Using Neurofeedback Treatment in Children with Neurodevelopmental Disorders

Neurofeedback je neinvazivna metoda samoregulacije s ciljem postizanja promjene nad kortikalnom aktivnošću preko procesa operantnog uvjetovanja. Jedna od metoda neurofeedbacka jest Infra Low Frequency (Infra niske frekvencije) koja počiva na potkrepljenju promjena moždanih valova na spektru nižem od 0,5Hz. Aspergerov sindrom predstavlja jedan od neurorazvojnih poremećaja iz autističnog spektra, a definiran je socijalnim deficitima i ograničenim interesima. Razliku naspram autizma čini česta razvijenost govora i viša kognitivna sposobnost, radi čega se dijagnoza kasnije uspostavlja. Cilj istraživanja bio je utvrditi učinak primjene neurofeedback tretmana kod djeteta s Aspergerovim sindromom. Uzorak ovog istraživanja činio je jedan ispitanik, dječak D. (KD=11) s dijagnozom Aspergerovog sindroma. Prije početka treninga proveden je polustrukturirani intervju s roditeljima te je ispunjena Australska ljestvica za Aspergerov sindrom. Rezultati intervjua i Australske ljestvice za Aspergerov sindrom ukazivali su na slijedeća kritična područja: emocije, postojanje nepoželjnih ponašanja, teškoće socijalne interakcije. Na temelju dobivenih rezultata kreiran je neurofeedback trening primjenom Infra Low Frequency metode. Program se provodio u okviru 20 seansi od kojih je u 15 seansi korišten jednokanalni trening na područjima zaduženim kontrolu impulzivnosti, stabilnost, fizičku smirenost, kontrolu pažnje, i emocionalnu reaktivnost, a u pet dvokanalni trening s težištem na prefrontalnu regiju zaduženu za emocionalne procese. Neurofeedback trening provodio se 3 puta tjedno u prostoru Privatne edukacijsko-rehabilitacijske prakse Angerona u Čakovcu. Terapijska seanse trajale su 30 minuta, a elektrode su raspoređivane prema međunarodnom sustavu 10-20. Kao evaluaciju efikasnosti treninga roditelji su ispunjavali EEG Expert listu i Autism Treatment Evautation Checklist (ATEC) u tri točke procjene: prije prvog treninga, kontrolno nakon 10. seanse te nakon završetku treninga. Podaci su obrađeni INDIF metodom. Rezultati na EEG Expert skali su pokazali smanjenje simptoma na svim varijablama te statistički značajnu promjenu na varijablama Emocije i Emocije2 (p=0,024; p<0,05) Emocije1 i Emocije3(p=0,01; p<0,05) dok su rezultati na ATEC-u pokazali smanjenje simptoma, ali ne statističku značajnost. Rezultate u problemskom području emocije smatramo vrijednim budući da je neurofeedback trening bio usmjeren na ublažavanje specifičnh teškoća kao što su: teškoće spavanja, griženje noktiju, sram, strahovi, ljutnja, impulzivnost. S obzirom na dobivene rezultate može se zaključiti da se provedeni program pokazao kao uspješna metoda u ublažavanju pojedinih specifičnih simptoma koji definiraju Aspergerov sindrom. Također, rezultati dobiveni u ovom kao i srodnim dosadašnjim istraživanjima naglašavaju važnost provedbe daljnjih sustavnih istraživanja na području koncipiranja i evaluacije učinka neurofeedback treninga (Infra Low Frequency metode) kod osoba s Aspergerovim sindromom, ali i drugih oblika neurorazvojnih poremećaja.Neurofeedback is an noninvasive method of selfregulation with goal of achieving changes over cortical activity by using process of operant conditioning. One of the methods is Infra Low Frequency training which consists of reinforcing changes in brain waves with frequency lower than 0,5Hz. Asperger's syndrome is neurodevelopmental disorder defined by social deficits and lack of interest. Difference over autism lays in developed speech and higher cognitive capabilities, which can be reason for later diagnosis. The goal of research was to find out effects and effectivness of neurofeedback treatment on child with Asperger's syndrome. Research sample was one boy, D. 11 years old, with diagnosis of Asperger's syndrome. Before training the semi-structured interview was made with parents along Australian scale for Asperger syndrome. The results of interview and scale, pointed to critical areas of emotion, problematic behaviours and social interaction problems. Furthermore, the Infra Low Frequency program was created that consisted of 20 trainings, of which 15 were one-channel training on areas in charge of impulsivity, stability, physical calmness, attention and emotional processes. The other five treatments were two channel training with empasise on prefrontal region in charge of emotional processes. Trainings were performed 3 times a week at Private education and rehabilitation practice Angerona, Čakovec. Trainings lasted 30 minutes each nad electrodes were placed on the skull by International 10-20 standard. As evaluation to the efficacy of the training parents assessed symptoms by filling EEG Expert list and Autism Treatment Evaluation Checklist (ATEC) three times: before first session, after tenth session and after finishing the program. Collected data was statisticaly processed using INDIF method. Results on EEG Expert list showed lowering of all the symptoms on every variable and statistical significance of changes on variables Emotion1 and Emotion2 (p=0,024; p<0,05) and Emotion1 and Emotion3 (p=0,01; p<0,05). Results on ATEC showed reduction od symptoms but without statistical significance. Results on variables of emotion are especially valuable because the training focused towards issues that were covered by this variables (shame, fears, impulsivity, sleep problems, etc). To conclude, the results are showing that neurofeedback treatment was successfull but it is really important to continue the research of Infra Low Frequency method effectivness with clients with Asperger syndrome and other neurodevelopmental disorders

