Effectiveness of neurofeedback training, behaviour management including attention enhancement training and medication
Sumedha Roy1, Nikhiles Mandal1, Anirban Ray1
1Department of Psychiatry, Institute of Psychiatry, A Centre Of Excellence, IPGME&R, 7 D.L. Khan Road, Kolkata, West Bengal, India.
Insights
Medication effectively reduced core Attention Deficit/ Hyperactivity Disorder (ADHD) symptoms, while neurofeedback showed superiority in improving learning problems in children. All interventions offered symptom improvement.
Area of Science:
- Child and Adolescent Psychiatry
- Neurodevelopmental Disorders
- Behavioral Science
Background:
- Attention Deficit/ Hyperactivity Disorder (ADHD) is a prevalent childhood neurodevelopmental disorder.
- Current ADHD treatments include behavioral interventions and medication.
- Neurofeedback, a biofeedback technique, shows potential but requires comparative efficacy studies.
Purpose of the Study:
- To compare the effectiveness of neurofeedback, behavior management, and medication for ADHD in children.
- To evaluate symptom reduction across core ADHD domains and specific areas like learning and peer relations.
Main Methods:
- A randomized controlled trial involving 90 children (6-12 years) diagnosed with ADHD.
- Participants were assigned to neurofeedback, behavior management, or methylphenidate (medication) groups.
- Symptom assessment using the Conners 3-P Short Scale at baseline and after 3 months.
Main Results:
- Medication yielded the most significant reduction in core ADHD symptoms (inattention, hyperactivity, executive functioning).
- Neurofeedback and behavior management showed no significant difference in core symptom improvement.
- Neurofeedback was most effective for learning problems; both neurofeedback and medication improved peer relations more than behavior management.
Conclusions:
- All three interventions (medication, neurofeedback, behavior management) improved ADHD symptoms.
- Medication demonstrated the greatest efficacy for core ADHD symptoms.
- Neurofeedback is a promising intervention for learning problems and can be used independently or in combination with other treatments for pediatric ADHD.
Background:
Attention Deficit/ Hyperactivity Disorder (ADHD) is one of the most common neurodevelopmental psychiatric disorders of childhood. Treatment of ADHD includes medications and Behavioural interventions. Neurofeedback, a type of biofeedback, has been found to be useful in ADHD. It helps patients to control their brain waves consciously. However, it is not yet conclusive if it is efficacious in comparison to behavioural management training and medication.
Aim:
To compare the efficacy of neurofeedback training, behaviour management including attention enhancement training and medication in children with ADHD.
Method:
Ninety children between 6 and 12 years with ADHD were taken and randomly divided into 3 treatment groups equally- neurofeedback, behaviour management and medication (methylphenidate). Conners 3-P Short Scale was applied for baseline assessment. The respective interventions were given and follow up was done at the end of 3 months by using Conners 3-P Short scale to assess the improvement in the symptoms. There were 6 dropouts, the final sample size was 84.
Results:
The medication group showed the greatest reduction of symptoms in inattention, hyperactivity, executive functioning domain (core symptoms of ADHD). No statistically significant difference was observed between Neurofeedback and Behaviour Management in these domains. Learning problems improved in all three groups, neurofeedback being the most effective followed by medication. Both Neurofeedback and Medication groups showed similar effect which was higher than the Behavioural Management group in Peer Relation.
Conclusion:
Improvement in core ADHD symptoms have been observed with all 3 interventions with medication showing the greatest improvement Neurofeedback has been superior for learning problems. Thus, Neurofeedback can be an independent or combined intervention tool for children with ADHD in outpatient department of Psychiatry.
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