Published by
Stanford Medicine

Category

Autism

Autism, In the News, Pediatrics, Research

Using theater’s sensory experiences to help children with autism

Using theater's sensory experiences to help children with autism

Gesamkunstwerk, my favorite German word and a term commonly associated with the operas of Richard Wagner, can be translated as a “total work of art” playing to many of the senses and synthesizing numerous art forms. The word came to mind as I read about a pilot study using theater as an environment for children with autism-spectrum disorders  to explore “communication, social interaction, and imagination skills – the ‘triad of impairments’ seen in autism,” a New Scientist piece notes, “engaging all the children’s senses at once.”

Twenty-two children ages 7-12 attended one weekly 45-minute session for 10 weeks involving improvisation exercises led by trained performers in enclosed make-believe environments such as a forest or outer space.

From the piece:

As well as looking at whether behaviours used to diagnose autism changed after the drama sessions, the researchers also assessed emotion recognition, imitation, IQ and theory of mind – the ability to infer what others are thinking and feeling. Subjective ratings were also gathered from parents and teachers and follow-up assessments were conducted up to a year later.

At the early assessments, all children showed some improvement. The most significant change was in the number of facial expressions recognised, a key communication skill. Nine children improved on this. Six children improved on their level of social interaction. The majority of these changes were also seen at the follow-up assessments.

The project’s lead psychologist, David Wilkinson, PhD, at the University of Kent, told New Scientist, ”It’s an opportunity for children to create their own narratives in an unconstrained, unfamiliar environment.” He continued, “They find this empowering, and we know from the psychology literature that individuals who are empowered enjoy increased attention skills and an improved sense of well-being.”

Previously: Making museums more inviting for autistic children and their familiesStanford study reveals why human voices are less rewarding for kids with autismDirector of Stanford Autism Center responds to your questions on research and treatment and A mother’s story on what she learned from her autistic son

Autism, Genetics, Neuroscience, Research, Videos

Building a blueprint of the developing human brain

Building a blueprint of the developing human brain

In an effort to identify and better understand how genes turned on or off before birth influence early brain development, scientists at the Allen Institute for Brain Science have created a comprehensive three-dimensional map that illustrates the activity of some 20,000 genes in 300 brain regions during mid-prenatal development.

A post on the NIH Director’s blog discusses the significance of the project, known as the BrainSpan Atlas of the Developing Human Brain:

While this is just the first installment of what will be an atlas of gene activity covering the entire course of human brain development, this rich trove of data is already transforming the way we think about neurodevelopmental disorders.

To test the powers of the new atlas, researchers decided to use the database to explore the activity of 319 genes, previously linked to autism, during the mid-prenatal period. They discovered that many of these genes were switched on in the developing neocortex—a part of the brain that is responsible for complex behaviors and that is known to be disrupted in children with autism. Specifically, these genes were activated in newly formed excitatory neurons, which are nerve cells that send information from one part of the brain to another. The finding provides more evidence that the first seeds for autism are planted at the time when the cortex is in the midst of forming its six-layered architecture and circuitry.

In the above video, Ed Lein, PhD, an Allen Institute investigator, talks about the atlas and explains how it will allow researchers to examine genes that have been associated with a range of neurodevelopmental disorders and pinpoint when and where that gene is being used.

Previously: NIH announces focus of funding for BRAIN initiative, Brain’s gain: Stanford neuroscientist discusses two major new initiatives and Co-leader of Obama’s BRAIN Initiative to direct Stanford’s interdisciplinary neuroscience institute

Autism, Medicine and Literature, Medicine and Society

“No, I’m not ready yet”: A sister’s translation for her brother with autism

Over on Medium.com, Abby Norman shares experiences from her youth in a family with a brother, Caleb, who has autism and a mother with an eating disorder. Able to observe and interpret Caleb’s ways of communicating, Abby acts as a translator to give him a voice that others will hear and, one hopes, understand.

From the piece:

What calmed him was lying on the bed for hours, motionless, watching the numbers of the digital clock change.

He did not potty train on schedule. Instead, he had somewhat of an intense penchant for smearing feces all over the rug and walls of the house. This was his way of saying, “No, I’m not ready yet.” … His relationship to the toilet had nothing to do with his bodily needs: the toilet was his method of rejecting objects. If he didn’t want something, he’d flush it down the toilet.

He was only aggressive in the sense that, when startled or overwhelmed, he would kick and scream. They started out seeming like normal tantrums; but while most kids could be consoled, Caleb could not be, and he would have to literally wear himself down before he would stop.

