St. Augustine Occupational Therapist Uses Neurofeedback to Support Children’s Self-Regulation

For the parent of a child with ADHD, autism, anxiety or difficulty regulating emotions, life can sometimes feel like an endless search for the thing that helps. Your child can’t sit still. Homework becomes a battle. Meltdowns seem to come from nowhere. Sleep is inconsistent. And when medication enters the conversation, some parents naturally wonder: Is there anything else we can try? One option families may encounter is neurofeedback — and despite its futuristic-sounding name, the basic idea is surprisingly simple.

Think about working out at the gym. You could perform 20 squats without a mirror and have no idea that your knees are turning inward or your posture is wrong. Put a mirror in front of you, however, and suddenly your body receives information about what it is doing. You adjust. Over time, better form can become more automatic. Neurofeedback works somewhat like a mirror for the brain. Small sensors placed on the scalp measure electrical brain activity. They do not put electricity into the brain. Instead, a computer monitors what the brain is doing and provides immediate feedback — often through changes in sound, music, video or another sensory experience.

“The monitor helps to show a brain its own information in real time,” explains Liana Valla, a St. Augustine occupational therapist, board-certified neurofeedback clinician and owner of VitalTherapy. The goal is to help the nervous system become better at regulating itself. And regulation can affect far more than whether a child can sit quietly. Our nervous system plays a role in attention, sleep, emotional responses, sensory processing and our ability to shift between being alert and being calm. That is why neurofeedback is sometimes incorporated into occupational therapy for children struggling with attention, learning, sensory regulation, sleep or emotional control. At VitalTherapy, EEG/biofeedback training is one of several tools used within occupational therapy to improve everyday functioning.

Traditional neurofeedback commonly works with recognizable EEG frequency bands, essentially helping the brain practice changing particular patterns of electrical activity. Some ADHD research, for example, has focused on training relationships between theta and beta brain-wave activity.

Infra-low-frequency neurofeedback, including the Othmer Method used by Valla, looks at extremely slow activity — below the frequency ranges typically emphasized in conventional neurofeedback. Rather than consciously trying to “make” a certain brain wave happen, the person receives continuous feedback while the clinician adjusts the training based on how the nervous system responds. In parent language: one approach is more like practicing a particular movement; the other is more like helping the nervous system find a more comfortable operating speed.

What does the child actually do during treatment sessions? They may watch a movie or play a game while the computer and clinician monitor their brain activity. When the brain begins moving outside the parameters being trained, the movie may dim, the picture may change or the sound may briefly pause. When the brain moves back toward the desired pattern, the experience returns to normal. The child doesn’t have to understand what is happening or consciously “fix” anything. The brain receives the feedback. The child isn't being told to “try harder,” sit still, control an impulse or explain what they are feeling. The brain is simply receiving information about its own activity, over and over, with an opportunity to respond and adapt.

For parents, that can offer a different way of looking at behaviors that are often frustrating or difficult to understand. Instead of asking, “Why can’t my child just focus?” or “Why does something so small cause such a big reaction?” neurofeedback considers another possibility: perhaps the nervous system is having difficulty regulating itself. Attention, sleep, sensory processing, emotional regulation and even the ability to transition smoothly from one task to another are all influenced by the nervous system. A dysregulated nervous system isn’t necessarily a damaged nervous system. Some children simply have a harder time shifting gears, moving from excited to calm, distracted to focused, frustrated to settled or awake to asleep. Genetics, neurodevelopment, temperament, sensory processing, sleep and stress can all influence how easily a child makes those transitions. The premise behind neurofeedback is to give the brain more information about what it is doing in real time, helping it practice those regulatory shifts. Neurofeedback isn’t about forcing a child’s brain to behave or repeatedly reminding a child to make a better choice. It offers the brain information it normally cannot see — a real-time reflection of its own activity. And just like checking your form in a mirror at the gym, sometimes seeing what is happening is the first step toward learning a better pattern.