goals of the presentation - amazon s3€¦ · (marco, khatibi, hill et.al, 2012; yi‐shin chang,...
TRANSCRIPT
3/12/2016
1
Neurological and Behavioral Distinctions between Autism & Sensory Processing Disorders
Session No.: SC 158
April 07, 2016
2:00 ‐3:30 PM
AOTA Conference, Chicago
Guy McCormack, Ph.D., OTR/L,FAOTA
Goals of the Presentation
Goal 1
To describe differences in the structural connectivity in children with Autism and children with Sensory Processing Disorder.
Goal 2
Provide examples of how sensory challenges impact
behavior and learning in
children with sensory
processing disorders.
Goal 3
Discuss some
biomarkers that show
Neurological Differences between
Autism and Sensory
Processing Disorders
Goal 4
Provide Examples of Interventions
that are promising for maintaining an optimal state of
arousal for self‐regulation
Trends in the Prevalence of Autism
3/12/2016
2
Alarming Statistics
• U.S. Department of Health and Human Services now estimates roughly 1 in 50 school‐aged children are diagnosed with Autism Spectrum Disorder (ASD).
• CDC estimates about 1 in 68 children has been identified with autism spectrum disorder (ASD)
• ASD is not generally diagnosed until after three years of age.
Three Major Symptoms or Autism:
1. Impaired Social Interactions
2. Impairment in Communication both Verbal & Nonverbal communication
3. Restricted Interests, repetitive and stereotyped patterns of behavior.
Problem
1. Children diagnosed within the autism spectrum have unusual sensory processing issues.
2. Deficits in sensory processing are often described with behavioral descriptions (Tomchek & Dunn, 2007).
3. Approximately, 90% of children with Autism are reported to manifest disrupted sensory processing (Leekam, Nieto, Libby, Wing, & Gould, 2007).
3/12/2016
3
Problem
4. Children with autism show impaired connectivity in the temporal tracts associated with auditory processing, social‐emotional processing and attention.
5. Children with autism also show diminished connections essential to the processing of facial emotion and memory (Bunim, 2014).
6. Clinical observations, parent reports and behavioral studies suggest a complex and highly variable phenotype across the spectrum.
Perception of Faces
3/12/2016
4
Observed Differences
Children with Autism Typically Developing Children
Children with Sensory Processing Disorder
Calming Children with Autism
SoothabilityThe difference was significant between groups for time taken to get child to stop crying,
(t = ‐2.92, p = .006), with mothers of children on the autism spectrum reporting taking more time to get their child to stop crying.
ComfortingA significant group difference in the level of difficulty in providing comfort, (t = ‐2.18, p = .034), mothers of children on the autism spectrum reported more trouble comforting their children than mothers of typically developing children.
Calming Children with Autism
HuggingSignificant group differences were found for hugs, (t = 2.79, p = .011), with more mothers of typically developing children reporting hugging as a successful method of comfort.
Music and Visual Mothers of children with autism were significantly more likely to report music (t = 2.68, p = .011) and television/video (t = ‐2.66, p = .011) as successful in comforting their children.
3/12/2016
5
Gold Standard Assessments In OT
• The Short Sensory Profile (SSP) McIntosh, et. al.1999
• The Sensory Integration and Praxis (SPIT) Ayres, 1989 for assessing sensory Integration and Praxis (Schaaf et al.2014)
New Developments
• Recent neuroscience imaging studies have revealed distinct differences in neuronal connections that regulate behavior in children with autism and children with sensory processing disorders (Marco, Khatibi, Hill et.al, 2012; Yi‐Shin Chang, Owen, Desai, et.al, 2014).
• Clinical studies have been inconsistent in revealing differences in somatosensory processing in children.
• About one percent of children in the United States are diagnosed with an autism spectrum disorder while five to 16 percent of children have sensory processing disorders (Mukherjee, 2015).
• Many studies have focused on auditory and visual sensory processing; few have explored early tactile processing despite the high prevalence of atypical tactile behaviors in children with ASD (Marco, et al., 2011).