The use of neurofeedback method in a child with Asperger\u27s syndrome

Neurofeedback predstavlja jednu od neinvazivnih metoda samoregulacije s ciljem postizanja promjena u području kortikalne aktivnosti posredstvom operantnog uvjetovanja. Cilj ovoga istraživanja odnosio se na procjenu učinka primjene neurofeedback tretmana u djeteta s Aspergerovim sindromom. Za potrebe istraživanja koncipiran je i proveden neurofeedback trening primjenom Infra Low Frequency metode na uzorku od jednog ispitanika, dječaka s Aspergerovim sindromom (KD = 11). Neurofeedback trening provodio se tijekom 20 seansi u okviru kojih je u 15 seansi korišten jednokanalni trening na područjima zaduženim za kontrolu impulzivnosti, stabilnost, fizičku smirenost, kontrolu pažnje, i emocionalnu reaktivnost, dok je u okviru 5 seansi korišten dvokanalni trening s težištem na prefrontalnu regiju zaduženu za emocionalne procese. U svrhu procjene učinkovitosti provedenog programa roditelji su ispunjavali upitnike EEG Expert i Autism Treatment Evaluation Checklist (ATEC) u tri točke procjene: prije, tijekom i po završetku provedenog programa. Rezultati na upitniku EEG Expert pokazali su smanjenje simptoma na svim varijablama procjene, te statistički značajnu promjenu na varijablama u području emocija, dok su rezultati na ATEC ukazali na tendenciju smanjenja simptoma, ali bez statističke značajnosti. Podaci dobiveni u problemskom području emocije mogu se smatrati vrijednima, budući da je neurofeedback trening bio usmjeren na ublažavanje specifičnih teškoća kao što su: teškoće spavanja, griženje noktiju, sram, strahovi, ljutnja, impulzivnost. Također, rezultati dobiveni u ovom, kao i dosadašnjim srodnim istraživanjima, naglašavaju važnost provedbe daljnjih sustavnih istraživanja u području koncipiranja i evaluacije neurofeedback metode u osoba s Aspergerovim sindromom, ali i u populaciji osoba s drugim neurorazvojnim poremećajima.Neurofeedback is one of the non-invasive methods of self-regulation with the aim of achieving changes in the area of cortical activity by using process operative conditioning. The aim of this study was to evaluate the effect of neurofeedback training in children with Asperger’s syndrome. In this study, neurofeedback training was developed using the Infra Low Frequency method on a sample of one boy with Asperger\u27s syndrome (age 11). Neurofeedback training consisted of 20 sessions of which 15 were one-channel training on areas responsible for the control of impulse, stability, physical relaxation, attention and emotional reactivity. Within the next 5 sessions two-channel training was used focused on the prefrontal region in charge of emotional processes. In order to evaluate the effectiveness of the applied therapy program, parents completed EEG Expert and Autism Treatment Evaluation Checklist (ATEC) questionnaires in three assessment points: before, during and after the therapy program. Results at EEG Experts have shown a reduction in symptoms on all variables and statistically significant changes in the area of emotion, whereas ATEC results indicate a tendency to reduce symptoms but without statistical significance. The data obtained in the area of emotions can be considered valuable since neurofeedback training was aimed at alleviating specific difficulties such as sleeping difficulties, nail scratching, shame, fear, anger, impulsiveness, etc. Also, the herein obtained results, as well as previous related researches, emphasize the importance of further systematic researches in the area of conceptualization and evaluation of neurofeedback methods in persons with Asperger\u27s syndrome, but also in the population with other neurodevelopmental disorders

