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Scan Could Diagnose Autism In 15 Minutes

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Good news for the next generation of autistics. :)

 

Certainly beats the 20¾ years it took to diagnose me. :rolleyes:

 

Having seen this report as the top story on Sky News tonight, I thought it only fair to link to their article (and video report) on it ...

Sky News: "Scan Could Diagnose Autism In 15 Minutes"

... and I think it's better.

 

But for those who prefer the Beeb, here's their version ...

BBC News: "New brain scan to diagnose autism"

 

James

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hi james

i have been watching this all morning, it seems to be a great breakthrough, would love to see what all the peeps on here think, i know my son who is only 7 would have a problem with the scanner it self as these are very scary, i had to go in one the other yr and it was awful, but i do think it is a great step forward.

theresa

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I think its brilliant :thumbs: It is so hard to accept a diagnoses of something we cannot see,so I think this will help us as parents to understand that it is real.

 

I heard that they will give anesthetic(sp?)where necessary for those children who wouldnt handle the machine.Also there are new machines that do not make any noise at all so these are they machines they will use specifically for this.From what I can gather it seems like they want to get this rolling out very soon.

Edited by justine1

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I think it's a potentially huge breakthrough (and very logical - brain pathology has been discussed in autism for decades, so scanning to look at those differences is, excuse the pun, a no brainer!) but I do see some problems that'll need ironing out. :(

 

Firstly, I think that 'ninety percent accuracy' is going to be very problematic. I suspect that as well as finding/confirming more borderline or undiagnosed cases there may well be anomalies among the diagnosed population - especially those diagnosed in the middle to latter half of the last decade - and I think that may well undermine the success of this as an accepted diagnostic tool, with that 10% growing to include a much larger 'grey area' of potentially unreliable tests.

 

The second problem that comes immediately to mind is where one thing ends and another begins - i.e. the cutoff point where 'autism' or 'aspergers' becomes 'traits of autism or aspergers' or even 'social anxiety' etc etc... Of course, that's assuming that there are going to be a number of fundamental 'markers' that can enable such differences to be identified and measured and that apply in each case, which may not be the case(?). And then there is the degree to which other influences - psychology, background, ethnicity, personality etc - impact on those measurable markers and day to day functioning.

 

One other thing that comes to mind about that odd '10%' where results were inaccurate is the make up of that 10%. Were they people with definitive diagnosis (by previous methods) of autism/as whose brain scans appear 'NT', or were they 'NT' with no autistic traits whatsoever whose scans indicated they should be? Or maybe a mix of the two or just people who fall into a 'grey area' iyswim? Very difficult!

 

As I say, a potentially brilliant breakthrough and can't wait til they publish some answers to the kind of questions above, but the really interesting bit is whether this is going to provide accepted, demonstrable and universal models of what autism/as are and what they 'look' like (from a pathological POV) or whether that 10% anomaly is going to grow to provide even more uncertaintly and confusion. Could we end up with a world where 'NT' turns out to be the exeption because there are so many 'greys', or will the tool be used to disenfranchise those who may well encounter significant social problems but for reasons that have been wrongly attributed to autism, or that don't fit the newly defined 'mindmap' that's being offered as a model? :unsure:

 

Wow! Deep stuff for a Tuesday morning!

 

:lol:

 

L&P

 

BD :D

 

oooh PS: and what about that tricky problems of ethics and eugenics? Will they be able to scan brain pathology in utero? And at what stage in the developmental process will a foetus be sufficiently formed for that scan to be deemed accurate? :unsure:

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oh wow!

 

 

I want that brain scan - does that mean any brain scan could detect it? cause i had one to do with the autism research thing -

 

at last!

 

ill watch the vid now! :)

 

 

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I think it's a potentially huge breakthrough (and very logical - brain pathology has been discussed in autism for decades, so scanning to look at those differences is, excuse the pun, a no brainer!) but I do see some problems that'll need ironing out. :(

 

Firstly, I think that 'ninety percent accuracy' is going to be very problematic. I suspect that as well as finding/confirming more borderline or undiagnosed cases there may well be anomalies among the diagnosed population - especially those diagnosed in the middle to latter half of the last decade - and I think that may well undermine the success of this as an accepted diagnostic tool, with that 10% growing to include a much larger 'grey area' of potentially unreliable tests.

 

The second problem that comes immediately to mind is where one thing ends and another begins - i.e. the cutoff point where 'autism' or 'aspergers' becomes 'traits of autism or aspergers' or even 'social anxiety' etc etc... Of course, that's assuming that there are going to be a number of fundamental 'markers' that can enable such differences to be identified and measured and that apply in each case, which may not be the case(?). And then there is the degree to which other influences - psychology, background, ethnicity, personality etc - impact on those measurable markers and day to day functioning.