Assessments for Autism
1. Autism Diagnostic Observation Schedule (ADOS)
2. Autism Treatment Evaluation Checklist (ATEC)
3. Modified Checklist for Autism in Toddlers (M‐CHAT)
4. Test for Variables of Attention ( TOVA)
5. Social Responsiveness Scale (SRS)
6. Sensory Profile Short Form
3/12/2016
6
Autism Diagnostic Observation Schedule (ADOS)
• “ Gold Standard” for Psychologist’s
• Mainly Observational
• Evaluates in four modules: behavior, communication, social interaction, play and imaginative use of materials
• Children with sensory processing disorders are often included in the Autism Category on the Diagnostic and Statistical Manual (DSM 5) used by psychologists and psychiatrists.
Dr. Winnie Dunne’s Research on Sensory Processing
Dunn W, Saiter J, Rinner L,(2002). Asperger Syndrome and Sensory Processing: A Conceptual Model and Guidance for Intervention Planning. AJOT.
Kientz M and Dunn W,(1997). A Comparison of the Performance of Children With and Without Autism on the Sensory Profile AJOT 51, 7, 530‐537.
Sensory Processing In Children With and Without Autism AJOT, 2007
Scott D. Tomchek, PhD, OTR/L, FAOTAWeisskopf Center Louisville, KY 40202
Winifred (Winnie) Dunn, PhD, OTR, FAOTA University of Kansas Medical Center
3/12/2016
7
Sensory Pattern Contributions to Developmental Performance in Children with Autism Spectrum Disorder. American Journal of Occupational Therapy,
September 2015, Vol. 69, 6905185040p1‐6905185040p10. doi:10.5014/ajot.2015.018044
Scott D. Tomchek, PhD, OTR/L, FAOTA
Winifred (Winnie) Dunn, PhD, OTR, FAOTA University of Kansas Medical Center
Lauren M. Little, Ph.D., OTR/L
Retrospective chart Review Study (N=400) Affects developmental skills and adaptive behavior.
Sensory Profile
• Evaluates the child’s threshold for Sensory Processing:
1. Auditory
2. Visual
3. Vestibular
4. Touch
5. Oral
Olfactory Sense in Autism
Alessandro Tonacci, Lucia Billeci, Gennaro Tartarisco, Liliana Ruta, Giovanni Pioggia, Sebastiano Gangemi. Olfaction in autism spectrum disorders: a systematic review. PROSPERO 2014:CRD42014013939 Available from http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42014013939
1. One of the most affected senses seems to be olfaction, whose role as a biomarker of neural functioning is well known. For this reason, the relationship between olfactory function and Autism has been investigated from a scientific point of view.
2. The vast majority of Autistic participants show an olfactory dysfunction, especially concerning the Olfactory Identification task, while others show an increase in their sense of smell.
3/12/2016
8
Projections from the Amygdala to the Brainstem, via the Hypothalamus, Regulate the Expression of
Autonomic Reactions to Social Signals
(shown by dotted arrows).
Meyer‐Lindenberg, A, Domes, G, Kirsch,P & Heinrichs,M (2011). Oxytocin and vasopressin in the human brain: social neuropeptides for translational medicineNature Reviews Neuroscience 12, 524‐538 doi:10.1038/nrn3044
Vasopressin Linked with Dysfunctions in Sensory Processing
• Vasopressin neurons in the olfactory system may modulate input, sending information about smells to influence activation and mood.
• Vasopressin may be essential for integration of sensory input during complex forms of social behavior in mammals.
• Children with Autism with low vasopressin levels performed poorly on ability to perceive the perspectives of others.
The Role of Vasopressin in the Social Deficits of Autism
• Neuropeptides, such as vasopressin and oxytocin, are molecules used by neurons in the brain to communicate with one another. Vasopressin is closely related to oxytocin, which is currently being tested as a treatment for autism, and has been shown to enhance social functioning in animals.
3/12/2016
9
Oxytocin and Autism
Oxytocin levels influence
• Social behavior,
• Communication
• Social bonding.
