Abstracts

Rationale: Obtaining quality electroencephalograms (EEG) can be extremely challenging in children and adults with behavioral difficulties and sensory defensiveness. Utilization of dense array EEG (dEEG) sensor nets allow placement of large numbers of electrodes in minutes, painlessly, and without the need for scalp abrasion or electrode pastes, allowing dEEG acquisition without sedation or restraint. A small number of individuals will require augmentation with behavioral desensitization protocols.Methods: Retrospective review and analysis of 1,149 patients with autism spectrum disorders (ASDs) and/or other behavioral challenges undergoing dEEG from 2010-2015 (Ages 1-30 years, mean = 10 years). dEEG were acquired without sedation or restraint. For the small number of patients that dEEG acquisition was unsuccessful, a systematic desensitization protocol was implemented, consisting of gradual and repeated exposure and familiarization with the dEEG sensor net and the acquisition process.Results: dEEG were obtained for 377 individuals diagnosed ASD, 34 diagnosed oppositional-defiant disorder, and 738 with ADHD of childhood. 1,131 (98%) patients had successfully acquired and fully interpretable dEEG studies without sedation or restraint on the first attempt. Eight (1%) were successful after augmentation with an analytical desensitization protocol. dEEG acquisition was unsuccessful on first attempt in 10 patients (1%), but they opted not to participate in desensitization.Conclusions: dEEG studies can be obtained in a majority of children and adults with behavioral challenges without sedation or restraint utilizing specialized sensor nets. In the minority unsuccessful on the first attempt, augmentation with desensitization protocols will improve yields further. Three examples of clinical desensitization: 5-year-old female diagnosed with severe autism and focal seizures. Progressive exposure to dEEG was conducted for 8 weeks during her regular neurologic music therapy sessions. At the 8th week, patient requested, “net on”, and a successful 24-minute dEEG was obtained. dEEG was reportedly abnormal, showing 183 spike and slow waves during the 24-minute recording. As a result, there was efficacious medication adjustment. 6-year-old male diagnosed with severe autism, with aggressions and non-compliance. Progressive exposure to dEEG was conducted over the course of two months. 21-minute dEEG was successfully completed during his 13th session, and was followed by two more successful 41-minute dEEGs, two and three years post-desensitization. 8-year-old male diagnosed with severe autism, with an inability to sit in a chair for more than five consecutive seconds and an intolerability of wearing items on the head. Progressive exposure to the dEEG process was conducted over the course of seven months during the patient’s regular therapy sessions. 21-minute dEEG was successfully completed during the 33rd session.