Can Neurofeedback Training Help ADHD Symptoms?

In a recent post, I wrote about our first neurofeedback (also called biofeedback or neurotherapy) training session to treat my daughter Natalie’s attention deficit hyperactivity disorder (ADD/ADHD) and comorbid conditions. In that post, as I processed the surprising information Natalie's neurofeedback practitioner shared -- that she believed Natalie has autism, not ADHD -- I employed this old maxim: If it looks like a duck and sounds like a duck, then it must be a duck. Now, after another week’s training, a different saying sticks in my mind: Which came first, the chicken or the egg?

To use the phrase to describe my current situation, the "chicken" is my recently improved mood, and the "egg" is my positive rating of Natalie’s improved behavior during the week between training sessions. Does one reflect the other? If so, which one came first? Is neurofeedback truly improving Natalie’s ADD/ADHD symptoms, or am I simply more optimistic and thus more generous in my assessment?

Natalie has had about a half dozen weekly training sessions so far. Each week, our neurofeedback practitioner, Ladell Lybarger, asks me to rate Natalie in five areas as a way of measuring whether or not the neurofeedback training is helping relieve Natalie’s symptoms. It’s a subjective measure, but it’s pretty much the only measure we have to go on. The five symptoms I rate, on a scale of 0 to 10, are attention, impulsivity, aggression, anxiety, and sleep problems. Lybarger and I developed this list before Natalie began the training protocol based on my report of Natalie’s most problematic issues.

After the first session, Nat was unusually calm for two days, and boy, did that get my hopes up! But since then, I really haven’t noticed any difference in her behavior after a session. If I were asked if I thought Natalie was changing, without benefit of the weekly ratings exercise to fall back on for memory recall, I would say no. However, my weekly ratings of Natalie’s symptoms have reflected a slow upward movement. And then yesterday, I gave her rave reviews. But are things actually changing for Nat, or am I simply in a better place and more generous in my assessment?

One thing that has definitely changed is my mood. I think I had been clinically depressed for a couple of months -- crying often, and for little reason, and irritable, oh so irritable! I was also tired all of the time, wanting nothing more, day or night, than to crawl into bed and lie there. During that time, Natalie wasn’t sleeping well. Three or four times a week, she would wake up in the middle of the night and be unable to go back to sleep for a couple of hours. I always stay awake with her when this happens, but I don’t function well without enough sleep. I’m sure that contributed to my lowered mood and chronic case of crabbiness.

But over the last two weeks, my mood has pretty much returned to normal, no doubt helped by the fact that Natalie has now slept through the night five nights running! And this brings us back to Nat’s improvement. Lybarger says that sleep is often the first thing that improves with neurofeedback. Natalie’s sleeping through the night five straight nights is an objective measure of improvement, but there’s no way to know if it’s a coincidence or attributable to the neurofeedback.

My mood has also improved because I had refreshing breaks from Nat two weekends in a row. The first was the “ordinary” weekend I recently blogged about when Natalie was at my sister’s house for respite. And this past weekend, my husband, Don, and I drove from our home in Iowa to Minneapolis to attend a U2 concert with old friends while both Nat and her older, non-ADHD brother, Aaron, stayed with their grandparents.

With my own moods factored in, it’s hard to be objective. I’m not sure if my recent rave reviews of the rest of Natalie’s behaviors are because of the chicken (my improved mood) or the egg (the effects of neurofeedback). For now, whether it’s real or simply a reflection of my heightened mood, I’m grateful for the improvement. If it looks like improvement and sounds like improvement, it must really be improvement -- right?