 

One other thing that comes to mind about that odd '10%' where results were inaccurate is the make up of that 10%. Were they people with definitive diagnosis (by previous methods) of autism/as whose brain scans appear 'NT', or were they 'NT' with no autistic traits whatsoever whose scans indicated they should be? Or maybe a mix of the two or just people who fall into a 'grey area' iyswim? Very difficult!

 

As I say, a potentially brilliant breakthrough and can't wait til they publish some answers to the kind of questions above, but the really interesting bit is whether this is going to provide accepted, demonstrable and universal models of what autism/as are and what they 'look' like (from a pathological POV) or whether that 10% anomaly is going to grow to provide even more uncertaintly and confusion. Could we end up with a world where 'NT' turns out to be the exeption because there are so many 'greys', or will the tool be used to disenfranchise those who may well encounter significant social problems but for reasons that have been wrongly attributed to autism, or that don't fit the newly defined 'mindmap' that's being offered as a model? :unsure:

 

Wow! Deep stuff for a Tuesday morning!

 

:lol:

 

L&P

 

BD :D

 

oooh PS: and what about that tricky problems of ethics and eugenics? Will they be able to scan brain pathology in utero? And at what stage in the developmental process will a foetus be sufficiently formed for that scan to be deemed accurate? :unsure:

Yes some very good questions indeed :thumbs: It is quite ironic as my brother and I have been discussing brain scans over the past few mths,not ASD related but generally.As I have said before he has suffered three unexpected strokes and feels if he had been offered a scan it could have been avoided,in fact his sentiments were reiterated recently on the BBC news when a man had an early detaction scan and he was fortunate enough to have had an op and therefore did not suffer what my brother went through.

 

So I think these scans should be open to other conditions.My other brother has suffered from epilipsy for what maybe up to five years,he had been dx'd with three different things before they finally discovered what was going on.

 

I dont think they will do routine scans for one and all during pregnancy,or indeed those "at risk" I think it will work the same way as it is now, i.e a parent can see some differences in their child sees a gp and is referred on,instead of being referred to a paed they may be referred to the scan.Or they may be encorporating both the scan and the usual diagnostic processes,to me that would make more sense.

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at the moment you can not have a mri scan while pregnant, so no in-utero detection to worry about yet ;) In fact, I believe this is only being used for adults atm anyway, although the potential to develop it for children may be there - childrens brains are sill developing and as the differences they are looking for are obviosly tiny, this specific technique may not be suitable for pre adolescents imho.

 

Having said that, they MRI'd my four month old while he was fast asleep - I aclimitised him to th sounds for a week or s before hand (had a CD), and they played music thruogh little baby headphones while he was in there and scanned how his brain reacted to the music/sounds even though he was asleep. Will be doing it again in a couple of months, same procedure. The biggest issue with scans is that the patient has to stay totally still - difficult for many autistics, even if sleeping/anaesthetised - they wrapped himin a clever beanbag/blanket thing to help with that.

 

I think this sounds a brilliant diagnostic tool, but we are still a long way from it being the diagnosis.....

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at the moment you can not have a mri scan while pregnant, so no in-utero detection to worry about yet ;)

 

Ah... that's good news. :thumbs:

 

In fact, I believe this is only being used for adults atm anyway, although the potential to develop it for children may be there - childrens brains are sill developing and as the differences they are looking for are obviosly tiny, this specific technique may not be suitable for pre adolescents imho.

 

I think from the article they feel this will actually be more accurate for children than for adults - they're just testing on adults at the mo because it's easier admin wise etc.

 

I think this sounds a brilliant diagnostic tool, but we are still a long way from it being the diagnosis.....

 

They think as quickly as maybe a couple of years - but then research like this often quotes short timescales and never actually comes to anything at all!

 

Justine - yes, they're def saying at the mo that this will start out as a further diagnostic tool, but think in the long term it will be the definitive one. The trouble with technology like this - with any technology come to that - isn't what it starts out being but what it has the potential to become. :ph34r:

No technophobe or anything like that (well, actually, a bit, maybe, but based on the premise that humans do stupid things unknowingly rather than on a fear of the technology itself, iyswim) - and the benefits of something like this should more than outweigh the pitfalls. That said, though, if this tool proves to be an effective way of establishing peoples needs/'rights' to support then the people deciding the boundaries and benchmarks will be the people controlling the money that is used to meet those needs and rights. Or to put it another way, the same people who are currently looking into just about every nook and cranny in the hope of finding something else they can cutback funding on :whistle:

 

L&P

 

BD :D

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saw this on the news last night. http://www.bbc.co.uk/news/health-10929032

 

very interesting in that autism is being widely recognised and considered. My person at 10 has a positive future as society becomes more accepting and knowlegable .It means autism needs no longer to be shut away and shunned. My person is not just normal but exceptional . :wub:

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Generally good news.

