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Neurofeedback Therapy May Offer Relief for ADHD
What the Study Showed
Preliminary research findings indicate that an innovative behavioral training technique using neurofeedback, which measures brain waves, can be an effective complement to conventional treatment for attention deficit hyperactivity disorder (ADHD). The study results were presented at the 2000 Annual Meeting of the American Psychological Association.

How It Was Done
The year-long study was conducted at the Family Psychology Institute in Endicott, New York, and involved 100 children and teens (83 boys and 17 girls) ranging in age from 6 to 19. All had been diagnosed with ADHD. Parents were notified of various treatment options, which consisted of:
 The stimulant medication Ritalin (methylphenidate). The average daily dose was 25 mg given three times a day.
 Behavioral counseling. This included 10 group sessions of skills training for the parents, which provided information on the disease, nutritional education, child-rearing tips, and school consultations to monitor students and provide academic support. Individual follow-up counseling was also provided.
 Neurofeedback therapy, also referred to as EEG biofeedback. In this novel approach, brain wave patterns are measured by wires attached to the scalp. A computer monitor provides positive feedback when a state of focus and attention is attained. Weekly sessions were provided and lasted for 30 to 40 minutes.

All of the children received Ritalin and behavioral counseling. About half (51) also received neurofeedback. Although parents were required to pay for the treatments, the two groups were similar in terms of age, gender, socioeconomic status, and type and severity of symptoms.

Both groups showed improvements in attention and concentration after a year of treatment, as assessed by a widely accepted standardized performance test, the Test of Variables of Attention (TOVA). However, only the children who had undergone regular neurofeedback sessions continued to show improvement when they discontinued their medications for a week.

In addition, on a commonly used behavioral test known as the Attention Deficit Disorder Evaluation Scale (ADDES), parents and teachers gave higher (more positive) ratings to children who had received neurofeedback training than to those who had not undergone the therapy. Children who received neurofeedback also showed less slowing of brain waves in their cortex, the part of the brain that helps to control impulsivity and attentiveness. Recent research suggests slowing of these brain waves, as assessed by a standard scanning technique that measures electrophysiological activity in certain brain regions, may be hallmark of ADHD.

Why It's Important
These results provide an important first step in validating the role of neurofeedback, a painless procedure with few if any side effects, in the treatment of ADHD. New and safe approaches are welcomed for treating the disorder, a chronic illness that causes hyperactivity and behavioral problems that can lead to depression, school failure, physical injuries, and myriad other difficulties in life.

When added to a double-pronged approach involving conventional medications and behavioral counseling, neurofeedback led to sustained improvements in attention, even when the participants went off their medications. Measurements of brain waves likewise confirmed physical changes in the brain that likely contributed to this improvement.

Additional follow-up and confirmation of these preliminary findings with a more rigorous and truly randomized study is needed. In addition, the impact of neurofeedback in adults with ADHD has yet to be examined.

Source: VJ Monastra, DM Monastra, S George, D Fox: The Family Psychology Institute, Endicott, NY (A-4): EEG Biofeedback Treatment for ADHD: A Controlled Clinical Field Study. Presented at the 108th Annual American Psychological Association (APA) Convention, Washington, DC April 5, 2000. Reviewed by David Rabiner, PhD, in Attention Research Update (www.attention.com), February 2001.


Date Published: 09/29/2002
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