BY ROBERT W. BOHLANDER, PH.D., BCN AND EDWARD SCHICATANO, PH.D.
Transitioning from high school to college is a daunting task for any emerging young adult. For a student with a disability, it can be more so. Although the undergraduate experience is often portrayed as not being “the real world,” and thus relatively “stress-free”, college life has many of the same or similar demands as the world off-campus, and can, in fact, be quite stressful. Several recent studies of stress among undergraduates have found that they report higher levels than any previous cohort.
Many of the same issues that face other young adults who are not in college impact the college student as well. Personal struggles, social challenges, relationship problems, issues of identify formation, and setting goals for the future, are challenges that are similar in both college and non-college populations of 18 to 22 year olds. Beyond these, college students often face additional concerns such as pressure to be academically successful, and financial burdens (including the ever-increasing cost of a college education and subsequent student loan debt). Other challenges specific to the college student population include the need for improved time management, organization, and self-regulation skills. In students who are coping with a physical, cognitive, emotional, or behavioral disability, these challenges can be multiplied, and the level of stress enhanced. This creates an even larger burden on their ability to make the necessary adjustments to college life, and ultimately to be successful in college and beyond.
The current article speaks particularly to parents of high school-age and college-age children with disabilities such as attention deficit hyperactivity disorder (ADHD), or any disability in which difficulty maintaining and selectively focusing attention is an issue. It will also be of interest to parents whose college-age children are having difficulty managing stress, or have issues with emotional dysregulation. It discusses the mission of a unique, campus-based center for braintraining, as well as its design, function, and benefits to students with disabilities. It is hoped that this center will serve as a model for other institutions who wish to provide similar services to students with disabilities.
The Mission of the NeuroTraining and Research Center
In January, 2016, Wilkes University opened The NeuroTraining and Research Center (NTRC) on its campus in Wilkes-Barre, PA. Wilkes University is a small (2200 undergraduates), private, liberal arts institution in Northeastern Pennsylvania. The Center’s mission is “to help students, faculty and staff achieve personal goals in the areas of attention, focus, stress management, athletic, artistic and academic performance, and overall wellbeing.” Though not specifically designed to target the needs of undergraduates with disabilities, the braintraining experiences provided at the Center can be of great value to this population.
Most undergraduate institutions have in place, a unit, or units designed to provide appropriate assistance to students with disabilities, whether it is referred to as a Learning Support Center, Disabilities Support Services, Campus Counseling Center, or any of a number of other similar titles. They can be excellent resources for students with disabilities, but are sometimes underutilized. Even if a student with a disability makes use of such resources, there are additional, complementary resources, such as the NTRC, that can provide even more assistance.
When they come to college, some students with disabilities say they want to “move past the label,” “do it on my own,” “prove myself,” “be normal,” “not stand out,” and so on. These students won’t self-identify as being eligible for, or needing, services. In our experience, we often find that one, two, or many semesters later, a student’s academic or psychological struggles are discovered to be, in part, due to the presence of a preexisting cognitive or behavioral disability for which the student has not sought support. There are also some students who develop a disability while in college, perhaps, for example, from a traumatic brain injury or other physical injury, or the onset of an emotional disorder such as anxiety. It is often difficult for them to acknowledge that services may be needed now when they never were before. For students who come to college with a disability already present, or those who become disabled while in college, using some type of support service on campus may be seen as unacceptable or stigmatizing. This may be due to self-stigma (“I don’t want to think of myself as someone with a disability who needs help.”) or social stigma (“If someone sees me entering the Learning Support Center, they’ll think I’m stupid.”). Because the NTRC serves all students, faculty and staff at the University, it may be a more attractive alternative than a dedicated Learning Support Center. Because the Center is open to all students, faculty and staff, there is no stigma associated with visiting for those students who have a disability. Athletes, artists, students, faculty and staff have visited, making use of the Center’s brain-training resources.
It must be kept in mind, however, that the NTRC is not a substitute for a disabilities support unit, but rather, functions as a complementary service. For those students who avoid the Learning Support Center or similar facility, it may be providing the only assistance they will be getting in terms of reaching personal goals that will enhance their wellbeing, quality of life, and ultimate success.
The Center does not “treat” existing mental or physical disorders per se, but provides an opportunity for personal growth and development for all students, faculty, and staff. Students who desire to use the Center are not queried about current behavioral health diagnoses or any disabilities, but rather, are asked to select three “goals of training” at the Center. These typically include such goals as the reduction of stress, improved concentration, improved focus, improved academic or athletic or artistic performance, greater sense of calmness, and others. The Center’s focus is on improving quality of life – personally, socially, academically, artistically, and athletically, rather than removing deficits or reducing existing impairments. Thus, the approach is always positive and forward-looking.