 

I do wonder what the reaction there will be when told, "Good news, we have been wrong all along, you/your child doesn't have autism after all, Oh, and by the way we will now be withdrawing the support you/they have been getting as you/they dont need it".

 

As has been said, 10%, is this 10% with ASD who wont be picked up or 10% without ASD who will be diagnosed as with it.

 

I am old enough to have seen a lot of "Breakthroughs" that have come to nothing, So until I see this being routinely used I will not get to excited.

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Generally good news.

 

I do wonder what the reaction there will be when told, "Good news, we have been wrong all along, you/your child doesn't have autism after all, Oh, and by the way we will now be withdrawing the support you/they have been getting as you/they dont need it".

 

As has been said, 10%, is this 10% with ASD who wont be picked up or 10% without ASD who will be diagnosed as with it.

 

I am old enough to have seen a lot of "Breakthroughs" that have come to nothing, So until I see this being routinely used I will not get to excited.

On another forum this is being discussed and a member said they would feel upset if it was proven that they do not have ASD,they said it is who they are.

I would be okay with it,I do not mind whether my children has ASD or not .

 

What support do we get? Nothing.I get DLA for Sam,I dont intend on claiming for Dan as I dont feel he needs it right now.But I dont rely heavily on that money anyway,it is Sams money,so wont change much if they remove it.It does mean he wont be able to join any clubs etc which will be sad and I cant save for his future,but not the end of the world.As a parent I would have to simply sacrafice more to provide this for him,just as I do for my NT son.

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oooh PS: and what about that tricky problems of ethics and eugenics? Will they be able to scan brain pathology in utero? And at what stage in the developmental process will a foetus be sufficiently formed for that scan to be deemed accurate? :unsure:

 

 

That is a very good question.

 

There are basically two types of theories about abnormal brain development and behaviour.

 

One is that abnormal brain tissue (due to damage or development) causes abnormal behaviours.

 

The other says that the human brain is very plastic, and the brains of babies and young children are very plastic indeed. Children's brains change significantly in the first three years after conception, so sensory input, the child's environment, and their own behaviour can all change the structure of the child's brain.

 

So, abnormalities in an adult's brain could be the result of genetic factors, experience, and an unusual pattern of behaviour. Obviously, if a group of adults diagnosed with autism all show similar brain abnormalities, then you have a useful diagnostic tool - for adults.

 

But things could be trickier when it comes to children. One of the reasons practitioners are often reluctant to diagnose children who might be autistic - by their behaviour - is that developmental delays are not uncommon, and a false positive diagnosis could cause as many problems as a false negative. If children's behaviour is not clearly autistic, then it's likely that their brain might not look clearly autistic either. I'd be surprised if the scan has a 90% reliability rate in children.

 

Another factor to take into account is that autistic characteristics could have different causes. A range of brain abnormalities have been found in the brains of people diagnosed with autism, so it's quite likely there are going to be sub-groups. Could be tough if you happen to be in a sub-group that hasn't been identified yet, and you're told you can't have autism because you don't match the stereotype. :tearful:

 

cb

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One is that abnormal brain tissue (due to damage or development) causes abnormal behaviours.

 

The other says that the human brain is very plastic, and the brains of babies and young children are very plastic indeed. Children's brains change significantly in the first three years after conception, so sensory input, the child's environment, and their own behaviour can all change the structure of the child's brain.

 

So, abnormalities in an adult's brain could be the result of genetic factors, experience, and an unusual pattern of behaviour. Obviously, if a group of adults diagnosed with autism all show similar brain abnormalities, then you have a useful diagnostic tool - for adults.

That is what I was thinking.

Does Autism cause the brain to develop differently.

Or do differences in the brain cause the Autism.

 

I dont think anyone is saying.

Edited by chris54

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I was thinking more along the lines of support in school.

Well I am not sure how it would work in my sons case as he attends an ASD unit 45min from my home.If it was proven he didnt have ASD would they keep him on at the school but on the mainstream class? or would they tell him to go to another school? most likely the latter cause they are paying for transport to take him there so if there is no cause for him to go then I guess they will send him away.This maybe the same for those in special schools and private schools paid for by the LEA.

 

However I think if a child has a statement the statement is likely to remain because supposedly a child can have a statement without a dx,if the child has behaviour problems they will still put things in place to help a child.It just means parents will have to fight all over again :wacko:

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However I think if a child has a statement the statement is likely to remain because supposedly a child can have a statement without a dx,if the child has behaviour problems they will still put things in place to help a child.

 

You would hope that would be the case but I'm sure that some AL would try it on.

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You would hope that would be the case but I'm sure that some AL would try it on.

So true especially with the current recession :thumbs:

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That is what I was thinking.

