title: ADHD and EEG-neurofeedback: a double-blind randomized placebo-controlled feasibility study The role of parent training in treatment of preschoolers with ADDH. Attention Deficit Hyperactivity Disorder: Does Cognitive Behavioral Therapy Improve Home Behavior? Effect of Supplementation with Polyunsaturated Fatty Acids and Micronutrients on Learning and Behavior Problems Associated with Child ADHD Neurofeedback in ADHD: a single-blind randomized controlled trial EFA supplementation in children with inattention, hyperactivity, and other disruptive behaviors The effects of essential fatty acid supplementation by efamol in hyperactive children Additive effects of psychostimulants, parent training, and self-control therapy with ADHD children. A Randomized Trial of Two Promising Computer-Based Interventions for Students with Attention Difficulties Synthetic food colors and hyperactivity in children: a double-blind challenge experiment. Parent-based therapies for preschool attention-deficit/hyperactivity disorder: a randomized, controlled trial with a community sample. Neurocognitive training for children with and without AD/HD Functional Magnetic Resonance Imaging Investigation of the Effects of Neurofeedback Training on the Neural Bases of Selective Attention and Response Inhibition in Children with Attention-Deficit/Hyperactivity Disorder Effectiveness of the Challenging Horizons After-School Program for young adolescents with ADHD. A 14-month randomized clinical trial of treatment strategies for attention-deficit/hyperactivity disorder. The MTA Cooperative Group. Multimodal Treatment Study of Children with ADHD. Gamma-linolenic acid for attention-deficit hyperactivity disorder: Placebo-controlled comparison to d-amphetamine CONTROLLED TRIAL OF OLIGOANTIGENIC TREATMENT IN THE HYPERKINETIC SYNDROME Hyperkinesis and food additives: testing the Feingold hypothesis. Combining Parent and Child Training for Young Children with ADHD The effect of phosphatidylserine containing Omega3 fatty-acids on attention-deficit hyperactivity disorder symptoms in children: a double-blind placebo-controlled trial, followed by an open-label extension. Computerized training of working memory in children with ADHD--a randomized, controlled trial. Is neurofeedback an efficacious treatment for ADHD? A randomised controlled clinical trial. Effects of a few food diet in attention deficit disorder. Training of slow cortical potentials in attention-deficit/hyperactivity disorder: evidence for positive behavioral and neurophysiological effects Parent training for Attention Deficit/Hyperactivity Disorder: is it as effective when delivered as routine rather than as specialist care? Effects of a restricted elimination diet on the behaviour of children with attention-deficit hyperactivity disorder (INCA study): a randomised controlled trial Young adult outcome of attention deficit hyperactivity disorder: a controlled 10-year follow-up study. Does oligoantigenic diet influence hyperactive/conduct-disordered children — a controlled trial A randomised controlled trial into the effects of food on ADHD Searching for unpublished trials in Cochrane reviews may not be worth the effort. Lack of Behavioral Effects from Feingold Diet Violations A randomized, double-blind, placebo-controlled trial of docosahexaenoic acid supplementation in children with attention-deficit/hyperactivity disorder. Omega-3 fatty acid treatment of children with attention-deficit hyperactivity disorder: A randomized, double-blind, placebo-controlled study. The Effects of the Triple P-Positive Parenting Program on Preschool Children with Co-Occurring Disruptive Behavior and Attentional/Hyperactive Difficulties A small-scale randomized controlled trial of the revised new forest parenting programme for preschoolers with attention deficit hyperactivity disorder Omega-3/Omega-6 Fatty Acids for Attention Deficit Hyperactivity Disorder Effectiveness of behavioral parent training for children with ADHD in routine clinical practice: a randomized controlled study. Relative effects of drugs and diet on hyperactive behaviors: an experimental study. Computer-Based Attention Training in the Schools for Children With Attention Deficit/Hyperactivity Disorder: A Preliminary Trial The influence of short-chain essential fatty acids on children with attention-deficit/hyperactivity disorder: a double-blind placebo-controlled study.
abstract: Electroencephalography (EEG)-neurofeedback has been shown to offer therapeutic benefits to patients with attention-deficit/hyperactivity disorder ( ADHD ) in several , mostly uncontrolled studies . This pilot study is design ed to test the feasibility and safety of using a double-blind placebo feedback-controlled design and to explore the initial efficacy of individualized EEG-neurofeedback training in children with ADHD . Fourteen children ( 8–15 years ) with ADHD defined according to the DSM-IV-TR criteria were r and omly allocated to 30 sessions of EEG-neurofeedback ( n = 8) or placebo feedback ( n = 6 ) . Safety measures ( adverse events and sleep problems ) , ADHD symptoms and global improvement were monitored . With respect to feasibility , all children completed the study and attended all study visits and training sessions . No significant adverse effects or sleep problems were reported . Regarding the expectancy , 75 % of children and their parent(s ) in the active neurofeedback group and 50 % of children and their parent(s ) in the placebo feedback group thought they received placebo feedback training . Analyses revealed significant improvements of ADHD symptoms over time , but changes were similar for both groups . This pilot study shows that it is feasible to conduct a rigorous placebo-controlled trial to investigate the efficacy of neurofeedback training  in children with ADHD . However , a double-blind design may not be feasible since using automatic adjusted reward thresholds may not work as effective as manually adjusted reward thresholds . Additionally , implementation of active learning strategies may be an important factor for the efficacy of EEG-neurofeedback training . Based on the results of this pilot study , changes are made in the design of the ongoing study The efficacy of group parent training was assessed in improving compliance and time on task in preschoolers with attention-deficit disorder with hyperactivity . Positive effects were obtained on measures of child compliance , but not on measures of attention . Parental compliance-management skills and overall style of interaction were also positively affected . The use of parent training for early intervention with ADDH children is discussed This study evaluates the effectiveness of cognitive behavioral therapy ( CBT ) in improving the home behavior of children with attention deficit hyperactivity disorder ( ADHD ) . Twenty-five boys ( age 7 to 13 ) with a diagnosis of ADHD were r and omized to a CBT or supportive therapy control group . Outcome measures included parent and teacher ratings of the child on the Behavior Problem Checklist-Attention Problem Subscale ( BPC-AP ) , and the Self-Control Rating Scale ( SCRS ) , parent ratings on the Modified Werry Weiss Activity Scale , and child ratings on the Piers Harris Self-Concept Scale and Matching Familiar Figures Task . Data were analyzed using a two-way analysis of variance for main effects . A significant improvement favoring CBT was found on the Werry Weiss Scale , which measures the parent 's perception of the child 's hyperactivity in the home , and the child 's rating of his/her self-esteem on the Piers Harris Self-Concept Scale . Other outcome measures did not demonstrate statistical differences . This research provides support for the use of CBT in children with ADHD .  