NEUROFEEDBACK THERAPY IN GROUP SETTING Ms Jerry Lee Association of - PowerPoint PPT Presentation

NEUROFEEDBACK THERAPY IN GROUP SETTING Ms Jerry Lee Association of Resource & Education for Autistic Children (REACh)

I. INTRODUCTION Ne Neur urof ofee eedb dbac ack th ther erapy y (NFT (NFT) ) is is a • techn te hnique ique th that t pr pres esen ents ts rea eal-time time fee eedb dbac ack k on on br brainw ainwave e ac activity tivity as as me meas asur ured ed by by se sens nsor ors s on on th the e sc scalp alp th throu ough gh th the e for orm of m of a a vide video o ga game, me, mo movie vie or or music music disp display lay. . (See, (See, 20 2010 10) NFT is NFT is use used d as as an an co compliment mplimentar ary y • th ther erapy for or sp spec ecial ial ne need eds s childr hildren en an and d ha has s pr prod oduc uced ed po positiv sitive e ef effec ects ts as as fou ound nd i in n pr previou vious s res esea earch. h.

1) 1) Autism utism Spect Spectrum Disor um Disorder der (AS (ASD) D) Jar arusiewicz usiewicz (2002) (2002)  24 participants:  12 received NFT  12 acted as control group  36 sessions:  Inhibit theta, enhance low beta at C4 site

 26% average reduction in total ATEC rated autism symptoms versus 3% in comparison with control group.  Children in NFT group showed Improvement in socialization, vocalization, anxiety, schoolwork, tantrums, and sleep, compared with control group.

Pined Pineda a et al. (20 et al. (2008) 08) 8 high-functioning ASD participants  Assigned to either placebo or  experimental groups 10 weeks training of the mu frequency  band (8 – 13 Hz). Experimental participants showed  increased sustained attention ability, and improved scores on subscales of the ATEC compared to the placebo group.

Kouijz ouijzer er, , de de Moor Moor, , Ger Gerrit rits, , Congedo Congedo, , & & van van Sc Schie hie (2009) (2009)  14 participants: 7 children received NFT  7 children acted as control group   40 sessions Inhibit theta, enhance low beta at C4   Participants who received NFT showed improvement in social interaction, communication and concept generation.

 Impr Improvements ements in cognitiv in cognitive function e functions s inc include: lude: Sustained auditory selective attention  Inhibition of verbal responses  Inhibition of motor responses  Set shifting (switch between the  numerical and alphabetical mode) Planning ability 

Fauzan auzan & & Mahayud Mahayuddin din (2014) (2014)  34 participants (age 3 to 20)  36 training sessions Inhibit theta, enhance beta at frontal  lobe  Participants were reported to show improvement in their social behaviors, sleeping pattern and reduction in aggressiveness and tantrum.

2) 2) Att Attentiv entive e Deficit Deficit Hy Hyper peractivity activity Disor Disorder der (ADHD (ADHD) Kais Kaiser er & & Othme Othmer (2000 (2000)  1089 subjects 726 children  186 subjects with ADHD or ADD diagnoses   20 or more sessions SMR-beta neurofeedback training 

 Neurofeedback training produced significant improvement in attentiveness, impulse control, and response variability.  Significant clinical improvement in one or more measures was seen in 85% of those subjects with moderate pre-training deficits.

Fuc Fuchs, B hs, Birbau irbaumer mer, , Lutz Lutzenber enberger ger, , Gr Gruz uzelier elier, , & & Kaiser Kaiser (2003) (2003)  34 children (age 8 to 12) 22 in neurofeedback group  12 in methylphenidate group   Neurofeedback group: reinforcement on the production of cortical SMR and beta activity

 Both neurofeedback and methylphenidate groups reported:  Improvements on all subscales of the Test of Variables of Attention.  Improvements on the speed and accuracy measures of the d2 Attention Endurance Test.  Significant reduction in behaviors related to the disorder as rated by teachers and parents on the IOWA-Conners Behavior Rating Scale.  These findings suggest that neurofeedback was efficient in improving some of the behavioral concomitants of ADHD in children .

Mohammadi Mohammadi, , Malmi Malmir, , Khale Khaleghi ghi (2015) (2015)  16 16 childr hildren en (a (age ge 9-15) 15)  13 13 bo boys ys and and 3 3 gir girls ls  All All childr hildren w en wer ere e dia diagno gnose sed d with with ADHD ADHD- combined comb ined type type st pha  1 st phase (15 ses se (15 session sions): enh s): enhanc ance e SMR SMR and and redu educe ce the theta a ta at C4. t C4. nd ph  2 nd phas ase (15 se e (15 sess ssion ions): e s): enh nhan ance ce beta beta and and redu educe theta ce theta at t C3. C3.

