Coaching parents, coaching kids; [CITY LIGHTS Edition]

EDUCATION

Sara Silber is an educational psychologist and family and marriage therapist.





 

Bioresonance Therapy - An Effective Technique
General Health and Attention Hyperactivity Disorder (ADHD) Aspects

Sara B. Silber

reprinted from ESRA (English-speaking Residents Association) magazine issue 108, February/March 2001

Sara Silber went to Ramat Hasharon to interview Liora Epstein, Bioresonance Therapist, about this little known, but effective treatment. Silber combined her personal successful experience with the technique, her research on the subject and her interview with Epstein to get a good working knowledge of it for this article.

If you suffer from a health problem, Bioresonance Therapy (henceforth called BT) may be the treatment you've been looking for. Recharging your body's batteries is the best analogy I can find to describe it. It is a computerized biophysical system of medicine using the Bicom machine. In Germany about one in seventy doctors use it as part of their regular practice and it is also used widely in Sweden, England, Switzerland and Austria.  Doctors who use it are very enthusiastic about its effectiveness. It represents a new era in electromagnetic treatment. Applied by NASA in American manned spacecraft, this method can maintain and support health and life functions and restore health in cases of illness.

Among the many indications it is best used in cases of stress-related illnesses, allergies, viruses, lack of concentration, headaches, migraine, weather front disturbance, parasites, vegetative complaints, rheumatic pain, infections and circulatory difficulties. It is unique for psychic problems like depression and sleeping disorders. The therapy is also useful for detoxification of the body.

Our bodies have electrical conductivity through which cell transmissions must navigate in order to communicate instructions that promote necessary bodily processes and well-being. Cells transmit these wave-like vibrations in addition to biochemical signals that may be sent. Every item on earth has its specific frequency of vibration and when interacting with the body, that frequency can enhance or interfere with the body's normal conductivity.

Prot. Cyril Smith of Salford University, UK, has demonstrated that allergic subjects may develop allergic symptoms not only to the presence of a sealed allergen in a glass tube but also to the frequency transmissions of the same allergen generated by means of an electronic resonator. It is evident that it is the physical vibrational properties of matter, rather than their chemical properties, that trigger the allergic response.

Allergens, environmental pollution, toxins, physical stress and mental stress all cause changes in our body's electrical conductivity and hence reduce the ability of our body to function optimally. It is accepted that stress (chemical, physical and mental) overextends the endocrine system, the hypothalamus-pituitary-adrenal axis in particular, and weakens the immune system. People with compromised immune systems tend to develop chronic health problems such as abnormal tiredness, food intolerances and allergic reactions. Prolonged exposure to stress may lead to degenerative disease. Conventional medicine is often merely palliative in the treatment of chronic disease.

The Bioresonance Therapist first analyses which substances are having a negative influence on the patient's conductivity. In the examination the patient, who is seated and fully clothed, holds metal bars which are attached to the Bicom machine which is connected to the computer. The frequencies of many substances are sent into the patient and the meter on the Bicom shows their effect on him. The patient feels nothing but can observe the meter along with the therapist. More than 20,000 substances can be tested! The culprits responsible for the patient's abnormal conductivity are identified. The therapist can then neutralize the effects of the negative substances by 'jamming' their frequencies, much like an enemy's radio waves can be jammed during wartime. This is done by passing back to the patient phase-inverted vibrations which are mirror images of the frequencies of the negative substances.

 The therapist also strengthens the patient's own healthy vibrations in treatment. The internal milieu of the body is rehabilitated as if a polluted and clogged river were cleaned up and now the clear stream can move along its natural path and nourish life. This is an oversimplification of the therapy, of course, but the best I can offer within the scope of this article.  I will now address the issue of bioresonance treatment  and attention deficit disorder.

Bioresonance and Attention Deficit Disorder

Children with ADHD often have a disturbed internal "milieu' causing some of their symptoms. Food sensitivities and allergies are both a result of this disturbance and a possible cause of some symptoms such as inattention and hyperactivity.  It has long been observed that children with attention and behavioural problems have a sweet tooth. The basis for this, says Epstein, is the probable presence of sugar-craving parasites in the child's system. Often these parasites will not show up in a lab test as they may be existing in the inner folds of the' intestine. These same parasites will sometimes cause toileting problems and the child may become averse to going to the bathroom. The BR therapist will determine the existence of parasites within the body and if they are present, she will have the machine pass onto the patient the frequencies that will cause the environment to be disfavourable to the parasites. This will decrease their numbers and their negative impact on the child's system. Rebalancing and cleansing the child's system is the first step towards health.

Hyperactivity, impulsivity and concentration problems are often allergic reactions to an unidentified substance and the therapist will test for food and chemical allergens as described previously. The frequencies of 20,000 substances will be tested including many foods, additives, medicines, cleaning agents, sprays used in the environment, chemicals used in toys and dolls' hair, animals, bacteria and viruses, radiation from TV and computer, pollens, dust, toxic metals and more. The machine's meter displays the child's inner reactions to all of the above and the abnormal reactions are indicated. Depending on what the allergen is the child will either need to avoid or limit his exposure to it or alternatively, the machine can neutralise the effect of the allergen on the child's system so that it will no longer create havoc.

Epstein has found that all the ADHD children referred to her reacted negatively to one or another substance and that once it was eliminated as a factor, the child's concentration improved significantly, according to both the child's and the parents' reports.

The therapist will then proceed to test the frequencies of important endocrine substances on the child's system and will determine if there is a deficiency in any of these by the reading on the meter. (If a child is deficient in an important endocrine chemical then his/her conductivity will improve as a result of introducing it into the system. If the child is not deficient. then it should not have an effect). We know that ADHD children have a chemical imbalance in the frontal lobe of the brain. If this deficiency is identified and replenished, then the neuro-transmitters can function optimally and the messages of control of attention and behavior can be received by the neurons involved. The child can then exercise control over these functions.