Nasal spray containing oxytocin improved social behavior.
Andari, E., Duhamel, J., Zalla, T., Herbrecht, E., Leboyer, M., & Sirigu, A. (2010). Promoting social behavior with oxytocin in high-functioning autism spectrum disorders Proceedings of the National Academy of Sciences DOI: 10.1073/pnas.0910249107
Autism’s Gut‐Brain Connection
• The different gut bacteria in autistic individuals may be contributing to the disorder.
• Researchers at the California Institute of Technology have shown for the first time that they may actually contribute to the disorder.
Brain‐Gut Relationship
• Knowing at the “Gut Level”
• The enteric nervous system, contains some 100 million neurons, more than in either the spinal cord or the peripheral nervous system.
• The enteric nervous system uses more than 30 neurotransmitters, and produces 95 percent of the body's serotonin.
• About 90 percent of the fibers in the Vagus nerve carry information from the gut to the brain.
3/12/2016
10
Excess Stress & Cortisol Levels
• Studies show mothers of children with autism have high levels of stress.
• Impaired cognitive performance
• Lowered immunity and inflammatory responses in the body, slowed wound healing, and other health consequences.
Sensory Processing Disorders
Sensory Processing Disorder
3/12/2016
11
DSM‐5 Diagnostic Criteria
Over 90% of children with Autism Spectrum Disorders (ASD) demonstrate atypical sensory behaviors.
In fact, hyperactivity or hyporeactivity to sensory input or unusual interest in sensory aspects of the environment is now included in the DSM‐5 diagnostic criteria.
Imaging Studies as Biomarkers
Brain changes in the hippocampus in children with autism suggest that this might be an important target for brain‐based treatments, including both therapy and medication.
Imaging the Brain
3/12/2016
12
Diffusion Tensor Imaging
Traces the pathways of nerve fibers by measuring the diffusion of water molecules in the brain.
— vector.childrenshospital.org
Structural Connectivity in the Autistic Brain
• ASD group show Impaired connectivity in temporal tracts associated with social‐emotional processing.
• Sensitivity to sounds or Auditory processing has been associated with ASD in a number of studies.
• One prevailing hypothesis [about autism] is that there is an underconnectivity (Just et al., 2004) localized and overconnectivity of more distant sites(Anderson et al., 2011).
Biomarkers for Sensory Processing Disorders
• White matter microstructure is a biological substrate for the atypical sensory behaviors of children with SPD.
• Social impairments in autism are likely caused by the poor frontal‐posterior connectivity.
• Studies of white matter may also help to establish SPD as a clinical entity distinct from overlapping conditions such as autism spectrum disorders and ADHD.
• In the case of autism, the connections between different brain regions are altered, and not altered evenly, which means to the ability of the brain to process information is impaired.
3/12/2016
13
Is the White Matter Neuroplastic?
Neuroimaging studies of visuomotor learning in humans have suggested that structural plasticity can occur in white matter (WM), but the biological basis for such changes is unclear.
Sampaio‐Baptista, C.; Khrapitchev, A. A.; Foxley, S.; Schlagheck, T.; Scholz, J.; Jbabdi, S.; Deluca, G. C.; Miller, K. L.; Taylor, A.; Thomas, N.; Kleim, J.; Sibson, N. R.; Bannerman, D.; Johansen‐Berg, H. (2013). "Motor Skill Learning Induces Changes in White Matter Microstructure and Myelination". Journal of Neuroscience 33 (50): 19499–503. doi:10.1523/JNEUROSCI.3048‐13.2013. PMC 3858622. PMID 24336716.
Researchers at four study sites nationwide used a type of MRI scan to look at brain development in the younger siblings of
autistic children, who are known to be at higher risk for autism themselves.
— news.stlpublicradio.org
Imaging Studies Showing Hypoperfusion in Temporal Lobes in Children with Autism Spectrum Disorder
3/12/2016
14
Diffusion Tensor Imaging Study UCSF
Elysa Marco, MDUniversity of California San Francisco
• Children with sensory processing disorders have over growth of brain’s white matter which is essential for perceiving, thinking and learning.