 Assessm Assessments ents con consisted of sisted of d2 d2 attention endur ttention endurance ance test, AD test, ADHD HD rating ting sca scale le (par (parent f ent for orm) a m) at thr t three ee time time periods periods: bef : befor ore, e, mid middle dle and and the the end end of of the tr the training. aining.  Based Based on parents’ reports, hyp hyper eractivity/impulsivity activity/impulsivity wer ere e nd pha impr improved after the ed after the 2 nd phase of se of beta beta tr training aining. .

II. OBJECTIVE OF STUDY 1. 1. To o explor xplore the possibility e the possibility of of ha having par ving parents c ents conduct the N onduct the NFT FT in in group oup. . 2. 2. To o explor xplore the pos e the possibility sibility of of using using standar standardiz dized ed neur neurof ofeedbac eedback tr trea eatment tment pr protocol f otocol for c or childr hildren en with autism. with autism.

III. STUDY STATEMENT  Incr Increase ease in in the po the power of er of SMR on SMR on C4 C4 is is associa associated with ted with the r the reduction of eduction of hype hyperactivity/im activity/impuls pulsivi ivity ty symptoms. symptoms.  Enhan Enhancemen cement t of of beta w beta waves es and and decr decrease in ease in excessiv cessive e theta in the theta in the left hemispheric left hemispheric on C3 on C3 ar are e recommended to impr ecommended to improve e att ttention. ention.

 Alpha Alpha activity activity is is tr trained ained most most fr frequentl equently y in in parietal parietal regions gions and and had sho had shown positiv wn positive e ef effects in ects in impr improvemen ement t of of cogn cognitiv itive e perf perfor ormance and to ac mance and to achie hieve e relax elaxed me ed mental ntal sta state. te.

IV. METHOD  Dur Duration: tion: 6 w 6 weeks eeks  The study he study was as car carried out ried out in a in a fr free ser ee service vice centr centre f e for c or childr hildren en with with autism autism in P in Penan enang, g, Malay Malaysia. sia.

 Eight Eight c childr hildren w en wer ere s e selected to elected to par parti ticipa cipate in t te in this his stu study dy.  They w hey wer ere assi e assigned to 2 g gned to 2 groups oups (4 per (4 persons sons in in eac each h group oup). ).  Eac Each g h group r oup receiv eceived 10 session ed 10 sessions s of of NFT NFT (2 (2 sess sessions ions per per week). eek).

GR GROUP OUP 1 1 GR GROUP OUP 2 2 Received standardized Received individualized neurofeedback treatment neurofeedback treatment protocols. protocols. Protocols: Protocols were based on 1. C3 Beta - improve participant’s critical attention needs. (clinical symptoms) 2. C4 SMR - reduce impulsivity and restless behavior 3. Pz Alpha - improve sensory regulation and cognition

V. SAMPLE GR GROU OUP P 1  Four our childr hildren en dia diagnosed with gnosed with autism autism spec spectr trum um disor disorder der (mode (moderate te le level el)  Age Age 7 to 11 7 to 11  Selection criteri Selection criteria: a: Able to sit through a 45 minutes session  Children who can commit to 10 sessions  of NFT

GR GROUP OUP 2  Four c our childr hildren en dia diagnos gnosed with ed with autism autism spectr spectrum um disor disorder der (3 moder (3 moderate, 1 te, 1 se sever ere) e)  Age Age 5 to 20 5 to 20  Selection Selection Crit Criteria: eria: Children are able to sit through a 45  minutes session Children who can commit to 10  sessions of NFT

VI. PROTOCOLS GR GROU OUP 1 P 1 Child Child Pr Protoco otocol Period eriod Frequ equenc ency A, B, C C3 Beta 6 All sessions & D C4 SMR 6 Sessions 1, 3, 5, 7 & 9 Pz Alpha 6 Sessions 2, 4, 6, 8 & 10

GR GROU OUP P 2 Child Child Pr Protoco otocol Period eriod Frequ equenc ency E P3 Beta 4 All (moderate) T4 Delta 4 sessions F C3 Beta 4 (moderate) F8 Delta 4 G P3 Beta 4 T4-P4 Delta 4 (severe) H C3 Beta 4 (moderate) T4-P4 Delta 4  Protocols are decided based on children’s needs.