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Neurotherapy Treatment Types
Clinical and Normative Assessment

There can be a lot of confusion around Neurotherapy treatment methods not the least of which is fancy nonsense jargon, impressive treatment names, flashy graphics, and overly automated systems.

Simplifying things, all Neurotherapy should be based upon encephalographic  (EEG / brainwave) readings. And there is only one way to ‘read’ the EEG of the brain. We read the brain by looking at the information provided by raw electrical wave forms, popularly referred to as brainwaves. The brainwaves are separated into categories by morphology (shape) and electrical speed (determined in Hz). Both shape and speed as well as strength (amplitude) give meaning.

After recording, there are three ways to interpret the raw electrical waves. But first the recording must be ‘cleaned’ (artifacted) where everything that is not a true brain-generated signal (from eye blinks and jaw tension to electrical interference from wall plugs to cell phones) is removed from the file. The file also needs to be collected under ‘clean’ circumstances without other forms of noise (impedance) wherein the contact of the electrode(s) is poor rendering the recordings inaccurate.

Trained individuals can tell bad (corrupted) signals from good (clean) signals, as well as read (see meaning) in the raw electrical signals (the brainwaves themselves), their numerical conversions, or their pictorial conversions.

Once the EEG is recorded and cleaned there are two ways to analyze the raw, numerical, or pictorial data. One way is to compare and contrast the data to Clinical Measures (comparing your brainwave patterns with the brains of people with symptoms, ailments, conditions and excellence). The other way is to compare and contrast your brainwaves with Normative Measures (comparing your brain signals to the brains of people without symptoms, to ‘neutral’ or to ‘typical’, the ‘normal’).

At Swingle Clinic we primarily apply Clinical Measures training the brain away from symptoms and towards goals. When prudent (e.g., with severe head injury, seizure disorders, etc.), we compare and contrast with Normative Measures wherein we can see sites of brain injury / damage and atypical wave forms such as eleptiform (wave forms associated with seizure activity).

How one analyses / assesses the brain (by Clinical or Normative comparative measures) will then inform the treatment or method(s) choice. Here again there are two methods or ways to treat, or rather train, the brain.

Amplitude and Ratio Training is usually applied for Clinical Training, while Z-Score Training is typically used for Normative Training.

Amplitude and Ratio Training

What is Amplitude and Ratio Training?

In simple terms, in Amplitude and Ratio Training we work to strengthen some waves and reduce the power of others, depending on where they are in the brain, and what they are supposed to be doing (or not doing) in that region. For example, Theta in one region will help with sleep, but in another is not particularly welcome as it is associated with inattention (as seen in inattentive forms of ADHD). Conversely, Beta in one region is excellent for focus, but in another region is highly associated with anxiety. In both cases we can train Beta and / or Theta up or down together (ratio training) or separately (amplitude training).

Amplitude and Ratio Training is the specialty of the Swingle Clinic. It is based in the principles of operant and / or classical conditioning and is highly individualized based upon intake assessments and rotational re-assessments thereafter.

What is Z-score training?

In simple terms in Z-Score Training we train the brain back to being ‘typical’. We follow the statistical laws of the normative curve (training towards how 68 of percent of people’s brains ‘normally’ work). Z-Score Training can be as precise or general as the equipment and the knowledge of the person using the equipment permits. Many Neurotherapy providers use Z-score Training programs indiscriminately. Meaning they, or their equipment train the brain back to a pre-established (pre-programmed) normative, ‘normal’, the typical, or neutral. One catch of using Z-score Training in an indiscriminate (pre-programmed) manner is the program only looks for ‘difference’ from statistical norms; meaning it does not recognize or differentiate ‘good’ difference from ‘bad’ difference. As Dr Mari Swingle often states in her critique of indiscriminate use of the method, she is rather sure Einstein’s brain, Mozart’s brain, or Marie Currie’s brain were not ‘normal’ or typical –so too our contemporary clients such as elite athletes, artists and inventors, or those with potential to become such. As such, we rarely ‘train to normative’ unless there is very specific purpose to doing so, for example, with brain injury (e.g., concussion or stroke). In sum, ‘normative’ neither includes or ‘respects’ the other side of ‘different’ including the desired states and traits of unique persons.

