August 2007: The first week of school: Behavioral Norms balanced by an Empathic Connection.
There is a concept in behavioral psychology called norms. Norms are behavior patterns. They are what people actually do. The first week of school is the time to set behavior norms. This is different than ‘expectations’. Expectations are more about talking. They are what we want to see from someone. We can tell someone what we expect, but that is different from “establishing norms”. Let me give you an example. Establishing norms is actually making sure that behavior patterns occur.
We transitioned babysitters at the end of the summer and it had become clear that the sitter during the school year had been lax about many things. We focused upon two. The first one gives the clearest example of establishing a norm because it was so behavioral in nature.
The behavior norm had become the boys left the garage door open consistently. This was a problem for several reasons. First, there were concerns about safety. Even though we live in a very safe neighborhood it is a bad idea to get in the habit of leaving the garage door open. Secondly, we just didn’t like the way it looked – junky. Third, there is a tendency by our kids to then expand leaving junk out onto the garage.
How to change this behavioral norm? The first week of the summer I disengaged the garage door openers. So, the kids would have to physically lift the garage doors themselves. Then we moved all their stuff to the garage which had a service door. So, they could go in and out the garage door without having to open the big doors. After the second week of disengaging the garage doors we no longer had that problem. This was a clean solution because physically it was difficult for the kids to open the door manually at all, so their behavior had to change.
So, with more complicated behaviors or where there is not a clear physical barrier how do you do this without behaving like a drill sergeant? Well, again it depends upon the norms you want to set within your family as to how you do this. As a matter of fact my son’s, when I click into this mode often spontaneously starting saying: “yes, sir”. They then salute me sometimes. It is their playful way of letting me know that they know I am in ‘git-r-done’ mode. I will return to that later.
Let me give another example of shoes not in the boy’s locker or ‘cubby’. My wife has very high standards regarding cleanliness and order. So we don’t wear shoes in the house. We bought a house that has a mudroom with lockers for the boy’s stuff and my stuff. The boys have a tendency to leave their shoes and backpacks out all over the mud room, a pattern that started last school year. So we began this behavior modification two weeks ago. The first two weeks I warned them and made them come back and put their shoes away. I reminded them that for each shoe it would be $2 off their allowance. (The notion of allowance in our house is that if you do the things expected of a child your age you get allowance of one dollar per year of age. Among the expectations is doing your schoolwork, keeping your room picked up and keeping your cubby and the mudroom picked up, etc.) So we have a trial period in which the boys get only warnings and reminders of the consequence.
Starting time: Then the day we start issuing the consequences is announced and they are given swiftly and preferably without emotion. When the shoes are found not where they are supposed to be the boy is called back to immediately address it and the money lost is recorded. From that day on the consequence is clear: you lose the money and you must interrupt whatever you are doing now to address it.
So it is with a new school year. Decided on your norms, have a brief ‘trial period’. Implement the change. The goal is to deliver consequences without emotion, firmly, clearly without negotiation. This is easier said than done, but if you discipline yourself to do this your kids will begin to be more disciplined themselves.
So, we start with a new sitter this week and focused on the norms with me home the first day to oversee and implement. Day two I have to be at work and my wife happens to be off early and she can oversee the process. As any mom knows, that moment when they hit the door can be the beginning of chaos or order depending upon how it is handled. Day three and the rest of the week I will get home to take some peaks at how it is going and intervene as necessary. After 1-2 2weeks the boys should have a good understanding of the norms and be following them and so should the sitter. This is how you establish norms.
Don’t worry this isn’t the end of the story. I will give you an update. By the way, housebreaking the puppy in the midst of the new school year and new sitter is our biggest challenge.
Balanced by an Empathic Connection:
So that is the establishing behavioral norms, which, by the way, is very much about your norms as much as the kids. Now, how do you maintain ‘empathic connection’? What do I mean by ‘empathic connection’? Or, another way to put it, how do I keep my perspective?
Let me give you two very direct and concrete answers: HeartMath and ‘special time’.
