Biofeedback

Neurofeedback Training

The American Academy of Pediatrics in their report on Evidence-based Child and Adolescent Psychosocial Interventions published in October 2012 concluded that for the Attention and Hyperactivity behavioural problems, Biofeedback was a “Level 1 Best Support’ intervention, the highest level of support.

In order to be ranked as a “Level 1 Best Support” treatment, neurofeedback had to be evaluated in at least two controlled studies of sufficient size, conducted by two independent groups. The method had to show itself to be superior to placebo, and to be equivalent in outcome to another level 1 or level 2 treatment. The clinical approach had to be manualizable.

Two fairly recent studies carried the burden. The first study compared frequency-based training with slow-cortical-potential or SCP-based training. The comparison group got computerized attention skills training. Neurofeedback yielded the better outcomes in this relatively large study that involved some 102 children (Gevensleben et al., 2009).

The second study was much smaller in size, involving some 20 children in two groups (15 actives, five controls). The distinguishing feature here was that fMRI data were acquired to document the changes induced with the neurofeedback training. These measurements yielded the expected confirming findings, manifesting localized changes in activation that were not seen in the control group. fMRI data were also taken during a continuous performance test, leading to the observation of additional features in the fMRI that discriminated between the experimental and control groups (Beauregard & Levesque, 2006; Levesque, Beauregard & Mensour, 2006).

In his latest publication on the subject, Gevensleben writes: “Despite a number of open questions concerning core mechanisms, moderators and mediators, Neurofeedback (theta/beta and SCP) training seems to be on its way to become a valuable and ethically acceptable module in the treatment of children with ADHD” (Gevensleben et al., 2013).