The most common way today of replenishing the dopamine chemical deficiency in ADHD children is through Ritalin medication. Using the Bicom, the frequencies of the required deficient endocrine substances can be passed onto the child through the machine, and the required positive changes can be implemented, without the possible side effects that some children have from Ritalin medication. This is great news for parents and kids who are reluctant to use stimulant medication.  If a child needs to continue on Ritalin for a while, until the BR therapy kicks in and while he has negative effects from the Ritalin, these can be neutralised by the Bicom.

Lastly, various homeopathic remedies can be tested on the child, such as Bach Flowers, vitamins and minerals, to see if these have a positive effect on the child’s conductivity. A personalized water “cocktail” can be made from the frequencies of newly identified beneficial substances and by drinking this the child is taking in the frequencies he/she needs for his well-being.

I left my interview with Leora Epstein exhilarated about the potential of Bioresonance Therapy and its endless possibilities for enhancing health. How much new hope and help we can now offer so many sufferers. While my focus here was on ADHD kids,  the Bicom’s benefits for many health-related problems for children and adults are just mind-boggling. Logical, scientific, neat, painless and short- term (four sessions on the average)- what more could one possibly hope for in a treatment?

In the future we can foresee that people will have in their homes their own Bicom machines with computerised frequencies of their personal health-care programs. You will be able to hook yourself up and recharge yourself back to health as needed. The Bicom has catapulted us into a new era of health-care. It has yet to be recognised by the medical establishment. Research studies still need to be done so that BT will gain scientific legitimacy. Drug companies are not funding Bicom research because there is no potential marketable drug to result from the research.

For the many people now suffering from a myriad of problems, benefits can already be gained which can change their lives and they need not wait. I myself would not hesitate to consult and be treated by a Bioresonace Therapist. In fact, it was my own cure of a persistent ear-nose –throat problem through BT that led me to inquire about its possible application to the many ADHD children whom I see in my clinical practice.

As a practitioner knowing all I now know of this therapy, I would incorporate BT testing and treatment as step one in the treatment plan of ADHD children. Other needed interventions such as counseling for parents, educational interventions, behaviour modification techniques and sensory processing exercises all have their parts to play as well. This will be dependent on the case, but first, get the internal biophysical milieu of the child in order so that he/she will have the biological, chemical, and physical basis to thrive as he/she  was meant to.

 For a comprehensive overview of bioresonance please see this website: liora-brc.com  Clinic address is Hachavatzelet 17/7, Kiryat Ono. Director: Liora Epstein. Therapist: Moran Even. Clinic tel: 03-7360887 emails: liora@liora-brc.com    or  talmoran.even@gmail.com

This is one of a continuing series of ESRA articles of ADHD that is one,of  Silber's areas of expertise. Her other articles in the series appear in ESRA issues 81,83,84,85,89,91 and 101. She welcomes comments, and ideas for future articles in this series.

Sara Silber is an American and Israeli-trained Educational Psychologist Specialist and a Certified Family & Marriage Therapist. She works extensively with ADHD children and their families. Sara and her own children and grandchildren have undergone bioresonance treatment at the above center and  successfully solved allergy and other problems. Sara occasionally  refers some of her clients to bioresonance therapy and this treatment, in conjunction with her comprehensive treatment, has proved to be  a productive combination of efforts in helping many children. Sara Silber has a private practice in Raanana, known as the Sara Silber Psychological-Educational Clinic.

clinic website: www.israelpsychology.com          clinic tel: 09-7710354

clinic address: Motzkin 23, Raanana    clinic email: sarasilber@yahoo.com

Esra Magazine, Issue 115 and Google News, July 14, 2005

By Israel News Agency Staff

Sara Silber, an educational psychologist in Israel, a specialist in family and marriage and serves as a court appointed therapist in divorce mediation, says secure control of your brain wave state and you can then control your mood, concentration, and state of consciousness.

Silber visited the Galim Institute in Ramat Gan, Israel, and spoke to Yael Langford, founder and director of the institute. Here is how neurofeedback works and how you can use it for yourself and your children.

Attention Deficit Disorder, (ADD), affects 7-12% of the population in both the US and in Israel and is usually recognized and diagnosed by age 7. With or without hyperactivity, it will affect many areas of functioning, including school performance, social skills, emotional development, marriage stability, family responsibility, and work performance.

Much research attests to the disorder having a neurological basis in the form of a biochemical imbalance which affects how the brain transmits and receives important messages from its 'neurotransmitters. Many cases have a genetic component with either a parent or a sibling also sharing the disorder.

The disorder, which can been seen among hundreds of children in Israel, can also appear as a result of difficulties during birth such as lack of oxygen. ADD adults and children are characterized as having a short attention span, difficulty completing a task that demands sustained attention, difficulty following directions, forgetfulness, disorganization and poor motivation for tasks deemed "boring" or irrelevant.

In the last 30 years it has been shown that when a person learns to monitor the pattern of his brain waves, as he can in neurofeedback training, he can improve his ability to focus and complete the task at hand. Neurological functioning will become normalized, learning ability will be enhanced and reactions to sensory input will become more efficient. It has been found that people with ADD have different brain wave patterns from other people.

To understand this let us first have a general understanding of brain waves. Don't panic - you don't have to be a neurologist to understand this simplified explanation. Different activities that we do coincide with different brain wave activity. They reflect different levels of demanded concentration and consciousness. Brain waves are measured in herzes which is a quantification of the electrical charges emitted by the brain. These can be displayed by an EEG test in Israel.

