JMIR Publications

ABSTRACT

Background:

Children and youth with developmental trauma frequently experience affect dysregulation, executive functioning difficulties, and complex comorbidities that limit responsiveness to conventional psychotherapeutic and pharmacological treatments. Neurofeedback therapy, a non-invasive brain-computer interface intervention, has demonstrated promise in improving affect regulation and trauma-related symptoms.

Objective:

This protocol describes a non-pilot feasibility study designed to examine the implementation feasibility, acceptability, and appropriateness of neurofeedback therapy delivered within day-treatment school programs for children and youth with developmental trauma.

Methods:

Up to 28 children and youth (ages 11-17) enrolled in two school-based day-treatment programs will be offered neurofeedback therapy twice weekly for 12 weeks during the school day. Implementation outcomes will be assessed using feasibility measures completed by mental health clinicians, educators, and child and youth workers, a weekly fidelity checklist completed by clinicians delivering the intervention, and assessments of the experience of neurofeedback therapy collected from children and youth, parents/caregivers, teachers, and child and youth workers collected at mid-point (6 weeks) and post-intervention. Clinicians delivering treatment-as-usual at the mental health treatment center will be invited to a post-intervention focus group to capture indirect implementation impacts on clinical workflow. Quantitative data will be summarized descriptively, and qualitative data will be analyzed using thematic analysis.

Results:

We will implement neurofeedback therapy in both elementary- and secondary-school cohorts. We enrolled six participants into our study from the secondary school cohort in April 2026 and completed data collection for mid-point assessments in May 2026. Data collection for the secondary school cohort ended mid-June 2026. The elementary school cohort study implementation will begin in Fall 2026.

Conclusions:

We expect that findings from both elementary and secondary school cohorts will provide insights into the feasibility, acceptability, and appropriateness of implementing neurofeedback therapy within a publicly funded school-based day-treatment program for children and youth with developmental trauma. Preliminary evidence of perceived changes in self-regulation, attention, emotional control, and classroom engagement will also be reported and discussed.