The effectiveness of computerized cognitive training and neurofeedback treatment in improving the functioning of ADHD children

A study conducted at the Center for the Study of Special Populations (See note below.) was designed to evaluate the effectiveness of commercially available computerized cognitive training (Captain’s Log) and neurofeedback (EEG brain wave biofeedback) treatment in helping to improve the functioning of children diagnosed as having an ADHD disorder. A total of 71 participants (85% males) between the ages of 8 and 11, and diagnosed by either a physician or a psychologist as having ADHD, completed the study. The volunteers were randomly assigned to the following three groups: 1) Cognitive Training, 2) Neurofeedback or 3) No Treatment. Each person in the two treatment groups was provided 20 half- hour sessions over a 10 week period. A battery of tests and parent rating scales were administered at the beginning and end of the study using test examiners who were “blind” to group affiliation. These tests supported the efficacy of the Captain’s Log computerized cognitive training system in helping to significantly improve the ability to focus and sustain attention, to encode and retrieve visual and auditory information and to increase the speed of mental processing. Cognitive training also significantly improved emotional and psychological functioning by apparently decreasing ADHD symptoms. One test rating scale of Hyperactivity also showed significant decreases in ADHD symptoms. On another scale of Hyperactivity no decreases were observed, possibly because this group’s mean scale score to start was already below the clinical cut-off level for Impulsive-Hyperactive behaviors. Neurofeedback treatment was found to be more specific in its benefits, and the evidence indicates that this treatment helped to reduce impulsive, hyperactive, and off-task behaviors for individuals who initially presented as significantly more impaired than the other two treatment groups in terms of Impulsive-Hyperactive behaviors. At the end of treatment for this group of individuals, the mean score, which was initially clinically elevated based on the Conner’s Impulsive- Hyperactive scale, decreased to below the clinical cut-off level. However, only the one area of memory related to an increased ability for immediate auditory recall showed improvement, and verbal recall of a story significantly declined. Thus, the neurofeedback treatment did not seem as reliable or broadly effective in improving attention, concentration and memory skills as cognitive training. While our understanding of who will best benefit from cognitive training and neurofeedback and how these new techniques may best be used is limited at this time, it is hoped that these findings will encourage further controlled research in these areas. This study also found the lack of any treatment for children with ADHD during the summertime led to a pervasive worsening of their emotional and behavioral problems. The No Treatment group also showed no gains in cognitive functioning on the objective tests. It is not clear to this researcher what kind of activities (e.g., camp, day care, summer school, vacations, etc.) these children participated in during the summer. However, the lack of regular tasks and exercises demanding focused attention, concentration, sitting still and increasing response inhibition clearly appears to be detrimental to the mental health and well being of ADHD children. Based on this research, these techniques show great promise as components in the multi-modal treatment of ADHD. It may prove beneficial to combine cognitive training and neurofeedback for some individuals. The traditional approaches of psychotherapy, behavior modification, school modifications, family therapy and parent education can all be integrated and combined with these approaches. While our understanding of who will best benefit from cognitive training and neurofeedback and how these new techniques may best be used is limited at this time, it is hoped that these findings will encourage further controlled research in these areas. Note: This analysis is based on independently conducted research completed during the Summer of 1993 at the Center for the Study of Special Populations, California State Polytechnic University, Pomona, California, by Drs. Aubrey Fine and Larry Goldman. The interpretation and views expressed in this analysis of the study’s findings are those solely of Dr. Sandford who has the other authors’ permission to disseminate their findings and his own analysis of the results.