The slowest waves are delta waves which occur when we are in deep sleep. Right before we fall asleep, in the transition period before actually falling asleep, theta waves predominate. These should occur for only a few minutes a day and are related to imaginative and creative processes and to our subconscious.

The next level of activity is alpha waves which occur during relaxed wakefulness when the brain is not engaged in any specific mental or emotional activity. They can be present when mental activity is habitual and required concentration is minimal and can be achieved when eyes are closed.

Moving up, we get to beta waves which are emitted when we are alert and doing concentrated mental activity. These are the waves that correspond to school learning and performance. They are also present when we are anxious and apprehensive. ADD people have a higher predominance of theta waves than they should have - they are walking around a large part of the day in a pre-sleep wave state. Alongside this they have a much lower activity of beta waves, just those that are needed for concentrated school learning.

Some medical research in the US, Europe and in Israel has found as much as a 30% imbalance. Brain waves are moods. A person can change his mood by controlling his brainwaves. You can learn what each wave feels like and consciously bring it about. In the ADD person the goal would be to bring about a higher frequency of beta waves and lessen the frequency of the theta waves.

In biofeedback therapy, which is administrated in Israel, the person is hooked up to body monitors and to a computer and he sees in a visual display on the screen how different things that he does, such as slow breathing or visual imaging, affect various parameters of his body, such as his pulse and body temperature. Neurofeedback is a form of biofeedback where we are looking particularly at how his actions affect his brain wave pattern. Anything that can be brought to my awareness can be changed if I have an instrument telling me if I am succeeding or not. In an actual session the child sits at a monitor with a sensor on his scalp; this is painless and noninvasive. His task is defined as a computer game.

The therapist has previously analyzed his typical brain wave pattern in the diagnostic session. The child may be given the game of pushing fish in a maze on the screen. This task necessitates the use of the desired beta waves, our goal. The computer is programmed by the therapist beforehand so that whenever the child's brain achieves the desired waves that normally elude him, the fish will move forward while gobbling black dots and beeping. (the feedback to the child). The therapist gives him cues which will help him - perhaps he has to stop moving a nervous hand or stop humming.

Soon the child is able to control the fish at will by recognizing the way it feels when it moves and gobbles. While he is succeeding with the game, the child's brain is growing more stable. Positive changes will be seen after the first few meetings and will be reinforced over time but in order to become permanent at least 30 sessions will be needed. After all, the brain has to learn new behavior.

A change in the EEG will be seen when permanent change has been effected. Some experts believe that regular brain-wave training improves blood flow to particular brain regions, fostering stronger connections between cells.

Treatment in Israel is not cheap and can cost 385 shekels per session (75 USD). Parents should note that there is only a small amount of research on the technique which is why some experts dismiss the treatment Proponents in Israel and abroad counter that since neurofeedback carries no risks and has been used successfully by thousands of people, there is no reason to suppress it until costly clinical trials can be performed. Practitioners claim an 80% success rate after screening initial candidates.

For the purpose of this article the writer spoke to two parents who had had their children treated by neurofeedback, one at Galim Institute in Israel and one at an institute in the US. Both parents were very pleased with the results in which they saw significantly improved school performance and decreased impulsive behavior. They recommended the treatment if the child and parents were able to persevere. In the view of this writer, neurofeedback shows much promise in helping the ADD child with a major obstacle and should certainly be considered as an approach to treatment in those children who show high motivation to help themselves and who will persist with the many treatment sessions.

This therapy should then be undertaken in conjunction with other aspects of a complete treatment plan outlined by the child's educational psychologist. In my experience in both New York and here in Raanana and Tel Aviv, Israel with ADD children, the more encompassing the approach the more effective the total management of the ADHD problem. Neurofeedback can greatly help the attention issue and reduce the need for medication for focusing and learning.

The ADD problem, however, also needs to address family issues and the school environment. The total treatment plan will need to consider other aspects that may be responsible for the attention difficulties such as undiagnosed hidden allergy and sensory-sensitivities. Guidance will need to be given to parents and teachers as well as individual sessions with the child to see where he specifically wants help and to address his individual concerns. ADD is a multidimensional problem which requires a few tracks of help operating simultaneously.

A study which was published in 2003 in the Journal of Applied Psychophysiology and Biofeedback, a respectable journal, and the scientist was T. Fuchs et al. It says that results from this study indicate that both stimulant medication treatment and neurofeedback treatment resulted in statistically significant and clinically meaningful improvement in children with ADHD. These gains were evident on laboratory assessments of attention and on behavior ratings from parents and teachers. The improvement reported by teachers is especially noteworthy because teachers - unlike parents - were not aware of which treatment children had received. Overall, the benefits obtained by children receiving each treatment appeared to be comparable. This study adds to a growing body of literature supporting the efficacy of neurofeedback as a treatment for ADHD. Results from this study suggest that neurofeedback can be an effective treatment on its own.

No one recommendation will cover all the aspects of the difficulty; that is why parents find it so difficult to tackle the problem and get exhausted in the process. It is heartening that another approach can offer so much help to ADHD children and adults. Choices, of course, also make the decision harder as to which therapy to try first. Your professional advisor will help you determine your priorities in the total treatment plan. Understanding neurofeedback and maximizing its benefits will require years of research but the future looks bright.

Sara Silber has dealt with many ADHD children and their families in her Raanana Israel family psychology clinic, since 1981. Her practice in psychology, family therapy counseling and therapy has led her to search out alternative methods for dealing with the disorder and she has interviewed many practitioners in her research for the ideal treatment modality.
In her clinic parents are informed of various ways of approaching the problem, alongside being given her expertise on the facets that she herself deals with - behavior modification techniques, classroom modifications, sensory sensitivities, parental guidance, and family and individual counseling. Silber unique, total treatment psychological approach has brought light, success, and hope to many born-again children in Israel.