CBT was found to improve the parent 's perception of the child 's hyperactivity in the home as well as the child 's self-esteem Methods : Various developmental problems including attention-deficit/hyperactivity disorder ( ADHD ) have been linked to biological deficiencies in polyunsaturated fatty acids ( PUFAs ) . Additionally , there is evidence that symptoms may be reduced with PUFA supplementation . This study investigated effects of supplementation with PUFAs on symptoms typically associated with ADHD . Because nutrients work synergistically , additional effects of micronutrient supplementation were also investigated . A total of 132 Australian children aged 7 to 12 years with scores ≥2 SD above the population average on the Conners ADHD Index participated in a r and omized , placebo-controlled , double-blind intervention over 15 weeks , taking PUFAs alone , PUFAs + micronutrients , or placebo . Due to unreturned question naires , data were only available for 104 children . Results : Significant medium to strong positive treatment effects were found on parent ratings of core ADHD symptoms , inattention , hyperactivity/impulsivity , on the Conners Parent Rating Scale ( CPRS ) in both PUFA treatment groups compared with the placebo group ; no additional effects were found with the micronutrients . After a one-way crossover to active supplements in all groups for a further 15 weeks , these results were replicated in the placebo group , and the treatment groups continued to show significant improvements on CPRS core symptoms . No significant effects were found on Conners Teacher Rating Scales . Conclusion : These results add to preliminary findings that ADHD-related problems with inattention , hyperactivity , and impulsivity might respond to treatment with PUFAs and that improvements may continue with supplementation extending to 30 weeks Neurofeedback treatment has been demonstrated to reduce inattention , impulsivity and hyperactivity in children with attention deficit/hyperactivity disorder ( ADHD ) . However , previous studies did not adequately control confounding variables or did not employ a r and omized reinforcer-controlled design . This study addresses those method ological shortcomings by comparing the effects of the following two matched biofeedback training variants on the primary symptoms of ADHD : EEG neurofeedback ( NF ) aim ing at theta/beta ratio reduction and EMG biofeedback ( BF ) aim ing at forehead muscle relaxation . Thirty-five children with ADHD ( 26 boys , 9 girls ; 6–14 years old ) were r and omly assigned to either the therapy group ( NF ; n = 18 ) or the control group ( BF ; n = 17 ) . Treatment for both groups consisted of 30 sessions . Pre- and post-treatment assessment consisted of psychophysiological measures , behavioural rating scales completed by parents and teachers , as well as psychometric measures . Training effectively reduced theta/beta ratios and EMG levels in the NF and BF groups , respectively . Parents reported significant reductions in primary ADHD symptoms , and inattention improvements in the NF group were higher compared to the control intervention ( BF , dcorr = −.94 ) . NF training also improved attention and reaction times on the psychometric measures . The results indicate that NF effectively reduced inattention symptoms on parent rating scales and reaction time in neuropsychological tests . However , regarding hyperactivity and impulsivity symptoms , the results imply that non-specific factors , such as behavioural contingencies , self-efficacy , structured learning environment and feed-forward processes , may also contribute to the positive behavioural effects induced by neurofeedback training This pilot study evaluated the effects of supplementation with PUFA on blood FA composition and behavior in children with Attention-Deficit/Hyperactivity Disorder (AD/HD)-like symptoms also reporting thirst and skin problems . Fifty children were r and omized to treatment groups receiving either a PUFA supplement providing a daily dose of 480 mg DHA , 80 mg EPA , 40 mg arachidonic acid ( AA ) , 96 mg GLA , and 24 mg α-tocopheryl acetate , or an olive oil placebo for 4 mon of doubleblind parallel treatment . Supplementation with the PUFA led to a substantial increase in the proportions of EPA , DHA , and α-tocopherol in the plasma phospholipids and red blood cell ( RBC ) total lipids , but an increase was noted in the plasma phospholipid proportions of 18∶3n-3 with olive oil as well . Significant improvements in multiple but outcomes ( as rated by parents ) were noted in both groups , but a clear benefit from PUFA supplementation for all behaviors characteristic of AD/HD was not observed . For most outcomes , improvement of the PUFA group was consistently nominally better than that of the olive oil group ; but the treatment difference was significantly , by secondary intent-to-treat analysis on only 2 out of 16 outcome measures : conduct problems rated by parents ( −42.7 vs. −9.9 % , n=47 , P=0.05 ) , and attention symptoms rated by teachers ( −14.8 vs. + 3.4 % , n=47 , P=0.03 ) . PUFA supplementation led to a greater number of participants showing improvement in oppositional defiant behavior from a clinical to a non clinical range compared with olive oil supplementation ( 8 out of 12 vs. 3 out of 11 , n=33 , P=0.02 ) . Also , significant correlations were observed when comparing the magnitude of change between increasing proportions of EPA in the RBC and decreasing disruptive behavior as assessed by the Abbreviated Symptom Question naire ( ASQ ) for parents ( r=−0.38 , n=31 , P<0.05 ) , and for EPA and DHA in the RBC and the teachers ' Disruptive Behavior Disorders ( DBD ) Rating Scale for Attention ( r=−0.49 , n=24 , P<0.05 ) . Interestingly , significant correlations were observed between the magnitude of increase in α-tocopherol concentrations in the RBC and a decrease in scores for all four subscales of the teacher 's DBD ( Hyperactivity , r=−0.45 ; Attention , r=−0.60 ; Conduct , r=−0.41 ; Oppositional/Defiant Disorder , r=−0.54 ; n=24 , P<0.05 ) as well as the ASQ for teachers ( r=−0.51 , n=24 , P<0.05 ) . Thus , the results of this pilot study suggest the need for further research with both n−3 FA and vitamin E in children with behavioral disorders Thirty-one children , selected for marked inattention and overactivity , were studied in a double-blind , placebo-controlled crossover study of essential fatty acid ( EFA ) supplementation . Subjects received the active treatment and placebo conditions for 4 weeks each and were assessed on a variety of cognitive , motor , and st and ardized rating scale measures .  