Asperger Syndrome and Neurofeedback

Image courtesy of David Castillo Dominici at FreeDigitalPhotos.net
Image courtesy of David Castillo Dominici at FreeDigitalPhotos.net

April is Autism Awareness Month! Autism affects about 1 in 68 children, yet autism can be exceptionally difficult to classify as each case is very unique to the patient. Asperger syndrome, once known as a specific subtype of autism, is now classified as part of the single autism diagnosis by the recently published 2013 DSM-5 diagnostic manual.

Patients with Asperger syndrome, considered to be a higher functioning form of autism, often have deficits in motor development, social interactions, repetitive behavior, and often display a restricted range of interests. Difficulties in language or cognitive development are usually not present in Asperger cases, as compared to autism. More behaviors associated with Asperger syndrome include:

– Repetitive speech

– Obsession with a specific topic

– Limited/inappropriate social interaction

– Challenges reading nonverbal communication cues such as gestures or facial expression

– Challenges understanding emotional issues

– Challenges understanding non-literal phrasing

– Challenges understanding intent in conversation

– Uncommon or awkward movements/mannerisms

– More often discussing oneself than others

– One-sided conversations

 

It is important to note that all individuals with Asperger syndrome may display all the above behaviors, which adds to the challenge of diagnosis.

For those struggling with Asperger syndrome, social interactions can be challenging, confusing, and overwhelming to the patient. With challenges seeing the perspective of others, they may not realize what is appropriate in social context. Difficulty controlling emotional reaction is also commonly seen with Asperger patients, as they may laugh at inappropriate moments or cry very easily. Additionally, since development delay can be present in motor skills as well, children have an even tougher time socializing, as they do not have the ability to play the same way other young children play.

Image courtesy of photostock at FreeDigitalPhotos.net
Image courtesy of photostock at FreeDigitalPhotos.net

Asperger syndrome is often undiagnosed until the child or adult experienced extreme difficulties in school or work. When diagnosed in adulthood, many of these patients are seeking treatment for anxiety or depression. Children are often misdiagnosed as ADHD or as having other behavioral issues. Diagnosing can be tricky, because children with Asperger’s often have notably high language development, but do not interact well with other kids due to the mental/social barrier. Inability to socialize is the key factor in diagnosing children with Asperger syndrome.

Neurofeedback can be effective in reducing or eliminating unwanted symptoms that may be disruptive in daily life. An EEG brain map is performed first to identify where the brain is having difficulties, and protocol is developed to naturally target these areas of the brain to improve overall function of the individual. Using Neurofeedback patients with Autism or Asperger’s can experience significant improvements in overall function, allowing them to live a happier and more effective life. To learn more about what neurofeedback can do for you and your family, please schedule a free in-person consultation with our director Dr. Jolene Ross. As mentioned, every individual case is different, so it is very important to develop an individual wellness plan with Dr. Ross to assess and treat all of your individual needs. Click here to schedule or call our office at 781-444-9115.

 

 

High-Functioning Autism

Photo courtesty of Stuart Miles at www.FreeDigitalPhotos.net
Photo courtesty of Stuart Miles at www.FreeDigitalPhotos.net

April is Autism Awareness Month, a time dedicated to raising awareness of autistic spectrum disorders in a continued effort to improve the quality of life for those struggling. Nationally, a puzzle piece is known to be a symbol for autism awareness because each puzzle piece is different, representing the diversity of the individuals affected, just as each individual case of autism is unique. The reason for classifying autism within the autistic spectrum is because every individual may have a variety of symptoms while simultaneously lacking other symptoms that are commonly associated with autism. In fact, sometimes autism can be difficult to fully identify for this reason. In 2013, new diagnostic criteria were developed to identify autism within three levels of support. However, there are no particular criteria that would automatically assign someone to a level as each case varies greatly. The term “high-functioning autism” refers to a person who may have mild symptoms of autism that are significant enough to warrant a diagnosis, yet who’s symptoms do not completely align with classic autism. This makes pinning down a diagnosis difficult at times. The diagnosis of Level 1 Autism Spectrum Disorder refers to those who are functional yet exhibit symptoms of autism.

