Questionnaire can help with early identification of autism

A growing body of research suggests that early intervention is important for helping children with autism spectrum disorders. But early identification, which is critical for early intervention, has been somewhat elusive.

A new questionnaire, designed to be completed by parents in the pediatrician’s office during the one-year-old well-baby checkup, may help. Researchers from the University of California at San Diego had pediatricians distribute the 24-question survey to parents of 10,479 babies. The test identified 1,371 babies as potentially having autism or other developmental delay. The researchers tracked 184 of those, of whom 32 were subsequently were found to have autism spectrum disorder, 56 had language delays, 9 had developmental delays and 36 had other problems.

The survey is promising, but there was one challenge: 25% of the babies identified as potentially having developmental delays ended up on a normal development path. Such a high false-positive rate could result in a lot of unnecessary anxiety for parents.

The New York Times recently highlighted the research, which was published in the Journal of Pediatrics:

Although many pediatricians don’t screen 1-year-olds for autism, there is a growing body of evidence suggesting early intervention can be effective, said Dr. Karen Pierce, the lead author of the study — published Thursday in The Journal of Pediatrics — and assistant director of the Autism Center of Excellence at University of California, San Diego.

The checklist poses simple questions, like whether a baby responds to his or her name, whether parents can tell when an infant is happy or upset, and whether a child engages in pretend play with dolls or stuffed animals.

It’s About Time…

Auditory processing describes what happens when the brain recognizes and interprets sounds. Humans hear when energy that we recognize as sound travels through the ear and is changed into electrical information that can be interpreted by the brain. For many students, something is adversely affecting the processing or interpretation of this information. As a result, these students often do not recognize subtle differences between sounds in words, even though the sounds themselves are loud and clear. For example: “Tell me how a chair and a couch are alike” may sound to a child struggling with auditory processing like “Tell me how a hair and a cow are alike.”

These kinds of problems are more likely to occur when the child is in a noisy environment or is listening to complex information.

The Temporal Dynamics of Learning Center (TDLC) at the University of California is one of six Science of Learning Centers funded by the National Science Foundation. Its purpose is “to understand how the element of time and timing is critical for learning, and to apply this understanding to improve educational practice.”

What is the role of timing in learning? From the TDLC Web site:

When you learn new facts, interact with colleagues and teachers, experiment with new gadgets, or engage in countless other learning activities, timing plays a role in the functioning of your neurons, in the communication between and within sensory systems, and in the interactions between different regions of your brain. The success or failure of attempts to communicate using gestures, expressions and verbal language also depend on timing.

In short, timing is critical for learning at every level, from learning the precise temporal patterns of speech sounds, to learning appropriate sequences of movements, to optimal training and instructional schedules for learning, to interpreting the streams of social signals that reinforce learning in the classroom.

Learning depends on the fine-scale structure of the timing between stimuli, response, and reward. The brain is exquisitely sensitive to the temporal structure of sensory experience:

• at the millisecond time scale in the auditory system;
• at the second time scale in reinforcement learning;
• at the minute time scale for action-perception adaptation; and
• at the day-to-week time scale for consolidation and maturation.

Each level of learning has its own temporal dynamics, and its own timing constraints that affect learning. These levels are not independent, but instead, timing constraints at one level affect learning at another level in a nested way. For example, the dynamics at the cellular level, which is often on the order of milliseconds, implement learning on the whole-brain and behavioral level on much longer time scales, including memories that last a lifetime.

The past decade of neuroscience research demonstrates that the intrinsic temporal dynamics of processes within the brain also reinforce and constrain learning. For example, we have discovered that slow learners tend to have slow “shutter speeds” in terms of how their brains take in and process information. For some poor readers, the underlying problem is the their inability to perceive fast acoustic changes in speech sounds (phonemes) that must be accurately perceived in order to learn letter-sound correspondence rules for reading.

Fortunately, says the TDLC Web site, “Neuroscience-based training regimes that improve this temporal processing ability improve both spoken and written language learning in struggling readers.”

One such training program is the Fast ForWord program, which can be an effective intervention for children with struggling with processing rates because it goes right to the cause of the problem, strengthening the gray matter in the area of the brain responsible for processing auditory information. With Fast ForWord, children are first exposed to sounds that are modified to enhance the minute acoustic differences between similar speech sounds. As children demonstrate proficiency and build new neural pathways, the program automatically reduces the level of modification, until eventually students are challenged to process normal speech sounds.

When their brains are processing speech sounds at peak efficiency, students can better  recognize and discriminate the rapidly changing sounds that are important for discriminating phonemes (the smallest units of speech that distinguish one word from another). As a result, they will more easily:

• Attend and respond to directions and class discussions
• Remember questions, directions, and information
• Learn to read and become a better reader

How children’s brains acquire language

In adults, injury to the areas of the brain that are responsible for language skills (Broca’s and Wernicke’s areas) result in loss of language abilities. However, injuries to those same areas in early childhood don’t seem to impact language development in a negative way. As a result, researchers have long thought that a different area of the brain was active in language acquisition. But new research from UC San Diego, published in the Oxford University Press journal Cerebral Cortex says otherwise: “similar left frontotemporal areas are used for encoding lexico-semantic information throughout the life span, from the earliest stages of word learning.”

From a recent Science Daily article summarizing the research:

Combining the cutting-edge technologies of MRI and MEG, scientists at the University of California, San Diego show that babies just over a year old process words they hear with the same brain structures as adults, and in the same amount of time. Moreover, the researchers found that babies were not merely processing the words as sounds, but were capable of grasping their meaning.

Study co-author Kathleen Travis, quoted in the Science Daily article:

“Babies are using the same brain mechanisms as adults to access the meaning of words from what is thought to be a mental ‘database’ of meanings, a database which is continually being updated right into adulthood.”

And from co-author Eric Halgren, also in the article:

“Our study shows that the neural machinery used by adults to understand words is already functional when words are first being learned. This basic process seems to embody the process whereby words are understood, as well as the context for learning new words.”