The author notes that even in understanding her brother’s differences, she was not necessarily his ideal caretaker. The piece continues:

Once he started school, the nightmare only intensified. I say that not to describe what life was like for us, but for him. School, with its unpredictable nature and constant social interaction, its lack of structure for kids who needed anything other than “normative learning.” The truth was, Caleb wasn’t really special needs. He was extremely intelligent.

At home, his day to day life was more or less consistent. While my experience growing up with a mum with an eating disorder was difficult, for Caleb, the obsessive-compulsive nature of her lifestyle was exactly what he required to stay calm and safe. He and my mother had, and to this day still have, a very symbiotic relationship.

Previously: Inspired by his autistic son, a Stanford researcher works to understand the biochemistry of autismThe Reason I Jump: Insights on autism and communication, A mother’s story on what she learned from her autistic son and Autism therapies: It still comes down to parents

Autism, In the News, Pediatrics, Research, Stanford News

Inspired by his autistic son, a Stanford researcher works to understand the biochemistry of autism

Inspired by his autistic son, a Stanford researcher works to understand the biochemistry of autism

dolmetschIn a Q&A published today in the New York Times, Stanford neurobiologist Ricardo Dolmetsch, PhD, tells reporter Claudia Dreifus that his immediate reaction to learning his son was diagnosed with autism was, “We’re not going to leave any stone unturned to help him.”

Leaving no stone unturned included changing the focus of his research to better understand the biochemistry of autism and leading an effort to create a technique that involves reprogramming skin cells from autistic children into neurons. As reported previously on Scope, this approach allows scientists to better study brain function in children with autism.

Dolmetsch, who is currently on leave from Stanford and working at Novartis, tells Dreifus that his main goal is to develop new pharmaceutical therapies for autism. When she asked him how he identifies patients to participate in his research, he responded:

Through social media. We’re often interested in groups or families who have specific kinds of mutations. Some of them are rare — 5,000 people worldwide.

So we have a committee that decides what’s the next mutation we’re going to work on. Then we find children with it. It used to be we’d spend half of our budget locating people. Now, we go to the families with a Facebook page for people with X, Y, or Z mutation. Then I’ll post a call. Parents will come forward.

The aim is to develop a database of the mutations we think are causative of the neuropsychiatric diseases. If we can get samples through stem-cell-derived neurons and create a library of them, we could change the way the diseases are diagnosed.

Previously: Using stem cells to advance autism research, Stanford Magazine spotlights scientists’ efforts to untangle the root causes of autism and Research on autism is moving in the right direction
Photo by Steve Fisch

Autism, Clinical Trials, Neuroscience, Pediatrics, Research, Stanford News

Volunteers sought for autism drug study

Volunteers sought for autism drug study

There is no known cure for autism, and there are no medications approved for treating the social aspects of the condition, such as difficulty interpreting nonverbal cues in face-to-face conversations, or maintaining eye contact.

The only medications approved for treating autism are antipsychotics, which don’t target the social deficits.

But efforts are underway to explore whether certain molecules used by neurons in the brain to communicate with one another - called neuropeptides – might have a moderating effect on some of the behavioral traits that characterize autism.

I recently talked with Dean Carson, PhD, a postdoctoral research fellow in the Department of Psychiatry and Behavioral Sciences, who told me that one neuropeptide, oxytocin, is currently being studied as a treatment for autism in a number of studies around the world. Some early stage, single dose trials showed oxytocin was effective in moderating the social deficits of people with autism, but so far subsequent studies haven’t produced a consensus.

Carson also told me about a study that he’s involved with looking at another neuropeptide, vasopressin, which is closely related to oxytocin. Carson thinks vasopressin has some promise, as it’s been shown to enhance social functioning in laboratory mice with a genetically induced form of autism. It’s already approved for use in humans by the FDA and has been shown to improve social cognition and memory in people who do not have autism.

Researchers are currently seeking volunteers – children ages 6 to 12 years old - for this trial. If you’re located near Stanford and interested in learning more, this link provides details. I also explain more in a press release.

Previously: Greater hyperconnectivity in the autistic brain correlates to greater social deficits, More Stanford findings on the autistic brain, Director of Stanford Autism Center responds to your questions on research and treatment and New autism treatment shows promising results in pilot study

Autism, Neuroscience, Pediatrics, Research, Stanford News

Greater hyperconnectivity in the autistic brain correlates to greater social deficits

Greater hyperconnectivity in the autistic brain correlates to greater social deficits

As researchers delve deeper into the wiring schemes of the brains of children with autism, more is being revealed about how the density of neural connections within the brain relates to the behavioral manifestations of autism.

New results from the lab of Vinod Menon, PhD, published today in Cell Reports, demonstrate that a greater degree of hyperconnectivity in the brains of children with autism correlates with greater severity of their social impairments.

