iPad access could help children with autism speak

A study shows that iPad access may help speaking skills for children with autism.

Adding access to a computer tablet to traditional therapy may help children with autism talk and interact more, new research suggests.

The study compared language and social communication treatment -- with or without access to an iPad computer tablet -- in 61 young children with an autism spectrum disorder (ASD) and found that the device helped boost the effect of the treatment.

"All the children improved, but they improved more if they had access to the iPad," said Connie Kasari, professor of human development and psychology and psychiatry at the University of California, Los Angeles' Semel Institute for Neuroscience and Human Behavior.

The children used the iPad when they were engaged in play, she said. "It focused on helping them initiate conversation, using the iPad to comment on what they were doing. The iPad worked because it is a visual stimulant with auditory feedback," she explained. For instance, children would mispronounce a word, hear it pronounced correctly on the iPad, and then learn to say it correctly, she said.

But, Kasari emphasized, "The iPad is just a tool." It worked because it was used within a treatment aimed at helping improve the children's communication skills, she noted.

The study was published in the June issue of the Journal of the American Academy of Child & Adolescent Psychiatry. Autism Speaks, a research and advocacy organization, funded the study.

Autism spectrum disorders are a group of developmental disorders. Communication and social problems are hallmarks of ASDs. As many as one in 68 U.S. children has an autism spectrum disorder, according to estimates from the U.S. Centers for Disease Control and Prevention.

Children in the study were between the ages of 5 and 8. All were considered "minimally verbal," which experts define as speaking fewer than 20 functional words, Kasari said. "The majority had far fewer." About 30 percent of children with an autism spectrum disorder are minimally verbal, she said, sometimes even after years of treatment.

For the first three months, all of the children received two sessions a week, totaling two to three hours a week. At the three-month mark, nearly 78 percent of children in the iPad-added group had an early response, but just 62 percent of those in the group without it did, the investigators found.

An early response was defined as an improvement of 25 percent or more in half of the 14 measures, such as the number of spoken words and the use of new words, Kasari said.

If a child was not progressing at the three-month mark, the researchers added the tablet. But adding it later was not as effective as using it from the start, Kasari's team found. The researchers followed the children for three years.

"The idea of using an iPad is a novel approach," said Dr. Ruth Milanaik, an attending physician at the Cohen Children's Medical Center in New Hyde Park, N.Y. Milanaik treats children with autism and reviewed the study's findings.

"The idea of technology being used to help children who really need different approaches is so important," she said. It's crucial, however, she agreed, to understand that the iPad "was simply a tool" and that it was an adjunct to the traditional interventions that aimed to improve communication and other developmental advances.

While a 25 percent improvement -- the measure used to define response -- may not seem like much to some, Milanaik said that "every small step, for the parents of an autistic child, is monumental."

Kasari and her team are continuing to study the iPad, planning to enroll about 200 children in four cities during a planned five-year study.

If the research continues to bear out, the hope would be to use the iPads in school programs and to train parents in its use at home, both experts agreed.

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Minority children with autism more likely to have a developmental regression - One third regress!

A study shows that one third of minority children with autism have a developmental regression! But why? JR

Minority children with autism are more likely to have lost critical developmental skills, such as walking or talking, than are white children, according to a new study.

The phenomenon, called developmental regression, occurs when children have reached milestones such as saying words and walking, and then those skills suddenly vanish. The new research found that the odds of developmental regression were twice as high for black children and 1.5 times higher for Hispanic children than they were for white youngsters.

It's estimated that one-third of children with autism go through developmental regression, said lead researcher Dr. Adiaha Spinks-Franklin, of Baylor College of Medicine and Texas Children's Hospital in Houston.

"They learn to babble or talk, then stop. They learn to play patty-cake, then stop," said Spinks-Franklin.

This appears to be the first study to show racial disparities in rates of developmental regression. And for now, the cause is unclear, Spinks-Franklin said.

No one knows why regression happens at all, said Dr. Dan Coury, medical director for the Autism Speaks Autism Treatment Network.

"But it does make us wonder if it might be a different type of autism, with different causes," Coury said.

Autism is a developmental disorder that -- to widely varying degrees -- impairs a child's ability to communicate and interact socially. Some kids have relatively mild problems relating to other people; others speak very little or not at all, and focus obsessively on only a couple of interests and engage in repetitive behaviors.

Researchers have managed to find a few hundred genes related to autism risk, and experts believe the disorder arises from a complex mix of genes and environmental exposures -- though it's not yet clear what those exposures are.

Coury said future studies could look into whether genes play a role in minority children's higher rate of regression. Another question, he said, is whether their parents might have had different environmental exposures before and during pregnancy.

Researching those possibilities, Coury noted, could also give clues to the causes of autism in general.

The current findings are based on 1,353 preschool children included in the Autism Speaks Autism Treatment Network (ATN) database. The children were from 17 different areas across the United States and Canada.

Based on parents' reports, 27 percent of the children had reached certain early milestones, such as saying words or making eye contact, then lost those skills.

Black and Hispanic parents were more likely to report lost skills, even when the researchers took into account for parents' education levels, whether they had insurance, and whether their child had already been diagnosed with autism before coming to the ATN.

It's already known there are other racial disparities in autism, Spinks-Franklin pointed out. Black and Hispanic children are typically diagnosed later than white children are -- whether they have developmental regression or not, Coury noted.

One reason, he said, is that minority families may have less access to health care.

According to the U.S. Centers for Disease Control and Prevention, children should be screened for developmental delays during routine "well-child" visits -- at the ages of 9 months, 18 months, and 24 or 30 months.

Autism can be difficult to diagnose, the CDC says, but can sometimes be detected by the age of 18 months. By age 2, a diagnosis from an experienced professional can be considered "very reliable," the agency says. Yet many children don't receive a definite diagnosis until school age.

That's something experts want to change. "The earlier we intervene, the better the outcomes," Coury said. "And that's pretty universal, whether children have regression or not."

Early intervention therapies start by age 3, and focus on building kids' language, movement and social skills.

Spinks-Franklin agreed that timely diagnosis is critical. "It's important for parents to be aware of the signs of autism," she said.

If you're worried about possible delays in your child's development, talk to your doctor, Spinks-Franklin advised. And if your child seems to have lost a skill, she added, that's a "red flag."

"In that case, don't hesitate to talk to your doctor," Spinks-Franklin said.

The findings from this study were presented on Tuesday at the Pediatric Academic Societies annual meeting in Vancouver. Findings presented at meetings should be considered preliminary until they've been published in a peer-reviewed journal.

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