An Effective Altenative Treatment for ADD & ADHD

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nWhile the most recent follow-up study to the major NIMH-funded "Multimodal Treatment Study of Children with Attention Deficit Hyperactivity Disorder (MTA)" continues to demonstrate the effectiveness of both medication and behavioral modification working together as part of a multi-modal treatment plan, there continues to be a number of alternative treatments put forth with the claim that they can effectively treat the symptoms of AD/HD.

One such treatment, neurofeedback [also known as electroencephalographic (EEG) biofeedback], has increasingly come into the spotlight, as parents continually search for ways to help their children cope with the effects of AD/HD.

Along with this increased interest, there are also many questions regarding neurofeedback:

• Is neurofeedback an effective method of treating AD/HD?
• If so, how effective is it?
• If it is effective, is the treatment worth the cost?

The effectiveness of neurofeedback is a topic of much debate among AD/HD researchers. The NRC has produced a new information sheet, What We Know #6A: Complementary and Alternative Treatments: Neurofeedback (EEG Biofeedback) and AD/HD that covers the topic in detail.

As indicated in WWK #6A, some researchers believe neurofeedback meets the American Psychological Association (APA) standard to be considered "Probably Efficacious," the third category on a scale of five. Other prominent AD/HD researchers, including members of the CHADD Professional Advisory Board (PAB) have concluded that neurofeedback is "Possibly Efficacious," the second level on the APA scale. The fifth level, "Efficacious and Specific," is the highest attainable level on the APA scale.

The American Academy of Child and Adolescent Psychiatry (AACAP) uses a different, four level scale. Some researchers have concluded that neurofeedback meets the guidelines for "Clinical Guidelines," the third of four levels, and only one-step removed from the highest rating. The CHADD PAB holds the position that neurofeedback meets the criteria for "Option," one level below "Clinical Guidelines."

There is much research left to do on the topic of neurofeedback to determine its effectiveness and feasibility as a treatment option for AD/HD. One thing to note is that neurofeedback, even if it is determined to be an effective form of treatment, is also cumbersome and costly. Each neurofeedback session must be administered by a trained clinician at normal rates, and the treatment can run as many as 40 sessions, as indicated in WWK #6A.

For all this discussion on the effectiveness of neurofeedback, the most basic question remains: What is neurofeedback? In the simplest terms, neurofeedback is a way to monitor and regulate brainwaves. EEGs can detect these brainwaves. It has been observed that individuals with AD/HD tend to show low levels of arousal in the frontal brain areas. The belief behind neurofeedback treatment is that this can be altered, thus increasing the levels of arousal and reducing the symptoms of AD/HD.

In addition to the What We Know sheet dealing with neurofeedback, more information is available on the National Resource Center's Web site. There is a review of the eight main studies done on neurofeedback available here (PDF). General information on alternative treatments can be found here.