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Introduction: Down syndrome is the most common identifiable cause of intellectual disability, accounting for almost one third of cases and approximately 1 in 800 births. Neurofeedback (NF) is an operant conditioning method for retraining brain wave (EEG) patterns. An increasing number of clinicians use operant conditioning of EEG activity as a method of helping children with Attention Deficit Hyperactivity and Generalized Learning Disability (ADHD/ADD or GLDO). Some Down syndrome children display symptoms of ADHD/ADD, GLDO or both. We believed that NF may have potential in helping children with Down syndrome. Methodology: Eight children with Down Syndrome (ages 6–14) were evaluated through questionnaire, parent interview, and pre- and post-treatment quantitative EEG's. All eight children were seen by the first author and by the special educator at the baseline, and at the 20th, 40th and 60th treatment sessions. Pre-treatment QEEGs were analyzed using the NxLink normative database and generally showed excess delta and theta EEG patterns. None of the subjects were able to speak more than one word sentences and they had very limited vocabulary (between 5-10 words). They usually pointed a finger to communicate and were not able to engage in basic conversation. All children displayed very poor attention and concentration, poor memory, impulsivity, behavior problems, in some cases balance problems. The purpose of this preliminary study was to evaluate whether QEEG guided, bipolar montage NF training is effective in developing speech, improving attention and concentration, improving learning, decreasing behavioral problems or impulsivity, and alleviating balance problems in Down Syndrome children. All subjects were medication-free during treatment. NF training was conducted using Lexicor Biolex software with electrode placement guided by QEEG findings, seeking to normalize abnormal QEEG patterns. Training continued until the subjects demonstrated improvement and there were significant improvements in the reports of parents, or until a total of 60 treatment sessions were provided. Scores derived from a combination of questionnaire and parental ratings were obtained pre- and post-treatment in the areas of memory, speech and language, attention, behavior, and balance. Results. One subject dropped out after eight sessions. All seven children who completed NF training showed significant (p < .02) improvement in all areas evaluated based on the questionnaire and parent interviewing, and changes were found in QEEGs. Further study with a control group and additional outcome measures is warranted. [ABSTRACT FROM AUTHOR]