Research and Evidence

9th Annual Conference
Monterey, CA 27-30 October 2001

Comparison of Videogame and Standard EEG Biofeedback With AD/HD Children: Results of the First Concept Study.

Roger J. deBeus, PhD, Olafur S. Palsson, PsyD, Alan T. Pope, PhD, John D. Ball, PhD, Marsha J. Turner, MA
Riverside EEG Biofeedback Services (RJD), Mindspire, LLC. (OSP), NASA Langley Research Center (ATP), Eastern Virginia Medical School (JDB & MJT)

Objectives: This project was a randomized and controlled technology concept study, funded by NASA's Langley Research Center. The study assessed whether a new video game biofeedback technology developed at NASA Langley Research Center was as effective as traditional neurofeedback in treating Attention Deficit Hyperactivity Disorder (ADHD), and whether there were significant differences in its appeal as a clinical method compared to standard neurofeedback treatment.

Participants: Twenty-two children with ADHD of the hyperactive-impulsive subtype (DSM-IV criteria plus physician diagnosis) participated. The age range was 9-13 years and there were 3 girls and 19 boys. All the children were on short-acting medications for ADHD. The children had to be of at least normal intelligence, and have no history of affective problems or learning disabilities.

Design: The children were randomized into treatment groups: video game (n=11) vs. standard neurofeedback (n=11). Children in both groups completed 40 individual treatment sessions, usually seen once or twice a week. The children came for one test session before and after treatment, where they completed a QEEG, TOVA and neuropsychological tests. BASC Monitor data was collected pre-and post-treatment and every ten sessions. Children in both groups were trained with a single active Cz electrode, with reference electrode and ground attached to the earlobes.

Equipment: The video game group equipment consisted of J&J I-330 EEG hardware, NASA-built modulation unit and a modified game controller used with a standard Playstation console. Training displays were EEG-influenced off-the-shelf Sony Playstation games. The standard group equipment consisted of Thought Technology ProComp+ hardware and Multitrace Software. Displays were bar graphs and simple figures representing changes in SMR, beta and theta bands.

Results: BASC Monitor and TOVA scores indicated similar significant improvements in both groups. No significant difference in treatment change was seen in between-group comparisons. Parents' subjective appraisal of treatment effect on ADHD was more positive for the video game group. The video game treatment was rated significantly more enjoyable by both parents and children. Trends on pre-post QEEG change maps indicated that the video game training may have advantages in creating more quantitative EEG effect in the therapeutic direction.

Conclusions: We conclude that the video game biofeedback technology, as implemented in the NASA prototype tested, produced equivalent results to standard neurofeedback in effects on ADHD symptoms. Both the video game and standard neurofeedback improved the functioning of children with ADHD substantially above the benefits of medication. The video game technology provided advantages over standard neurofeedback treatment in terms of enjoyment for the children and positive parent perception, and possibly has stronger quantitative post-treatment effects on EEG.