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Mark Dombeck, Ph.D.Mark Dombeck, Ph.D.
Essays and Blogs Concerning Mental and Emotional Health

Playstation Neurofeedback Hybrid for ADHD Treatment

Mark Dombeck, Ph.D. Updated: Apr 12th 2006

I came across some rather nifty equiptment while at a behavioral health conference this weekend. I'm walking around the exhibit hall and amidst the sea of computer software vendors, book publishers, and service agencies I see a guy playing a Sony Playstation car racing game on a big screen tv. It turns out that this is the booth of CyberLearning Technology, LLC (www.smartbraingames.com) out of Southern California, and they have figured out a way to incorporate brain-based biofeedback (neurofeedback, actually) into a gaming console. I was immediately intrigued with the possibilities, and as I asked the vendor a bit about his products, I broke into a grin. What the vendor had on his hands was essentially a bit of behavioral medicine for children with attention, concentration and arousal issues that the kids would actually *want* to consume.

Let's say you have a child with ADHD or something to that effect. The child is hyperactive and/or has difficulty focusing on tasks and concentrating, most likely as a result of slight brain function problems. Naturally, you'd be concerned and you'd want to explore ways to help your child calm down and focus better. The prefered method of treatment for a problem like this is medication based treatment, typically a stimulant drug. Such drugs are treatments of choice for a good reason (they work well), but they aren't suitable for everyone, they do have side effects, and they tend to encourage children to develop a passivity or helplessness towards their issues (e.g., that they cannot affect them themselves, but rather must rely on authorities for help). As a concerned parent, you'd want your child to be on the medications if medications were the best avenue of treatment, but you'd also want to know about alternative treatments that might not involve medications (and which would thus not have side effects).

Probably the best studied candidate for a useful non-medicine treatment of ADHD is brain-based biofeedback, specifically the use of real-time brain-wave feedback (recorded using an Electroencephalograph or EEG, a tool that records patterns of electrical activity in the brain). ADHD children show measureably different brain wave patterns compared to normal children. However, normally, those children would have no way to know that their brain waves were not "normal". Lacking in any way to sense what was wrong, they would have no basis for improving. People simply cannot learn effectively without a basis of feedback on how they are doing. The EEG provides children that missing basis. When real-time brain wave recordings are shown to children, they gain the ability to see what their brain is doing, and for the first time in their lives, are able to start learning how to change those brain patterns. They do something (like relax, or tense up, speak or remain silent), and they get feedback as to how that action has changed their brain waves. Over time they learn what actions they can take to move their brain waves towards a normal pattern of firing.

The problem with this approach is that it can be deathly boring. EEG feedback is generally presented as graphed waves or sound beeps which change in frequency as the brain waves change. While this is very important information for children to have, they aren't going to want to pay attention to it for long.

This is where the playstation car racing games come in. The bright folks at CyberLearning Technology have essentially figured out how to use the video game as a means of providing the EEG neurofeedback. The lucky child who gets to use this technology wears a cap of electrodes that pick up brain waves, the data from which is fed into a computer. The computer processes the EEG data and feeds that directly into the Playstation game controller that kids use to operate their game (typically a car race game or other game that provides a steady forward motion). The computer knows when the child's brain waves are moving towards a target 'normal' profile and when they are moving away from that target. As brain waves move away from the desired configuration, the computer sends a signal to the game controler which makes that controller less responsive. The controler lights up, and the car suddenly doesn't go as fast, or the stearing suddenly doesn't work as well. The child is then free to do something (such as take a deep breath) which is likely to move their brain waves in the right direction, and suddenly the car becomes more responsive. Repetitive play with this system enables and trains the child to have brain waves that approximate normal. What's more, the kid is likely to enjoy every minute of the training becuase it is delivered in the context of a very kid friendly game system.

Of course, gaming is not just for kids today (many 30 year olds play), and EEG neurofeedback is not just useful for ADHD. Many problems related to attention, concentration, arousal and impulsiveness can be trained in this manner, and people with epilepsy, anxiety, depression, addictions, and traumatic brain injuries may benefit from such treatment. Biofeedback is a very old and well respected treatment modality; until now it has just been cumbersome to use and to motivate people to engage. But with cool technologies like the smart braingames system, I think the worst part of the problem is now licked.

Mark Dombeck, Ph.D.

Mark Dombeck, Ph.D. was Director of Mental Help Net from 1999 to 2011. Presently, he is an Oakland Psychologist (Lic#PSY25695) in private practice offering evidence-based acceptance and commitment therapy (ACT) and cognitive behavioral therapy (CBT) and addressing a range of life problems. Contact Dr. Dombeck by calling 510-900-5123, send Dr. Dombeck email or visit Dr. Dombeck's practice website for more information.