Does Autism cause the brain to develop differently.

Or do differences in the brain cause the Autism.

 

I dont think anyone is saying.

 

Long time since i did any reading on the subject, but the theory when I was reading research was that the 'blueprint' for autistic (or NT, come to that) brain development was laid down in the womb - i.e. the brain was programmed to grow a certain way at a genetic level. I've never entirely bought into that, considering that around seventy percent of brain development (the building blocks for all subsequent development) occurs after birth in the first two to three years, but it did offer a very neat response for any suggestion that external factors like MMR or pollution etc. could be 'triggering' the condition...

It's not so much that differences in the brain cause autism, it's more that autism is a difference in brain pathology, iyswim. There is no 'cause and effect', there's just a fundamental difference (or a number of fundamental differences), which is precisely what this new research claims to be able to identify and measure.

 

 

As coolblue points out there is new research emerging to indicate that the brain is far more adaptable than was previously thought. Mostly this seems to be related to areas of the brain taking over roles traditionally associated with other areas of the brain in the event of damage - making new connections to replace old ones. I don't think that can or does apply to something like autism, though, where the entire 'mechanism' is missing or corrupt. If you think of a computer, no amount of additional wiring could replace the central processor... or, if you think about a (landline) telephone, no matter how sophisticated the model might be it's just a piece of plastic when not plugged into a telephone jack...

 

The research suggests that the 'structural signatures of autism' are actually more pronounced (and therefore easier to identify) in children - I guess because there's less of that ancillary wiring to complicate the picture(?)

 

Dunno - but a very thought provoking peice of research on so many levels.

 

L&P

 

BD :D

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I'm interested to see where this goes. And I would love to see some scans of 'autisitic' people and for the differences in the scans to be explained to us. And I wonder if there is just one 'difference' or whether there are a number of differences on scan results that would indicate autism. Afterall, even from this forum, I can see that there is a many and varied difference between all the children and adults that post here.

 

If it does turn out to be reliable, I wonder if they will scan if your child already has a diagnosis? My reason for wanting that would be if there are 'differences' within the scan results that fall under the 'autistim' umbrella. So you might get a slightly different brain scan result if your child had alot of routines, and another slightly different result if they have poor social skills etc. I can't imagine that there is just one scan result and it is a 'one size fits all' difference for everyone on the spectrum.

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Long time since i did any reading on the subject, but the theory when I was reading research was that the 'blueprint' for autistic (or NT, come to that) brain development was laid down in the womb - i.e. the brain was programmed to grow a certain way at a genetic level. I've never entirely bought into that, considering that around seventy percent of brain development (the building blocks for all subsequent development) occurs after birth in the first two to three years, but it did offer a very neat response for any suggestion that external factors like MMR or pollution etc. could be 'triggering' the condition...

 

You did well not to buy into it, baddad.

 

What has been found is that although there is indeed a genetic blueprint that is sometimes disrupted, brain development before birth is also affected by environmental factors - the mother's diet, and alcohol and nicotine intake are ones that spring immediately to mind. After about 24 weeks gestation, the fetus can process sensory information, which could also affect brain structure. The neurons in the brain continue to develop after birth and the number of synapses (connections) in the brain peaks in the second year of life. Then a period of pruning of synapses starts that continues through to adulthood. Basically, connections that aren't used die off.

 

It's not so much that differences in the brain cause autism, it's more that autism is a difference in brain pathology, iyswim. There is no 'cause and effect', there's just a fundamental difference (or a number of fundamental differences), which is precisely what this new research claims to be able to identify and measure.

 

Depends what you mean by 'autism'. Technically, 'autism' is a set of behavioural characteristics. It isn't what causes those characteristics, because in most cases we don't know what causes them. Children with Fragile X syndrome show 'autism', but it's not because they have a separate condition called autism as well as problems as a result of having a fragile X chromosome. Having a fragile X chromosome is what leads to the autistic characteristics. In the introduction to the MRI diagnosis paper, the authors point out that ASD has 'multiple causes and courses'.

 

As coolblue points out there is new research emerging to indicate that the brain is far more adaptable than was previously thought. Mostly this seems to be related to areas of the brain taking over roles traditionally associated with other areas of the brain in the event of damage - making new connections to replace old ones. I don't think that can or does apply to something like autism, though, where the entire 'mechanism' is missing or corrupt. If you think of a computer, no amount of additional wiring could replace the central processor... or, if you think about a (landline) telephone, no matter how sophisticated the model might be it's just a piece of plastic when not plugged into a telephone jack...

 

The research suggests that the 'structural signatures of autism' are actually more pronounced (and therefore easier to identify) in children - I guess because there's less of that ancillary wiring to complicate the picture(?)

Dunno - but a very thought provoking peice of research on so many levels.