The use of neurofeedback method in a child with Asperger\u27s syndrome

Neurofeedback predstavlja jednu od neinvazivnih metoda samoregulacije s ciljem postizanja promjena u području kortikalne aktivnosti posredstvom operantnog uvjetovanja. Cilj ovoga istraživanja odnosio se na procjenu učinka primjene neurofeedback tretmana u djeteta s Aspergerovim sindromom. Za potrebe istraživanja koncipiran je i proveden neurofeedback trening primjenom Infra Low Frequency metode na uzorku od jednog ispitanika, dječaka s Aspergerovim sindromom (KD = 11). Neurofeedback trening provodio se tijekom 20 seansi u okviru kojih je u 15 seansi korišten jednokanalni trening na područjima zaduženim za kontrolu impulzivnosti, stabilnost, fizičku smirenost, kontrolu pažnje, i emocionalnu reaktivnost, dok je u okviru 5 seansi korišten dvokanalni trening s težištem na prefrontalnu regiju zaduženu za emocionalne procese. U svrhu procjene učinkovitosti provedenog programa roditelji su ispunjavali upitnike EEG Expert i Autism Treatment Evaluation Checklist (ATEC) u tri točke procjene: prije, tijekom i po završetku provedenog programa. Rezultati na upitniku EEG Expert pokazali su smanjenje simptoma na svim varijablama procjene, te statistički značajnu promjenu na varijablama u području emocija, dok su rezultati na ATEC ukazali na tendenciju smanjenja simptoma, ali bez statističke značajnosti. Podaci dobiveni u problemskom području emocije mogu se smatrati vrijednima, budući da je neurofeedback trening bio usmjeren na ublažavanje specifičnih teškoća kao što su: teškoće spavanja, griženje noktiju, sram, strahovi, ljutnja, impulzivnost. Također, rezultati dobiveni u ovom, kao i dosadašnjim srodnim istraživanjima, naglašavaju važnost provedbe daljnjih sustavnih istraživanja u području koncipiranja i evaluacije neurofeedback metode u osoba s Aspergerovim sindromom, ali i u populaciji osoba s drugim neurorazvojnim poremećajima.Neurofeedback is one of the non-invasive methods of self-regulation with the aim of achieving changes in the area of cortical activity by using process operative conditioning. The aim of this study was to evaluate the effect of neurofeedback training in children with Asperger’s syndrome. In this study, neurofeedback training was developed using the Infra Low Frequency method on a sample of one boy with Asperger\u27s syndrome (age 11). Neurofeedback training consisted of 20 sessions of which 15 were one-channel training on areas responsible for the control of impulse, stability, physical relaxation, attention and emotional reactivity. Within the next 5 sessions two-channel training was used focused on the prefrontal region in charge of emotional processes. In order to evaluate the effectiveness of the applied therapy program, parents completed EEG Expert and Autism Treatment Evaluation Checklist (ATEC) questionnaires in three assessment points: before, during and after the therapy program. Results at EEG Experts have shown a reduction in symptoms on all variables and statistically significant changes in the area of emotion, whereas ATEC results indicate a tendency to reduce symptoms but without statistical significance. The data obtained in the area of emotions can be considered valuable since neurofeedback training was aimed at alleviating specific difficulties such as sleeping difficulties, nail scratching, shame, fear, anger, impulsiveness, etc. Also, the herein obtained results, as well as previous related researches, emphasize the importance of further systematic researches in the area of conceptualization and evaluation of neurofeedback methods in persons with Asperger\u27s syndrome, but also in the population with other neurodevelopmental disorders

