title: Game-based combined cognitive and neurofeedback training using Focus Pocus reduces symptom severity in children with diagnosed AD/HD and subclinical AD/HD.
abstract: Previous studies report reductions in symptom severity after combined working memory (WM) and inhibitory control (IC) training in children with AD/HD. Based on theoretical accounts of the role of arousal/attention modulation problems in AD/HD, the current study examined the efficacy of combined WM, IC, and neurofeedback training in children with AD/HD and subclinical AD/HD. Using a randomized waitlist control design, 85 children were randomly allocated to a training or waitlist condition and completed pre- and post-training assessments of overt behavior, trained and untrained cognitive task performance, and resting and task-related EEG activity. The training group completed twenty-five sessions of training using Focus Pocus software at home over a 7 to 8-week period. Trainees improved at the trained tasks, while enjoyment and engagement declined across sessions. After training, AD/HD symptom severity was reduced in the AD/HD and subclinical groups according to parents, and in the former group only according to blinded teachers and significant-others. There were minor improvements in two of six near-transfer tasks, and evidence of far-transfer of training effects in four of five far-transfer tasks. Frontal region changes indicated normalization of atypical EEG features with reduced delta and increased alpha activity. It is concluded that technology developments provide an interesting a vehicle for delivering interventions and that, while further research is needed, combined WM, IC, and neurofeedback training can reduce AD/HD symptom severity in children with AD/HD and may also be beneficial to children with subclinical AD/HD.
authors.affiliation: School of Psychology, University of Wollongong, Wollongong, NSW, Australia; Early Start Research Institute, University of Wollongong, Wollongong, NSW, Australia. Electronic address: sjohnsto@uow.edu.au.
authors.forename: Stuart J
authors.initials: SJ
authors.lastname: Johnstone
authors.affiliation: School of Psychology, University of Wollongong, Wollongong, NSW, Australia; Early Start Research Institute, University of Wollongong, Wollongong, NSW, Australia. Electronic address: steven@uow.edu.au.
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Roodenrys
authors.affiliation: School of Psychology, University of Wollongong, Wollongong, NSW, Australia. Electronic address: kej436@uowmail.edu.au.
authors.forename: Kirsten
authors.initials: K
authors.lastname: Johnson
authors.affiliation: School of Psychology, University of Wollongong, Wollongong, NSW, Australia. Electronic address: rb983@uowmail.edu.au.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Bonfield
authors.affiliation: School of Psychology, University of Wollongong, Wollongong, NSW, Australia; Early Start Research Institute, University of Wollongong, Wollongong, NSW, Australia. Electronic address: sbennett@uow.edu.au.
authors.forename: Susan J
authors.initials: SJ
authors.lastname: Bennett
mesh_terms: D001289:Attention Deficit Disorder with Hyperactivity / Q000503:physiopathology* / Q000534:rehabilitation*; D058256:Brain Waves / Q000502:physiology*; D002648:Child; D000072466:Cognitive Remediation / Q000379:methods*; D005260:Female; D006801:Humans; D007266:Inhibition, Psychological; D008297:Male; D008570:Memory, Short-Term / Q000502:physiology*; D058765:Neurofeedback / Q000502:physiology*; D012720:Severity of Illness Index; D016896:Treatment Outcome
keywords: AD/HD; EEG; Inhibitory control; Neurofeedback; Training; Working memory