Dr. Morayo Jimoh CPsychol 17 th meeting and scientific sessions of the Biofeedback Federation of Europe, Venice, Italy

Can Neurofeedback help? Cognitive Flexibility Shifting Attention Response Inhibition Working memory Reasoning Problem solving

Introduction Neurofeedback is thought of as a treatment modality that elicits growth and changes at cellular levels of the brain, which in turn support brain functioning, behavioral and cognitive performance (Demos, 2005).

Objective This study aimed at establishing the efficacy of neurofeedback therapy in improving the executive functions of two children diagnosed with Autism Spectrum Disorder (ASD)

Method Client Descriptions: Two clients A and B, both 10 year old males diagnosed with Pervasive Developmental disorder – Not Otherwise Specified (PDD-NOS) and were not under medications. Medication: None Instruments :  Children’s Questionnaire (adapted by Mobile Health Consult Nigeria Limited)  Central Nervous System Vital Signs (CNSVS)  Equipment: QEEG (Quantitative Electroencephalogram) training was done with Biograph Infiniti EEG System

Neurofeedback Training Reward SMR 12-15Hz (15mins) Reward SMR 12 – 15Hz (15mins) Alpha training (5mins)

Results- Case One Prior to therapy, Client A’s mother reported behavioral difficulties such as  oppositional behavior,  short attention span,  hyperactivity,  inability to follow instructions and  poor social skills.

Fig. 1: Pre-test Trend report of Client A’s QEEG Assessment The QEEG Trend report for client A showed high slow waves on almost all points measured.

Fig. 2: Post-test Trend report of Client A’s QEEG Assessment A reduction in slow brainwaves was evident after 80 sessions

Results- Case Two Client B, prior to therapy,  Exibited tantrums that made it difficult for his parents to take him on an outing.  Experienced difficulties in social interaction  Was constantly aloof. After therapy, his mother reported slight improvements in his social and communicative behavior as he related more and better with his peers.

Behavioral and Cognitive Improvements Improvements were noted in his social, communicative and self- stimulating behaviors. Client A showed :  marked improvements in eye to eye gaze,  reduced tantrums,  better communication with peers  improved executive functions as indicated by a CNSVS pre and post test. (Table 1) Table 1: Pre and Post CNSVS Test Results Executive Function Test Pre test Post test Stroop Test (ST) Reaction Time* Shifting Attention Test (SAT) 2936 Symbol Digit Coding (SDC) 1841 Continuous Performance Test (CPT) 3940 Verbal Memory and Visual Memory Test8594 * Denotes more lower scores are better otherwise higher is better

Fig. 3: Pre-test Trend report of Client B’s QEEG Assessment The QEEG Trend report for client B showed high slow waves on almost all points measured.

Fig. 4: Post-test Trend report of Client B’s QEEG Assessment Client B’s post test trend report clearly shows a reduction in slow waves on all points measured relative to the pre-test trend report.

Discussion  Reduction of Theta power was hypothesized to improve executive functions in the two children.  Results revealed a large improvement in performance on a range of executive function tasks after 80 sessions of neurofeedback training.  Findings corroborate research by Kouijzer et al (2008) suggesting neurofeedback improves executive functioning in children with ASD.

Recommendations  Further studies with improved methodology are needed.  Use of individualized protocols based on an individual’s QEEG Assessment may yield better results.

Conclusion  Neurofeedback can improve basic executive function impairment in Autism Spectrum Disorders.  This treatment modality may also improve social and behavioral difficulties as evident in the case studies.

References Demos, J. N. (2005). Getting Started with Neurofeedback. New York: WW Norton & Company Inc. Kouijzer, M.E.J, De Moor, J. M.H., Gerrits, B. J.L., Congedo, M., Van Schie, H.T.(2009) Neurofeedback improves executive functioning in children with autism spectrum disorders, Research in Autism and Spectrum Disorder Vol. 3 (1),

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