 

By Joel Leyden
Israel News Agency

Tel Aviv----April 13...... Dr. Steven Richfield, an American child psychologist, has developed a new "parent training model", one that asks parents to switch from "Parent Cop" to "Parent Coach." His resulting parenting program has received extensive national and international attention and is now being practiced in Israel by Sara Silber, a child psychologist based in Ra'anana, Israel.

In the family advice program, both mothers and fathers in Israel learn how to be proactive in helping the child develop self-talk coping skills that the child will, in time, learn to use by himself when faced with emotional or behavioral "traps".

In traditional parenting and child education, most of us tend to react to our children's misbehaviors and mistakes by giving criticism, sometimes yelling, and dishing out punishment. Mothers and fathers feel badly about it then, but hope that the child will thereby learn from his mistakes. The problem there, however, is that the child then is so involved with his hurt pride and anger at the excited parent, that he is not really open to absorbing the lesson you may be trying to teach him. In addition, even if the child is learning what they should not have done they are not really learning what they should have done.

The child parent relationship becomes strained and the child may view his excited and angry parent as against him rather than on his side. Children resist being instruments of control or criticism and will resist lessons being taught when in that frame of mind. In the Parent Coach model parents help the child anticipate common problems, avoid hazardous situations, and develop and practice the skills necessary to meet and beat challenges. The focus is not on the child's mistakes but on life skills that are needed to be learned by all the family. The child sees the parent as an ally, not an adversary. In fact, the parent even asks for coaching tips from the child. All are in it together.

The program, which was also designed for educators, child psychology clinics, schools, social workers, child welfare department workers, guidance counselors, speech, drama, and art therapists, kindergartens, grade schools, and university professionals in Israel, uses a tool called Parent Teacher Coaching Cards, which contain 20 illustrated child psychology messages.

This professional advice is relayed and discussed with the child when there is a calm atmosphere between the parent and child. One child therapy message for example is "Step Into Your Cantaloupe Skin" and it's point is to give the child sturdiness when he is feeling vulnerable, to help him armor himself emotionally when he knows he is entering into an area where he will feel weak. Maybe he will be taking an exam on a subject where he feels dumb or he will be going to a party where he knows a bully will torment him. The message teaches the child to say to himself in such a situation, "I can't expect success all the time. Hard times are a part of everyone's life. I must remember that although I feel bad when things don't work out, I am not a bad person. I do plenty of things just fine and people notice my strengths. I need to remember my successes right now, the pride I can feel and all the good things others believe about me. I can use this pride and grow a thicker "cantaloupe skin" (as opposed to having a thin banana skin) to prepare for what's coming. My "thinking side" will help me do this."

In implementing the technique the parent talks about his own daily frustrations and when he himself needed to don the cantaloupe skin in order to handle himself successfully, and the child learns the self-talk messages with the help of parental modeling.

In Israel, where children are under a high level of daily stress due to terrorism, war, and trauma, the need for emotional tools is even more pronounced. Children who hear about terror attacks in Israel need a way to bounce back to normal life in order to maintain basic sanity.

The card "Quick Recovery" can be one of a few psychology tools to help children recover from stress. Likewise, children in stressful life situations such as divorce, death of a family member, relocation, serving in Israel Defense Forces, immigration adjustments, needing to learn a new language, can all benefit from this child psychology program. With the parents comfortably talking about their own experiences in the situations depicted, the family develops a language with catch-phrases that remind and prompt children how to act. Phrases such as "quit the clowning", "quick recovery", "don't take the bait", and "beat the fear" will, in the end, be enough to coach the youngster successfully through tough situations.

This child psychology therapy approach is suitable for all Israel children, (ages 4 onwards), teens too, and is especially helpful for children with attention or learning problems. Adults find it helpful for themselves as well, as I know that I use the technique myself. When parents in Israel talk naturally, in a peaceful milieu, about the best ways to cope with probable future challenges, talk about their own tough times, and model the program's self-talk messages themselves, at home, in front of their children, the messages then become internalized by children. This internalization translates into more mature social and emotional behavior and your kids will come back for more.

The Parent Coaching Cards have been reviewed by the Jerusalem Post and several Israel magazines.
The Sara Silber Israel Child Psychology Clinic in Raanana offers workshops, seminars, and lectures on the subject to mothers, fathers, psychologists, therapists, social workers, kindergarten, gans and grade school teachers, art, speech, and drama therapists, at her clinic and throughout Israel. Sara Silber, Educational Psychologist Specialist, certified family and marriage therapist, and Israel Court approved divorce dispute mediator was trained in Israel and in the United States. Silber is bilingual, specializes in ADHD, sensory sensitivities, learning and emotional problems, and uses a wide array of therapeutic tools including play therapy. She is the exclusive authorized trainer in Israel for Dr. Steven Richfield's Parent-Coach approach, having received permission from him to bring it to Israel after she used it successfully with her child patients in her private practice. Sara Silber offers clinics and workshops to parents on the coaching cards, in English and in Hebrew, in her Raanana clinic and in schools across Israel.

Biofeedback Used to Help Hyperactive Children

ESRA Magazine #91, June 1997

Sara Silber, ESRA's Educational Consultant, continues this series of articles on Attention Deficit and Hyperactivity Disorder - a prevalent condition of many children which is widely recognized and researched.