 

L&P

 

BD :D

 

 

Actually the opposite is probably the case, because in young children diagnosed with autism, there has been found to be less pruning of synapses than in typically developing children. This is often described as 'neuronal overgrowth'. You could probably reliably identify children with autism by looking at the degree of overgrowth, although this might be difficult to pick up accurately on a brain scan. If you could get the child into the scanner to start with.

 

I'm not sure what 'mechanism' you are referring to that might be missing or corrupt in autism. In the scan images in the MRI paper, a whole range of brain areas are affected in different ways - some areas of cortex are thicker than normal, others thinner. The authors of the paper believe that this shows a pervasive problem with the way the cells in the cortex develop, and that this abnormal development then produces pervasive behavioural problems. That's a reasonable conclusion.

 

I suspect, however, that because the thicker areas tend to be primary sensory processing areas and the thinner areas 'higher' processing areas, that the problem lies with unstable sensory processing. It's what you'd expect to see if sensory input was variable.

 

cb

 

 

 

 

 

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This sounds a good news but I am not sure how good it actually is.

 

I agree with baddad that people sometimes do stupid things when using technology because of not knowing and I would say arogance as well. Although in some cases it might be a very useful tool I fear in some others might be not.

 

I also agree with Chris 54 that in this bad economic climate some LEA might use this as an excuse to cut funding for statements if the child's scan doesn't show a tipical ASD scan. I AM concern with possible excuse for withdrawal of DLA because we use this money (but not only us, many other families do as well) for my son's private SALT and OT because in the area where we live there are none availlable on NHS! Without DLA we wouldn't be able to finance that.

 

And what about the idea that many autistic people are/have contributed to the society? I didnt like some terms that were used in the artical such as 'disorder', 'suferers' etc. All autistic people are different, like any other NT people. How could one scan in 15 minutes dx the whole personality? And what about individual needs of each person with ASD? If this tool becomes the only one to dx the child, treatments would probably be designed the same for all ASD 'sufferers'. One size fits all, indeed.

 

Danaxxx

 

 

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Been mulling over all the 'what if's here for some time due to the geneticist thinking she'd found something that fitted DS which would mean he doesn't have an ASD after all. No diagnostic conclusions yet and I am hesitating to pursue it without some kind of reassurance that his placement at his ASD-specific school would continue. We have decided not to 'risk' the school placement so pursuit of an accurate label will be delayed.

Edited by call me jaded

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Been mulling over all the 'what if's here for some time due to the geneticist thinking she'd found something that fitted DS which would mean he doesn't have an ASD after all. No diagnostic conclusions yet and I am hesitating to persue it without some kind of reassurance that his placement at his ASD-specific school would continue. We have decided not to 'risk' the school placement so pursuit of an accurate label will be delayed.

 

This is what worries me about deciding on educational provision because of a diagnosis rather than because of an assessment of a child's needs.

 

Ds's paediatrician was in no doubt that he was showing autistic characteristics, because he was showing significant abnormalities in social interaction and communication and restricted and repetitive behaviours. But she did a battery of blood tests first to see if there was an identifiable organic cause for his autistic behaviours. There wasn't, so she did the ADI test and gave him a formal diagnosis of ASD.

 

Just because a child has a known genetic condition doesn't mean they can't be autistic, and they should get appropriate educational support regardless of the formal diagnosis.

 

cb

 

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I suppose it's a bit of a double edged sword... provision shouldn't be based on a specific dx, but neither should a dx restrict or compromise a wider assessment, which seems to be the case sometimes. For some parents, the dx itself is taken as an explanation for everything their child does - and it isn't. Even worse, it's often the basis of lowered expectations which then further disable...

 

I think the emphasis regarding schools will shift from 'autism specific' (assuming the technology does lead to the breakthrough in diagnosis they're predicting) to 'social communication specific', rather than a complete withdrawl of services from those identified with significant needs. An assumption, of course, but I would guess that the scans of those with more profound autistic traits will show more of the 'structural signatures' the research mentions, so it probably wouldn't be an issue anyway(?)

 

I think any big controversy will centre on those 'borderline' cases, and I'm sorry (apologising beforehand, you'll note), but in that respect I think there are potential major benefits to this research. It's my opinion that autism - especially at the HF/AS end of the spectrum - has reached a point where diagnosis has become far too casual, both socially ( with the likes of TA's/Dinner Ladies and anyone who knows anyone who knows anyone who has an autistic child feeling qualified to make a dx on a parent's behalf) and professionally. Like ADHD and Dyslexia that kind of saturation can only damage rather than help. Not to say, of course, that 'borderline' children shouldn't be supported or helped, but I do think, as highlighted in the first paragraph of this post, that often the dx does more harm than good in such cases, creating 'pigeon holes' rather than challenging them.

