Presenting concerns
- Minimally verbal: typically 1–3 word phrases.
- Significant frustration episodes when needs were misunderstood.
- Limited eye contact during structured tasks.
- Sleep onset latency averaging 60+ minutes.
qEEG findings
Elevated delta and theta power over left temporal regions (language network), with reduced alpha coherence between frontal and temporal sites.
Treatment plan & timeline
Protocol: qEEG-guided, low-frequency TMS targeting left temporo-parietal network, 5×/week × 6 weeks, then 2×/week × 6 weeks. SLP collaboration weekly.
Baseline
qEEG mapping, parent intake, baseline VB-MAPP and sleep diary.
Tolerance confirmed
Sessions well-tolerated. Sleep latency dropped to ~30 minutes.
Early verbal expansion
Spontaneous 4-word requests began appearing 2–3×/day.
Generalization
Verbal requests observed at school, not just home and clinic.
Repeat qEEG
Left-temporal delta normalized 38%. Alpha coherence improved.
Progress tracking — outcome metrics
| Measure | Baseline | Follow-up | Change |
|---|---|---|---|
| Mean utterance length (words) | 1.9 | 5.4 | +184% |
| Spontaneous requests / day | 4 | 22 | +450% |
| Sleep onset latency (min) | 62 | 18 | −71% |
| Frustration episodes / week | 11 | 2 | −82% |
Parent observations
- “He started asking for the show by name instead of pointing.”
- “Meltdowns at transitions dropped from daily to about once a week.”
- “He's sleeping through the night for the first time in years.”
Outcome summary
Functional communication moved from single words to short conversational requests, with measurable normalization of left-temporal qEEG markers and durable sleep gains. Plan continues at maintenance cadence.
Clinical notes: Family declined medication trial. Gains attributed to combined qEEG-guided TMS + weekly SLP coordination, not TMS alone.
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