- LATIN AMERICA
- MIDDLE EAST
- United Kingdom
- United States
- New Zealand
- South Africa
- iHaveNet.com: Health
A controversial treatment for overcoming attention deficit hyperactivity disorder is getting new respect. Called neurofeedback therapy, it supposedly retrains the brain to produce electrical patterns associated with calm and focus. While the technique is costly, time consuming, and far from proven, its promise is tantalizing. Advocates claim that neurofeedback brings permanent ADHD cures, a seemingly magical alternative to years of medication.
During a typical 45-minute session, the child is seated in front of a computer. Wires lead from different points on his head. A therapist starts up a videogame or movie on the child's screen--he can bring a favorite to the session if he wants--and monitors his brain waves on another screen. He locks his eyes on the action, concentrating on sending the kind of brain waves that will keep a virtual airplane flying or perhaps a Harry Potter movie rolling. If his attention wanders or he begins to fidget, the car slows or the movie screen darkens, and the therapist encourages him to regain focus using techniques such as slow, deep breathing. As he watches the effect of his own thoughts, "it's like looking in a mirror," says Leslie Sternberg, a neurotherapist and a psychologist in Acton, Mass.
Neurofeedback, also called EEG biofeedback, has been under investigation as a treatment for epilepsy and ADHD since the 1970s. Putting it to use on children with attention deficits has logical appeal. Studies suggest that in ADHD, the brain generates insufficient beta waves, which are associated with focus and attention, and an overabundance of lower-frequency theta waves, produced during periods of daydreaming or drowsiness. Praising and rewarding a child when he steps up production of beta waves by concentrating on the game or movie should therefore teach him how to focus at will in other settings, such as doing homework assignments or cleaning his room. And at least for some children, that seems to have happened.
One of them is Cameron Rose, 26, from Kingston, Ontario. Before receiving neurofeedback treatments when he was 11, says his mother, Joan, he could not be taught to read, although both she and her husband were teachers. She would try to coax her son at age 6 or 7 to read the simplest book she could find--like one about frogs. "Frog," she'd say, turning the page and pointing out where the word was repeated. It wouldn't register.
Diagnosed with ADHD just before he started sixth grade, after spending two years in a class for the severely learning disabled, Rose had 60 sessions of neurofeedback therapy at the
Lynda Thompson, psychologist and director of the Toronto center where Rose was treated 15 years ago, observes that many kids with ADHD are extremely good at "hyperfocusing" on something that interests them. Rose, for example, loved playing chess, a game known to test patience and concentration. The challenge, says Thompson, is to get them to concentrate on something they find boring--and the idea of neurofeedback is to teach kids how to do just that.
While neurofeedback works in theory and has had anecdotal successes, it was largely dismissed by ADHD experts until recently. They have noted that most studies showing benefits have been run by investigators with a financial stake; even a rigorously designed study "tends to find what it wants to find" under such conditions, says Peter Jensen, cochair of the division of child psychiatry and psychology at the
Nor have the studies met standards for rigorous design. Historically, most have been too small to be credible, with fewer than 50 patients, and have been sloppily done. Results have not been compared with results from medication or other forms of therapy, for example, nor has a control group received "sham treatment" that patients believed was neurofeedback but in fact did nothing, like a placebo sugar pill in a drug trial. A 2005 review coauthored by Russell Barkley, a leading expert on ADHD at the
But newer research has begun to build a promising foundation. A German study published earlier this year, which found that neurofeedback improved attention and reduced impulsivity and hyperactivity, was fairly large (94 children ages 8 to 12) and included a control group. Fifty-nine of the children received 36 sessions of neurofeedback over three to four weeks, while the other 35 children were trained in a different technique designed to improve attention. Observations by the children's parents and teachers indicated that most kinds of ADHD-related behavior improved much more in the neurofeedback group than in the control group.
The study and 14 others were analyzed in the July issue of the
Still, as evidence of benefit accumulates, increasing numbers of parents will ask themselves whether neurofeedback may be worth trying. The question, says Jensen, is whether the expense is justifiable. Forty to 60 sessions, typically costing
While many practitioners envision neurofeedback as a drug-free solution, others see it as a complement to drug therapy. Eugene Arnold, a professor emeritus of psychiatry at the
The catch with drugs is that many children stop taking them. In one large study, more than 60 percent of the children on stimulants discontinued them within eight years. Parental concern may be a factor--side effects are not uncommon, and lately some of the drugs have been linked to stunted growth and, in rare cases, an increased risk of heart attack. By contrast, says Arnold, neurofeedback "by and large doesn't appear to be a risky treatment. Undoubtedly, it has less side effects than medicine."
That's why Kim Sanders of Aubrey, Texas, decided to try neurofeedback a few years ago with Macy, now 15, and Trent, 14. The stimulants they were taking for their attention disorders, says Sanders, inhibited their growth. She has seen a "night and day" difference in Trent's behavior and a "remarkable" improvement in Macy's performance in school. They no longer take medicine.
Neurofeedback: An ADHD Treatment That Retrains the Brain