The economic burden of providing special education and training for a child diagnosed with ADHD (attention-deficit/hyperactivity disorder) is estimated to cost the average American family five times as much as a child without ADHD. Such cost considerations force many families to focus on the remission of the condition through prescribed medications. 

A recent study in the Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP), reports on a review of nonpharmacological treatments for ADHD, specifically electroencephalogram (EEG biofeedback, or neurofeedback). The study shows a large improvement of inattention at the end of the trial, but without a significant difference between the two treatments.

ADHD Treatments

ADHD is a common disorder usually first noticed in childhood that impairs attention and regulation of impulses and activity. There are many treatments, including medication and behavior modification, which are not completely satisfactory for many patients.

Consequently, many other treatments have been proposed. One proposed treatment is neurofeedback, which shows the EEG on a screen and rewards the patient for changing it. The most common form of neurofeedback for ADHD has been training down the theta-waves and training up beta-waves. The JAACAP study is the first large, well-blinded study of theta-beta neurofeedback designed to clarify this.

Children with ADHD & Neurofeedback Study Data

The findings for the study are based on the International ADHD Neurofeedback (ICAN) study, which began recruiting in 2014.

A sample of 142 children with ADHD and high inattention scores between the ages of 7 – 10 years of age were used as criteria. The children were randomly assigned 38 sessions of either a real theta-beta neurofeedback, or an identical-appearing control treatment that differed only in having screen display and rewards based on a pre-recorded EEG of another child. 

This resulted in the child, parent, and trainers being unable to guess the treatment assignment. To ensure the study remained blind, the child’s own muscle artifacts were superimposed on the pre-recorded EEG. Treatment at three times a week lasted 3-4 months. The primary outcome was the average of parent and teacher ratings of inattention.

At the end of treatment and following a 13-month follow-up, the experimental and control treatments both showed a very large and highly significant improvement in the composite inattention ratings initially made by the parents and teachers.

An additional outcome also showed that the group who received the real neurofeedback treatments needed less medication at the13-month follow-up.

The Future of Neurofeedback Therapy for Children with ADHD

The principal investigator of one site said “These results show that the large benefit for ADHD symptoms reported by others and replicated in this study are not due to the neurofeedback itself, the training down of EEG theta-wave power and training up of beta-power, but to other, nonspecific effects.”

Further analysis mentioned, “These included the EEG biofeedback incidentally provided by withholding rewards during muscle artifacts; the practice focusing on a screen; the supportive coaching; the improvement of the parent-child relationship from the parent supporting child progress; and of course a super-placebo effect from a novel treatment with wires attached to the head—a strong rationale for hope of improvement—and a feeling of accomplishment from the rewards.”

The results also co-incidentally clarify that the tendency for teachers to observe less improvement than parents from neurofeedback is not due to teacher insensitivity to treatment effects as previously hypothesized. When parents are well-blinded, they report no more advantage for neurofeedback over the control treatment than did teachers.

A conclusion of the study noted, “This could have some value in cases of intolerable side effects; side effects are dose-dependent, and neurofeedback might allow optimal effects with a lower dose.”

Neurofeedback Therapy

Here at Neurohealth Associates, we specialize in Neurofeedback treatments. Neurofeedback may be helpful for treating ADHD symptoms, especially if you are unsure about putting yourself or your child on medication. The easy, noninvasive treatments can painlessly improve your mental health condition and outlook on life. Schedule a consultation with NeuroHealth today and find out how we can help you.


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