The Symphony

For an eight-year-old named Jake the rest of the world has disappeared as he sits quietly in a darkened room and stares intently at a computer screen with a yellow Pac-Man gobbling dots as it moves across a bright blue background. A soft, steady beeping is the only sound. Jake is not using a joystick or keyboard to control the cartoon character; instead, a single thin wire with a dime-sized, gold-plated cup is fastened to his scalp with conducting paste. The sensor picks up the boy's brain waves — his electroencephalogram (literally, electric head picture), or EEG — and as he changes his brain waves by relaxing or breathing deeply or paying closer attention, he also controls the speed of the Pac-Man.

This is more than a game for the boy. Jake was born in crisis: he arrived more than three months before his due date, in July of 1990, and weighed just over a pound. He required open-heart surgery when he was three days old and spent the first two months of his life in an intensive care unit for infants. He survived, but with serious damage to his brain. The most severe symptoms showed up at the age of four when he entered his parents' room one evening drooling and unable to speak. He went into a grand mal seizure and fell unconscious on the floor. After that, the seizures came frequently, usually at night as he was falling asleep. Antiseizure medications blunted the severity of the seizures but could not prevent their onset. His parents, Ray and Lisa, kept an overnight bag packed for frequent trips to the emergency room, where the slight boy received injections of Valium to arrest the seizures. The sight of the needle going into their son filled them with apprehension. He also had small absence, or petit mal, seizures throughout the day, when his mind would go elsewhere, when he could neither hear nor speak for five or ten seconds. He was diagnosed with a speech problem and cerebral palsy, which diminished his fine-and gross-motor skills. Even at age seven, when I met him, he had not learned to tie his shoes, zip his zipper, or button his shirt. His learning disabilities were numerous and included attention deficit disorder and hyperactivity. He had speech problems and ground his teeth together constantly, something called bruxism. His sleep was troubled, and he often woke up ten or eleven times in the night. Despite this list of problems, there is a bright little boy inside of Jake, with a wonderful and sometimes peculiar sense of humor.

At the age of five, Jake started taking two heavy-duty antiseizure medications: Depakote and Tegretol. Both are depressants, both control seizures, and both have serious and worrisome side effects. The boy seemed logy and often tired. "We felt Jake was losing his personality," Lisa told me. "He was zoned out all the time."

I have known Jake's family since he was born; the incredible story of his birth made him something of a celebrity in our town of Helena, Montana. A local insurance company put his smiling baby picture up on billboards with the line "Baby Jake will always be special to Managed Care Montana," and talked about how its coverage had paid almost all of the approximately $350,000 in medical bills. On assignment in Santa Fe for a story about different technologies designed to enhance brain performance, I had heard about neurofeedback and thefact that its first and most effective use was with epilepsy. (Neurofeedback works on the same principle as other kinds of biofeedback except that it provides information about the brain, hence the prefix neuro.) At a Christmas party, I mentioned it to Jake's parents, who were eager to investigate an alternative to drugs. They researched the therapy on the Internet, made a series of appointments over a week, and drove three hundred miles to the nearest neurofeedback site in Jackson, Wyoming. They turned the week into a vacation, swimming in the motel pool, hiking in the Grand Tetons, watching elk at a wildlife refuge, and taking Jake to the local hospital for two one-hour "brain training" sessions per day on the computerized EEG biofeedback program.

Jake's brain has places where the electrical activity is not as stable as it should be. Research shows that the brain's electrical signals are subject to change and that people can be taught how to change them. All neurofeedback does is help guide the client to a specific frequency range and help him or her stay there. The brain does the rest. A technician has set the computer Jake is playing Pac-Man on so that when Jake spends time in those hard-to-reach frequencies, the Pac-Man gobbles dots and beeps like crazy. When he is not in those frequencies, the Pac-Man stops gobbling and turns black. Jake knows nothing about brain waves or his EEG, he simply knows that when the Pac-Man is gobbling and beeping, he is winning, and so he has learned how to adjust his brain waves to make the Pac-Man gobble dots all the time. It was easy: he caught on in just one session. As he spends more time in those frequencies his brain has trouble generating, his brain learns to function there on its own. This exercise makes the brain more stable.

It didn't take long for changes to begin to appear in Jake. "It took care of the teeth grinding within two sessions," Lisa told me when they returned from Jackson. "It took care of the sleep problems immediately." As the sessions continued, Jake became more settled, more centered. "We could carry on a conversation in the car on the way home for quite a while, the first time ever that we could carry on a two-way conversation for any length of time. His fine-motor skills improved, and he wanted to cut and draw and zip and button. He could never do any of that," Lisa continued. Unprompted, friends and relatives remarked that Jake seemed calmer and more centered. Later, Jake's parents repeated the protocol for another week. Again they noticed dramatic improvement. Jake went to see his pediatric neurologist, who had been skeptical at the outset, though he had signed off on the treatment. He examined the boy alone for twenty minutes. When he was done, he told Lisa and Ray that the treatment had indeed been effective. "Jake seemed more focused," Dr. Don Wight, the neurologist, told me later. "He could do things cognitively he couldn't do before the training. There was a qualitative and quantitative improvement in the way he was functioning. It was very real."

Jake's parents bought one of the $10,000 neurofeedback units from Neurocybernetics, a California biofeedback manufacturer, and have made it available to the community. Dr. Wight has been trained in the technique and has incorporated it into his practice. Jake has regular sessions with the local neurofeedback technician, Bernadette Pedersen, and continues to improve. In 1999, he received a three-year evaluation for...