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Early Intervention with Neurofeedback: A potential for school based support

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Early intervention with neurofeedback should be considered as a vital strategy to support children who are struggling in their learning and development. With the convergence of NDIS changes that emphasise early intervention, and the growing number of young children experiencing difficulties that affect their education, the need for effective, evidence-based supports in schools has never been greater. And if the information from parents and teachers wasn’t enough to go on, the 2024 AEDC National Report highlighted a significant decrease in the number of children who are developmentally on track for social, emotional, communication, and language skills. This further highlights the need for new approaches to be considered.

Professional neurofeedback looks at the individual needs of each child and supports the training of neural pathways to reduce difficulties and improve capacity. Whether reducing overwhelm, improving emotional regulation, or just the reward-based mechanism of training attention and regulation, neurofeedback has been shown to be an effective therapy when compared to true control groups. This makes it an optimal early intervention tool for use within a school setting. The best part is this is not a new idea; Neurofeedback has been trialed in schools for decades, with research consistently showing encouraging outcomes for attention, behaviour, and emotional wellbeing across ALL students.

Past Research into Neurofeedback in Schools

Past Research into Neurofeedback in Schools

The first controlled explorations of neurofeedback for children began in the 1990s. While some of these were clinic-based, they laid the groundwork for integrating neurofeedback into educational settings.

  • Lubar et al. (1995) worked with children and adolescents diagnosed with ADHD. Those who learned to reduce excess theta brainwave activity demonstrated improved attention on formal testing, and better parent ratings of behaviour. This study was influential in framing neurofeedback as more than a behavioural intervention, showing it directly targeted brain function [1].
  • Carmody et al. (2000) trialled EEG biofeedback in an elementary school setting. Children with ADHD who received neurofeedback showed fewer impulsive errors and improved attention, with teachers reporting noticeable improvements in classroom focus [2].
  • Steiner and colleagues (2011; 2014) conducted large-scale, randomised controlled trials directly in schools. They found that children receiving neurofeedback made significant improvements in inattention, executive functioning, and hyperactivity compared to control groups. Importantly, these gains were maintained at six-month follow-up, and unlike the control and cognitive training groups, the neurofeedback group did not require increases in medication dosages [3, 4]. It is a commonly reported effect of neurofeedback that medications require educed dosages over time.
  • Foks (2005) extended school-based neurofeedback to children with special educational needs. Students not only showed improved attention and behaviour but also emotional gains, benefiting from one-on-one, non-failure-based tasks that enhanced resilience [5].
  • Krell et al. (2023) demonstrated that neurofeedback can benefit even the general student population. After a series of game-based neurofeedback sessions, students showed stronger sustained attention, planning, and organisation skills, all skills directly linked to learning outcomes [6].

Together, these studies show a clear trajectory: neurofeedback is effective not only for children with diagnosed ADHD but also for broader populations, with consistent improvements in the very capacities schools aim to strengthen yet are being seen to be weakened.

Early intervention with Neurofeedback in a school setting

Outcomes from the Studies

  1. Improved attention and focus: Students demonstrated better capacity to stay on task.
  2. Reduced impulsivity and disruptive behaviour: Classrooms benefited from calmer, more engaged learners.
  3. Enhanced executive functioning: Planning, organisation, and working memory improved.
  4. Emotional and behavioural regulation: Students developed stronger resilience and stability in their emotional responses.
  5. Sustained benefits: Improvements held months beyond the intervention, suggesting lasting neural changes.
  6. Reduced reliance on medication: Unlike comparison groups, children receiving neurofeedback did not require increased stimulant medication.

Barriers to Wider Implementation

Despite strong evidence, neurofeedback remains under-utilised. Barriers exist both within schools and across the broader healthcare and research landscape:

