"Exploring the use of Biofeedback video games to help children diagnosed with Attention-Deficit/Hyperactivity Disorder"

An increasingly common childhood behavioural disorder is Attention-Deficit/Hyperactivity Disorder (AD/HD). Difficult to diagnose, it can be complex to understand, but more so challenging to manage and treat. Research towards managing AD/HD has predominantly focused on the option of medication such as Methylphenidate (eg. Ritalin) and Dextroamphetamine (eg. Dexdrine) (Viteiello et al, 2001; Chronis et al, 2002; and Connor, 2002), but in recent years the media has raised the concern of over prescribing medication to young children (The World Today, 2005; Sunday, 2006; Fife-Yeomans, 2008).

One study has depicted expressive (eg. sensory integration, music, dance, art), vitamin dietary manipulation (eg. Feingold diet, sugar elimination), special exercises (eg. yoga, tai chi), relaxation techniques (eg. meditation), and dietary supplements (eg. blue green algae, pycnogenol) as the top five most commonly used complementary alternative therapies for AD/HD, of surveyed parents whose children were referred or diagnosed with AD/HD as at a major urban children's hospital in America (Chan, 2003).

As a form of non-standard treatment, meditation has been noted to be one of a number of 'Lifestyle/mind-body therapies', which elicit relaxation training method to invoke the ability of the mind to influence body function and symptoms (Chan, 2003). Investigator discoveries have found that meditation has the potential as a promising therapy for children diagnosed with AD/HD, with improvements in self-esteem, self-confidence, social ability, and involvement; improvements in concentration, sleep ability, and parent-child relationship quality; reductions in inattention, hyperactivity, and impulsivity; and reductions in medication doses (Harrison et al, 2004).

What has also been studied, but not as publicly known or understood is the use of biofeedback for AD/HD. Biofeedback is a treatment technique where people are trained to use signals from their own bodies to improve their health (Schwartz and Beatty, 1977).

There is an amount of international research knowledge on the use of biofeedback through neurofeedback technology on AD/HD children. Studies have demonstrated the beneficial effects of biofeedback using electrocephalogram (EEG) measurements for children diagnosed with AD/HD (Boyd and Campbell, 1998; Masterpasqua and Healey, 2003; Monastra et al 2005; and Fox et al, 2005). These clinical studies have revealed as much as 86 percent AD/HD subject improvement (Alhambra et al, 1995) after partaking in neurofeedback sessions, demonstrating improvements in attention, impulse control, and speed for improvement processing (Rossiter and La Vaque, 1999). As well as documented reductions in associated problems with AD/HD, such as seizures, nightmares, bed-wetting, and depression (Alhambra et al, 1995).

Rather than the commonly studied neurofeedback technology, instead, this study will look at the use of biofeedback through heart rate variability (HRV) and skin conductance levels (SCL)  and combining meditation-like techniques to help children manage their AD/HD. Compared with EEG feedback, HRV feedback is considerably more straight forward to learn and use, using a simple pulse sensor makes it extremely versatile, and it is more reflective of changes in emotional and psychological states (McCraty and Tomasino, 2004).

HRV biofeedback has been found a powerful educational tool in mental health settings including Attention- Deficit/Hyperactivity Disorder. A study using another biofeedback system with 'Freeze-Framer' software, has found children responsive to its abilities, with noticeable positive shifts in classroom dynamics, lowered tension, conflict, and distractibility, and greater calmness, focus, attention, and cooperation. Participants using the Freeze-Framer software demonstrated significant reductions in risky behaviours , and notable improvements in areas including motivation, work management and focus, stress and anger management, self-reliance, and relationships with teachers, families, and peers (McCraty and Tomasino, 2004; and McCraty 2005).

Documented positive improvements from alternative treatment options such as meditation and biofeedback, provides support towards this current research of using biofeedback video games to help children diagnosed with AD/HD.

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This study will look at the use of biofeedback through measurements of HRV and skin SCL in helping children manage their AD/HD. Not only will this study provide up to date findings on AD/HD in Australia, but will examine a form of biofeedback that has limited investigation on AD/HD children. The aims of this study are to:

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Using The Wild Divine Project to monitor heart rate and skin conductance activity and provide measured feedback in the form of visual games, coupled with electronic questionnaires completed by parents  of the participating children, the project looks to document:

It is hypothesized that:

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Click here to read the Preliminary Results