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Evaluation and Remediation of Attentional Deficits

Susan F. Othmer and Siegfried Othmer, Ph.D.
December, 1992

Page 2 of 3
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INDIVIDUAL CASE SUMMARIES
JC is a five-year-old boy with ADHD and oppositional behavior. He was aggressive; he had difficulty falling asleep. His history included a head injury as an infant. EEG training was done at Cz with SMR. Changes observed with EEG training included improved school and home behavior, and higher academic skills. Figure 2 shows the T.O.V.A. data for this child. The first test was done after ten sessions of EEG training had already been performed, and behavior had already shown improvement. Nevertheless, inattention, response time, and variability scored far beyond norms. The retest in this case was done after a total of twenty-five sessions, and show all scores to be within one standard deviation of norms. This demonstrates that very dramatic normalization of attention variables can occur in as few as 15 sessions.

Figure 2

Figure 2. T.O.V.A. data for JC (oppositional behavior; M; age 5) at sessions 10 and 25.

MS is a 16-year-old boy with ADHD, anxiety, panic attacks, and phobias. His history included long labor and a head injury at age 5. SMR training was undertaken at Cz. Figure 3 shows his T.O.V.A. data. Normalization of scores was achieved within twenty sessions of EEG training. Additionally, his hand writing has improved; he is enunciating more clearly; and his grades have improved. No more panic attacks have been reported.

Figure 3

Figure 3. T.O.V.A. data for MS (anxiety; M; age 16)

MW is a 12-year-old boy with ADHD and oppositional behavior. He reported frequent stomachaches and many fears. He was described as a deep sleeper. He is taking Cylert for his ADHD. He was trained with the SMR protocol at Cz except for a single session at C4. Figure 4 shows his T.O.V.A. data. Impulsivity normalized. Also, his school performance improved. He was able to reduce his Cylert dose to half. He is no longer angry or oppositional, and his sleep is improved.

Figure 4

Figure 4. T.O.V.A. data for MW (oppositional; M; age 12)

CT is a 13-year-old girl with ADHD, dyslexia, and frequent headaches. She undertook the EEG training primarily for the reading disorder. She was undergoing concurrent educational therapy. EEG training used the beta protocol at C3, Cz, and Pz, successively. Whereas ADHD was not the primary complaint in this case, T.O.V.A. data were nevertheless acquired, and the results are given in Figure 5. The data indicate significant improvement in impulsivity and inattention. There was significant improvement in reading skills, and she is no longer reporting headaches.

Figure 5

Figure 5. T.O.V.A. data for CT (dyslexia; F; age 13)

JS is a boy of age 7 with ADHD and depressive symptoms. He is slow in completing work. He has a history of early stammering. EEG training used the beta protocol at C3. Figure 6 shows the T.O.V.A. data for JS. Improvement was demonstrated in all four categories, with significant change in impulsivity, reaction time, and variability. His attention improved. He is now more talkative, and happier.

Figure 6

Figure 6. T.O.V.A. data for JS (depression; M; age 7)

MT is an 8-year-old boy with ADHD whose primary complaint was night terrors. EEG training was performed with the beta protocol at Cz. Figure 7 shows the resulting T.O.V.A. data. Both impulsivity and variability improved significantly with 20 sessions of EEG training. The night terrors also subsided.

Figure 7

Figure 7. T.O.V.A. data for MT (night terrors; M; age 8)

AK is a 13-year-old girl with ADHD. She had very low self- esteem, poor reading comprehension, and was somewhat immature. Her history includes an unidentified illness at three months which changed her subsequent behavior. She suffered a head injury in the 5th grade. The biofeedback protocol was beta at Cz for the first 20 sessions, and SMR at Cz for the second 20. The high impulsivity score would have argued for SMR; however, beta was chosen for other reasons. Whereas some behavioral improvement was seen, the impulsivity actually worsened with the beta training, as seen in Figure 8. SMR training was then adopted to address the impulsivity in the second series of 20 sessions. Impulsivity and inattention improved significantly with the SMR protocol. AK is also acting more maturely. She is calmer, better organized, and expresses herself better verbally and in writing. She is clearly happier.

Figure 8

Figure 8. T.O.V.A. data for AK (poor reading; F; age 13)

EP is an 8-year-old boy with ADHD, oppositional-defiant disorder, obsessive-compulsive disorder, and motor tics. He suffers from anxiety, nightmares, and stuttering. He benefited from Ritalin and was taking it when initiating EEG training. Figure 9 shows the T.O.V.A. results for this boy. The first data set was acquired off Ritalin. The impulsivity score was very high, and the subject found the test so challenging that the response time data did not have sufficient statistics to be valid, due to excessive anticipatory responses (impulsivity). Ritalin was administered immediately after the first test. The second data set was acquired two hours later, and demonstrates highly significant effects on the T.O.V.A. scores. SMR training at Cz was employed. The third test was administered after twenty training sessions and after EP had been off Ritalin for a week. All parameters showed improvement with respect to pre-training no-Ritalin baselines. They do not quite match on- Ritalin scores, but are nevertheless largely within age-appropriate norms (scores lower than +1). Other changes noted include that he appears more self-aware, he is more affectionate, and recovers more quickly from being out of control.

Figure 9

Figure 9. T.O.V.A. data for EP (oppositional; M; age 8)

JT is a boy of age 11 with ADHD and oppositional behavior. He has anxiety, poor social skills, and poor verbal expression. It is difficult for him to get to sleep. His history includes chronic ear infections and a head injury at age 2. He exhibits motor tics on Cylert. His medications include Dexedrine and Tofranil. The EEG training protocol was SMR at Cz. The T.O.V.A. data are shown in Figure 10. Whereas inattention improved significantly, we also observe significant degradation of the variability score. This is the only instance of a significant performance decrease in a parameter in the entire data set. EEG training is ongoing. Improvements were noted in his sleep patterns. He is becoming more self- aware, and less oppositional about chores. He is able to express emotions better. His medication doses have been reduced.

Figure 10

Figure 10. T.O.V.A. data for JT (oppositional; M; age 11)