 

L&P

 

BD :D

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I have been aware of this research for quite some time; in fact I believe I mentioned it in the MMR thread some time ago and I have been following the development of this technology quite closely for a couple of years now since the preliminary research was released in 2005.

 

The 90% figure is quite conservative, which is necessary for any new medical technology in the current financial climate. What we are basically talking about here is software that analyses MRI & voxel based morphometry neuroimaging analysis which is a technique for analysing the specific ratio of white/gray matter in specific areas of the brain.

 

This software can be used on any MMR machine with a few slight modifications, but you would do well to think of this software as still being in a beta test stage. Over the next two years as more and more people are scanned and a larger comparative database is formed the results will become much more accurate. The team developing this technology is aiming for 99.9% accuracy within five years and they are hoping to be able to diagnose all specific flavours of autism with equal accuracy.

 

The technology works extremely well for adults, and it is hoped that children as young as four will be able to be diagnosed easily. Another interesting development recently has been this Urine Test, which hopefully become a standard test carried out by all GP’s. Interestingly, it turns out that children with Autism tend to have a unique chemical signature within their urine. This being the case, it shouldn't be long before children who test positive are being referred for scans.

 

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I think my major reservation about it is that they are still using the DSM criteria as their basis for diagnosis. In other words, the MRI diagnostic criteria correlate highly with the behavioural diagnostic criteria. But because, as the authors point out in their introduction, ASD as diagnosed behaviourally has multiple 'causes and courses', and they used a small sample of adults, as their sample gets larger, they are likely to find a diminishing correlation with the behavioural criteria, because of the likelihood of coming across sub-groups.

 

Say 80% of people diagnosed with autism have cause A for their autism, 10% have cause B, 5% have cause C and then there are small numbers of people with causes D-G. If the 20 guys in the sample all happened to be in the cause A group, are the people in the other causal groups going to get a diagnosis of autism or not? There were some interesting issues with the classifier putting half the ADHD controls in the ASD group when it was doing the right hemisphere test.

 

Or will the scan be used to look for clusters of specific anomalies that indicate sub-groups? Hope so. That could be a really fruitful line of enquiry.

 

cb

 

 

 

 

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Say 80% of people diagnosed with autism have cause A for their autism, 10% have cause B, 5% have cause C and then there are small numbers of people with causes D-G. If the 20 guys in the sample all happened to be in the cause A group, are the people in the other causal groups going to get a diagnosis of autism or not? There were some interesting issues with the classifier putting half the ADHD controls in the ASD group when it was doing the right hemisphere test.

 

Or will the scan be used to look for clusters of specific anomalies that indicate sub-groups? Hope so. That could be a really fruitful line of enquiry.

 

cb

That is a fair point. However this research is based on the premise that although the symptoms of Autism can be very varied, the underlying condition is developmental - in the womb. It also works on the premise that Symptom A whish is present in 80% of cases is caused by developmental problem A. For example have looked at facial recognition in NT's and ASD's and found a 40 -60% reduction in grey matter in that area in all ASD's who cannot or struggle to interpret facial expressions.

 

The software examines not only activity, but abnormalities in the ratio of white matter which facilitates communication vs the much denser grey matter which performs function. SO in short it looks for common factors in ASD's but also uncommon factors comapered to the NT brain. As the database increases, this technology will make identifying things like Schizoid Personality Disorder or Bipolar much easier to diagnose too. It has quite far reaching implications really.

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Are they not just identifying the commonalities?

 

The same differences that tick all the behavioural boxes, show on the MRIs?

 

 

The problem is that the behavioural boxes are very big ones. The brain of someone with no speech, who doesn't make eye contact at all, and with limited mobility but repetitive motor movements will not look like the brain of someone with a speech impediment, who's a bit socially awkward, and who's obsessed by trains. But they both get a diagnosis of ASD according to the DSM. They probably wouldn't with the MRI.

 

Interesting to see if that happens.

 

cb

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That is a fair point. However this research is based on the premise that although the symptoms of Autism can be very varied, the underlying condition is developmental - in the womb. It also works on the premise that Symptom A whish is present in 80% of cases is caused by developmental problem A. For example have looked at facial recognition in NT's and ASD's and found a 40 -60% reduction in grey matter in that area in all ASD's who cannot or struggle to interpret facial expressions.

 

But you don't need to do an MRI scan to tell you that the fusiform facial area will be smaller in people who have problems with interpreting facial expressions. You know it's going to be smaller. We aren't born with a fully functioning fusiform facial area. It develops in response to information about faces that people acquire after birth. 3% of the population have problems with face recognition. They are going to have small FFAs, but they don't all qualify for a diagnosis of autism.

