ADHD treatment

Additive effects of neurofeedback on the treatment of ADHD: A randomized controlled study

Neurofeedback (NF) has been identified as a “possibly efficacious” treatment in current evidence-based reviews; therefore, more research is needed to determine its effects. The current study examined the potential additive effect of NF for children diagnosed with ADHD beginning a medication trial first. Thirty-six children (6–12 years) with a DSM-IV-TR diagnosis of ADHD were randomly assigned to an NF with medication (NF condition) or a medication only condition. Children in the NF group attended 20 twice-weekly sessions. Outcome measures included individual cognitive performance scores (ADS, K-WISC-III), ADHD rating scores completed by their parents (ARS, CRS) and brainwave indices of left and right hemispheres before and after NF treatment. Significant additive treatment effect in any of the symptom variables was found and a reduction of theta waves in both the right and left hemispheres was recorded in NF condition participants. However our randomized controlled study could not demonstrate superior effects of combined NF on intelligent functioning compared to the medication treatment only. This study suggested any possible evidence of positive and additive treatment effects of NF on brainwaves and ADHD symptomatology.

Neurofeedback Requires Better Evidence of Efficacy Before It Should Be Considered a Legitimate Treatment for ADHD: What is the Evidence for this Claim?

The article reviews the evidence for the claim that neurofeedback lacks sufficient evidence of efficacy and, therefore, cannot be considered a legitimate treatment for ADHD.

Nonpharmacological Treatments for ADHD: A Meta-Analytic Review

Objective: The authors replicated and expanded on Fabiano et al.’s meta-analysis of behavioral treatments for ADHD, systematically comparing the efficacy of 7 nonpharmacological interventions. Method: A total of 14 controlled treatment studies conducted post-1994—evaluating behavior modification, neurofeedback therapy, multimodal psychosocial treatment, school-based programs, working memory training, parent training, and self-monitoring—were identified, primarily by searching electronic English-language databases. The results were meta-analyzed: mean-weighted effect sizes for the treatment outcomes of 625 participants (382 treatment, 243 controls) were calculated, and moderator analyses examined contributions of gender, ADHD subtype, and treatment “dosage” to outcome. Results: Behavior modification and neurofeedback treatments were most supported by this evidence. Interventions were generally more efficacious for girls, and least efficacious for the “combined” ADHD subtype. The authors found no dose or age effects. Conclusion: Based on the small, published literature, this study supports some nonpharmacological interventions for ADHD, and indicates directions for more evaluation research into psychological treatments.

A Position Paper on Neurofeedback for the Treatment of ADHD

This position paper provides the current evidence supporting the use of neurofeedback in the treatment of ADHD and recommendations on the implementation of neurofeedback in clinical practice. The paper also provides basic information regarding the diagnosis and psychophysiological etiology of ADHD. The paper does not focus on a specific age range of a clinical population. Unless otherwise noted, we are referring to all subtypes of ADHD (inattentive, hyperactive only, and combined). Conclusions and recommendation are based on the most recent research; however, we also refer to relevant historical studies that support our position on neurofeedback. The readers are strongly advised to research behavioral diagnostic criteria and testing methods elsewhere. This paper is not intended as a comprehensive educational tool for diagnosis or treatment of ADHD. Our purpose is to demonstrate the rationale and to reference the necessary support for neurofeedback in order to be recognized as a legitimate, scientific, and evidence-based intervention for the treatment of ADHD.

Neurofeedback for Children with ADHD: A Comparison of SCP and Theta/Beta Protocols

Behavioral and cognitive improvements in children with ADHD have been consistently reported after neurofeedback-treatment. However, neurofeedback has not been commonly accepted as a treatment for ADHD. This study addresses previous methodological shortcomings while comparing a neurofeedback-training of Theta-Beta frequencies and training of slow cortical potentials (SCPs). The study aimed at answering (a) whether patients were able to demonstrate learning of cortical self-regulation, (b) if treatment leads to an improvement in cognition and behavior and (c) if the two experimental groups differ in cognitive and behavioral outcome variables. SCP participants were trained to produce positive and negative SCP-shifts while the Theta/Beta participants were trained to suppress Theta (4–8 Hz) while increasing Beta (12–20 Hz). Participants were blind to group assignment. Assessment included potentially confounding variables. Each group was comprised of 19 children with ADHD (aged 8–13 years). The treatment procedure consisted of three phases of 10 sessions each. Both groups were able to intentionally regulate cortical activity and improved in attention and IQ. Parents and teachers reported significant behavioral and cognitive improvements. Clinical effects for both groups remained stable six months after treatment. Groups did not differ in behavioural or cognitive outcome.

Place of electroencephalograpic biofeedback for attention-deficit/hyperactivity disorder.