Her other articles in the series,” Symptoms of ADHD, not within the Child’s Control”,” Helping the ADHD Child” and “Aid with an Aide for ADHD Children”, appeared in ESRA issues 83, 85, and 89 respectively. ­

     Attention Deficit and Hyperactivity Disorder Seminar, held in Haifa University School of Social Work, featured professionals from the fields of neurology, psychology, and biofeedback, each of who presented his approach in the treatment of ADHD. Pediatric Neurologist, Dr. Yaacov Sokol, stressed the importance of the accurate diagnosis of ADHD as the common symptoms of the disorder - ­impulsivity, hyperactivity and attention deficits can be mimicked by other disorders. Depression, for instance, can cause symptoms of inattention and inability to focus and complete tasks. Sleep Disorders can cause fatigue which would result as well in the inability to concentrate and perform as expected. Frustration resulting from a stressful family environment can lead to symptoms of impulsivity and restlessness which could be mistaken for ADHD hyperactivity. Accurate diagnosis is therefore the first step in formulating a proper treatment plan. Psychological and social worker assessments will assist the neurologist in making these differentiations.

     Prescribing medication for the impulsivity and hyperactivity in ADHD children is a crucial element in the management of the disorder but it is not the total plan. The psychologist will need to guide the parents on home management techniques including behavior modification programs. Teachers will need to be given guidance on how to optimize the child's learning environment. The multi-track approach to helping ADHD children was stressed by all the experts.

Sara Silber, educational psychologist specialist and certified family and marriage therapist, spoke of treatment aspects within the school system. Her case study presentation demonstrated the overlap of the many necessary interventions required. These included: I) activating the municipal social worker to intercede with the Ministry of Education to obtain a subsidy for individual help for the child within the regular classroom. 2) instruction to the teacher on use of time-out technique in the classroom, an isolating strategy used to decrease the frequency of aggressive behaviors. 3) giving instruction to parents and teachers on the use of charts and a system of consistent concrete rewards and punishments to manage behavior.  4)meeting with all the childcare helpers at one time in the child's home so that there would be clear and consistent reactions to his behaviors which would help him internalize family rules. 5) monitoring the results of different dosages of medication through use of teacher rating forms. 6) overseeing the implementation of necessary accommodations in the classroom in order to ease the child's stress, adjust expectations and demands upon him, and utilize his strengths and interests in learning.

The designated role of the case manager to one of the professionals involved in the treatment plan is crucial to its success as there are many elements that need to be integrated and followed up. One person has to have the responsibility of pulling it all together; monitoring the implementation of recommendations and decisions and coordinating all of the treatment efforts. Revisions and periodic re-evaluation of progress and needs are essential. Unfortunately, the system does not usually designate this role even though it should naturally be assumed by the municipal school psychologist. If it is not assigned nor acted upon, the parents of the ADHD child would be wise to hire the professional services of a private psychologist to act on the child's behalf.

 Key elements to classroom success were relayed but are beyond the scope of this article. Suffice it to say that there are so many accommodations that can  be tried by the teacher to help the ADHD child and all of the professionals present were urged to encourage the child's teachers to be flexible, creative, and accommodating.

  An interesting and new angle to the treatment plan of ADHD children was presented by Jason Alster, biofeedback expert. Alster is formerly from the USA where he worked at Columbia Presbyterian Medical Center and NYU Medical Center on research projects on nerve conduction, EEG technology, and sleep disorders. In Israel he works at two Kupat Cholim Maccabi Alternative Medicine Clinics in Ramat Aviv Gimmel and Netanya as well as at his private Clinic for Biofeedback, Psychophysiology and Self-Control.

  Alster has integrated different technologies in studying and helping children with ADHD. The approach he has developed and which I will describe is 5 years old. Essentially, biofeedback (BFB) is a way to train the body to alter biological functions using correcting signals. The child sits in front of the monitor, which looks similar to a video screen, to which he is hooked up with painless wires. Some of the wires are attached to electrodes which are stuck onto the child's scalp and which monitor his brain waves. The brain waves appear as visual signals, such as colored bars, on the screen. When the child daydreams some waves swell and the gold bar will shoot skyward. As attention is focused, other waves surge. BFB shows exactly what is happening in the brain at that precise moment.

    By observing his brain waves fluctuate on the monitor in reaction to various directives given by the instructor, the child learns to monitor his inner processes. He can then alter his state of mind which will alter his brain waves which in turn will affect his levels of arousal. It is known that the human mind can transform ideas and expectations into a biochemical reality. There is a strong interconnection between mind and body which, when used properly, can effect a positive change in one's health. Most people mistakenly think that they have no control over what happens inside their bodies and when they are shown that this is not true they exhibit a measure of control and derive encouragement.

  Try this simple exercise: sit comfortably, hold a thermometer, and measure your hand temperature. That is your baseline temperature. Now, shut your eyes and breathe deeply for four minutes. Think of something pleasurable that happened to you that made you feel very good at the time. Recall the memory vividly and as realistically as you can and immerse yourself into the experience, reliving it anew. You might exclaim aloud or laugh from joy. Now look at the thermometer - you have probably raised your hand temp. by some 2-5 degrees in this process.

  In BFB, the trainer hooks up the hyperactive child to physiological indicators which measure physiological stress. These indicators measure finger temp., muscle tension, sweating and brain waves. In a study done jointly by Alster and Sokol it has been shown that ADHD children have a chronically Iow level physiological stress. Their systems are hyper even if they seem to be sitting still momentarily. This chronic physiological stress will wear down, with time, the body's defenses and immune system. Some studies have pointed out the high incidence of ear, nose and throat problems, allergies, respiratory problems and sleep disorders among ADHD children. It is, therefore, important to teach ADHD kids how to relax their systems. Through visual and auditory feedback the children quickly learn how to initiate certain brain waves and other physiological parameters like GSR, CMG and temperature which equal specific physiological states.

