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Tero Toivanen

The Mirror Neuron Revolution: Explaining What Makes Humans Social: Scientific American - 0 views

  • In recent years, Iacoboni has shown that mirror neurons may be an important element of social cognition and that defects in the mirror neuron system may underlie a variety of mental disorders, such as autism.
  • Mirror neurons are the only brain cells we know of that seem specialized to code the actions of other people and also our own actions. They are obviously essential brain cells for social interactions. Without them, we would likely be blind to the actions, intentions and emotions of other people.
  • The way mirror neurons likely let us understand others is by providing some kind of inner imitation of the actions of other people, which in turn leads us to “simulate” the intentions and emotions associated with those actions. When I see you smiling, my mirror neurons for smiling fire up, too, initiating a cascade of neural activity that evokes the feeling we typically associate with a smile.
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  • In 2006 your lab published a paper in Nature Neuroscience linking a mirror neuron dysfunction to autism. How might reduced mirror neuron activity explain the symptoms of autism?
  • Reduced mirror neuron activity obviously weakens the ability of these patients to experience immediately and effortlessly what other people are experiencing, thus making social interactions particularly difficult for these patients. Patients with autism have also often motor problems and language problems. It turns out that a deficit in mirror neurons can in principle explain also these other major symptoms. The motor deficits in autism can be easily explained because mirror neurons are just special types of premotor neurons, brain cells essential for planning and selecting actions. It has been also hypothesized that mirror neurons may be important in language evolution and language acquisition.
  • Thus, a deficit in mirror neurons can in principle account for three major symptoms of autism, the social, motor and language problems.
  • There is convincing behavioral evidence linking media violence with imitative violence. Mirror neurons provide a plausible neurobiological mechanism that explains why being exposed to media violence leads to imitative violence.
  • I think there are two key points to keep in mind. The first one is the one we started with: mirror neurons are brain cells specialized for actions. They are obviously critical cells for social interactions but they can’t explain non-social cognition. The second point to keep in mind is that every brain cell and every neural system does not operate in a vacuum. Everything in the brain is interconnected, so that the activity of each cell reflects the dynamic interactions with other brain cells and other neural systems.
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    In recent years, Marco Iacoboni, a neuroscientist at the University of California at Los Angeles, has shown that mirror neurons may be an important element of social cognition and that defects in the mirror neuron system may underlie a variety of mental disorders, such as autism.
Tero Toivanen

Autism Therapy: pivotal response training | Healing Thresholds - 0 views

  • Future research may allow therapists to know in advance which type of applied behavior analysis (ABA therapy) is most likely to work for any given child with autism.
  • This study of six children was designed to see if it is possible to predict which type of ABA therapy will work for which child with autism.
  • The authors were able to predict which children would respond to pivotal response training, but not which ones would respond to discrete trial training. The authors note that all children were first exposed to pivotal response training and then to discrete trial training and this may have influenced the results. Children who liked toys were more likely to respond to pivotal response training than children who did not like toys.
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  • This study looked at whether or not a type of applied behavior analysis (pivotal response training) could be used to teach play skills to children with autism.
  • . Both children in the study improved their social skills during recess time.
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    Type of training in which certain behaviors are assumed to be crucial for other behaviors. These pivotal behaviors are then targeted so that the behaviors that depend upon them can change as well.
Tero Toivanen

Why parents swear by ineffective treatments for autism. - By Sydney Spiesel - Slate Mag... - 0 views