EFA supplementation ( evening primrose oil ; Efamol ® ) result ed in significantly lower levels of palmitoleic acid ( a nonessential fatty acid ) and higher concentrations of dihomogammalinolenic acid , an EFA previously found to be deficient in some hyperactive children . Supplementation was also associated with significant changes on two performance tasks and with significant improvement to parent ratings on the subscales design ated as Attention Problem and Motor Excess of the Revised Behavior Problem Checklist . However , a variety of eight other psychomotor performance tests and two st and ardized teacher rating scales failed to indicate treatment effects . When the experimentwise probability level was set at.05 , only 2 of 42 variables showed treatment effects . Baseline EFA concentrations appeared to be unrelated to treatment response . It was concluded that EFA supplementation , as employed here , produces minimal or no improvements in hyperactive children selected without regard to baseline EFA concentrations Utilizing a double-blind , placebo design , the effects of a high ( 0.8 mg/kg ) and a low ( 0.4 mg/kg ) dose of methylpheni date alone and in combination with behavioral parent training plus child self-control instruction were evaluated with 96 attention deficit hyperactivity disorder children . No evidence of the superiority of the combined conditions relative to medication alone was found . Some limited support was found for the hypothesis that the effects of a high dose of psychostimulant medication  could be achieved by combining the low dose with a behavioral intervention . The importance of the latter finding is highlighted by the fact that both the benefits and untoward effects of the psychostimulants appear to increase with the dose Few studies have examined whether attention can be improved with training , even though attention difficulties adversely affect academic achievement . The present study was a r and omized-controlled trial evaluating the impact of Computerized Attention Training ( CAT ) and Computer Assisted Instruction ( CAI ) on attention and academic performance in 77 inattentive first grade rs . Students receiving either intervention were more likely than controls to show a moderate decline in teacher rated attention problems in first grade . Students receiving CAI also showed gains in reading fluency and in teacher ratings of academic performance . Intervention effects for attention were absent by second grade largely because attention problems declined in all groups . However , post hoc analyses indicated potential longer-term benefits for children with 6 or more inattentive symptoms at baseline . Persistent attention problems were associated with poorer academic performance in multiple domains . Results provide initial evidence that CAT and CAI can improve children ’s attention in the classroom - and support additional studies to determine whether more clinical ly significant benefits are attainable Nine hyperactive male subjects , selected on the basis of showing a favorable " response " to the Feingold diet in an earlier study , were maintained on a  strict elimination ( Feingold ) diet for 11 weeks , and were given multiple trials of placebo and challenge food material s.  Parental and teacher ratings , classroom behavior observations , and neuropsychological test scores obtained during baseline , placebo , and challenge conditions , in general , were not found to be adversely affected by the artificial color challenge material s. As expected , comparable data gathered on a matched control group showed them to receive substantially better ratings than the hyperactive subjects on the majority of the comparison measures employed . Possible explanations for the discrepancy between the dramatic clinical -anecdotal reports that have been given and the much more equivocal findings from formal experimental projects are presented OBJECTIVE To evaluate two different parent-based therapies for preschool attention-deficit/hyperactivity disorder ( ADHD ) in a community sample . METHOD Three-year-old children displaying a preschool equivalent of ADHD ( n = 78 ) were r and omly assigned to either a parent training ( PT ; n = 30 ) , a parent counseling and support ( PCO&S ; n = 28 ) , or a waiting-list control group ( n = 20 ) . The PT group received coaching in child management techniques . The PC&S group received nondirective support and counseling .  Measures of child symptoms and mothers ' well-being were taken before and after intervention and at 15 weeks follow-up . RESULTS ADHD symptoms were reduced ( F2,74 = 11.64 ; p < .0001 ) and mothers ' sense of well-being was increased by PT relative to both other groups ( F2,74 = 10.32 ; p < .005 ) . Fifty-three percent of children in the PT group displayed clinical ly significant improvement ( chi 2 = 4.08 ; p = .048 ) . CONCLUSIONS PT is a valuable treatment for preschool ADHD . PC&S had little effect on children 's behavior . Constructive training in parenting strategies is an important element in the success of parent-based interventions . Psychostimulants are not a necessary component of effective treatment for many children with preschool ADHD There is accumulating evidence that computerised cognitive training of inhibitory control and /or working memory can lead to behavioural improvement in children with AD/HD . Using a r and omised waitlist control design , the present study examined the effects of combined working memory and inhibitory control training , with and without passive attention monitoring via EEG , for children with and without AD/HD . One hundred and twenty-eight children ( 60 children with AD/HD , 68 without AD/HD ) were r and omly allocated to one of three training conditions ( waitlist ; working memory and inhibitory control with attention monitoring ; working memory and inhibitory control without attention monitoring ) and completed with pre- and post-training assessment s of overt behaviour ( from 2 sources ) , trained and untrained cognitive task performance , and resting EEG activity . The two active training conditions completed 25 sessions of training at home over a 4- 5-week period . Results showed significant improvements in overt behaviour for children with AD/HD in both training conditions compared to the waitlist condition as rated by a parent and other adult . Post-training improvements in the areas of spatial working memory , ignoring distracting stimuli , and sustained attention were reported for children with AD/HD . Children without AD/HD showed behavioural improvements after training . The improvements for both groups were maintained over the 6-week period following training . The passive attention monitoring via EEG had a minor effect on training outcomes . Overall , the results suggest that combined WM/IC training can result in improved behavioural control for children with and without AD/HD Two functional magnetic resonance imaging ( fMRI ) experiments were undertaken to measure the effect of neurofeedback training ( NFT ) , in AD/HD children , on the neural substrates of selective attention and response inhibition . Twenty unmedicated AD/HD children participated to these experiments . Fifteen children were r and omly assigned to the Experimental ( EXP ) group whereas the other five children were r and omly assigned to the Control ( CON ) group . Only subjects in the EXP group underwent NFT . EXP subjects were trained to enhance the amplitude of the SMR ( 12–15 Hz ) and beta 1 activity ( 15–18 Hz ) , and decrease the amplitude of theta activity ( 4–7 Hz ) . Subjects from both groups were scanned one week before the beginning of NFT ( Time 1 ) and 1 week after the end of NFT ( Time 2 ) , while they performed a “ Counting Stroop ” task ( Experiment 1 ) and a Go/No-Go task ( Experiment 2 ) . At Time 1 , in both groups , the  Counting Stroop task was associated with significant activation in the left superior parietal lobule . For the Go/No-Go task , no significant activity was detected in the EXP and CON groups . At Time 2 , in both groups , the  Counting Stroop task was associated with significant activation of the left superior parietal lobule . This time , however , there were significant loci of activation , in the EXP group , in the right ACC , left cau date nucleus , and left substantia nigra . No such activation loci were seen in CON subjects . For the Go/No-Go task , significant loci of activation were noted , in the EXP group , in the right ventrolateral prefrontal cortex , right ACcd , left thalamus , left cau date nucleus , and left substantia nigra . No significant activation of these brain regions was measured in CON subjects . These results suggest that NFT has the capacity to functionally normalize the brain systems mediating selective attention and response inhibition in AD/HD children There are no empirically supported psychosocial treatments for adolescents with attention-deficit hyperactivity disorder ( ADHD ) .  