    Reader Comments
    Discuss this issue below or in our forums.

    Thinking of nerofeedback treatment - victoria - Mar 16th 2009

    I have read through all the comments about neurofeedback and EGG but it was rather out of date.  Can someone update me iformation on this topic?

    I have an eleven years son who has been dinogsised as AD and has been on contera for 8 mnonts but I do not find it is for effective for him.  Thinking of nerofeedback treatment.  Please help??

    Interesting Concept - - Feb 22nd 2008
    I'm 20 years old (now in college) and have been taking concerta since high school after trying adderal in junior high.  When I switched to concerta I felt more free to be myself as well as I did not feel so burnt out once it wore off.  I found that after taking concerta for 6 or more months straight I could take it on and off and it was still just as effective.  As for neurofeedback treatments I find the idea to be atractive, since it is a visual demonstration of how my brain works.  How ever, I do not nessisarily agree with teaching the unique thinkers of the world to be ordinary.  My ADD has most likely been a driving factor for me to try new things and explore.  This exploration aloud me to find the things I really like to do, instead of settling for things I don't like.

    Try Concerta or Videogames - Jake - Dec 19th 2007
    I'm 17 years old and I suffer from ADHD. I have tried many treatments such as prescription drugs and have found that Concerta works suprisingly well in the affect of subduing the ADHD tendencies. I find when I'm on Concerta that it is really easy to pay attention and get my work done with few destractions. Now I'm not a doctor but I recommend this for anyone who's suffering from ADHD, just try it I'm not promising miracles but it worked for me. Also I play videogames a lot, it seems to calm me when I'm angery or fustrated. Why? No Clue. But I think it has something to do with the fact that videogames allow me to escape away from my problems for a while and calm down. Then I go right back to the problem and try to tackle it from a different angle. Also, going back to Concerta; it seems to me that Concerta has no risk of dependency or side affects; that I can tell. So give it a try.

    video games - adam garcia - Mar 9th 2007
     hi my name is adam im 17 and i have ADHD and im taking adderal i dont know if thats how its spelled but i have played video games prefferably XBOX but playing video games is like the only thing im good at i cant get a job and ive almost flunked out of school like 8 times but video games are the only thing that keeps me at attention for long periods of time and they keep me calm and they let me relieve stress we tried sending to bootcamp to help control me but that didnt work is it normal for an ADHD teen to have a sevre anger problem because when i dont take my medication the littleist thing set me off and i flip out but why do video games keep me calm can somebody who reads this please email me and give me some advice on my anger problem or the video games

    credentials neuro biofeedback - Ardena - Sep 25th 2006

    I have my son in neuro biofeedback "treatment" for his ADHD. The treatment cost $150.00/session and the clinician insisted on 3 sessions/week (combining biofeedback and talk-therapy). After 30 sessions I began questioning the effectiveness - I wanted to take my son to a psychiatrist for ADHD evaluation - the clinician told me that his previous diagnosis was perhaps incorrect and my son did not have ADHD - he told me to take my son off of his meds & that he needed to continue treatments otherwise he may suffer from future OCD and/or bi polar. Should I be concerned??? Any suggestions? - Ardena

    Editor's Note: I (Dr. Dombeck) think you should be concerned about a few things here. First, treatment should never be an ongoing, open-ended thing. You should be able to expect that certain treatment goals will be met by certain times, and if those goals are not met, the treatment may not be effective. How is this clinician defining success for the treatment he is offering your son? How is he measuring this effectiveness? Second, there is no reason to think, that I am aware of, that anyone would get OCD or Bipolar or ADHD for that matter if they go off a treatment. These conditions either happen or don't happen - they are not linked to coming off a therapy or not. If your son was suddenly diagnosable with Bipolar disorder after coming off neurofeedback, it'd be a reasonably sure bet that he already had Bipolar disorder. Third, neurofeedback is not a reasonable treatment for Bipolar disorder if that is what your son has. Really, the only good treatment for Bipolar disorder involves medication. Fourth, talk therapy is not a reasonable treatment for ADHD, and especially not with children (Benefiting from talk therapy requires an attention span and a well developed frontal lobe, neither of which young children have in abundance). I would recommend getting a third party Psychiatrist diagnosis, which will hopefully be able to establish what conditions are really present and what are not and hook you into treatments that will be maximally helpful. The only downside to working with a Psychiatrist is that he/she may not be open to non-medical but nevertheless useful therapies. But this is a small downside compared to getting your son on a proper therapy regime.

    how does the machine work? - futureboy - Sep 15th 2006
    can someone who has got the machine tell how well it works? is it good? worth the money? problems? i saw http://www.adhdnews.com/forum/forum_posts.asp?TID=21581&PN=1&TPN=3 but not many answers its alot of money and i don't want to go for it if its not all the "nasa" its cracked up to be!!!

