
NeuroShifts
Dr. Randy Cale is a psychologist and brain-change expert who offers brief but impactful episodes on rewiring the brain and body for lasting and purposeful change.
NeuroShifts
Why Neurofeedback should be first choice for treatment with ADHD
Imagine a treatment for ADHD that doesn't require daily medication, doesn't cause side effects, and actually creates lasting change. Neurofeedback might sound too good to be true, but the science tells a different story.
This deep dive explores why our current approach to ADHD treatment often falls short. The landmark MTA study—the most extensive ADHD research ever conducted—revealed troubling limitations of both medication and behavioral therapy. Despite costing $21 million and following 579 children, researchers found that behavioral therapy failed to outperform standard community care, while medication benefits completely disappeared in long-term follow-ups. More concerning still, children who stayed on medication often showed worse symptoms over time.
Neurofeedback offers a compelling alternative based on fifty years of science. By monitoring brainwave activity in real-time and providing immediate feedback through interactive media, neurofeedback helps the brain learn to self-regulate more effectively—like learning to ride a bike, but for your brain. The evidence is impressive: over 60 published studies demonstrate significant improvements in core ADHD symptoms that persist long after treatment ends. In direct comparisons, neurofeedback produces results equal to medication but with longer-lasting benefits and no side effects.
So why isn't neurofeedback more widely recommended? Medical system inertia plays a role, but awareness is growing. The American Academy of Pediatrics rated neurofeedback a "Level 1 Best Support" treatment for ADHD back in 2012—the same category as medication. In clinical practice, customized neurofeedback protocols help children who couldn't sit still become focused, teens struggling with impulsivity make better choices, and families find relief from overwhelming stress. If you've been battling ADHD with limited success, this research-backed alternative might be the game-changer you've been seeking. Your child's brain—and your family's well-being—deserve a closer look at neurofeedback.
Also posted here: https://medium.com/@capitaldistrictneurofeedback/why-neurofeedback-should-be-first-choice-for-treatment-with-adhd-15813855493f
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Why neurofeedback should be the first-line treatment for ADHD. If you're a parent of a child with ADHD or you've struggled with ADHD yourself, you're probably all too familiar with the typical path a diagnosis, a prescription for stimulant medication, maybe a referral to behavioral therapy and a sincere hope that something will finally click. Neurofeedback, a non-invasive, drug-free treatment that uses real-time monitoring of brainwave activity to teach self-regulation, is a promising alternative to these traditional approaches. For many families, this hopeful journey often turns into a frustrating one. Medications work until they don't. Therapy helps, but it doesn't last and the challenges at school, at home and in relationships continue, leaving you feeling like you're back at square one. So the question becomes what actually works Long-term? Let's talk about that and let's talk about neurofeedback. The problem with first-line treatments yes, even the gold standard ones. The most extensive ADHD study ever funded by the National Institute of Mental Health, called the MTA study, set out to compare the most common ADHD treatments stimulant medication, behavior therapy, a combination of both, and standard community care. This wasn't a small study. It cost $21 million and followed 579 children with ADHD. The researchers went all in to ensure that the medication was perfectly managed and the behavioral therapy was delivered at an elite level, daily summer camps, school aides, teacher consultations and more. What they found was surprising and, for some, deeply disappointing. Behavior therapy BT failed to outperform community care, a result that was not only surprising but, for some, deeply disappointing. The kids who received weeks of intensive behavior training didn't fare any better than those who were simply referred to usual care in their community, leaving many feeling let down by the system. Medication showed short-term improvements, mostly on unblinded parent and teacher ratings. However, there were no meaningful differences in the blinded, objective measures, the ones less likely to be biased. Long-term benefits disappeared At follow-ups, 10 months, 2 years and even 6 years later, the initial benefits from medication or combined treatment vanished. Even more troubling, the children who remained on medication often did worse than those who didn't. In fact, one of the follow-up papers reported that medication use was associated with worse symptoms of hyperactivity, impulsivity and oppositional behaviors, of hyperactivity, impulsivity and oppositional behaviors. By year three, many of these kids had been prescribed additional psychiatric medications antipsychotics, ssris and others, despite a lack of evidence for long-term benefit. Let me be blunt If any other treatment had these kinds of results, it wouldn't be considered a first-line option. And yet that's exactly where we are with ADHC care Neurofeedback a safer, more sustainable option. Unlike medication, neurofeedback doesn't come with side effects like insomnia, appetite suppression, mood swings or increased blood pressure. It's a safe and sustainable alternative that can bring lasting improvements.
