Training the brain to pay attention

2013-09-23 00:00

WAS trying hard to get the dolphin to swim down to the sea bed, but it wasn’t co-operating. My goal was to make it reach some treasure boxes and my only connection to it was an EEG armband measuring brain waves to gauge my level of attention.

The technology I was using is part of a programme offered by a company called Bio-Link, which uses a form of neurofeedback it says can teach children skills to improve concentration and focus (see box). The programme costs R4 300 for the recommended 40 sessions plus assessment. The company, part of a growing global industry offering “brain training”, was founded by University of the Free State chemistry professor Deon Visser and his wife Karin, whose two sons have attention deficit hyperactivity disorder (ADHD). Their older boy also has Asperger’s Syndrome.

In an interview, Visser said that after some research a few years ago, they bought a system that uses hemoencephalography biofeedback (HEG), initially to help their elder son. The younger one also used it after he was diagnosed.

Later, they came across Play Attention, a programme that uses a system developed to train pilots to pay attention, and invested in that too.

“Both sons are [now] off medication and the older one, who we were told would never function in a normal school, is in a normal school completing Grade 6 with an average of 65%. They don’t use the systems anymore,” he said.

The Vissers began helping other children, their company grew and it now has over 50 branches around the country, including six in KwaZulu-Natal. Visser said that anyone can benefit from neurofeedback, although his company has chosen to focus on children.

Many of Bio-Link’s clients are children who have one or other form of ADHD, and according to Kathy Thyssen, holder of the Durban franchise, most parents who approach them do so before trying Ritalin, or are looking for an alternative to the drug, which can have adverse side effects.

In Pietermaritzburg, one such parent is Aneesa Deen Mohammed, whose daughter Miriam (10) was diagnosed with attention deficit disorder (ADD) last year. She was prescribed Ritalin by her doctor but it affected her badly and she began suffering from insomnia and stopped eating.

Mohammed took Miriam to the Maritzburg branch of Bio-Link, run by Jenna Hornby, where she did the recommended 40 sessions. “She didn’t show a big improvement — it was less than 30% — but it was more than with Ritalin, and there were no side effects,” said Mohammed.

“We decided to try another 40 sessions. I’m quite confident that it’s worth it. This is more natural than drugs and her teachers have noticed a difference. She has good days and bad days … but she is able to concentrate for longer and can complete tasks within the required time.”

Hornby said that normally, it takes about six months or 20 sessions before a change is seen in concentration, and sessions must be attended consistently.

Abongwe Bhusa (6), in Grade 1 at a school on the Bluff, was taken to Bio-Link in Durban because his teacher said that he wasn’t paying attention. “We’ve seen an improvement at home and the teacher says he’s improved a lot. He used to disturb other children when he’d finished his work but now he doesn’t,” said his mother, nurse Teesh Bhusa. He’s been going for four months — about 32 sessions. She said her husband, Unathi Bhusa, is a doctor and is “happy” with the programme.

Hilton mother Julie Louw said Bio-Link’s programme appears to have had a calming effect on her nine-year-old son Liam, who has ADD and is taking Concerta, as well as going to occupational therapy (OT) and speech therapy.

“Liam was tested and it was suggested he do 40 sessions. About halfway through we started noticing changes at home and his teacher noticed that he was concentrating better,” she said. “He’s never been able to sit and watch TV, for example, but now he can sit and watch a movie. Homework used to be a nightmare but it got easier.”

The test she speaks of is the Tova (Test of Variable Attention), which helps to assess a person’s attention and impulse control. Bio-Link administers it to determine if children are likely to benefit from intervention. The test is also given at the end of the recommended period to measure if there has been any improvement.

Louw says that whereas Liam’s test results before doing the 40 sessions were “way out”, his results were normal on being retested afterwards.

Liam’s doctor is Dr Ralph Gilbert, who is based in Hilton and has an interest in treating children with ADHD. He believes there is value in bio-feedback in the management of ADHD and ADD. “There is enough research to show that it does help, and that the effects are likely to be lasting as it trains the brain to concentrate, and probably creates effective neural pathways when it come to the task of focusing and not being easily distracted,” he said.

Not everyone is as positive. Thyssen, a former teacher who comes from a family of ADHD sufferers, said she’s found that teachers are often reluctant to attibute an improvement in pupils to Bio-Link. “They’ll say it’s because the child has matured,” she said.

“And parents are often doubtful, even when there is an improvement.”

One expert, who did not wish to be named, also said that where a child has seen other professionals, it’s difficult to say exactly what has helped them.

Visser emphasised that Bio-Link is not “the only solution to ADHD, etc. What we do will add to all the other treatment (pharmacology, OT, speech therapy) and what we do works better if the parents get involved.”

• See


A KIND of biofeedback for the brain, neurofeedback is said by practitioners to enable patients with a host of neurological conditions – including ADHD, autism, depression and anxiety — to alter their own brainwaves through practice and repetition.

• Although controversial, neurofeedback received a boost earlier this year when a study done by a team at the University of Montreal was published showing that patients who received neurofeedback experienced improvements in their visual and auditory attention levels, and — most notably — MRI scans revealed that the brains of those patients showed structural changes in regions linked to attention skills.

PROFESSOR Deon Visser explains: “Bio-Link uses two different measuring devices, namely an EEG device from Play Attention and a nIR HEG device. Both measure concentration and give the user immediate feedback of increased or dwindling concentration. The first device does it by measuring changes in the EEG patterns of the brain and the other does it by measuring changes in blood oxygenation in the frontal lobes by way of near Infrared spectroscopy. As concentration increases, the brain uses more oxygen. This is what is measured and communicated to the computer. “The technique is quite simple: we make use of the fact that the brain is neuroplastic — it can learn new skills. Concentration and focus are skills. The training works with a reward process. If you are, for example, watching a DVD on our computer, it will keep playing for as long as your concentration levels are high, but if it dwindles, the DVD will stop. It can only play again if you regain a high level of concentration. Your brain controls what is happening on the screen through concentration. With repetition, subjects get better, building new neuronal pathways and learning to focus on a task for longer periods.”

CHILDREN with attention deficit hyperactivity disorder (ADHD) have an unusually short attention span and become easily distracted. They are also overactive and restless. Attention deficit disorder (ADD) is a form of ADHD where the person is mostly inattentive.

What is ADHD and add?

V Teesh Bhusa Durban mother

“We’ve seen an improvement at home and the teacher says he’s improved a lot. He used to disturb other children when he’d finished his work but now he doesn’t.”

V Julie Louw Hilton mother

“Liam was tested and it was suggested he do 40 sessions. About halfway through, we started noticing changes at home and his teacher noticed that he was concentrating better … He’s never been able to sit and watch TV, for example, but now he can sit and watch a movie. Homework used to be a nightmare but it got easier.”

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