How, when, and why should one consider a normative (19 Channel) Brain Map and Z-score training?

Brain Map Assessments

5 Site Swingle ClinicalQ Vs. 19 Channel Normative Q

The 5 site Swingle ClinicalQ assessment has been explicitly designed so that a qualified Neurotherapist can gain a wealth of information within 40 minutes, and report back to a client within one clinical hour. The information from the ClinicalQ is targeted, extracting precise EEG signatures associated with the majority of the symptoms for which individuals seek assistance. In difference to other brainmapping assessments, the ClinicalQ can also see excellence, as well as signatures with ‘two faces’ or two-sided coins, such as determination and drive versus obsession and OCD.

Dr Paul Swingle

Dr Paul Swingle, BCIA Emeritus, Retired

History of the ClinicalQ

The ClinicalQ was the brainchild of Dr Paul Swingle, then of Ottawa University & Mclean’s Hospital (Harvard University). In the early 1990’s Dr Paul Swingle queried the relative value of normative measures when treating clinical conditions. He then set out to collect as much data as he could on the brain measures (signatures) associated with active symptoms. Selecting the five brainwave recording locations most commonly sited in the clinical literature and combining this with hundreds (now thousands) of brainwave readings, he devised parameters of / relative to symptoms rather than lack of symptoms. This was an innovative conceptual flip. Dr Paul Swingle’s clinical data set was the first of its kind.

The parameters of the ClinicalQ are intentionally not proprietary, freely published for any Clinician to apply in their assessments / treatments & training. They can be found in his book Adding Neurotherapy to Your Practice.

We do however ask that the data & formulas are not commercialized (packaged within systems and equipment sold or otherwise used for profit).  We remain saddened that this request has not been observed.

Please note that the ONLY Swingle vetted (checked for accuracy), current (adapted & upgraded)  and approved (obtained our permission to produce) program / assessment system available for purchase* is produced by and available for purchase through the Biofeedback Federation of Europe (BFE) website BFE.

The BFE also sponsors Grand Rounds, wherein Dr Mari Swingle teaches and mentors use of the method.

* Please contact the Swingle Clinic if you wish for permission(s) to commercialize or otherwise package our intellectual property including the formulas / parameters of the Swingle ClinicalQ in equipment and programs. We are open to collaborations.

Less time and money on assessment means more on treatment and betterment.

We offer the 5 site ClinicalQ as our primary assessment as the majority of Swingle Clinic clients do not need a 19 Channel Normative Brain Map. For most, the extra time and expense is not necessary to target the symptoms or goals for which they are seeking our assistance. In sum, 19 channel full capping and analysis is expensive overkill for information that is usually not required for the vast majority of conditions (symptoms) we treat. We often feel monies would be better spent on actual treatment rather than the collection of superfluous information. For a select few however, 19 site mapping is not only recommended, but necessary.

Who Should Get a 19 Channel Normative Brain Map?

For anyone seeking treatment for stroke, significant closed / traumatic head injury, as well as a known or suspected seizure disorder a Normative (19 Channel) brain map can be central to / for efficacious treatment. 19 Channel maps give us information on coherence, phase lag and provide a closer look at amplitude asymmetry. (In plain English this means the maps show us about connectivity; areas of the brain that due to damage cease talking to each other or in contrast talk to each other too much. It also shows us areas or systems that are much more or less powerful than they should be for efficient brain function –Hence your symptoms). Some forms of normative mapping also provide information on deeper structure and brain circuitry.

The Grey Areas on Grey Matter:

Complex learning disorders associated with any form of apraxia or dyspraxia, chromosomal or genetic disorders, developmental delay and speech delay can also benefit from normative mapping. Elderly clients fearing dementia or Alzheimer’s can potentially benefit from 19 Channel Brain Maps as well. Delusions, illusions / hallucinations, suspected or diagnosed Schizophrenia can also benefit from further insight provided from full capping. In these cases, we start with a Clinical Brain Map and somewhere between 3 and 10 sessions your Neurotherapist may discuss the potential benefits of a Normative Brain Map and, further determine where in the treatment cycle said Normative Brain Map might be of assistance to the advancement of treatment.