• Trouble with Emotional Regulation and Attention
White Matter Correlates of Sensory Processing in Autism
Diffusion Tensor Imaging was used to examine white matter fiber tracts associated with aberrant sensory processing.
N=32 ASD
N=26 TDC
1. Inferior Longitudinal fasciculus which plays a role tactile defensiveness.
2. Splenium involved in attentional orienting
3/12/2016
15
White Matter Microstructural Integrity
This imaging biomarker not only presents an ideal diagnostic tool to be used in conjunction with other parent reports and direct behavioral measures, but also informs treatments based on cognitive rehabilitation.
Children with Sensory Processing Disorders (SPD) have impaired white matter microstructure, and that this white matter structural connectivity correlates with atypical sensory behavior.
http://www.ucsf.edu/news/2013/07/107316/breakthrough‐study‐reveals‐biological‐basis‐sensory‐processing‐disorders‐kidsi
Splenium of the Corpus Callosum
White matter modulates the distribution of action potentials, acting as a relay and coordinating communication between different brain regions. The splenium fibers, affect the interhemispheric synchronization of neural networks.
3/12/2016
16
Splenium means Bandage
s
sp
Citation
Knyazeva, MG (2013). Splenium of Corpus Callosum: Patterns of Interhemispheric Interaction in Children and Adults. Neural Plasticity. volume 2013, Article ID 639430.
http://doi.org/10.1155/2013/639430
Splenium of the Corpus Callosum
• Allows modulation of responses to superfluous information from the visual environment, leading to a reduction of metabolic and structural redundancy in a child's brain.
• The size of the Corpus Callosum in animals and humans increases with learning or training.
3/12/2016
17
Splenium of the Corpus Callosum
• One such function is figure‐ground segregation, which refers to the ability of the visual system to segment images of the external world into objects and background.
• It relies on inhibition among neurons with neighboring receptive fields tuned to the same feature.
• The functions of the splenium may encompass communication among different levels of hierarchy.
Splenium of the Corpus Callosum
The impact of the splenium in synchronizing the electrical activity between the hemispheres is supported by animal models and noninvasive human studies.
fMRI Images showing Interhemispheric integration in children and Adults
• Myelination facilitates interhemispheric interaction by enhancing the coordination of interhemispheric input .
• The Splenium is slow to Myelinate
• Continuing development leads to the cortex rewiring through elimination of overproduced connections.
3/12/2016
18
Study Links Brain Size to Regressive Autism
Consistent with postmortem and head‐circumference studies, brain imaging studies suggest that overall brain volumes are increased in children with autism (David Amaral‐MIND Institute at the
University of California, Davis
Cortical Connectivity
These abnormalities suggest aberrant connections between cortical regions, is consistent with the hypothesis of abnormal cortical connectivity in autism.
The Thickness of the Corpus Callosum is Reduced in Autism
Vidal, CN, Nicolson, R,. DeVito, TJ, Hayashi, KM
(2014). Mapping Corpus Callosum Deficits in Autism: An Index of Aberrant Cortical Connectivity
3/12/2016
19
Citation
Fine JG, Musielak KA, Semrud‐ClikemanM.(2014). Smaller splenium in children with nonverbal learning disability compared to controls, high‐functioning autism and ADHD. Child Neuropsychol.;20(6):641‐61. doi: 10.1080/09297049.2013.854763. Epub 2013 Nov 12.PMID: 24215424
Event Related Potential
Electroencephalography (EEG) provides an excellent medium to understand neurobiological dysregulation, with the potential to evaluate neurotransmission. Time‐locked EEG activity or event‐related potential (ERP) helps capture neural activity related to both sensory and cognitive processes.
WHAT IS EVENT‐RELATED POTENTIAL?
• Event‐related potentials (ERPs) are very small voltages generated in the brain structures in response to specific events or stimuli (Blackwood and Muir, 1990).