First, what is HeartMath? It is an approach of connecting with your own heart and center of feeling through slowing the breathing and focusing upon feelings of appreciation, gratitude, etc. It actually involves going in your mind and heart to the feeling of gratitude, actually getting to that feeling state. It is not hard once you practice it. I have several references to it on my website, the technology for measuring whether you are there and books and tools to get you there and sustain that. Let me give an example again, I always find specifics very helpful.
This morning we had an incident in which the boys followed the ‘new norms’ for the school year very well for about 85-90% of the time. The youngest was up, dressed on his own and got his breakfast started and only needed helping pouring a full gallon jug of milk. The oldest was up much earlier today and was on the ball, not in slow-motion. He was moving along fine. The middle guy was going along well too. We were ready in the mudroom ready to go much earlier than yesterday which was pushing it to the limits of punctuality.
I had taken the dog out to go to the bathroom and he went number one, but not number 2. I had him out there 10 minutes. I had to go in and shower and change myself. I go in. Dog gets passed to second son after he has dressed. He is to take dog out for at least 10 minutes stay in one place and wait for dog to go. He does not do his job well. He goes to the front where there are many distractions. Dog does not go. He puts dog in cage and as we go to leave out door dog goes in cage. Dad is not happy.
So, I am firm about this. We are not going back now. Dog must learn not to go in cage. Son must learn to give sufficient time for dog to go. Through my frustrated monologue I decide the new plan is we will move bedtime up 10 minutes and wakeup time up 10 minutes until we have enough time for dog to go to the bathroom. Son number 3 says: “Can we stop talking about this?” My answer: “Yes.”
So, I discipline myself and stop talking about it. I shift to a neutral place; slow breathing and think about the things the boys have done in the last 24 hours for which I have gratitude. I share some of this with each one of them. I go to work and connect to the EmWave PC and proceed to do more HeartMath. The moment the night before when I was reading to my son from his “Complete Guide to Fishing” book and we were talking about the history of fishing and how it is about nature, understanding nature and imitating nature that allows one to fish well. You may not think about this, but when you fish you imitate the animals in the environment of the fish to get them to bite. He has always been a great outdoors person, first bugs, deer, salamanders, and now fish. That was a moment I felt love, connection and awe for him. Then I shifted to the moment when son number 2 said: “we had to do these math problems and the teacher, well she is real young, didn’t know how to teacher division with remainders, but I did them anyway. I finished the whole sheet when they were on number 17.” Then he told me about football and the highlights there. Then I shifted to the moment when my oldest made this wry comment in the front seat and he turned and grinned with a great big smile and we enjoyed the moment as I got it and he didn’t get it for being a smart Alec. These moments give me perspective and allow me to truly connect with the boys, but hold firm as it is time to establish new norms.
Special time:
This is a concept borrowed from Russell Barkley and his book Taking Charge of ADHD. It is an idea kind of like “time in” instead of time out. The idea is that you set aside 15 minutes or so and truly focus on your child, not the dishes, the phone, the laundry, etc. The concept is that he chooses an activity and you essentially narrate out loud what he is doing. This gives him the feeling that you are ‘in there with him’. You let him make the rules and choose the game. It is his time. Kids really love this. It is like their batteries are charged up by this. These empathic moments are the foundation upon which you continue to build as a child gets older. Over time my sons continue to turn to me and talk to me about important things on their mind because I often try to do some version of special time – an activity on their terms in which I narrate or empathize and shut off my own mind chatter. This empathic link to my sons balances when I am in ‘drill sergeant’ mode which I must do sometimes especially with these boys who are loud and rowdy at times. Those are two critical tools or skills I use. They work. Try them yourself.
Now ‘git-r-done’ and set some ‘new behavioral norms’.
Charles Shinaver, Ph.D.
Tuesday, August 21, 2007
Monday, July 9, 2007
"To Catch a Predator": The internet, safety and social networking. In my next blog I will coment on this article from Dateline
Go to this linke to read the article about the Dateline show "To Catch a Predator". http://www.msnbc.msn.com/id/17584928/
I will comment about this in my next blog.
I will comment about this in my next blog.
Wednesday, June 6, 2007
When should I start my Son in kindergarten?
When should I start my son in kindergarten?
