QEEG Brain Map in Autistic Children:
The QEEG database analysis shown in the bottom left, comparing the child with their age group, revealed an increase in Beta and High Beta waves above normal. Neurofeedback treatment contributed to the improvement by reducing the increase in Beta.

Neurofeedback Treatment in Autistic Children:
After 3 months of EEG Biofeedback sessions twice a week, aggressive behaviors and temper tantrums subsided significantly, language development progressed considerably, the child began playing parallel games with peers, and communication with family and siblings improved significantly.
Overall improvements included attention, executive functions, decreased anxiety and emotional uncontrollability, and most importantly, the ability to step out of their "own world" and become aware of their surroundings and the outside world.

QEEG Findings in Autistic Children:
Many studies have shown varying degrees of EEG differences when comparing autistic children with typical children (Tsai LY, 1987). Studies using different EEG recordings (normal, awake, Stage II, sleep, and during cognitive activation) have identified hemispheric differences in normal children and children with autism, and this is the largest study to date on children with intellectual disabilities in the same age group (Cantor DS, 1986).

Autistic children showed increased frontal/temporal and left temporal total power and decreased power asymmetry when compared to normal children and children with intellectual disabilities. They noted that EEG coherence abnormalities in autistic children and children of the same age group were more pronounced within the brain and between the two hemispheres than in the other two groups. EEG findings in autistic children showed a decreased feature in brain hemispheric and topographic discrimination, suggesting a connection to maturational lag (Kinsbourne M, 1982).

 

The degree of maturation delay and the amount of EEG slowing in each autistic child's EEG measurements prove the necessity of developing educational strategies. (Marosi E, 1992)

Neurofeedback Treatment Studies in Autism:

In a published study of EEG Biofeedback (EBF) in autism with a control group (Jarusiewicz, B, 2002), 24 autistic participants were randomly assigned to either EBF treatment or the control group. 20 or more sessions (average 36) of EEG Biofeedback were performed using a standard protocol.

EEG Biofeedback participants showed significant improvements in social communication, health, and sensory awareness measurements compared to the control group.

 

The second controlled study on autism (Coben R, Padosky I, 2008) showed that after 20 sessions of neurofeedback in 37 autistic patients, the success rate in positive improvements in Autism Spectrum Disorder symptoms was 89% compared to the control group (p<.0001). An average reduction of 26% was recorded in total symptoms on the Autism Treatment Checklist, compared to 3% in the control group.

Neurofeedback Treatment as an Evidence-Based Medicine Criterion:

The second controlled study removed neurofeedback treatment from experimental use in autism and included it in the AAPB's Probable Effective Classification. (Monastra, 2005)

3. In a double-blind neurofeedback study conducted at the University of California, Department of Cognitive Science, titled "Modulation of Mu Rhythm Suppression in Response to Known or Unknown Stimuli in Children with Autistic Spectrum Disorder" (Lindsay M. Oberman, Jaime A. Pineda, 2008), neurofeedback was applied to 13 typically developing and 13 autistic spectrum disorder boys aged 8 to 12 years. Recent multifaceted research suggests that mirror neuron systems (MNS) are more impaired in those with autistic spectrum disorder, which may hinder their ability to connect with others. This study is the first to demonstrate mu wave suppression while watching an action in children with autistic spectrum disorder. This observation suggests that mirror neuron systems may function normally in these children under certain conditions, which is particularly beneficial for therapeutic interventions aimed at socialization.

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4. Another double-blind study conducted at the University of California, Department of Cognitive Science, titled "Behavioral and Electrophysiological Changes Seen in Autistic Children After Neurofeedback Training" (J. A. Pineda, 2008), tested the hypothesis that mu-rhythm-operant conditioning via neurofeedback training normalizes mu-rhythm suppression, improves mirror neuron activity, and corrects behavioral problems in children with autism spectrum disorder.

