Does Brain Training Work? ADHD Brain Games and Neurofeedback Under Scrutiny

Your newsfeed is overloaded with programs, apps, and interventions that claim to effectively treat attention deficit hyperactivity disorder (ADHD). Some are complementary treatments designed to augment an existing medication regimen; others suggest they should replace medication. Without reading a pile of medical journals, how can you sort through the hype and make informed decisions, especially when some of these interventions are quite costly?

Here, we examine brain training programs — including neurofeedback and cerebellar (or movement/balance) interventions — and determine whether they effectively improve ADHD symptoms.

Brain Games for Adults and Kids with ADHD

Also called neurocognitive training, brain games are designed to train the brain to learn something. Many claim to improve focus, attention, and executive function skills impaired by ADHD, such as working memory. Working memory is the ability to remember information, use it for a task, and then dump it once you no longer need it. When playing brain games, either on a computer in a clinician’s office or at home, users are asked to complete tasks that may include sorting items by shape and color, recalling a sequence of shapes or objects, or remembering what items flashed on the screen.

ADHD Brain Games: Our Conclusion

Do brain games help reduce ADHD symptoms for the rest of your life, or just while doing the tasks involved in your training? This is the key question. After all, playing lots of Candy Crush will lead to higher scores, but not much else.

To that end, researchers have found that brain games don’t actually reduce ADHD symptoms.^{1 2 3} While players may improve their performance in a game, those skills likely won’t transfer to other areas, such as following directions for a class assignment at school. Furthermore, there is no evidence that you can train a brain to improve working memory, or any other executive function.^{1 2 4 5}

[Free Download: Learn the Facts About Neurofeedback]

Neurofeedback for ADHD

Neurofeedback is biofeedback that uses an electroencephalogram (EEG) to measure brain activity and train the user to produce brain wave patterns like those of a non-ADHD brain. Electrodes are placed on a person’s head to monitor brain activity while they play a video game in a clinician’s office. The hope is that the person will see improvements in attention, and a decrease in hyperactive or impulsive behavior, that will continue after the neurofeedback sessions are completed. Neurofeedback involves a significant investment of time (30-plus sessions total, multiple times per week) and can carry a price tag of up to $3,000. This intervention may not be covered by insurance.

EEG Neurofeedback: Our Conclusion

Neurofeedback has not shown enough effectiveness in studies to be recommended as a “stand-alone” treatment for ADHD. Also, there is little evidence that neurofeedback reduces ADHD symptoms long-term.^{6 7 8} It’s possible that future versions of neurofeedback may prove to be effective, but we cannot recommend this right now. Given the high cost in time and money, neurofeedback doesn’t seem to be worth the investment.

Cerebellar or Movement Exercises for ADHD

The so-called “cerebellar developmental delay” theory claims that different parts of the brain lack sufficient connections to coordinate the processing of information, resulting in symptoms of ADHD, dyslexia, and dyspraxia.⁹ Movement and balance exercises claim to “remediate” ADHD symptoms by improving the functions of the cerebellum through specific movements that involve crossing the body’s midline, such as touching your left shoulder with your right hand. The idea is that these exercises will integrate the two sides of the brain, resulting in cognitive improvements, such as in paying attention and processing information. But this premise is flawed, as it does not match up with established medical science regarding how the brain operates. (If this theory were valid, we would need to re-write much of neurological theory.)

Cerebellar Exercises: Our Conclusion

Cerebellar exercises do not reduce ADHD symptoms. Any benefits from movement and balance exercises likely come from the benefits of exercise in general. Exercise of any kind increases levels of certain neurotransmitters in the brain, some of which are naturally low due to ADHD. That’s why exercise has been shown to temporarily improve cognitive functioning and ADHD symptoms. As far as cerebellar exercises and “movement therapies,” there is nothing efficacious about them specifically.¹⁰

[Read: Exercise and the ADHD Brain — The Neuroscience of Movement]

ADHD Brain Training: The Bottom Line

Based on the research, we can’t personally recommend computerized brain training, neurofeedback, or cerebellar/movement/balance exercises to treat ADHD. If you are still considering any of these approaches for yourself or your child, remember that the placebo effect can be potent, meaning that a program may work simply because you expect it to work, at least initially. Keep in mind that any proposed intervention that is expensive and/or time-consuming must be able to make a much stronger case about its effectiveness.