This question was recently posed to me by a good friend. Her son is very close to the cutoff for the birthdays to begin kindergarten. He is a smart boy, as are his parents, who are both physicians. If he were to go to school next year he would basically be the youngest child in his class. My short answer was essentially: “What’s the hurry?”
Now, yes, that may come off as flippant. But really, what’s the hurry? So, your son, who is definitely a smart ‘little guy’ will definitely be the ‘littlest guy’ in terms of age and quite possibly the ‘littlest guy’ in physical stature. “So, what?” says mom, who, I might remind you, did not grow up as a little boy. Well there’s a short answer to this one too: “Size matters.” I know you have heard that in a different context before, but I am not talking about that (this friend, if she is reading this now, is laughing out loud especially since her husband, the urologist, has been telling her this for years!).
For boys it is very much about the pecking order and both physical size and physical attributes like strength, speed, agility, all those things, really matter. Whether you like it or not, it is real. I don’t know if you noticed, but most kindergarten boys are not having contests about who can write the neatest, spell the best, or read the biggest books. Not unless there is some mother or father working very hard to drill this into the kid. Sitting still, being quiet in little chairs in little circles or rows, or pods, no, not on the top of their list.
The games we played were: “king of the hill”, “kick the can”, football, basketball, tag, races, etc. etc. Some of the games even had names that are not politically correct today, so we’ll skip those. The point is this. Just because your son might win all those intellectual contests even if everyone is a year older than he is, if he loses at all the games that establish pecking order: trouble is coming. Don’t believe me? Ask some guys who lost all those contests and see what they say. See if they remember getting beat up by a girl at recess. I’m betting they might.
If you think well, by that logic, he will probably struggle at all those games after a year’s more growth. Well, there you go you have something to work on for a year at home instead of sitting at a desk all year. Besides, where is the research that says the youngest, smallest kid in the class does the best?
As a matter of fact most research says the opposite: the oldest kids do the best. There was a great article in the New York Times on June 3, 2007 by Elizabeth Weil called “When Should a Kid Start Kindergarten?” Google this article and it will answer all your questions – especially those parents who do school as a ‘competitive sport’ as noted in this article. This is a well-written and very recent article on this topic and you will see that there is overwhelming and substantial research that supports letting your son wait a year.
This article refers to what they call an ‘age effect’ in the research. Essentially this is a negative effect of a child being younger than most kids in his grade. The focus here is on academics. Now, in our example here I am assuming that my friend’s son will be fine academically, but this research suggests that that there are some risks here too. And, the ‘age effect’ apparently last for several years. When I had this conversation with my friend I had not read this particular article, but I was familiar with some of the research. I am not basing my opinion on this article, but it truly is good food for thought.
I was basing my opinion on the fact that I am a psychologist, I was a boy, I have three smart boys, and many more boys are referred for treatment to all psychololgists than girls. For all variety of things including social develoment, emotional development, ADHD, learning disorders, etc. Most childhood disorders are dominated by boys. So, that extra year can help in all those social and emotional areas.
Yes, I did work on much of the academic activities I assume my friend focuses upon with her son, but I know how the pecking order works. I was just as focused on preparing my sons for the pecking order as I was on academic skills.
One other thought, and this, by the way, appeared to be the clincher for my friend, ask yourself: “What are my son’s true gifts?” No, not is he ‘gifted’, based upon IQ and achievement tests, and this boy is likely ‘gifted’ in terms of the normative population defined in this way. Just with his parents’ education and social economic status he is likely to land in that neighborhood. No, in what ways is your son truly gifted, distinct, special, in a way that you can tell already even before kindergarten? Now, is there a way you can work on his true gifts in the next year? Can you, yourself help him with that? Can you get someone else to help? That, and preparing for ‘pecking order stuff’, is how I would spend the next year. Good handwriting, chapter books, sitting still and being quiet, yeah, all great things, just not this year.
Charles Shinaver III, Ph.D.
This question was recently posed to me by a good friend. Her son is very close to the cutoff for the birthdays to begin kindergarten. He is a smart boy, as are his parents, who are both physicians. If he were to go to school next year he would basically be the youngest child in his class. My short answer was essentially: “What’s the hurry?”
