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Walden University 2012 Walden Universit y COLLEGE OF SOCIAL AND BEHAVIORAL SCIENCES This is to certify that the doctoral dissertation by Michael Lucido has been found to be complete and satisfactory in all respects, and that any and all revisions required by the review committee have been made. Review Committee Dr. Lisa Scharff, Committee Chairperson, Psychology Faculty Dr. Patricia Loun, Committee Member, Psychology Faculty Dr. Brian Ragsdale, University Reviewer, Psychology Faculty Chief Academic Officer Eric Riedel, Ph.D. Walden University 2012 Abstract Effects of Neurofeedback on Neuropsychological Functioning in an Adult with Autism by Michael J. Lucido M.A., University of Detroit Mercy, 2003 B.A., University of Detroit Mercy, 2001 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Psychology Walden University May 2012 Abstract Autism spectrum condition (ASC) is a complex neurodevelopmental disorder that impacts physiological processes, cognition, functional behaviors, social-communication, and often has comorbidities. One approach gaining empirical support for ASC treatment is neurofeedback. Neurofeedback uses operant conditioning to normalize cerebral activity through auditory and visual reinforcement. Live Z-score Training (LZT) has become the latest advancement in neurofeedback. There is no published research to date on LZT neurofeedback in adulthood ASC. The purpose of this study was to evaluate LZT’s impact on neuropsychological measures in an adult with ASC. A multiple baseline single-case research design was used with a convenience sample of one adult with ASC to evaluate the effects of 20 LZT sessions using the Conservative Dual Criterion visual inspection method as the primary form analysis. ADHD, mood stability, anxiety, depression, and ASC symptoms were significantly reduced according to the Neuropsych Questionnaire. The participant improved significantly on the CNS Vital Signs (CNVS) Neurocognitive measures of executive function, cognitive flexibility, reaction time, and complex attention. Also, the participant increased intelligence as measured by the Test of Nonverbal Intelligence. Lastly, the participant had changes in brain function according to quantitative electroencephalography and low-resolution brain electromagnetic tomography. CNVS processing speed was the only measure that did not significantly change. No adverse effects were reported. This study may lead to positive social change by providing a technologically advanced intervention for adults with ASC, which may improve their overall quality of life and promote self-sufficiency through adulthood. Effects of Neurofeedback on Neuropsychological Functioning in an Adult with Autism by Michael J. Lucido M.A., University of Detroit Mercy, 2003 B.A., University of Detroit Mercy, 2001 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Psychology Walden University May 2012 Dedication First and foremost, this dissertation is dedicated to my sweet Melissa and our doggies, Helios and Cash, for their love and support in allowing me to dedicate these years toward obtaining my doctorate. Melissa, you are my best friend and twin flame for whom I owe so much. I would have never been able to do this without your unconditional love and words of encouragement that empowered me to continue. Thank you for being you- I love you so much. Secondly, this project is devoted to my mother and father who have provided me with the foundation and encouragement to pursue higher education and always strive to learn more. Since my first day of kindergarten, I still remember their mantra every morning, “Do good in school.” This dissertation reflects the product of all those years you both dedicated in helping me succeed- thank you. Finally, this dissertation is dedicated to adults with autism who struggle with the condition, and their caregivers who work so hard to find the best treatment. You are admired for your strength, energy, and advocacy. I would especially like to thank the participant in this study and his mother for playing a key role in advancing the research in this area. The findings in this study exemplify that there can be significant improvement in many areas for an adult with autism. Finding the cure should not be goal. The goal should be to improve the overall quality of life of people with autism, so that they can be happier and achieve more goals than ever expected. There is always hope! Acknowledgments First and foremost, I am in debt to Dr. Lisa Scharff’s guidance throughout this process. She provided thorough reviews of countless rough drafts and offered the continuous support I needed to complete this project. She was always available either by phone, conferencing or email. You have really helped me to work through the many obstacles that might have otherwise set me back or abandoned the project completely. One last time- thank you! I would like to also acknowledge the important perspectives of Dr. Patricia Loun. You provided the expertise for advancing the methodology and allowing me the freedom to use the single case research method as a viable way to test my hypotheses. You gave key recommendations to this study for which I am so grateful. Also, to Dr. Brian Ragsdale, as the University Research Reviewer, you ensured I met the high standards of Walden University. This project would not have been completed if you did not provide this necessary feedback. Thank you for supporting and approving this project. Next, I am greatly appreciative of Dr. Andrew Sahara’s mentoring and encouragement. Sharing your experience provided me the motivation I needed to accomplish this great task. Finally, I would not have been able to complete this study without Linda Walker’s mentoring, partnership, guidance, and assistance. You gave me the opportunity to explore the efficacy of neurofeedback in autism while maintaining the highest level of professional standards set forth by the field. Thank you so much Linda for your many hours, materials, and equipment that you donated to this study. I look forward to our future collaboration. Table of Contents List of Tables ..................................................................................................................... vi List of Figures ................................................................................................................... vii Chapter 1: Introduction ........................................................................................................1 Introduction to the Study .....................................................................................................1 Background of the Study .....................................................................................................2 Problem Statement ...............................................................................................................3 Purpose of the Study ............................................................................................................4 Nature of Study ....................................................................................................................4 Research Questions and Hypotheses ...................................................................................5 Theoretical Basis ..................................................................................................................7 Definition of Terms..............................................................................................................8 General Terms ..........................................................................................................8 Neurofeedback Terms ..............................................................................................9 Assumptions .......................................................................................................................11 Limitations .........................................................................................................................12 Delimitations ......................................................................................................................14 Significance of the Study ...................................................................................................15 Social Change Implications ...............................................................................................16 Summary and Transition ....................................................................................................16 Chapter 2: Literature Review .............................................................................................18 Introduction to the Literature Review ................................................................................18 Overview of Autism Spectrum Conditions ........................................................................19 i Diagnosis Background of Autism Spectrum..........................................................19 Neurocognitive Theories ........................................................................................21 Genetic & Neurochemical Abnormalities ..............................................................26 Neuroimaging Patterns in ASC ..............................................................................29 Neurological Patterns in ASC ................................................................................33 Prevalence Rates & Costs ......................................................................................38
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