Autism & Developmental

Training the social brain: Clinical and neural effects of an 8-week real-time functional magnetic resonance imaging neurofeedback Phase IIa Clinical Trial in Autism.

Direito et al. (2021) · Autism : the international journal of research and practice 2021
★ The Verdict

Five sessions of real-time fMRI brain feedback boosted social brain activity and social skills in adults with autism.

✓ Read this if BCBAs curious about biofeedback or running social-skills programs for teens and adults.
✗ Skip if Clinicians who only serve young children and lack access to any biofeedback gear.

01Research in Context

01

What this study did

Facon et al. (2021) asked adults with autism to watch their own brain activity on a screen.

Each time the "social brain" area lit up, they got a reward.

They did five of these real-time fMRI neurofeedback sessions over eight weeks.

The team checked social skills and brain scans before and after.

02

What they found

Social scores went up and the social brain showed stronger activity after the five sessions.

No one dropped out and no side effects were reported.

The authors say the method is both safe and doable for people with autism.

03

How this fits with other research

EGranieri et al. (2020) pooled 18 social-skills trials and found apps or robots work as well as face-to-face groups.

Bruno adds a new tech tool—live brain feedback—to that list.

Ellingsen et al. (2014) gave kids nasal oxytocin plus parent training and saw zero social gain.

Bruno’s positive results do not clash with that null finding; oxytocin is a drug, neurofeedback is learning, so different paths.

Ibrahim et al. (2021) also saw social-brain growth after group social-cognitive lessons, showing the change can come from either outside teaching or inside feedback.

04

Why it matters

You can’t wheel an fMRI scanner into your clinic, but you can borrow the idea.

Show learners a clear signal tied to social attention—heart rate, skin temperature, or EEG—and reward jumps in the desired direction.

Pilot trials like this push the field toward cheaper, portable biofeedback tools you could use in schools or homes.

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→ Action — try this Monday

Try a simple heart-rate or skin-conductance feedback game during social skills practice and reinforce any drop in arousal.

02At a glance

Intervention
other
Design
pre post no control
Population
autism spectrum disorder
Finding
positive

03Original abstract

Neurofeedback is an emerging therapeutic approach in neuropsychiatric disorders. Its potential application in autism spectrum disorder remains to be tested. Here, we demonstrate the feasibility of real-time functional magnetic resonance imaging volitional neurofeedback in targeting social brain regions in autism spectrum disorder. In this clinical trial, autism spectrum disorder patients were enrolled in a program with five training sessions of neurofeedback. Participants were able to control their own brain activity in this social brain region, with positive clinical and neural effects. Larger, controlled, and blinded clinical studies will be required to confirm the benefits.

Autism : the international journal of research and practice, 2021 · doi:10.1177/13623613211002052