Neurofeedback As A Brain Self-Regulation Therapy
There is a scientific technique that has been documented to be widely used by professionals and athletes for attaining peak performance and to give them an edge over the competition. This technique, called neurofeedback or EEG biofeedback, was integrated into NASA astronauts’ space mission training program for better focus. In addition, performing artists, musicians and scientists use it to enhance their creativity and skills, whilst the Italian national soccer team mentioned neurofeedback as their ‘secret weapon’ in attaining their 2006 World Cup victory.
So just what exactly is neurofeedback? In a nutshell, it is a drug-free, non-invasive form of brain self-regulation exercise that essentially does one thing: improve central nervous system function by voluntarily controlling one’s brainwaves to produce beneficial patterns and inhibit undesirable ones. Because every human activity involves the central nervous system, its improvement logically improves every cognitive, emotional and physiological aspect of daily existence.
Neurofeedback’s self-regulation model makes it a compelling therapy modality for the problems of brain disregulation. These typically include, but are not limited to, the anxiety-depression spectrum, attention deficits, behavior disorders, sleep disorders, headaches & migraines and emotional disturbances. Recent evidence supports neurofeedback’s efficacy when applied to neuro-developmental disorders such as autism, Rett syndrome, child disintegrative disorder, and Asperger’s syndrome.
Research on autistic spectrum disorders shows that neurofeedback can remediate irregularities in brain activation, leading to symptom reduction and functional improvement. As a result, increasing numbers of healthcare professionals, including many who follow the Defeat Autism Now! protocol developed by the Autism Research Institute, have adopted neurofeedback as a core component of their autism treatment protocol.
The neurofeedback process
The neurofeedback process involves attaching electrodes (sensors) to the scalp to pick up EEG or brainwave activities. Nothing is actually physically inserted/applied to the brain. Brainwaves are amplified and then presented to the child in the form of a computer game. The child plays the game by creating desirable brainwaves in order to score points in the game. Attempts to mentally control the outcome of the game by thinking, concentrating or even by deliberately trying to relax do not help in generating these brainwaves. The child is instead encouraged to naturally allow the game to proceed by generating the desired mix of brainwaves.
Neurofeedback is based on the principle of operant conditioning, where the award of points and good feelings from successful achievement help the person produce more of the desired brainwaves.
One way to think of neurofeedback is as a process of regulating and establishing connections that will allow a child to perform at his functional best. Because autism is associated with underconnectivity between parts of the brain, the neurofeedback process endeavours to optimize existing synaptic connections through brainwaves to bring about better regulation and overall improvement in the cognitive, emotional and physiological functions of a child.
In recent years, numerous studies have been performed that provide empirical evidence attesting to the efficacy of neurofeedback in the treatment of autism. A prominent pilot study by Dr. B. Jarusiewciz and a case cited in a scientific paper by Dr Arthur G Sichel, Lester G Fehmi and David M Goldstein are discussed here.
Neurofeedback for Autism: Research on 16 autistic children
In September 2001, Dr. Betty Jarusiewicz of the Atlantic Research Institute presented a scientific paper, Efficacy of Neurofeedback in the Autistic Spectrum.
The study was conducted on 16 children who received neurofeedback for autism, and compared with another 16 controls who did not receive neurofeedback for autism. Here is an excerpt from the study:
Our study involved the training of 16 individuals using neurofeedback, applying a number of assessment processes, and comparing those trained with 16 non-trained individuals.
88% of those trained reduced their levels of autism within months (measured by Rimland’s ATEC check-list) - on average 26% compared with control group on average of less than 5%.
Before and after videos (Greenspan method) were also used for comparison purposes. All results show significant improvement on average in the areas of speech (30%), socialization (34%), other types of health (sleep, anxiety, tantrums – 29%), and cognitive awareness (16%).
Neurofeedback for autism: Scientific Paper by Dr Arthur G Sichel, Lester G Fehmi and David M Goldstein
In 2005, Dr Arthur G Sichel, author of The Alphabet Kids and a world authority on autism, presented a scientific paper with two co-researchers, titled Positive Outcome With Neurofeedback Treatment In a Case of Mild Autism.
This paper discussed the case of Frankie, an 8 1/2 year old boy who received neurofeedback for autism:
Frankie exhibited a seeming lack of awareness of the existence of others. He did not seek comfort when distressed. He showed no imitation of his siblings and did not engage in social play.
His mother reported that he did not vocalize until the age of three, when he began to babble. He did not make eye contact, did not look at the person or smile in social approach. He had a fixed stare in social situations.
Two separate psychologists, each in private practice, one also a school psychologist, diagnosed him autistic. A neurologist specializing in autism, who is on the faculty of a medical school, diagnosed him autistic. A special education professor at a state college said he was autistic-like but brain damaged and said there was no hope for improvement.
As of this writing, Frankie has received 31 sessions (of neurofeedback training). His mother reported significant changes after three training sessions. She said he was talking more and had been affectionate with his siblings. For the first time in his life he played with his sister, and even kissed her, and he put his arm around his older brother.
Over the course of training, Frankie's behavior continued to change. He began attending to and reacting to others. He started making eye contact. He presented his biofeedback trainers with valentine cards he had made; he appeared shy while presenting them and seemed thrilled when the cards were praised. After 31 neurofeedback sessions he notices his sister's distress and tries to interfere when she resists taking a bath or going to bed. He seeks comfort when he reads something upsetting. He imitates his older brother and plays with his brother, his sister and a friend.
He no longer tires easily and no longer has trouble falling or staying asleep. His headaches are significantly reduced, as is his tendency to appear anxious and worried. He is much less shy and withdrawn. At this point in treatment, Frankie's verbalizations are still limited and responses continue to appear slow. He now sometimes makes eye contact and no longer has a fixed, vacant stare in social situations. He engages in a lot of imaginative play with his sister. He now reads with some expression.
He does not speak much and speaks monotonously, but a singsong quality was not present during later sessions. He now refers to himself as 'T" He initiates conversations at home and asks for what he wants. Before, he frequently engaged in a repetitive jumping activity. Now, he rarely does this. Before, he showed great attachment to a number of unusual objects, insisting on carrying them around. He now carries markedly fewer things around with him.
The behavioural changes and the brain wave changes in this 8-year-old autistic boy are viewed as a positive outcome of neurotherapy. These results are suggestive that neurotherapy can be an effective treatment for some of the symptoms of mild autism. It would be interesting to follow possible further gains with additional neurotherapy sessions.
Home training program
Home training is now a reality for parents across Indonesia. Although improvements from neurofeedback training have been shown as enduring and sustainable over time, training for autistic children can take months if not years. The Peak Performance Centre offers practical workshops for parents that wish to be proactive in helping their child. In the workshop, the principles and practical application of neurofeedback therapy can be learned and continuing supervision provided thereafter by certified trainers.
Our thanks to By Thio Chong, Reg. Psychologist (NSW Psychologist Reg. Board, Australia) for the contribution of this article. Mr. Thio Chong (Registered Psychologist – NSW Psychologists Registration Board, Australia) is the director of Dayspring Child & Family Associates in Singapore and consultant psychologist at the Peak Performance Centre in Sports Mall, Kelapa Gading – North Jakarta. He is a practicing neuro-therapist and counselling psychologist that founded the Autism Support Network in Singapore. The Peak Performance Centre offers scholastic & psychological assessments, hair tissue mineral analysis (HTMA), counselling as well as neurofeedback training. Thio Chong may be contacted at (021) 9474-7614 or (021) 4585-0754.
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