Viktor, 15, autistic traits, ADHD

One year of neurofeedback training resolved autistic traits, ADHD and medication

Summary:

Victor, a 16-year-old student about to enter year 11 (10th grade), faced significant challenges in his life, particularly related to mental health issues. His parents were deeply concerned about his ability to start the school year at his boarding school. He had experienced panic attacks, engaged in excessive checking behaviors, and struggled to socialize, even with familiar individuals.

Victor had a history of mental health issues, including an ADHD diagnosis at a young age. He had been prescribed stimulant medication, which had initially been helpful but had lost its effectiveness over time. Additionally, Victor displayed several symptoms associated with Autism Spectrum Disorder (ASD), such as deficits in social functioning, repetitive behaviors, inflexibility with routines, and difficulties with perspective-taking.

Neurofeedback training was initiated, and Victor’s brain map confirmed many of these traits, along with other vulnerabilities. He showed signs of sensory overwhelm and hypervigilance, as well as various anxiety markers, mood control issues, distractibility, and low self-worth.

As Victor underwent neurofeedback sessions while watching light comedies and series, he began to experience increased calm and self-assuredness. Notably, his mother expressed concern about his continued panic attacks and his ongoing use of stimulant medication. After discontinuing the medication, Victor’s anxiety significantly decreased.

By mid-term, Victor’s self-confidence had improved, and he had made friends at his boarding school. He began participating in extracurricular activities, which was a positive change from his previous social isolation. His parents noted his emotional progress and newfound maturity.

However, Victor’s academic performance was lagging, resulting in poor mock-GCSE exam results. To address this, he received additional support and guidance for self-study, as well as limits on his game console use. His parents worked to help him structure his self-study time, and they implemented sanctions.

The continuation of neurofeedback training from January through May focused on addressing Victor’s anxiety related to upcoming exams and improving his focus, motivation, and sequencing of actions. This effort paid off as Victor began studying more effectively, and his attention and interest in subjects improved. He successfully navigated his GCSE exams, and his parents organized an internship for him over the summer.

Despite his success during the exam period, Victor experienced conflict with his father, which resulted in a return of checking behaviors, difficulties sleeping, and apprehension about the upcoming internship. A few neurofeedback sessions helped him regain his composure and assert himself in expressing his desires and boundaries. Victor showed significant personal growth throughout this period, transforming from a shy, underperforming child into a more self-assured and confident individual.

Victor's Full Story:

Victor is 16 years old. A year ago, his parents were extremely concerned about his ability to start the school year at his boarding school. About to enter year 11, or 10th grade, he would be due to sit his GCSE exams that are hugely important for university application. His self-confidence was decimated; he was suffering frequent panic attacks; engaged in checking behaviour regarding fire safety and other hazards; felt unable to socialise, even with familiar persons; and his constant anxieties were a burden on him and his parents.

Victor had a history of mental health issues and his mother engaged both a psychiatrist and life coach since he was nine years old. Diagnosed with ADHD at this early age, he was prescribed stimulant medication, which had initially boosted his confidence and raised his academic performance substantially; however the positive effects had abated in recent years as his grades slumped, confidence eroded and the (low) dosage was maintained. Victor was also found to have three out of five assessed ASD symptoms:

Deficits in social functioning: Victor appeared oblivious to social boundaries and conversational cues, masked in part by shyness and hypervigilance, especially in unfamiliar surroundings. His friendships were limited to peers he had grown up with and who were now in different schools, and on steeper academic trajectories that widened the gap in their interests and ambitions; at his boarding school, he showed loner qualities despite social encouragement from his housemaster and activity organisers
Mild repetitive, restrictive habits of self-regulation, such as resorting to playing console games for hours on end despite every effort to present him with social engagements and activites; and a hyperfixation on following his favourite sports of basketball and football (soccer), a motivation and interest that did not translate into any other subject areas, including school
Inflexibility with regard to changes of plans and daily routines; a need to understand exactly what new experiences such as travel and activities would entail, accompanied by a low appetite for risk, exploration and novelty; exacting requirements for food choice, preparation and presentation, for example having to clearly separate vegetables from meat on his plate, and limited options; and a complete lack of ability to sequence, plan and anticipate future developments, from daily time management, which was compensated by a tight school and after-school schedule with tutoring; to career choices and consequent school options, which contrasted starkly with his younger brother

To his mother, Victor appeared to be living in his own fantasy world. He was not learning essential living skills, which was not helped by possibly excessive attention and servants at home catering to his every need. Her ambition for him to follow his father’s footsteps in attending a prestigious US university and becoming a successful banker seemed far removed from Victor’s lack of vision and engagement with his environment. The immediate disconnect however materialised in his parents’ concern that he felt unable to commence this crucial school year.