  • Demands for sham neurofeedback as placebo control: Some trials and reviews continue to frame sham neurofeedback as a valid placebo, despite evidence that it produces its own active learning effects. This methodological issue has been used to minimise the value of real neurofeedback by emphasising the small differences between sham and active groups, rather than acknowledging the substantial baseline improvements both groups achieve [7]. This would be akin to demanding stimulant mediations use caffeine tablets as a placebo control group, or a study looking at respiratory improvements of runners using a cycling control group.
  • Research framing and review bias: Systematic reviews often highlight these “reduced differences” as evidence against neurofeedback, rather than recognising the clinical and educational significance of gains in attention, behaviour, and emotional functioning. This framing has slowed acceptance despite positive trial results. Equally reviews conducted by professional organisations have prioritised the opinions of professionals with no experience or training in the modality over that of equally qualified practitioners who are subject matter experts. 
  • The perception of a lack of trained practitioners: professional neurofeedback and neuromodulation is widely available in Australia. However relatively few practitioners openly identify as providing it, or choose to voluntarily register with the BCIA-A. This shortage limits both clinical and educational implementation, and equally important the recognition within insurance schemes as they perceive it to be inaccessible.
  • Dominance of the medical model: Many systems continue to favour pharmacological solutions as the “gold standard,” making it difficult for neurofeedback, which sits outside this model, to gain traction in policy and practice. Ironically many of the recommendations made by these same groups are not based in the same standards of evidence, rather on the opinion of those accepted into the panels even when effect sizes for accepted modalities are much smaller. 
  • Regulation and commercialism: With no formal regulation of Neurofeedback or Neuromodulation in Australia, there continues to be those who take advantage of the gains achieved. They do this by marketing commercial systems to persons without the formal training or education to adequately provide neurofeedback or neuromodulation. Some of these systems do not provide anything better than sham neurofeedback to begin with, and many persons using it do not have regulatory bodies,, or the training to understand what they are doing to the brain. See my blog about what to ask a potential practitioner.

These barriers are not insurmountable, but they highlight the systemic issues that need to be addressed if neurofeedback is to move from promising intervention to widespread application.

Moving Forward.

For neurofeedback to become a genuine early intervention option, several steps need to be taken:

  1. Reframing evidence:  Shifting the focus of reviews and policy discussions from ‘placebo/sham feedback’ comparisons to real-world functional gains and comparisons to actual control groups. Undertaking new research rather than undertaking new reviews of the same research.
  2. School-provider partnerships: Building pilot projects that embed neurofeedback within existing wellbeing and learning support frameworks. An opportunity for new research here.
  3. Policy reform: Broadening recognition of interventions that strengthen brain and behavioural function, moving beyond reliance on medication-only approaches.
  4. Early intervention focus: Positioning neurofeedback not as a last resort or alternative, but as a proactive tool to prevent difficulties from escalating, supporting children earlier in their educational journey. If a child can learn to regulate they will be better positioned to continue developing faster

The evidence base for neurofeedback as an early intervention is strong and growing. Research consistently demonstrates improvements in attention, behaviour, executive functioning, and emotional regulation, with benefits that last well beyond the training period and reduce reliance on medication. Yet barriers in research framing, practitioner availability, and entrenched medical models continue to limit its implementation.

If these barriers can be addressed, neurofeedback offers a powerful, evidence-based tool to help children thrive in the classroom and beyond especially if partnered with school programs for delivery. With increasing pressures on educational systems to support diverse learning needs, the case for school-based neurofeedback is not only compelling, but urgent.

References

  1. Lubar, J. F., Swartwood, M. O., Swartwood, J. N., & O’Donnell, P. H. (1995). Evaluation of the effectiveness of EEG neurofeedback training for ADHD in a clinical setting. Biofeedback and Self-Regulation, 20(1), 83–99.
  2. Carmody, D. P., Radvanski, D. C., Wadhwani, S., Sabo, M. J., & Vergara, L. (2000). EEG biofeedback training and attention-deficit/hyperactivity disorder in an elementary school setting. Journal of Neurotherapy, 4(3), 5–27.
  3. Steiner, N. J., Frenette, E. C., Rene, K. M., Brennan, R. T., & Perrin, E. C. (2011). In-school neurofeedback training for ADHD: A preliminary randomized controlled trial. Journal of Attention Disorders, 15(5), 391–402.
  4. Steiner, N. J., Sheldrick, R. C., Gotthelf, D., & Perrin, E. C. (2014). Computer-based attention training in school children with ADHD: A randomized trial. Journal of Developmental & Behavioral Pediatrics, 35(1), 18–27.
  5. Foks, M. (2005). Neurofeedback as an educational intervention for children with special needs. Journal of Neurotherapy, 9(4), 87–101.
  6. Krell, M., et al. (2023). Game-based neurofeedback for sustained attention in the student population. Applied Psychophysiology and Biofeedback, 48(2), 127–139.
  7. Arns, M., et al. (2017). Editorial perspective: Neurofeedback in ADHD – the long and winding road. Journal of Child Psychology and Psychiatry, 58(5), 656–658.

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