History
The concept of the NTRC was developed by the Co-Directors, Dr. Ed Schicatano and Dr. Robert Bohlander. Dr. Schicatano, a neuroscientist and Coordinator of both the Psychology Program and the Neuroscience Program at Wilkes University, has been involved for over a decade teaching students about neuroplasticity as well as conducting research in the field. In addition to his role as a Professor of Psychology at Wilkes University, Dr. Bohlander is a Licensed Psychologist, and Board Certified in Neurofeedback, with 25 years of clinical experience.
Both had seen the power and value of training protocols that rely upon neuroplasticity – Dr. Schicatano through his years of research, and Dr. Bohlander through his clinical practice in Kingston, PA, working with primarily children and young adults with impairments in attention and information processing. “Neuroplasticity” refers to the fact that experience can change the structure, function, and organization of the brain. The “right” experiences can produce desirable brain changes. The authors discussed the potential value of bringing the power of neuroplasticity to an undergraduate student population. Why not merge available brain-training approaches such as biofeedback, neurofeedback (brain biofeedback) and audio-visual entrainment into a single location on campus? Thus, cutting edge brain-training tools would be available to all students, faculty and staff in order to help them improve quality of life in a variety of ways. When considering the best way to deliver this training, and create additional benefits to Wilkes students, it was determined that this new facility would use highly-trained student interns, thus providing them with technical and clinical-like experience that could be an important part of their education as well – an added bonus. It could also serve as resource for faculty and student research on neuroplasticity.
The NeuroTraining and Research Center was proposed to the Wilkes University administration and received tremendous support. In the end, the 30-thousand-dollar startup budget was equally funded by Student Government and the University Provost’s office. With both Co-Directors offering their time and expertise pro bono, the annual budget for the center is $4,000, mostly for replenishing supplies, equipment maintenance and upgrades, and other minor expenses. Likewise, the fact that the Center is staffed by highly-trained interns, all with a background in psychology and/or neuroscience, produces great savings in addition to the benefit to the interns from the training and experience that they receive during their three-credit, semester-long internships.
The NeuroTraining and Research Centerand Its Programs
The NeuroTraining & Research Center occupies a 1200 sq. ft. suite in a multi-use building near the center of campus. It consists of a large waiting room, a front office for a receptionist, and four training rooms. The Center is open Monday through Friday, for an average of six hours per day.
The Center utilizes a variety of training modalities, including biofeedback, neurofeedback, audio-visual entrainment, mindfulness training and yoga. There are a variety of programs available within each modality, and the program to be used with any particular client is selected by the Center Co-Directors after examining each prospective client’s stated goals. Programs typically run for two to six weeks. Training modalities are used that have a strong empirical research base for efficacy in helping bring about positive change. For example, the American Academy of Pediatrics has recently elevated the use of neurofeedback to a “Level I – Best Support” intervention for “Attention and Hyperactivity Disorders”, putting it on a par with pharmacotherapy.
Biofeedback: The Biofeedback Program is a six-week program designed to increase a client’s heart rate variability (HRV). High levels of HRV (the difference between heart rate while we are breathing in, and heart rate while we are breathing out), are associated with feelings of calmness and decreased body tension. Clients learn to increase HRV through practice using a computer-based application that teaches them to control and pattern their breathing.
Neurofeedback (Brain Biofeedback): This 10-sesson program uses biofeedback to help clients change their patterns of brain activity in order to achieve their goals. Once an area of the brain is targeted for training based upon each client’s goals, the psychological principle of operant conditioning is used to help clients learn how to change their own brain activity in order to achieve their goals.
Audio-Visual Entrainment (AVE): AVE involves the client wearing goggles that produce flashes of light, and headphones that emit a series of pulsed tones. The rate and timing of these flashes and pulses is chosen in order to help create a temporary brain state that is more in line with the client’s stated goals (e.g. calmness, focus, etc.). Although the effects on brain activity, and resulting changes in mood, focus or behavior are temporary, lasting only an hour or so after training, the effects of training can be cumulative. This means that continued participation in the 10-Session AVE Program may lead to desired changes in brain activity occurring more easily and having greater duration following each training session.
Mindfulness Program: This six-week, 12-session program is designed to introduce the client to the practice of mindfulness and mindfulness meditation. It is an introduction only, and is meant to give the client some basic skills and knowledge on which they can build through further reading and practice on their own.
Yoga Program: This two-week, four-session program is designed to introduce a client to the practice of yoga. It is an introduction only, and is meant to give the client some basic skills and knowledge on which they can build through further practice on their own.
The Referral Process
Contacts with the Center are initiated by the students themselves. Many new clients indicate that they have a friend or classmate who has benefited from using the Center. They may self-refer or be referred by a coach, instructor, or the Campus Counseling Center, Learning Support Center, or Disabilities Services. No formal or informal referral is ever sent to the Center, and it is up to the referred student to make the contact. The decision to utilize the NTRC always resides with student, and students are never “mandated” to train at the Center.