  • Since most of the ways we diagnose autism are based on behavior, we can't rely on biological, structural, or chemical findings to determine if a treatment is working. We primarily measure success based on a patient's change, or lack thereof, in behavior.
  • The behavioral changes produced by the few effective treatments make life in social settings (including the home) possible, but we have no idea whether they have any effect on the underlying cause (or causes) of autism or whether they even make severely affected patients feel better.
  • One method intended to help, "facilitated communication," is based on the idea that a sensitive facilitator will hold the hand of a patient over a kind of Ouija board. She will then help the patient respond to questions by sensing his intention and helping guide his hand to spell out answers. Rigorous studies have shown that the spelled-out answers come from the unconscious (or, worse, the conscious) mind of the facilitator. Nonetheless, the practice is still in use, and I know parents who are utterly convinced that it is valid and useful. Frankly, something important did happen when facilitated communication was introduced to my patients: They improved, they brightened, they became more social and more interactive, and they seemed, somehow, happier, even though facilitated communication didn't actually translate their thoughts into words. I'll come back to "why" in a minute.
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  • The techniques of sensory integrative treatment include rubbing or brushing skin (using graded and tactile stimulation), balance exercises, exposure to soft music, and the use of weighted clothes, among other things. Does it work? Most of the research has been of very poor quality, but, in virtually all of the recent studies, sensory integration doesn't seem to be any more beneficial than any other treatment.
  • It looks as if environmental alteration, especially if coupled with increased attention and perhaps expectation, often leads to change in human behavior. It's called the "Hawthorne effect."
  • People respond—mostly favorably—to positive attention and interaction. The question we need to ask about all the treatments available for autism is whether they actively shape and change brain development and thus treat the underlying condition, as many proponents believe, or whether the benefits (if they are present at all) are simply another example of the Hawthorne effect.
  • Perhaps my patients who became more alive and more interactive after facilitated communication was introduced changed because their families and caretakers were taking them more seriously as people who might have an inner life—people worthy of attention and interaction.
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    People respond-mostly favorably-to positive attention and interaction. The question we need to ask about all the treatments available for autism is whether they actively shape and change brain development and thus treat the underlying condition, as many proponents believe, or whether the benefits (if they are present at all) are simply another example of the Hawthorne effect.
Tero Toivanen

Yale Study Suggests Children with Autism Watch for the Wrong Visual Clues - 0 views

  • Individuals with autism spectrum disorders (ASD) tend to stare at people's mouths rather than their eyes. Now, an NIH-funded study in 2-year-olds with the social deficit disorder suggests why they might find mouths so attractive: lip-sync—the exact match of lip motion and speech sound.
  • Such audiovisual synchrony preoccupied toddlers who have autism, while their unaffected peers focused on socially meaningful movements of the human body, such as gestures and facial expressions.
  • "Typically developing children pay special attention to human movement from very early in life, within days of being born. But in children with autism, even as old as two years, we saw no evidence of this," explained Ami Klin, Ph.D., of the Yale Child Study Center, who led the research. "Toddlers with autism are missing rich social information imparted by these cues, and this is likely to adversely affect the course of their development."
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  • In theory, this finding could lead to educational techniques that could help very young children with autism build their social referencing skills. This could be hugely important for children with autism, since their challenges with "reading" social cues create so many problems as they enter school, interact with peers, and begin to navigate social relationships.
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    Individuals with autism spectrum disorders (ASD) tend to stare at people's mouths rather than their eyes. Now, an NIH-funded study in 2-year-olds with the social deficit disorder suggests why they might find mouths so attractive: lip-sync-the exact match of lip motion and speech sound.
Tero Toivanen

Early intervention for toddlers with autism highly effective, study finds - 1 views

