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Kouijzer, M. E. UJ, de Moor, J. M. H., Gerrits, B. J. L., Buitelaar, J. K., & van Schie, H. T. (2009). Research in Autism Spectrum Disorders, 3(2), 496–501.
When evaluating any treatment, it is essential to also study its long-lasting effects – whether the treatment truly results in structural improvement or if the clients relapse to pre-assessment levels. Previous studies give evidence for the effectiveness of neurofeedback in treating women with autism spectrum disorders. Positive results included improved executive functioning, social behavior, and general and non-verbal communication.
These results can be accounted for by a mechanism involving the ACC of the default mode network (DMN). The ACC is one of the main generators of theta activity in the brain and occupies a significant role in regulating emotional processes contributing to cognitive control and executive function. Autistic subjects do not deactivate their ACC in order to allow activation of other task-relevant brain areas. By learning to reduce theta activity in the ACC by neurofeedback, subjects with autism spectrum disorder may allow functional activations and deactivations of the ACC in line with cognitive and executive demands. This increased flexibility of the DMN might allow areas supporting cognitive functions to active more effectively to carry out cognitive tasks, thus improving performance.
By contrast, activation of the DMN is required for tasks requiring Theory of Mind, the ability to ascribe mental states, such as desires, beliefs, and intentions to oneself and to other people. There is a closer relationship between Theory of Mind performance and executive functions. As a result, improved flexibility of the ACC in autistic individuals through neurofeedback might support both executive functions (by attenuating DMN activation) and Theory of Mind performance (by activation).
In this follow-up study, the performance in executive functioning and social behavior prior to treatment (pre-assessment) and immediately after treatment (post-assessment) were compared with data collected 12 months following treatment (follow-up). It was determined that treatment results pertaining to executive function were maintained or increased 12 months after ending neurofeedback behavior. Follow-up data assessing social behavior revealed that children’s immediate improvement on social interaction skills, communicative abilities, and typical behavior were also maintained giving further evidence to the hypothesis that neurofeedback increases the flexibility of the brain and can produce long-term beneficial effects.
Sichel, A. G., Fehmi, L. G., & Goldstein, D. M. (1995). Journal of Neurotherapy, 1(1), 6064.
This article describes the experience of Frankie, an 8 and ½ year old boy with mild autism. Frankie seemed to lack awareness of the existence of others – his behavior had been described as looking through the people, rather than looking at or attending to them. He failed to follow the behavior of his siblings and did not engage in social play. Though his mother had worked a great deal to develop his verbal communication, his verbalizations were minimal at the beginning of the treatment and he did not actively engage in social situations. Frankie had been diagnosed as autistic by two separate private practice psychologists, a neurologist specializing in autism, as well as a special education professor at a state college.
A Test of Variables of Attention (TOVA), typically used in diagnosing attention deficits in children and adults, was administered in order to evaluate Frankie. His performance indicated an attention deficit disorder. His brain’s electrical activity was recorded and revealed deviations from what is average for his age group, consistent with attention deficit disorders, including high theta/beta ratios.
Frankie was assigned a theta/beta/EMG treatment which rewarded him for raising his SMR (12-15 Hz) brain activity and decreasing theta (4-8 Hz) activity. As of the publishing of this article, Frankie had received 31 sessions of training. His mother reported that he was talking more and had been affectionate with his siblings. For the first time in his life, he played with his sister and put his arm around his older brother. Over the course of the training, Frankie continued to show significant behavioral improvement – he began attending to and reacting with others, making eye contact, acknowledging his sister’s distress, among other things. Though his vocalizations were still limited and his responses comparatively slow, his speech therapist reported that he had improved one whole entire diagnostic category since his previous evaluation.
Frankie’s QEEG mapping following the completion of 31 sessions of neurotherapy exhibited reduced theta/beta power ratios in 15 of the 19 brain sites. These modifications corresponded to reduced autistic symptoms and the development of normal patterns of social interaction and communication.
Pineda J., Carrasco K., Datko M., Pillen S., and Schalles M.
This study investigates the efficacy of EEG Neurofeedback on improving the symptoms associated with ASD by specifically training the Mirror Neuron System (MNS). The human MNS has been linked to social cognition which is strongly associated to the social and cognitive deficits reflected in the symptoms of ASD. The Neurofeedback training in this experiment specifically targeted the mu rhythms which are connected both perception and action. Researchers analyzed the results from the 24 patients after approximately 30 hours of Neurofeedback training. The effects of this training were measured using the Social Responsiveness Scale (SRS), the Autism Treatment Evaluation Checklist (ATEC), and Vineland Adaptive Behavior Scales, and in all three measures researchers saw significant improvement. The results of this experiment suggest that Neurofeedback training can positively change the dysfunctional mirror networks in autistic children.
Kouijzer M., de Moor J., Gerrits B., Buitelaar J., and van Schie H.
In a previous study, the results of neurofeedback treatment in children with ASD were compared to a control group. Their treatment included 40 neurofeedback sessions involving inhibition of theta activity and rewarding low beta activity over the right hemisphere. Results showed improvement in verbal and non-verbal communication as well as typical behavior. The present study investigates if the improvements of the children’s executive functioning and social behavior were maintained a year later by comparing follow-up data with the pre- and post-assessment data from a year earlier. The results confirmed that enhancement of activation in the ACC gives long lasting improvement in executive function and social behavior in children with ASD.
Betty Jarusiewicz, PhD
This study looked at the effects of neurofeedback on autistic children by treating an experimental group of 12 autistic children with neurofeedback training and using the remaining 12 children as a control. The controls were matched to the experimental group by age, gender, and severity of autism. The children were evaluated via the Autism Treatment Evaluation Checklist, as well as behavioral assessments by parents. The study showed a significantly greater decrease in autism symptoms in the experimental group, as evaluated by the Autism Treatment Evaluation Checklist. Behavioral assessments also showed a significant improvement in the behaviors of the experimental group including tantrums, anxiety and socialization; however, these improvements were not seen in the control group.