What symptoms occur for Level 1 Autism Spectrum Disorder?

Those identified as Level 1 are able to function while still having difficulties in some of the key areas that are identified within the autistic spectrum. They are typically able to read, write, do math, and other education-related work. However, socially, they have difficulties such as trouble picking up on social cues, keeping eye-contact, or maintaining conversations. Level 1 is also associated with mild to significant speech delays and sensory challenges. Those identified as level 1 may have a some of these symptoms, but not others, as each case is uniquely individual.

The Difference Between High Functioning and Low Functioning Autism

Photo courtesty of marin at www.FreeDigitalPhotos.net
Photo courtesty of marin at www.FreeDigitalPhotos.net

High-functioning autism is a term used to describe someone who is able to function in every day settings. Using spoken language to communicate is considered high-functioning as many people with autism may have limited spoken language. Having language abilities makes the stresses of academic settings are more manageable. High-functioning autism is also identified by a person’s ability to pick up on social cues, because they have a greater awareness of social conventions.

It is important to note that the difference between high and low functioning autism is neither definite nor obvious. The terms high and low functioning are never intended to indicate intelligence level. The terms do not take into account levels of anxiety or levels of sensory challenges. Additionally, aggressive behavior can be seen in all levels of autism.

Dr. Ross has helped identify and reduce or eliminate symptoms of autism using neurofeedback and other effective interventions. If you suspect your child may be exhibiting symptoms of autism, call to schedule a free in-person consultation with Dr. Ross. 781-444-9115.

Anxiety and Neurofeedback – By Dr. Jolene Ross

drross

Over the past nearly 20 years, I have worked successfully with children, adolescents, and adults with anxiety disorders using neurofeedback. There are times when anxiety is secondary to a learning or social problem. If a person has a problem with their brain, they cannot trust their brain function and conclusions, which is very anxiety provoking. This is especially true if these challenges have been happening for a long time. In this case, it is necessary to address the neurological underpinnings of the learning problems as well as the anxiety.

It is also possible that anxiety is related to repeated attempts at social interaction that resulted in rejection. In this case, the problems that need to be addressed with neurofeedback include anxiety itself as well as social competence.

Anxiety can be the result of a language-based learning disability where the person may have difficulty either understanding what people are saying or forming a response. In either case, language is not working as an effective communication vehicle resulting in anxiety. Of course, in this case, we address the language and/or auditory processing challenges.

Anxiety can have it’s own life in the brain. It can show up as problems in the midline of the brain, somewhere from the middle of the forehead to the middle of the back of the head. This is over the cingulate gyrus, which, when not working properly, can result in anxiety and Obsessive Compulsive Disorder. We see these problems on our brain maps and address them with neurofeedback.

Image courtesy of David Castillo Dominici at FreeDigitalPhotos.net
Image courtesy of David Castillo Dominici at FreeDigitalPhotos.net

There are times when anxiety appears as over suppression, meaning the brain waves are too small  in the prefrontal region, the forehead. This is associated with a style of hyper vigilance and is seen in anxiety in addition to Post Traumatic Stress Disorder. This is related to a person never feeling quite safe. Teaching the brain to increase the size of these brain waves is very helpful in relieving the distress of anxiety.

Feelings of anxiety can also be related to the orbital frontal portion of the cingulate gyrus. This is the portion of the brain that is responsible for scanning the universe to see if everything is okay. If not, the person feels either anxious and/or the need to “fix it”, leading to repetitive behaviors such as those seen in Obsessive Compulsive Disorder.