     The children cooperate willingly and love the exercises. They are thrilled to see their body reacting visually on the monitor to their every thought and feeling. The treatment is not only painless, it is fun.          

Alster combines other elements into the BFB program to make it stronger, hasten results and shorten the number of sessions needed to complete the program to about 12. With the aid of supplementary techniques such as art therapy, dietary guidance, muscle relaxation, yoga and guided imagery techniques, Alster's Multi-Modality Holistic Biofeedback Treatment Plan is a powerful program effective in building the hyperactive child's ability to control his own behavior. In the US similar protocols called for 40 sessions of training when EEG was used alone without the addition of the supplementary techniques cited above. For many ADHD children, BFB has additionally helped them improve their concentration, better their school adjustment and experience less moodiness.

 BFB has been used in the past to help people with stress management, test phobias, social phobias and other anxiety disorders. It has also been used to alleviate symptoms of asthma, respiratory disorders, headaches, insomnia, high blood pressure and bed-wetting. Its use now to help hyperactive children is innovative. Sometimes BFB and medication are used simultaneously in treatment and sometimes BFB used alone can be sufficient to help the child be less active for periods of time. Relaxation techniques will lessen the child's anxiety. Medication dosage and psychotherapy sessions can be decreased if the child learns these techniques. The method gives tools for self-management even after the program has been completed.

 Members of Maccabi Health Insurance Plan can now receive subsidized biofeedback sessions in Maccabi alternative medicine treatment centers in Ramat Aviv Gimmel 03-6424032, and Netanya 09-8845579. Members can call and make an appointment. The clinics will subsidize 8-10 sessions and bring down the cost by 50%.

 The heightened awareness, increased knowledge and research into new treatment modalities offer more hope to parents and children with ADHD. As more of this continues we can be optimistic that they will have a brighter future.

Sara Silber, educational psychologist specialist and certified family& marriage therapist, works extensively with ADHD children and their families. She welcomes comments and ideas for future segments in this series.

Clinic tel: 09-7710354, Fax: 09-7741175.
Google News, April 2005

הכרטיסיות המנחות לפיתוח כלים חברתיים ורגשיים של ילדים

קלפי אימון- דרך ליצירת כישורים חברתיים

קרדיט: רבקה צור

"כאשר בני, אדם, נכנס לכתה א' הרגשנו שיש לו קושי להשתלב. בגלל שהוא ילד רגיש שהגיע לכתה לא קלה, הוא הצטייר כילד בעייתי וממש סבל בבית הספר". לגילה, אימו של אדם, נדלקו מיד נורות אזהרה. "הוא הילד הרביעי במשפחתנו ואנחנו הורים בעלי ניסיון, היינו כמובן מודאגים וחיפשנו דרך לתת לו את העזרה הדרושה. הגענו לקליניקה של  שרה סילבר שהיא פסיכולוגית חינוכית מומחית המטפלת בילדים ובמשפחות, היא באה לראות אותו בכתה והמליצה לנו להעביר אותו מיד לבית ספר אחר. זה היה באמצע השנה ובבית הספר רצו שנחכה עד סוף שנת הלימודים אבל  לילד נוצרה כבר סטיגמה. לכן, למרות הקושי הכרוך בכך העדפנו לקבל את חוות דעתה של שרה ולתת לו הזדמנות במקום חדש". גילה מספרת שהשיפור היה מיידי, אדם נקלט היטב והיום הוא תלמיד מצטיין בחטיבה. מה שעזר לאדם להיקלט בסביבה החדשה ולהתמודד טוב יותר עם המעבר, היה הטיפול שקבל משרה בשיטה המיוחדת של "קלפי אימון" (coaching cards) לאימון ושיפור הכישורים החברתיים, אותה הביאה מארצות הברית.

סילבר מפרטת: "השיטה פותחה על ידי ד"ר סטיבן ריצ'פילד בארה"ב והיא בנויה על כרטיסיות שמנחות את הילד בכל מיני סיטואציות בתהליך ההתפתחות הרגשית והחברתית שלו. הוא בנה את הכרטיסיות יחד עם הילדים שהיו בטיפולו וחיפשו מענה לבעיות יומיומיות שנתקלו בהן. הוא יצר  20 כרטיסיות כאשר המסר בכל כרטיסיה הוא ברור ופשוט להבנה ומלווה בציור הממחיש אותו. הכרטיסיות מחוברות על ידי טבעת למין חוברת קטנה מניר קשיח בעל ציפוי עמיד שהיא ידידותית למשתמש ואפשר לשאת אותה בתוך התיק ולשלוף אותה במקרה הצורך. זה חשוב כי הסיטואציות שדורשות התייחסות תופסות אותנו הרבה פעמים דווקא כשאנו מחוץ לבית ולאו דווקא מתי שנוח לנו "לשוחח עם הילד".

- תני לנו כמה דוגמאות למסרים המופיעים בכרטיסיות.

"הכרטיסיה הפותחת והחשובה ביותר לדעתי, אומרת לילד, ותאמינו לי שזה נכון כמובן גם למבוגרים, יש לך צד חושב וצד מגיב. 'הצד החושב' שבמוח עוזר לנו בפתרון בעיות ומוביל להצלחה בחיים ואילו 'הצד המגיב' מבטא את הרגשות שלנו. הרבה פעמים 'הצד המגיב' משתלט על 'הצד החושב' ואם אנחנו מודעים לכך אנחנו יכולים להתמודד טוב יותר. ניקח לדוגמא מצב לא נדיר לצערי, שבו ילד מרגיש שהוא 'לא מקובל' כמו שילדים קוראים לזה. ההרגשה של דחייה חברתית היא קשה מאוד ויכולה להוציא החוצה התנהגויות של אלימות או מחשבות כמו: 'אף אחד לא אוהב אותי'. 'אני שונא את כולם'. 'אני לא מספיק טוב וכו'".

