Introduction of Neurofeedback and QEEG at The Hong Kong Polytechnic University

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1 Introduction of Neurofeedback and QEEG at The Hong Kong Polytechnic University P R E S E NTED B Y : K I M - H U N G S I N A c t i n g C e n t r e C o o r d i n a t o r Y a n O i T o n g C h i l d D e v e l o p m e n t C e n t r e T h e H o n g K o n g P o l y t e c h n i c U n i v e r s i t y

2 Outline Introduction of The Hong Kong Polytechnic University The Psychological Service with NF at The HK POLYU The background Experience sharing on ADHD NF Introduction of academic studies NF on Chinese Dyslexic Children (associated with ADHA) Implementation Intention on Low-Privileged Adolescents - A EEG study

3 The Hong Kong Polytechnic University

4 The Hong Kong Polytechnic University

5 The Hong Kong Polytechnic University The story of The Hong Kong Polytechnic University can be traced back to the founding of the Government Trade School in The Hong Kong Polytechnic was formally established on 1 August It was granted full university status on 25 November 1994, changing its name to The Hong Kong Polytechnic University.

6 The Psychological Service with NF at The HK POLYU A psychological service was established in 2014 in Yan Oil Tong Child Development Centre. Supervised by Dr. Raymond Chan who has been over 30 years in clinical practice for children and adolescents. Associate Professor at The HK PolyU and The HK University For Children who need clinical assessment and treatment such as ADHD, Emotional problem, Autism etc.

7 The Psychological Service with NF at The HK POLYU

8 Psychological Service with NF at The HK POLYU Clients are referred from psychiatrists and psychologists Age from 7 to 12 Most are suffered from ADHD at present

9 The Psychological Service with NF at The HK POLYU Successful case: A girl at 9 years old Neurofeedback training One session per week After 30 sessions Improved as evidenced Better in attention and focus in activities and learning as reported by the parents; Score 80% on task as reported by her school

10 The Psychological Service with NF at The HK POLYU Experience sharing: 1. Parents expectation 2. Motivation from NF trainer 3. Relationship between the therapist/trainer and the child 4. The activities and emotion before the training 5. Comparison with others such as brother 6. Family life style effect

11 NF on Chinese Dyslexic Children (associated with ADHA) Study Title : Implication of Neurofeedback on Cognitive Deficits in Chinese Dyslexic Children An Exploratory Study. (By Elizabeth Choi & Gladys Ho) Given the 30% co-morbidity between dyslexia & ADHD Children with dyslexia experienced various level of attention deficits (Vidysagar, 2004)

12 NF on Chinese Dyslexic Children (associated with ADHA) Empirical evidence for neurofeedback: Dyslexia Neurofeedback can improve dyslexic children s concentration and reading quotients and academic grades (Jacobs, 2005; Thorton and Carmody, 2005; Walker and Norman, 2006)

13 NF on Chinese Dyslexic Children (associated with ADHA) Neurofeedback: Power protocol Target: enhance beta wave activity (15-20Hz) and suppress theta activity (4-8 Hz) at the sensorimotor cortex. Power protocol was adopted to address the modular insufficiencies or excesses in the brain regions by enhancement and suppression respectively.

14 NF on Chinese Dyslexic Children (associated with ADHA) Neurofeedback: Power protocol (Attention) Theta activity: Indicator of non-alert (deep) mental state Reducing theta activity improvement in cognitive skills (Rippon& Brunswik, 2000; Orekhova, Stroganova & Posikera, 1999) Beta activity: indicator of focusing & sustained attention Increasing beta activity alleviate inattentive symptoms (Lubar & Lubar, 1984; Luber et al., 1995a) Dyslexic children, who often experience attention deficits, could benefit from power training with theta suppression/beta enhancement protocol. (lubar, 1980)

15 NF on Chinese Dyslexic Children (associated with ADHA) Neurofeedback: Coherence protocol Coherence protocol was adopted to address the brain dysfunctional connectivity found in dyslexic children. EEG coherence is a measure of the functional cooperation between the brain areas, and reflects the deviation in functional interplay between neuronal networks commonly found in the dyslexic population. Increased neurological efficiency Increased EEG coherence Increased learning ability

16 NF on Chinese Dyslexic Children (associated with ADHA) Neurofeedback: Coherence protocol (Attention) In term of cognitive functioning, Dyslexic children showed improved attention switching & response inhibition after integrated beta power and coherence training at C3 (Breterier et al., 2010)

17 NF on Chinese Dyslexic Children (associated with ADHA) In this pilot study Rationale & Hypothesis Implemented a theta suppression and beta enhancement NF training at the sensorimotor cortex (C3 and C4), using both power and coherence training protocols. The Hypotheses (extract) 1. NF training will lead to changes in their brain wave activity as reflected in the theta/beta ratios. 2. NF training will improve cognitive deficits of attention and inhibitory control in Chinese dyslexic children.

18 NF on Chinese Dyslexic Children (associated with ADHA) Participants characteristics (extract) 3 boys and 1 girl (aged from 4-11) All are dyslexic of various profiles; some with inattentive features, one co-morbid with ADHA All except one with average IQ;

19 NF on Chinese Dyslexic Children (associated with ADHA) Result (extract) Positive outcomes: Vigilance, response inhibition Phonological awareness etc. Not significant improvement (with favourable trend): Attention tasks Rapid digit naming Minimal improvement: Sustained attention literacy

20 NF on Chinese Dyslexic Children (associated with ADHA) Changes in theta/beta ratio was minimal at baseline changes observed later could be attributed to effect of neurofeedback treatment Decreasing trends of theta/beta ratios Neurofeedback training successfully reduced theta power and increased beta power in all participants. Consistent with findings of classic neurofeedback studies Imply improvement in alertness, attention and dyslexia-related outcomes.

21 Implementation Intention on Low-Privileged Adolescents - A EEG study <A new study in progress>

22 Implementation intention Background Low socioeconomic status Life stress Neighborhood quality Physical health Mental health Language Cognitive ability (Bradley, 2002; Heckman, 2006) IQ, school achievement, cognitive measures How about cognitive neuroscience?

23 Implementation intention

24 Implementation intention The model of action phases (Peter M. Gollwitzer) Predecisional phase To set a goal by making the best-possible choice between different wishes they entertain Form a goal intention Preactional phase Commitment To plan the implementation of the chosen goal when, where to start acting, how to act, and how long to act Actional phase Action initiation Postactional phase Evaluating the success of goal attainment

25 Implementation intention Implementation intentions They are if-then plans aimed at helping people overcome self-regulatory problems in goal striving by successfully achieving the task they are confronted with in the preactional phase of goal pursuit - preparing the execution of actions that are instrumental to attaining the chosen goal This form of planning is assumed to increase the likelihood of attaining one's objectives compared to the formation of a mere goal intention.

26 Implementation intention Go/NoGo tasks typically invoke the P300 component in the electroencephalogram (EEG). P300 occurs when selective attention is paid and a response decision is required. (Picton TW., 1992) NoGo stimuli evoke higher amplitudes than Go stimuli, reflecting the endogenous evaluation of response control or conflict monitoring. In children with ADHD the amplitude increase in response to NoGo stimuli compared with Go stimuli is less pronounced

27 Implementation intention - Objectives To investigate the effectiveness of implementation intention in socially disadvantage adolescents To investigate to neurocognitive mechanisms for implementation intention

28 Implementation intention - Hypotheses Implementation intention facilitate cognitive performances Frontal area (Fz, Cz) will be significant change for implementation group