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Controlled Analysis of EEG Coherence and it’s impact on Learning Disabilities
Robert Coben, PhD
Co-Founder/Neuropsychologist, integrated neuroscience services, LLC
Presented at ISNR 2015, Denver, Colorado
The child does not achieve adequately for the child’s age
or to meet State-approved grade-level standards in one or
more of the following areas, when provided with learning
experiences and instruction appropriate for the child’s age
or State-approved grade–level standards:
Oral expression.
Listening comprehension.
Written expression.
Basic reading skills.
Reading fluency skills.
Reading comprehension.
Mathematics calculation.
Mathematics problem solving.
IDEA 2004:
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The group determines that its findings under paragraphs
(a)(1) and (2) are not primarily the result of—
(i) A visual, hearing, or motor disability;
(ii) Mental retardation;
(iii) Emotional disturbance;
(iv) Cultural factors;
(v) Environmental or economic disadvantage; or
(vi) Limited English proficiency.
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Calculating Delays
O IQ-Achievement discrepancy cannot be used.
O Calculate expected grade equivalent.
O Calculate learning quotient.
O Expected Grade Equivalent = (IQ x CA / 100) – 5
O Learning Quotient = Reading age/Expectancy age
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The diagnosis of LD
O Can only be done through neuropsychological/educational testing.
O That must show a significant delay compared to expected or “normal.”
O No IQ-Ach Discrepancy.
O Not from neuroimaging.
O Not from QEEG, Discriminant functions.
Types of Specific Learning Disabilities
O Satz, P. & Morris, R. (1981). Learning Disability Subtypes: A review. In Pirozollo & Wittlock (Eds.): Neuropsychological and Cognitive Processes in Reading. NY: Academic Press.
O 236 students tested with educational and neuropsychological measures subjected to cluster analysis.
O Achievement variables: two groups (89 students) had low scores. Low in reading spelling math by at least two years.
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Types of Specific Learning Disabilities
O Satz, P. & Morris, R. (1981). Learning Disability Subtypes: A review. In Pirozollo & Wittlock (Eds.): Neuropsychological and Cognitive Processes in Reading. NY: Academic Press.
O Neuropsychological variables: 5 subtypes emerged.
O 1) language measures (fluency, vocab, comprehension), 2) verbal fluency, 3) language and visual-pereptual, 4) only visual-perceptual, and 5) no impairment.
O 1-3-4 had more positive findings/achievement/neuro
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LD Subtypes: Neuropsychology
LD Subtype Achievement Neuropsychology
Dyslexia Reading, Reading Fluency, Reading Comprehension
Visual form perception,semantics, comprehension, phonology
Dysgraphia Writing, Drawing, Copying
Visual perception, visual-motor integration, visuospatialorganization
Dyscalculia Mathematics Visual form, visual discrimination, executive functions – problem solving
Spelling Spelling, Word formation
Visual form, sequencing, lexical, semantic, phonology
Mixed Combinations Multiple impairments
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Dyslexia
O Reading achievement, as measured by individually administered standardized tests of reading accuracy or comprehension, is substantially belowthat expected given the person's chronological age, measured intelligence, and age-appropriate education.
O The disturbance in Criterion A significantly interferes with academic achievement or activities of daily living that require reading skills.
O If a sensory deficit is present, the reading difficulties are in excess of those usually associated with it (the specific sensory deficit).
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Mixed Specific Learning Disabilities
Mixed LDReading / Reading Comprehension
Math / Writing
Math / Spelling / Writing
Reading / Spelling / Writing / Math
Reading / Spelling / Writing
Treatment Intervention
Intervention Efficacy
Medications None
Education as usual None
Resource Room Negative
LD Training Programs Minimal
Neurofeedback ?
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Institute of Educational Sciences: What Works Clearinghouse
Reading Intervention Findings
Wilson Reading Program No efficacy
Read 180 No efficacy
Voyager Reading Program No efficacy
Reading Mastery Minimal
Lindamood Phoneme Sequencing
Minimal
Fast Forward Medium for alphabetics but not reading fluency
Repeated Reading Only for comprehension
Spelling Master Medium
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Neurofeedback
O Most papers are of case studies and case series.
O The first group studies were those of Fernandez et al. (2003) and Orlando and Rivera (2004).
O Only a handful of group, controlled studies since that time.