Now, yes, that may come off as flippant. But really, what’s the hurry? So, your son, who is definitely a smart ‘little guy’ will definitely be the ‘littlest guy’ in terms of age and quite possibly the ‘littlest guy’ in physical stature. “So, what?” says mom, who, I might remind you, did not grow up as a little boy. Well there’s a short answer to this one too: “Size matters.” I know you have heard that in a different context before, but I am not talking about that (this friend, if she is reading this now, is laughing out loud especially since her husband, the urologist, has been telling her this for years!).
Anyway, life growing up as a boy is all about size, physical skill, the ability to run, to play tag, to knock each other around and to be ‘tough’. I think you have heard of the ‘Napoleon complex’. Need I say more?
No, not all of life is about size. And, yes, certainly school is about learning, reading, math, writing, sitting still, waiting in line, and all of those lessons you are supposed to learn in kindergarten. I know, I know, a lot of mom’s are getting really juiced up about the thrill their son will experience the first time in kindergarten when junior gets to wait in line, wait his turn, sit still, finish his work, write neatly, etc., but most boys… not so much. Really, really, adult life has lots of that action-packed-fun-seeking stuff. He will get to kindergarten in good time.
For boys it is very much about the pecking order and both physical size and physical attributes like strength, speed, agility, all those things, really matter. Whether you like it or not, it is real. I don’t know if you noticed, but most kindergarten boys are not having contests about who can write the neatest, spell the best, or read the biggest books. Not unless there is some mother or father working very hard to drill this into the kid. Sitting still, being quiet in little chairs in little circles or rows, or pods, no, not on the top of their list.
The games we played were: “king of the hill”, “kick the can”, football, basketball, tag, races, etc. etc. Some of the games even had names that are not politically correct today, so we’ll skip those. The point is this. Just because your son might win all those intellectual contests even if everyone is a year older than he is, if he loses at all the games that establish pecking order: trouble is coming. Don’t believe me? Ask some guys who lost all those contests and see what they say. See if they remember getting beat up by a girl at recess. I’m betting they might.
If you think well, by that logic, he will probably struggle at all those games after a year’s more growth. Well, there you go you have something to work on for a year at home instead of sitting at a desk all year. Besides, where is the research that says the youngest, smallest kid in the class does the best?
As a matter of fact most research says the opposite: the oldest kids do the best. There was a great article in the New York Times on June 3, 2007 by Elizabeth Weil called “When Should a Kid Start Kindergarten?” Google this article and it will answer all your questions – especially those parents who do school as a ‘competitive sport’ as noted in this article. This is a well-written and very recent article on this topic and you will see that there is overwhelming and substantial research that supports letting your son wait a year.
This article refers to what they call an ‘age effect’ in the research. Essentially this is a negative effect of a child being younger than most kids in his grade. The focus here is on academics. Now, in our example here I am assuming that my friend’s son will be fine academically, but this research suggests that that there are some risks here too. And, the ‘age effect’ apparently last for several years. When I had this conversation with my friend I had not read this particular article, but I was familiar with some of the research. I am not basing my opinion on this article, but it truly is good food for thought.
I was basing my opinion on the fact that I am a psychologist, I was a boy, I have three smart boys, and many more boys are referred for treatment to all psychololgists than girls. For all variety of things including social develoment, emotional development, ADHD, learning disorders, etc. Most childhood disorders are dominated by boys. So, that extra year can help in all those social and emotional areas.
Yes, I did work on much of the academic activities I assume my friend focuses upon with her son, but I know how the pecking order works. I was just as focused on preparing my sons for the pecking order as I was on academic skills.
One other thought, and this, by the way, appeared to be the clincher for my friend, ask yourself: “What are my son’s true gifts?” No, not is he ‘gifted’, based upon IQ and achievement tests, and this boy is likely ‘gifted’ in terms of the normative population defined in this way. Just with his parents’ education and social economic status he is likely to land in that neighborhood. No, in what ways is your son truly gifted, distinct, special, in a way that you can tell already even before kindergarten? Now, is there a way you can work on his true gifts in the next year? Can you, yourself help him with that? Can you get someone else to help? That, and preparing for ‘pecking order stuff’, is how I would spend the next year. Good handwriting, chapter books, sitting still and being quiet, yeah, all great things, just not this year.
