New research suggests that children with attention-deficit/hyperactivity
disorder (ADHD) may benefit from getting a type of training during school
hours that monitors their brain waves to help improve attention.
The study involved 104 elementary school
children with ADHD who were randomly assigned to one of three groups: a brain-wave
monitoring ("neurofeedback") group; a cognitive attention
training group; and a "control" group.
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The students attended one of 19 public
elementary schools in the greater Boston area. They received three 45-minute
sessions per week of either neurofeedback training or cognitive attention
training, while the control group received no treatment.
Six months later, the researchers followed
up on the kids with parent questionnaires and classroom observations made by
researchers who did not know which child had received which treatment.
Neurofeedback involves measuring and giving
feedback on a child's brain wave activity while the child "plays" or
focuses on a computer game revolving around attention activities. The child is
asked to try to focus every time feedback information indicates that their attention
Cognitive training involves a computer
programme that engages students in games or activities that strengthen attention.
Neurofeedback has been studied in children
with ADHD in the past, and is controversial, noted study author Dr Naomi
Steiner, a developmental behavioural paediatrician at Floating Hospital for
Children at Tufts Medical Centre in Boston.
results did the researchers discover?
The study team found that the kids who were
given neurofeedback training made greater improvements in their ADHD symptoms,
compared to the other two groups. The findings were published online
and in the print issue of Paediatrics.
"They showed significant improvements
in attention and executive function. This study suggests that neurofeedback
works, and you can actually do it in schools," Steiner said.
"The cognitive attention training
group improved a little bit but not as much as the neurofeedback group, and not
on as many scales," she added.
An estimated 9.5% of US children aged 4 to
17 are diagnosed with ADHD, a disorder that leaves kids struggling with
attention, hyperactivity and impulsivity issues, according to the authors.
One expert welcomed the research.
"I have been following the field and I
was encouraged that there was finally a well-controlled study on neurofeedback
and ADHD," said Dr. Caroline Martinez, an assistant clinical professor in
the division of behavioural paediatrics at the Mount Sinai Kravis Children's
Hospital, in New York City.
"Prior studies have been inconclusive
or not adequately controlled, and it was nice to have the benefit of being
compared to a control group and the cognitive training group."
is Neurofeedback not that well known?
Martinez noted that she believes that
neurofeedback for ADHD is not readily available.
"They are expensive and are not
usually covered by insurance, that I know of," she said. She estimated
that neurofeedback training runs at roughly $100 per session.
Steiner noted that about 50% of the
children in the study were on a common ADHD medication at the start of the
months later, the drug dosage remained the same among participants in the
neurofeedback group, but the parents of the students in the cognitive training
and control groups reported increased medication doses, which Steiner said is
to be expected as a child matures.
Another expert lauded the research, but
wondered about its applicability to classroom performance.
"I think it's important to do studies
that look for the effects of other interventions besides medication on ADHD
symptoms. I think the study was rigorously done," said Dr. Donald Gilbert,
an ADHD researcher and professor of paediatrics and neurology at Cincinnati
Children's Hospital Medical Centre.
Neurofeedback improve classroom performance?
But while the neurofeedback intervention
made a difference and attention scores were better, Gilbert questioned whether
it would equate to better classroom performance.
"I'm not sure we can expect a
difference in learning in the classroom because, on average, after
neurofeedback their symptoms were still in the ADHD range, according to the
data graphs," he noted.
"I guess it's kind of promising, but
the benefit is still fairly small, and I would say it is nothing to write home
about. I think it's worth exploring further," Gilbert said.
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