ADHD - Neurofeedback

Dr. med. Nina Buschek and Ingrid Müller
Transmission from German – Evgeny Sheronov

How it works

With biofeedback, people can focus on and even direct bodily functions that they are usually unaware of. Through auditive or visual feedback, processes, events, and signals within the body (bio) can be made perceptible. This works for example for the respiratory rate, muscle tension, or brainwaves. The patient immediately gets a real-time response as to what is happening in the body.

Biofeedback is used in the treatment of a variety of diseases, e.g. headache, migraine, tinnitus, and even ADHD. ADHD affects in Germany around 5% of all children, where boys are more affected than girls. Children with ADHD are often unconcentrated, easily distracted and flared-up, have low perseverance and tend to hyperactivity and act rashly.

Control behavior

Neurofeedback is a kind of biofeedback of brain-activity. The later is measured by an electroencephalogram (EEG). Therefore, experts refer to it as EEG-Biofeedback.

The electrical activity in the brain consists of slow and fast frequencies. Sleeping, dozing, quiet relaxation, attention, mental tension – depending on the state the wavelengths change. Children with ADHD need to learn to perceive their brain-activity, to control it and to manipulate it – to either raise it or suppress it. Through this method, they learn how to better control their behavior. If you are rewarded for faster brainwave frequencies, i.e. attention, you will accordingly change your behavior. Attention and perseverance become states that can be more easily reproduced. Neurofeedback- training tries to turn this behavior into a habit, in order to make it accessible in other situations and environments as well – for example in school.

In order to succeed, it is inevitable that the young patients are motivated and continue their training at home. It is also helpful to have well-informed parents that can support their children in the process.

Virtual Soccer

During neurofeedback-training, the child sits in front of a screen while its brainwaves are being measured by electrodes on its head. Depending on the degree of concentration the child can save a penalty – or fail to do so- in a virtual soccer game with the power of his or her thought. The goalkeeper can only catch the ball if the ball is moved upwards from the lower part of the screen, where it turns red. Alternatively, the kids move a virtual bug through a maze, control a race-car, or let a movie play faster or slower. Later training aims at creating changes without the feedback from the screen, that has in the meantime been turned off.

Neurofeedback – effectiveness

The University of Tübingen, together with the research institute “Brainclics” from the University of Nijmwegen, published a meta-analysis of all 15 studies that have so far been published concerning the topic neurofeedback and ADHD. Their conclusion: neurofeedback is an evidence-based and effective method to treat children with ADHD. The treatment shows significant effects regarding impulsivity and attention and average effects regarding the key symptom hyperactivity. The necessary data was gathered in parent questionnaires. However, the method was not effective in all children. Neurofeedback is not a replacement for a medical treatment but rather a complementary addition to it.

The guidelines state, that neurofeedback can be helpful in treating ADHD, but further studies regarding its effectiveness are recommended. The costs for neurofeedback-training are usually not covered by health insurance.

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