  • The study, published online today in the journal Pediatrics, examined an intervention called the Early Start Denver Model, which combines applied behavioral analysis (ABA) teaching methods with developmental 'relationship-based' approaches.
  • The five-year study took place at the University of Washington (UW) in Seattle and was led by Dawson, then a professor of psychology and director of the university's Autism Center, in partnership with Rogers. It involved therapy for 48 diverse, 18- to 30-month-old children with autism and no other health problems.
  • At the conclusion of the study, the IQs of the children in the intervention group had improved by an average of approximately 18 points, compared to a little more than four points in the comparison group. The intervention group also had a nearly 18-point improvement in receptive language (listening and understanding) compared to approximately 10 points in the comparison group. Seven of the children in the intervention group had enough improvement in overall skills to warrant a change in diagnosis from autism to the milder condition known as 'pervasive developmental disorder not otherwise specified,' or PDD-NOS. Only one child in the community-based intervention group had an improved diagnosis.
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  • In this study, the intervention was provided in a toddler's natural environment (their home) and delivered by trained therapists and parents who received instruction and training as part of the model.
  • Parents are taught strategies for capturing their children's attention and promoting communication. By using these strategies throughout the day, the children were offered many opportunities to learn to interact with others.
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    A novel early intervention program for very young children with autism - some as young as 18 months - is effective for improving IQ, language ability, and social interaction, a comprehensive new study has found.
Tero Toivanen

According to Pritchard, one of the main reasons autistic chi - 2 views

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    Video game helps autistic children with social interaction
Tero Toivanen

Abstract | Hyperbaric treatment for children with autism: a multicenter, randomized, do... - 0 views

  • Children with autism who received hyperbaric treatment at 1.3 atm and 24% oxygen for 40 hourly sessions had significant improvements in overall functioning, receptive language, social interaction, eye contact, and sensory/cognitive awareness compared to children who received slightly pressurized room air. Trial Registration: clinicaltrials.gov NCT00335790
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    Hyperbaric treatment for children with autism: a multicenter, randomized, double-blind, controlled trial Children with autism who received hyperbaric treatment at 1.3 atm and 24% oxygen for 40 hourly sessions had significant improvements in overall functioning, receptive language, social interaction, eye contact, and sensory/cognitive awareness compared to children who received slightly pressurized room air. Trial Registration: clinicaltrials.gov NCT00335790
Tero Toivanen

Interactive Multimedia Technology: Interactive Visual Supports for Children with Autism... - 2 views

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    Here is an update about the work of Gillian Hayes, an assistant professor at the School of Informatics at the University of California at Irvine. Much of her work focuses on technology that supports young people with autism spectrum disorders.
Tero Toivanen

Research Unearths New Treatments for Autism - 2 views

  • The Utah researchers found that children receiving a combination of the two treatments (Lovaas-type training at school and TEACCH methods at home) showed three to four times greater progress on all outcome tests than did children who received only the school-based treatment. That study was reported in the Journal of Autism and Developmental Disorders (Vol. 28, No. 1, p. 2532).
  • Researchers in Washington, D.C., are comparing a discrete trial training approach with a "developmental, individual-difference, relationship based" (DIR) approach, says child psychiatrist Stanley Greenspan, MD, professor of psychiatry at George Washington University Medical School.
  • Psychologist Robert Koegel, PhD, at the University of California, Santa Barbara, and his colleagues are attempting to tailor a standard treatment to the specific needs of an autistic child and family. The standard treatment is called pivotal response training
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  • An initial retrospective study is comparing two groups of 20 children initially diagnosed with autism who were functioning well after two or more years of treatment, either with a discrete trial training approach or the DIR approach. The study aims to determine if treatment differences lead to subtle differences in outcome, for example, in terms of flexibility, emotional range, creativity and richness of the child's inner life. Investigators are planning to follow this research with a prospective, randomized, more rigorous study of the two approaches.
  • "In our previous studies we found out that it looks like you can't just deliver a standard treatment to autistic kids, that there's so much variability among the children that what works for one child doesn't work for another child," he says. "Our hypothesis is that...unless you individualize treatment, you're not going to get the best effect."
  • Researchers at the University of Maryland are testing an intervention to trigger children's "social engagement system," which includes behaviors such as listening, looking, facial expressions and vocalizations that support social interaction, says psychologist Stephen Porges, PhD. The treatment is designed to improve autistic children's ability to interact with others, thereby making them more receptive to traditional therapies.
  • The intervention is based on the theory that tensing the middle ear muscles enables people to pick out the human voice from lower frequency sounds in the environment, Porges says. Treatment involves exercising middle ear muscles by playing music that has been altered to include only frequencies associated with the human voice, which improves one's ability to listen to human voices. This, in turn, stimulates the entire social engagement system, Porges says. About 80 percent of 50 children with autism or other behavioral problems receiving this treatment via five 45-minute sessions in a double blind, randomized controlled study showed marked improvements in listening, language and other communication skills.
  • In a report last year in the Journal of Autism and Developmental Disorders (Vol. 28, No. 1, p. 15-23) evaluating an intensive home-based discrete trial training intervention, Stephen Sheinkopf, PhD, of the University of Miami and Bryna Siegel, PhD, of the University of California, San Francisco, noted that children receiving an average of only 21 hours per week of treatment showed gains in IQ comparable to those achieved by children receiving 32 hours per week. The intensity question remains an issue of importance for the autism community. "If we need 40 hours a week, fine," says psychologist Geraldine Dawson, PhD, of the University of Washington. "But if you only need 25, you have to realize that 40 hours is a tremendous burden not only financially, but on families and on the child."
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    Several treatments, and combinations of treatments, are under intense study.
Tero Toivanen