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In the first study, 8 high-functioning autistic children were placed in either a placebo or experimental group. After training, decreased mu-rhythm strength and coherence were observed in the experimental group. An increase in long-term attention and ATEC results was also observed compared to the placebo group.

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In the second study, 19 high-functioning children with autism spectrum disorder underwent a modified double-blind conditioning procedure with the same procedure as their confirmed diagnoses.

They received training in the imitation protocol and high mu-band. As in study 1, there was an increase in their attention and ATEC results, but there was no improvement in imitation skills after training.

Verbal Statements of Autistic Children's Families:
Based largely on verbal statements from families of children with Autism Spectrum Disorders, EEG Biofeedback is a rapidly developing clinical experience. The well-founded general opinion of EEG Biofeedback clinicians working with the Autism Spectrum Disorder group is that EEG Biofeedback provides significant benefit in a significant percentage of this group. It has been shown to be helpful in children ranging from very severely autistic to high-functioning autistic individuals and those with Asperger's syndrome. Approximately 70 to 80 percent of patients with Autism Spectrum Disorder have benefited from this treatment. The degree of benefit varies from mild to very significant.

 

Essentially, the use of EEG Biofeedback in Autistic Spectrum Disorders is similar to the use of psychopharmacology in this group. Almost all of these children have significant attention deficits and impulsivity. Although this fact is often ignored in practice, DSM-IV states that Attention Deficit Hyperactivity Disorder should not be diagnosed in pervasive developmental disorders.

Symptoms that Benefit from Neurofeedback Treatment:

Almost all children in this spectrum have attention problems and impulsivity. Almost all children in this spectrum also experience anxiety, obsessive-compulsive symptoms, and mood disorders.

The rationale for using neurofeedback in this population is similar to using medication. EEG Biofeedback, in this group, targets all these specific problems, attention and executive function problems in general, anxiety, and obsessions, just as in psychopharmacology. (Hirshberg LM, 2005)

Neurofeedback is used to treat epileptic seizures (Lubar & Shouse, 1976), attention problems (Lubar, Swartwood, Swartwood & O’Donell, 1995, Swingle, 1996), and anxiety problems (Thomas & Sattlberger, 1977). It is also quite beneficial in information processing (ability to do schoolwork), sleep disorders, and obsessive-compulsive behaviors (Hauri, 1981; Hauri, Percy, Hellekson, Hartmann and Russ, 1983; Tansey, 1990; Sterman, 1993; Sterman, Kaiser and Veigel, 1996; Abarbanel, 1995; Mann, Sterman and Kaiser, 1996; and Linden, Habib and Radojevic, 1996). They reported significant improvements in measured attention, impulsivity, and response variability (Kaiser and Othmer, 1995).

Number of Neurofeedback Sessions for Autism Treatment:

In Autistic Spectrum Disorders, longer sessions may be required compared to other disorders, therefore, this training can usually be continued at home under the clinician's supervision (Hirshberg LM, 2005).

Autism Biofeedback Training:

Follow-up studies after biofeedback treatment showed lasting effects in ADHD for 6 months, Autism for 12 months, ADHD for 24 months, and ADHD for 10 years, with no complications observed. (See Footnotes 1-5)

A recent meta-analysis has shown that the effect of neurofeedback treatment is lasting. A 2018 meta-analysis of 10 randomized controlled trials with over 500 participants, mostly children aged 8-12, found that neurofeedback significantly reduced inattention, hyperactivity, and impulsivity in children with ADHD between 2 and 12 months after treatment cessation. Neurofeedback also supports long-term improvement of ADHD symptoms. (See Footnote 6)

Autism Brain Connectivity Difference:

In 2012, Duffy et al. demonstrated that QEEG recordings of brain activity helped diagnose children with autism spectrum disorder with 100% accuracy in the 1-year-old age group.

In 10-30% of children with ADHD, autism, and learning disabilities, non-seizure epileptic discharges negatively contribute to their clinical symptoms (Fonseca et al, 2008). QEEG recordings are necessary for their detection.