More than one ball in the air  pg. 6

Pittsburgh’s Minshew calls autism a disorder of complex information processing. “People with autism can hear and remember information, but they have trouble making sense of it,” she says. “It’s a generalized brain phenomenon where complex circuitry and higher order cognitive abilities supported by that circuitry fail to develop.” She points out that all areas of the brain—including those controlling skilled motor movements—are affected.

Minshew and her colleagues first observed the disconnect between basic skills and higher order skills during behavioral testing. They have recently confirmed, using functional magnetic resonance imaging (fMRI), that basic brain circuitry, but not higher order circuitry, is intact in individuals with autism.

Wendy L. Stone, Ph.D., demonstrates the Screening Tool for Autism in Two-year-olds (STAT), a 12-item play-based, interactive kit used to detect early signs of autism.
Photos by Dana Johnson
The larger than normal brain sizes of children with autism may offer clues to the miswiring that occurs during brain development. Eric Courchesne, Ph.D. and his colleagues at the University of California, San Diego, reported in July that children with autism were more likely to have a reduced head size at birth and a sudden or excessive increase in head size during the first year of life. The authors suggested that this accelerated head growth could be an early warning sign for autism.

Brain development during the first two years of life sets the stage for the complex circuitry and information processing capabilities of the mature brain. An acceleration of neuronal growth during this critical period, and/or a failure of the mechanisms that normally “prune” away unnecessary neurons, could lead to disarray, Minshew says.

Using neuroanatomy and powerful new techniques like fMRI to get at the regions of brain dysfunction in autism is part of a progressive search for the cognitive and brain basis of behavior, Minshew says. “How well we understand behavior makes an enormous difference in how well we can intervene,” she says. “We are most effective at changing behavior when we understand why someone’s doing what they’re doing.”

Finding what works

Behavioral and educational interventions for children with autism have come a long way since the days when diagnosis was accompanied by a suggestion for institutionalization, but even now it is unclear which treatment will work best for a given child.

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