<![CDATA[Children with cognitive disabilities frequently experience interconnected nutritional, cognitive, and behavioral challenges that may restrict learning participation. This mixed-methods one-group pilot study examined the preliminary outcomes and acceptability of an integrated Neuro-Nutrition Biofeedback and Balinese Gamelan Sensorimotor-Rhythm (SMR) stimulation program. Twenty children aged 6–12 years from special education schools in Bali participated in an eight-week intervention. Quantitative outcomes included BMI-for-age z-score, sustained attention, working memory, and EEG-recorded SMR amplitude, while qualitative data were obtained from parent and teacher interviews, behavioral observations, and field notes. Repeated-measures MANOVA indicated a significant multivariate effect of time. Holm-adjusted follow-up analyses showed significant changes in attention and working memory. BMI-for-age and SMR amplitude showed positive changes but did not remain statistically significant after adjustment. Qualitative findings revealed gradual food acceptance, improved learning focus, calmer behavioral responses, and strong cultural acceptance of Balinese gamelan. The integrated findings provide preliminary support for a culturally responsive neuro-educational framework linking nutritional readiness, neuroregulatory support, and culturally mediated engagement. SMR should be regarded as a candidate neurophysiological indicator rather than a demonstrated mediator. Larger controlled studies are required to establish efficacy and causal mechanisms.]]>
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