I traded e-mails with the lead author of the Cell Reports study, Kaustubh Supekar, a postdoctoral researcher, who wrote, “A hyper- or over-connected brain may make it more difficult for children with autism to modulate brain activity levels in response to cognitive demands such as those required while navigating real-world social scenarios.”

Last June, scientists led by Menon, published research demonstrating hyperconnectivity in the brains of children with autism and showing that at least five major brain networks were hyperconnected. They were able to discern associations between some of the networks and certain behavioral traits.

Supekar also wrote, “Our findings suggest that from early ages the brains of individuals with autism develop differently from their neurotypical peers, and this atypical development might contribute to the observed atypical social behavior that is a core characteristic of the disorder.”

These study results may prove useful for diagnosing – and perhaps someday even treating – autism. Currently autism is diagnosed purely on behavioral criteria.

Previously: Unusual brain organization found in autistic kids who best peers at math, More Stanford findings on the autistic brain, Stanford study reveals why human voices are less rewarding for kids with autism, New public brain-scan database opens autism research frontiers, New imaging analysis reveals distinct features of the autistic brain

Autism, Behavioral Science, Mental Health, Neuroscience, Research, Stanford News

“Love hormone” may mediate wider range of relationships than previously thought

"Love hormone" may mediate wider range of relationships than previously thought

palsOxytocin, a veritable pipsqueak of a protein (or “peptide” in science-speak) punches well beyond its weight. If you’re a woman, oxytocin induces uterine contractions leading to childbirth and, afterward, induces lactation. It’s also often called the “love hormone,” because it’s secreted in a woman’s brain during sexual arousal and appears to be involved in both men’s and women’s experience of falling in love, as well as in parent-child bonding.

In a just-out Nature study, Stanford neuroscientist Rob Malenka, MD, PhD, and his colleagues have shown just how oxytocin may figure into a much broader range of social interactions – and, possibly, in neurological disorders such as autism.

In fact, oxytocin has been administered to autistic children in clinical trials. The new study pinpoints a unique way in which oxytocin alters activity in a part of the brain that is crucial to experiencing the pleasant sensation neuroscientists call “reward,” as is explained in a news release about the study:

“People with autism-spectrum disorders may not experience the normal reward the rest of us all get from being with our friends,” said [Malenka]. “For them, social interactions can be downright painful. So we asked, what in the brain makes you enjoy hanging out with your buddies?”

The researchers actually “asked” mice, not people, this question. They let each of their experimental subjects spend 24 hours in a room filled with “buddies” (a mouse’s littermates) and another 24 hours in a room devoid of pals. Then they gave each mouse his choice of rooms (all the mice were males) and measured how much time he spent in each of them. Sure enough, the guests overwhelmingly favored the room whose look, feel, and smell brought back happy memories of time spent socializing.

But when the researchers played a trick on the mice’s brains that disrupted the action of oxytocin in the nucleus accumbens, an area of the brain intimately involved in the sensation of reward, the mice lost their preference for the boom-boom room. If something’s no fun anymore, it stands to reason that you’re going to want to do a lot less of it.

The scientists then embarked on a series of sophisticated experiments that showed precisely what brain connections are involved in the link between oxytocin and the sensation of reward.

Earlier studies have found significantly lower levels of oxytocin in blood plasma of autistic children, but until now nobody knew anything about what, exactly, the connection between oxytocin, reward, group activity and autism might be.  The new findings go a long way toward explaining that connection.

Previously: Revealed: The brain’s molecular mechanism for why we get the blues, Better than the real thing: How drugs hot wire our brains’ reward circuitry and Stanford study reveals why human voices are less rewarding for kids with autism
Photo by emdot

Autism, In the News, Media, Medicine and Literature, Mental Health

The Reason I Jump: Insights on autism and communication

As I write this, I’m keenly aware that communication is one of the most common, and perhaps most difficult, things we do. That’s why I was both humbled and heartened when I read about Naoki Higashida’s book The Reason I Jump on Biographile today.

The book is described as a “stunningly clear-eyed look into the experiences of a boy with autism.” But, as explained in the review, many of the themes Higashida addresses in his book, “reveal truths about communication and connection that all humans should contemplate.”

In the Biographile interview, Higashida, who was 13 when he wrote the book, describes hard-to-grasp, prickly concepts such as communicating with compassion, and why good communication is hard work but worth the effort, with bell-like clarity. I cannot wait to get my hands on the book.

From the review:

Some people tend to assume that individuals with all kinds of disabilities have a less than mature understanding of language. But in many cases, even when speech and language production are impaired, understanding is not. Higashida explains to readers that baby talk is disheartening for him to hear as a young man. He encourages people not to talk down to people with autism, or anyone. “True compassion is about not bruising the other person’s self respect,” he writes, revealing not only an expert command of language but also wisdom beyond his years.