People on the autistic spectrum are typically very anxious. This anxiety can show up on our brain maps over the cingulate gyrus or can show up as very large slow brain waves, especially in the front of the brain. This problem is associated with a lack of frontal lobe controls including emotional control and state control. It is also true that if a person is on the autistic spectrum, the world is very bewildering. I can remember working with a child who used to climb up on the garage roof, having no idea that it was dangerous. He also thought he could walk through walls and could not understand that this did not work. You can imagine how anxiety provoking it is for a person with autism to try to figure out the day-to-day and moment-to-moment demands and expectations placed on him or her. With neurofeedback, we can address the frontal lobe control issues, the cingulate gyrus if it is an issue, and challenges reading social cues. Strengthening frontal lobes increases emotional control, frustration tolerance and cause and effect thinking.

It can also be very upsetting and therefore anxiety provoking to have no language or insufficient language to either understand or communicate ones needs effectively. Frustration, explosiveness, apparent lack of cooperation, and agitation can result. Neurofeedback is wonderful at helping improve vocabulary, language expression, comprehension, and social pragmatics. Combine this with targeting the anxiety itself helps to establish a calmer demeanor.

Image courtesy of stockimages at FreeDigitalPhotos.net
Image courtesy of stockimages at FreeDigitalPhotos.net

Many challenges are stress activated or stress enhanced. These include slow processing speed, attention, focus, Tourette’s and tick behaviors, obsessive-compulsive behaviors, and anxiety disorders. Strengthening the brain and the brain’s ability to control it’s own state strengthens stress resilience. This in itself reduces the effect of these types of challenges.

Anxiety can also manifest itself in the brain in the right central area, about three to four inches above the right ear. This is on the sensory motor strip, and area that goes from ear to ear like a headband. This location is where information goes from the brain to the body and from the body to the brain. The right side of the brain is related to self-soothing and self-calming. If this particular area is not working effectively, the signals from the body are danger, agitation, and over arousal. This is particularly important if the problem manifests itself in the alpha wave band, which is a meditative, calming brain wave.

Improving anxiety improves not just the comfort and quality of life but enhances many cognitive functions as well such as memory, attention, focus, word finding, and processing speed. Anxiety can create a ‘brain freeze’ feeling, where a person has trouble accessing their good brain. How many people have been in front of a group and couldn’t think what they were going to say or raised their hand in class and lost the answer they were so eager to share. This is the result of anxiety.

A young man, age 17, just beginning his senior year of high school, came to my office for help with his anxiety. He had spent the summer traveling internationally and came home terribly anxious. His mother, who was hoping to avoid medication, brought him to see me. By the time he completed neurofeedback, his anxiety was completely under control and it has not returned.

Image courtesy of Stuart Miles at FreeDigitalPhotos.net
Image courtesy of Stuart Miles at FreeDigitalPhotos.net

A high school freshman came in for help with his anxiety. As a child he had been diagnosed with Pervasive Developmental Delay, Not Otherwise Specified, also known as PDD, NOS, which is an autistic spectrum disorder. His main problem had been a language delay. He was extremely anxious about doing any kind of class presentation. Fear of public speaking is the most common psychological problem in the United States. He was required to give a presentation to the class and ended up having a panic attack. Ultimately, his teacher allowed him to do the presentation in private, not in front of the class. The following year, as a result of neurofeedback, he was able to present his sophomore speech in front of the class, a major victory!

An adult professional male in his early 50”s came to Advanced Neurotherapy with a tendency to get angry at his clients. He became frustrated when clients would not take his advise, which he interpreted as not trusting his expertise and judgment. He had struggled with sleep problems for years partly due to his anxiety and in part to his difficulty “shutting down” his brain for sleep. He had struggled with fear of rejection and not being good enough for most of his life. His brain map showed a signature of over-arousal and hyper-vigilance. Neurofeedback and some psychotherapy has helped tremendously, resulting in less reaction to his clients on such a personal level, no longer getting angry at clients, an improved relationship with his clients (and his wife), and improved sleep with a major reduction in dose of sleep medication.

An eleven-year-old girl was incredibly anxious when she came in for her brain map. She needed to be reassured at absolutely every step that this was safe. Now, at about half way through her neurofeedback sessions, her mother reports that she is much less anxious and has had a 40% improvement in her obsessive-compulsive behaviors. We all look forward to seeing how much more improvement she experiences before she completes treatment. She came with behaviors consistent with ADD inattentive, Oppositional Defiant Disorder, and anxiety disorder. Our office assistant now describes her as very sweet and talkative. Her behavior no longer reflects an anxiety disorder.