Genes implicated in twins' autism | The Autism News - 1 views

  • Researchers have known for years that when one identical twin has autism, the other is also likely to be diagnosed with it – evidence that autism likely has a genetic component.
  • Researchers at Kennedy Krieger Institute studied 277 pairs of twins and found that when one identical twin had the disorder, the other developed it 88 percent of the time; for fraternal twins, that figure was 31 percent.
  • Despite this progress in unlocking the mysteries of autism, scientists have simply confirmed that there are likely numerous genetic links to autism.
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  • Each discovery explains just a tiny fraction of autism’s causes. Researchers think the great majority – 90 percent – of autism cases have a genetic cause, but they’ve found fewer than 10 percent of the triggers.
  • researchers have found about 50 genes so far that might be tied to autism, which explain very few cases, he said.
  • Autism isn’t one disease; it’s too individual to locate just one genetic cause. It’s not like cystic fibrosis, a disorder for which researchers have identified one gene – and tests to diagnose it.
  • autism researchers envision that a wide variety of gene defects are responsible for the symptoms collectively known as autism spectrum disorders. The disabilities, different in each child, range from the mild Asperger syndrome to more severe impairments in social interaction and communication.
  • “It’s going to take some work before we understand the true causes of autism,” he said. “We need to make much more headway to ever have enough understanding so that patient management and therapies can be improved.”
  • None of the new findings explains why more children are being diagnosed with autism. Genes, said Goldstein, tell only part of the story.
  • “The idea is there is an environmental interaction with the genetic component,” he said.
  • Autism may be inherited to some degree, but even twin studies show that not all sets of identical twins have autism. And when they do, they don’t always have the same severity of the disorder
  • That connection between genes and the environment, called epigenetics, might explain these distinctions
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    Researchers have known for years that when one identical twin has autism, the other is also likely to be diagnosed with it - evidence that autism likely has a genetic component.
Tero Toivanen

What Do New Genetic Findings Mean to Families with Autism? - 0 views

  • reply from lead researcher Hakon Hakonarson:
  • The variant we detected at the 5p14 locus (common variant) has been present for a long time in the genome (most likely since man moved out of Africa) and this region is highly conserved between species which means that it is regulating gene expression and gene function (the CHD10 gene being the most critical one).
  • We know that the association is strongest in those individual who have the greatest abnormalities in social skills/interactions and those that show least interest in interactions; we have not detected any other characteristics yet, but we keep working on it.
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  • Once we learn about this difference, we can then look for medications that block the consequences of the variant and once we make sure they are safe, we can then start testing these new medications in children who are at risk of developing autism, with the objective of preventing autism (i.e., avoid breakdown in connections between nerves and abnormality in brain connectivity).
  • Response: Yes, all of them could be tested in utero; we have identified 10 new variations (9 rare and 1 common) and we have replicated (and confired) four other once that were previously published (neurexin 1, contactin 4, 15q11 and 22q11). However, we do not have a yes or no answer as to whether the fetus will be autistic -- but if we are testing a fetus in an autistic family the value of the test is much higher.
Tero Toivanen

