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The term Autism Spectrum Disorder (ASD) includes the diagnoses of Autism and what used to be called Asperger’s
Disorder, and Pervasive Developmental Disorder, Not Otherwise Specified. The primary deficit in ASD is
impaired social communication. This can stem from a poor ability to recognize social behaviors in others,
a poor ability to understand or interpret social behavior, a poor ability to respond socially and/or a poor ability to form
social attachments and connections. Individuals on the Autism spectrum often have difficulty with the give
and take of social interactions. They are unable to recognize the subtleties and nuances of social communication
and to respond appropriately. It is difficult for them to empathize with others or to understand their
own subjective and emotional experiences. These are things that people without Autism do intuitively.
While helping individuals with ASD learn to improve their social and communication
skills, and their control over their behavior, is an important part of their therapy, it can also help to work with their
underlying neurobiology through monitoring and helping them to change the electrical activity of their brain, or their brain
wave activity. The brain works through an interaction of electrical and chemical activity that continuously
influence each other. The electrical signals in the brain get transmitted at different speeds or frequencies.
These frequencies help determine our mental state at any moment. They range from very slow frequency
activity in sleep states, known as delta waves, to somewhat faster, but still slow activity in semi-awake states,
know as theta waves, to more relaxed but not outwardly attentive states dominated by alpha waves, to more
engaged and attentive states characterized by beta wave activity. Parts
of the brain that might be inefficiently processing sensory information, or paying attention, or deciding what is important
to attend to or act on might be generating too much slow activity or not enough beta activity, which would make the brain
process information inefficiently. This could possibly contribute to the inefficient and ineffective way
some individuals process social information and fail to act on the most important signals coming from other people or their
own feelings. On the other hand, parts of the brain might be over-aroused and need to calm down in order
to efficiently process information about one’s own feelings and from the outside world. These individuals
might need help reducing anxiety and that feeling of being overwhelmed by reducing very fast brain wave activity and increasing
slower activity in certain parts of the brain.
Neurofeedback has been found to have the capability
of reducing some of major deficits in ASD by individually targeting specific areas of the brain to increase or decrease its
brain wave activity in certain frequency ranges. One research study found improvements in sociability, communication, health
and sensory awareness after neurofeedback training by tailoring the treatment to the individuals’ needs.
More recently, brain mapping, or quantitative electroencephalogram (qEEG) analyses of ASD individuals found abnormal
patterns of connectivity between parts of the cerebral cortex (the outermost part of the brain). To perform
any function, different parts of the brain have to communicate with each other. It is presumed that this
happens when the electrical signals in different parts of the brain fire in synchrony with each other. At
the same time, different parts of the brain have to remain somewhat independent from other regions because each region of
the brain has a different job to do. Therefore, we want the different parts of our cortex coordinating
to a certain degree, but also maintaining their independence.
It
has been found that, in ASD, parts of the frontal lobes are often not independent enough; they are too connected.
The frontal lobes are known as the executive parts of the brain, because they are involved with coordinating and integrating
all the other parts of the brain through processes such as attending, planning, organizing, inhibiting, delaying, controlling
our emotional responses, considering long-term consequences, and considering alternative meanings of information and alternative
courses of action. It is important for parts of the frontal lobes to coordinate, but not to be too rigid or inflexible.
It has also been found that the frontal lobes and areas in the back of the brain, such as the parietal lobes, are often
not coordinating enough. The parietal lobes are involved in processing sensory information from the outside
world and from the body. It is easy to see why communication between the parietal and frontal lobes is
so important, as sensory and bodily information has to be interpreted and reacted to in order for us to function properly
and to be socially successful. Neurofeedback that is based on adjusting the degree of connectivity in different
areas of the brain has been found to be particularly powerful in reducing symptoms of Autism.
In neurofeedback treatment for ASD, we monitor the individual’s brain wave state or EEG in a
comfortable and painless way while the individual sits in a comfortable chair and “plays” a video game-like exercise
which is controlled by his or her brain wave activity. For example, the exercise can be set up so when
the individual’s brain wave activity shows that he or she is increasing beta activity and inhibiting theta, or another
form of slow wave activity, the individual earns points in the “game” and the action on the screen advances.
Or, when two parts of the cortex are firing in synchrony with each other or, on the other hand, firing more independently,
whichever we are trying to accomplish, the individual will succeed at the game. When the brain wave activity
gets out of the desired pattern, the action in the game stops, and the brain then has to find a way to get back into the desired
pattern to earn more points. The brain does this unconsciously through the individual attending to the
visual and auditory feedback that is provided when succeeding at the game. This is like exercise for the
brain, and the brain learns to produce this pattern on its own.
Of
course, no treatment works for everyone and there is always a potential risk of unwanted effects in any form of treatment.
That is why we encourage you to discuss this treatment with someone knowledgeable about the scientific studies and
the clinical applications of neurofeedback so you can make an informed choice for yourself or your child.
Studies dealing with the use of neurofeedback with ASD are as follows:
Coben, R. (2007). Connectivity-guided neurofeedback
for autistic spectrum disorder. Biofeedback, 35(4), 131-135.
Coben, R., & Pudolsky, I. (2007). Assessment-guided neurofeedback
for autistic spectrum disorder. Journal of Neurotherapy, 11(1), 5-23.
Jarusiewicz, G. (2007). Use of neurofeedback
with autistic spectrum disorders. Chapter in J. R. Evans (Ed.), Handbook of Neurofeedback. Binghampton, NY: Haworth Medical Press, pp. 321-339
Jarusiewicz, B. (2002). Efficacy of neurofeedback for children in the
autistic spectrum: A pilot study. Journal of Neurotherapy, 6(4), 39-49.
Kouijzer, M. E. UJ.,
de Moor, J. M. H., Gerrits, B. J. L., Buitelaar, J. K., & van Schie, H. T. (2009). Long-term effects of neurofeedback treatment in autism. Research in Autism
Spectrum Disorders, 3, 496-501.
Pineda JA, Brang D,
Hecht E, Edwards L, Carey S, Bacon M, Futagaki C, Suk D, Tom J, Birnbaum C, Rork A.(2008). Positive behavioral and electrophysiological
changes following neurofeedback training in children with autism. Research in Autism Spectrum
Disorders 2. 557-581.
Pineda, J. A., Brang, D., Futagaki, C., Hecht,
E., Grichanik, M., Wood, L., Bacon, M., & Carey, S. (2007). Effects of neurofeedback training on action comprehension
and imitation learning. Chapter in Puckhaber, H. L. (Ed.), New research in biofeedback.
Hauppauge, NY: Nova Science Publishers, pp. 133-152.
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