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fMRI Imaging Results for Adolescents Who Received Treatment for Autism As Preschoolers
Numerous studies have found that a large proportion of children with autism show significant gains in cognitive, social, language and academic skills following early intensive behavioral therapy. It has also been found that due to processes underlying brain plasticity, learning and practicing new skills results in growth of new synapses in the brain and improved connectivity in typically developing adults and children. However, there has been little information on whether behavioral improvement resulting from intensive behavioral treatment is reflected in normalized brain functioning within structures known to be abnormal in autism.
Objectives:
This study aimed to determine whether behavioral gains and improved test scores following intensive behavioral treatment would be reflected in changes in brain functioning. It was hypothesized that adolescents diagnosed with autism as preschoolers, who demonstrated large improvement during intensive behavioral treatment (Rapid Learners), would show patterns of brain activation similar to that of typically developing adolescents. In contrast, it was hypothesized that adolescents diagnosed with autism as preschoolers, who demonstrated more modest gains during treatment (Moderate Learners), as well as untreated high functioning adolescents with autism, would continue to show aberrant patterns of brain activation similar to that described in studies of individuals with autism.
Methods:
Follow up data was collected at age 16 for 15 adolescents who had participated in intensive behavioral treatment for autism when they were 3 to 7 years old. Ten of the 15 had shown large gains to the average range. Eleven untreated high functioning adolescents with autism and six typically developing adolescents served as controls. All groups were matched on age and IQ. Participants were scanned during a facial emotion recognition task to examine patterns of activation in the fusiform gyrus and amygdala. Several previous studies of autistic adolescents had found abnormal activation in these areas during this task. FMRI was also used to examine activation in occipital and frontal areas, which have been implicated in aberrant brain activation in autism during face processing. DTI data were obtained during resting state scans to examine issues related to connectivity, which has been found to be atypical in autism.
Results:
Adolescents who had shown dramatic improvement to the average range on test scores during treatment (Rapid Learners) showed patterns of brain activation and DTI values that were similar to those of typically developing adolescents. Adolescents who had shown less robust response to treatment (Moderate Learners), as well as the group of untreated autistic adolescents with average IQs, showed aberrant brain activation patterns characteristic of individuals with autism. Summarizing, Rapid Learners were similar to typically developing adolescents, but different from Moderate Learners and different from untreated high functioning adolescents with autism.
Conclusions:
Although the sample size was small, these findings suggest a trend toward supporting the hypothesis that early intensive behavioral treatment and processes underlying brain plasticity, may result in remediation of abnormal brain functioning, at least for children who show large improvements during treatment.