Biofeedback: What You Need to Know

Biofeedback is an alternative therapy some people use to treat the symptoms of attention-deficit hyperactivity disorder (ADHD). It’s also called neurofeedback, EEG biofeedback or neurotherapy.

This treatment has been used since the late 1960s, but evidence on whether it can help ADHD symptoms is still mixed.

What Biofeedback Is

Biofeedback has long been used to treat problems like high blood pressure, muscle tension and anxiety. Neurofeedback, a form of biofeedback, is used mainly with kids who have ADHD. It may also help kids with learning and thinking differences who struggle with organization, working memory and executive functioning skills.

When used for ADHD, a device reads a child’s brain wave activity and sends feedback via a game-like challenge. Supporters claim this process can train the brain to behave differently and reduce ADHD symptoms.

The concept of neurofeedback for ADHD is based on evidence that some people with ADHD show differences in brain activity, especially in the frontal lobe. This part of the brain affects concentration and organization.

How Biofeedback Works

A biofeedback device acts like a sixth sense that allows a patient to “see” or “hear” activity inside his body. A typical device picks up electrical signals in the muscles. It translates these signals into a form the patient can sense, such as a flashing light or a sound, every time muscles tense up. He tries to slow down the flashing or beeping by becoming aware of the tense muscle and figuring out how to relax it.

During neurofeedback, electrodes (which look like flattened ear buds) are placed on a child’s head or in a headband, to monitor his brain activity. These electrodes are not painful.

Here’s how neurofeedback works:

1. The child watches a video and listens for a prompt to change something he sees. For example, he might be asked to make a dot onscreen stand still.

2. He focuses his mind on the task, which sends a message through the electrodes on his scalp to the computer. He does this without using a mouse, joystick or keyboard.

3. As the computer senses electrical activity in the child’s brain, it sends him feedback (the dot on the screen does or doesn’t stop moving, for example).

4. This feedback helps the child figure out how to “control” or change the way he’s concentrating or paying attention.

The idea is that over time, having a child alter his brain waves through practice and repetition will help him concentrate for longer periods of time while playing the neurofeedback game.

Weekly sessions of an hour or less are usually recommended. Depending how severe the ADHD symptoms are, treatment may take 10 to 20 sessions.

Who Provides Biofeedback

This therapy is provided by a biofeedback therapist. Laws that regulate this therapy vary from state to state. Some biofeedback therapists are certified in a certain approach.

Biofeedback therapists are usually professionals in psychology and psychiatry, physical therapy or nursing. Some provide biofeedback therapy under the supervision of a medical doctor.

Your child’s doctor or other specialists, such as psychologists, can often help you find a good biofeedback therapist in your area.

What to Watch Out For

So far, research on how well neurofeedback works for ADHD is inconclusive. Some scientists who reviewed the studies say the therapy is “probably helpful.” But others found that it’s only “possibly helpful” for ADHD.

Neurofeedback can be expensive, and your health insurance may not cover it.

The Bottom Line

There is little harm in trying neurofeedback. But the evidence that it helps kids with ADHD and other learning and thinking differences is mixed. Before trying any alternative therapy for your child, be sure to investigate it. Here’s a list of questions to ask.