ABSTRACT Background Autism Spectrum Disorder is a neurodevelopmental disorder and symptoms are considered to be due to brain deregulation and dysfunction in multiple regions of the brain. There is no cure for autism and the management guidelines are defined to reduce the symptoms and reinstitute normal functioning in life. Neurofeedback is one of these methods in treating children with Autism. Several studies have shown that individuals with autism are able to alter their brain activity in specific frequency bands through the use of neurofeedback which induces prolong changes in autism symptoms, cognitive functioning and long-term changes in EEG. Neurofeedback is a way of training the brain to use more productive patterns of brainwaves which teaches the brain to self-regulate, strengthening neural pathways while increasing mental endurance and flexibility Objective To observe the effect of Neurofeedback Treatment in Children with ASD in areas of speech, language, communication, sociability, sensory ,cognitive awareness, health, physical and behaviors Methods and Materials It is a descriptive longitudinal study with purposive sampling done from January 2018 to March 2020 among children diagnosed with ASD who underwent Neurofeedback training for at least 80 sessions. 70% were boys 30% were girls. Assessment was done by Autism Treatment Evaluation Checklist. Data were analyzed by SPSS 21 Result The study showed Improvements in all ATEC Evaluation Categories in Speech, Language, and communication39.1%, Sociability53.7%, Sensory and Cognitive awareness56.8%, and in Health, Physical, and Behaviors58% Conclusion The study shows marked improvement in all 4 specific Areas of evaluation of ATEC after Neurofeedback training of children with Autism. Since Autism has no specific cure and neurofeedback has its efficacy without any untoward effects may be used as a treatment option for Autism

1. Neurofeedback as
treatment of autism
spectrum disorder:
Clinical Experiences

2. Prof. Dr. M O K Wahedi
MBBS(BD), DCH(Ire), MSc-ECD(BD), MRCP(UK),
MRCPCH(UK), FRCP(EDIN)

3.  Certified in Pediatric Neurology , British Paedaitric Neurology Association (BPNA), UK
 MSc in Early childhood development, BRAC University
Neurology & Child Development Experiences

4.  Affiliated with Spectrum Learning Asia, Singapore
 Member Asia Pacific Neuro-Biofeedback Association (APNA)
 Member Institute of Neural Regulation and Research(ISNR), USA
 Affiliate Member Brain Master Technologies, USA
 Contact: Tel: 01977226840
 Email: Spectrumneurology@gmail.com
Spectrum Neurology & Neurofeedback Centre (SNNC)

5. Neurofeedback as treatment
of autism spectrum disorder:
Clinical Experiences

7. What is Neurofeedback

8.  Neurofeedback is a direct training of brain waves by which the brain learns to function
more efficiently. It's based on the idea that you can consciously alter the way your brain
functions using real-time displays of your brain's electrical activity (known as
brainwaves). It is also called EEG (Electroencephalogram) Biofeedback.
 It is non-invasive and a drug-free treatment , it teaches the brain to self-regulate,
strengthening neural pathways while increasing mental endurance and flexibility.
What is Neurofeedback ?

9. “The whole of man’s life stands in need of
a right rhythm.”

10.  In the late 1960s and 1970s, researchers discovered that it was possible
to recondition, retrain or learn different brainwave patterns.
 Some of this work began with training to increase alpha brainwave
activity to increase relaxation, while other work originating at UCLA
focused on uncontrolled epilepsy.
This brainwave training is called
Neurofeedback or EEG biofeedback .
Introduction

11.  Within every human brain can be found different types of brainwave patterns.
 Several types of brainwaves are present at any given time, but each brain area has a
predominant pattern reflective of the current mental state.
 These patterns can be measured and recorded by an electroencephalogram (EEG), which
can then be used to make a ‘map’ of an individual’s mental function.
Brain Waves

12. Basic EEG Associations
 Beta waves 15-36hz
 High beta is associated with anxious hyperactive
thinking
 Low beta is associated with alert active things
 SMR 12-15 hz
 Associated with external focus
 Alpha waves 8-12hz
 Associated with relaxed awareness
 Theta waves 4-7hz
 Associated with internal focus
 Delta waves .5-4hz
 Associated with deep, dreamless sleep

15. Brain map in Different Conditions

16. Distributions of Brain Wave in Disorders
 LD often appears as posterior elevated delta
 ADHD often appears as elevated frontal theta
 Depression often appears as elevated central
or frontal alpha
 Anxiety often appears as elevated frontal
beta often in conjunction with diminished
alpha
 Depression often also appears as more
slowing on the left, while anxiety appears as
increased activity on the right

17. •When the brain is not functioning well, evidence of this often shows up in the
EEG (Electroencephalogram).
•Neurofeedback is a technique in which one trains the brain to help improve its
ability to regulate all bodily functions and to take care of itself.
What does EEG tell us?

18.  In Neurofeedback (NF) the current parameters of EEG recorded from a
subject’s head is presented to the subject through visual, auditory, or
tactile modality, where the subject alters these parameters to reach a
more efficient mode of brain functioning.
What is Neurofeedback ?

19. What is Neurofeedback ?

20. What is Neurofeedback ?

21.  Over the last 20 years, neurofeedback has been used to treat various neurological and
psychiatric conditions, and to improve cognitive function in various contexts.
 It has been found to produce symptom relief and changes in brain activity that endure
over time in neuropsychological disorders.
What is neurofeedback?

22.  •The brain is highly adaptable and has great plasticity. Thus it has an
innate capacity to change, learn and improve performance.
 •EEG makes information available to the brain about how it is
functioning and thus making adjustments.
Basis of Neurofeedback

23. Neurofeedback as treatment of
autism spectrum disorder: Clinical
Experiences

24. Autism In South Asia & Bangladesh

25. Neurofeedback as treatment of
autism spectrum disorder: Clinical
Experiences

26. Autism spectrum disorder:
Brain Deregulation & Dysfunction

27. STUDY Introduction

28. Study Design

29. Selection Criteria

30. Exclusion Criteria

31. Cases

32. Materials & Methods

33. ATEC:
autism treatment evaluation checklist

34. ATEC

35. Autism Evaluation Check List:
English and Bangla format

36. ATEC Scoring

37. Neurofeedback Equipment's

38. Brain Trainer
System

39. 10-20 EEG Sites

40. Neurofeedback Session

41. General Treatment Protocol

42. Investigations
1)LFT (SGPT, SGOT, ALP, S.
Albumin)
2)RFT (BUN, Creatinine, S.
Electrolyte)
3)Toxicological Screening
 Selenium
 Manganese
 Copper
4)S. Ig E level
1)EEG
2)MRI Brain
3)Karyotyping, Microarray, Gene
sequencing

43. Session Records Form
RECORDING OBSERVATIONS: NEUROFEEDBACK TRAINING SESSIONS
Name ____________________________________________ Age ______________ Sex M F
Objectives:
1. ___________________________________________________________________________________
2.___________________________________________________________________________________
3.___________________________________________________________________________________
Session 1. Date Started: _____/____/______ Date Ended. _____/____/________
Name of Therapist: ___________________________________________
S/N DATE PROTOCOL OBSERVATIONS REMARKs

44. RESULTS

45. Age & Sex Distribution

46. ATEC Score of Speech/ Language
/ Communication

47. ATEC Score of Sociability

48. ATEC Score:
Sensory/Cognitive Awareness

49. ATEC Score:
Health/Physical/Behaviors

50. ATEC Score: Total

51. Case Summaries:
Speech/Language/Communication

52. Case Summaries:
Sociability

53. Case Summaries:
Sensory/Cognitive Awareness

54. Case Summaries:
Health/Physical/ Behaviors

55. ATEC Score Percent Improvement

56. ATEC Score Percent Improvement

57. Conclusions

58. Conclusions

59. Recommendation

60. Acknowledgements