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Study Offers Hope For Early Autism Detection and Intervention

A Stanford University offers new clue into Autism with the use of brain data.

Despite suffering from severe autism, Sue Rubin, 33, will graduate from college this year.

Rubin is unable to speak except for two- to three-word utterances, but learned to type with one finger at age 13. She uses this form of communication to express herself. She takes classes at Whittier College, and expects to graduate this year after persevering to complete her bachelor’s degree, one class at a time, for 14 years.

Through extraordinary tenacity, Rubin has been able to achieve success. Still, her mother Rita Rubin, can’t help but think of how much more could have been done for her daughter’s development if doctor’s had been able to diagnose her and intervene before she turned four.

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“We knew from day one that something was wrong,” Rubin said, but it was four years and innumerable visits to different doctors before the specific diagnosis was made at UCLA.

Stanford University offers hope for families such as the Rubins with a study that could help doctors provide earlier and more precise insight into the nature of a child’s developmental delay or disorder, allowing for earlier and more intense behavioral and educational treatment.

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The study revealed that brain scan data can be used to search out anatomical differences in the brain that distinguish children with autism from children with other developmental disorders. This finding that may increase the ability to identify the severity or degree of autism.

Using data from MRI scans from 24 autistic children ages 8 to 18, researchers learned that areas of the brain related to social communication and self-related thoughts are organized differently in people with autism.  The data were compared with scan data from 24 typically developing children of the same ages.

This brain structure analysis differed from previous studies that examined the sizes of individual brain structures in people with autism. The Stanford study provided a three-dimensional map of the entire brain using a method called multivariate searchlight classification. This brain map allows scientists to see individual features and identify differences in gray matter organization in specific regions of the brain.

Researchers found anatomic differences in the Default Mode Network, a group of brain structures with key governing roles in communication and self-related thoughts. The findings revealed that the children with the greatest degree of communication deficits, measured by a behavioral test, also had the biggest brain structure differences. Social behavior impairment and repetitive behavior were also associated with greater brain differences in the study.

Brain scans are only part of the process of diagnosing autism. Children who show delays or deficits in their ability to reach certain milestones, such as babbling and pointing by 12 months and speaking single words by 18 months, for example, are referred for more in-depth psychological, neurological, and genetic testing. MRI or CT scans of the brain may also be part of this further testing to determine if the child has autism or another developmental disability.

“The gold standard for diagnosis of autism should entail multiple sources of information,” said Cindy Kim, pediatric psychologist at Children’s Hospital of Orange County. The extensive process involves ruling out brain injury or underlying medical conditions, and then gathering information through clinical observation and family history, using standardized tools designed specifically for the identification of autism, she said.

Kim noted that autism research that focuses on gathering a wealth of information, including blood tests to examine immune function, an assessment of exposure to environmental toxins, and a functional MRI test, along with standardized clinical exams and observations may eventually lead to the ability to identify degrees or subcategories of autism, something that is not possible now.

“As more research becomes evident, there will be a greater understanding of autism as a category with different classes,” Kim said.  “MRI studies will help highlight different subclasses of autism, where different areas of the brain are more impacted.”

Along with the potential for earlier intervention in autism, confirmation of the Stanford research findings in larger studies involving more children may allow physicians to predict whether the sibling of a child with autism will develop similar behavioral and communication patterns.

Information and support are available from The Autism Society  and from Autism Speaks.

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