"The importance of language to human development cannot be emphasized enough. It was language, with its tremendous flexibility and richness of meaning, that enabled us to communicate with one another in the first place." (Harari, 2015).
Language is a fundamental component in child development. When suffering from a so-called language development disorder, communication, language comprehension, vocabulary and language formation or several of these areas are affected.
In his practice in Munich, the psychologist Gernot Wührer treats, among others, patients with language development disorders. In this interview he reports on how neurofeedback can help.
Gernot, how did you come to work with speech development disorders?
I cooperate with a speech therapist who works mainly with children from the autism spectrum as well as children with a migration background who often do not learn the German language properly until kindergarten. This colleague has been integrating neurofeedback into the treatment of her patients in addition to speech therapy for some time. Speech therapy can be very challenging for the children and demand a lot from them - especially when the speech disorder is accompanied by problems with attention, concentration and impulsivity.
We experience that children with motivational problems as well as children from the spectrum strengthen their cognitive-emotional abilities through neurofeedback. Thus, they also achieve faster progress in speech therapy. The children are more motivated, more concentrated and can engage better in therapy - in individual cases, children have needed up to a year less therapy through the combination of neurofeedback and speech therapy and have also quickly caught up on large developmental delays.
Language development disorders are a large field. Is neurofeedback indicated equally in all of them?
It is usually the complex cases and developments for which we additionally recommend neurofeedback, for example if, in addition to speech errors, the understanding of or the relationship to language is also affected. But in general, neurofeedback is a brain training that helps to improve the children's flexibility and performance - everyone can benefit from it.
The children in my practice are mostly kindergarten age. This is where non-age appropriate language development is usually first noticed, but I also work with school-aged children, adolescents, and adults, especially those with autism spectrum disorders. The problems I observe in practice range from systematic grammatical errors to lack of complex sentences up to problems with language content. Children with autism may also only have limited communication, not speak at all or only be able to make sounds.
What can neurofeedback do in the therapy of language development disorders? How does it contribute to improvement?
Neurofeedback, as a concomitant therapy to speech therapy, has a positive effect on speech development disorders in at least three ways.
First, it strengthens cognitive-emotional conditions and improves parameters like attention and concentration in an implicit and playful way. For example, children who receive accompanying neurofeedback training find the work phases in speech therapy easier. They can work concentrated for a longer time, don't give up as quickly, and also increasingly find joy in it because they don't just have negative experiences with languages, but are increasingly strengthened in their abilities. This is what I would call the non-specific effects of neurofeedback.
In addition, there are the positive effects that neurofeedback has on the children's everyday life. Family life often calms down a bit, because parents also quickly notice behavioral changes in their children - this can lead to everything from better sleep to longer independent play and less bedwetting. This also eases the burden on parents and raises the quality of life for everyone involved.
Thirdly, neurofeedback also has specific effects on language: for me it is a great success when, in the course of therapy, the children begin to form longer sentences, tell something out of their own motivation or start a conversation. I also notice an increasing verbality, an enlarged vocabulary or differentiated sound formation. Especially if you choose specific electrode positioning for speech in neurofeedback and train there, such results become obvious, while the other two non-specific effects often show up even in the typical initial positions, especially with interhemispheric training.
What are your experiences with neurofeedback in speech development disorders and what feedback do you receive from patients and parents?
The children often perceive neurofeedback as an "easy" therapy - they are allowed to come to me and, unlike in speech therapy, have no explicit pressure to speak, but are allowed to watch a movie while exercising their brain - this is a helpful setting for children who have had negative experiences with language.
I am convinced that they benefit especially from the interdisciplinary approach when neurofeedback is used alongside speech therapy - and the therapists benefit from a better anamnesis and close observation. Many parents who bring their children to me for neurofeedback pay for this treatment themselves - but they see quick progress and are therefore happy to invest in their children's development and language. In addition, they are normally grateful to have found a therapy option that does not require medication and thus usually has no side effects.
What is particularly important when using neurofeedback in language development disorders?
For me, good and sound training as a neurofeedback therapist is central. The treatment of language development disorders goes far beyond the basic positions in neurofeedback. Often the electrode positions have to be fine tuned and it has to be clinically assessed which symptom and which position should be treated first. For this, therapists should already have neurofeedback experience. Furthermore, close observation of the patients is essential - especially if they are not able to communicate verbally, signs of over- and underactivation have to be recognized quickly and the training frequency has to be adjusted. However, from my experience especially young children react very sensitively and clearly to frequency changes already in the session - for changes between sessions, dialogue with parents and other treating therapists is essential!