Charles Shinaver III, Ph.D.
Thursday, May 3, 2007
May 3, 2007 Making EEG biofeedback for ADHD affordable and an investment for families. Aggression and EEG biofeedback do not mix.
May 3, 2007.
I am very excited to be in my new office space at Majestic Plaza. If you go to their website you can easily see the location at Building number one. I am on a cozy spot on the first floor next to a Chinese doctor who does Chinese acupuncture, a neorologist and then there also some lawyers on the first floor. It is very quiet and the foyer to this red brick building is elegant.
Two issues have come up in the last several weeks that I am compelled to discuss here:
1. Aggression and biofeedback do not mix. I have two boys who were doing EEG biofeedback who are not only ADHD, but they are aggressive. The issue that is prompted by that is: Can you use biofeedback to address aggression? My answer, "Not so much." The issue here is that there is a long history of research and clinical evidence about what works with aggression and it is behavioral and cognitive behavioral therapy along with family therapy or parent training. So, my new answer when patients who have a child with aggression and ADHD is to say I can help you with the aggression first in individual and family therapy. Only when we get a handle on that we can discuss whether EEG biofeedback makes sense for his ADHD issues. Obviously on the triage model aggression is more emergent than ADHD and must be addressed NOW. So that is what I will do.
2. How to make EEG biofeedback affordable and more of an INVESTMENT? Cost, length of treatment time and the gradual change seen in EEG biofeedback make this a challenging modality. This has been an issue that has been nagging for my attention. The issue is somewhat complex, but demmands attention and sorting. Here is the deal. Nationwide research has shown that for PSYCHOTHERAPY the average number of sessions patients attend are 6 sessions. Now psychotherapy is very different from biofeedback. Biofeedback is substantially dependent upon the patient's typical rate of learning. To accomplish success in treating ADHD a group of differnt studies have found 25-40 sessions as a minimum. Yes, that is a minimum.
Having been traditionally trained as a psychologist, knowing that the typical number of psychotherapy sessions is 6, getting to 25, let alone 40 is difficult for me to endure. I get antsy. I always question the process in which I engage which is simply part of my nature and it was definitely reinforced in my training as a research-scientist. So, I question the process along the way. This complicates things.
However, the issue is that I truly have seen kids make consistent progress, but it really is slow and subtle. It really does take 25 to 40 sessions. Usually is seen more gains on the IVA follow-up test than losses. Most kids are going in a positive direction, but not blazing new paths. Now, since I have done EEG biofeedback for only a little over 2 years this long treatment period is long for me to endure. It is definitely long for the child and the parent to endure and it is clearly costly.
Now obviously on strictly business level it would make sense for me to see all patients in my office for the entire 40 sessions or whatever it turns out to be. Yet, I am not comfortable with either the cost for parents nor the time I spend myself often in training which is repeated over time. Once a good protocol is worked out it is not that complicated to do it at home. What happens is kids lose motivation and don't want to continue. Parents get frustrated at the rate of progress. So the question is: How to address this?
Well, a comment a father made the other day came back to me as I struggled with this issue. He said that this was an investment in his son. When his son expressed frustration with the slowness of the process and the desire to quit his fater looked quite despondent. So what struck me today was doing 10 to 20 sessions in the office and make those agreed upon choice points.
The choices at 10 and then 20 sessions are these: 1. Continue with office sessions. 2. Buy a machine and begin training and I supervise over the phone or through e-mail. 3. Stop altogether if the family just feels that they don't see progress, but the child must take the IVA test to objectively measure progress first. To at least have an objective measure of progress. The reality is that consistently I see progress on the objective computerized test first. Truth is, people are just not that objective. Moms and dad yearn for their child to make leap and bounds of progress even if that has not been the child's history. So when you reach 10 or 20 sessions and you have only seen baby steps there is a tendency to bolt. I hope this approach tempers that tendency.
How does this solution help families: The family limits up front costs and the money spent from there on out is truly an investment. They will own the machine and if their child takes a large number of sessions then they will have the money to do them at home.
Here is how the numbers work "roughly". Without including the initial testing or initial session or the updated testing, right now patients are paying $120 per biofeedback session.
