The cognitive process of attention allows us to access the world around us. The brain is concerned with filtering stimuli from the environment, focusing on the important ones and suppressing irrelevant ones. In order to learn and to carry out our daily activities, we need to pay attention. Attention problems can affect other cognitive functions, in addition to bringing with them social, academic and/or occupational impairment. Therefore, poor attention management not only leads to academic failure but also to unproductiveness at work and anxiety in any event that requires concentration at low levels of environmental feedback. ADHD treatment with Neurofeedback optimizes attention, stress management and concentration. It is a brain training where feedback is obtained in real time.

What is ADHD?

Attention deficit disorder with or without hyperactivity is a neurobiologically based disorder. The condition usually begins in childhood and persists into adulthood (crying babies, disruptive students, adults who are unstable in their activities, etc.). It manifests as difficulty or impossibility to maintain attention in an activity for a prolonged period of time, they are easily distracted, they cannot organize their day, watch a complete movie, forget their obligations, forget their class schedules, lose things, do not pay attention to details, among other significant behaviors.

When these symptoms are associated with disinhibition, they cannot control their impulses, cannot sit still, have difficulty waiting and interrupt other people when they are talking. However, they are able to attend to what motivates and interests them but, in such cases, they find it difficult to disengage from that activity and procrastinate in other activities.

When these behaviors are persistent, professional intervention is required because ADHD negatively affects the academic, family and social life of the person, so appropriate treatment is necessary to improve and reduce the associated symptoms and their consequences.

ADHD and Neurofeedback

The practice of focusing attention is like training a muscle, if we do not use it, it weakens and if we exercise it, it develops and strengthens.

It has been demonstrated that the achievements obtained with an attention training program based on neurofeedback are permanent achievements. If we are dispersed people we can exercise our attention and improve our performance.

Benefits of the treatment of ADHD with Neurofeedback

• Improves attention.
• Increases the ability to concentrate.
• Develops working memory.
• Improves processing speed.
• Optimizes academic and work performance.
• Strengthens relationships and social skills.
• Improves stress management.
• Facilitates self-control.
• Reinforces self-esteem.
• Improves cognitive skills needed to control our thoughts, emotions and actions

Why carry out the treatment of ADHD with Neurofeedback?

Because with Neurofeedback we can see our attention levels in real time.

In addition, it is a learning system, a feedback system that motivates, that encourages progress. It is based on a neurobehavioral treatment, brain training, a form of brain training that allows us to know at the moment the functions of which we do not have information consciously (level of concentration, ability to filter both internal and external distractors, inhibition capacity, management of impulsivity, among others). It enables new learning and then apply those behaviors and skills in our daily lives.

How do we organize the treatment of ADHD with Neurofeedback and NeuronUP?

Working plan

After the neuropsychological evaluation, a personalized work plan is drawn up according to age and treatment objective.

Here is an example of a work plan made for a 15 year old patient for the treatment of ADHD. It consists of a daily program of 15 minutes online with NeuronUP’s NeuronUP2GO remote therapy interventions.

Attention program

• Selective attention activities – 5 minutes.
• Sustained attention exercises – 5 minutes.
• Processing speed activities – 5 minutes.

This program is performed on Mondays, Wednesdays and Fridays.

It alternates with attention and executive functions programs where they work:

• Alternating attention exercises – 5 minutes.
• Inhibition activities – 5 minutes.
• Flexibility activities – 5 minutes.

By scheduling it at the same time every day, a habit is generated that favors organization, since organization and routine are fundamental tools to be able to train attention and achieve efficient time management.

Neurofeedback training

Neurofeedback training is done twice a week for half an hour and we implement a system of rewards for training levels surpassed.

We have proven that greater resilience and a greater capacity to face life’s challenges is obtained when a personalized and directed work plan is framed that fulfills the objective of working on self-control and the capacity to manage current and future tasks.

Real achievement takes time, progress is made in stages and mistakes are a natural part of the process. When you work on increasing concentration, you consciously adopt new habits, thus producing a change that favors self-regulation. That is why the sessions, both NeuronUP and Neurofeedback, end with a self-evaluation of their performance, an activity that is fundamental for the treatment of ADHD.

Role of the coach

The role of the coach is important in the treatment of ADHD with Neurofeedback.
The coach encourages reflection, collaborates by marking inappropriate behaviors, stimulates a positive valuation of achievements and works as a support and mediator of the training.

The trainer designs the reward system and agrees with the patient on short and medium term behavioral objectives, such as encouraging tolerance to frustration, not abandoning the activity in spite of difficulties, reducing nervous habits or motor restlessness. It is the one that favors the organization to comply with the training and improves listening and communication skills.

A clinical vignette

A 15-year-old adolescent girl came in for a consultation in June 2020, she had emigrated from another country, with a previous diagnosis of ADHD without pharmacological treatment and, as a result of the Covid-19 pandemic and the move, her disruptive behaviors worsened, presenting serious academic and behavioral problems.

A neuropsychological diagnosis was performed. The results yield the following considerations:

– She presents a profile of inattentive ADHD.

– She presents a profile of Specific Learning Difficulty, dyslexia.

Due to her profile we can be observe:

• Greater variability in academic performance and in the execution of daily life tasks.
• Her quality of work is dependent on the stimulus and the environment, she needs more organization, structuring and supervision for the achievement of tasks.
• She does not manage to complete activities if they are extensive.
• Her speed of work can be either very slow or very fast, and with difficulty in reviewing errors, presenting impulsive behaviors.
• Deficient regulation of the general level of attentional alertness, i.e., to focus on the demands of the environment and the moment.
• Poor self-motivation and/or self-reinforcement.
• Reading deficit that implies a greater cognitive attentional effort.
• Lowered global self-concept, with a marked affectation of the intellectual and behavioral self-concept.
• Generalized anxiety disorder, showing high levels of anxiety in almost all behavioral, emotional and physical areas.
• Feelings of stress, insecurity, negative expectations and frustration.

Suggestions based on observations

Work plan combining NeuronUP2GO and ADHD treatment with Neurofeedback.

Behavioral modeling was based on working with sustained attention, distraction filtering, working memory, time tasks, inhibition or processing speed, among other cognitive functions.

Coping strategies were encouraged:

• Anticipation through purpose and goal planning, as well as identification and achievement expectations.
• Monitoring through behavioral control or modeling of behavior.
• Awareness and self-evaluation.
• Coping and resolution that paralleled progress in brain training and visualization of achievement.
• Behavioral coaching with reward systems.

After 6 months of work, her attentional level was evaluated and a functional improvement was observed, which had a positive impact on her academic performance, behavior and global self-perception.

Results of ADHD treatment with Neurofeedback and NeuronUP

Today she is able to start an activity and finish it, to generate problem-solving strategies independently and to sustain the level of concentration adequate to the demand.

These achievements strengthened her self-esteem, favoring the adolescent to deploy adequate emotional self-regulation strategies, not succumbing to stress, anger or procrastination.