticism

How Does Neurofeedback Work?

We use EEG technology to snapshot brain activity to identify
neurologically-based strengths and weaknesses. Results of the
qEEG guide intervention to target specific areas of the brain and
reward positive activity corresponding to improved focus,
memory, learning, and positive mood. In Neurofeedback
sessions, clients are reinforced (through game-like or movie
formats) for changing their brain wave patterns. Some clients
and/or parents report noticing transient improvement after only
one session. Use of an Audio Visual Entrainment device (see
www.mindalive.com) between sessions can be helpful for some
clients, particularly if clients are only able to attend 1-2 sessions
per week (as initially, 3+ sessions per week is desirable to
maintain regular practice and learning). Sessions last
approximately 50 minutes and include time for preparation and
neurofeedback procedures, and clients frequently receive
treatment suggestions (e.g., use of self-talk and relaxation
strategies), as well as information pertaining to treatment results
based on quantitative data.

Is There Research Evidence That Neurofeedback
Works?

Over the past 15+ years, numerous studies have supported the
benefits of Neurofeedback for various conditions, including
ADHD. In fact, Neuroguide (the program we use) achieved FDA
approval in 2003 for functions related to ADHD and Traumatic
Brain Injury. The use of qEEG technology lies at the root of
Neurofeedback technology and is now being used all over the
world as a treatment approach for ADHD and other problems
and disorders. Neurofeedback has even become reimbursable
through insurance companies under certain circumstances for
certain type of conditions. We can provide clients with a superbill
to submit to their insurance companies for Neurofeedback
sessions.   

Four randomized controlled trials have shown Neurofeedback to
be superior to a (semiactive) control group, whereby the
requirements for Level 4: Efficacious are fulfilled (Criteria for
evaluating the level of evidence for efficacy established by the
AAPB and ISNR). In line with the AAPB and ISNR guidelines
for rating clinical efficacy, both prospective controlled studies
and studies employing a pre- and post-design concluded
Neurofeedback treatment for ADHD was considered
‘Efficacious and Specific’ (Level 5) with a large Effect Size (ES)
for inattention and impulsivity, and a medium ES for
hyperactivity. These results are consistent with meta-analytic
research showing that Neurofeedback is equal or superior to
stimulant medication in the treatment of inattention and
impulsivity. The effects of Neurofeedback have been found to
persist up to 9 years or longer (after Neurofeedback treatment
was ended). As noted in an article below from the official journal
of the American Academy of Pediatrics ("Pediatrics"), a recent
study found that students with ADHD maintained almost all
behavioral gains from Neurofeedback six months after treatment
was stopped, whereas students who instead received
computerized interventions for attention only maintained a small
portion of treatment improvements. The minimal potential for
side-effects of Neurofeedback treatment (in comparison to
medication) result in many clients and/or parents choosing
Neurofeedback instead of medication for the treatment of
inattention and hyperactivity/impulsivity. It is also possible to use
both medication and Neurofeedback in the treatment of
symptoms associated with ADHD.

As described in an article (see below) by Hammond (2011), peer-
reviewed and scientific research has strongly supported the use
of Neurofeedback with ADHD, learning disabilities (e.g., reading
disorder/dyslexia), autism-spectrum disorders, neurological
disorders (e.g., traumatic brain injury and stroke), anxiety (e.g.,
Generalized Anxiety Disorder and OCD), posttraumatic stress
disorder (PTSD), migraine headaches, chronic pain, sleep
disturbance, alcohol and substance abuse, and depression.
Neurofeedback has also been used successfully in optimizing
peak performance in athletes, musicians, and surgeons.

Are there benefits to using Neurofeedback instead of
(or in addition to) psychotropic medication?

Most neurofeedback providers strongly emphasize the use of
neurofeedback instead of psychotropic medication, which has
unfortunately resulted in physicians seeing neurofeedback
providers as the "opposition". I feel psychotropic medication can
be very effective in certain cases, either alone or in conjunction
with neurofeedback. However, there are certainly cases where
neurofeedback can be much more effective than medication in
treating symptoms. For instance, by treating certain symptoms a
person exhibits, it is possible for medication to actually worsen
other symptoms. For example, there are many children and
adults with a combination of both ADD/ADHD and anxiety,
which is very difficult for psychiatrists to treat. When using a
stimulant medication such as Ritalin or Adderall to treat the
ADD/ADHD symptoms (which may normalize Theta and Beta
waves in the frontal lobes), at the same time the medication may
also speed up areas of the brain that are already going too fast
(excessive Beta wave activity), causing an over-aroused state in
which the person feels keyed up/on edge and uncomfortable.
Similarly, when treating children with explosive anger with
medications that tend to have a sedative quality (e.g.,
antipsychotics or anticonvulsants), the neurological slowing that
helps reduce impulsive anger outbursts frequently reduces
attention/concentration and processing speed. With
neurofeedback, it is possible to slow down fast activity in one
area of the brain, while also speed up slow activity in another
area of the brain at the same time. Also, even when the effects
of both neurofeedback and medications are similar, when the
person discontinues medication, the effects often go away.
However, with neurofeedback there tends to be long-lasting
change once symptoms have had an adequate amount of
treatment.  