    Game Console - Nicole - Jul 18th 2006
    The game console is $584.00. I would like one for my 9 year old son but that is very expensive for me.

    IT WORKS! - Ms. K Paradise - Apr 18th 2006
    I am a high school English teacher with ADHD, so I see A LOT of ADHD children, both diagnosed and undiagnosed, whose parents are trying a variety of treatments, from behavior modification to reward systems to medication and therapy. I also have an ADHD son who also experienced traumatic birth (studies have found a very high correlation between traumatic birth and anger). He is now 16 years old and on the outside appears to be the perfect young man: handsome, athletically-inclined, has many friends and has very good social skills in many situations and loves to do hard, physical labor. Unfortunately, he has dropped out of all sports, attends an alternative school for children with behavior problems, changes friends frequently, and becomes aggressive with authority figures in school and at home. His moods are frequently changing and have a real impact on the family. He has struggled with focusing problems in school, high intelligence but low grades, and negative anger issues (For example, this week he responds negatively to every comment we make and complains about every person we might mention. He is a loving, sensitive boy but also quick to anger, and he often is not even aware of these behaviors.) Nine years ago (1997), Jimmy and I went to what was then called Biofeedback Training with a very progressive psychiatrist. Due to ADHD and other circumstances (sleep problems, an active alcoholic in the household, stress and my repeated illnesses), we were both a mess. At first, we could barely even stay in our seats because our restless legs took over and we could focus on nothing else! My problems were inability to sleep restfully, anxiety, severe premenstrual stress, and repeated illnesses (due to Candida albicans, I eventually discovered). I was then 40 years old. Jimmy's problems were mainly focusing, EXCESSIVE hyperactivity, refusal to sleep, low emotional self-awareness, over-assertiveness, quick mood changes, intense anger and frustration, and trouble processing information due to his hyperactivity. He was 7 years old at the time. By the time we stopped Biofeedback Training, I was able to refocus, create greater calm when necessary, sleep more restfully than ever in my life, and take better control of my life and my parenting. As for Jimmy? When we compared his ending TOVA test to his beginning TOVA test, the results were off the chart in every area in which we were concerned! Dr. Smith was simply amazed because Jimmy showed more progress than had ever been expected in the past. Unfortunately, the strains of alcoholism, my increasing poor health, separation, and impending divorce provided too many obstacles to treatment, because when his father moved out of the house, Jessup refused to attend any more biofeedback sessions. He was ADAMANT and no amount of rationale, demanding, bribing would change his mind. Dr. Smith and I decided to allow Jimmy a break and plan to return to biofeedback when things at home has settled somewhat. Within a year, the divorce was final and we moved to another state. MY MAIN POINT IS THAT NEUROFEEDBACK WORKS! Jimmy only went through HALF of the training program -- JUST IMAGINE what kind of progress he would have had if we had been able to finish the program! I have no doubt that neurofeedback is an incredible tool for people suffering with problems such as inability to focus, depression, sleep disorders, memory problems, hyperactivity, hypoactivity, stress, premenstrual stress, panic attacks, etc. I just came online today to look for a way for Jimmy to deal with his anger and mood swings without having to go through "Anger Management Class" (because he simply REFUSES to go that route). I was quickly reminded that we already discovered an effective tool for Jimmy -- now we just have to return to the program! Good luck and God bless you (no offense intended), K. Paradise

    Access to Playstation - Jo Ramsfield - Apr 12th 2006

    What is the cost of this game equipment and software? Where can you get it? I have a 10 year old I'd like to try it on along with her 35 year old father. She has not been diagnosed with ADHD but has the signs. Her father has been diagnosed and really needs something to help him. Thank you!

    Mark Dombeck, Ph.D. Responds: The playstation EEG system is available through CyberLearning Technology, LLC, 663 S. Rancho Santa Fe., #663, San Marcos, CA 92078. Their telephone number is 760-613-0901. Their website is http://www.smartbraingames.com. I'm not sure of the cost of this equiptment, but I believe there is a consumer model available at a relatively reasonable price.

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