Brain Retraining Programs for ADHD

October 26, 2009 by Dr.Yannick Pauli

For many kids with ADHD, the biggest challenge they confront everyday is the inability to pay attention – in the classroom, while doing their homework, sometimes while watching a movie. Of all the human faculties, attention used to be one of the least understood. It’s neither a skill nor a talent; it seems to be an inborn ability that cannot be taught or acquired. However, the latest developments in neuro-imaging and genetics provide us with a wider and more sophisticated understanding of how attention works. Studies show that attention is critical to more practical life skills, like the ability to organize things, make deep connections with others, even developing a conscience. More importantly, researchers have discovered that people can be taught how to pay attention, even if they suffer from ADHD.

Brain retraining programs are designed to correct old habits of thinking that lend itself to distractibility, inattention, and lack of focus. Using imaging technology and foundations in neuroscience, brain retraining programs are an alternative treatment that can target the same deficits ADHD medications seek to correct. Although these technologies have not been around long enough to determine if their benefits will last, kids and adults who have tried them found that brain retraining helps in the here and now. The following brain retraining programs are particularly helpful for children with ADHD, but they come with their own drawbacks and limitations.

Neurofeedback

What it does: Neurofeedback is based on the principle that individuals with ADHD have abnormal brain wave pattern that are either over-stimulated or under-stimulated. Beta waves should appear in tasks that require concentration and focus, but individuals with ADHD usually have large theta wave patterns, which indicate a state of daydream. Neurofeedback can retrain the brain until they emit beta waves, thus eliminating symptoms of inattention and distractibility.

How it works: The practitioner will take the medical history of the child and identify the symptoms that need to be treated. Then electrodes will be strapped on to the child’s head while he or she performs a cognitive task like reading out loud. The brain wave activity will be mapped out so the practitioner can figure out the abnormalities in the pattern – which is the theoretical source of the child’s ADHD symptoms. Through a computer game, the child’s brain will then be retrained. The computer game will only work if the child concentrates and emits beta waves. If there are too many theta waves, the game stops working and will only resume when the child concentrates once more. The positive benefits of neurofeedback training remain for months and years after the last session. After a year of therapy, patients tend to reduce their medication dose by 50% or stop taking them altogether.

Costs and drawbacks: The sessions are only 30 minutes long and completely painless. However, the average cost of a treatment course can range anywhere from $2,000 to $5,000. Neurofeedback practitioners are also only available in certain areas. Finally, neurofeedback can only address the inattention issues of the ADHD spectrum and should be used in combination with other treatments.

Bottom line: If you can afford to pay for the neurofeedback treatments, it seems to be worth a shot, especially if your child cannot concentrate on schoolwork.

Working Memory Training

What it does: Working memory is the region of the brain that retains information long enough to accomplish a task. For instance, a child taking a test holds the instruction in the mind as he or she writes the answers. This program can help improve working memory, thus improving the child’s ability to finish tasks, solve problems, and adapt to new situations.

How it works: Of all the brain retraining programs, Cogmed Working Memory Training is the only one that provides convenience and flexibility. A computer program called Robomemo is downloading on to a home computer like an ordinary software. For five weeks and five days in a week, the child will then spend one hour performing several exercises that are designed to improve working memory. As the days go by, the exercises become more and more challenging. Purchasing the program also entitles the child and parent to sessions with a trainer, who can keep track of progress, troubleshoot the program, encourage the patient, and provide feedback.
At least 75% of children who complete the program have improved attention and reduced hyperactivity. Parents also report that they become more “mature” – they accomplish chores without being reminded, and they no longer lose schoolbooks and other materials. Follow-up studies show that 80% of children retained or improved upon their working memory gains a year after their last session.

Costs and drawbacks: The Cogmed Working Memory Training is a rigorous program designed for older children and for children who have better control of their ADHD symptoms. Kids aged 7 and below may be too young to understand or accomplish the exercises. The program is also expensive and costs at least $1,500.

Bottom line: The convenience provided by the Cogmed Working Memory Training is attractive to parents who live too far away from clinics that offer other non-medical ADHD treatments. Like other treatments for ADHD, the Working Memory Training program should be a component of a more holistic solution.

LearningRx

What it does: LearningRx is a series of tutorial centers in the United States that offer one-on-one training to improve cognitive skills. Kids with ADHD, autism, and learning disabilities can benefit from LearningRx’s specialized programs based on their problem areas.

How it works: The child will be asked to take an evaluation exam that will reveal his or her unique learning style and cognitive skills. The exam is an important first step because this will determine which of the LearningRx programs is best suited for him or her.
There are four programs offered by LearningRx. The first is ThinkRx, which provides the foundation of the whole learning program. ReadRx is designed to improve the reading abilities and correct dyslexia. MathRx teaches the child how to use mathematical concepts and logical reasoning. Liftoff provides the cognitive training needed by pre-school children so they can prepare to enter elementary school. Unlike most tutorial centers, LearningRx does not teach academic subjects. Rather, this program teaches children how to use their basic cognitive skills, control their attention span, and overcome their weaknesses with the help of a trainer. The program lasts 12-18 weeks, depending on the child’s needs.

Costs and drawbacks: The first drawback to LearningRx is the expense – the evaluation test costs $100, and every hour spent on the program costs around $90. This means that a whole course of treatment can range anywhere between $2,000 and $5,000. Unlike the first two brain retraining programs covered by this article, there are no published studies evaluating the efficacy of LearningRx’s approach. A small, yet unpublished study, suggest that a 24-weeks program might have a beneficial effect on various cognitive functions.

Bottom line: The evidence for this program is mainly anecdotal and through testimonials. If money is no problem then LearningRx might be worth trying.