New Study: Autism has Multiple Genetic Roots | Suite101 - 3 views

  • The study’s major finding was that children with ASD have significantly more CNVs affecting their genes than children without ASD. Children with ASD have 20 percent more CNVs in general, and 70 percent more CNVs impacting genes known to be associated with ASD or cognitive problems. Significantly, many of the genes that are affected control important functions such as cell proliferation and cell-to-cell communication.
  • Some of the newly discovered genetic variants are inherited, and are found in parents or siblings of children with them. Others, however, seem to have originated spontaneously in the affected child, and do not appear in other family members.
  • While these findings add significantly to the scientific understanding of the genetic and biological underpinnings of ASD, the immediate usefulness is limited. That’s because there are a very large number of CNVs, and each child shows a different pattern of genetic changes. Each of these changes is rare; no CNV showed up in more than one percent of the children studied.
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  • “This will lead to a paradigm shift in understanding the etiology of autism,” says Stephen Scherer, a senior scientist at The Hospital for Sick Children in Toronto, Canada. “Until now, most scientists thought individuals with autism shared common genes. We now think each person has his own rare variations.”
  • If significant CNVs show up, behavioral treatment can be started early. That has been shown to improve children’s outcomes significantly. “If we provide stimulation early, while the brain is still plastic, we can improve cognitive development, social interaction and communication,” says Geri Dawson, Chief Science Officer of Autism Speaks, the major sponsor of the research project.
  • What this new research suggests is that autism and ASD probably result from the interaction between many different genes and a child’s environment. Rather than search for one single cause and one “magic bullet,” researchers will try to find as many significant genetic variants as possible, link them to the biological functions and pathways they control, and then search for medications that can improve or normalize the functioning of damaged pathways.
Tero Toivanen

Autism Therapies and Outcomes -- Outcomes and Autism - 0 views

  • The view of the behavior analyst should be that the subject is always right. If the child isn't learning, you need to know why. It's not that the child is defective, it's that the approach isn't working. The therapist needs to ask, "what do I need to do to teach this child?" ...Being autistic shouldn't stop children from learning. It has nothing to do with their ability to learn. They just don't learn typically. That's the problem we have. You can't use "autism" as way to explain behaviors: it is the behaviors. Why do the behaviors occur? We don't always know. But that doesn't mean we can't teach children with autism language and social interaction. They don't need us to have fun -- they can create their own reinforcers. The therapist has to find a reinforcer that's better than what the child can do on his own. That "better thing" should always have a social component.
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    It's important to remember that, when it comes to therapy for children with autism, failure to progress is never the fault of the child. If you hear from a therapist that your child doesn't progress because of his behaviors, attention span, intelligence level, or stubbornness, it's time to question the therapist's technique.
Tero Toivanen

Facilitated communication: Facts, Discussion Forum, and Encyclopedia Article - 1 views

