EEG Neurofeedback – A Novel Treatment Modality for Children with Attention Deficit Hyperactivity Disorder


EEG neurofeedback (EEG-NF) is a novel treatment modality. Many studies have assessed its efficacy for childhood ADHD. There is some evidence that it improves inattention and other behavioral and cognitive symptoms of ADHD. It is associated with minimal adverse effects, and can be used alone or in combination with medications to enhance their efficacy. Though double-blind placebo controlled studies have recently raised some doubts about its efficacy, EEG-NF remains an option to consider in ADHD management at least as an add-on to pharmacological interventions.


American Psychiatric Association. Diagnostic and statistical manual of mental disorders (4th ed). Washington, DC; 2000.

Barkley, RA. Attention deficit hyperactivity disorder: A handbook for diagnosis and treatment (2nd ed.) New York: Guilford; 1990.

Clarke C, Prior M, Kinsella G. The relationship between executive function abilities, adaptive behaviour, and academic achievement in children with externalising behaviour problems. J Child Psychol Psychiatry 2002; 43:785-96.

Venkata JA, Panicker AS. Prevalence of attention deficit hyperactivity disorder in primary school children. Indian J Psychiatry 2013; 55:338-42.

Biederman J, Faraone S, Milberger S, Guite J, Mick E, Chen L, et al. A prospective 4-year follow-up study of attention-deficit hyperactivity and related disorders. Arch Gen Psychiatry 1996; 53:437–46.

Claude D, Firestone P. The development of ADHD boys: A 12 year follow-up. Can J Behav Sci 1995; 27:226–49.

Lahey BB, Pelham WE, Stein MA, Loney J, Trapani C, Nugent K, et al. Validity of DSM-IV attention-deficit/hyperactivity disorder for younger children. J Am Acad Child Adolesc Psychiatry 1998; 37(7): 695–702.

Sergeant JA, Geurts H, Huijbregts S, Scheres A, Oosterlaan J. The top and the bottom of ADHD: a neuropsychological perspective. Neurosci Biobehav Rev 2003; 27:583-92.

Castellanos FX, Sonuga-Barke EJ, Milham MP, Tannock R. Characterizing cognition in ADHD: beyond executive dysfunction. Trends Cogn Sci 2006; 10:117-23.

Sonuga-Barke EJ, Halperin JM. Developmental phenotypes and causal pathways in attention deficit/hyperactivity disorder: potential targets for early intervention? J Child Psychol Psychiatry 2010; 51:368-89.

Emond V, Joyal C, Poissant H. Structural and functional neuroanatomy of attention-deficit hyperactivity disorder (ADHD). Encephale 2009; 35:107-14.

Shaw P, Rabin C. New insights into attention-deficit/hyperactivity disorder using structural neuroimaging. Curr Psychiatry Rep 2009; 11:393-98.

The MTA Cooperative Group. A 14-month randomized clinical trial of treatment strategies for attention-deficit/hyperactivity disorder. Arch Gen Psychiatry 1999; 56(12):1073–86.

Araone SV, Buitelaar J. Comparing the efficacy of stimulants for ADHD in children and adolescents using meta-analysis. Eur Child Adolesc Psychiatry 2010; 19:353–64.

VandeLoo-Neus GH, Rommelse N, Buitelaar JK. To stop or not to stop? How long should treatment of attention-deficit hyperactivity disorder be extended? Eur Neuropsychopharmacol 2011; 21:584–99.

Kutcher S, Aman M, Brooks SJ, Buitelaar J, van Daalen E, Fegert J, et al. International consensus statement on at-tention-deficit/hyperactivity disorder (ADHD) and disruptive behaviour dis-orders (DBDs): clinical implications and treatment practice suggestions. Eur Neuropsychopharmacol. 2004; 14:11-28.

Berger I, Dor T, Nevo Y, Goldzweig G. Attitudes towards attention deficit hyperactivity disorder (ADHD) treatment. Parents and children’s perspectives. J Child Neurol 2008; 23:1036-42.

Sonuga-Barke EJ, Brandeis D, Cortese S, Daley D. Nonpharmacological interventions for ADHD: systematic review and meta-analyses of randomized controlled trials of dietary and psychological treatments. Am J Psychiatry 2013; 170(3):275-89.

Patrick N, Friel BS. EEG biofeedback in the treatment of attention deficit/ hyperactivity disorder. Alternative medicine Review, 2007; 12(2):146-51.

Hughes JR, John ER. Conventional and quantitative electroencephalography in psychiatry. J Neuropsychiatry Clin Neurosci 1999; 11:190-208.

Mann CA, Lubar JF, Zimmerman AW, Miller CA, Muenchen RA. Quantitative analysis of EEG in boys with attention-deficit hyperactivity disorder: Controlled study with clinical implications. Pediatr Neurol 1992; 8:30-6.

