Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental condition that impacts attention, executive function, and impulse control. While often managed with medication, non-pharmacological approaches are gaining attention. One such method is neurofeedback, a therapy that utilizes electroencephalogram (EEG) technology to train the brain to regulate its own activity and manage ADHD symptoms.
Using EEG to Map ADHD Brain Activity
Before treatment begins, a specialized type of EEG called a Quantitative EEG (QEEG) is used to create a “brain map.” This procedure involves placing a cap with numerous sensors on the scalp to measure the brain’s electrical activity. The recording is painless and non-invasive, capturing the brainwaves the brain naturally produces. These brainwaves are categorized into frequency bands, such as delta, theta, alpha, and beta, each associated with different mental states.
The QEEG provides a detailed analysis of these brainwave patterns, comparing an individual’s brain activity to a database of neurotypical individuals of the same age. For ADHD, clinicians often look for specific markers, most notably the ratio of slow-wave theta activity to fast-wave beta activity. A higher-than-average theta-to-beta ratio is a common finding in individuals with ADHD, indicating under-arousal in brain areas responsible for focus and executive function.
This initial brain map serves as a baseline, identifying the specific patterns of brain activity that correlate with the individual’s ADHD symptoms. The map guides the creation of a personalized training protocol for the subsequent neurofeedback sessions.
The Mechanism of Neurofeedback Training
Neurofeedback, also known as EEG biofeedback, functions as a form of brain training based on the principles of operant conditioning. During a session, sensors are placed on the scalp to read the brain’s electrical activity in real-time. These sensors do not deliver any electrical current; they only record the brainwaves being produced. The brainwave data is then fed into a computer, which translates it into visual or auditory feedback.
This feedback is presented in the form of a simple video game, a movie, or music. For example, a movie might play clearly when the individual’s brain produces desired brainwave patterns, but dim if their brain activity shifts into a less optimal state. This immediate feedback loop provides a “reward” for the brain when it functions in a more regulated way, such as by increasing faster beta waves associated with focus.
Through this process, the brain learns to self-regulate more effectively. The positive reinforcement encourages the brain to maintain the states associated with focused attention and calm. Over many sessions, this repeated practice strengthens the neural pathways for self-regulation. The goal is for this learned control over brainwave patterns to become more automatic, improving attention in everyday life.
The Neurofeedback Treatment Journey
The path to neurofeedback treatment begins with an initial consultation and the QEEG brain mapping. This first step establishes a baseline of brain activity and helps the practitioner tailor a specific training protocol. Following the assessment, a structured treatment plan is developed which outlines the recommended number of sessions and their frequency.
A neurofeedback treatment plan consists of 20 to 40 sessions. For the training to be effective, these sessions are scheduled frequently, often two to three times per week, with each session lasting between 30 and 45 minutes. Consistency is important, as the brain requires repeated practice to learn and consolidate new patterns of activity.
Throughout the course of the treatment, progress is closely monitored. This can involve tracking symptom improvements as reported by the individual or their parents, as well as periodic reassessments. In some cases, a follow-up QEEG map may be conducted to objectively measure changes in brainwave patterns from the initial baseline.
Efficacy and Important Considerations
The effectiveness of neurofeedback for ADHD is supported by scientific evidence. The American Academy of Pediatrics has recognized neurofeedback as a “Level 1 – Best Support” intervention for attention and hyperactivity, placing it on par with medication in terms of evidentiary backing. Studies have shown that neurofeedback can lead to improvements in inattention, impulsivity, and hyperactivity. These gains in focus and executive function have been shown to be sustained even six months after treatment has concluded.
While the results are promising, it is not a universal solution. The response to neurofeedback can vary based on factors like ADHD subtype and individual brain patterns. The goal is a lasting positive change in behavior and brain function, which may reduce or, in some cases, eliminate the need for medication.
For those considering this treatment, finding a qualified provider is recommended. It is best to seek a professional certified by the Biofeedback Certification International Alliance (BCIA) to ensure they meet high standards of training. The cost of neurofeedback can be a factor, as a full course of treatment can be expensive, and insurance coverage is often limited.