A NEW TACTIC IN THE FIGHT AGAINST AUTISM
Elaina M. Jannell, Ph.D.
© 1996 Flexyx, LLC All Rights Reserved.
Autism can cruelly shatter all of the hopes and dreams of parents. When expectant parents envision their new baby, they see a child who will grow up to become a caring, independent, and successful adult. Then they hear the diagnosis of autism. Not only are their dreams shattered, but their lives become disrupted by the many needs of their autistic child.
Our society has many lingering beliefs that place guilt on the parents for causing autism. Theories, growing out of Freudian Psychology, propose that a cold, unnurturing mother is responsible for shaping a child who is withdrawn, temperamental, and injurious to him or herself. Psychologists have debated the question of nature versus nurture for many years. Most would probably agree that personality, behavior and disorders are a combination of the two. Over the past few years, a number of research projects have led away from nurture theories and led scientists to believe that physiological disorders are causing autism. As yet, no specific cause has been identified.
When behavioral problems respond to chemical treatments, the scientists gain evidence supporting a physiological cause. Studies dealing with bipolar disorder, a behavior leading to emotional extremes, have proven a chemical cause for this behavior disorder. The drug Lithium has been found to control the chemical problem and help rebalance behavior. Autism has also responded to chemicals, suggesting that it is physiologically based. In Autism Research Review International, it was reported that McDougle et al found that all three violent, self-injurious subjects in their study reduced or ceased dangerous behaviors when resperidone was administered. In the same journal, another article reported that a genetic defect causing a deficiency in the enzyme adenylosuccinate lyase was linked to some form of autism. A third article in the same journal, a Swiss researcher linked autism with seizure disorders. A boy with an abnormal EEG (showing very frequent generalized polyspike and spike-wave discharges followed by a brief flattening both during the waking and sleep state on a disorganized slow wave background) was treated with the anticonvulsant, clonazepam. This resulted in "immediate cessation of seizures and a marked and rapid improvement in behavior, communication and language, with disappearance of the autistic behavior."
So far, there has been no study that definitively identifies any one single cause of autism, and certainly, no study identifies a "cure." Parents of autistic children are very involved and extremely well-read on the topic of autism. They are also keen observers of the variables associated with their children's behavior. They are all anxious to solve the riddle of autism. Reports from the parents suggest that one reason for the wider variety of problems reported to be associated with autism is that there is no one cause of autism.
One nineteen-year old's mother has observed that there are more cases of autism now that there have been in previous years. She recalls that when she was in labor with her son, labor was stimulated with the drug, pitocin. She believes that pitosis (human derived oxytocin) triggers a genetic predisposition to autism in the child. Her other son was delivered in a similar manner, but the labor was better managed. He has some autistic features, but not as fully-developed as her younger son. She has asked other mothers about their delivery experiences, and has found that many received pitocin during labor. In addition, she cites a study done in Japan, which found a 19% autism rate in mothers who received oxytocin one week before delivery.
Another mother reported research done in Utah, where a gene for autism has been identified. However, researchers believe that other factors must be present to trigger the appearance of symptoms. Other possible causes of autistic symptoms which researchers suspect may be involved include: uterine infections, allergies, immune deficiencies, protein deficiencies and other metabolic disorders.
The range of treatments for autism are equally diverse. They include psychotropic medications like Prozac and Mellaril, specific diets, behavior modification, vestibular motion, visual training, speech and physical therapy, dietary supplements such as grape seed extract, sensory integration, and stimulation treatment. Parents have to investigate and decide whether or not to pursue any of the dozens of treatments promising to help relieve the debilitating symptoms of autism. The search for help is time consuming and expensive; and the disappointment can be devastating. There is a very promising new treatment under investigation, a new approach that addresses the underlying neurological and physiological components of autism. It is called EEG-Driven Stimulation or EDS.
EDS came to be developed as a result of a serendipitous accident. Len Ochs, Ph.D., spent thirty years investigating physiological phenomenon when he was asked to develop a sound and light device to aid elementary school students with learning difficulties. This project eventually led to the development of EDS. Ochs is the first to admit that he is baffled by the effects of his EEG-driven feedback system. While he stresses that it is neither a cure for autism nor for all of life's ills, clinical observations with several autistic clients have lead him to believe that autism is helped by the use of EDS. While the numbers have been very small, the immediacy, reliability, and significance of the use of EDS with autistic children and young adults warrants further investigation. Ochs has observed that autism is a stimulation processing problem characterized by specific brainwaves patterns, and being locked into reacting to stimulation with an abnormally high level of levels of very slow (Delta) and mid frequency (Alpha) brain waves. This fixed reaction pattern can be interrupted with EDS, which uses a special form of photic (light) stimulation.
