Autism is a neurodevelopmental disorder. It is characterized by problems in language, communication, sociability, sensory modulation, cognitive awareness, and physical and behavioral function. Current estimates from the Centers for Disease Control are that autism spectrum disorder occurs in 1 out of 150 children.

Historically there have been many theories explaining the nature of autism spectrum disorder. A recent theory, supported by evidence in neurophysiology, is that autism is a disorder of atypical neurological connectivity, in other words, the crux of the problem is the neurological highway connecting different parts of the brain.

Like a good orchestra, for the brain to work coherently, activity in one area needs to be coordinated or synchronized with other areas. Problems in connectivity can result in difficulty with thinking and acting. Intuitively this fits with our experience in working with children with autism in that they often present with "islands" of cognitive strength while more complex functions such as social interaction are much more difficult for them.

In the field of neurofeedback, connectivity problems have been classified as either not enough synchronization between some brain areas (Hypo-connectivity), or too much synchronization between other brain areas (Hyper-connectivity). More recent scientific studies have found both. One study found that relative to children with no developmental challenges, those with autism showed reduced synchronization of brain activity between the frontal and parietal areas of the brain (Just, Cherassky, Keller, Kana, & Minshew, 2007). The frontal area of the brain is associated with "managerial" functions, like a conductor in an orchestra. One of the hallmarks of autism is weak executive function, and this research suggests that less synchronization between the frontal and parietal areas of the brain contributes to this challenge. Another study found excessive synchronization between the left and right sides of the frontal lobes (Courchesne and Pierce, 2005). In other words, these two sides were way more coordinated than studies of neurotypical children will show. Courchesne and Pierce suggest that excessive connectivity between the left and right sides of the frontal lobes disrupts the communication between the frontal lobes and other brain areas. This hypothesis suggests that the deficits with executive function (the "managerial" aspect of the brain) might be caused by too much synchronization between the two sides of the frontal lobes--like two managers who are too busy chatting and not paying enough attention to the tasks at hand.

Recently, Coben and Myers (2008) have described a neurofeedback program aimed to address brain connectivity problems in children with autism. Neurofeedback is a non-invasive treatment that can be used to decrease areas of hyper-connectivity where it is excessive, and increase connectivity in brain areas where the level of connectivity is too low. The process begins with a comprehensive EEG procedure in order to create a brain map. This map identifies specific areas of the brain with hyper- or hypo-connectivity. Once these specific areas have been identified, neurofeedback treatment begins. Children play games on a specialized computer while wearing sensors that monitor the child’s brainwave activity. Via a process of operant conditioning, the level of synchronicity in various brain connections or "highways" is adjusted with the goal of normalizing that level. This normalization appears to bring a reduction of symptoms and improvement in communication, cognition, behavior, and social skills.

In an initial study using this procedure with children with autism, Jarusiewicz (2002) demonstrated a 26% reduction in autism related symptoms. Coben and Padolsky (2007) improved on those results, demonstrating a 40% reduction in autistic symptoms with just 10 weeks of neurofeedback treatment. Most recently, Coben and McKeon (2009) have demonstrated even better results--reduction of 60% of symptoms in a group of 85 children during a course of treatment lasting 6-7 months. Specifically they reported improvements in behavioral and emotional controls, social skills, communication abilities, and reductions in repetitive behaviors.

As these initial findings are very impressive, here at Family Compass we started providing this protocol to children with autism and we follow up closely on the efficacy of this method. Our initial impression is that children treated using this protocol of treatment indeed show a pattern of improvement.

References:

Coben, R., & McKeon, K. (2009) EEG assessment and treatment for autism spectrum disorders. The Autism File (32), 40-48.

Coben, R., & Myers, T. (2008). Coonectivity theory of autism: Use of connectivity measures in assessing and treating autistic disorders. Journal of Neurotherapy, 12 (2-3), 161-179.

Coben, R., & Pudolsky, I. (2007). Assessment-guided neurofeedback for autistic spectrum disorder. Journal of Neurotherapy, 11(1), 5-23.

Courchesne, E. & Pierce, K. (2005). Why the frontal cortex in autism might be talking only to itself: Local over-connectivity but long-distance disconnection Current Opinion in Neurobiology, 15, 225-230.

Jarusiewicz, B. (2002). Efficacy of neurofeedback for children in the autistic spectrum: A pilot study. Journal of Neurotherapy, 6(4), 39-49.

Just, M.A., Cherkassy, V.L., Keller, T.A., & Minshew, N.J. (2004). Cortical activation and synchronization during sentence comprehension in high-functioning autism: Evidence of underconnectivity. Brain, 127(8), 1811-1821.

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