But newer research has begun to build a promising foundation. A German study published earlier this year, which found that neurofeedback improved attention and reduced impulsivity and hyperactivity, was fairly large (94 children ages 8 to 12) and included a control group. Fifty-nine of the children received 36 sessions of neurofeedback over three to four weeks, while the other 35 children were trained in a different technique designed to improve attention. Observations by the children's parents and teachers indicated that most kinds of ADHD-related behavior improved much more in the neurofeedback group than in the control group.
The study and 14 others were analyzed in the July issue of the Official Journal of the EEG and Clinical Neuroscience Society. Ten of the studies, involving a total of nearly 500 children, used a control group. "The clinical effects of neurofeedback in the treatment of ADHD can be regarded as clinically meaningful," the authors concluded. "I look at this article, and I'm persuaded that there's something here," says Mayo's Jensen, who also is president and CEO of the REACH Institute, a nonprofit group that trains pediatric health practitioners in the latest mental health therapies. "Previously, I was very skeptical that this treatment had much to offer," says Barkley. He says of the German study, "It looks like based on this study that there might be some promise to it," and he stresses "might" and "some." He is not ready to embrace the technique. "Should [neurofeedback] be offered to the public?" he says. "My answer would be no."
Still, as evidence of benefit accumulates, increasing numbers of parents will ask themselves whether neurofeedback may be worth trying. The question, says Jensen, is whether the expense is justifiable. Forty to 60 sessions, typically costing $100 per session, are generally recommended; most health insurance plans consider neurofeedback an alternative treatment and will not cover the expense. Drug treatment can be more expensive over the long run—about $180 a month for some stimulants—but generic medications can cost as little as $10 a month. Kids might go five to eight years on medication before reaching the amount spent on neurofeedback, says Barkley. And if the family has health insurance, most plans cover much of the cost of drugs.
While many practitioners envision neurofeedback as a drug-free solution, others see it as a complement to drug therapy. Eugene Arnold, a professor emeritus of psychiatry at the Ohio State University, is conducting a study, funded by the National Institutes of Health, of how the neurofeedback sessions are spaced and how many are used. He says neurofeedback alone does not produce the immediate and dramatic results of medication. Anne Hollows of Sudbury, Mass., mother of 9-year-old Nicholas, feels that while medication has been vital in easing her son's symptoms, his 57 sessions of neurofeedback have helped, making him calmer and better able to control his actions.
The catch with drugs is that many children stop taking them. In one large study, more than 60 percent of the children on stimulants discontinued them within eight years. Parental concern may be a factor—side effects are not uncommon, and lately some of the drugs have been linked to stunted growth and, in rare cases, an increased risk of heart attack. By contrast, says Arnold, neurofeedback "by and large doesn't appear to be a risky treatment. Undoubtedly, it has less side effects than medicine."
That's why Kim Sanders of Aubrey, Texas, decided to try neurofeedback a few years ago with Macy, now 15, and Trent, 14. The stimulants they were taking for their attention disorders, says Sanders, inhibited their growth. She has seen a "night and day" difference in Trent's behavior and a "remarkable" improvement in Macy's performance in school. They no longer take medicine.