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EEG Neurofeedback & Quantitative Electroencephalogram ( qEEG ). A Comparative Case Study of a SMTC Resident. Client Background History:. Caucasian male; age twelve at the onset of treatment. Experienced parental neglect and abuse from birth to age six.
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EEG Neurofeedback & Quantitative Electroencephalogram (qEEG) A Comparative Case Study of a SMTC Resident
Client Background History: • Caucasian male; age twelve at the onset of treatment. • Experienced parental neglect and abuse from birth to age six. • Placed in numerous foster homes since age six.
Presenting Symptoms: • Suicidal verbalizations and behaviors • Severe impulsivity and explosive anger • Severe defiant, disruptive, or destructive behavior • Dangerous, self-injurious, or unsafe behaviors • Severe deterioration of functioning • Serious lack of development of age appropriate functioning • Serious depressive symptoms • Aggressiveness or assaultiveness • Recurrent thoughts, impulses, or images • Irritable or labile mood • Enuresis
Admitting Diagnoses: • Posttraumatic Stress Disorder • Attention-Deficit/Hyperactivity Disorder • Oppositional Defiant Disorder • History of Reactive Attachment Disorder • Rule-Out: Mood Disorder • Rule-Out: Learning Disorder • Rule-Out: Intermittent Explosive Disorder • Rule-Out: Complex-Partial Seizure Disorder • Suspected History of Child Physical and Sexual Abuse • Suspected Fetal Drug and Alcohol Exposure
Treatment History: • Multiple inpatient admissions to North Star Behavioral Health System between May and August 2013, with a brief period spent at Palmer Residential Treatment Center in the beginning of August 2013. • Transferred to San Marcos Treatment Center on October 1, 2013. • Has also been receiving outpatient counseling services from a local counselor for approximately three years
Neuropsychological Evaluation Results: May 18, 2013 Within Normal Limits: • Full Scale IQ (SS=90) • Verbal Comprehension (SS=88) • Perceptual Reasoning (SS=94) • Working Memory (SS=94) • Processing Speed (SS=97) • Visual Spatial Processing • Social Perception • Language Skills • Sensory Motor Integration Below Normal Limits: • Sustained Attention and Concentration • Executive Functioning (patterns, sequences, cause & effect relationships) • Memory/Learning
Quantitative Electroencephalogram (qEEG) The qEEG is a painless and non-invasive procedure which begins with data collection. The scalp is prepared and measurements are calculated.
Quantitative Electroencephalogram (qEEG) A stretchable elastic electrode cap is slipped onto the head, and the recording electrodes filled with a water soluble contact gel.
Quantitative Electroencephalogram (qEEG) Brain waves are then recorded onto the computer while the client relaxes with eyes closed and with eyes open.
qEEG Recommended Protocols: • Suppress frequency activity 8 - 10 Hz at O2. • Suppress frequency activity 9 - 10 Hz at F3. • Reinforce EEG coherence at 8 – 12 and/or 15 - 18 Hz between FP2 and F8.
Completed Treatment Protocols: From October 2014 to May 2015: • SMR 12-15 Hz @ C4 (27 sessions) • Suppress 8-10 Hz @ O2 (14 sessions) • Suppress 9-10 Hz @ F3 (14 sessions) • Suppress 15-18 Hz @ FP2 (12 sessions) • Suppress 8-12 Hz @ FP2 (10 sessions) • Suppress 15-18 Hz @ F8 (12 sessions) • Suppress 8-12 Hz @ F8 (10 sessions)
Absolute Power (Linked Ears): February 4, 2014 May 19, 2015
Absolute Power (Linked Ears): February 4, 2014 May 19, 2015
Absolute Power (Laplacian): February 4, 2014 May 19, 2015
Absolute Power (Laplacian): February 4, 2014 May 19, 2015
Amplitude Asymmetry: February 4, 2014 May 19, 2015
Coherence: February 4, 2014 May 19, 2015
Phase Lag: February 4, 2014 May 19, 2015
Predicted Neuropsychological Scores: February 4, 2014 May 19, 2015
Conclusions: • Discharged from SMTC in June 2015 • His caseworker reported that he has shown significant improvement in many emotional and behavioral domains • He continues to exhibit occasional issues with: • Hyperactivity • Impulsivity • Lack of development of age-appropriate functioning • Enuresis
Conclusions: • Adopted by a family in Alaska • Enrolled in regular public school. School is no longer perceived as a trigger for behavioral issues • Predicted IQ scores from the qEEG suggest an IQ increase near one standard deviation compared to his May 2013 neuropsychological evaluation.