Research Project for McNair Scholarship Program

1. A Preliminary Exploration for the Benefits of Neurofeedback on ADHD Judith Collins Harding University McNair Scholarship Program OSU Research Symposium

2. Abstract ADHD is characterized by a persistent pattern of behavioral symptoms of inattention, hyperactivity, and impulsivity (APA, 2000). Play Attention is the brand name of a neurofeedback technique This current pilot study will investigate the effects of Play Attention protocol.

3. Introduction Studies have suggested that 3-5% of school-aged children qualify for a diagnosis of ADHD (Dryer, Kiernan & Tyson, 2006). There are 20 to 25% children diagnosed with ADHD also has a learning disability (Padolsky, 2008). ADHD cannot be cured, but must be managed. Five million people diagnosed (Nowacek and Mamlin, 2007). 2.5 million using medication as a form treatment (CBS News, 2009).

4. School/Home Environments Children’s behavior may be influenced by or influence other’s actions. Teachers can utilize manipulation in the classroom to prevent behavioral problems (Fox, Tharp, and Fox, 2005). ADHD is commonly partnered with some type of comorbid disorder, such as Learning Disability (Faigel,1998). Children with symptoms of Attention Deficit Hyperactivity Disorder are among the most common childhood mental health referrals (Edwards, Gardner, Chelonis, Shultz, Flake, and Diaz ,2007).

5. Treatment/Neurofeedback Play Attention is a computerized game designed to increase, among other things, the attention span of users (“attention stamina”) and their ability to stay on task (Play Attention, 2004). Subjects were reassessed on the CCPT II after having completed twenty-four sessions of Play Attention, and their Play Attention scores on attention stamina and ability to stay on task were noted after the sixth and twenty-fourth sessions.

6. Treatment/Neurofeedback Medications for ADHD have become an interesting topic. Parents and teachers are interested in neurofeedback as an alternative treatment for controlling behaviors at home and school. Some behaviors associated are: Poor academic performance, learning disability, conduct disorders, oppositional defiant disorder (Doehnert, Brandeis, Straub, Steinhausen & Drechsler,2007)

7. Methods The Current Pilot Study Pre-test and post-test design Focused on a small group of children’s grades and attention span /the study target home and school. Measured by the Connors’ Continuous Performance Test II and Play Attention. Explore to see if there is any improvement after utilizing the Play Attention protocol. The data include grades, number of Play Attention sessions, and Conners’ Continuous Performance Test II results.

8. Participants Six males ranging in age from 7 to 14 years Five Caucasians and one Hispanic. The clinical samples are from the general population of local public schools in central arkansas. Two of the samples were twins age 14 at the mid-level grade, and four ranged in age from 8 to 10. They were treated at Harding University Professional Counseling Clinic with the parents’ permission.

9. InstrumentsPlay Attention and CCPT II The Play Attention system is a neurofeedback instrument which uses a computerized game interface. (Play Attention, 2009). Play Attention’s system consists of a lightweight bicycle-style helmet with a sponge-lined sensor connected to a standard personal computer (Play Attention, 2009). Conners’ Continuous Performance Test II is used in assessing inattention, hyperactivity and impulsivity in children’s behaviors (Conner’s, 2004).

10. Results Different schools, grades, number of sessions, ages and subject matter The scenarios could affect CCPT II results, Play Attention performance and school grades thereby causing results to be inconsistent. Five of the six participants showed improvements in their average math and english grades Three of the six participants showed a lower clinically significant attention problem. Confounding Factors

11. CCPT II This scale indicates the chance, out of 100, that the individual in question has a significant attention problem. Table 1. Clinical Confidence Index Associated with ADHD Assessment Participant Pre Play Attention Post Play Attention 1 73.40 35.87 2 30.94 7.42 3 29.47 31.22 4 50.00 67.84 5 38.59 70.25 6 71.63 50.00

12. Play Attention Scores Tables 2 and 3 Attention Stamina Ability to Stay on Task Session 6 Session 24 Session 6 Session 24 1 Participant 90% 88% 89% 50% 2 Participant 98% 100% 76% 64% 3 Participant 89% 98% 98% 99% 4 Participant 67% 85% 71% 89% 5 Participant 83% 90% 92% 81% 6 Participant 72% 72% 60% 66%

13. Discussion The results are inconclusive and no inferential statistics. CCPT II results could be adversely affected. Results could also have been altered by unforeseen events. A larger samples suggested for future research. Some participant improved and some got worse. Life stressors, medication, difficulty of school material could be the reasons. Neurofeedback appears to be helpful.

14. Proposed Future Research The limitations of this pilot study have created a need for further research. A larger sample size of the general population Better research design, more consistent data collection A broader diversity of participants and a host of other limitations should be addressed in future research. This pilot study did seem to indicate the potential benefits of neurofeedback.

15. Conclusion There are some benefits of neurofeedback as an alternative to ADHD medications. No known side effects as some ADHD medications. A child’s behavior could improve. Teachers could benefit with increased knowledge of ADHD. A positive intervention for behavior at home and at school.

16. Acknowledgments The Author Express Thanks to… Dr. Gene Wright The McNair Program Directors Anne Lehman Harding University Counseling Department (LPC’s) Counseling Dept. Graduate Students Dr. Kathy Howard

17. References American Psychological Association. (2000) Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Text Revision. Conners, K. (2004). Conner's Continuous Performance Test (CPT ll) Manuel. Multi-Health Systems: North Tonawanda, N.Y. Doehnert, M. B., Brandeis, D., Straub, M., Steinhausen, H.C., & Drechsler, R. (2008). Slow cortical potential neurofeedback in attention-deficit hyperactivity disorder: is there neuropsysiological evidence for specific effects? Biological Child and Adolescent Psychiatry , 115, 1445-1456. Dryer, R. K., Kiernan, M.J., & Tyson, G.A. (2006 ). Implicit theories of the characteristics and cause of attention-deficit hyperactivity disorder held by parents and professionals in the psychological, educational, medical and allied health fields. Australian Journal of Psychology , 58, (2), 79-92. Edwards, M. C., Gardner, E.S., Chelonis, J.L., Schulz, E.G., Flake, R.A. & Diaz, P.F. (2007). Estimates of the validity and utility of the conners' continuous performance test in the assessment of inattentive and/or hyperactivity behaviors in children. J Abnorm Child Psychol , 35, 393-403. Fox, D. J., Tharp, D.E., & Fox, L.C. (2005). Neurofeedback: an alternative and efficacious treatment for attention deficit hyperactivity disorder. Applied Psychophysiology and Biofeedback ,30, (4), 365-37. Http://www.playattention.com. (2009). Nowcacek J. E., & Mamlin. N. (2007). General education teachers and students with ADHD: What modifications are made? Preventing School Failure , 51,(3), 28-35. Play Attention User’s Manual (pp. 1-8). (2004). Ashville, NC: Unique Logic & Technology, Inc.