Right now if a patient pays for 40 sessions that is 40 times $120=$4800
So, if, instead we do 10 sessions X 120=$1200
Right now a brainmaster can be purchased for roughly $1500
Add these together and you get $2700.
For supervision you would pay me $240 a month. (This is 2 hours a month.)
The difference between the $4800-2700=$2100 divide this by supervision fees per month and you get 8.75 more months of training. You do 3 sessions a week which is 12 a month. That will give you 105 sessions after the initial 10 for a total of 115.
Now with this number of sessions, I can confidently say that the vast, vast majority of patients with only ADHD are quite done by that time. If there is a learning disability or some other problem then it is a different story. Also, you would then own the machine for the whole family to use. Given that ADHD runs in families it truly has become an investment. I stay on as your consultant supervisor and you chug along with as many sessions as you want. At minimal you get approximately 115 sessions instead of 40. You most definitely would have completely answered whether or not EEG biofeedback would successfully work with ADHD and you can try it with other family members too.
So this is what I will do. I will offer to do 10, 20 or 40 in office sessions and the family can then decide at any choice point what they want to do. However, I will require that they do the IVA test again to 'OBJECTIVELY' check progress.
That is the best I can do for now.
Sincerley,
Charles Shinaver III, Ph.D., HSPP
I hope this was interesting and informative.
I am very excited to be in my new office space at Majestic Plaza. If you go to their website you can easily see the location at Building number one. I am on a cozy spot on the first floor next to a Chinese doctor who does Chinese acupuncture, a neorologist and then there also some lawyers on the first floor. It is very quiet and the foyer to this red brick building is elegant.
Two issues have come up in the last several weeks that I am compelled to discuss here:
1. Aggression and biofeedback do not mix. I have two boys who were doing EEG biofeedback who are not only ADHD, but they are aggressive. The issue that is prompted by that is: Can you use biofeedback to address aggression? My answer, "Not so much." The issue here is that there is a long history of research and clinical evidence about what works with aggression and it is behavioral and cognitive behavioral therapy along with family therapy or parent training. So, my new answer when patients who have a child with aggression and ADHD is to say I can help you with the aggression first in individual and family therapy. Only when we get a handle on that we can discuss whether EEG biofeedback makes sense for his ADHD issues. Obviously on the triage model aggression is more emergent than ADHD and must be addressed NOW. So that is what I will do.
2. How to make EEG biofeedback affordable and more of an INVESTMENT? Cost, length of treatment time and the gradual change seen in EEG biofeedback make this a challenging modality. This has been an issue that has been nagging for my attention. The issue is somewhat complex, but demmands attention and sorting. Here is the deal. Nationwide research has shown that for PSYCHOTHERAPY the average number of sessions patients attend are 6 sessions. Now psychotherapy is very different from biofeedback. Biofeedback is substantially dependent upon the patient's typical rate of learning. To accomplish success in treating ADHD a group of differnt studies have found 25-40 sessions as a minimum. Yes, that is a minimum.
Having been traditionally trained as a psychologist, knowing that the typical number of psychotherapy sessions is 6, getting to 25, let alone 40 is difficult for me to endure. I get antsy. I always question the process in which I engage which is simply part of my nature and it was definitely reinforced in my training as a research-scientist. So, I question the process along the way. This complicates things.
However, the issue is that I truly have seen kids make consistent progress, but it really is slow and subtle. It really does take 25 to 40 sessions. Usually is seen more gains on the IVA follow-up test than losses. Most kids are going in a positive direction, but not blazing new paths. Now, since I have done EEG biofeedback for only a little over 2 years this long treatment period is long for me to endure. It is definitely long for the child and the parent to endure and it is clearly costly.
Now obviously on strictly business level it would make sense for me to see all patients in my office for the entire 40 sessions or whatever it turns out to be. Yet, I am not comfortable with either the cost for parents nor the time I spend myself often in training which is repeated over time. Once a good protocol is worked out it is not that complicated to do it at home. What happens is kids lose motivation and don't want to continue. Parents get frustrated at the rate of progress. So the question is: How to address this?
