Autismo Y Neurofeedback

Appl Psychophysiol Biofeedback DOI 10.1007/s10484-012-9204-3

Is EEG-biofeedback an Effective Treatment in Autism Spectrum Disorders? A Randomized Controlled Trial
Mirjam E. J. Kouijzer • Hein T. van Schie Berrie J. L. Gerrits • Jan K. Buitelaar • Jan M. H. de Moor
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Ó Springer Science+Business Media, LLC 2012

Abstract EEG-biofeedback has been reported to reduce symptoms of autismspectrum disorders (ASD) in several studies. However, these studies did not control for nonspecific effects of EEG-biofeedback and did not distinguish between participants who succeeded in influencing their own EEG activity and participants who did not. To overcome these methodological shortcomings, this study evaluated the effects of EEG-biofeedback in ASD in a randomized pretest–posttest control groupdesign with blinded active comparator and six months follow-up. Thirtyeight participants were randomly allocated to the EEGbiofeedback, skin conductance (SC)-biofeedback or waiting list group. EEG- and SC-biofeedback sessions were similar and participants were blinded to the type of feedback they received. Assessments pre-treatment, post-treatment, and after 6 months included parent ratings ofsymptoms of ASD, executive function tasks, and 19-channel EEG recordings. Fifty-four percent of the participants significantly reduced delta and/or theta power during EEG-biofeedback sessions and were identified as EEG-regulators. In these EEG-regulators, no statistically significant reductions of symptoms of

ASD were observed, but they showed significant improvement in cognitive flexibility ascompared to participants who managed to regulate SC. EEG-biofeedback seems to be an applicable tool to regulate EEG activity and has specific effects on cognitive flexibility, but it did not result in significant reductions in symptoms of ASD. An important finding was that no nonspecific effects of EEG-biofeedback were demonstrated. Keywords EEG-biofeedback Á Skin conductance Á Autism spectrum disordersIntroduction Autism spectrum disorders (ASD) are characterized by qualitative abnormalities in social behavior and communication skills and restricted, repetitive, and stereotyped patterns of behavior, interests, and activities. Currently, many behavioral training programs exist to reduce symptoms of ASD. Behavioral training programs based on applied behavior analysis (ABA) are evidence basedtreatments that have been shown to be effective in the reduction of the core features of ASD (Peters-Scheffer et al. 2011). However, such behavioral training programs often do not entirely take away the symptoms of ASD, are expensive and demanding to administer, and take years to complete. Medication may also play a role in the management of associated symptoms of ASD, such as irritability, rigidity,hyperactivity, impulsivity, and inattention, but side-effects may compromise therapeutic benefits (King and Bostic 2006). In the search of alternative treatment options for children with ASD, electroencephalography (EEG)-biofeedback emerged as a promising option for reducing symptoms of ASD.

M. E. J. Kouijzer (&) Á H. T. van Schie Á J. M. H. de Moor Behavioural Science Institute, RadboudUniversity Nijmegen, P.O. Box 9104, 6500 HE Nijmegen, The Netherlands e-mail: mirjamkouijzer@gmail.com M. E. J. Kouijzer GGz Breburg, Breda, The Netherlands B. J. L. Gerrits Psychologenpraktijk Gerrits, Nijmegen, The Netherlands J. K. Buitelaar Department of Clinical Neuroscience, Donders Institute for Brain, Cognition, and Behavior, Radboud University Nijmegen, Nijmegen, The Netherlands

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ApplPsychophysiol Biofeedback

The rationale of applying EEG-biofeedback to children with ASD is based on findings from EEG studies. These studies have revealed abnormal patterns of EEG activity in individuals with ASD as compared to normal controls, such as increased delta and theta power (Chan et al. 2007; Murias et al. 2007; Pop-Jordanova et al. 2010), decreased alpha power (Chan et al. 2007;...