Children and adults on the Autistic spectrum sometimes also benefit from information provided by a 19 Channel Normative Brain Map. Although some of these clients would benefit from a Normative Brain Map on intake, many are not able to sit still enough, are fearful of the process, or have sensory issues that inhibit the wearing of the 19 point electrode cap. For these clients we carefully assess timing versus quality of data collection. With such clients spontaneous and / or situational change may also occur (e.g., a child is having a very good day and the time is ripe for data collection), and parents / guardians should be prepared for such. Conversely, a 19 channel map may be booked and thereafter changed to single site (channel), sequential point or 5 point (5 channel) mapping to ensure that the data collection process is both efficient and the information obtained is useful for treatment planning (e.g., not corrupt due to high impedance / poor signal(s), and / or  high artifact AKA false readings due to excessive movement or expressed discomfort).

A good rule to follow:

Yet another grey area is concussion. If you are seeking treatment due to symptoms attributed to a concussion, a 19 Channel Normative Brain Map is the recommended route. If you are not directly symptomatic but have had three sequential concussions, again, the information from a 19 Channel Normative Map could be helpful in guiding your treatment. Many individuals are not symptomatic, and the brain has successfully repaired itself. Others do not believe they are symptomatic but, once in treatment, the brain reveals patterns that suggest that a 19 Channel Brain Map would be helpful. Again, if your BCIA Certified Neurotherapist sees such patterns, they will discuss the potential benefits of seeking Normative, as opposed to, or in addition to, Clinical comparatives to aid with the precision of your treatment / training.

When a 19 Channel Mapping is a choice:

Curiosity: If you are curious and have the luxury of funds to afford a 19 Channel Normative Map, it can be an interesting experience of self-discovery but it is surely not necessary.

Known Risk: If you know you are at risk of head injury and would like a reserve road map back to brain health. E.g., elite athletes with a couple of ‘minor’ head injuries in sports known for major head injury such as boxing, MMA, various forms of racing (ski & car), football / rugby, bobsledding, etc., will often chose to have Normative mapping.

Reserve: Families of wealth will sometimes also choose to have themselves or their children mapped ‘just in case’. Much like some choose to preserve umbilical cord blood ‘just in case’.


Brain Driving first released as Braindryving TM was another brain child (pun intended 😉 ) of Dr Paul Swingle. Brain Driving involves the pairing of precise frequencies of sound and light and feeding them (back) to the brain to influence its efficiency.  It is classic / passive conditioning (as opposed to operant / active conditioning).

‘Feeding’ the brain through frequency is nothing new. Light and sound have long been used to influence the human state.  Think strobe lights in discos to excite dancers, slow glows to calm in spas, and meditate in living rooms. Sound influence has also arguably been used for centuries if not millennia. Think deep drumbeats to induce trance / meditative states or conversely incite or convey fear, all rhythm or frequency dependent.

Photosonics: Using independent or complementary light (photo) and to a much lesser extent sound (sonic) was common in early Neurotherapy practice.  What was new, was Dr Paul Swingle’s direct pairing of photosonic components directly with brain activity itself! –Specifically, pairing and unpairing light and sound with the real-time-EEG to directly (rather than indirectly) influence brainwave production.

Brain Driving can be an extremely efficient form of Neurotherapy when applied discriminately. At Swingle Clinic we find it particularly helpful for conditions wherein volition can be affected (e.g., stroke and head injury), challenged (e.g., Autism), or contraindicated in training (as with some pernicious forms of ADHD and anxiety-based disorders) wherein ‘willing’ the brain to quiet is counter-productive.

Dr Paul and Mari Swingle

In the early 2000’s Dr Mari Swingle took Dr Swingle Senior’s Brain Driving process to the next level devising highly individualized precision protocols (Targeted Treatment) to facilitate learning and retention. She pairs individual specific deficit tasking (e.g., reading, writing or other scholastic / mental challenge) with very precise photosonic blends, or cascades, derived from the information from the real-time EEG. Her protocols ‘drive’ the brain into more efficacious states for learning, memory, attention and retention while actively skill building.