AIRWAY MANAGEMENT IN A CHILD WITH EDWARD’S SYNDROME

Prikazujemo zbrinjavanje dišnog puta u djevojčice s mozaičnim tipom Edwardsovog sindroma za planirani zahvat laparotomije u općoj anesteziji. Manifestacije Edwardsovog sindroma među ostalima su kraniofacijalne malformacije te je moguća otežana ventilacija i intubacija. U našem slučaju djevojčica je, ovisno o potrebi zahvata, imala postavljeno supraglotično pomagalo tijekom anestezije za dijagnostičku pretragu magnetskom rezonancijom (MR), intubirana je fi berbronhoskopski za elektivni zahvat laparoskopije, a u jedinici intenzivne medicine direktnom laringoskopijom. Ventilacija i intubacija protekle su bez komplikacija. Poslijeoperacijski oporavak komplicirao se hipotonijom, pneumonijom te potrebom za reintubacijom i mehaničkom ventilacijom.We report on airway management in a girl with mosaic type of Edward’s syndrome for elective surgery, laparotomy in general anesthesia. In Edward’s syndrome, among other manifestations, craniofacial anomalies are expressed and there is a possibility of diffi cult ventilation and intubation. In this case, we secured the airway with supraglottic airway device during diagnostics (anesthesia for magnetic resonance imaging), we performed fi beroptic intubation for elective laparoscopy, and in the intensive care unit, she was intubated with direct laryngoscopy. Ventilation and intubation were accomplished without problems. Postoperative recovery was complicated with hypotonia, pneumonia and the need of reintubation and mechanical ventilation

