This document describes two case studies using creative biofeedback protocols for children with health issues. The first case discusses a 7-year-old boy adopted from a Russian orphanage with hyperactivity, sensory and emotional issues. Diagnostic art assessments revealed themes of abandonment fears. Biofeedback and neurofeedback combined with art therapy increased his attention span. The protocol uses art, biofeedback and neurofeedback together to foster self-expression and improve physical and cognitive abilities.

1. Creative
Biofeedback Protocols
for Children
AAPB Symposium presented by
Elizabeth Stroebel, PhD
Elizabethstroebel@hotmail.com &
Susan E. Antelis, MPS, LMHC
Susantelis@biofeedback.net

2. Two Case Studies
• Diagnostic Art Techniques, Art as Therapy
and Bio and Neurofeedback for a 7 year old
boy with multiple health and psychological
issues
• Peripheral Biofeedback Protocol for a 12
year old boy with spectrum disorders & and
an18 year old girl with conversion disorder
• Discussion of Creative Protocols

3. Case 1: 7 Year Old Boy
Medical history Family history Diagnostic test:
Social & Emotional & House-Tree-
Educational Intelligence Person
issues information
Art Productions: Biofeedback & Summary of
Slide show Neurofeedback Creative
Protocol
Brain Research Applications
& Art

4. Family History
• J. is 7 yrs. old, adopted at age 4 from a Russian
Orphanage
• Child neglect and possible abuse is suspected;
child has chronic leg pain of unidentified origin,
possibly from having been strapped into a crib for
long time periods
• Mother is a single parent with a 12 yr. old
biological son, from a former marriage.

5. Primary Symptoms/complaints
• Episodic extreme hyperactivity
• Incessant movement
• Sensory symptoms (pressing, stretching,
pushing/pulling, sliding, crashing,
swinging, rocking)
• Bad moods/fits, Obstinacy
• Wears a diaper at night

6. Medical Issues
• Born with cleft palate and lip
• One partial surgery for correction
• High mercury levels found through blood
testing; having chelation therapy
• Takes vitamins: fish oil and magnesium
prescribed by wholistic health practitioner

7. Educational Issues
• Is in Second Grade, Special Ed classified
• Teachers say he is bright and understands quickly;
reads at grade level and does fine in math; has a
good memory.
• “Never stops moving”, get too excited especially
in gym & recess, likes to play outside.
• Loves books, his dog, cars, trucks & trains
• Receives speech therapy; speech &hearing are
good.

8. Social/Behavioral Issues
• Can be calm & sweet; appears at times to be
happy, eager to help, very friendly and
affectionate; moods are erratic.
• His hyperactive movements are a social turn
off to his peers according to his mother
• Has not responded to ADHD type
medications, behavior charts, rewards or
punishments.

9. Emotional Issues
• Expresses fears that mother will abandon
him
• Is clingy to mother, looking for her
approval and involvement, but only until he
feels comfortable in a situation
• Is pushy with and possessive of his older
brother whom he idolizes.

13. Discussion of Art
• House-Tree-Person:
• HOUSE has many windows, shows curiosity, near
protective tree, no roots.
• TREE is cut off at the “roots” or legs & in a pot, a
“transplant” like J.…., but very rich in design
showing his creativity.
• PERSON is very small, poorly formed, sad and
powerless. He is crying because he is sad for his
mother who has “lost” her child (his fear of her
abandoning him)

14. Art…
• Seventeen Rainbow pictures with small
variation in number of bows, size and color
choices. A defended expression of “hope”.
• Therapist responsive imagery of rain-
clouds; to which child adds fish swimming
upstream,

25. Art…
• Poster size picture of butterfly and tree painted from the side instead of
head-on; maybe indicative of LD. Butterfly as symbol of
transformation and freedom; tree still with no “roots”.
• Poster size picture of tree with huge sun, painted from the side, with
older brother in room; also very optimistic and expansive,
uncharacteristic of the typical 7 yr. olds use of space.
• Poster size picture of fiery sun, hurricane and tree, painted from front;
unfinished.

29. Biofeedback
• Wild Divine Light-stone used for interest
with Somatic-vision software, both Particle
Editor and Inner Tube. Initial attention span
before using Art was one minute. After
using art in the session before biofeedback,
attention increased to up to 10 minutes of
total still behavior and total concentration.

30. Neurofeedback
• First SMR training in session 3 reveals up
to a 6:1 ratio of Theta to smr/beta; attention
span of 5 minutes.
• Goal: up to 15 minutes of SMR training to
lower theta or improve theta to beta ratio.

31. Art and the Brain
• PET scans were used in a 1995 study to explore
the brain mechanisms underlying the act of
drawing. Results suggested that even simple
drawing depends on a complex interaction
between many brain systems.
• Brain scans were used in a 1999 study of an artist
at work: results showed that the front part of the
brain was more active the the rear where the visual
cortex is; The artist was thus thinking the art.

32. Art & the Brain…
• Blood testing from a 1997-8 study showed that
Neurobiologically, art making produces high seratonin
levels in the artist; higher seratonin has been associated
with higher self-esteem
• A 1998 study with TBI patients showed that art making
can enhance brain functioning by “waking up” damaged
areas.
• Other neuroscience experts have shown that art and
language are connected; that art experiences can enhance
language development in children.

33. Summary of Creative Pediatric
Protocol
• Diagnostic Art Assessment
• Biofeedback Baseline Profile
• Neurofeedback Baseline Profile
• “Art as Therapy” split session to discharge
creative energy and foster self-expression;
• Add biofeedback and then add
neurofeedback as physical ability allows.

34. References
Stephanie L. Brooke, PhD: Tools of the Trade: A
Therapist’s Guide to Art Therapy Assessments
Kathy Evans & Janek Dubowski: Art Therapy with
children on the Autistic Spectrum
Art, Science & Art Therapy: Repainting the
Picture: Frances F. Kaplan