In summary, a QEEG brain map is very effective in determining the neurological underpinnings of anxiety, making it possible to effectively relieve anxiety.

Autism and Neurofeedback

Image courtesy of David Castillo Dominici at FreeDigitalPhotos.net
Image courtesy of David Castillo Dominici at FreeDigitalPhotos.net

Autism Spectrum Disorder (ASD) categorizes a group of neurodevelopmental disorders that affect about 1 in 68 children, 1 in 42 boys, making it the most rapidly growing developmental disorder in the US today. One of the most notable characteristics of someone affected by autism is difficulty communicating or socializing with others, even in early infancy. Repetitive and limiting behavior is another common, recognizable quality that may point to ASD, although symptoms vary greatly.

For many, ASD is diagnosed at a young age, however symptoms of ASD sometimes go unnoticed and undiagnosed well into adulthood. Children who have developmental problems with language before the age of three have a higher risk for developing epilepsy as well. Over the course of a person’s life, the symptoms of ASD may change, and may cause depression and behavioral issues into adolescence. Although the cause of ASD remains unclear, scientists do believe both genetics and environment have an impact. ASD can occur for all intelligence levels. Although there is no known cure for ASD, there are ways to improve the lives of those suffering and reduce symptoms to allow for an independent and successful life.

Has Your Child Shown Signs of ASD?

The signs and symptoms of ASD differ case to case, however some signs to look for in a child’s behavior include:

  • No pointing or speaking of any kind (babbling) by age 1
  • No speaking by age 2 or 3
  • Unresponsive to hearing their name
  • Inability to make and sustain eye contact
  • Negatively reactive to touch
  • Difficulty communicating desires
  • Unusual or socially inappropriate facial expressions and/or gestures
  • No smiling
  • Abnormal posture
  • Trouble with social interaction/ inability to make friends
  • Repetitive behaviors, particularly organizational patterns like putting objects in a line
  • Lack of interest in others
  • Inability to initiate and/or sustain conversations
  • Difficulty with social cues
  • Difficulty reading other people’s expressions/feelings
  • Unusual use and/or repetition of words
  • Intense preoccupation with particular subjects or materials
  • A strong desire to have order and routines
  • Inability to break routines or rituals
  • Repetitive body motions, such as rocking or spinning/constant motion
  • Clumsiness

How Neurofeedback Can Help!

Peer reviewed published research on the effect of neurofeedback has shown an average improvement of 40% in symptoms as a result of treatment. In the almost 20 years we have been working with children on the autism spectrum, our clients have improved in the following areas: attention, anxiety, the expansion of vocabulary, and its functional and pragmatic usage.  One of our clients, a child who had no language at all, developed language over the course of neurotherapy sessions.  Additionally, we have seen improvements in eye contact, social interest, social competence, reduction in self-stimulatory behavior, such as the repetition of words and movements, and a reduction of outbursts.  For those of our more seriously involved individuals, we have seen significant improvement in cooperation, tantrums, and sensory integration. We have noted reductions in running away in potentially dangerous locations, such as parking lots, reduced dropping to the ground during refusals, and reduced sensitivity to sound and light.

For the past six years we have been coordinating with Oxycare, a clinic in Amman, Jordan, that is dedicated to the treatment of children and young adults with autistic spectrum disorders, many of whom we find to have undiagnosed epilepsy as well.  We trained their staff in EEG ( electrical brain wave) data collection and neurofeedback treatment.  They send us their EEG data which we process, interpret, and develop treatment protocol.  They have a six-year history of impressive success with their clients.

In our clinic, we have had a small number of high functioning autistic children and children with Asperger’s Syndrome who have lost their diagnoses due to the improvements resulting from neurofeedback.  That is not to suggest that all autistic spectrum clients experience this level of results, however, the typical result of neurofeedback is substantial improvement in functioning.