This study examined the treatment benefits of the Challenging Horizons Program ( CHP ) , a psychosocial treatment program design ed to address the impairment and symptoms associated with this disorder in young adolescents . In addition to evaluating social and academic functioning outcomes , two critical questions from previous studies pertaining to the timing , duration , and family involvement in treatment were addressed . Forty-nine students recruited in two cohorts were r and omly assigned to receive either the CHP or a  community care condition . Outcomes suggested that students who received the CHP  improved compared to students in the control condition on measures of symptoms and impairment . Implication s related to timing , duration , and family involvement are reported , as well as recommendations for future studies BACKGROUND Previous studies have demonstrated the short-term efficacy of pharmacotherapy and behavior therapy for attention-deficit/hyperactivity disorder ( ADHD ) , but no longer-term ( i.e. , > 4 months ) investigations have compared these 2 treatments or their combination . METHODS A group of 579 children with ADHD Combined Type , aged 7 to 9.9 years , were assigned to 14 months of medication management ( titration followed by monthly visits ) ; intensive behavioral treatment ( parent , school , and child components , with therapist involvement gradually reduced over time ) ; the two combined ; or st and ard community care ( treatments by community providers ) . Outcomes were assessed in multiple domains before and during treatment and at treatment end point ( with the combined treatment and medication management groups continuing medication at all assessment points ) . Data were analyzed through intent-to-treat r and om-effects regression procedures . RESULTS All 4 groups showed sizable reductions in symptoms over time , with significant differences among them in degrees of change . For most ADHD symptoms , children in the combined treatment and medication management groups showed significantly greater improvement than those given intensive behavioral treatment and community care . Combined and medication management treatments did not differ significantly on any direct comparisons , but in several instances ( oppositional/aggressive symptoms , internalizing symptoms , teacher-rated social skills , parent-child relations , and reading achievement )  combined treatment proved superior to intensive behavioral treatment and /or community care while medication management did not . Study medication strategies were superior to community care treatments , despite the fact that two thirds of community-treated subjects received medication during the study period . CONCLUSIONS For ADHD symptoms , our carefully crafted medication management was superior to behavioral treatment and to routine community care that included medication . Our combined treatment did not yield significantly greater benefits than medication management for core ADHD symptoms , but may have provided modest advantages for non-ADHD symptom and positive functioning outcomes In a Latin-square double-crossover with r and om assignment to sequence , 18 boys , aged 6 - 12 years , with attention-deficit hyperactivity disorder received 1 month each of placebo , D-amphetamine , and Efamol ( evening primrose oil containing gamma-linolenic acid , with vitamin E as preservative ) . Parents ' ratings were noncontributory . Teachers ' ratings showed a trend of  Efamol effect between placebo and D-amphetamine . The trend reached significance ( p less than 0.05 ) only on Conners Hyperactivity Factor . Dosage may be crucial ; 8 Efamol capsules per day were used in this study . Heuristic data scrutiny suggested possible interaction ( sequence effect ) . Further study with a different design and dose is suggested . This study does not establish Efamol as an effective treatment 76 selected overactive children were treated with an oligoantigenic diet , 62 improved , and a normal range of behaviour was achieved in 21 of these . Other symptoms , such as headaches , abdominal pain , and fits , also often improved . 28 of the children who improved completed a double-blind , crossover , placebo-controlled trial in which foods thought to provoke symptoms were reintroduced . Symptoms returned or were exacerbated much more often when patients were on active material than on placebo . 48 foods were incriminated . Artificial colorants and preservatives were the commonest provoking substances , but no child was sensitive to these alone Teacher ratings , objective classroom and laboratory observational data , attention-concentration , and other psychological measures obtained on 36 school-age , hyperactive boys under experimental and control diet conditions yielded no support for the Feingold hypothesis . Parental ratings revealed positive behavioral changes for the experimental diet ; however , they seemed primarily attributable to one diet sequence . Parents ' behavioral ratings on ten hyperactive , preschool boys indicated a positive response to the experimental diet ; again , laboratory observations showed no diet effect The efficacy of the Incredible Years parent and child training programs is established in children diagnosed with oppositional defiant disorder but not among young children whose primary diagnosis is attention-deficit/hyperactivity disorder ( ADHD ) . We conducted a r and omized control trial evaluating the combined parent and child program interventions among 99 children diagnosed with ADHD ( ages 4–6 ) . Mother reported significant treatment effects for appropriate and harsh discipline , use of physical punishment , and monitoring , whereas fathers reported no significant parenting changes . Independent observations revealed treatment effects for mothers ' praise and coaching , mothers ' critical statements , and child total deviant behaviors . Both mothers and fathers reported treatment effects for children 's externalizing , hyperactivity , inattentive and oppositional behaviors , and emotion regulation and social competence . There were also significant treatment effects for children 's emotion vocabulary and problem-solving ability . At school teachers reported treatment effects for externalizing behaviors and peer observations indicated improvements in treated children 's social competence OBJECTIVE To study the efficacy and safety of phosphatidylserine ( PS ) containing Omega3 long-chain polyunsaturated fatty acids attached to its backbone ( PS-Omega3 ) in reducing attention-deficit/ hyperactivity disorder ( ADHD ) symptoms in children . METHOD A 15-week , double-blind , placebo-controlled phase followed by an open-label extension of additional 15 weeks . Two hundred ADHD children were r and omized to receive either PS-Omega3 or placebo , out of them , 150 children continued into the extension .  