A Randomized Control Trial of Computer Attention Training with and without neurofeedback in Children with Attention-Deficit/Hyperactivity Disorder

We report results from a study in 19 schools examining the efficacy of two computer-based attention training systems in teaching children with Attention Deficit/Hyperactivity Disorder (ADHD) to concentrate more effectively. We compared neurofeedback (NFB), which teaches children to alter their brainwave activity and cognitive attention training (CAT). Methods: 105 children with ADHD in grades 2-4 were randomly assigned to receive the NFB, CAT, or a control. Participants received forty 45-minute sessions three times per week at elementary school for four months. We report results from the T-SKAMP completed by teachers, assessing symptoms of ADHD in the classroom, the PERMP, a math test completed by students, analyzing speed and accuracy, and the BOSS, a double-blind objective classroom observations. Results: We conducted ANOVAs of the PERMP, T-SKAMP, and BOSS. The NFB group showed improvement on the PERMP in accuracy (p=0.002), and in speed (p=0.008). The NFB group demonstrated a decrease in ADHD symptoms as reported by teachers on the T-SKAMP Total Score (p=0.006). On the BOSS classroom observation, the NFB group demonstrated significant increased classroom engagement (p=0.002) and decreased off-task behaviors (p=0.001). The CAT group showed improvement in accuracy on the PERMP (p=0.002) and in speed (p=0.04). On the BOSS, the CAT group showed a trend in increased classroom engagement (p=0.08) and a significant decrease in off-task behaviors (p=0.02). The control group showed no significant effects on the PERMP, T-SKAMP, or BOSS. Conclusion: These data suggest that computer-based attention training offered in elementary school settings may be effective in reducing ADHD symptoms and improved math achievement.