Neurofeedback Therapy for AD/HD

By Dr. Doug Seiden

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Although it’s been 20 years since I worked as a psychologist in the Coney Island, New York, school system, there is a moment that continues to stand out in my memory.

At the time, I was doing weekly therapy with an elementary school student who rarely stayed in his seat and even more rarely paid attention to his teachers’ lessons. One day, I went to fetch him from class for our therapy session, and was told that he was in the computer room.

When I went there, not only he but several of my other clients with attention, impulsivity or hyperactivity problems were in front of computers, sitting still and paying complete attention to the screens.

“So?” might ask any parent of a child with an attentional challenge who knows that this difficulty strangely doesn’t carry over to video games. But the children in that room weren’t playing video games. They were learning math.

During their classroom math lessons these students either spaced out or zoomed around the room. Why were these kids so quiet and attentive while they were being taught math on a computer? The answer is that the computers were teaching them at a level and speed that at any given moment was not so easy as to be boring, yet not so hard as to be frustrating. One solution to attention problems is to change characteristics of the object or thing requiring attention.

A second approach is to change characteristics of the person having the difficulty. Most people can pay attention to things that are too easy, too difficult, or not particularly stimulating. But for some of us, there is something that interferes with paying attention under less than optimal conditions. Current research suggests that this “something” involves the power of brainwaves of various speeds in certain regions of the brain.

You may have wondered why when some overactive children take a stimulant medication such as Ritalin they slow down, rather than speed up. The simple answer is that difficulty with attention can sometimes be caused by slow brainwaves being much stronger than fast brainwaves.

The hyperactivity we often see in people with attention problems may be a way of self-stimulating — zooming around in an effort to speed up their brains. When their brain is sped up with stimulant medications, they no longer feel the urge to speed it up themselves. It is now easier to sit still, and even pay attention to a teacher expounding on long division or some other topic that doesn’t involve superheroes.

The downside of using stimulants is that they can reduce sleep and appetite and increase heart rate and blood pressure. The most common alternative, behavior modification (such as a point system to reward attention, sitting still and doing schoolwork) has some success, but it still does not address the brainwave issue.

A lesser known treatment that due to its effectiveness has been endorsed by the American Academy of Pediatrics as a “Level 1 – Best Support” treatment — along with medication, behavior therapy, parent management training and self-verbalization — is neurofeedback, which trains the brain to self-regulate. Whereas medication for AD/HD is helpful only while being used, and the other therapies help to manage symptoms without necessarily reducing the underlying distress, neurofeedback trains the brain to self-regulate.

Neurofeedback's beneficial effects on attention, impulsivity and hyperactivity have been found to last and even to further improve after treatment is completed.