Efficacy was assessed using Conners ' parent and teacher rating scales ( CRS-P , T ) , Strengths and Difficulties Question naire ( SDQ ) , and Child Health Question naire ( CHQ ) . Safety evaluation included adverse events monitoring . RESULTS The key finding of the double-blind phase was the significant reduction in the Global : Restless/impulsive subscale of CRS-P and the significant improvement in Parent impact-emotional ( PE ) subscale of the CHQ , both in the PS-Omega3 group . Exploratory subgroup analysis of children with a more pronounced hyperactive/impulsive behavior , as well as mood and behavior-dysregulation , revealed a significant reduction in the ADHD-Index and hyperactive components . Data from the open-label extension indicated sustained efficacy for children who continued to receive PS-Omega3 . Children that switched to PS-Omega3 treatment from placebo showed a significant reduction in subscales scores of both CRS-P and the CRS-T , as compare to baseline scores . The treatment was well tolerated . CONCLUSIONS The results of this 30-week study suggest that PS-Omega3 may reduce ADHD symptoms in children . Preliminary analysis suggests that this treatment may be especially effective in a subgroup of hyperactive-impulsive , emotionally and behaviorally-dysregulated ADHD children OBJECTIVE Deficits in executive functioning , including working memory ( WM ) deficits , have been suggested to be important in attention-deficit/hyperactivity disorder ( ADHD ) . During 2002 to 2003 , the authors conducted a multicenter , r and omized , controlled , double-blind trial to investigate the effect of improving WM by computerized , systematic practice of WM tasks . METHOD Included in the trial were 53 children with ADHD ( 9 girls ; 15 of 53 inattentive subtype ) , aged 7 to 12 years , without stimulant medication . The compliance criterion ( > 20 days of training ) was met by 44 subjects , 42 of whom were also evaluated at follow-up 3 months later . Participants were r and omly assigned to use either the treatment computer program for training WM or a comparison program . The main outcome measure was the span-board task , a visuospatial WM task that was not part of the training program . RESULTS For the span-board task , there was a significant treatment effect both post-intervention and at follow-up . In addition , there were significant effects for secondary outcome tasks measuring verbal WM , response inhibition , and complex reasoning . Parent ratings showed significant reduction in symptoms of inattention and hyperactivity/impulsivity , both post-intervention and at follow-up . CONCLUSIONS This study shows that WM can be improved by training in children with ADHD . This training also improved response inhibition and reasoning and result ed in a reduction of the parent-rated inattentive symptoms of ADHD BACKGROUND For children with attention deficit/hyperactivity disorder ( ADHD ) , a reduction of inattention , impulsivity and hyperactivity by neurofeedback ( NF ) has been reported in several studies . But so far , unspecific training effects have not been adequately controlled for and /or studies do not provide sufficient statistical power . To overcome these method ological shortcomings we evaluated the clinical efficacy of neurofeedback in children with ADHD in a multisite r and omised controlled study using a computerised attention skills training as a control condition . METHODS 102 children with ADHD , aged 8 to 12 years , participated in the study . Children performed either 36 sessions of NF training or a computerised attention skills training within two blocks of about four weeks each ( r and omised group assignment ) . The combined NF treatment consisted of one block of theta/beta training and one block of slow cortical potential ( SCP ) training . Pre-training , intermediate and post-training assessment encompassed several behaviour rating scales ( e.g. , the German ADHD rating scale , FBB-HKS ) completed by parents and teachers . Evaluation ( ' placebo ' ) scales were applied to control for parental expectations and satisfaction with the treatment . RESULTS For parent and teacher ratings , improvements in the NF group were superior to those of the control group . For the parent-rated FBB-HKS total score ( primary outcome measure ) , the effect size was .60 . Comparable effects were obtained for the two NF protocol s ( theta/beta training , SCP training ) . Parental attitude towards the treatment did not differ between NF and control group . CONCLUSIONS Superiority of the combined NF training indicates clinical efficacy of NF in children with ADHD . Future studies should further address the specificity of effects and how to optimise the benefit of NF as treatment module for ADHD Seventy-eight children , referred to a diet clinic because of hyperactive behaviour , were placed on a ' few foods ' elimination diet . Fifty nine improved in behaviour during this open trial . For 19 of these children it was possible to disguise foods or additives , or both , that reliably provoked behavioural problems by mixing them with other tolerated foods and to test their effect in a placebo controlled double blind challenge protocol . The results of a crossover trial on these 19 children showed a significant effect for the provoking foods to worsen ratings of behaviour and to impair psychological test performance . This study shows that observations of change in behaviour associated with diet made by parents and other people with a role in the child 's care can be reproduced using double blind methodology and objective assessment s. Clinicians should give weight to the accounts of parents and consider this treatment in selected children with a suggestive medical history BACKGROUND Learned self-control of slow cortical potentials ( SCPs ) may lead to behavioral improvement in attention-deficit/hyperactivity disorder ( ADHD ) . Hence , training effects should also be reflected at the neurophysiological level . METHODS Thirteen children with ADHD , aged 7 - 13 years , performed 25 SCP training sessions within 3 weeks . Before and after training , the German ADHD rating scale was completed by parents , and event-related potentials were recorded in a cued continuous performance test ( CPT ) . For a waiting-list group of nine children with ADHD , the same testing was applied . RESULTS ADHD symptomatology was reduced by approximately 25 % after SCP training . Moreover , a decrease of impulsivity errors and an increase of the contingent negative variation were observed in the CPT task . CONCLUSIONS This study provides first evidence for both positive behavioral and specific neurophysiological effects of SCP training in children with ADHD BACKGROUND The effectiveness of parent training ( PT ) when delivered as part of specialist tier-two services for preschool AD/HD children has been recently demonstrated . AIMS To assess the effectiveness of the same PT programme when delivered as part of routine primary care by non-specialist nurses . METHOD A sample of 89 3-year-old children with preschool AD/HD took part in a controlled trial of an eight-week ( one hour a week ) , health visitor delivered , PT package . Children , allocated r and omly to PT ( n = 59 ) and waiting list control ( WLC ; n = 30 ) groups , were compared . RESULTS PT did not reduce AD/HD symptoms . Maternal well-being decreased in both PT and WLC groups . CONCLUSIONS While PT is an effective intervention for preschool AD/HD when delivered in specialized setting s , these benefits do not appear to generalize when programme are delivered as part of routine primary care by non-specialist nurses BACKGROUND The effects of a restricted elimination diet in children with attention-deficit hyperactivity disorder ( ADHD ) have mainly been investigated in selected subgroups of patients . We aim ed to investigate whether there is a connection between diet and behaviour in an unselected group of children . METHODS The Impact of Nutrition on Children with ADHD ( INCA ) study was a r and omised controlled trial that consisted of an open-label phase with masked measurements followed by a double-blind crossover phase . Patients in the Netherl and s and Belgium were enrolled via announcements in medical health centres and through media announcements . R and omisation in both phases was individually done by r and om sampling . In the open-label phase ( first phase ) , children aged 4 - 8 years who were diagnosed with ADHD were r and omly assigned to 5 weeks of a