Slow-Oscillation Neurofeedback: A Narrative Review on Clinical Efficacy in Pediatric Settings

Slow-oscillation neurofeedback (NF), encompassing slow cortical potential (SCP), infra-low-frequency (ILF), and infra-slow-fluctuation (ISF) protocols, has gained increasing interest as a non-pharmacological intervention in pediatric mental health and neurodevelopmental care. This narrative review synthesizes peer-reviewed literature on the clinical efficacy of slow-oscillation NF in children and adolescents across various conditions, including attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), epilepsy, tic disorders, and eating-related concerns. SCP NF is the most extensively studied protocol and shows preliminary efficacy in reducing ADHD symptoms, particularly among individuals capable of learning self-regulation. For ASD and other conditions, early evidence from primarily small-scale or uncontrolled studies suggests possible benefits in emotional regulation, impulsivity, and behavioral symptoms, though findings remain mixed and often non-specific. Methodological heterogeneity, including variation in control conditions, training protocols, and outcome measures, limits the comparability of results. ILF and ISF protocols, while promising, are still emerging and require further validation. Overall, slow-oscillation NF appears to offer potential as a personalized therapeutic option for pediatric populations, but robust, well-controlled trials are needed to clarify its clinical utility and optimize its integration into multimodal care.