To share his experiences and his fiction with the world, and even to communicate basic needs to his family and caretakers, he painstakingly spells out the words on alphabet grids while others transcribe. He admits learning to communicate independently was hard work and at times, he felt “utterly beaten” by the process. But, Higashida reminds us, “to live my life as a human being, nothing is more important than being able to express myself […] it’s about getting across to other people what I need and what I need them to understand.”

Holly MacCormick is a writing intern in the medical school’s Office of Communication & Public Affairs. She is a graduate student in ecology and evolutionary biology at University of California-Santa Cruz.

Previously: More Stanford findings on the autistic brainA mother’s story on what she learned from her autistic sonUsing music to improve communication skills in children with neurodevelopmental disorders and Stanford study reveals why human voices are less rewarding for kids with autism

Autism, Pediatrics, Research, Stanford News

Unusual brain organization found in autistic kids who best peers at math

Unusual brain organization found in autistic kids who best peers at math

math homework - smallPeople with autism are often portrayed in popular media as dysfunctional savants – think Dustin Hoffman’s character in the movie Rain Man – or worse yet, simply dysfunctional, hobbled by a debilitating lack of social and communication skills, compulsive repetitive behavior and narrowly focused obsessions.

But there is far more subtlety to the range and intensity of symptoms associated with autism than that.

There is also, it seems, much more going on in the mind of someone with autism than meets the eye, as shown by some School of Medicine researchers who conducted brain scans on autistic and nonautistic children as they solved mathematics problems while lying in a magnetic resonance imaging machine.

In the study, published today in Biological Psychiatry, children with autism and average IQs outperformed a control group of nonautistic kids in the same IQ range on math problems. As I describe in our our press release:

The autistic children’s enhanced math abilities were tied to patterns of activation in a particular area of their brains — an area normally associated with recognizing faces and visual objects.

“There appears to be a unique pattern of brain organization that underlies superior problem- solving abilities in children with autism,” said Vinod Menon, PhD, professor of psychiatry and behavioral sciences and a member of the Child Health Research Institute at Packard Children’s.

People with autism often have difficulty interpreting the facial expressions of others, which contributes to their difficulties in social situations.  It may be that some of their lack of ability in that realm arises because they’re using the visual processing area of their brain for numerical tasks.

“Our study supports the idea that the atypical brain development in autism can lead, not just to deficits, but also to some remarkable cognitive strengths. We think this can be reassuring to parents,” Menon said. He is senior author of the study and postdoctoral scholar Teresa Iuculano, PhD, is lead author.

The cognitive strengths possessed by some people with autism include an extraordinary ability to concentrate and stay focused on extremely detail-oriented or repetitive tasks such as data entry or software testing. They often surpass the performance of nonautistic people at these jobs.

Continue Reading »

Autism, In the News, Neuroscience, Pediatrics, Research, Stanford News

More Stanford findings on the autistic brain

More Stanford findings on the autistic brain

Following closely on last week’s news about human voices and brain circuits in autism comes another set of Stanford findings about the wiring of the autistic brain: New work from the lab of Vinod Menon, PhD, shows hyperconnectivity in five major networks in the brains of children with autism. The findings add to the Menon lab’s already-significant contributions to understanding how the autistic brain differs from a typically-developing brain and how it changes as children grow.

A story in today’s Los Angeles Times gives a good overview of the new findings:

New evidence from [the study]… suggests that children with autism have higher connectivity in certain large-scale circuits, including one that helps determine the relative importance of stimuli, and another that mediates between the “inside” and “outside” world of the mind.

The results suggest that the neuronal map of children with autism may differ from that of the adults and adolescents who make up the bulk of autism brain-scan studies. And they show that such brain scans can be used to distinguish between a child who has tested as autistic and a typically developing one. Such scans were matched to diagnosed autistic children with an accuracy as high as 83%, according to the study, which examined 20 children, who ranged in age from 7 to 12.

“Eventually, down the line, perhaps this can help aid in having more objective criteria for determining autism and distinguishing it from other disorders,” said Lucina Uddin, a Stanford cognitive neuroscientist who wrote the study. “We’re looking for biomarkers, very specific things that you can see in the brains of kids with autism that discriminate them from typically developing kids.”

Not only could the findings help scientists develop a diagnostic test for autism, the work could also provide hints as to why children with autism sometimes have special skills, such as unusual mathematical or spatial abilities, the researchers said.

Previously: Stanford study reveals why human voices are less rewarding for kids with autism, New public brain-scan database opens autism research frontiers and New imaging analysis reveals distinct features of the autistic brain

Stanford Medicine Resources: