Neurofeedback treatment for autism spectrum disorders: Scientific foundations and clinical practice

Neurofeedback is a technique to enable individuals to change their brain activity by using an instrument that provides information on the activity of the brain. The goal of neurofeedback is to improve behavioral or cognitive processes related to brain activity. The technique of neurofeedback, although available for some time, is rapidly gaining interest as a treatment of various disorders (Yucha & Montgomery, 2008). Recent evidence indicates that the technique may also be used beneficially for the treatment of autism spectrum disorders. Currently, the most frequent application of neurofeedback lies in the treatment of epilepsy and attention deficit hyperactivity disorder (ADHD). Epilepsy has been treated with neurofeedback since the 70s of the previous century. Epilepsy is a chronic neurological disorder characterized by abnormal, excessive or synchronous neuronal activity in the brain resulting in seizures. The main focus of neurofeedback in epilepsy is to enhance the sensorimotor rhythm (SMR) originating from the sensorimotor cortex of the brain. This 12 to 15 Hz activity is involved in the inhibition and control of movement. Increased SMR is found to be related to improved movement inhibition and consequently offers protection to seizures in individuals with epilepsy (Sterman & Egner, 2006). Scientific studies that investigated the efficacy of neurofeedback in individuals with epilepsy were recently evaluated by Tan and colleagues (2009). They found that in a total of nine studies, neurofeedback was effective in reducing the number of seizures in 79% of participants with severe epilepsy who did not respond to medication. The number of sessions that was used in these studies varied from 24 to more than 200 sessions. It was concluded that neurofeedback is a promising treatment for individuals with severe epilepsy, but that future randomized, sham controlled studies are required to confirm the efficacy of neurofeedback (Tan et al., 2009). Most research on neurofeedback has been conducted in individuals with ADHD. ADHD is a developmental disorder characterized by inattention, hyperactivity and impulsivity (American Psychiatric Association, 2000). The EEG profiles of 85 to 90% of the individuals with ADHD show elevated theta power and reduced beta power over frontal and central, midline cortical brain areas (Monastra et al., 2005). Neurofeedback in ADHD aims to inhibit