Traumatic Brain Injury in Young Children and Neurofeedback [Interview][Transcript]

carol_shifflett_mary_lee_esty_traumatic_brain_injury3carol_shifflett_mary_lee_esty_traumatic_brain_injuryGuests: Carol Shifflett and Mary Lee Esty
Presenter: Neal Howard
Guest Bio: Carol Shifflett is a science and technical writer with a background in earth sciences, physiology, sports and martial arts. Her other books include Migraine Brains and Bodies: A Comprehensive Guide to Solving the Mystery of Your Migraines, Ki in Aikido, Aikido Exercises for Teaching and Training.
Mary Lee Esty, LCSW-C, Ph.D., is a licensed social worker with a Ph.D in health psychology. She is a Senior Fellow in Biofeedback and Neurotherapy with the Biofeedback Certification International Alliance (BCIA).

Segment overview: Shifflett and Mary Lee Esty, co-authors of the book “Conquering Concussion: Healing TBI Symptoms with Neurofeedback and Without Drugs,” talks about the long term consequences of TBI when it occurs in young children.

Health Professional Radio – Traumatic Brain Injury in Young Children

Neal Howard: Welcome to Health Professional Radio, I’m your host Neal Howard. Thank you so much for joining us here on the program today. There’s research that shows every hour, 2 toddlers are treated for injuries related to strollers or car carriers and most of these kids are suffering head injuries including concussions. Our guests in studio today are returning to talk with us, Conquering Concussion: Healing TBI Symptoms with Neurofeedback and Without Drugs written by Mary Lee Esty and Carol Shifflet. Both of which are in studio today with us to talk about some of the long-term consequences of traumatic brain injury when those injuries occur in young kids. Welcome to the program.

Carol Shifflet: Thank You Neal.

Mary Lee Esty: Thank You Neal.

N: Thank you. Now, you’ve authored the book, Conquering Concussion. Now Mary, your background, you’re a medical practitioner. Talk about your background and how you got into treating traumatic brain injuries?

M: I’m a social worker.

N: Oh, okay.

M: With a Doctorate in Health Psychology and then I got into the biofeedback and neurofeedback.

N: Well tell our listeners about biofeedback and neurofeedback and how it’s helping folks especially when they’re dealing with traumatic brain injuries. Sometimes they result in severe headaches, sometimes severe headaches without the injury are still being treated with this technology.

M: Yes. Just quickly, biofeedback is an umbrella term for any kind of therapy that uses information that is possible to get back from your own body using simple technology and now of course computers can just provide an enormous amount of information about how our own systems are working together or not. And when the information that is received by the computer is from the brain, from the central nervous system there are many, many ways to help a person learn to reduce their symptoms. For example MRIs are being used now to reduce pain, that’s a very expensive way to do that but being in a MRI machine, I think it’s first done in Stanford, a person can see an image of the hotspot in the brain that is involved in pain and they are told to just imagine that spot getting slower and slower, so using a kind of guided imagery, it works. But biofeedback practitioners using simple or laptops are able to do that now and so effectively that even Cleveland Clinic’s Cardiology unit has now published their research getting information from a screen with filters … on the fingers and nothing invasive, okay, painless, nothing invasive, simply learning true information that one can see about your own body on a computer screen. They have been able to take people off of the heart transplant waiting list (crosstalk).

N: Off of the transplant list, that’s amazing.

M: And they practice at home with some simple devices. The brain is capable of doing an enormous amount, so that’s an incredible example of the power of biofeedback. We used to hear many, many neurotherapists and biofeedback therapists around the country are using this to help with panic attacks, anxiety, test anxiety. It’s possible to find practitioners around the country, there are couple of websites, and because there are many people doing this and many physicians are getting involved in this. There’s a big article in the Washington Post which is my area, with the psychiatrist in New York City, Hasan Asif who is using neurofeedback has a wonderful picture of a cap on the head that he is using and helping people with depression with all kinds of mood disorders but depression is a common aftermath of concussion. So the body doesn’t sort of neatly segment things out like our diagnostic manuals trying to do. So that’s just, as we were talking earlier, headache seems to respond to neurofeedback even though you start out thinking you’re treating just traumatic brain injury or post-traumatic stress, they all fit together somehow. So neurofeedback is using information from the brain to help a person in one way, either learn by watching the screen to change the way their brain firing or the kind that I do is … kind offshoot of that which the brain and the computer are interacting with each other. So our brain is our best friend in many, many ways, it is always trying to heal itself and the computer technology now enables us to even in a stronger way, help heal our own systems. So pain goes down, cognition goes up, people are able to return to work, they’re no longer being in fights and being put in jail. There’s a lot of that because the violence and impulsivity follows concussion and head injury. There’s a lot of data behind that.

N: What about these injuries in kids who may not, they’re not experiencing any combat situations, they’re not doing adult things and the injury happened on a playground, yet they’re going to go through depression? Does the brain have to be an adult brain in order to give this valuable information or does it work regardless?

M: Not at all. (Crosstalk) It works really well on children, because the likelihood is that they are going to be diagnosed as being attention deficit with or without hyperactivity. That’s been known for a long time and there’s enormous amount of information coming out now. I think most recently within the Journal of American Medical Association of Neurological … about Pediatric Traumatic Brain Injury and Attention Deficit. The symptoms are almost the same, so the treatment, neurofeedback is just a wonderful treatment for that because the American Academy of Pediatrics has listed, they called it biofeedback but all of the research they say is neurofeedback as a level 1 intervention to be recommended by pediatricians for these attention deficit disorders.

