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Original article

Development of Reading Abilities in Children with ADHD Following fNIRS-Neurofeedback or EMG-Biofeedback

Published Online:April 30, 2020https://doi.org/10.1024/2235-0977/a000302

Abstract

Abstract. Children with attention deficit/hyperactivity disorder (ADHD) show deficient reading skills, which, like ADHD symptoms, are associated with limitations in neurocognitive abilities. Neurofeedback (NF) aims to improve the latter, to alleviate ADHD symptoms, and to promote school and reading performances. Whether frontal lobe-NF based on functional near-infrared spectroscopy (fNIRS) and electromyogram (EMG)-biofeedback (BF), however, improve reading abilities of children with ADHD and whether these changes are associated with changes in neurocognitive abilities, has not yet been clarified. It was also unclear whether embedding trainings in virtual reality (VR) could increase their effectiveness. These questions were examined using data of 35 children with ADHD (6–11 years) who participated in 15 sessions of fNIRS-NF in VR, fNIRS-NF in 2D, or EMG-BF in VR. On average, children's reading performance improved in all training groups. Stronger improvements were found after VR trainings. Improvements in reading natural words were, on a trend level, accompanied by decreasing attention, while improvements in reading pseudowords were accompanied by improved sustained attention and response inhibition. The results suggest that fNIRS-NF and EMG-BF effectively improve reading abilities of children with ADHD, especially when training in VR.


Entwicklung der Lesefähigkeiten von Kindern mit ADHS nach fNIRS-Neurofeedback oder EMG-Biofeedback

Zusammenfassung. Kinder mit Aufmerksamkeitsdefizit-/Hyperaktivitätsstörung (ADHS) zeigen defizitäre Lesefähigkeiten, welche, wie ADHS-Symptome, mit Einschränkungen in neurokognitiven Fähigkeiten verbunden sind. Neurofeedback (NF) zielt darauf, diese Fähigkeiten zu verbessern und ADHS-Symptome zu mildern, sowie Schul- und Leseleistungen zu fördern. Ob NF basierend auf funktioneller Nahinfrarotspektroskopie (fNIRS) des Frontallappens und Elektromyogramm (EMG)-Biofeedback (BF) allerdings die Lesefähigkeit von Kindern mit ADHS verbessern und ob diese Veränderungen mit solchen in neurokognitiven Fähigkeiten einhergehen, war bislang unklar. Des Weiteren war unklar, ob die Einbettung von Trainings in virtuelle Realität (VR) deren Wirksamkeit steigern könnte. Diese Fragestellungen wurden anhand der Daten von 35 Kindern mit ADHS (6–11 Jahre alt), die an 15 Sitzungen eines fNIRS-NF in VR, fNIRS-NF in 2D oder EMG-BF in VR teilnahmen, untersucht. Die Leseleistung verbesserte sich im Mittel durch jedes Training. Stärkere Verbesserungen fanden sich nach Training in VR. Verbesserungen im Lesen natürlicher Wörter gingen mit einem Trend in der Abnahme der Aufmerksamkeit einher, während Verbesserungen im Lesen von Pseudowörtern von Verbesserungen in der Aufmerksamkeit und Impulskontrolle begleitet wurden. Die Ergebnisse legen die Wirksamkeit von fNIRS-NF und EMG-BF hinsichtlich der Verbesserung der Leseleistung von Kindern mit ADHS – vor allem bei Training in VR – nahe.

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