• Event‐related potentials can be elicited by a wide variety of sensory, cognitive or motor events. They are thought to reflect the summed activity of postsynaptic potentials produced when a large number of similarly oriented cortical pyramidal neurons (in the order of thousands or millions) fire in synchrony while processing information (Peterson et al., 1995).
3/12/2016
20
EVENT‐RELATED POTENTIAL
• ERP constitutes a millisecond‐by‐millisecond record of neural information processing, which can be associated with particular operations such as sensory encoding, inhibitory responses and updating working memory. Thus it provides a noninvasive means to evaluate brain functioning in persons with cognitive disorders.
Event‐Related Potential(Auditory, Visual, or Tactile).
https://www.youtube.com/watch?v=iteBq04‐UQY
Study Used 70 Electrodes
Study found that children diagnosed with autism process auditory input less effectively than typically developing children.
Brandwein, Foxe, Butler et al.(2014) Neurophysiological Indices of Atypical Auditory Processing and Multisensory Intergration are Associated with Symptom Severity in Autism. Journal of Autism and Developmental Disorders.Springer Science + Business Media New York
3/12/2016
21
Severity Scores: N1a & N1b
Children with Sensory Processing Disorder (SPD)
• Aberrant connectivity in the pathways that serve Auditory, Somatosensory and Visual attention.
• Children with SPD have difficulty processing incoming sensory input.
Neuroplasticity
Myelination in the nervous system is a plasticity‐dependent process.
3/12/2016
22
Enriched Environments and Sensory Input Promotes Dendritic Growth.
Touch Pressure Removes Biochemical Substances in Soft Tissues:
Vasopressin Levels Reduced
Rapport MH, Schettler, Bresee,C (2010). A Preliminary Study of the Effects of a Single Session of Swedish Massage on Hypothalamic-Pituitary Adrenal and Immune Function in Normal Individuals.J. of Alternative and Complementary Medicine 16,10 pp. 1079-1088.
INSULA
Deep Pressure on Primary Rami
3/12/2016
23
Qigong Massage Program
Silva, L.M., Schalock, M & Gabrielse, K. (2011). Early intervention for Autism with a parent‐delivered qigong Massage Program: A randomized controlled trial. AJOT,65 ,550‐559.
OT’s can help families understand that children with autism have unique styles of sensory processing that influence
their behavior in the parent‐child relationship.
Music is Globally Processed in the Brain
Loewy, J., Stewart, K., Dassler, A (2013). The Effects of Music on Vital Signs, Feeding and Sleep in Premature Infants. Beth Israel Medical Center, N.Y.,N.Y.
Elements such as rhythm affect physiological and developmental functions
3/12/2016
24
Hall, L., & Case‐Smith, J. (2007). The effect of sound‐based intervention on children with sensory processing disorders and visual–motor delays.
American Journal of Occupational Therapy,61,209–215
Occupational therapists use music as preparation for therapeutic activities on the basis of the belief that sensory input through the auditory and vestibular systems can be calming and organizing to children (Ayres, 1979; Frick & Hacker, 2001)
Dr. Alfred Tomatis, a French physician and researcher theorized that the ear is an integrator for the entire nervous system and that we listen with our whole body. The ear affects the body’s ability to integrate information for hearing, listening, motor control, communication, and learning, and helps bring about cortical impulses in the brain.
Dr. Jane Case‐Smith, EdD, OTR/L, FAOTA
Children with Autism
• Have decreased connectivity in the Inferior Longitudinal fasciculus, Inferior front‐occipital fasciculi, fusiform amygdala and the fusiform‐hippocampus.
• Difficulty Processing Socio‐emotional Input
Music Promotes Plasticity of the Corpus Callosum & Longitudinal Fasciculus
Steele,CJ, Bailey, JA, Zatorre, RJ and Penhune,VB (2013).Early Musical Training and White‐Matter Plasticity in the Corpus Callosum: Evidence for a Sensitive Period. The Journal of Neuroscience, 16 January 2013, 33(3): 1282‐1290; doi: 10.1523/JNEUROSCI.3578‐12.2013
“Training before the age of 7 years results in changes in white‐matter connectivity that may serve as a scaffold upon which ongoing experience can build.”
