"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) and/or tACS/tDCS device (see
www.foc.us) between sessions can be helpful for some clients). Sessions last
approximately 50 minutes and include time for preparation and neurofeedback
procedures.
Is There Research Evidence That Neurofeedback Works?
Over the past 20+ 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 potentially brief cognitive
testing (e.g., computerized attention testing) is $650. 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 after that. Sessions last
approximately 50 minutes. Depending on the condition, clients often reach
their goals within 25-30 sessions (although optimal length of treatment is
variable). Most clients attend sessions 2-3 times per week. Symptom
monitoring is conducted through the use of 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), and
sometimes through repeat cognitive testing and/or behavioral questionnaires.
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: 90901). If you contact your insurance company to inquire about
coverage, Dr. Baker's NPI number is 1487868436. Insurance companies do
not typically reimburse for the qEEG assessment unless it is a medical
necessity 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 four 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 they are 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. This appointment will typically last 2 to 2.5
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 supplement to 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 4-5 days of the week
for 2-3 weeks. Nicholas Dogris, Ph.D., the health psychologist who developed
NeuroField, has documented dramatic improvements in symptoms in many
individuals receiving 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
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) and/or tACS/tDCS device (see
www.foc.us) between sessions can be helpful for some clients). Sessions last
approximately 50 minutes and include time for preparation and neurofeedback
procedures.
Is There Research Evidence That Neurofeedback Works?
Over the past 20+ 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 potentially brief cognitive
testing (e.g., computerized attention testing) is $650. 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 after that. Sessions last
approximately 50 minutes. Depending on the condition, clients often reach
their goals within 25-30 sessions (although optimal length of treatment is
variable). Most clients attend sessions 2-3 times per week. Symptom
monitoring is conducted through the use of 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), and
sometimes through repeat cognitive testing and/or behavioral questionnaires.
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: 90901). If you contact your insurance company to inquire about
coverage, Dr. Baker's NPI number is 1487868436. Insurance companies do
not typically reimburse for the qEEG assessment unless it is a medical
necessity 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 four 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 they are 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. This appointment will typically last 2 to 2.5
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 supplement to 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 4-5 days of the week
for 2-3 weeks. Nicholas Dogris, Ph.D., the health psychologist who developed
NeuroField, has documented dramatic improvements in symptoms in many
individuals receiving 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
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A 6-year-old girl
completing Z-Score
Neurofeedback with Dr.
Baker
completing Z-Score
Neurofeedback with Dr.
Baker
A 5-year-old girl
completing Z-Score
Neurofeedback with
Dr. Baker
completing Z-Score
Neurofeedback with
Dr. Baker
Are there benefits to receiving
qEEG brain mapping if my
child does not receive
neurofeedback training?
*Assistance with medication
decision-making/monitoring:
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.
*Developing home-based
auditory-visual entrainment
and/or neurostimulation
protocols:
Audio-Visual Entrainment (often in
conjunction with cranial electrical stimulation
or transcranial alternating current stimulation)
can be very beneficial for a wide variety of
conditions. The David Delight Pro is a very
popular Audio-Visual Entrainment device (see
www.mindalive.com), and tACS/tDCS
devices (see www.foc.us) can dramatically
improve various symptoms, including
inattention, hyperactivity/impulsivity,
academic difficulties, mood problems, and
anxiety. Dr. Baker often encourages clients to
use these devices between neurofeedback
sessions. Clients can also be seen for a qEEG
evaluation to determine home-based
stimulation protocols to address symptoms
and weaknesses (and often return for a
follow-up qEEG in 2-3 months to assess the
progress made and revise the
neurostimulation protocol).
qEEG brain mapping if my
child does not receive
neurofeedback training?
*Assistance with medication
decision-making/monitoring:
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.
*Developing home-based
auditory-visual entrainment
and/or neurostimulation
protocols:
Audio-Visual Entrainment (often in
conjunction with cranial electrical stimulation
or transcranial alternating current stimulation)
can be very beneficial for a wide variety of
conditions. The David Delight Pro is a very
popular Audio-Visual Entrainment device (see
www.mindalive.com), and tACS/tDCS
devices (see www.foc.us) can dramatically
improve various symptoms, including
inattention, hyperactivity/impulsivity,
academic difficulties, mood problems, and
anxiety. Dr. Baker often encourages clients to
use these devices between neurofeedback
sessions. Clients can also be seen for a qEEG
evaluation to determine home-based
stimulation protocols to address symptoms
and weaknesses (and often return for a
follow-up qEEG in 2-3 months to assess the
progress made and revise the
neurostimulation protocol).
| Neurofeedback Videos on You Tube |