Two reports about autism came out last week. The first was a study published in the New England Journal of Medicine that demonstrated anatomic changes — “patches of disorganization” — in the brain’s neocortex in children with autism. The study’s author told Amy Norton:
“This is pretty direct evidence of a prenatal origin,” Lein said.
An autism researcher who reviewed the study agreed. “The foundation for this would likely be prenatal,” said Dr. Walter Kaufmann, a neurologist at Boston Children’s Hospital. “How early in the prenatal period? That’s hard to say.”
Maggie Fox spoke to another of the study’s authors:
Courchesne said his team’s findings support the idea that both genes and some outside influence are working together to disrupt brain development. “It has to be something that involves mom, something that she is exposed to or that is happening to her,” he said.
It’s already known that kids with autism have larger-than-normal brains. One hypothesis is that the growing brain of a child with autism doesn’t “prune” unneeded connections properly, and the resulting overgrowth of nerve connections sends the brain into overdrive.
It seems we know this about autism: In children who have a genetic predisposition, something triggers (“turns on”) the gene(s) that affects the formation and development of the neocortex — especially those areas responsible for higher order brain functions, such as understanding language and social cues — to produce the anatomic and functional abnormalities seen in this study. What turns on these switches (genes) has been the focus of many studies, some of which point to environmental pollution, vitamin deficiencies, and infections such as influenza. This study tells us that this sequence of events occurs while the brain is developing, before the baby is even born. The good news, says Norton, is that what you see at birth may not be set in stone:
Lein said the fact that the brain tissue showed small patches of disruption, rather than pervasive abnormalities, is “potentially good news.” It suggests that much of the neocortex is actually typical in children with autism, he said.
That might help explain why autistic toddlers who get early behavioral therapy often show significant improvements, Lein said. It’s possible the brain is able to “rewire,” to an extent, to get around some of the trouble spots seen in this study.
In general, experts say the earlier such therapy starts, the better. The problem is, most children are not diagnosed with autism until after they reach age 4, according to the U.S. Centers for Disease Control and Prevention.
Early developmental, cognitive, and behavioral intervention is the key to unlock any child’s potential with the emphasis on early for those with autism. The second piece of news about autism comes from the CDC and indicates to Fox that more children will be needing more interventions:
The latest look at autism in the U.S. shows a startling 30 percent jump among 8-year-olds diagnosed with the disorder in a two-year period, to one in every 68 children.
The Centers for Disease Control and Prevention, which did the survey, says the numbers almost certainly reflect more awareness and diagnosis of kids who would have been missed in years past. The new estimate for 2010 was a jump from one in 88 children in 2008, the last year for which numbers had been available.
“The number of children diagnosed with autism continues to rise,” the agency’s Dr. Coleen Boyle told reporters.
The CDC came to this number by analyzing statistics from 2010 in 11 states, where the numbers varied wildly: The number of children with the diagnosis of autism spectrum disorder (ASD) ranged from 1-in-45 in New Jersey to 1-in-175 in Alabama.
Why the discrepancy among states? Is there more pollution in New Jersey? (Probably.) Is there less access to pediatric care in Alabama, so fewer children are diagnosed and plugged into early intervention? (Maybe.) Are parents in New Jersey more focused on their children’s academic successes that they will look for any advantage to help their very young preschoolers cognitively and developmentally — even if that means pushing for a diagnosis of ASD when it’s still not clearly demonstrated? (Most likely, since it could be argued that values and priorities associated with early childhood and primary- and secondary-education are not uniform throughout the U.S.) Will these and other differences between New Jersey and Alabama help unlock the mystery of what causes autism? Or will they just create even more questions that must be answered first?