N: Carol, the brain has been injured either severely or at all. How can we trust that the feedback from this injured organ is accurate?

C: Well it’s looking at, what the system is looking at is the speed, the quality of the brain wave. You have your very fast waves, you have your very slow waves and it isn’t that any of them are good or bad, it is that they are appropriate when they are appropriate. You want the brain to be doing what it needs to do, you want balance. So you have the faster wave, the beta waves for example are ones that you want for alertness and boom, boom, boom getting things done, good memories, sharp responses, that sort of thing. Alpha, slightly lower which all we knew from the 60s is a more relaxed brainwave appropriate where relaxation is, when it’s time to relax. With theta is your pre sleep wave that’s slower and longer, that’s what comes up with the images that you see right before you fall asleep and delta is your deep sleep wave. Now, when you have somebody walking around who never ever comes above alpha, you’re going to see someone, you can guess this pretty well just by seeing someone who is a little foggy, a little out there, a little quiet (Crosstalk) a ‘spaceist’ is a good word for it, they’re in a different space and that you to make a map of that person that’s what you will see. You have people even walking around in theta, those are your ADD folks, kids very strong ADD signature, theta signature in ADD and you also have people walking around in delta in the frontal lobes, injured frontal lobes. Frontal lobes especially in the left side is supposed to be the fastest part of your brain, when you have delta signals coming from there, you have someone, Mary Lee has a wonderful phrase for this, ‘Conscious coma’ (Crosstalk) and I think we mentioned this last time, the conscious coma. Their brain is not really awake and it is not remarkably different from the person who is actually lying in bed in a coma. The only difference is they’re walking around and (Crosstalk) they may be the one that is sitting in the basement apartment, staring at the wall for several years. Mary Lee you have some comments on that I think.

M: (Crosstalk) There’s a wonderful test that will show whether the brain is working right or not. It’s called the Quantitative EEG, the National Institute of Medicine put out a book on sports injury about 2 years ago. Beautiful, wonderful thing about almost every aspect of sports injury. The Quantitative EEG which neurofeedback people use will show and make some map of brain wave activity, it shows where the imbalances are in the way the brain is producing these various feeds of neurons. When there is an imbalance people will be symptomatic, it can be in a variety of ways. But they will not be functioning as well as they could. I just finished treating a couple of retired NFL players, one was actually diagnosed with dementia, the other one was not in quite that bad of shape, but of course they had many, many years of playing and the Quantitative EEG showed this and in fact it is now, there’s a data out that, first of all the Supreme Court has approved the use of Quantitative EEG data in lawsuits. It is accurate, it has been used just forever and it gives a percentage, a number of the percentage likelihood that the imbalances of the map shows are from a head injury (Crosstalk) and maybe actually permanent.

C: Maybe a mention of ‘why’ it would’ve been in the Supreme Court it’s because the courts, so many lawyers have tried for so many years to block it because it shows too much information too well.

N: Ah yeah and it doesn’t sit well when you’re trying to defend someone who’s wrong.

M: Yeah. And in fact it is the only thing that shows after a sports injury, what could be any injury but in this book it’s about the sports injuries. Whether the brain is really healed and off to return to play, right now children are put back especially the young children are put back on the field much sooner than they should be. Just imagine you’ve got a 6 year old and the coach says, ‘Well, how do you feel?’

N: He wants to play.

M: There’s not a lot of baseline there, right? And no whether you really feel good or not when you’re 6, if you’re awake, you’re okay. And that’s dangerous.

N: Yeah. Absolutely.

M: Because the effects of each subsequent head injury build on each other, the brain never truly goes back to its original, healthy state. Which is why nutrition is so terribly important because our bodies, including the brain, are always healing and just how many cuts you’ve had over your lifetime? But what if I didn’t heal, we’d all be a mess of band aids, right? The brain is no (laughs), right, mummies maybe. So brain’s trying to heal but it needs good nutrition and it appals me, I ask people, ‘What do you eat for breakfast?’ Most people eat something that is mostly sugar, that’s not usable. A good, balanced nutrition makes a huge a difference in kids and adults who are very have attention problems. Once I get them to eating a good balance breakfast, whole grains and lots of protein, good quality protein, their grades go up, their performance at work goes up.

N: Simply from changing nutrition?

M: If you haven’t put (Crosstalk) gas in your gas tank, your car is not going to run long. You can’t run on an empty tank.

N: Now ladies, where can our listeners get their hands on a copy of this book, Conquering Concussion: Healing TBI Symptoms with Neurofeedback and Without Drugs?

C: Well Neal, it’s in all the usual bookstores and also Amazon and you can see more information about it on Mary Lee’s website at and we just recently posted the Kindle edition, it’s just out. So all of those are available now.

N: Thank you.

C: And my office is in Bethesda in Maryland near Walter Reed, we have hard copies here too.

N: Great. You’ve been listening in the Health Professional Radio, I’m your host Neal Howard in studio with Mary Lee Esty and Carol Shifflet, authors of the book, Conquering Concussion: Healing TBI Symptoms with Neurofeedback and Without Drugs. It’s been great having you in studio today with us.

C: Thank you.

M: Thank you Neal.

N: Thank you Mary and thank you Carol. Transcripts and audio of this program are available at and also at and you can subscribe to this podcast on iTunes.