title: In-school neurofeedback training for ADHD: sustained improvements from a randomized control trial.
abstract: OBJECTIVE
  To evaluate sustained improvements 6 months after a 40-session, in-school computer attention training intervention using neurofeedback or cognitive training (CT) administered to 7- to 11-year-olds with attention-deficit/hyperactivity disorder (ADHD).
  
  
  METHODS
  One hundred four children were randomly assigned to receive neurofeedback, CT, or a control condition and were evaluated 6 months postintervention. A 3-point growth model assessed change over time across the conditions on the Conners 3-Parent Assessment Report (Conners 3-P), the Behavior Rating Inventory of Executive Function Parent Form (BRIEF), and a systematic double-blinded classroom observation (Behavioral Observation of Students in Schools). Analysis of variance assessed community-initiated changes in stimulant medication.
  
  
  RESULTS
  Parent response rates were 90% at the 6-month follow-up. Six months postintervention, neurofeedback participants maintained significant gains on Conners 3-P (Inattention effect size [ES] = 0.34, Executive Functioning ES = 0.25, Hyperactivity/Impulsivity ES = 0.23) and BRIEF subscales including the Global Executive Composite (ES = 0.31), which remained significantly greater than gains found among children in CT and control conditions. Children in the CT condition showed delayed improvement over immediate postintervention ratings only on Conners 3-P Executive Functioning (ES = 0.18) and 2 BRIEF subscales. At the 6-month follow-up, neurofeedback participants maintained the same stimulant medication dosage, whereas participants in both CT and control conditions showed statistically and clinically significant increases (9 mg [P = .002] and 13 mg [P < .001], respectively).
  
  
  CONCLUSIONS
  Neurofeedback participants made more prompt and greater improvements in ADHD symptoms, which were sustained at the 6-month follow-up, than did CT participants or those in the control group. This finding suggests that neurofeedback is a promising attention training treatment for children with ADHD.
authors.affiliation: The Floating Hospital for Children at Tufts Medical Center, Department of Pediatrics, Boston, Massachusetts; and.
authors.forename: Naomi J
authors.initials: NJ
authors.lastname: Steiner
authors.forename: Elizabeth C
authors.initials: EC
authors.lastname: Frenette
authors.forename: Kirsten M
authors.initials: KM
authors.lastname: Rene
authors.forename: Robert T
authors.initials: RT
authors.lastname: Brennan
authors.forename: Ellen C
authors.initials: EC
authors.lastname: Perrin
mesh_terms: D001289:Attention Deficit Disorder with Hyperactivity / Q000523:psychology* / Q000628:therapy*; D002648:Child; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D058765:Neurofeedback / Q000379:methods*; D012572:School Health Services / Q000639:trends; D013334:Students / Q000523:psychology*; D013997:Time Factors; D016896:Treatment Outcome
keywords: ADHD; biofeedback; cognitive training; growth model; neurofeedback