AAPB and ISNR have established standards for Neurofeedback research [Moss & Gunkleman (2002)] that confer a status of Possible Efficacy for Autism/Aspergers. Neurofeedback provides evidence-based practices on par with health care establishment demands (Gemon, Devon & Ramsey (2000), Sacket et al, (2000). Levels of evidence include: case reports, observational studies, randomized clinical trials, fMRI scans (Andrasik & Rime (2007), and so on. “Efficacy” determination of training or treatment effect is derived from systematic evaluation in controlled clinical trial (La Vaque et al (2002).
Case A
This case involved a fourteen year old male with mild mental retardation and recurrent episodes of lethargy. The boy had great difficulty focusing due to extreme hyperactivity. The parents described their son's constellation of symptoms: he was deficient in his ability to interpret social cues, and could be oppositional, preferring to retreat from people, including his family. He had, from a young age, related strongly to inanimate objects, spending his time lining them up, or folding and refolding towels or blankets. The boy still could not organize himself to execute and complete other tasks without prompting and supervision. His short-term memory was compromised, and he suffered from sensory processing and perceptual motor integration deficits, becoming easily overwhelmed and unable to cope with stimulating environments. When under stress the boy rocked himself or hummed. He ambulated poorly, with an unsteady gait. The parents noted their son had benefited from attending a private school for children with severe disabilities, years of Social Skills Training and occupational therapy, plus a prescribed stimulant and an anti-depressant.
Initially after he received Neurofeedback training the parents reported their son's oppositional behaviors had briefly diminished. In another early report, the boy seemed to be “about the same” with the exception of an improved gait. Soon after, the parents reported their son was responding better to prompts, and seemed to be focusing better. After a number of setbacks the parents reported their son was coping better in stimulating social environments, and that he was responding to people more appropriately in social situations. Later, the parents reported their son was attending to daily tasks of living without supervision and prompting. The boy's teachers were reporting more participative behaviors and improved fine and gross motor skills. Midway through treatment the parents reported diminished repetitive behaviors. The boy reported that he had joined a community baseball team and that he was "having a better time" while interacting with his parents, sister and others. Both parents and teachers were consistently reporting that the boys' moods had stabilized, and that he demonstrated generally improved social interactions with normal eye contact and improved voice modulation. By the end of treatment the boy was able to prepare a simple meal for his family. The parents were able to transition to home training, with reports of continued progress toward self-actualization for their son in most previous areas of deficit.
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Case B
This case involved an eighteen year old male who, during his first three years of life had experienced an onset of lethargy that became increasingly debilitating. He was often confined to bed during early adolescence. His parents noted that he had always demonstrated atypical posturing (excessive rocking, limping, rolling up into a ball) and that he was accident prone and often collided with objects and people. They also noted their son failed to demonstrate appropriate empathy, made poor eye contact and was oblivious to most social norms. They felt his awkwardness contributed to “hiding away in bed all the time”, and in their country of origin there were many stigmas which precluded them from having their son medically evaluated. After the family immigrated the boy was diagnosed with Asperger’s at age eight, upon enrollment into the U.S. public school system. Thereafter the boy benefited from limited occupational therapy and also from receiving Irlen lenses, which helped minimize sensory overload so much that he began to excel academically. Now the bilingual young man was about to start college as a mathematical engineering student. Among his parent’s chief concerns was their son’s inability to organize himself enough to adequately complete many adult daily living tasks. His disheveled appearance, continued lack of communication and difficulty in socializing worried his parents, who felt that, despite vast collections of music and books that kept their son busy all of the time, their son was a very lonely and dependent young man.
After he received a few Neurofeedback training sessions the young man reported a new behavior,with prompting from his parents: he was smiling. As training continued the man slowly made gains in his ability to sort out meanings of spoken words more effectively then in the past, which was enabling him to socialize more appropriately. He reported that he was feeling more comfortable “making eye contact”. The man’s parent’s also reported that their son was “looking better”; was cleaning himself and brushing his teeth without prompting. Midway through treatment the man recognized and self-reported that he was ambulating differently, “walking better” because he was feeling “calmer and calmer”. He joined the swim team at school, to the amazement of his parents, who reported a long-standing aversion to water immersion. Toward the end of training the man had become significantly more autonomous and was considering learning how to drive.
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