Oechslin,MS,Imfeld,A, Loenneker,T et al. (2009). The Plasticity of the Superior Longitudinal Fasciculus as a Function of Music Expertise: A Diffusion Tensor Imaging Study. Frontiers of Neuroscience;3 :76 ‐Doi: 10.3389/neiro.09.076.2009
3/12/2016
25
Auditory Processing and the Nucleus Basalis
Main subcortical source of cortical acetylcholine (Ach) which is
associated with speed and strength of synaptic connections.
Acetylcholine accelerates Activity‐dependent neuroplasticity &
neurodevelopmental.
Therapeutic Applications
Children with Autism become socially engaged when they mouth words & rhythms.
Oscillation Activity in the Brain
• The network activity of the brain is oscillatory in nature.
• Oscillations provide a temporal frame for neuronal firing by means of synchronization of pre‐ and postsynaptic potentials.
• In the context of this discussion, oscillations in the EEG alpha rhythm are of special interest.
3/12/2016
26
Monitoring Brain Waves (EEG’s)
EEG Studies to Diagnose Autism
EEG’s are more accurate than behavioral assessments to diagnose Autism.
3/12/2016
27
Why EEG’S
http://www.ted.com/talks/aditi_shankardass_a_second_opinion_on_learning_disorders.html
Alpha Rhythm
• Alpha rhythm is the most prominent oscillatory activity that can easily be recorded by means of noninvasive surface EEG electrodes within a wide range of ages.
• Alpha waves are generated by visual cortical circuits interacting with thalamocortical loops.
• Alpha waves operate within a relatively narrow frequency range between 8 and 12 Hz.
Alpha Rhythm in Children
• The development of alpha rhythm in children seems to be closely linked to the maturation of the Corpus Callosum.
• Alpha Rhythms are patterns of smooth, electrical oscillations in the brain that reflect a transcendent and dynamic state of consciousness.
3/12/2016
28
Protocols Rewarding 12‐15 HZ at the Temporal lobes at Sites T3 and T4
Splenium
The Neurofeedback Signal is derived from assemblies of Pyramidal Cells located on the outer
surface of the cortex (Electrical Potentials)
Neurofeedback Training
Neurofeedback trains the brain to self‐regulate brain oscillations leading to improved attention and social responsiveness. The specific areas of the brain affected by Autism can also be targeted and trained to produce higher frequencies brainwaves.
Alpha Rhythm Training
3/12/2016
29
Predominant Brain Waves Influence Behavior
Test for Variables of Attention (TOVA)
Continuous Performance Test:
1. Response Time Variability‐measures inconsistency or inability to stay on task.
2. Commission Errors‐measures impulsivity or dys‐inhibition or incorrect responses to non‐target
3. Omission Errors‐Measures inattention when child does not respond to designated target.
4. Performance over time‐measures response to signal detection over four quadrants of time.
Test for Variables of Attention (TOVA)
• Continuous Performance test
• Provides objective measures of child’s performance on visual attention tasks over time (21.6 minutes).
• Measures response time on an electron micro switch in milliseconds.
Target Non-Target
3/12/2016
30
fMRI Images visual Input (Green) Auditory Input (Red)
Stanford University Imaging Center
Neurofeedback Outcomes
Six‐months post‐intervention, gains were maintained in the neurofeedback group, but not in the cognitive training group.
Steiner, N KJ, Frenette, EC, Rene, KM, Brennan, RT& Perrin, EC (2013). In‐School Neurofeedback Training for ADHD: Sustained Improvements From a Randomized Control Trial.http://pediatrics.aappublications.org/content/early/2014/02/11/peds.2013‐2059
Increased Attention
Activities that engage attention seem to improve the ability to develop language skills.
