Pilot Project to Ascertain the Utility of Tower of London Test to Assess Outcomes of Neurofeedback in Clients with Asperger's Syndrome

Abstract

Introduction. Behavioral and cognitive improvements in clients with Asperger’s Syndrome (AS), employing continuous performance tests (CPTs), intelligence and academic measures, and electroencephalographic data, have been reported following 40 sessions of neurofeedback (NFB) training combined with coaching in metacognitive strategies. However, measures of executive functions (EFs) in this population have not been commonly employed and NFB is still not commonly used as a treatment for AS. Therefore, this pilot project used Tower of London – Drexel University (ToLDX), an individually administered test of EFs, in addition to the previously mentioned measures. The goal of the current study was to investigate the utility of ToLDX as an assessment tool for clients with AS as well as further study the effects of NFB and training in metacognitive strategies on executive functioning in clients with AS. Method. Nineteen consecutive clients at the ADD Centre, Toronto, Canada (M age=12 years 0 months) recruited over a 2½-year period all had full clinical assessment, completed age appropriate questionnaires, and were tested pre- and post-40 NFB sessions. Results. Following the training, clients with AS were able to plan more efficiently, inhibit premature responses, and shift set with greater ease, as well as solve problems more quickly as measured by their ToLDX scores. On CPTs, clients with AS showed a trend toward less impulsivity. Finally, improvement in their scores on ToLDX was not affected by age or IQ. Conclusion. These data are important because they provide an extension of results of previous studies (Reid, 2005), demonstrate the utility of tests of executive functions in a clinical setting with clients with AS, and suggest directions for further controlled research in this area.