The EDS process consists of an EEG, and a computer to analyze the brainwave signals, converting them into light stimulation. The client sits comfortably, eyes closed, engaged in no specific task while the EEG-driven light is displayed to them through a set of glasses. The glasses are equipped with lights flashing at a rate matched to the client's brain waves. While the client is receiving the stimulation, the resultant brain waves are displayed on a color monitor so that the therapist can see what is occurring both during and after stimulation.
EDS is completely passive and has the goal of increasing brain functioning, as evidenced by greater excursion (flexibility) of the dominant frequency (the frequency of the strongest brain wave) up and down the brain wave spectrum. Before exposure to stimulation, the movement of the autistic individual's dominant frequency was restricted by the immense amount of energy in the low and mid frequencies. As that energy decreases through the effects of the stimulation, the dominant frequency is no longer restricted. More important, as the energy of the low and mid frequencies decreases, the individual becomes less frightened, less ritualistic and perseverative, clearer, more energetic, less depressed, more comfortable, more thoughtful, and better coordinated.
The EDS process is similar to brain wave biofeedback in that it gives back to the person information about their physiological processes. It is different from other forms of biofeedback in that the feedback requires no conscious learning, attention, or homework, a plus considering that the individuals involved in the process all have cognitive, mood, energy, and movement problems.
The EDS system was first used on closed-head injury clients. Over the next six years, Ochs found that EDS had applications for any disorder associated with low and mid-frequency activity, including stroke, fibromyalgia, depression, attention deficit disorder (ADD), and autism. The high amplitude, low and mid-frequency activity, called Delta and Theta band activity, is called "EEG slowing."
It has been known for years that the brain sends messages both electrically and chemically, and that the amount and kind of chemicals present can greatly influence how a person perceives, feels and thinks. "Wonder drugs" like Prozac and Lithium have been enormously effective in correcting emotional disabilities such as bi-polar mood disorders. Ochs theorizes that EDS also alters the brain chemistry. He believes that when the brain is traumatized, either physically or psychologically, it secretes certain chemicals that help protect it from further injury. How this works and which chemicals are involved is still unknown. However, it is theorized that these chemicals also limit brain functioning. The brain appears to lose the ability to function flexibly and proportionately to both outer and inner stimuli. These inhibitory chemicals, as much as any structural problem, prevent normal functioning. While tissue damage may have occurred, the amount of impairment attributable to structural damage may be less extensive than is usually believed. This is based on the discovery by Ochs that light and sound stimulation which carefully track the electrical changes in the brain may relatively rapidly return functions that were thought to be permanently lost.
The salutary effects of EDS have persisted long after treatment has been discontinued (unless the person suffers another trauma), with side-effects similar to those from any change in a person's situation, i.e. anxiety, lack of familiarity with improved functioning, doubts, outdated self-image, etc. EDS is non-invasive and involves no drugs or psychotherapy. Any discomfort that clients may experience can usually be dealt with by changing the protocol within the sessions, or relieved by a brief session of a just few minutes of light stimulation if discomfort develops.
In order to return the brain to its pre-trauma level of flexibility, Ochs sets the lights in the glasses to keep flashing at frequencies that are related to, but not exactly the same as the client's strongest brainwaves. The flashing frequencies are to a large extent, but not completely, matched to the brain activity of the client, in a way much psychotherapy and interaction in matched to the behavior and expressions of the autistic treatment. He has found it important not to overload the brain, and that a client must be exposed to extremely dim lights for only short periods of time for this process to be successful. Most of the time, in fact, the brightness of the lights is kept below the level of visibility, at a level still detectable by the brain, with effects measurable in the EEG. Ideally, the treatment should be given daily for however long it takes to eliminate that client's particular symptoms.
EDS light stimulation is very different from that used by neurologists to evoke and study seizures. The light stimulation used by Ochs is much dimmer and is constantly changing in frequency as it follows the person's own brain waves. The client cannot be more than momentarily stimulated at the frequency of a seizure because the system is set to stimulate at other than the dominant or strongest frequency. In addition, Ochs has noted an advantageous side effect of the treatment: clients who have seizures show decreased seizure activity both during and after receiving stimulation. Clients report that EDS has the same effect as their anti-convulsant medication and consider EDS to have anticonvulsant properties.