Using Neurofeedback Treatment in Children with Neurodevelopmental Disorders

Neurofeedback je neinvazivna metoda samoregulacije s ciljem postizanja promjene nad kortikalnom aktivnošću preko procesa operantnog uvjetovanja. Jedna od metoda neurofeedbacka jest Infra Low Frequency (Infra niske frekvencije) koja počiva na potkrepljenju promjena moždanih valova na spektru nižem od 0,5Hz. Aspergerov sindrom predstavlja jedan od neurorazvojnih poremećaja iz autističnog spektra, a definiran je socijalnim deficitima i ograničenim interesima. Razliku naspram autizma čini česta razvijenost govora i viša kognitivna sposobnost, radi čega se dijagnoza kasnije uspostavlja. Cilj istraživanja bio je utvrditi učinak primjene neurofeedback tretmana kod djeteta s Aspergerovim sindromom. Uzorak ovog istraživanja činio je jedan ispitanik, dječak D. (KD=11) s dijagnozom Aspergerovog sindroma. Prije početka treninga proveden je polustrukturirani intervju s roditeljima te je ispunjena Australska ljestvica za Aspergerov sindrom. Rezultati intervjua i Australske ljestvice za Aspergerov sindrom ukazivali su na slijedeća kritična područja: emocije, postojanje nepoželjnih ponašanja, teškoće socijalne interakcije. Na temelju dobivenih rezultata kreiran je neurofeedback trening primjenom Infra Low Frequency metode. Program se provodio u okviru 20 seansi od kojih je u 15 seansi korišten jednokanalni trening na područjima zaduženim kontrolu impulzivnosti, stabilnost, fizičku smirenost, kontrolu pažnje, i emocionalnu reaktivnost, a u pet dvokanalni trening s težištem na prefrontalnu regiju zaduženu za emocionalne procese. Neurofeedback trening provodio se 3 puta tjedno u prostoru Privatne edukacijsko-rehabilitacijske prakse Angerona u Čakovcu. Terapijska seanse trajale su 30 minuta, a elektrode su raspoređivane prema međunarodnom sustavu 10-20. Kao evaluaciju efikasnosti treninga roditelji su ispunjavali EEG Expert listu i Autism Treatment Evautation Checklist (ATEC) u tri točke procjene: prije prvog treninga, kontrolno nakon 10. seanse te nakon završetku treninga. Podaci su obrađeni INDIF metodom. Rezultati na EEG Expert skali su pokazali smanjenje simptoma na svim varijablama te statistički značajnu promjenu na varijablama Emocije i Emocije2 (p=0,024; p<0,05) Emocije1 i Emocije3(p=0,01; p<0,05) dok su rezultati na ATEC-u pokazali smanjenje simptoma, ali ne statističku značajnost. Rezultate u problemskom području emocije smatramo vrijednim budući da je neurofeedback trening bio usmjeren na ublažavanje specifičnh teškoća kao što su: teškoće spavanja, griženje noktiju, sram, strahovi, ljutnja, impulzivnost. S obzirom na dobivene rezultate može se zaključiti da se provedeni program pokazao kao uspješna metoda u ublažavanju pojedinih specifičnih simptoma koji definiraju Aspergerov sindrom. Također, rezultati dobiveni u ovom kao i srodnim dosadašnjim istraživanjima naglašavaju važnost provedbe daljnjih sustavnih istraživanja na području koncipiranja i evaluacije učinka neurofeedback treninga (Infra Low Frequency metode) kod osoba s Aspergerovim sindromom, ali i drugih oblika neurorazvojnih poremećaja.Neurofeedback is an noninvasive method of selfregulation with goal of achieving changes over cortical activity by using process of operant conditioning. One of the methods is Infra Low Frequency training which consists of reinforcing changes in brain waves with frequency lower than 0,5Hz. Asperger's syndrome is neurodevelopmental disorder defined by social deficits and lack of interest. Difference over autism lays in developed speech and higher cognitive capabilities, which can be reason for later diagnosis. The goal of research was to find out effects and effectivness of neurofeedback treatment on child with Asperger's syndrome. Research sample was one boy, D. 11 years old, with diagnosis of Asperger's syndrome. Before training the semi-structured interview was made with parents along Australian scale for Asperger syndrome. The results of interview and scale, pointed to critical areas of emotion, problematic behaviours and social interaction problems. Furthermore, the Infra Low Frequency program was created that consisted of 20 trainings, of which 15 were one-channel training on areas in charge of impulsivity, stability, physical calmness, attention and emotional processes. The other five treatments were two channel training with empasise on prefrontal region in charge of emotional processes. Trainings were performed 3 times a week at Private education and rehabilitation practice Angerona, Čakovec. Trainings lasted 30 minutes each nad electrodes were placed on the skull by International 10-20 standard. As evaluation to the efficacy of the training parents assessed symptoms by filling EEG Expert list and Autism Treatment Evaluation Checklist (ATEC) three times: before first session, after tenth session and after finishing the program. Collected data was statisticaly processed using INDIF method. Results on EEG Expert list showed lowering of all the symptoms on every variable and statistical significance of changes on variables Emotion1 and Emotion2 (p=0,024; p<0,05) and Emotion1 and Emotion3 (p=0,01; p<0,05). Results on ATEC showed reduction od symptoms but without statistical significance. Results on variables of emotion are especially valuable because the training focused towards issues that were covered by this variables (shame, fears, impulsivity, sleep problems, etc). To conclude, the results are showing that neurofeedback treatment was successfull but it is really important to continue the research of Infra Low Frequency method effectivness with clients with Asperger syndrome and other neurodevelopmental disorders