- זה באמת נוגע ללב. מה אפשר להגיד לילד שחש כך?

"התגובה שאנחנו מנסים ליצור אצל הילד בעזרת 'הצד החושב' היא בסגנון של: 'נכון, הם אולי לא אוהבים אותי ואני לא אוהב שהם מתייחסים אלי כך אבל יכול להיות שזה בגלל שהם עדיין לא הצליחו להכיר אותי וכשיכירו מי אני באמת הם ישנו את דעתם'. זה מאוד עוזר שהדברים על השולחן ומטופלים, שהילד מקבל לגיטימציה לרגשות שלו ושנותנים לו אמצעי להתמודד עם אותם רגשות. מסר אחר נוסף הוא 'אתה לא תמיד יכול לקבל את מה שאתה רוצה'. כל הורה עובר את השלב הזה שמתישהו בסביבות גיל שנתיים הילד משתטח על הרצפה וצורח עד לב השמיים כשהוא רוצה משהו. זה לא נגמר בזה כי כשהוא קטן הוא רוצה סוכרייה ובגיל שבע עשרה יתכן שהוא ירצה אופנוע, תמיד יש משהו שאנחנו לא יכולים לקבל ואנחנו צריכים להיות מסוגלים להשלים עם זה. מה שיפה במסרים האלה שהם באמת משמשים אותנו לאורך החיים".

- תני עוד כמה דוגמאות לכרטיסיות בהן את משתמשת?

"היה גמיש", הגעת לקולנוע ונגמרו הכרטיסים, אתה מאוכזב השתמש בצד החושב כדי להתגבר על אכזבות. דברים לא תמיד מסתדרים לפי הציפיות והתכנונים שלנו, אין לנו שליטה על כל מה שקורה ואנחנו צריכים להיות גמישים ולחשוב על פתרונות אחרים. "כשמילים נפלטות יש בעיות!", היום יש הרבה ילדים שסובלים מהפרעות קשב שסימפטום בולט לכך הוא אימפולסיביות. הם אלה שיקפצו עם התשובה לפני שהמורה מסיימת את השאלה או, וזה קורה לכולנו, שפולטים הערות פוגעות מבלי לחשוב על התוצאות. "אל תיתפס בחכה", זה מאוד רלבנטי, אתה שוקע במשחק מחשב ושוכח שיש לך שיעורים ודברים אחרים, נתפסת בחכה ועכשיו אתה צריך לשחרר את עצמך לדברים אחרים. כאשר מתאמנים ומפנימים את המסרים זה פשוט עושה את החיים קלים וזורמים יותר, משיגים יותר ומצליחים יותר גם אחר כך כבוגרים".

- בנוסף להיותך מטפלת את גם מעבירה סדנאות להורים.

"קיבלתי את רשותו של ד"ר ריצ'פילד לתרגם את הכרטיסיות לעברית להעביר סדנאות בארץ. הסדנאות מיועדות להורים וגם לאנשי מקצוע העוסקים בחינוך. הסדנא נערכת במפגש אחד בו אני מדריכה את ההורים איך להשתמש בכרטיסיות, הם מתנסים בהן בעצמם ובעצם רוכשים 'ארגז כלים', שבעזרתו יוכלו ליישם התנהגויות מועילות יותר מבחינה אישית וחברתית. הסדנא היא במחיר סמלי ומכסה רק את העלויות, יש סדנאות בעברית ויש באנגלית".

- זה לא קצת בעייתי שההורה הופך למאמן, לא עדיף לפנות לאיש מקצוע?

"הייתי אומרת שתפקיד שלנו כהורים הוא לאמן ולהכין את ילדינו לחיים. הילדים משוועים להדרכה אך ברגע שהורה מרצה או מטיף לילד הוא יכול ליצור אצלו התנגדויות וחיכוכים נוספים. כאשר משפחה מאמצת את המסרים בכרטיסיות היא גם יוצרת שפה וגם ההורה הופך לבן ברית כי הוא משתמש בה בעצמו. כבר קרה לי שהתרגזתי על משהו והילדים שלי אמרו לי: 'הי, מה עם הצד החושב שלך, מה הוא אומר עכשיו'? אחד הדברים היפים כשמפנימים ומיישמים את השיטה הוא שיש משפחות שממציאות כרטיסיות חדשות עם מסרים שמתאימים להם. הייתה לי משפחה שבה כדי למנוע מריבות על צעצועים הם חיברו את המסר: 'אלמד לוותר ואהנה יותר', ואז הילדים גם מציירים ציורים מתאימים וזה הופך להיות כייף גדול".

אחת האימהות שעברה את הסדנא היא מיכל (שם בדוי). "בני לא דיבר עד גיל ארבע", היא מספרת, "כשפנינו להתפתחות הילד לא בדיוק ידעו להגיד מה לא בסדר איתו ויצאנו עם האבחון הכוללני 'קוים אוטיסטיים'. נורא נלחצנו והתחלנו בטיפולים אצל אנשי מקצוע שונים, קלינאית, מרפאה בעיסוק, התעמלות וכן הלאה. השקענו המון בעבודה עם הילד ולשמחתנו סגרנו את מרבית הפערים. היום בני בכתה ג' אבל עדיין יש אצלו בעיה מסוימת בתקשורת. הוא ילד מדהים, חכם מאוד, שמח וטוב לב ויש לו הרבה מה לתת לאחרים אבל יש בו שונות מסוימת שילדים בחושים שלהם מזהים אותה ולא ששים להתחבר איתו. יש לו קושי לקרוא את  המפה החברתית, להבין את הסיטואציה ולדעת להגיב בהתאם".