Autism, from Ochs' point of view, is a pervasive, developmental nervous system dysfunction. The term, autism, applies to a class of problems characterized by a lack of clarity of consciousness, difficulty taking in, processing and integrating stimulation, and disturbances in mood, thinking, movement and energy. These are the same problems that he has found to be associated with other disorders associated with EEG-slowing. The traces of intellectual brilliance, as well as perseverative, and ritualistic behavior, combined with social withdrawal, explosiveness, and communications problems give autism its particular flavors.
Ochs sees autism as one end of a continuum, followed by Asperger's Syndrome, Attention-Deficit Disorders (ADD), Asperger's Syndrome to Normal, at the far end of the continuum. Each disorder is distinguished by the number of domains in which a person is reactive. In autism, no reaction can be as inappropriate and disturbingly extreme as a wildly expressive reaction. People with autism will under or over-react in more areas than those with Attention Deficit Disorder, Asperger's Syndrome, etc.
Ochs does not speculate on the cause of autism. However, he does believe that stimulation problems lay at the center. People with autism frequently have great difficulty relating to others, not because of psychological deprivation by a "cold" mother, or stubborn resistance, but because when they try, they are overdosed by their own internally produced stimulation. In other words, whenever they start to accomplish a task, they are overwhelmed. In the rehabilitation field this is called a problem of "initiation." That is, the person is unable to initiate all sorts of behavior because starting to do something, beginning a project, making interpersonal contact, or writing a letter, cause so much trauma, in whatever way, that those behaviors are never undertaken. Initiation problems appear to be problems of lack of motivation. In reality, people with these problems try too hard, and are incapacitated by their over-reactive brains.
Using EDS with the autistic population, Ochs has observed that extreme reactions grow shorter in duration and ultimately less intense. Interestingly, as they become shorter in duration, they initially appear to be growing more intense. Eventually, as people become more comfortable with more stimulation, they become less anxious, more spontaneous, and more at ease with themselves and others. They struggle less to control themselves because their reactions lose their extreme intensity. They become more discriminant about their emotions, more thoughtful before acting, less perseverative in their speech and less stereotyped in their motions.
What this has meant to parents in real-life terms has been most rewarding. Their children became better able to understand things from another's point of view. Their social behavior become more appropriate. Day-to-day interactions became easier for them. There were fewer fights; behaviors such as biting and head banging have reduced or eliminated; and much less energy has had to be expended to get the child to move through the day's activities. It became easier for the child to fit in and benefit from school, and relieved the parents from having to make the painful decision of whether or not to institutionalize the child. Frequently, children responded more easily in social situations, or called a parent "Mother" for the first time. The children became more open to instruction, giving them pleasure out of childhood activities like bowling, or baseball. They now take instruction and make improvements in their playing which made games enjoyable for them. Fine-motor coordination has increased. Clinging behavior also decreased. One mother of a nineteen year-old man with autism noticed that her son now walked ahead of them on walks through the country rather than clinging to them as they walked. This allowed the son time to be by himself while his parents caught up, and gave him time to really see the things around him for the first time.
Another mother noticed that her son with Asperger's syndrome became much less of a recluse, got part time jobs, took college classes while still in high school, and went to Europe by himself. This young man, who was suicidal before kindergarten, found himself enjoying the beauty of a sunset and laughing while reading Dorothy Parker. He was able to see reasons to be alive for the first time in his life. While he continued to have a hilarious sense of humor and great creativity, his former excessive tendencies to comply and blend in were replaced with a keen sense of not wanting to waste his time with those whose company he didn't enjoy. The inevitable adjustment that the parents and schools often make &endash; sometimes with mixed happiness, fear, and exasperation &endash; is that the children become more independent, self-directed, opinionated, and may develop management problems that such independence often brings with it.
Management of emotions improves because there is an increased and easier awareness of feelings, as well as of cause and effect. The children are better able to realize what they feel, and what made them feel the way they do. They also become better able to talk about their feeling rather than simply bursting into a tantrum. All these changes amount to a child who is more relational, learns better, is more cooperative, happier, and requires less supervision. While changes at first seem small, they are monumental to those involved, and they continue to develop as EDS application continues.
While EDS is lacking sufficient clinical trials to met FDA approval, research is continuing to bring increasing understanding of the brain's functioning through an examination of clues to its functioning, clues in the form of brain waves. Ochs-trained EDS therapists continue to share their insights and learn new ways to fine tune the EDS system. The therapists using EDS continue to practice on both coasts in the United States, in Canada, Mexico, and in Australia, and contribute to research into a wide range of functioning problems. The end result is that clients continue to receive therapy custom-tailored to them and to their biology. The people affected by autism are beginning