My last blog provided an overview of the various psychological assessments available in practice. All are valuable tools to understand clients’ functioning; and to support them with important future decisions at any given time of their development stage.
But assessments are not only for decisions and diagnosis. When performed by skilled clinicians, discussions should leave clients with insight and an understanding of their behaviour patterns. Above all, it should provide hope, choices for the future; and opportunities for improvement or personal growth, where possible.
QEEG: (Quantified) EEG: One of the most advanced neuropsychological assessment tools available to psychology is called the QEEG. It enables a client to understand his brain-behavior connections; and empower them with skills to re-wire / re-train the brain patterns that are associated with their unwanted symptoms. This (brain) training process is based on the information obtained from the QEEG of the client. The process is described below:
- EVALUATION OF EEG DATA QUALITY
1.1 First analysis: A digital EEG 19-channel recording is performed and visually inspected by an experienced clinician for abnormal activity or anomalies; while the background rhythm is also determined. Information is also inspected by a clinical neurophysiologist for careful medical interpretation.
1.2 Secondary level of analysis: QEEG: Once the EEG raw data is returned to the clinician, a computer analysis is performed and results are displayed in the form of statistical tables and topographic maps (see pictures below). The QEEG has the ability to compare aspects of the EEG like power; relative power; symmetry; coherence; phase cross spectrum correlation; peak frequency; etc to provide in-depth detail of the client’s brain’s functioning. The QEEG also provides certain clusters of patterns that could be associated with the client’s clinical condition, complaints or problems. It is the pattern of the clustering that defines the QEEG profile of that specific individual.
1.3 Summary: EEG-to-QEEG-to-training process:
- Raw EEG data visually inspected by clinical neurophysiologist
- EEG is quantified into colour maps
- Interpretation: The colour-bar provides for easy interpretation of how far the client’s score is removed from the norm. The dark blue: Indicates values greater than -2. Orange/red indicates deviances more than +2 standard deviations from the mean of the reference group.
- Final step before Neurofeedback training commences: Clients need to understand their QEEG and the connection to their behaviour/symptoms. Terms defined in our first session includes:
EEG frequency bands
Delta 1-3 (hz): Associated with sleeping.
Theta 4-7 (hz): Theta is a slow wave activity and is associated with deep relaxation; inward focus and meditation.
Alpha 8-12 (hz): Alpha occurs when a person relaxes. It is associated with relaxation; and passive attention.
Beta 13-25 (hz): Low beta (13-15 hz) is the mental state that maintains alertness and focus, as well as decreased anxiety and impulsivity. Mid Beta (14-20 hz) is the mental activity when you feel wide awake, focused and orientated towards your task; while High beta (20-28 hz) is a busy brain, stormy; and associated with rumination and anxiety.
Z Scores: Z scores indicate whether there is deficient or excessive brain activity in a given frequency; as well as how far that activity is deviant from the norm. Z scores are computed and displayed for each of the measurements that the QEEG provide eg absolute power, relative power, coherence, frequency, and symmetry.
Topographic maps: Provides a visual display of clusters and distribution of the bandwidths: Delta, Theta, Alpha and Beta activity. The colour-bar (as shown above) provides for easy interpretation of how far the client’s score is removed from the norm. The dark blue highlighted values indicated differences greater than minus 2, while the orange/red colours indicate deviances more than plus 2 standard deviations from the mean of the reference group. (refer to paragraph 1.3)
Your clinician should have a good understanding of brain functioning; brain structures and networks, which require a background in neuroscience. Interpretation of the location of the dysregulation; or imbalances with reference to the client’s symptoms, requires further clinical correlation.
Markers for ADHD usually include incorrect Theta/ HiBeta ratios; Alpha asymmetry is often disturbed; while dominant frontal slow wave activity is often present. Similarly the brain offers markers (patterns) for anxiety; depression; OCD; insomnia and other disorders or learning problems. These patterns are based on neuroscientific research and is targeted in the Neurofeedback training sessions.
- NEUROFEEDBACK TRAINING: For more information on the Neurofeedback Training process please visit www.drvdryst.co.za.