John F. Shackelford, Psy.D.
ADHD Testing Specialist
Serving North Dallas and Metroplex
Treatment for Anxiety
I am a clinical psychologist with thirty years experience. ADHD assessment has been my speciality over the last twelve years. I assess children as young as four and adults as old as eighty.
In our first session I do interview and testing to see if some form of ADHD is present. In assessing ADHD in children, I gather history from the parents. I then have the client take the T.O.V.A. (Test of Variable Attentions). This is a proven test based on age norms which gives objective information on their ability to pay attention and inhibit impulses. This is highly relevant information based on their actual performance, not based on surveys. Information is also gained from client ratings or parent ratings of their child.
During our second session, I attach three sensors, on top of the client's head (it's painless) and gather readings on brain wave activity. This helps determine what subtype of ADHD is present. This has relevance for what medication or what treatment to recommend.
At the end of the second session I share all the testing findings with the parents and client, or with the adult client. I then write a report which goes to the client. If they request, I send a copy of this report to their physician for possible medication. I also inform regarding the option of neurotherapy as a non-medication treatment for ADHD. See column to the right for more info.
I take most insurances. If you have met your deductible, you may only have a copay. Please call my insurance person, Roseann, at 972-932-6019 to verify and obtain details of insurance coverage. Cash clients don't need to call her.
Call me directly with non-insurance questions and to make an appointment. I keep my own schedule. 972-979-1949
To read more about types of ADHD, go to top of this page and checkout ADHD Subtypes.
The medical treatment for anxiety disorders has been benzo (like Xanex) meds or SSRI anti depressants. Benzo meds weren't meant for longterm use, yet some patients became dependent and have taken them for years. Others self-medicated their anxiety with alcohol or marijuana.
A growing option for treatment is biofeedback and neurotherapy. These are non-medication approaches. Biofeedback helps one learn to breathe and relax the body which has a calming effect on the mind as well. Relaxation is a learned skill, a tool one can use to calm themselves when the stress builds.
Neurofeedback is therapy for the brain. Those with anxiety disorders tend to have an over-aroused brain. Sophisticated Brain Mapping pinpoints the location and particular brain wave which is over-aroused.
Neurotherapy is painless and non-invasive. No electrical stimulus is applied to the brain, rather the sensors read the natural electrical activity as it arises from the brain. Because the electrical activity can be measured and displayed on the computer monitor, it can be rewarded or inhibited, depending on what the brain needs. For example, one protocol for anxiety is to train fast-wave Beta activity down at the location where it is too high.
As the locations of over-arousal are trained down, anxiety symptoms decrease. This may take 25 to 40 sessions depending on the level of imbalance. To Read More and see two common brain maps patterns, go to the top and click Anxiety Subtypes.
Testing for ADHD
Neurotherapy is biofeedback for the brain. Pioneered by Dr. Joel Lubar at the U. of Tennessee in the early 1980’s, studies have documented improvements in attention and decreases in hyperactivity with a course of neurotherapy.
Pre-treatment assessment includes administration of the QEEG which produces colored Brain Maps. These maps pinpoint which type of brain wave is causing the ADHD symptoms. These colorful brain images serve as a roadmap for efficient neurotherapy treatment.
Over a number of sessions excessive “slow-wave activity” or excessive “fast-wave activity” is reduced, resulting in better academic performance and less behavioral problems.
How Is Neurotherapy Done?
Neurotherapy treatment is done by placing a sensor or sensors on the head over the area to be addressed. No electricity is put into the head, rather electrical activity coming up through the skull is measured and seen on the computer monitor.
Because the electrical activity can be measured, it can also be reinforced. For example, a common ADHD treatment is to reduce slow-wave Theta in the frontal lobe. When the Theta wave goes down, the child is rewarded as they play a game or watch a movie. When Theta goes down, they score higher on the game or if watching a movie, they see and hear the movie better. Gradually, their brain waves are conditioned down toward more normal levels for their age.
Twice a week sessions are recommended. Twenty to thirty sessions is usually needed for Inattentive type of ADHD, and thirty to forty sessions are usually required for the hyperactive/impulsive type of ADHD.
Advantage of Neurotherapy
As you can see from the previous section on Diagnosis and Subtypes of ADHD, a medication approach can result in side effects. There are very seldom any side effects from neurotherapy. It is gentle and has a gradual effect on the brain waves. We are only treating specific areas which the Brain Maps identified as out of balance. A medication is likely to have a broad effect on the brain whereas neurotherapy is specific. We reduce slow wave in locations where it is high, and we reduce fast wave in locations where it is too high. The approach is specific, tailored to the child's EEG activity, i.e. we know what is going on in the brain and we address it specifically.
In fairness I want to clarify that stimulant medication does not necessarily cause side effects in the most common type of ADHD where there is only a slow-wave problem. In that case the right amount of stimulant can help with attention and not cause side effects. Some of the other subtypes with which have excessive fast-wave activity or a mixture of fast and slow wave activity, side effects are much more likely. Thus a medication approach become complicated. Neurotherapy can be a great option in these difficult cases.
Coverage and Fees
In most cases insurance doesn't cover, but this is gradually changing as insurance companies become aware of neurotheapy's efficacy and of parents' desire for a treatment which avoids the side effects of stimulant medication. Fees for neurotherapy may be discounted if paid in blocks of ten sessions.
Effectiveness of Neurotherapy
In November 2012, the American Academy of Pediatrics approved biofeedback and neurofeedback as a Level 1 or “best support” treatment option for children suffering from ADHD.
Arns, M., de Ridder, S., Strehl, U., Breteler, M., & Coenen, A. (2009). Efficacy of neurofeedback treatment in ADHD: the effects on inattention, impulsivity and hyperactivity: a meta analysis. Clinical EEG and Neuroscience, 40(3), 180-189.
Treatment for ADHD