Does Neurofeedback Work For Autism?

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Welcome to our first post in a series that looks in-depth at how neurofeedback is used for specific disorders. In each we share some experiences and insights from our practice as well as highlight current and relevant research.

We begin by discussing Autistic Spectrum Disorders (ASD) and Asperger’s Syndrome. This is a natural place to start, not only because I have my Master’s in Special Education, but also because watching neurofeedback transform the life of one of my student’s with ASD was the initial reason I become involved in it.

I want to be clear that neurofeedback does not “cure” Autism, nor do I believe that Autism is something to be “cured.” Neurofeedback helps to optimize the brain’s own potential and adaptability; it doesn’t change the brain into something it’s not.

Neurofeedback helps address and reduce the symptoms and maladaptive behaviours relating to ASD, such as: anxiety, social struggles, inattention, communication skills, impulsivity, emotional regulation, and executive functioning.

 

My First Experience with Neurofeedback and Autism

As a Special Education teacher, a number of students on my caseload are on the Autistic Spectrum.

One student in particular would go into non-responsive meltdowns once or twice a week, lasting for 1-2 hours at a time. His mother and I tried multiple different strategies over several months but nothing seemed to make a significant or lasting impact. After expanding our research we came across neurofeedback as a possible option and his mother decided to try it.

After a few weeks we started to notice that he wasn’t having his non-responsive meltdowns. Then multiple colleagues, who were unaware that this student was going to neurofeedback, approached me wondering what had changed. They noticed he was engaged in class, was making more friends, and would respond to adults using full sentences rather than just shaking his head or giving one-word replies.

I can’t emphasize enough how profound these changes were – for his family, his schooling, and his well-being. It has been two years since this student started neurofeedback treatment and the number of non-verbal meltdowns at school or at home he has had can be counted on a single hand.

Not all ASD clients experience such drastic results, although every client with ASD who I’ve seen or known who has used neurofeedback has improved markedly.

 

The Research

Since neurofeedback’s impact on Autism was first observed in 1994, the research for ASD and Asperger’s Syndrome has been consistent. Studies show that neurofeedback has the ability to make lasting changes to increase self regulation and executive functioning skills, as well as decrease social ineptitude, anxiety, and attention-related issues.1,2

For example, in one of the most recent studies in 2016, 18 children and adolescents with ASD were treated with neurofeedback and there was a statistically significant reduction in Lethary/Social Withdrawal and Hyperactivity.3

One prominent study divided twenty-four children in the Autistic Spectrum into two matching groups based on their Autistic symptoms: one group received neurofeedback while the other was a control group. Before and after treatment the Autism Treatment Evaluation Checklists (ATEC), a widely used scale for measuring improvements for Autistic-related symptoms and behaviours, was used. The group that received neurofeedback significantly improved their ATEC scores: Sociability improved by 33%; speech/language/communication by 29%; health by 26%; and sensory/cognitive awareness by 17%. The overall average ATEC improvement for neurofeedback group was 26% compared to 3% for the control group.4

In 2008, a modified double-blind method was used to measure attention related behaviours for people with ASD. This meant that after 10 weeks of neurofeedback treatment, the participants and their parents did not know whether they were in the neurofeedback group or the placebo group. Using the TOVA’s ADHD score, there was a 70% improvement for the neurofeedback group.5

Admittedly, the biggest caution for many of the studies mentioned with neurofeedback and ASD is their smaller sample sizes. Yet, considering the specific populations needed for these studies and the time commitment of treatment for families involved this is not unsurprising. Furthermore, the overwhelming positive results that neurofeedback has been shown to have on ASD populations argues a strong case for it’s efficacy and value.

Many of these studies mentioned above also revealed additional benefits from neurofeedback. Up to 89% of parents saw significant improvement in their child’s ASD symptoms, two different studies saw significant increases in IQ (one by 9 points the other by 10 points)2,6 and one study revealed that many ASD participants were able to reduce or eliminate their medications after neurofeedback.1

This research and our personal experience working with ASD clients, makes neurofeedback, in our opinion, a valuable treatment option for clients and families with Autistic Spectrum Disorders.
 

Specifics for Clients with Autistic Spectrum Disorders

  • As changes to routines and environments can be difficult for some ASD clients, we do send home an outline of what a session will look like so parents and clients can review and prepare ahead of time.
  • If mobility is an issue for ASD clients we offer home sessions.
  • For clients with ASD the 15-20 session average does not necessarily apply. Positive changes will be noted very early on but, generally, clients with ASD will have more ongoing treatment – although the frequency of sessions are often reduced.

We explain the benefits of the type of neurofeedback we use which is called Clarity Direct Neurofeedback on our webpage over here, but there are some specific benefits with the system we use for ASD clients:

  1. It allows us to make shorter appointments as necessary (for ASD clients we often streamline the process with parents and family members so that the whole appointment can be streamlined to 15 minutes in office).
  2. The time needed for the client to sit relatively still can be broken up into 1-2 minutes rather than 40+ minutes.

 

References
  1. Coben, B., Linden, M., & Myers, T. E. (2010). Neurofeedback for autistic spectrum disorder: A review of the literature. Applied Psychophysiology Biofeedback. 35, 83–105. DOI 10.1007/s10484-009-9117-y
  2. Thompson, L., Thompson, M., & Reid, A. (2010). Neurofeedback outcomes in clients with asperger’s syndrome. Applied Psychophysiology Biofeedback. 35, 63-81. DOI 10.1007/s10484-009-9120-3
  3. Wang, Y., et al. (2016). Relative power of specific EEG bands and their ratios during neurofeedback training in children with Autism Spectrum Disorder. Frontiers in Human Neuroscience, 9, 723.
  4. Jarusiewicz, B. (2002) Efficacy of Neurofeedback for Children in the Autistic Spectrum: A Pilot Study, Journal of Neurotherapy: Investigations in Neuromodulation, Neurofeedback and Applied Neuroscience, 6:4, 39-49. http://dx.doi.org/10.1300/J184v06n04_05
  5. Pineda J. A., et al. (2008). Positive behavioral and electrophysiological changes following neurofeedback training in children with autism. Research in Autism Spectrum Disorders, 2, 557–581. doi:10.1016/j.rasd.2007.12.003
  6. Thompson, M., & Thompson, L. (2003). The neurofeedback book: An introduction to basic concepts in applied psychophysiology. Wheat Ridge, CO: Association for Applied Psychophysiology and Biofeedback.