- ואת מרגישה שאת יכולה לעזור לו?

"כן,אני מלמדת אותו כאילו באופן מלאכותי מיומנויות שאצל אחרים אולי באות בטבעיות. אחותו הקטנה למשל פשוט נולדה עם זה ואיפה שלא 'נזרוק' אותה היא תסתדר. אבל יחד עם זה כולנו נהנים ומרוויחים כבודדים וכמשפחה מהשימוש בכרטיסיות. יצרנו בובות גרב, אחת לצד החושב ואחת לצד המגיב וזה עוזר להמחיש את הדברים. לדוגמא, באחד מימי ההולדת שנערכו בכתה בני לא הוזמן. התקשרתי לאימו של הילד שהיא חברה שלי והיא אמרה לי שהיא נורא מצטערת ושהיא השתדלה ודיברה על ליבו אבל בנה בשום אופן לא הסכים להזמין אותו. אין מילים לתאר כמה זה כאב לי. באותו רגע שהנחתי את שפופרת הטלפון לקחתי את הבובות ושיחקנו את שני הצדדים. הצד הכועס, הנעלב והפגוע ואחר כך את הצד החושב. בני הקסים אותי כשהוא אמר לעצמו, 'זה בסדר, אולי החבר הזה עדין לא מכיר אותי מספיק, אני בכל זאת אזמין אותו ליום הולדת שלי ואולי בשנה הבאה הוא יזמין אותי'. למרות הצער הגדול שהיה לי כאם, הרגשתי שהיה לי ביד כלי להתמודדות, לא הייתי חסרת אונים ויכולתי לעזור לו וגם לעצמי להתגבר. אני מודעת לזה שרכישת הכישורים החברתיים זה תהליך ואנחנו רואים שיפור כל הזמן".

אדם היה לפני כשש שנים אחד המטופלים הראשונים של סילבר בארץ בשיטת הכרטיסיות והוא זוכר אותה עד היום לטובה. "אהבתי לצייר את המסרים על הכרטיסיות ,זה עזר ויזואלי שממחיש את המסר ושרה עד היום שומרת את הציורים שלי ומראה אותם בסדנאות. בעזרתם למדתי להשתלט על כל מיני מצבים ובסך הכל זה מאוד עזר לי מבחינה חברתית".

למרות שהכרטיסיות מיועדות לעבודת הורים גם אנשי מקצוע יכולים להיעזר בהן ליצירת אקלים חברתי במסגרות בהן הם עובדים. לכרטיסיות מתלווה חוברת צביעה שמתאימה לילדי גן ומי שעובר את הסדנא מורשה לצלם אותם לשימוש פרטי. יקי מור הוא גנן ב""Kid's Gan, גן דו לשוני ברעננה. גם הוא עבר את הסדנא וכבר משתמש בה בעבודתו עם קבוצת בני ארבע-חמש שבגן.

- איך אתה מיישם את השיטה בגן עם ילדים כל כך צעירים?

"יש כמה דרכים שבהן אני עושה שימוש. האחת היא בזמן מפגש, אני בוחר כרטיסיה אחת עם סלוגן מסוים שאותו אני רוצה להעביר ואז בדרך כלל אנחנו מציגים את זה. נגיד שבחרנו את "אל תהיה הליצן" אז הגננת יכולה לעשות משהו מגוחך או מצחיק ואז אני אומר לה Don't be the clown! ואז היא אומרת :אבל למה לא? והילדים נותנים רעיונות, כי תסתבכי בצרות וכן הלאה. אחר כך אנחנו צובעים את הדף המתאים מתוך חוברת הצביעה. לפעמים אנחנו קודם צובעים ואז משוחחים, זה גמיש, אבל החלק החשוב זה שזה נותן לנו הזדמנות לשוחח על רגשות. כשאני שואל 'האם מצב כזה קרה למישהו'? מליון ידיים מורמות ואז אנחנו משוחחים ומסיקים מסקנות. דרך אחרת היא לתפוס את הדברים כשהם קורים בשטח ואז אני משתמש במסר המתאים או שהילדים בעצמם מנדבים את הסלוגן".

- אין מצב שסלוגן "יאמץ" ילד ויצור סטיגמה כמו במקרה של הליצן שבחבורה?

"זה יכול לקרות אבל פה כמובן תמיד המבוגר צריך לגלות ערנות ולשמש כמתווך. הסלוגן נוצר בשביל הליצנים והתפקיד שלנו הוא לעזור להם לצאת מזה, לא להתקבע לתוך התפקיד. בזמן הדיון אנחנו ממקדים את ההתנהגויות ומציעים פתרונות אחרים להתנהגות רצויה".

- המסרים בכרטיסיות לא קשים להבנה לילדים כל כך צעירים?

"יש מסרים שהם קצת מורכבים מידי אבל אני זורם עם הילדים כי זה גם מה שיפה בשיטה, היא פתוחה לדברים נוספים ולאינטרפרטציות. במקום הצד המגיב, למשל, אצלנו בגן קוראים לזה הילד העצבני והילד החושב. הילדים בוחרים את הדימויים שנוחים להם להבנה והעבודה היא חלק ממכלול של דברים שאנחנו עושים בגן בתחום של טיפול ברגשות ובהתנהגות". 

פרטים נוספים באתרי האינטרנט:

www.sarasilber.com
www.parentcoachcards.com
הכותבת היא עיתונאית, בעלת תואר בחינוך ועוסקת בתחום של ליקויי למידה.
rivkonet@gmail.com





 

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