Biofeedback for Attention Deficit and Hyperactivity Disorder in children: A pilot study of a multimodal approach of respiratory biofeedback to improve functional impact
Biofeedback for Attention Deficit and Hyperactivity Disorder in children: A pilot study of a multimodal approach of respiratory biofeedback to improve functional impact

Biofeedback for Attention Deficit and Hyperactivity Disorder in children: A pilot study of a multimodal approach of respiratory biofeedback to improve functional impact

Encephale. 2026 Aug 31:S0013-7006(26)00164-8. doi: 10.1016/j.encep.2026.06.007. Online ahead of print.

ABSTRACT

Defined as a complex syndrome combining attentional and behavioral difficulties, Attention Deficit Hyperactivity Disorder (ADHD) is a widespread condition affecting approximately 5.3% of children worldwide. Treatments mainly include psychotherapy and amphetamine derivative-based pharmacotherapy. Respiratory biofeedback may represent an additional, promising non-pharmacological approach for ADHD, in addition to neurofeedback, biofeedback’s actual main application protocol based on cerebral activity. However, to date, there are few studies regarding other physiological rhythms, such as breathing. This study explored the potential effects of a therapeutic intervention based on respiratory, haptic and visual biofeedback, aiming to reduce the intensity of attentional dysfunction symptoms in children with ADHD aged 8 to 11 years. In this crossover protocol, we set two intervention groups: an immediate group and a delayed group. The intervention phase consisted of five weekly respiratory biofeedback sessions focused on attention processes, along with the monitoring of symptomatic manifestations using validated psychometric tools. Among the 17 participants, the results showed a significant overall decrease in ADHD evaluation scale scores both immediately after the intervention and at the 30-day follow-up, indicating short-term benefits from the sessions. However, these benefits were attenuated in the medium term, possibly due to the limited number of biofeedback sessions. In conclusion, respiratory biofeedback was well accepted, and few sessions decreased in the short term symptomatic manifestations and functional impacts related to ADHD. However, treatment effects, permanence and acceptability need to be assessed in larger and longer cohort studies. Thus, a multimodal biofeedback approach based on respiratory feedback is an innovative preliminary but promising emerging perspective for children presenting ADHD.

PMID:42674893 | DOI:10.1016/j.encep.2026.06.007