                      
Research Articles

Clients or parents interested in learning more about qEEG
assessment and Neurofeedback can download and read the
following articles from scientific journals which describe the
potential benefits associated with qEEG-Guided Neurofeedback.
What is Neurofeedback - 2011 Update
Efficacy of Neurofeedback for ADHD - meta-analysis
Neurofeedback for ADHD - A Position Paper
Lasting effects of Neurofeedback (from "Pediatrics")
Neurofeedback for Autism Spectrum Disorders        

       Cost of qEEG/Brain Mapping Assessment

The cost of a qEEG assessment (which includes a clinical
interview, qEEG/brain mapping, follow-up consultation, and
report illustrating the results), and potentially brief cognitive
testing (e.g., computerized attention testing), is $850. If clients
do not request a formal report, the cost is reduced to $600.
Clients are also provided with a complimentary Neurofeedback
session immediately following the qEEG assessment.

         
Cost of Neurofeedback Sessions

As noted above, clients receive a complimentary Neurofeedback
session immediately following the qEEG/Brain Mapping session.
Additional Neurofeedback sessions are $150 per session for the
first three sessions, and are then discounted to $140 per session
after that. When "intensive" sessions are done (typically
involving back-to-back sessions on the same day; see
"NeuroField" section at the bottom of the page), the cost is $250
for the double-session. Sessions last approximately 50 minutes.
Depending on the condition, clients often reach their goals within
20-30 sessions (although optimal length of treatment is variable).
Symptom monitoring is conducted through the use of repeat
cognitive testing, behavioral questionnaires, and/or follow-up
qEEG assessments (the latter of which can document changes in
neurological functioning related to Neurofeedback, as has been
demonstrated in numerous scientific studies).

                      Insurance Billing

Although our office is not contracted with insurance companies,
we are happy to provide clients with a superbill for
neurofeedback sessions (CPT code: 90
901). If you contact your
insurance company to inquire about coverage, Dr. Baker's N
PI
number is 1487868436.
Insurance companies do not typically
reimburse for
the qEEG assessment unless it is a medical
ne
cessity for a condition such as epilepsy (which is typically
done by a neurologist).
However, as part of the qEEG
assessment, Dr. Baker typically bills for a total of three hours of
Diagnostic Interview and Psychological Testing, which is often
reimbursable to clients.
Although insurance companies do not
always reimburse for neurofeedback sessions, at times this
service is covered.

                    How Do I Get Started?

Your first appointment will consist of brain mapping using qEEG
technology, in addition to an interview with the client (and/or the
parent of children), and potentially brief cognitive testing. T
his appointment will typically last two hours. Typically, clients
and/or parents are given feedback on the day of the evaluation to
review the results and provide recommendations. If clients
and/or parents decide to proceed with a trial of Neurofeedback,
the results of brain mapping will guide treatment. Give us a call
at 602-274-1462 if you have any questions or would like to
schedule an appointment.

           Additional Information: NeuroField

We are one of only several NeuroField providers in Arizona.
NeuroField is a special/advanced form of neurofeedback that is
highly effective in treating a wide variety of conditions, with
treatment effects being seen very quickly in most cases.
NeuroField is often combined with other neurofeedback
techniques (e.g., Z-score training) to facilitate the brain's ability
to produce specific wave forms. One treatment option, referred
to as
"Intensives", involves the client coming in for treatment at
least once a day for two weeks. Although clients are able to
come in for NeuroField treatment in the morning, followed by
Loreta Z-score training in the afternoon, most clients receive a
back-to-back session involving these modalities. Nicholas Dogris,
Ph.D., the health psychologist who developed NeuroField, has
documented incredible improvements in symptoms in many
individuals receiving the Intensive treatment protocols. Following
the qEEG/brain mapping, we can discuss whether NeuroField
could be helpful for you or your child.

Videos describing NeuroField:
Nicholas Dogris, Ph.D., NeuroField video #1
Nicholas Dogris, Ph.D., NeuroField video #2
A 6-year-old girl
completing Z-Score
Neurofeedback with Dr.
Baker
A 5-year-old girl
completing Z-Score
Neurofeedback with
Dr. Baker
Are there benefits to
receiving qEEG brain
mapping if my child
does not receive
neurofeedback
training?

There are many ways qEEG
brain mapping findings can be
useful. For instance, many
children with ADD/ADHD
exhibit signs of cortical
underarousal, and these
children may benefit from
stimulant medication to speed
up cortical activity. However,
there are also children with
ADHD symptoms who do not
exhibit excessive slow wave
(e.g., theta) and/or deficient
fast wave (e.g., beta) activity,
but may instead show signs of
overactivity in the brain
(which may suggest anxiety).
For these children, physicians
may choose to treat the same
symptoms differently. Also,
receiving a baseline qEEG
assessment, with follow-up
assessment following a
medication trial, can help
determine whether (and to
what degree) neurological
functioning has been affected
by the medication, which can
help inform treatment
decisions.
Neurofeedback
Videos on
You Tube
Neurofeedback for Autism
Evidence Supporting
Neurofeedback for ADHD