Once a promising treatment for autism spectrum disorders, neurofeedback involves teaching an individual to control his brain activity, consciously making it appear more neurotypical. This treatment is not widely available, and researchers doubt its effectiveness in the treatment of autism, Asperger's, and other pervasive developmental disorders. It's important to educate yourself about the procedure, its effectiveness, and the research behind it before considering it an option.
What Happens During Neurofeedback Therapy?
During a typical neurofeedback session, the practitioner attaches electrodes to the patient's face and head as in a typical electroencephalographic test (EEG). These electrodes transmit EEG activity, which is displayed on a screen for both the patient and the practitioner to see or hear. Typically, the EEG activity is converted into something easy for the patient to understand, such as sounds or images.
In a format somewhat similar to a computer game, the patient can then try to modify his brainwave activity to move an object on the screen or produce a certain tone. Each time the patient achieves the desired movement or tone, he receives a reward, often in the form of points. In theory, this process will help patients better learn to control their behavior.
Goals of Treatment
Broadly speaking, the goal of neurofeedback therapy is to help a person with ASD learn to control his brainwaves and modify behaviors. According to a 2012 study published in the journal BMC Medicine, there are significant differences in the brains and brainwave patterns of people on the autism spectrum as compared to neurotypical individuals.
Targeting Specific Brain Wave Frequencies
Neurofeedback is designed to target these specific brainwave frequencies that can present a problem for people with autism spectrum disorder (ASD):
- Delta waves (0.5 - 3 hertz): People with learning disorders, social impairments, and brain damage often have high delta waves, resulting in a zoned out feeling.
- Theta waves (3 - 7 hertz): ASD patients typically have high theta waves resulting in unusual sleepiness and trouble focusing on things outside themselves.
- Alpha waves (8 - 13 hertz): Learning to increase alpha waves may help keep patients with ASD calm, aware, and more relaxed.
- Sensorimotor Rhythms (13 - 15 hertz): Low SMR waves in patients with ASD may cause involuntary movements or tics, sensory difficulties, impulsive behavior, and motor issues.
- High beta waves (19 hertz or higher): The stress associated with cognitive and sensory disorders may cause high beta waves resulting in increased emotional intensity and feelings of alarm.
Coordinating Hemispheres of the Brain
In many individuals with autism spectrum disorder, there is some level of disconnect between the hemispheres of the brain. Neurofeedback therapy targets this disconnect, attempting to help the patient form a connection.
Regulating the Mirror Neuron System
For many people with ASD, there may be some form of dysfunction in the mirror neuron system, which is linked to perspective-taking and Theory of Mind. Neurofeedback treatment can target the "mu" rhythm, which scientists believe this may help regulate the mirror neuron system.
Potential Side Effects
According to an article published in the Journal of Neurotherapy, this type of treatment sometimes comes with unpleasant side effects. The journal article stresses that the incidence of many of these side effects is much higher when the treatment is conducted by practitioners who don't have the proper training.
Some people undergoing neurofeedback therapy experience extreme emotional changes. These changes can include sadness, irritability, anxiety, and anger.
In some cases, the patient may regress, or lose previously learned skills and coping measures. This means that the symptoms of ASD may worsen with treatment.
In some patients, the therapy has resulted in increased involuntary tics. These tics can be both verbal and physical.
Some patients report feeling sick to their stomachs after a treatment. This may or may not result in vomiting.
A number of patients describe having headaches after their treatments. These range from mild to severe.
Wetting the Bed
In children and the elderly, this type of therapy can occasionally result in bed wetting. This is more common if bed wetting has been a problem in the past.
Depending on the frequency used during the treatment, mental fogginess can be a side effect of therapy. Patients may have trouble remembering things or concentrating for a few days after treatment.
In some patients, the treatment can leave them "keyed up" or agitated. Sometimes, this means the patient is unable to sleep at night.
In other patients, the treatment leaves them tired for the rest of the day. Fatigue is common, even when treatment is conducted by a licensed professional.
Effectiveness of Neurofeedback Therapy for ASD
Although neurofeedback treatment is a well-respected therapy for ADHD and other conditions, there's conflicting evidence about its effectiveness in treating autism spectrum disorders. A 2011 review of the literature published in Developmental Medicine & Child Neurology provides an exhaustive list of studies and their results. The article maintains that there is not sufficient evidence to recommend neurofeedback therapy for people with ASD but that it can be effective in treating ADHD symptoms in the 50% of ASD patients who also suffer from ADHD.
Additionally, a small controlled trial of neurofeedback treatment for autism, published in the journal Applied Psychophysiology and Biofeedback in 2012, found that this type of treatment did not result in a significant improvement in autism symptoms. The report noted that separating other variables like the reassurance of the structured therapy environment made it difficult to prove that this type of therapy was effective.
If you are considering this type of treatment for autism, it's essential that you work with a licensed professional in order to avoid the potential side effects of treatment. The International Society for Neurofeedback and Research is a good place to find information about licensing requirements. You can also work with your neurologist to learn more about this type of treatment and whether it may be a good choice for you or your child.