Groundbreaking research could change how autism is diagnosed and treated

Rutgers researchers have completed studies that could radically change the way autistic children learn and communicate by helping them develop self-motivation, rather than relying on external cues and commands.

An autistic child discovers how to evoke the onscreen video he likes best. Courtesy of Rutgers Sensory-Motor Integration Lab

The sensory impairments of children with autism, which often prevent them from connecting their movements with their intentions, are the main reason they have trouble communicating and retaining knowledge, contends Elizabeth Torres, a computational neuroscientist at Rutgers, who led the studies in collaboration with researchers from Indiana University.

“These children can’t follow instructions, even if they want to, because there is a disconnect between what they want to do and what their body does,” said Torres, an assistant professor in the Department of Psychology, School of Arts and Sciences.

What is often interpreted as autistic children’s lack of emotion or willingness to socialize is rooted in their inability to make physical gestures that convey feeling and responsiveness. “Every autistic person I have met yearns for social acceptance,’’ Torres said. “It’s not that they don’t want to be social.”

Torres also has conducted studies on a screening method of diagnosing autism based on measuring minute fluctuations in movement rather than relying on the more subjective criteria currently used to detect signs of the disorder. Torres’ findings, funded by a grant from the National Science Foundation, were published this week on the website of Frontiers in Neuroscience, which has a partnership with Nature, a leading scientific journal.Her work is part of a special issue called “Autism: The Movement Perspective,” featuring the work of researchers from around the world.

Torres' discoveries were lauded as transformative by Anne M. Donnellan, a professor and director of the USD Autism Institute at the University of San Diego and a pioneer in the study of autism and movement. She was also the co-editor of Frontiers' special issue.

"This research is truly groundbreaking and is bound to have a broad impact across multiple disciplines of brain science,” Donnellan said. “It provides a powerful, radical new framework for the assessment and categorization of autism and invites a transformation of current behavioral therapies.”

Torres and her team created a digital set-up that works much like a Wii, triggering the onscreen media of children’s choice whenever their arm passes a certain point in space.

“Children had to search for the magic spot themselves,’’ Torres said. “We didn’t instruct them. They figured out if they held their hand a certain way deliberately, they could see whatever they wanted to watch.’’

Researchers found that all 25 children in the study, most of them nonverbal, spontaneously learned how to choose their favorite media and retained the knowledge over time, Torres said. “Their movement patterns became more reliable and anticipatory for the media they liked, but not for the media they didn’t like.’’

The children independently learned that they could control their bodies to convey and procure what they want, rather than relying on commands, prompting and rewards, which are the basis of behavioral therapy for children with autism.

“If you evoke autonomy, this can have an impact on everything they do, from spontaneously getting up and walking to solving a puzzle,’’ Torres said.

She believes that traditional forms of therapy, which place more emphasis on socially acceptable behavior, can actually hinder children with autism by discouraging mechanisms they’ve developed to cope with their sensory and motor differences, which vary greatly from individual to individual.

“The therapist decides what to emphasize and what to teach the child, and what to ‘abolish’ without ever measuring what that therapy is actually doing to their system,’’ said Torres. "Tics, lack of eye contact, weird reflexes and repetitive body motions may be a way to establish an anchor in their environment and lower the uncertainty of their moment-to-moment existence.”

Torres’ experiments were conducted at the Rutgers Sensory-Motor Integration Lab and Indiana University in conjunction with Jorge V. José, an Indiana University theoretical physicist and computational neuroscientist. He helped Torres create a screening system that can precisely determine how an autistic child’s patterns of motion differ from the movements of more typically developing children.

Torres said the system can detect signs of autism as early as infancy. “This research may open doors for the autistic community by offering the option of a diagnosis at a much earlier age and possibly enabling the start of therapy sooner in the child’s development,” said José, vice president for research at Indiana University and and a professor of cellular and integrative physiology at the university’s school of medicine.

The prevailing method of diagnosing autism relies on a subjective means of detecting social and cognitive problems and doesn’t factor in the importance of sensory and motor impairments, according to Torres.

Elizabeth Torres

The new measurement system has far-ranging implications. Torres has used it to measure the movements of people with Parkinson’s disease, as well as those with advanced skills in science and math, such as physicists, to see if they register atypical movement patterns that could signal autistic traits linked to their ability to socialize.

It’s too early to tell whether her research will translate into a form of therapy and diagnosis that would be available to the public. But Torres thinks both her screening techniques and her study involving computer media could be easy for parents to use.

“Anybody who has a home computer could videotape motions in real time and track them that way,’’ Torres said.

Also helping Torres develop and implement the measurement system was Dimitri Metaxas, a professor in the Rutgers Computer Science Department with assistance from his doctoral student Polina Yanovich and Robert W. Isenhower, a former postdoctoral fellow in Torres’ lab.

The clinical portion of the study was partially conducted at the Rutgers Douglass Developmental Disability Center. At Indiana University, psychiatry professor Kimberly Stigler, director of the Christine Sarkin Autism Center, and geneticist John Nurnberger, a professor of psychiatry, oversaw a portion of the study.