The Learning and Study Strategies Inventory (LASSI) is made available to many incoming students at the University. Our Learning Center and Disabilities Support offices are aware that the types of brain-training available at NTRC can help with at least five of the components of the LASSI assessment – Information Processing, Concentration, Time Management, Anxiety, and Motivation, and refer students as appropriate. Many of the athletic coaches on campus have asked for presentations about the NTRC to their teams, or have brought their teams to the Center in order to acquaint them with the training offered and to encourage their use.
The Process: What happens when students request training at the NTRC?
Potential clients need to complete a Client Information Form, which is available at the Center or can be downloaded from the Center website. The most basic information is requested, including name, email, and telephone number. At no time are they asked about any existing or prior disabilities or mental health or physical health diagnoses, with the exceptions noted below. In addition, the following statement appears in bold on the form: Please keep in mind that the NTRC offers equipment and training techniques that may help you reach your stated personal goals. However, this does not constitute “therapy” or “treatment” for any diagnosed or suspected mental or physical disorder. Clients are asked if they have been diagnosed with a seizure disorder or a concussion, or suspect they have either condition. This does not exclude them from training at the Center, but does mean that certain types of training will be avoided. For example, if there is a history of seizures, AVE will be avoided, as it exposes the client to flashing lights and pulsing tones.
Clients are asked to rank order the goals they have for training at the Center, and select from these: Enhanced sense of calmness, Improved focus and attention, Better management of stress. Clients are also given the opportunity to provide more detail about their personal goals for training. Once the completed Client Information Form has been received at the Center, it is examined by one of the Center Co-Directors, who then assigns the client to complete a particular brain-training program, and determines the particular parameters of the program. For example, if a client is assigned to use AVE, a specific AVE protocol would be selected. This would include sessions that encourage the particular brainwave patterns that are most likely to meet that client’s goal.
Training is guided by undergraduate student interns. All interns are highly trained in the techniques used, and in issues of confidentiality of each client’s identity, goals, and training modalities. Training rooms are monitored by a video recording system, of which all clients are made aware prior to training. This is for the protection of clients and interns alike.
Does it Help?
We are currently analyzing data collected during the first full semester over which the NTRC has operated. It can be stated already, however, that student response to their experiences at the NTRC have been positive, and in some cases, life-altering. After completing the AVE program, one client stated “This is the most relaxed I have felt in my entire life!”. Another client remarked “AVE helped me reduce my jitters when I had to give public presentations is my Speech class”. Some clients choose to repeat a program they have completed because they would like to continue to benefit from it, or choose one of the other programs in order to work on a different goal, or the same goal but using a differing strategy.
Conclusion
The increased academic, social, and personal demands of undergraduate life poses a special challenge to the emerging young adult, and those challenges can be even greater for a student with a disability. A facility such as the NTRC can provide a complement to standard, on-campus disability services, offered in a non-threatening, non-stigmatizing environment. We at the Center are privileged to be able to help all students improve their quality of life (academic and non-academic) and their psychological well-being. It is hoped that this article informs parents of exceptional children about the types of additional campus-based assistance that may be available to them in order to be more successful in their undergraduate careers. It is also hoped that the establishment of this Center on campus (the only one of its type from what we been able to ascertain) will serve as a guideline for other higher-education institutions who may want to provide similar services on their campuses. We hope that the NTRC can serve as a model to other institutions that may wish to follow Wilkes University’s lead, and establish their own version of the NTRC, thus strengthening even more their commitment of the success and wellbeing of all students. •
If you would like more information about The NeuroTraining & Research Center, please visit our website at www.wilkes.edu/NTRC, or contact the Co-Directors: robert.bohlander@wilkes.edu or
edward.schicatano@wilkes.edu.boh
ABOUT THE AUTHOR:
Robert W. Bohlander, Ph.D., BCN, is Co-Director of The NeuroTraining and Research Center, Wilkes University, Wilkes-Barre, PA. He has 37 years of college teaching experience, and is currently Professor of Psychology at Wilkes University, where he teaches courses in Personality, Abnormal Behavior, Critical Thinking, Mindfulness, and Positive Psychology. He is a Pennsylvania-Licensed Psychologist in private practice since 1989, and works with children and adults with disabilities, doing psychotherapy, biofeedback and neurofeedback. Dr. Bohlander is an “Associate Fellow” of BCIA, Biofeedback Certification International Alliance, and is Board Certified in Neurofeedback.
Edward Schicatano, Ph.D., is Co-Director of The NeuroTraining and Research Center, Wilkes University. He has 16 years of college teaching experience, and is currently an Associate Professor of Psychology at Wilkes University, where he teaches courses in Neuropsychology, Psychopharmacology, Behavioral Neuroscience, General Psychology and Life Coaching. Dr. Schicatano is the Coordinator for the Neuroscience Program and the Department of Psychology. He is a certified Life Coach and Hypnotherapist with the International Certification Board of Clinical Hypnotherapy.