  • The procedure is controversial, since a majority of peer reviewPeer reviewPeer review is the process of subjecting an author's scholarly work, research, or ideas to the scrutiny of others who are experts in the same field. Peer review requires a community of experts in a given field, who are qualified and able to perform impartial review...ed scientific studies conclude that the typed language output attributed to the clients is directed or systematically determined by the therapists who provide facilitated assistance. Some peer-reviewed scientific studies have indicated instances of valid FC, and some FC users have reportedly gone on to type independently.
  • Harvard UniversityHarvard UniversityHarvard University is a private university located in Cambridge, Massachusetts and a member of the Ivy League. Founded in 1636 by the colonial Massachusetts legislature, Harvard is the oldest institution of higher learning in the United States and currently comprises ten separate academic units... psychologist Daniel WegnerDaniel WegnerDaniel M. Wegner is an American social psychologist. He is a professor of psychology at Harvard University and a fellow of the American Association for the Advancement of Science. He is known for his work on mental control and conscious will, and for originating the study of transactive memory and... has argued that facilitated communication is a striking example of the ideomotor effectIdeomotor effectThe ideomotor effect is a psychological phenomenon wherein a subject makes motions unconsciously. As in reflexive responses to pain, the body sometimes reacts reflexively to ideas alone without the person consciously deciding to take action..., the well-known phenomenon whereby individuals' expectations exert unconscious influence over their motor actions. Even FC users and proponents do acknowledge the possibility of facilitators at times "guiding" users, consciously or unconsciously. Other theorists (Donnellan and Leary, 1995) argue that autism is in significant part characterized by dyspraxia (a movement disorder), and that there exists a synchronistic "dance" to communication in all mammalian social interaction which accounts for the mixed results in validation studies.
  • Stephen von Tetzchner, the author of another leading textbook on Augmentative and Alternative CommunicationAugmentative and alternative communicationAugmentative and alternative communication is communication for those with impairments or restrictions on the production or comprehension of spoken or written language.-Definition :... has done theoretical research about facilitated communication. In his opinion "The existing evidence clearly demonstrates that facilitating techniques usually led to automatic writingAutomatic writingAutomatic writing is the process or production of writing material that does not come from the conscious thoughts of the writer. Practitioners say that the writer's hand forms the message, with the person being unaware of what will be written...., displaying the thoughts and the attitudes of the facilitators."
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  • Mark Mostert (2001) says: "Previous reviews of Facilitated Communication (FC) studies have clearly established that proponents' claims are largely unsubstantiated and that using FC as an intervention for communicatively impaired or noncommunicative individuals is not recommended." In March 2007, Scott Lilienfeld included facilitated communication on a list of treatments that have the potential to cause harm in clients, published in the APSAssociation for Psychological ScienceThe Association for Psychological Science , previously the American Psychological Society, is a non-profit organization whose mission is to promote, protect, and advance the interests of scientifically oriented psychology in research, application, teaching, and the improvement of human welfare... journal Perspectives on Psychological Science.
  • The phrase "independent typing" is defined by supporters of FC as "typing without physical support", i.e., without being touched by another person. Skeptics of FC do not agree that this definition of independence suffices because of the possibility of influence by the facilitator. For example, Sue RubinSue RubinSue Rubin is a functionally non-verbal published autistic author who was the subject of the Oscar-nominated documentary Autism Is A World in which she communicated via the controversial communication technique of facilitated communication...., an FC user featured in the autobiographical documentary Autism Is A World, reportedly types without anyone touching her; however, she reports that she requires a facilitator to hold the keyboard and offer other assistance.
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    The procedure is controversial, since a majority of peer reviewed scientific studies conclude that the typed language output attributed to the clients is directed or systematically determined by the therapists who provide facilitated assistance. Some peer-reviewed scientific studies have indicated instances of valid FC, and some FC users have reportedly gone on to type independently.
Tero Toivanen

Pivotal Response Teaching - 0 views

  • Pivotal Response Teaching  is an Advanced Behavioral Treatment intervention based on the principles of Applied Behavior Analysis (ABA) and derived from the work of Drs. Koegel, Schreibman, Dunlap, Horner, Burke and other researchers.
  • PRT builds upon the older ABA paradigms and has a focus on targeting “Pivotal” skills or behaviors in order to produce more broad changes in a child’s development.
  • Pivotal Response Training (PRT) provides a guideline for teaching skills and has been most successful for language, play and social interaction skills in children with autism and related disorders. 
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    Pivotal Response Teaching is an Advanced Behavioral Treatment intervention based on the principles of Applied Behavior Analysis (ABA) and derived from the work of Drs. Koegel, Schreibman, Dunlap, Horner, Burke and other researchers.
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