Attention Deficit Hyperactivity Disorder (ADHD) is a very common developmental disorder that usually appears in childhood, and it's so common that 10% of children get an ADHD diagnosis. For many, ADHD is accompanied by other problems such as learning disabilities, motor and sensory difficulties, mood disorders and behavioral problems.
The currently accepted treatment for ADHD is Ritalin, a medication which has shown very positive results but causes various side effects. Now, many researchers are looking into additional treatment options. Schneider Children’s Medical Center for Israel in Petah Tikva near Tel Aviv recently investigated using neurofeedback to treat ADHD, and found that it is a significantly effective treatment.
The large-scale study was conducted at the ADHD Clinic in the Department of Psychological Medicine at the hospital, led by Dr. Irit Shur Sapir and supported by the “Our Children" organization.
As part of the effectiveness of different treatment methods in children with ADHD, it has been shown that neurofeedback therapy is significantly effective in improving ADHD, no less than medication.
Among other things, there was a significant improvement in the attention and hyperactivity indices, when after the neurofeedback treatment the children were able to concentrate better and were less impulsive and hyperactive.
Neurofeedback is a treatment method in which the patient's brain is taught to work more efficiently with the help of real-time feedback from reading brain activity.
"One way to observe the brain is through its metabolic activity, or in other words, examining the amount of oxygenated blood that reaches certain areas of the brain," Sapir explained.
"To do this, we use a neurofeedback treatment method called HEG (Hemoencephalography) during which we monitor the amount of oxygenated blood flowing in the prefrontal lobe of the brain, while at the same time training the brain to operate this area more efficiently and teaching it new behavior patterns.”
How is the treatment performed?
"During treatment, the child watches a computer screen with a sensor strapped onto the head. The sensor reads the brain activity and displays it on the screen. The activity can be seen as a color column that changes its height, as an image moving forward on the track or as an animated video.
"The child's task is to make the character go up a mountain, or allow the video to progress clearly and without interruptions. The purpose of the task is to increase the amount of oxygenated blood flowing in the frontal areas of the brain. Success in the task is positive feedback or 'reward' for the patient, and at the same time positive feedback to his brain.
"The patient comes out of the encounter with a sense of satisfaction, the mind actually learns to work more efficiently and thus gradually reduces the symptoms being treated,” said Sapir.
It’s important to clarify that kids with attention and concentration difficulties often have difficulty with daily organizational tasks and behavioral regulation, and often exhibit impulsivity and hyperactivity. The anterior (front) regions of the brain are responsible for managerial functions, attentional resources, and the ability to do emotional and behavioral inhibition (along with other regions).
"Training of these areas strengthens the brain's ability to regulate itself, optimize resource allocation, as well as filter, organize and focus the work of other areas of the brain," explained Sapir.
How long does the treatment last and is it effective over time?
"At the end of about 20 sessions, which take place twice a week, the brain learns and assimilates the change," said Sapir.
"Once the new pattern is established it’s enacted, and the reinforcements previously given to the brain as part of the therapy sessions are replaced with positive feedback that the child receives in the real world from parents, teachers and friends.
"The treatment doesn’t cause drastic changes in the structure or wiring of the brain, but provides the brain with the necessary flexibility so that it can develop new strategies for conducting and dealing with the various tasks and challenges.”
Although this is a groundbreaking and original study in Israel, further research is needed in order to deepen the understanding of the effectiveness of the treatment, as well as to study its limitations.
"But, we’re happy to see that there are other treatments that can be offered to children in addition to the medication that is sometimes not effective enough or that they don’t want to take," concluded Sapir.