Study: Early Autism Intervention Improves Brain Responses to Social Cues

A study shows promising signs that behavioral intervention can positively change brain function in toddlers with autism.

An autism intervention program that emphasizes social interactions and is designed for children as young as 12 months has been found to improve cognitive skills and brain responses to faces, considered a building block for social skills. The researchers say that the study, which was completed at the University of Washington, is the first to demonstrate that an intensive behavioral intervention can change brain function in toddlers with autism spectrum disorders.

"So much of a toddler's learning involves social interaction, and early intervention that promotes attention to people and social cues may pay dividends in promoting the normal development of the brain and behavior," said Geraldine Dawson, lead author and chief science officer for the advocacy group Autism Speaks.

"For the first time, parents and practitioners have evidence that early intervention can result in an improved course of both brain and behavioral development in young children," she said.

Dawson began the study while she was the director of the UW Autism Center. The study was published online Oct. 26 in the Journal of the American Academy of Child & Adolescent Psychiatry.

Forty-eight children, aged 18 to 30 months and diagnosed with autism, either participated in routine community-based interventions or the Early Start Denver Model, which emphasizes interpersonal exchanges and shared participation in activities. The model was developed by Dawson and co-author Sally Rogers, a professor at the UC Davis MIND Institute.

Participants received one of the interventions for about 20 hours each week over a period of two years. For the children randomly assigned to the ESDM group, treatment took place two hours, twice a day, five days a week, by trained interventionists who came to the child's home. The children got an extra boost from their parents, who were trained to use ESDM strategies during routine exchanges with their child.

A previous study found that the ESDM intervention improved IQ, language, and adaptive skills and the researchers wanted to know if the approach also led to brain changes.

After two years of treatment, the brain function of the participants -- now about four to five years old -- was measured with electroencephalography while the youngsters viewed social stimuli, such as faces, and nonsocial stimuli, such as toys.

"Humans are experts at processing faces, but the brains of children with autism have delays in the ability respond to faces," said co-author Sara Webb, a UW research associate professor. If the brain can quickly identify a face, she said, then it can build on this to also quickly decide whether the face is of a man or a woman, happy or sad, and familiar or not.

Children in both intervention groups showed similar brain responses to faces as did children in a control group who did not have autism, suggesting that "the high level of intervention in both groups allowed the children with autism to catch up to the children in the control group," Webb said. "That's fantastic news."

Looking at a higher level of brain processing, the researchers studied whether the treatments changed brain measures of attention and cognitive engagement when seeing faces compared with a nonsocial stimulus. Eleven of 15 -- or 73 percent -- of children in the ESDM group showed greater attention to faces than to toys. In contrast, the EEGs of only five of the 14 recipients of the community intervention, or 36 percent, showed similar activation.

"The ESDM intervention resulted in greater attention and cognition brain activity to social stimuli, and these brain function patterns are more similar to the typical developing group of children," Webb said.

She stressed not only the importance of receiving intensive early intervention for autism, but that the intervention should focus on enhancing social attention, reciprocal interactions and engagement with a social partner.

Other study authors at UW are Emily Jones, Kaitlin Venema, Rachel Lowy, Susan Faja, Dana Kamara, Michale Murias, Jessica Greenson, Jamie Winter and Milani Smith, as well as Kristen Merkle of Vanderbilt University.

The study was funded by a grant from the National Institute of Mental Health and an Autism Speaks postdoctoral fellowship awarded to Jones.

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Study: Popular Autism Treatment Lacks Scientific Evidence

Researchers from the University of Texas at Austin claimed that sensory integration therapy, a popular autism treatment, does not have a strong scientific basis showing that it is effective.

One of the most popular intervention therapies for children with autism spectrum disorders (ASD) lacks scientific support according to a literature review published by University of Texas at Austin professor Mark O’Reilly and an international team of scientists.

The researchers reviewed 25 major studies on sensory integration therapy (SIT) to see if the current evidence base supports use of this therapy in the education and rehabilitation of children on the autism spectrum. Their conclusion that research does not support the use of SIT means providers who work with children with ASD will need to reassess their education and treatment strategies.

Many agencies serving children on the autism spectrum are mandated to use research-based, scientifically valid interventions, but several previous surveys indicate SIT remains one of the most common intervention choices. In one study, 99 percent of interviewed occupational therapists reported using it.

“According to the Diagnostic and Statistical Manual of Mental Disorders, or DSM, a person has to have severe communication and social deficits as well as restrictive and repetitive behaviors to be diagnosed with ASD,” said O’Reilly, interim chair of the College of Education’s Department of Special Education. “SIT was proposed as a way to help with these symptoms. Rigorous, methodologically sound studies do not indicate that it helps and, in fact, the majority of studies that were reviewed reported no benefits for children with ASD.”

Because many children on the autism spectrum have abnormal responses to auditory, visual, tactile and oral stimuli, sensory integration therapy is designed to offer specific forms of sensory stimuli in the appropriate amounts, with the aim of improving how the nervous system processes sensory stimuli. Therapists who use SIT may have a child with ASD wear a weighted vest, swing, sit on a bouncy ball, or be compressed between pillows, said Dr. Russell Lang, lead investigator in the SIT literature review.

"Many researchers have pointed out that SIT may actually lead to an increase in undesirable behavior because it gives children who exhibit unwanted behavior access to fun activities, more attention from therapists and breaks from less desirable tasks like schoolwork,” said Lang, executive director of Texas State University’s Clinic for Autism Research, Evaluation and Support. “It also can undermine the effectiveness of research-based behavioral interventions that the therapist is administering at the same time.”

