NeuroFeedback to treat young people with ADHD and Tics.

Current evidence suggests that the treatment of attention deficit hyperactivity disorder (ADHD) in minors should comprise a multimodal treatment approach, including stimulant medications. However, many children with ADHD also suffer from co-morbid tics, which can create significant impairments. Moreover, stimulants (which are frequently prescribed to children with ADHD) can make tics even worse. In this project we will use EEG (electroencephalography or brain wave)-based neurofeedback (NF) as a non-pharmacological approach to treat ADHD and tic symptoms in children, with the aim of avoiding stimulant medication. During a NF session, sensors (so-called electrodes) will be placed on the subjects scalp to detect brainwaves in order to see their brain in action (this is a so-called electroencephalography or EEG). These signals are presented to the subject in real time on a computer screen. This will be done by presenting a correlate of this brain activity and not by showing the real brain waves outlined before. Your subject will have the task to up or down regulate brain activity that is related to attentional processes, motor activity and concentration. A computer compares their real-time brain activity to targets or goals for them to reach (that means to successfully up or down regulate). Images on a computer screen can tell them immediately when their brain reaches their goal and when not - when they are activating or deactivating the mentioned brain activity.  Through this simple method, the subject can learn how to quiet brainwaves associated with low attentional performance, and increase brainwaves associated with better attentional and cognitive control. Very much like physical exercises strengthen and develop specific muscles, the more your brain is exercised into reaching a more efficient way of working, the better and stronger it gets at it. Like any new skill, it requires feedback and practice. There will be three sequential phases to the study. The first phase will consist of a week for pre-assessment of exclusion criteria and related symptomatology (urine drug test, behavioural / psychological assessments, cognitive testing battery). EEG-based neurofeedback will be administered in the second phase to participants (N = 10 subjects) over two weeks within daily one-hour sessions on weekdays (5 sessions per week, 10 sessions per subject). If possible, each participant will be allocated a regular daily training time with the same neurofeedback trainer. Phase three will involve completion of the post-assessments (behavioural / psychological assessments, cognitive testing battery) over a week period. The NF intervention will be delivered by researchers that have undergone a recognised NF training course. All NF trainers have university degrees. The subject will have a participant diary card that will provide a record of all study appointments / commitments which will help encourage compliance.