Monastra VJ, Lubar JF, Linden M. The development of a quantitative electroencephalographic scanning process for attention deficit-hyperactivity disorder: reliability and validity studies. Neuropsychology 2001; 15:136-44.

Monastra VJ, Lynn S, Linden M, Lubar JF, Gruzelier J, LaVaque TJ. Electroencephalographic biofeedback in the treatment of attention-deficit/hyperactivity disorder. Appl Psychophysiol Biofeedback 2005; 30:95-114.

Sterman MB. Effects of brain surgery and EEG operant conditioning on seizure latency following monomethyl hydrazine intoxication in the cat. Exp Neurol 1976; 50:757-65.

Sterman MB. Basic concepts and clinical findings in the treatment of seizure disorders with EEG operant conditioning. Clin Electroencephalogr 2000; 31:45-55.

Burkett SV, Cummins JM, Dickson R, Skolnick MH. An open clinical trial utilizing real-time EEG operant conditioning as an adjunctive therapy in the treatment of crack cocaine dependence. J Neurother 2005; 9(2):27–47.

Lubar JF. Discourse on development of EEG diagnostics and Biofeedback for attention deficit / hyperactivity disorders. Biofeedback Self Regul. 1991; 16(3):201-25.

Mann CA, Lubar JF, Zimmerman AW, Miller CA, Muenchen RA. Quantitative analysis of EEG in boys with attention-deficit hyperactivity disorder: Controlled study with clinical implications. Pediatr Neurol 1992; 8:30-6.

Thompson L, Thompson M. Neurofeedback combined with training in metacognitive strategies: Effectiveness in students with ADD. Appl Psychophysiol Biofeedback 1998; 23:243-63.

Kaiser DA, Othmer S. Effect of neurofeedback on variables of attention in a large multi-center trial. J Neurother 2000; 4:5-28.

Rossiter TR, La Vaque TJ. A comparison of EEG biofeedback and psychostimulants in treating attention deficit/hyperactivity disorders. J Neurother 1995; 1:48-59.

Carmody DP, Radvanski DC, Wadhwani S, Sabo MJ, Vergara L. EEG biofeedback training and attention-deficit/ hyperactivity disorder in an elementary school setting. J Neurother 2001; 4:5-27.

Linden M, Habib T, Radojevic V. A controlled study of the effects of EEG biofeedback on cognition and behavior of children with attention deficit disorder and learning disabilities. Biofeedback Self Regul 1996; 21:35-49.

Monastra VJ, Monastra DM, George S. The effects of stimulant therapy, EEG biofeedback, and parenting style on the primary symptoms of attention-deficit/ hyperactivity disorder. Appl Psychophysiol Biofeedback 2002; 27:231-49.

deBeus, R. Progress in efficacy studies of EEG biofeedback for ADHD. Presentation at the Annual Meeting of American Psychiatric Association 2006; Toronto, Canada.

Levesque J, Beauregard M, Mensour B. Effect of neurofeedback training on the neural substrates of selective attention in children with attention deficit/ hyperactivity disorder: a functional magnetic resonance imaging study. Neurosci Lett 2006; 394:216-21.

Li L, Yang L, Zhuo CJ, Wang Y. A randomized controlled trial of combined EEG neurofeedback and methyl phenidate therapy for the treatment of ADHD. Swiss Med Wkly 2013; 143:w13838.

La Vaque TJ, Rossiter T. The ethical use of placebo controls in clinical research: the Declaration of Helsinki. Appl Psychophysiol Biofeedback 2001; 26:23–37.

Perreau-Linck E, Lessard N, Levesque J, Beauregard M. Effects of neurofeedback training on inhibitory capacities in ADHD children: a single blind, randomized, placebo-controlled study. J Neurother 2010; 14:229–42.

Arnold LE, Lofthouse N, Hersch S, Pan X, Hurt E, Bates B, et al. EEG Neurofeedback for ADHD: double-blind sham-controlled randomized pilot feasibility trial. J Atten Disord 2012; 17:410–19.

vanDongen-Boomsma M, Vollebregt MA, Slaats-Willemse D, Buitelaar K. A randomized placebo-controlled trial of electroencephalographic (EEG) neurofeedback in children with attention-deficit/hyperactivity disorder J Clin Psychiatry 2013; 74:821–27.

Hammond DC, Kirk L. Negative effects and need for standards of practice in neurofeedback. Biofeedback 2007; 35(4):139-45.

Sterman MB. Basic concepts and clinical findings in the treatment of seizure disorders with EEG operant conditioning. Clin Electroencephalogr 2000; 31:45-55.