URGENT CARE COUNSELING, LLC

RICHARD FINCKE, BRE, MS, LMHC 

OWNER/ PYSCHOTHERAPIST

WITH

DENISE CHIVINGTON, PMHNP-BC

NOW OFFERING PSYCHIATRIC SERVICES:

PSYCHIATRIC EVALUATION AND MEDICATION MANAGEMENT

Treatment for Austism Spectrum Disorder

People with Autism & Aspergers appear to be extremely over aroused which is related to their sensory overload, hyper focus, and difficulty processing the subtleties of relationships. In the most severe cases they are forced to retreat into a trance-like world because their system is overloaded by sounds, movements, and even physical touch.

These issues seem to respond best to neurotherapy that exercises slower frequencies. This can teach them to slow down their excessive processing speed so that they don’t feel so overwhelmed by the world. One of the first things to improve can be observed in their social interactions, including initiating conversations and their ability to better communicate their needs and desires. Teenagers may begin exhibiting more teen-like opposition, which could be mistaken as a negative side effect. This population also commonly experiences a significant improvement from neurotherapy in their attention and reasoning skills.

The term Autism spectrum disorders (ASD) includes the diagnoses of Autism, 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.

Research Papers and Case Studies

Neurofeedback for the Autism Spectrum
by Siegfried and Susan F. Othmer
ABSTRACT

Neurofeedback is a highly promising emerging therapy for the autism spectrum. At issue here is a tool for the direct training of brain function, one that has already shown itself highly effective in addressing a wide range of "mental health" concerns. As has been the case for other therapies, its application to the autism spectrum has been complicated by the inherent complexity of the condition we confront. In the following, we recapitulate the development of neurofeedback for the autism spectrum and give some guidance to both therapists and parents with regard to the choices open to them.
School-Based Neurofeedback for Autistic Spectrum Disorder
by Darling M.
ABSTRACT

Neurofeedback is an intervention that is showing a lot of promise for people diagnosed with Autistic Spectrum Disorder (ASD). While other childhood behaviour disorders such as Attention Deficit Hyperactivity Disorder (ADHD) have been in the neurofeedback limelight for some years, it would appear that ASD is about to have its day in the sun. Recent research is showing that children with ASD are responding very well to both electroencephalographic (EEG) and haemoencephalographic (HEG) neurofeedback. Furthermore, our own research indicates that neurofeedback can be an effective schoolbased intervention for children in the autistic spectrum.
Assessment-Guided Neurofeedback for Autistic Spectrum Disorder
by Coben R Ph.D. and Padolsky I Ph.D.
ABSTRACT

In recent years, Autistic Spectrum Disorder (ASD) has shown a dramatic increase in prevalence. A review of prevalence survey research for ASD (identified by DSM-IV criteria for Autism, Asperger's Syndrome, and Pervasive Developmental Disorder-Not Otherwise Specified) across the United States and the United Kingdom reported rates of ASD substantially increased from prior surveys indicating 5 to 10 per 10,000 children to as high as 50 to 80 per 10,000 (equivalent to a range of 1 in 200 to 1 in 125 children with ASD) (Blaxill, 2004).
EEG Power and Coherence in Autistic Spectrum Disorder
by Coben R, Clarke AR, Hudspeth W, Barry RJ
ABSTRACT

These results suggest dysfunctional integration of frontal and posterior brain regions in autistics along with a pattern of neural underconnectivity. This is consistent with other EEG, MRI and fMRI research suggesting that neural connectivity anomalies are a major deficit leading to autistic symptomatology.
Positive Outcome With Neurofeedback Treatment In a Case of Mild Autism
by Sichel AG, Fehmi LG, Goldstein DM
ABSTRACT

This article looks at the experience of Frankie, an autistic 8 and 1/2 year old boy. He was diagnosed mildly autistic by several specialists. One specialist claimed he was brain damaged and "autistic-like" and that there was no hope for improvement. At Frankie's mother's request, neurotherapy diagnosis and treatment was begun. After 31 sessions, Frankie showed Positive changes in all the diagnostic dimensions defining autism in DSM-111-P, This has profound implications for treatment in a field with few low-risk alternatives.
Efficacy of Neurofeedback for Children in the Autistic Spectrum: A Pilot Study
by Jarusiewicz B Ph.D.
ABSTRACT

The efficacy of Neurofeedback training was evaluated in 12 children in the autistic spectrum with matched controls, based on established training protocols for other conditions with similar symptoms. Twenty-four autistic children were divided into two groups, matched by sex, age, and disorder severity. One group received Neurofeedback training and the second acted as a control group.
Autism: Case Study
by Cowan J Ph.D.
ABSTRACT

About 8-9 years ago I reported the case history of an eight-year-old autistic girl (triply diagnosed as high-functioning autistic) who came to me for training at the Winter Brain Meeting. She was so non-communicative that she would hide under the couch.
Autism/Asperger's/Obnoxious Child, 3 Case Histories: How We Get Positive Results with Complex ADD Clients
by Thompson L Ph.D. and Thompson M M.D.
ABSTRACT

Three brief case histories on the scale of primarily organic to primarily psychologically based social-behavioural disorders are described. All three children and their families, previous to coming for neurofeedback, had had very considerable intervention both from the school system and from other clinical resources. All previous efforts from other clinical resources had minimal benefit.