Neurofeedback for the
Attention Deficit Disorders
JOEL F. LUBAR
Attention-deficit/hyperactivity disorder (ADHD) exists in all countries and in all cultures. Its recognition and characteristics became considerably clearer in the last two decades. It is a very significant neurobiological and genetically based disorder affecting a large number of children and many adults. Certainly ADHD can be debilitating in terms of achieving educational objectives, maintaining employment, and developing careers. It is also a disorder that can be extremely disruptive within family systems, and it affects most aspects of one's ability to function effectively in a complex society and to set and achieve important life goals.
In this chapter, I describe a relatively new, very promising, and powerful adjunctive procedure for treatment and long-term management of this disorder. My work in this area began in the mid-1970s. Later publications (Lubar, 1991; Lubar, Swartwood, Swartwood, & Timmermann, 1995; Lubar & Lubar, 1999) have described the details of the development of this treatment approach for ADHD. During the early development of this technique, the treatment involved what was commonly called "electroencephalographic (EEG) biofeedback." However, in the last few years, a new term emerged—neurofeedback. (Note that in this as in other chapters, terms in italics are included in the glossary at the end of the chapter.) This word specifically refers to feedback designed to alter a condition that displays evidence of being neurologically based.
However, neurofeedback in a broader sense is defined as biofeedback linked to a specific aspect of the electrical activity of the brain—such as the frequency, amplitude, or duration of activity such as theta (4–8 hertz), alpha (8–13 hertz), or beta (13 hertz or greater)— from certain scalp or brain locations. Neurofeedback can also be linked to components of auditory, visual, or somatosensory event-related potentials (ERPs) or slow direct-current shifts in cortical excitability, as shown by Schneider et al. (1992) and others in the research group in Tuebingen, Germany, in their work with schizophrenia and other conditions. (See Neumann, Strehl, & Birbaumer, Chapter 5, this volume, for an introduction to EEG instrumentation written by some of the Tuebingen group.)
Currently, there are over 1200 organizations in the United States and many in Australia, Israel, Europe, and Japan using EEG neurofeedback in the treatment of ADHD, based on