Well, a comment a father made the other day came back to me as I struggled with this issue. He said that this was an investment in his son. When his son expressed frustration with the slowness of the process and the desire to quit his fater looked quite despondent. So what struck me today was doing 10 to 20 sessions in the office and make those agreed upon choice points.
The choices at 10 and then 20 sessions are these: 1. Continue with office sessions. 2. Buy a machine and begin training and I supervise over the phone or through e-mail. 3. Stop altogether if the family just feels that they don't see progress, but the child must take the IVA test to objectively measure progress first. To at least have an objective measure of progress. The reality is that consistently I see progress on the objective computerized test first. Truth is, people are just not that objective. Moms and dad yearn for their child to make leap and bounds of progress even if that has not been the child's history. So when you reach 10 or 20 sessions and you have only seen baby steps there is a tendency to bolt. I hope this approach tempers that tendency.
How does this solution help families: The family limits up front costs and the money spent from there on out is truly an investment. They will own the machine and if their child takes a large number of sessions then they will have the money to do them at home.
Here is how the numbers work "roughly". Without including the initial testing or initial session or the updated testing, right now patients are paying $120 per biofeedback session.
Right now if a patient pays for 40 sessions that is 40 times $120=$4800
So, if, instead we do 10 sessions X 120=$1200
Right now a brainmaster can be purchased for roughly $1500
Add these together and you get $2700.
For supervision you would pay me $240 a month. (This is 2 hours a month.)
The difference between the $4800-2700=$2100 divide this by supervision fees per month and you get 8.75 more months of training. You do 3 sessions a week which is 12 a month. That will give you 105 sessions after the initial 10 for a total of 115.
Now with this number of sessions, I can confidently say that the vast, vast majority of patients with only ADHD are quite done by that time. If there is a learning disability or some other problem then it is a different story. Also, you would then own the machine for the whole family to use. Given that ADHD runs in families it truly has become an investment. I stay on as your consultant supervisor and you chug along with as many sessions as you want. At minimal you get approximately 115 sessions instead of 40. You most definitely would have completely answered whether or not EEG biofeedback would successfully work with ADHD and you can try it with other family members too.
So this is what I will do. I will offer to do 10, 20 or 40 in office sessions and the family can then decide at any choice point what they want to do. However, I will require that they do the IVA test again to 'OBJECTIVELY' check progress.
That is the best I can do for now.
Sincerley,
Charles Shinaver III, Ph.D., HSPP
I hope this was interesting and informative.
Monday, April 23, 2007
This is my first blog and my first day in my new office at Majestic Plaza in Carmel, Indiana. I am happy to be here and it does feel like a second home.
My Weekend:
Over the weekend I had a fun moment when my son's assisant soccer coach came up to me and said that she wanted me to help her out this week while the head coach is gone. She said that I had a 'good way with the kids'.
My son jokingly said: "She needs to talk to me first."
My wife laughed as it has been a running joke that I tend to be very loud at the sporting events of my kids. She said: "she must have heard you yelling on the sidelines."
I argue that I am more quiet when I am a head coach because I have more input. This has been true, but usually I am an assistant coach because I have three boys who are all in activities and my wife has an unforgiving work schedule which means I have to be available for much of the transportation between activities. Indeed, this week my oldest son has a game the same time as my middle son's first practice this week and then a game an hour after his second practice this week.
Anyway, I was flattered and I will try to help out as much as I can.
Dr. Shinaver.
My Weekend:
Over the weekend I had a fun moment when my son's assisant soccer coach came up to me and said that she wanted me to help her out this week while the head coach is gone. She said that I had a 'good way with the kids'.
My son jokingly said: "She needs to talk to me first."
My wife laughed as it has been a running joke that I tend to be very loud at the sporting events of my kids. She said: "she must have heard you yelling on the sidelines."
I argue that I am more quiet when I am a head coach because I have more input. This has been true, but usually I am an assistant coach because I have three boys who are all in activities and my wife has an unforgiving work schedule which means I have to be available for much of the transportation between activities. Indeed, this week my oldest son has a game the same time as my middle son's first practice this week and then a game an hour after his second practice this week.
Anyway, I was flattered and I will try to help out as much as I can.
Dr. Shinaver.
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