 

That's my problem with this system. If its parameters are derived from people diagnosed using the DSM criteria, and the DSM criteria encompass people whose characteristics vary widely, their brains will vary widely and the more samples that are included, the fewer commonalities there will be, and the less accurate the diagnostic ability of the system will become.

 

The software examines not only activity, but abnormalities in the ratio of white matter which facilitates communication vs the much denser grey matter which performs function. SO in short it looks for common factors in ASD's but also uncommon factors comapered to the NT brain. As the database increases, this technology will make identifying things like Schizoid Personality Disorder or Bipolar much easier to diagnose too. It has quite far reaching implications really.

 

I would attach the same provisos to the ratio of white matter to grey matter. White matter is comprised of myelinated neurones. Myelination is a process that takes place in frequently used neural pathways. That's why it varies so much between individuals. You could predict how much white matter a person's brain had, and where it would be, by analysing their behaviour carefully. Of course there are conditions that interfere with myelination, or demyelinate neurons, but that doesn't appear to be happening in people diagnosed with autism.

 

I have no problem with its potential, very exciting, just grappling with the diagnostic systems used by psychiatry.

 

cb

 

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You did well not to buy into it, baddad.

 

What has been found is that although there is indeed a genetic blueprint that is sometimes disrupted, brain development before birth is also affected by environmental factors - the mother's diet, and alcohol and nicotine intake are ones that spring immediately to mind. After about 24 weeks gestation, the fetus can process sensory information, which could also affect brain structure. The neurons in the brain continue to develop after birth and the number of synapses (connections) in the brain peaks in the second year of life. Then a period of pruning of synapses starts that continues through to adulthood. Basically, connections that aren't used die off.

 

 

 

Depends what you mean by 'autism'. Technically, 'autism' is a set of behavioural characteristics. It isn't what causes those characteristics, because in most cases we don't know what causes them. Children with Fragile X syndrome show 'autism', but it's not because they have a separate condition called autism as well as problems as a result of having a fragile X chromosome. Having a fragile X chromosome is what leads to the autistic characteristics. In the introduction to the MRI diagnosis paper, the authors point out that ASD has 'multiple causes and courses'.

 

 

 

 

Actually the opposite is probably the case, because in young children diagnosed with autism, there has been found to be less pruning of synapses than in typically developing children. This is often described as 'neuronal overgrowth'. You could probably reliably identify children with autism by looking at the degree of overgrowth, although this might be difficult to pick up accurately on a brain scan. If you could get the child into the scanner to start with.

 

I'm not sure what 'mechanism' you are referring to that might be missing or corrupt in autism. In the scan images in the MRI paper, a whole range of brain areas are affected in different ways - some areas of cortex are thicker than normal, others thinner. The authors of the paper believe that this shows a pervasive problem with the way the cells in the cortex develop, and that this abnormal development then produces pervasive behavioural problems. That's a reasonable conclusion.

 

I suspect, however, that because the thicker areas tend to be primary sensory processing areas and the thinner areas 'higher' processing areas, that the problem lies with unstable sensory processing. It's what you'd expect to see if sensory input was variable.

 

cb

 

 

I too think that alot of autistic behaviours could be down to overgrowth of connections in some areas and over pruning of connections in other areas. So there needs to be more research into what causes the synapse connections and pruning.

 

I remember from my studying days, that if kittens have a good eye covered with a patch that the eye will not develop because it will not be used, and therefore the kitten becomes blind in that eye eventhough there is nothing 'wrong' with the eye. So it you don't use it, you lose it.

 

And many adults with autism talk about this huge difference they experience, and even explain it has 'having excess wiring in some areas and little or no wiring in others'.

 

I would be very interested to see some of the brain scans and to see the differences.

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I too think that alot of autistic behaviours could be down to overgrowth of connections in some areas and over pruning of connections in other areas. So there needs to be more research into what causes the synapse connections and pruning.

 

I remember from my studying days, that if kittens have a good eye covered with a patch that the eye will not develop because it will not be used, and therefore the kitten becomes blind in that eye eventhough there is nothing 'wrong' with the eye. So it you don't use it, you lose it.

 

And many adults with autism talk about this huge difference they experience, and even explain it has 'having excess wiring in some areas and little or no wiring in others'.

 

I would be very interested to see some of the brain scans and to see the differences.

 

There's been quite a lot of research into synapse formation and pruning in typically developing individuals. It looks as if synapse formation starts during the second half of gestation and peaks at about the age of two. So the average two year old has a huge number of synapses. Synapse pruning then starts, and continues through to adulthood, speeding up after puberty. But pruning isn't haphazard. Neurons that fire simultaneously tend to develop stronger connections. Synapses that aren't used get pruned. Gradually, synapses gets pared down to the ones that the individual uses most often - it's basically a process of increasingly fine-tuning.