A few weeks into his first term, we began neurofeedback training with a brain map and a first session on a Saturday, as he had chosen not to take part in weekend activities at school and preferred to return home. His brain map confirmed many of the traits above, and showed other vulnerabilities. Of particular concern was a sense of feeling sensory overwhelm that contributed to his rigidity of thought. He mentioned that he felt that at times he thought people were talking about him, when in fact they weren’t. Various trauma markers showed up, as did social and general anxieties, mood control and motivation issues, severe distractibility, personal space and social boundary issues, feelings of guilt and a lacking sense of self-worth, organisational and executive deficiencies, self-absorbtion and tendency to prioritise internal content, a lack of sense for the intention of others and an active, unfulfilled search for being part of a group or greater cause. Structurally, his brain had developed soundly and in line with expectations, which was encouraging.

Victor enjoyed the neurofeedback sessions, choosing light comedies and series such as “Friends” and “Ted Lasso”, which he could watch for two hours at a time. He began feeling calmer and more self-assured. After the fifth session, his mother expressed concern that his panic attacks had not subsided, occurring especially when left to his own devices. Victor was still taking stimulant medication prescribed for his ADHD diagnosis, and in consultation with him and his psychiatrist, he agreed to stop taking it, particularly as he felt they were no longer of any benefit to him. Within two sessions, his anxieties had dropped immensely and he reported no further panic attacks. It is noteworthy that a brain map after the tenth session showed a remarkable change in his ability to take on different perspectives and proneness to relational thinking, or the sense that everything is directed at oneself, which can be a precursor or constituent of psychosis. We will never know whether it was the stimulant medication in the first place that instituted this vulnerability, and/or whether neurofeedback training made him more sensitive to the medication and thus helped him transition off it.

By mid-term, Victor expressed that he “felt really good about myself”, and the family trip abroad went well, without the expected fallbacks. He also enjoyed a much daunted school trip, getting to know other peers from different classes. By Christmas, he felt free from anxieties and of particular note, had established a circle of friends at boarding school that gave him confidence and a sense of belonging. He started to remain at school some weekends, joining the tennis team and other extracurricular activities. Victor’s parents were delighted by his emotional progress. In parallel, it was noticeable how Victor was maturing emotionally, exemplified by his choices of movies, and comments on their content and plot developments. He asked his parents to talk him to theatre performances during this time, and was commended for his performance and initiative in his school drama class.

Victor’s academic performance however had been lagging, and the mock-GCSEs before his mid-term break produced atrocious results. His mother was panicking, and his father upset. Provided with every tutoring resource, Victor appeared not to be able to manage his own time, and although his tutors reported a new level of focus they had not seen in him before, this was still conditional on substantial guidance and ‘warm-up’ in each session. It seemed that he was not provided with guidance and micromanagement of his self-study time, nor did Victor seem to feel accountable for his performance. A new plan was instated to help him structure his self-study, as well as sanctions on his game console use.

We continued with neurofeedback training from January through May, managing Victor’s natural anxieties regarding the upcoming exams, as well as working on sites relating to focus, distractibility, motivation and sequencing of actions. His tutors found that this worked – Victor was studying more effectively by himself, and his attention and interest in subject matter were transformed. GCSE exams are spread over the course of a month, and his mother was happy with his mental state, stating that he was “in a good space”. Victor seemed to hold up under the pressure, and made sure to integrate as much sports and activity into his limited free time as possible for balance. His parents were optimistic about his prospects, and organised an internship for him over the summer.

During the last week of exams, with the internship looming, Victor fell out with his father. Their relationship had never been close, as Victor felt a sense of pressure and expectations he couldn’t live up to. Suddenly, checking behaviour he had not shown for many months reappeared, and he had difficulties falling asleep. The upcoming placement became a daunting prospect, and his father became angry at his lack of enthusiasm, culminating in various confrontations. This contrasted strongly with the way Victor had managed his exam period. We did three sessions before his summer vacation, which calmed him substantially and helped with the guilt and disappointment he feared to have caused. Victor appeared to have been pushed too far by his father’s ambitions, stood his ground with respect to his desire, which was to relax and spend time with his friends after the stressful exam period, and asserted himself naturally. There was a noticeably stronger sense of self, and Victor appeared to be a transformed person from the shy, underperforming child he presented as less than a year earlier.