The Effectiveness of Neurofeedback on Working Memory Performance and Cognitive Planning Ability in Children with Attention-Deficit/Hyperactivity Disorder

The present study aimed to examine the effectiveness of neurofeedback on working memory performance and cognitive planning ability in children with ADHD. This semi-experimental study employed a pretest–posttest control group design with a follow-up phase. The statistical population consisted of all children aged 7 to 14 years diagnosed with ADHD who attended the Shiva Counseling and Psychology Center in Rasht in 2025. From this population, 70 children (35 in the experimental group and 35 in the control group) were selected through purposive sampling. The experimental group received 20 sessions of neurofeedback training (two sessions per week, each lasting 30 to 40 minutes). The neurofeedback protocol involved reducing the theta/beta ratio in the F4 region, enhancing sensorimotor rhythm (SMR), and decreasing theta and delta activity in the frontal and Cz regions. Data collection instruments included the Conners-3 Questionnaire, the Wechsler Digit Span Subtest, the Corsi Block-Tapping Test for visuospatial memory, and the Tower of London Test for cognitive planning. Data were analyzed using descriptive statistics and mixed-design ANOVA with repeated measures in SPSS version 29. Results revealed that the mean scores of verbal and visuospatial working memory, cognitive planning ability, and the reduction of ADHD index significantly improved in the neurofeedback group compared to the control group in both posttest and follow-up stages (p < .001). The effects of time, group, and the interaction between time × group were significant across all variables (partial η² ranging from .43 to .70). Bonferroni post hoc tests indicated that the changes from pretest to posttest were significant and remained stable at the follow-up phase. Moreover, 76.5% of children in the neurofeedback group demonstrated a clinically significant reduction (more than 10 T-score points on the Conners Questionnaire). The findings suggest that neurofeedback, through the modulation of brainwave patterns in frontal and central regions, can produce lasting improvements in working memory and cognitive planning abilities among children with ADHD.