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The impact of Coherence Neurofeedback on Reading
Delays in Learning Disabled children: A
randomized controlled study
Robert Coben, PhD*
Integrated Neuroscience Services, Fayetteville, AR
Emma Kate Wright, MA
University of South Carolina, Columbia, SC
Scott L. Decker, PhD
University of South Carolina, Columbia, SC
Tina Morgan, BA
NeuroRehabilitation and Neuropsychological Services, PC,
Massapequa Park, NY
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Method: Forty-two school-aged participants were randomly
assigned to experimental and control groups. The experimental
group received QEEG-guided, individually-tailored, 2-channel
coherence training/neurofeedback over the left hemisphere. This
included two sessions per week for a total of 20 sessions. The
control group they were compared to received typical resource
room instruction at school. All participants received pre- and
post-training educational measures focused on reading, reading
fluency and reading comprehension.
Results: Comparing these two groups, there were no significant
differences for various demographic variables or baseline reading
scores. Following the intervention period, the experimental group
enhanced their reading scores, while the control group did not.
Coherence neurofeedback led to an average enhancement of 1.2
grade levels in reading scores, but resource room instruction led
to no such improvement at all.
3 3 3 3 3 3 3
2 2 2 2 2 2
1 1 1 1 1 1 1 1 1
8.00 9.00 10.00 11.00 12.00 13.00 14.00 15.00
Estimated mean = 12.03 ± 0.563
11.467 12.593
Distribution of age
33
81
0 0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8 0.9 1.0 1.1 1.2 1.3 1.4 1.5 1.6 1.7 1.8 1.9 2.0 2.1
Estimated mean = 0.238 ± 0.151
0.087 0.389
Distribution of medication
No significant diff for any of these variables between the groups.
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(Mann-Whitney, p = 0.240)
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Effect Size of Intervention
-0.29
0.65
0.77
1.99
-1 0 1 2 3
resource rm
reading
O & R
Coben et al
effect size
effect size
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Case formulation: Dyslexia
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Controlled Analysis of EEG Coherence and it’s impact on Learning Disabilities
O Total sample of 63 children and adolescents with documented Learning Disabilities.
O Pre and post educational testing and qeeg.
O Random assignement to one of three groups: resource rooom, 2 channel coherence training, 4 channel multivariate coherence training.
O Change in reading scores was primary dependent variable. Also following math and writing changes.
EEGer4 QPSO EEGer4 version 4.30f and later includes an option
for a 4-channel coherence mode.
O Smoothing of the signal is performed with EWMA
(weighted moving average) filter:
O In EEGer psync is a feedback mode which is a
coherence measure between peak values (user
specified for the reward band):
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QPS: Averaging coherences
A method of combining averaged psync values.
4 channels of EEG
Each pair has a running psync calculation
For each channel, the 3 pairs of psync values are computed, averaged and this is used as the output reward value
If a raw channel is in artifact condition, the channel is not used in the averaging calculation
A
B
C
D
A = (AB + AC + AD)/3B = (BA + BC + BD)/3C = (CA + CB + CD)/3D = (DA + DB + DC)/3
QPS Ave = (A + B + C + D)/4
QPS Average
O 3 modes:
O Avg: average value (sum/samples)/number of samples
O Lag: delay constant can be specified
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4 4 4
3 3 3 3 3 3
2 2 2
1 1 1 1 1 1
6.00 7.00 8.00 9.00 10.00 11.00 12.00 13.00 14.00 15.00 16.00 17.00 18.00 19.00
Estimated mean = 11.887 ± 0.579
11.308 12.467
Distribution of age
52
91 1
0 0.2 0.4 0.6 0.8 1.0 1.2 1.4 1.6 1.8 2.0 2.2 2.4 2.6 2.8 3.0 3.2 3.4 3.6 3.8
Estimated mean = 0.222 ± 0.139
0.083 0.361
Distribution of medication
21
8432 2 2
11 12 13 14 15 16 17 18 19 20
Estimated mean = 17.048 ± 1
16.048 18.047
Distribution of # of sessions
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Number above 1 month per session
0
2
4
6
8
10
12
14
16
18
% above
2 ch
4 ch
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Percent above 1 month per session
0
20
40
60
80
100
% above
2 ch
4 ch read
4 ch math
4 ch write
Nineteen year old male seen for symptoms of ADHD, LD
O FSIQ = 92
O Delays in reading, comprehension, writing
and reading comprehension (7 – 9 years)
O Severely impaired word processing
O Attention basically intact
O Rated as high for attention problems,
working memory and intiation
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Enhanced academics
Academics Pre Post
Reading Fluency 12-11 14-5
Reading Comprehension
11-6 16-11
High rating of attention and working memory problems
have normalized.
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Twelve year old with speech and language delays
!
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Improved speech/language abilities
6063
58
8076
7068 69
9288
82
7779
98
40
50
60
70
80
90
100
CELFCoreLanguage CELFExpressive CELFRecep ve WJIIIReadingFluency
WJIIIReadComp
Time1 Time2 Time3
Reading fluency: 8.9 11.9. Pass Comp 8.4 11.6
References
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