Our Assessment and Treatment Steps

1. Assessment (approx 3.5 hours):

An assessment for an executive or athlete trying to optimize their performance will be different than that of a child with ADHD. The following tactics may or may not be utilized in an assessment.

  • Interview and history taking
    • During this time the history of the client’s strengths and difficulties are reviewed and any available reports are discussed. For children these may include school or psychological reports. Clients or parents are asked to fill out questionnaires appropriate to the problems they are reporting.
  • Review of previous assessments, if applicable
  • Continuous Performance Tests: Test of Variables of Attention (TOVA) & Intermediate Visual Auditory continuous performance test (IVA)
    • The client is also given the TOVA (test of variables of attention) and/or the IVA (Intermediate Visual and Auditory) continuous performance test. These are the most widely used computerized tests for such factors as attention span, impulsivity and variability of response time, which are among the key factors in Attention Deficit Disorder but are also factors in a number of other problems including learning difficulties, Tourette’s, anxiety problems, Asperger’s, dysphoria and even athletic performance. These tests involve pressing a button when a target appears on the screen and inhibiting that response when a non-target appears.
  • EEG Assessment
    • This is a simple painless procedure which involves placing 3 small sensors (one on the scalp and one on each ear lobe) using EEG paste. Data collection takes only a few minutes. For example, in attention span difficulties one may see a predominance of slow wave activity; with anxiety and ruminations there may be an increase in fast wave activity.
  • Abbreviated Training Session
  • Questionnaires and Behavior Check-lists
  • With adolescents and adults, a ‘stress-test’ may be done.
    • This demonstrates to the client how their respiration, heart-rate, skin temperature, skin conduction, and muscle tension varies with even a minor mental stress such as math.
  • CNS Vital Signs Neuropsychology Assessment

The results of all of the procedures are discussed in the context of suitability for training and a demonstration of the training programs is given.

2. Perceptual Cognitive Attention Assessment with Cognisens Neurotracker (approx 2.5 hours)

  • This evaluation is five 1/2 hour sessions that need to take place within a two week time period.
  • This evaluation provides the client with a detailed baseline assessment pertaining to their selective, distributed, dynamic, and sustained ability to pay attention.
  • At the completion of the EEG training clients will be reassessed to determine their progress.

3. Training (50 minutes/session):

Training usually takes between 40 and 60 sessions, although some adult clients have taken fewer than 20 sessions to reach their goals. Children who have extreme hyperactivity and/or learning disabilities or Asperger’s in addition to attentional problems take more sessions than those who are simply ADD and inattentive. Progress testing is routinely carried out after at least 40 sessions and this is done without additional cost.

By the end of training, most clients with ADHD no longer require drugs as their symptoms no longer warrant medication. ADHD clients who are on a stimulant medication when they begin training remain on their medication until the neurofeedback training takes effect. The only time we request that a person be off stimulant medication is for the first assessment interview.

Training sessions involving the steps listed below. The goal is optimal performance for each individual. Each client will receive a EmWave PSR (www.heartmath.com) to train Heart Rate Variability to promote emotional well-being and self-regulation. Each client will also receive the CogMed Working Memory Training Program.

  1. Relaxed and Alert Mental State:
    • Regulation of EDR (alertness level) and skin temperature using Biofeedback with respiration, pulse, muscle tension, RSA, as required
  2. Focused Concentration using Neurofeedback
    • Reduction in Theta Amplitude & Variability. Theta brainwave activity is a marker for ADD, associated with “tuning out”.
    • Increase SMR & Beta activity in order to be calm and focused.

    Goal: to gain a more flexible brain and learn self regulation of individual brain wave states. Be able to remain relaxed, alert and focused without fidgeting.

4. Progress testing after 40 sessions. The initial assessment battery is repeated at NO CHARGE and results are discussed verbally with Registered Psychologist John Stevenson (Written report fee is $200).