Miscellaneous Issues

There is some controversy among NF practitioners about which site-frequency combinations should be used for specific syndromes. For example, even in the case of ADHD in which the increase b (or SMR)-decrease 0 band amplitude protocol is used extensively, there are some who argue that decreasing 0 is sufficient or that increasing only SMR (or b) or some narrower band within one or the other of those frequency bands is most efficient and speeds treatment. To the author's knowledge, however, these claims have not been supported by scientific research. An area of some disagreement among practitioners is whether the time of day of NF treatment needs to be matched to the individual client to conform to his or her unique biorhythms. This concern also has been voiced by some in regard to traditional medical treatments and seems worthy of further consideration. The importance of personality characteristics of the NF practitioner also is debated. It seems essential that he or she be empathic, patient, and highly skilled at motivating the client to put adequate effort into the task, e.g., knowing when to adjust EEG target and artifact thresholds to maintain an optimal reinforcement rate. These characteristics seem especially critical when working with children.

Criteria for when to terminate NF also are controversial. Some have advocated the cessation of treatment after only a few sessions if no desired changes in targeted EEG features are observed, whereas others recommend continuing through 50 or more sessions, trying various site-frequency combinations (or phase or coherence training) even if no EEG or behavioral changes are noted. The latter may cite cases in which a positive response occurred quite suddenly only after a very large number of sessions. There have been some attempts to provide specific guidelines for termination. Joel and Judith Lubar, for example, suggest termination when a client's learning curve plateaus for at least 2 weeks (or after a minimum of 25 sessions), there is approximation of normative age-based EEG criteria, and maintenance of a 50-70% reward level and 30-50% inhibit activity.

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