According to experts, the only scientifically valid treatment and intervention for individuals on the autism spectrum is applied behavior analysis. The University of Texas at Austin’s Department of Special Education, of which Lang is an alumni, is one of only a few in the nation that trains graduate students in this therapy. With applied behavior analysis, the therapist teaches children age-appropriate skills and offers systematic, repetitious positive reinforcement for desired behaviors.

“The American Academy of Pediatrics, the premier professional organization for pediatrics, recently issued a policy statement which offers similar cautions regarding a lack of research support for SIT with this population,” said O’Reilly.

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Different impacts of autism for men and women

This article discusses the differences in the impact of autism based on gender and how findings for one gender canot be assumed to be applicable for the other gender.

Men and women with autism spectrum conditions (ASC) may show subtle but significant differences in the cognitive functions impacted by the condition, according to new research published Oct 17 by Meng-Chuan Lai and colleagues from the Autism Research Centre at the University of Cambridge, UK in the open access journal PLOS ONE.

Though individuals with autism show sex-specific differences in serum biomarkers, genetics and brain anatomy, little is known about any sex-dependent differences in cognition caused by ASC. Following their previous report on behavioral sex differences in adults with ASC (also published in PLOS ONE, in this new study the researchers compared four aspects of cognition in adults with ASC to those with typical development. They found that perception of facial emotions was equally impaired across both sexes in individuals with ASC. In tasks involving attention to detail or dexterity requiring strategic thinking, women with ASC performed comparably to women without ASC, but men with ASC showed more difficulties than neurotypical men.

According to the authors, their results suggest that the severity with which certain cognitive functions are affected by autism may be dependent on sex, and has implications for assessment and intervention of ASC.

"What we know about males with ASC should not be assumed to generalize to females", said Dr. Lai. "Their similarities and differences need to be investigated systematically in autism research."

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Study Shows Children With Autism Experience Interrelated Health Issues

Children who have autism are more likely to also have anxiety, gastrointestinal issues, and sensory problems, all of which can effect their daily lives.

One in 88 children has been diagnosed with an autism spectrum disorder (ASD) in the United States, according to the Centers for Disease Control and Prevention. A new study by a University of Missouri researcher found that many children with ASD also experience anxiety, chronic gastrointestinal (GI) problems and atypical sensory responses, which are heightened reactions to light, sound or particular textures. These problems appear to be highly related and can have significant effects on children's daily lives, including their functioning at home and in school.

Micah Mazurek, an assistant professor of health psychology and a clinical child psychologist, found in her study of 2,973 children and adolescents with ASD that nearly one-fourth also had chronic GI problems, such as constipation, abdominal pain, bloating, diarrhea or nausea. The results also showed that children with chronic GI problems were more likely to experience anxiety and sensory problems.

"These problems can have a very real impact on daily life. Children with anxiety may be distressed or reluctant to engage in new activities, and those with sensory problems may have trouble paying attention or participating in over-stimulating enviornments," Mazurek said. "These children may also suffer uncomfortable GI problems that they may not be able to communicate about to adults."

Clinicians should be aware that anxiety, GI problems and sensory sensitivity often co-occur in individuals with ASD. Effectively managing these concurrent issues may improve children's quality of life and their responses to treatment, Mazurek said.

"Parents need to be aware that these problems may underlie some of their children's difficulties, so if they notice any symptoms, they should talk to their doctors or therapists about treatment options," Mazurek said. "Practitioners who work with children with ASD need to be mindful that there is a pretty high rate of these problems, so if children are treated for one issue, it may helpful to screen for these additional symptoms."

This is the first study to examine the relationships among anxiety, GI problems and sensory over-responsivity in a large, nationally representative sample of children and adolescents with ASD. Participants in the study were enrolled in the Autism Treatment Network, a network of 17 autism centers throughout North America that are focused on best practices for medical treatment of children with ASD.

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New York Man Catches Autistic Girl Falling From Window

New York Man Catches Autistic Girl Falling From Window

A 7-year-old New York City girl escaped injury after she fell from a third-story window when she was caught by a neighbor.

Cell phone video taken by a resident in the Coney Island section of Brooklyn shows Keyla McCree standing on an air conditioning unit moments before she fell and landed in the bushes. Her dramatic fall was broken by the arms of Steven St. Bernard, who rushed to the scene and caught the girl.

“Please let me catch her, please let me catch her, that’s all I could say. Let me catch the little baby, that’s all,” said St. Bernard.

The 52-year-old bus driver and father of four told ABC News affiliate WABC that he was just in the right place at the right time.

“It feels good now to know that I did something,” said St. Bernard, who lives in the apartment complex.

Keyla, who is autistic, managed to perch herself on the air conditioner by pushing through one of the accordion pieces that holds the unit to the window while her mother was in the next room. Moments before she fell, McCree was seen dancing on the air conditioning unit. Police tell WABC they do not believe McCree’s parents  did anything criminal.

“She did hit the bushes and the ground a little, but not straight on because of his arms,” said witness Latasha Marcus.

St. Bernard tore a tendon in his left shoulder and was sporting a sling after the incident. As for Keyla, she’s doing just fine thanks to the man who certainly lived up to his name.

“I saw her in the hospital. She doesn’t have a scratch on her,” said St. Bernard.

This morning, friends and neighbors are calling St. Bernard a hero. “No. A hero is a sandwich. I just saw a kid, that’s it,” said St. Bernard.