3/12/2016
31
Social Responsiveness Scale (SRS)
Parent & Teacher rating scale
Measures1. Social Awareness
2. Social Cognition
3. Social Communication
4. Social Motivation
5. Autistic Mannerisms
Brain Computer Interface Game Applications‐ UC San Diego
Transcranial Direct‐current Stimulation
3/12/2016
32
Transcranial Direct‐current Stimulation
Schneider, H, 2010“We feel that tDCS is a useful therapeutic intervention particularly for children that have autism with language difficulties”
In combination with functional MRI investigational research being completed at New York City (Columbia University Program for Imaging and Cognitive Sciences
Chewing Gum Auditory Stress
• Noise activated the bilateral superior temporal sulcus and the left anterior insula.
• Gum chewing inhibited the connectivity to the bilateral superior temporal sulcus and the left anterior insula.
• Anterior Insula and the dorsal anterior cingulate cortex was affected to a lesser extent when chewing gum.
Yu H, Chen X, Liu J, Zhou X. (2013). Gum chewing inhibits the sensory processing and the propagation of stress‐related information in a brain network. PLoSOne.;8(4):e57111. doi: 10.1371/journal.pone.0057111. Epub2013 Apr 3.
J Dent Res. 2013 Mar; 92(3): 272–278. doi: 10.1177/002203451247268
3/12/2016
33
OT Areas of Occupation
• Rest and Sleep in OTPF
• Rest induces a relaxed state and renewed interest in engagement.
• Sleep preparation‐ establishing sleep patterns
• Sleep Participation‐ sustaining a sleep state without interruption.
Nedergaard and Colleagues of Rochester University
The main detoxifying system in the brain consists of the cerebrospinal fluid (CSF) that is produced by
filtration through the brain arteries into the surrounding spaces, and circulates among the
brain structures.
Researchers found that the space inside the brain increases by 60 percent during sleep.
Prognosis for Autism
• No Cure at the Present Time
• Early intervention may reduce undesirable behaviors
• Treatments & interventions are aimed at specific symptoms in each individual (highly variable).
• Best practices and outcomes are achieved with a team approach
3/12/2016
34
Studies on Recovery
• Clinical Study at the University of Connecticut shows a small percentage of children recover as a result of intensive interdisciplinary therapy in a sample of 34 participants.
Prognosis
• Autism is not curable but is treatable
• Symptoms Improve with early Intervention
• Ivar Lovaas (UCLA) saw 47 percent recovery with intensive behavioral Therapy.
• Some will lead normal or near‐normal lives
• Symptoms may get worse in adolescence
Questions?
Neurological and Behavioral Distinctions between Autism & Sensory Processing
Disorders
Guy L. McCormack, PhD, OTR/L,FAOTA
3/12/2016
35
Selected References
1. Brandwein, A.B., Foxe, J.J., Butler, J.S., Frey, H.P., Bates, J.C. ,Shulman, L.H., Molholm, S. (2014). Neurophysiological Indices of Atypical Auditory Processing and Multisensory Integration are Associated with Symptom Severity in Autism. Journal of Autism and Developmental Disorders; Springer Science +Business Media New York.
2. Buzsaki, G. (2011). Rhythms of the Brain. New York: Oxford University Press.3. Tomchek, S.D., Dunn W. (2007). Sensory processing in children with and without
autism: a comparative study using the short sensory profile. Am J OccupTher. 2007 Mar‐Apr; 61(2):190‐200.
4. Leekkam, S.R., Nieto, C., Libby, S.J., Wing, L., Gould, J. (2007). Describing the sensory abnormalities of children and adults with autism. Journal of Autism and Developmental disorders; 37(5):894‐910.
5. Marco, E. J. , Khatibi, K. Hill, S.S. et al.(2012).Children with autism show reduced somatosensory response: An MEG study. Autism Research; 5(5):340‐351.
6. Yi‐Shin C., Owen, J. P., Desai, S.S., Hill, S.S., Arnett, A.B., Harris, J., Marco, E.J., Mukherjee, P. (2014). Autism and Sensory Processing Disorders: Shared White Matter Disruption in Sensory Pathways but Divergent Connectivity in Social‐Emotional Pathways. PLOs one. Doi:10.1371/journal.pone.0103038