Practice in Clinical & Health Psychology
Autism
Autistic Spectrum Disorders

Autism is a disorder of brain function that begins in early childhood and causes impairment in three crucial areas of development: communication, social interaction, and creative or imaginative play. In some cases, children with autism may never develop patterns of typical speech and social interaction. Their speech may be inflexible and unresponsive to context or limited to narrow topics of specialized knowledge or echolalia. Communication impairment includes nonverbal cues such as eye contact, facial expression, and gesture. Social behaviors are often characterized by a lack of interaction and cooperation. Play lacks cooperation and imagination and is often narrowly focused on repetitive activities.

Research shows that autism can be further categorized as part of a spectrum of heterogeneous disorders called Autistic Spectrum Disorders (ASD) characterized by a broad range of abilities and levels of severity but all showing the same triad of core symptoms involving impairments in communication, social interaction, and imagination. The Autistic Spectrum Disorders include: Autistic Disorder, Asperger's Disorder, Semantic Pragmatic Communication Disorder, Non-Verbal Learning Disabilities, High Functioning Autism, and Hyperlexia.

Autistic Disorder and Asperger's Disorder are also classified as forms of Pervasive Developmental Disorder (PDD)—a group of heterogeneous developmental disorders characterized by delays in the development of multiple basic functions including socialization, verbal and nonverbal communication, posture and movement, eating and drinking or sleeping patterns, and responses to sensory input. This group of disorders includes: Autistic Disorder, Asperger’s Disorder, Rett’s Disorder, and Childhood Disintegrative Disorder.

In recent years, ASD has shown a dramatic increase in prevalence. A recently published review of prevalence survey research for ASD across the United States and the United Kingdom reported rates of ASD substantially increased from prior surveys indicating 5 to 10 per 10,000 children to as high as 50 to 80 per 10,000.

Classified as a neurodevelopmental disorder, the specific cause of ASD remains unknown; although numerous theories linking ASD to genetic factors, viral infection, or early exposure to various chemicals or environmental toxins have been proposed and are under research.

Current research suggests that ASD may be associated with functional disconnectivity between brain regions. There is evidence for anomalies in the functional connectivity of the medial temporal lobe. Abnormalities have been found specifically in the functional integration of the amygdala and parahippocampal gyrus. Such abnormalities in brain function point to the need for therapeutic interventions that address ASD as a neurodevelopmental and brain disorder.

EEG neurofeedback is a non-invasive therapeutic intervention which has been shown to enhance neuroregulation and metabolic function in the brain. In contrast to behavior therapy, positive treatment outcomes as a result of neurofeedback training are achieved over the course of several months as opposed to a year or more of intensive behavioral training. EEG neurofeedback has no adverse side-eefects while psychopharmacological interventions, as well as certain vitamin/mineral supplementation and secretin are associated with side-effects. The therapeutic treatment outcomes of neurofeedback training are maintained over time and do not reverse after treatment has been withdrawn as in drug therapy, diet therapy, and supplementation with vitamins, minerals and enzymes. 

 

Assessment–Guided EEG Neurofeedback is an Effective Treatment for Autism

Robert Coben & Ilean Padolsky

 

This clinical research article presented results of 20 sessions of EEG neurofeedback treatment with 37 children (31 male; 6 female; aged 3.9 to 14.7 yrs) diagnosed with Autistic Spectrum Disorder (ASD). Of these 37 ASD children, 21 were diagnosed with Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS); 7 with Autism, 5 with Asperger’s Disorder, and 4 with Childhood Disintegrative Disorder. The 37 children in the Neurofeedback Treatment Group (NFT) were compared to 12 similarly-diagnosed children in a Wait-List Control Group (WLC). The NFT and WLC groups were matched on the basis of age, gender, race, handedness, other treatments, and severity of their Austistic Spectrum Disorder as indicated by the Autism Treatment Evaluation Checklist (ATEC).

All the children included within this study were comprehensively assessed prior to treatment by means of a thorough neurodevelopmental history, neurobehavioral rating scales, and baseline measurements of neuropsychological functioning , as well as a 19-channel quantitative EEG (QEEG) recording.

Individualized neurofeedback training protocols for each of the children in the NFT group were based on the combined use of all assessment information with a heavy emphasis on initial QEEG findings. Protocols included primarily sequential (bipolar) or interhemispheric montages individualized for each patient. The focus was on reducing EEG hyperconnectivity which was frequently observed in posterior-frontal to anterior-temporal regions. Once selected, each patient’s protocol remained constant during the training period of 20 sessions; with training conducted twice weekly.

Results

Treatment efficacy was analyzed by calculating difference scores between pre- and post-treatment clinical values. These difference scores were then tested for statistical significance with ANOVA measures comparing changes in the NFT versus WLC groups. Overall, significant findings suggest therapeutic changes in the NFT subjects and little to no changes for the WLC subjects.

Following treatment, an average 40% decrease in core Autistic Spectrum Disorder symptoms was reported by parents for 89% (n = 33) of the NFT group. This rate of improvement was significantly different from that found in the WLC group in which 83% reported no change. All positive treatment outcomes reported by parents were confirmed by neuropsychological and neurophysiological assessment. There were no reports of symptoms worsening. The benefit to harm ratio was calculated at 89:1 exceeding all currently available therapies or treatments for Autistic Spectrum Disorders.

Significant improvement was noted for the NFT group on measures of attention, executive, visual perceptual and language functions. Fully 76% of the NFT group (28 of 37) demonstrated a statistically significant decrease in EEG hyperconnectivity patterns with neurofeedback.

Published as:  Coben, R. & Padolsky, I. (2007). Assessment-guided neurofeedback for Autistic Disorders. Journal of Neurotherapy, Vol. 11, No. 1, pp.5-23.

 

Other published papers on treatment of autism with EEG Neurofeedback…

Scolnick, B. (2005). Effects of electroencephalogram biofeedback with asperger’s syndrome. International Journal of Rehabilitation Research, Vol. 28, No. 2, pp. 159-163.

Jarusiewicz, B. (2002). Efficacy of neurofeedback for children in the autistic spectrum: A pilot study. Journal of Neurotherapy, 6Vol. 6, No. 4, pp. 39-44.

Sichel, A., Fehmi, L., Goldstein, D. (1995). Positive outcome with neurofeedback treatment in a case of mild autism. Journal of Neurotherapy, Vol. 1, No. 1, pp. 60-64.

Cowan, J. & Markham, L. (1994). EEG Biofeedback for the attention problems of autism: A case study. Presented at the Annual Meeting of the Association for Applied Psychophysiology and Biofeedback. March 1994.