Dec. 14, 2002
BY BECKY HAM

A year's worth of counseling and medication relieved some symptoms of attention-deficit hyperactivity disorder among a group children, but only children receiving additional biofeedback therapy managed to hold on to these healthy gains after going off the medication, according to a new study.

Half of the 100 children in the study received EEG biofeedback therapy, a treatment in which individuals are taught to retrain electrical activity in their brains. The biofeedback group also experienced significant changes in these "brain wave" patterns associated with attention-deficit disorder, according to Vincent J. Monastra, Ph.D., of the FPI Attention Disorders Clinic and colleagues.

"While ADHD is diagnosed on the basis of behavioral symptoms, our findings suggest that the disorder also involves neurophysiological factors," says Monastra and colleagues.

The study results are published in the December issue of Applied Psychophysiology and Biofeedback.

Most studies suggest that drugs like Ritalin, the medication used in this study, do a good job of relieving ADHD symptoms. But up to 45 percent of patients diagnosed with certain forms of the disorder do not respond to medication, and some researchers have raised concerns about the long-term use of Ritalin, especially in children. Alternative behavioral therapies like EEG biofeedback are receiving increased attention as a result.

Monastra and colleagues followed 100 children between 6 and 19 years old through a year of ADHD treatment that included special parenting classes, school consultation and Ritalin. The researchers evaluated the severity of each child's ADHD symptoms using a computerized attention test and survey of their behavior before and after the year's therapy.

Fifty-one of the children also received weekly EEG biofeedback treatments. The treatment uses a device called an electroencephalograph to measure the types of electrical activity, or brain waves, produced in certain areas of the brain.

According to a few previous studies, therapies that reduce the amount of "slow," or low-frequency, brainwaves and boost the number of "fast," or high-frequency, brain waves can relieve some symptoms of ADHD. The children in the study were rewarded for their efforts to change their slower brain waves to faster ones after seeing how certain behaviors affected their brain wave patterns.

The year's worth of Ritalin treatments improved attention deficit and impulse control in most children, independently of the effects of parental counseling and the biofeedback therapy. But without the medicine, the symptoms of attention deficit quickly returned in among all children except for those who had participated in the biofeedback therapy. Biofeedback was also the only treatment that significantly reduced the amount of slow brain waves in the children.

Parental counseling appeared to ease ADHD symptoms at home, but not at school, Monastra and colleagues concluded.

"Systematic school intervention, typically through 'individual education plans' were necessary in order to reduce the adverse effects of ADHD in the classroom," says Monastra.

Further research is necessary to find out whether EEG biofeedback is an effective long-term treatment for ADHD and to discover how Ritalin and biofeedback work together, the researchers say.

Attention-deficit-hyperactivity disorder affects between 3 percent and 5 percent of school-aged children. Along with the main symptoms of hyperactivity and inattention, individuals with ADHD frequently suffer from anxiety and depression and may have learning disorders.

---Health Behavior News Service