Metacognitive Strategies
Research Papers
Pilot Project to Ascertain the Utility of Tower of London Test to Assess Outcomes of Neurofeedback in Clients with Asperger's Syndrome
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 21/2-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.
View Full Paper →Neurofeedback combined with training in metacognitive strategies: effectiveness in students with ADD
A review of records was carried out to examine the results obtained when people with Attention Deficit Disorder (ADD) received 40 sessions of training that combined neuro-feedback with the teaching of metacognitive strategies. While not a controlled scientific study, the results, including pre- and post-measures, are consistent with previously published research concerning the use of neurofeedback with children. A significant addition is that a description of procedures is included. The 111 subjects, 98 children (age 5 to 17) and 13 adults (ages 18 to 63), attended forty 50-min sessions, usually twice a week. Feedback was contingent on decreasing slow wave activity (usually 4-7 Hz, occasionally 9-11 Hz) and increasing fast wave activity (15- 18 Hz for most subjects but initially 13-15 Hz for subjects with impulsivity and hyperactivity). Metacognitive strategies related to academic tasks were taught when the feedback indicated the client was focused. Some clients also received temperature and/or EDR biofeedback during some sessions. Initially, 30 percent of the children were taking stimulant medications (Ritalin), whereas 6 percent were on stimulant medications after 40 sessions. All charts were included where pre- and post-testing results were available for one or more of the following: the Test of Variables of Attention (TOVA, n = 76), Wechsler Intelligence Scales (WISC-R, WISC-III, or WAIS-R, n = 68), Wide Range Achievement Test (WRAT 3, n = 99), and the electroencephalogram assessment (QEEG) providing a ratio of theta (4-8 Hz) to beta (16-20 HZ) activity (n = 66). Significant improvements (p < .001) were found in ADD symptoms (inattention, impulsivity, and variability of response times on the TOVA), in both the ACID pattern and the full-scale scores of the Wechsler Intelligence Scales, and in academic performance on the WRAT 3. The average gain for the full scale IQ equivalent score was 12 points. A decrease in the EEG ratio of theta/beta was also observed. These data are important because they provide an extension of results from earlier studies (Lubar, Swartwood, Swartwood, and O'Donnell, 1995; Linden, Habib, and Radojevic, 1996). They also demonstrate that systematic data collection in a private educational setting produces helpful information that can be used to monitor students' progress and improve programs. Because this clinical work is not a controlled scientific study, the efficacious treatment components cannot be determined. Nevertheless, the positive outcomes of decreased ADD symptoms plus improved academic and intellectual functioning suggest that the use of neurofeedback plus training in metacognitive strategies is a useful combined intervention for students with ADD. Further controlled research is warranted
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