restricted elimination diet ( diet group ) or to instructions for a healthy diet ( control group ) . Thereafter , the clinical responders ( those with an improvement of at least 40 % on the ADHD rating scale [ ARS ] ) from the diet group proceeded with a 4-week double-blind crossover food challenge phase ( second phase ) , in which high-IgG or low-IgG foods ( classified on the basis of every child 's individual IgG blood test results ) were added to the diet . During the first phase , only the assessing paediatrician was masked to group allocation . During the second phase ( challenge phase ) , all persons involved were masked to challenge allocation . Primary endpoints were the change in ARS score between baseline and the end of the first phase ( masked paediatrician ) and between the end of the first phase and the second phase ( double-blind ) , and the abbreviated Conners ' scale ( ACS ) score ( unmasked ) between the same timepoints . Secondary endpoints included food-specific IgG levels at baseline related to the behaviour of the diet group responders after IgG-based food challenges . The primary analyses were intention to treat for the first phase and per protocol for the second phase . INCA is registered as an International St and ard R and omised Controlled Trial , number IS RCT N 76063113 . FINDINGS Between Nov 4 , 2008 , and Sept 29 , 2009 , 100 children were enrolled and r and omly assigned to the control group ( n=50 ) or the diet group ( n=50 ) . Between baseline and the end of the first phase , the difference between the diet group and the control group in the mean ARS total score was 23·7 ( 95 % CI 18·6 - 28·8 ; p<0·0001 ) according to the masked ratings . The difference between groups in the mean ACS score between the same timepoints was 11·8 ( 95 % CI 9·2 - 14·5 ; p<0·0001 ) . The ARS total score increased in clinical responders after the challenge by 20·8 ( 95 % CI 14·3 - 27·3 ; p<0·0001 ) and the ACS score increased by 11·6 ( 7·7 - 15·4 ; p<0·0001 ) . In the challenge phase , after challenges with either high-IgG or low-IgG foods , relapse of ADHD symptoms occurred in 19 of 30 ( 63 % ) children , independent of the IgG blood levels . There were no harms or adverse events reported in both phases . INTERPRETATION A strictly supervised restricted elimination diet is a valuable instrument to assess whether ADHD is induced by food . The prescription of diets on the basis of IgG blood tests should be discouraged . FUNDING Foundation of Child and Behaviour , Foundation Nuts Ohra , Foundation for Children 's Welfare Stamps Netherl and s , and the KF Hein Foundation BACKGROUND Our objective was to estimate the lifetime prevalence of psychopathology in a sample of youth with and without attention deficit hyperactivity disorder ( ADHD ) through young adulthood using contemporaneous diagnostic and analytic techniques . METHOD We conducted a case-control , 10-year prospect i ve study of ADHD youth . At baseline , we assessed consecutively referred male , Caucasian children with ( n=140 ) and without ( n=120 ) DSM-III-R ADHD , aged 6 - 18 years , ascertained from psychiatric and pediatric sources to allow for generalizability of results . At the 10-year follow-up , 112 ( 80 % ) and 105 ( 88 % ) of the ADHD and control children , respectively , were reassessed ( mean age 22 years ) . We created the following categories of psychiatric disorders : Major Psychopathology ( mood disorders and psychosis ) , Anxiety Disorders , Antisocial Disorders ( conduct , oppositional-defiant , and antisocial personality disorder ) , Developmental Disorders ( elimination , language , and tics disorder ) , and Substance Dependence Disorders ( alcohol , drug , and nicotine dependence ) , as measured by blinded structured diagnostic interview . RESULTS The lifetime prevalence for all categories of psychopathology were significantly greater in ADHD young adults compared to controls , with hazard ratios and 95 % confidence intervals of 6.1 ( 3.5 - 10.7 ) , 2.2 ( 1.5 - 3.2 ) , 5.9 ( 3.9 - 8.8 ) , 2.5 ( 1.7 - 3.6 ) , and 2.0 ( 1.3 - 3.0 ) , respectively , for the categories described above . CONCLUSIONS By their young adult years , ADHD youth were at high risk for a wide range of adverse psychiatric outcomes including markedly elevated rates of antisocial , addictive , mood and anxiety disorders . These prospect i ve findings provide further evidence for the high morbidity associated with ADHD across the life-cycle and stress the importance of early recognition of this disorder for prevention and intervention strategies A crossover ‘ placebo’-controlled , double-blind design was used to examine the effectiveness of an oligoantigenic diet in 49 children with hyperactive/disruptive behavior disorder . Effects of diet were compared with those yielded by stimulant medication ( methylpheni date ) . The study was conducted in an inpatient unit at the Department of Child and Adolescent Psychiatry , Central Institute of Mental Health , Mannheim .  Change in behavior was measured in st and ardized situations by trained raters , including behavior assessment when testing with CPT and PAT , during a free play situation , and at school . Twelve children ( 24 % ) showed significant behavioral improvement in two behavior ratings during diet relative to control diet conditions . Methylpheni date used in 36 children yielded more responders ( 44 % ) than diet . The amount of positive changes in behavior in those who received both treatments was about the same . Although only effective in a minority of children , dietary treatment can not be neglected as a possible access to treating hyperactive/disruptive children and merits further investigation The aim of this study is to assess the efficacy of a restricted elimination diet in reducing symptoms in an unselected group of children with Attention deficit/hyperactivity disorder ( ADHD ) . Dietary studies have already shown evidence of efficacy in selected subgroups . Twenty-seven children ( mean age 6.2 ) who all met the DSM-IV criteria for ADHD , were assigned r and omly to either an intervention group ( 15/27 ) or a waiting-list control group ( 12/27 ) . Primary endpoint was the clinical response , i.e. a decrease in the symptom scores by 50 % or more , at week 9 based on parent and teacher ratings on the abbreviated ten-item Conners Scale and the ADHD-DSM-IV Rating Scale . The intention-to-treat analysis showed that the number of clinical responders in the intervention group was significantly larger than that in the control group [ parent ratings 11/15 ( 73 % ) versus 0/12 ( 0 % ) ; teacher ratings , 7/10 ( 70 % ) versus 0/7 ( 0 % ) ] . The Number of ADHD criteria on the ADHD Rating Scale showed an effect size of 2.1 ( cohen ’s d ) and a scale reduction of 69.4 % . Comorbid symptoms of oppositional defiant disorder also showed a significantly greater decrease in the intervention group than it did in the control group ( cohens ’s d 1.1 , scale reduction 45.3 % ) . A strictly supervised elimination diet may be a valuable instrument in testing young children with ADHD on whether dietary factors may contribute to the manifestation of the disorder and may have a beneficial effect on the children ’s behaviour OBJECTIVE To assess the value of search ing for unpublished data by exploring the extent to which Cochrane review s include unpublished data and by evaluating the quality of unpublished trials . STUDY DESIGN AND SETTING We screened all 2,462 completed Cochrane review s published since 2000 in the Cochrane Data base of Systematic Review s Issue 3 , 2006 . In a r and om sample ( n=61 ) of 292 review s , including unpublished trials , we studied all 116 references . RESULTS Unpublished trials make up 8.8 % of all included trials in our sample . Thirty-eight percent of the " unpublished " trials have in fact been published . Allocation concealment was " unclear " or not adequate in 54.3 % and 61.3 % reported blinding . In 47.2 % reported withdrawal rates were > 20 % . Trials that were eventually published had larger mean population sizes ( P-value , 0.02 ) . Of the reported sponsors , 87.3 % were drug companies . Method ological quality and publication bias are mentioned in half of the review s and explored in a third . Quality ratings did not have consequences for pooling , because 82.8 % was included in the forest plots . CONCLUSIONS A minority of Cochrane review s include " unpublished trials " and many of these are eventually published . Truly unpublished studies have poor or unclear method ological quality . Therefore , it may be better to invest in regular updating of review s , rather than in extensive search ing for unpublished data Children were included in this challenge study if according to parental report ( 1 ) the child 's hyperactive behavior had been noticeably improved for at least 3 mo . as a result of adherence to the Feingold diet and ( 2 ) dietary violations such as those used in the study were reported to have a noticeable negative effect . Evaluations of 14 objective measures in a double-blind , cross-over design yielded no significant differences between diet infraction and noninfraction conditions . In addition to question ing the stated efficacy of the diet , findings suggest that one should not depend solely on parental report when evaluating a dietary effect and should also weigh potential negative effect of adherence to the diet OBJECTIVE To determine whether docosahexaenoic acid ( DHA ) supplementation for 4 months decreases the symptoms of  attention-deficit/hyperactivity disorder ( ADHD ) .  STUDY DESIGN Sixty-three 6- to-12-year-old children with ADHD , all receiving effective maintenance therapy with stimulant medication , were assigned r and omly , in a double-blind fashion , to receive DHA supplementation ( 345 mg/d ) or placebo for 4 months . Outcome variables included plasma phospholipid fatty acid patterns , scores on laboratory measures of inattention and impulsivity ( Test of Variables of Attention , Children 's Color Trails test ) while not taking stimulant medication , and scores on parental behavioral rating scales ( Child Behavior Checklist , Conners ' Rating Scale ) . Differences between groups after 4 months of DHA supplementation or placebo administration were determined by analysis of variance , controlling for age , baseline value of each outcome variable , ethnicity , and ADHD subtype . RESULTS Plasma phospholipid DHA content of the DHA-supplemented group was 2.6-fold higher at the end of the study than that of the placebo group ( 4.85 + /- 1.35 vs 1.86 + /- 0.87 mol % of total fatty acids ; P < .001 ) . Despite this , there was no statistically significant improvement in any objective or subjective measure of ADHD symptoms . CONCLUSION A 4-month period of DHA supplementation ( 345 mg/d ) does not decrease symptoms of ADHD BACKGROUND Although several clinical trials have evaluated the impact of n-3 polyunsaturated fatty acid ( PUFA ) on patients with attention-deficit hyperactivity disorder ( ADHD ) , changes in plasma PUFA composition were not always assessed following n-3 supplementation . Furthermore , no reports are available on the efficacy of n-3 PUFA in Canadian youth with ADHD . OBJECTIVES To determine fatty acid ( FA ) composition , and the efficacy and safety of n-3 PUFA supplementation on ADHD clinical symptoms in French Canadian primary school children . PATIENTS AND METHODS The Strengths and Weaknesses in ADHD and Normal Behaviors ( SWAN ) and Conners ' question naires were used to assess changes in ADHD symptoms in 37 children ( only 26 children completed the study from zero to 16 weeks ) . They were divided into two groups ( A and B ) , and participated in a 16-week , double-blind , one-way , crossover r and omized study . In the first phase , group A received the n-3 PUFA supplement and group B received n-6 PUFA ( sunflower oil ) as a placebo . During the second phase , group B received the active n-3 PUFA supplement that was continued in group A. FA composition and lipid profile were assessed during the phases of the study . RESULTS FA differences between groups were observed in the 26 patients . Supplementation with n-3 PUFA result ed in significant increases in eicosapentaenoic and docosahexaenoic acids in group A , while group B was enriched with alpha-linolenic , gamma-linolenic and homo-gamma-linolenic acids . The n-3 PUFA supplement was tolerated without any adverse effects . A statistically significant improvement in symptoms was noted based on the parent version of the Conners ' question naire from baseline to the end of phase 1 , and this amelioration continued from phases 1 to 2 , although the latter changes from phases 1 and 2 were not statistically significant in any of the subscales except for the subscale measuring inattention in group B. The improvement was greater in patients from group A in phase 1 and in patients from group B in phase 2 . A subgroup of eight patients ( four in each group ) displayed a statistically significant clinical improvement following the administration of the n-3 PUFA supplement , particularly for the inattention and global Diagnostic and Statistical Manual of Mental Disorders , Fourth edition , total Conners ' subscales . CONCLUSIONS A subgroup of children with ADHD who used n-3 PUFA supplements achieved and maintained symptom control . The data of the present study also supported n-3 PUFA  safety and tolerability , but limited changes were noted in the FA profile in French Canadians with ADHD Two variants of a behavioral family intervention ( BFI ) program known as Triple P were compared using 87 preschoolers with co-occurring disruptive behavior and attentional/hyperactive difficulties . Families were r and omly allocated to enhanced BFI ( EBFI ) , st and ard BFI ( SBFI ) , or a waitlist ( WL ) control group . At postintervention both BFI programs were associated with significantly lower levels of parent-reported child behavior problems , lower levels of dysfunctional parenting , and greater parental competence than the WL condition . The EBFI condition was also associated with significantly less observed child negative behavior in comparison to the WL . The gains achieved at postintervention were maintained at 1-year follow-up . Contrary to predictions , the enhanced program was not shown to be superior to the st and ard program using any of the outcome measures at either postintervention or follow-up . Each of the programs produced significant reductions in children 's co-occurring disruptive behavior and attentional/hyperactive difficulties with 80 % of the children showing clinical ly reliable improvement in observed negative behavior from preintervention to follow-up The revised new forest parenting programme ( NFPP ) is an 8-week psychological intervention design ed to treat ADHD in preschool children by targeting , amongst other things , both underlying impairments in self-regulation and the quality of mother – child interactions . Forty-one children were r and omized to either the revised NFPP or treatment as usual conditions . Outcomes were ADHD and ODD symptoms measured using question naires and direct observation , mothers ’ mental health and the quality of mother – child interactions . Effects of the revised NFPP on ADHD symptoms were large ( effect size > 1 ) and significant and effects persisted for 9 weeks post-intervention . Effects on ODD symptoms were less marked . There were no improvements in maternal mental health or parenting behavior during mother – child interaction although there was a drop in mothers ’ negative and an increase in their positive comments during a 5-min speech sample . The small-scale trial , although limited in power and generalizability , provides support for the efficacy of the revised NFPP . The findings need to be replicated in a larger more diverse sample Objective : The aim of the study was to assess omega 3/6 fatty acids ( eye q ) in attention deficit hyperactivity disorder ( ADHD ) . Method : The study included a r and omized , 3-month , omega 3/6 placebo-controlled , one-way crossover trial with 75 children and adolescents ( 8—18 years ) , followed by 3 months with omega 3/6 for all .  