Dr Mari Swingle’s targeted Brain Driving protocols are known to help children ‘catch up’ and adults (re)gain portions of losses in record time –often alleviating the need for remedial adaptations (school support) and lessening extended recovery support. Her Targeted Treatments are also applied in Peak Performance (e.g., sport) and accelerated learning (e.g., advanced academics).

Prior to the Swingle Clinic’s real-time Brain Driving innovations neither light nor sound were commonly part of the (neuro)feedback process and the brain-computer interface itself. Rather, photosonics were used as an adjunctive to neurotherapeutic interventions. Today however, they are indiscriminately proforma in Neurofeedback programs and ‘one-size-fits all’ equipment.  So much so, that prospective clients of Neurotherapy need to be prudent when selecting a service provider and turnkey equipment packages available for purchase online. [See choosing a provider].

Photo Components: Photo (light) components administered through glasses or goggles placed over the eyes (the only exposed part of the brain) are also widely applied in Neuortherapeutic practice. The brain health industry is now also widely exploring light administered to the brain to  / or through the skull and nasal cavities. There is great buzz now surrounding what has been termed photo-biomodulation and photo-neuromodulation wherein specific light bands (including laser and infrared and near-infrared ranges) are selected for specific influence ranging from body inflammation to adjusting cerebral perfusion pressure.

Sonic Treatments & Soundhealth Products:

Dr Paul Swingle also developed a line of Harmonics comprised of specific frequency blends designed to influence the power and amplitude of various brainwaves.  Over 40 years of precision testing resulted in an ever-expanding product line honed to influence the production, or suppression, of brainwaves known to influence states and traits of persons. The Swingle Soundhealth Harmonics are used for focus, calming, mood regulation, sleep assistance, craving reduction, and much more. They are available through SoundHealth Products.

A new line of Harmonics is currently in the final stages of development* and expected to be released in the fall / Winter of 2023-2024. Dr Mari Swingle has also paired up with Neurodelve (Italy). Together, Swingle Clinic and Neurodelve will be releasing a Sonic APP. It will be available by subscription to healthcare providers and their clients. Stay tuned!

*Please note, in difference to many products that ‘claim’ influence all SoundHeath Harmonics have been rigorously tested, and influence mapped on the EEG.

Using Harmonics in Treatments: The Harmonics used in Swingle Clinic treatments are specifically paired with your EEG (brainwave) activity.  The choice of Harmonic is derived from your intake assessment (QEEG or ClinicalQ) and your re-assessments thereafter. Complementary or competing Harmonics are chosen for very specific effect. E.g., to propagate augmentation of a desired brainwave (e.g., Theta) and  / or dampen or supress an overriding brainwave (e.g., Beta). How, and how frequently, the sonic (Harmonic) is activated is based upon what your Clinician or attendant sees real-time on your EEG.  It is not an automated program or AI (artificial indiscriminate intelligence/ or pre-programmed algorithm).  It is an Assisted Intelligence wherein your BCIA Certified attendant or Clinician is continuously monitoring and adjusting according to how your brain (not just the program) is reacting.

Direct Current and Magnetic Treatments: At Swingle Clinic we were on the forefront of many innovative therapies including electro and magnetic medicine. Over our 25 plus years in practice, we have successfully used many forms of complementary Direct Current ranging from single point electroacupuncture to transcranial direct current.

That said, since the recent introduction and commercialization of increasingly powerful neuromodulation modalities we have become increasingly conservative in our administration regimens.  This is largely due to compounding treatment effects. Effects of both tDCS (transcranial direct current stimulation) and PEMF (pulsed electromagnetic field therapy) can arise days or weeks after treatment sessions. Implying, we may not fully know the effect of one treatment before we administer another.  As such we are not as aggressive in treatment frequency, treatment length, and treatment intensity as many other providers. We build slowly, regularly monitoring the objective influence on the brain, your subjective reports on symptom improvement, as well as control for unwanted side effects. We take frequent breaks between treatment groupings, respecting the complex, yet delicate, nature of the brain. Please contact the clinic directly to explore if (how & why), electromedicine and magnetic therapy, may be an appropriate adjunct to your Neurtheraputic treatment.