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Controversial Treatments for Children With Attention-Deficit/Hyperactivity Disorder

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By Sam Goldstein, Ph.D.

EEG Biofeedback

Proponents of this approach believe that children with AD/HD can be trained to increase the type of brainwave activity associated with sustained attention and to decrease the type of activity associated with daydreaming and distraction. They claim the result is improvement in attention and reductions in hyperactivity and impulsivity.

The technique of EEG biofeedback involves measuring levels of electrical activity in various regions of the brain. This information is fed into a computer which transforms it into a signal, such as a light, tone or video game. Using this signal as feedback, the child is taught to increase certain kinds of brainwave activity and decrease other kinds (increase beta, decrease theta). Training involves between forty and eighty treatment sessions according to the proponents of this program. Each session lasts up to forty minutes or more. Since sessions are held two to three times per week, treatment can extend over three to ten months or longer.

Although this treatment has become quite popular and is marketed throughout the country, there continues to be limited, published peer reviewed research to support its use. Although there is an increasing interest in research in this area, the extensive claims initially made by proponents of this treatment (e.g., dramatic improvements in intelligence scores, dramatic reductions in AD/HD symptoms) seem almost too good to believe. Many of the initial studies published were seriously flawed by the use of small numbers of children with ambiguous diagnoses. Furthermore, published studies thus far have not included appropriate control groups to rule out the effects of maturation or placebo.

Biofeedback technology is not new. Although some believe it holds great promise in the treatment of AD/HD, at this time it must be considered at the very most an ancillary treatment used to support other treatments. From a research prospective it must be considered unproven. Parents are advised to proceed with caution. It is an expensive approach whose effectiveness, until better studies have been completed, has been not consistently demonstrated.

Other Controversial Treatments

Among other treatments that parents may hear about on the radio, view on television, or read about are the use of applied kinesiology (the manipulation of bones in the body, particularly plates of the skull to improve body and brain functioning), optometric vision training (exercises to improve eye tracking) and auditory training (enhancing the capacity to listen to and process certain frequencies of sounds). All three of these approaches have been marketed as effective for AD/HD. However, there is limited if any scientific support that any of these three will exert a significant, positive impact on the functioning of children with AD/HD.

Sam Goldstein, Ph.D. is a Clinical Professor of Psychiatry at the University of Utah, a Research Professor of Psychology at George Mason University and Director of the Neurology, Learning and Behavior Center in Salt Lake City, Utah. He is Editor-in-Chief of the Journal of Attention Disorders, author, co-author or editor of 26 books and dozens of book chapters and peer reviewed research articles.

This article originally appeared on Dr. Sam Goldstein's website in 2000,, and is reprinted here with permission.

Comments from readers

"When did Goldstein write this? His information about the Feingold diet is inaccurate and out of date. For example,the double-blind Rowe & Rowe (1994) study found a dose-response effect for tartrazine (Yellow #5), and there is the 2007 McCann study that found that even normal children react to a modest amount of food dyes with increased activity and decreased attention span. There is the landmark 2006 Lau study in which he tested additives in combination and found that the combinations were many times more powerfully toxic to developing nerve tissue. Actually, every single study done since 1987 has shown clearly that the diet works - often dramatically. Some tested a more restrictive diet called an oligoantigenic (few foods) diet, but they got the same results. These studies have been replicated over and over with similar results. Most recent literature reviews agree that the diet is effective to treat ADHD. The 2004 Schab meta-analysis agrees as well. The American Academy of Pediatrics published an article in their 2008 Grand Rounds that admitted that after 30 years of saying the diet doesn’t work they “may have been wrong.� They now say, “. . . a trial of a preservative-free, food coloring–free diet is a reasonable intervention.� The British Medical Journal, in May 2008, said a “trial of eliminating colourings and preservatives should be part of standard treatment . . .� "
"Thank you so much for this artical on questionable ADD Treatments. I was wondering if you had another artical with Treaments that have proven success and how to get them? I am a desperate parent trying to help my son hear and understand me when I am talking to him. Thanks "