Investigator-rated ADHD Rating Scale — IV and Clinical Global Impression ( CGI ) scale were outcome measures . Results : A majority did not respond to omega 3/6 treatment . However , a subgroup of 26 % responded with more than 25 % reduction of ADHD symptoms and a drop of CGI scores to the near-normal range . After 6 months , 47 % of all showed such improvement . Responders tended to have ADHD inattentive subtype and comorbid neurodevelopmental disorders . Conclusion : A subgroup of children and adolescents with ADHD , characterized by inattention and associated neurodevelopmental disorders , treated with omega 3/6 fatty acids for 6 months responded with meaningful reduction of ADHD symptoms . ( J. of Att . Dis . 2009 ; 12(5 ) 394 - 401 OBJECTIVE To investigate the effectiveness of behavioral parent training ( BPT ) as adjunct to routine clinical care ( RCC ) . METHOD After a first phase of RCC , 94 children with attention-deficit/hyperactivity disorder ( ADHD ) ages 4 - 12 , all referred to a Dutch outpatient mental health clinic , were r and omly assigned to 5 months of BPT plus concurrent RCC ( n = 47 ) or to 5 months of RCC ( n = 47 ) alone . BPT consisted of 12 sessions in group format ; RCC included family support and pharmacotherapy when appropriate . Exclusionary criteria were minimized , and children with and without medication could participate . Parent-reported behavioral problems , ADHD symptoms , internalizing problems , and parenting stress were assessed before and after treatment . Follow-up assessment of the BPT + RCC group was completed 25 weeks post-BPT intervention . Repeated- measures analyses of variance were carried out on an intention-to-treat basis . RESULTS Both groups showed improvements over time on all measures .  BPT + RCC was superior to RCC alone in reducing behavioral ( p = .017 ) and internalizing ( p = .042 ) problems . No outcome differences were found in ADHD symptoms ( p = .161 ) and parenting stress ( p = .643 ) . These results were equal for children with and without medication . Children allocated to RCC alone received more polypharmaceutical treatment . CONCLUSIONS Adjunctive BPT enhances the effectiveness of routine treatment of children with ADHD , particularly in decreasing behavioral and internalizing problems , but not in reducing ADHD symptoms or parenting stress . Furthermore , adjunctive BPT may limit the prescription of polypharmaceutical treatment In a test of Feingold 's hypothesis that food additives trigger the hyperactive response , 26 hyperactive children were r and omly assigned to treatment conditions whereby they were given active or placebo medications in combination with challenge cookies with artificial food colors or control cookies without the additives . The children were crossed over into each of the four treatment conditions and experimental procedures were employed , including double-blind assessment s through the completion of behavior checklists , by teachers and parents . Stimulant medications were clearly more effective than diet in reducing hyperactive behavior . The parent ratings indicate strong drug effects and inconclusive diet effects . Drug effects are marked in teacher ratings as well . However , when the children were receiving placebos , their hyperactive behaviors in the classroom were greater when eating cookies with artificial colors than when eating cookies without artificial colors . According to the ratings , approximately seven children were no longer hyperactive . There is evidence to suggest that the behavior of three to eight children was diet-responsive , depending on the criteria used . There is evidence , particularly in teacher ratings , in support of Feingold 's hypothesis if it is modified . Further research is required to specify which subtypes of  hyperactive children respond to a diet free of artificial food colors Objective . This study examined the efficacy of 2 computer-based training systems to teach children with attention deficit/hyperactivity disorder ( ADHD ) to attend more effectively . Design / methods . A total of 41 children with ADHD from 2 middle schools were r and omly assigned to receive 2 sessions a week at school of either neurofeedback ( NF ) or attention training through a st and ard computer format ( SCF ) , either immediately or after a 6-month wait ( waitlist control group ) . Parents , children , and teachers completed question naires pre- and postintervention . Results . Primary parents in the NF condition reported significant ( P < .05 ) change on Conners ’s Rating Scales — Revised ( CRS-R ) and Behavior Assessment Scales for Children ( BASC ) subscales ; and in the SCF condition , they reported significant ( P < .05 ) change on the CRS-R Inattention scale and ADHD index , the BASC Attention Problems Scale , and on the Behavioral Rating Inventory of Executive Functioning ( BRIEF ) . Conclusion . This r and omized control trial provides preliminary evidence of the effectiveness of computer-based interventions for ADHD and supports the feasibility of offering them in a school setting Essential fatty acids ( EFA ) are needed for normal sensory , cognitive , and motor function . The EFA blood profile seems to be different in children with attention-deficit/hyperactivity disorder ( ADHD ) as compared to matched controls . Previous open EFA supplementation trials were successful in demonstrating significant therapeutic effects in this population , whereas most of the r and omized controlled trials failed to show any benefit over placebo . The current r and omized , double-blind , placebo-controlled trial tested the influence of short-chain EFA supplementation on ADHD children , using parent and teacher question naires and a computerized continuous performance test . A total of 73 unmedicated children aged 7 - 13 years with a diagnosis of ADHD participated in the study ; 63 children completed the study . The EFA supplement contained 480 mg of linoleic acid and 120 mg of alpha-linolenic acid , and the placebo contained 1000 mg of vitamin C ( daily amounts ) ; both were given for a 7-week supplementation period . Analysis of variance for repeated measures revealed that both treatments ameliorated some of the symptoms , but no significant differences were found between the groups in any of the treatment effects
target: Free fatty acid supplementation produced small but significant reductions in ADHD symptoms even with probably blinded assessment s , although the clinical significance of these effects remains to be determined .
  Artificial food color exclusion produced larger effects but often in individuals selected for food sensitivities .
background: OBJECTIVE Nonpharmacological treatments are available for attention deficit hyperactivity disorder ( ADHD ) , although their efficacy remains uncertain .
  The authors undertook meta-analyses of the efficacy of dietary ( restricted elimination diets , artificial food color exclusions , and free fatty acid supplementation ) and psychological ( cognitive training , neurofeedback , and behavioral interventions ) ADHD treatments .