You should also be aware of tactics companies use to sell such programs, along with other red flags:

• Is there sales pressure to sign up immediately, without time to do your own research into a program’s efficacy?
• Is the pitch about an approach’s effectiveness based on testimonials, not peer-reviewed journal articles or research?
• Is the intervention “radical” and brand new to the marketplace, and therefore hasn’t been out long enough to be fully evaluated?
• Does the program claim to be 100 percent safe and free of side effects (which might suggest it is also zero percent effective)?

If you or your children are benefiting from brain games, neurofeedback, or similar approaches, and it isn’t causing financial hardship or taking an unreasonable amount of your time, then it should be fine to continue. But know that there is no such thing as a miracle cure for ADHD.

Does Brain Training Work for ADHD? Next Steps

• Free Download: Unraveling the Mysteries of Your ADHD Brain
• Read: Can Neurofeedback Effectively Treat ADHD?
• Read: Like a Personal Trainer for Your Brain

Stephanie Sarkis, Ph.D., is a psychotherapist and the author of Healing from Toxic Relationships: 10 Essential Steps to Recover from Gaslighting, Narcissism, and Emotional Abuse and Gaslighting: Recognize Manipulative and Emotionally Abusive People—and Break Free. Ari Tuckman, Psy.D., C.S.T., is a psychologist, international speaker, and author of four books on ADHD, including More Attention, Less Deficit and Understand Your Brain, Get More Done.

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Sources

¹ Gathercole S. E. (2014). Commentary: Working memory training and ADHD – where does its potential lie? Reflections on Chacko et al. (2014). Journal of child psychology and psychiatry, and allied disciplines, 55(3), 256–257. https://doi.org/10.1111/jcpp.12196

² Chacko, A., Bedard, A. C., Marks, D. J., Feirsen, N., Uderman, J. Z., Chimiklis, A., Rajwan, E., Cornwell, M., Anderson, L., Zwilling, A., & Ramon, M. (2014). A randomized clinical trial of Cogmed Working Memory Training in school-age children with ADHD: a replication in a diverse sample using a control condition. Journal of child psychology and psychiatry, and allied disciplines, 55(3), 247–255. https://doi.org/10.1111/jcpp.12146

³ Shipstead, Z., Hicks, K. L., & Engle, R. W. (2012). Cogmed working memory training: Does the evidence support the claims? Journal of Applied Research in Memory and Cognition, 1(3), 185–193. https://doi.org/10.1016/j.jarmac.2012.06.003

⁴ Melby-Lervåg, M., & Hulme, C. (2013). Is working memory training effective? A meta-analytic review. Developmental psychology, 49(2), 270–291. https://doi.org/10.1037/a0028228

⁵ Hulme, C., & Melby-Lervåg, M. (2012). Current evidence does not support the claims made for CogMed working memory training. Journal of Applied Research in Memory and Cognition, 1(3), 197–200. https://doi.org/10.1016/j.jarmac.2012.06.006

⁶ Gevensleben, H., Moll, G. H., Rothenberger, A., & Heinrich, H. (2014). Neurofeedback in attention-deficit/hyperactivity disorder – different models, different ways of application. Frontiers in human neuroscience, 8, 846. https://doi.org/10.3389/fnhum.2014.00846

⁷ Arnold, L. E., Lofthouse, N., Hersch, S., Pan, X., Hurt, E., Bates, B., Kassouf, K., Moone, S., & Grantier, C. (2013). EEG neurofeedback for ADHD: double-blind sham-controlled randomized pilot feasibility trial. Journal of attention disorders, 17(5), 410–419. https://doi.org/10.1177/1087054712446173

⁸ Ramsay, J. R. (2010). Neurofeedback and neurocognitive training. In J. R. Ramsay, Nonmedication treatments for adult ADHD: Evaluating impact on daily functioning and well-being (pp. 109–129). American Psychological Association. https://doi.org/10.1037/12056-006

⁹ Bishop D. V. (2007). Curing dyslexia and attention-deficit hyperactivity disorder by training motor co-ordination: miracle or myth?. Journal of paediatrics and child health, 43(10), 653–655. https://doi.org/10.1111/j.1440-1754.2007.01225.x

¹⁰ Snowling, M. J., & Hulme, C. (2003). A critique of claims from Reynolds, Nicolson & Hambly (2003) that DDAT is an effective treatment for children with reading difficulties–‘lies, damned lies and (inappropriate) statistics’?. Dyslexia (Chichester, England), 9(2), 127–135. https://doi.org/10.1002/dys.245

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