Speaker 1:Neurofeedback isn't new. It's been around for more than 50 years and it's built on two solid scientific foundations Operant conditioning learning through feedback and reward, similar to how we train animals or learn to ride a bike and neuroplasticity the brain's ability to rewire itself, which means it can learn and change throughout life. Here's how it works in simple terms During a neurofeedback session, sensors are placed on the scalp to monitor brainwave activity in real time. The brain receives feedback, usually in the form of a video game, movie or animation that rewards it for producing healthier patterns. Over time, the brain learns to self-regulate more effectively, just like learning to ride a bike or play an instrument, and the evidence it's impressive.
Speaker 1:More than 60 published studies have examined the effectiveness of neurofeedback for ADHD. When we look at these studies, the results are clear. Parents reported significant improvements in core ADHD symptoms inattention, impulsivity, hyperactivity. Teachers saw the same improvements even though they weren't involved in the treatment process. Objective measures of attention and impulse control improved, including computerized testing and neuropsychological assessments. Brainwave patterns changed and those changes persisted months and even years after treatment ended. In one long-term study, 80% of kids who received neurofeedback reduced or eliminated their medication use within three years and still showed lasting improvements in focus and behavior.
Speaker 1:Head-to-head neurofeedback versus medication A number of studies have compared neurofeedback directly to stimulant medication. What they found is noteworthy neurofeedback often produced results equal to medication in improving attention and reducing hyperactivity and impulsivity. Academic performance improved more with neurofeedback than medication in at least one study. Most importantly, the gains lasted longer, often for months or years after training ended, while medication effects stopped when the pills stopped. And unlike medication, neurofeedback doesn't come with side effects like insomnia, appetite suppression, mood swings or increased blood pressure. So why isn't this common knowledge? That's the million-dollar question. Part of the reason is inertia in the medical system. Guidelines are slow to change, insurance companies want fast fixes and many clinicians are simply unaware of the robust evidence base behind neurofeedback. But as the data mounts, that's starting to shift. In fact, the American Academy of Pediatrics rated neurofeedback a level one best support treatment for ADHD back in 2012, placing it in the same category as medication and behavior therapy.
Speaker 1:Real life changes what we see in our practice At Capital District Neurofeedback. We've seen firsthand how neurofeedback transforms lives. Children who couldn't sit still in class are now focused and calm. Teens who struggle with impulsivity and anxiety begin making thoughtful, grounded choices. Parents who were overwhelmed and burned out begin to breathe again. Violent and impulsive behavior dissipates at home and at school.
Speaker 1:The process isn't magic. It's training, or perhaps better understood as retraining. Retraining the brain is really what neurofeedback is all about, but it is a change process, working with the brain at the source of the problem, not just trying to suppress symptoms. We work with each child's unique brain patterns, often combining neurofeedback with coaching on sleep, nutrition and home structure. The results speak for themselves Better behavior, improved focus, reduced anxiety and often a much happier family dynamic. And why do we often almost always get better results than the literature suggests? It's actually quite simple. The literature is built upon retraining ADH with a single protocol. One protocol with a single protocol, one protocol. In practice, we often have our clients retraining the brain with a series of six to ten proctocalls over three to six months.
Speaker 1:This is a game changer and we see it over and over your destiny, your child's destiny. The future can be better than you ever imagined, without drugs and without a life of endless therapy sessions. Final thoughts what you deserve to know. If you've been down the road of therapy appointments, medication trials and behavioral plans that don't stick, it's not your fault. You're not alone and your child isn't broken, but you do have options. Neurofeedback offers a science-based, safe and sustainable way to help your child's brain and your family thrive. It's not a quick fix, but it is a lasting one. So, whether you've just received a diagnosis or you've been battling ADHD for years, I encourage you to explore neurofeedback, Ask questions, do your research and know that real change is possible. You and your child deserve that. Please reach out to us. I am certain we can help.