 

As you say, it is a case of use it or lose it. Except that new synapses are forming all the time in response to new sensory input - which is why we can continue to learn new skills throughout life. What's interesting about the 'overgrowth' in autism, is that although the individual might have too many synapses compared to a typically developing child of the same age, it's not necessarily a case of too many synapses developing, but could be that not enough have been pruned. This might be a physiological issue - the pruning process doesn't work properly - or it might be an input issue - that sensory input (fundamental to all information processing) isn't consistent so there is no clear strengthening of some pathways at the expense of others.

 

What happened with the kittens was that the neural pathways in the visual processing area of the brain connected to the covered eye didn't develop properly. So the visual areas of the brain connected to the good eye developed fine. And the kittens would not have developed 3-D vision because they would have had visual information coming from only one eye.

 

If you look at the scan images in the paper, most of the thicker areas of cortex are in primary sensory areas. There's a huge thickened part (red/yellow in the images) right at the back, where visual information is processed, for example. Whereas most of the thinner parts (blue) are in secondary processing areas - where information from several brain areas is brought together. To me, that suggests that inconsistent sensory input (a lot of autistic people have poor control of eye movement and variable auditory processing) is preventing pruning in primary sensory areas, which would make them thicker, and because of that, secondary areas are thinner because they are not developing normally.

 

I think what will be really informative about this project is what it's going to be able to tell us about commonalities and differences between individuals.

 

cb

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Hi,

 

Haven't read all posts...my attention is shot to pieces, since my DD spent 10 months in psychiatric hospital then moved to 52 week school 6 hours away i have had a breakdown after years of holding life together and spent the last 9 months unable to work or face life!!

I have been asking for the last two years for a scan on my daughter who is now 16 and has dx of aspergers and now adhd and possible bpd and at 8 years old gender identity disorder, but that seems to have either been locked away in her head or is gone!!

I am desperate to get some one to study her brain function and try to unravel the complexities of her. she also self harms is unpredictably violent and agressive, she says inappropriate things usually loudly at in appropriate times, she is 5'9 and weighs about 15 stone so you can imagine containing her is difficult.

But no one seems to want to try to unravel her head!!! it's so frustrating. she has also have psychosis which was very scarey!!

I know that a childs brain is still developing but there must be indicators, I know alot of teenagers are diagnosed with bpd when infact if they were an adult they would get the dx of schitzophrenia( dont know how to spell sorry) My DD is also very paranoid!!

 

Hopefully scans will help people like my DD but may be too late for her.

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Hi,

 

Haven't read all posts...my attention is shot to pieces, since my DD spent 10 months in psychiatric hospital then moved to 52 week school 6 hours away i have had a breakdown after years of holding life together and spent the last 9 months unable to work or face life!!

I have been asking for the last two years for a scan on my daughter who is now 16 and has dx of aspergers and now adhd and possible bpd and at 8 years old gender identity disorder, but that seems to have either been locked away in her head or is gone!!

I am desperate to get some one to study her brain function and try to unravel the complexities of her. she also self harms is unpredictably violent and agressive, she says inappropriate things usually loudly at in appropriate times, she is 5'9 and weighs about 15 stone so you can imagine containing her is difficult.

But no one seems to want to try to unravel her head!!! it's so frustrating. she has also have psychosis which was very scarey!!

I know that a childs brain is still developing but there must be indicators, I know alot of teenagers are diagnosed with bpd when infact if they were an adult they would get the dx of schitzophrenia( dont know how to spell sorry) My DD is also very paranoid!!

 

Hopefully scans will help people like my DD but may be too late for her.

 

I was wondering how things were with your daughter and am sorry they are still very difficult. >:D<<'>

I thought I might be able to offer you some support.

I had what is now considered to have been a breakdown a few years ago.

I was very anxious and unwell at one time and came nearer than I like to think about to being admitted to hospital.

I am very well now.

I have not gone back to work.However I enjoy life and take far better care of myself than before I was unwell.

I go to the gym regularly and have spent several months attempting to create an allotment in the small garden of a terraced house.

>:D<<'> >:D<<'> >:D<<'>

Things can get better even after feeling very bad indeed.

Karen.

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Hi,

 

Haven't read all posts...my attention is shot to pieces, since my DD spent 10 months in psychiatric hospital then moved to 52 week school 6 hours away i have had a breakdown after years of holding life together and spent the last 9 months unable to work or face life!!

I have been asking for the last two years for a scan on my daughter who is now 16 and has dx of aspergers and now adhd and possible bpd and at 8 years old gender identity disorder, but that seems to have either been locked away in her head or is gone!!

I am desperate to get some one to study her brain function and try to unravel the complexities of her. she also self harms is unpredictably violent and agressive, she says inappropriate things usually loudly at in appropriate times, she is 5'9 and weighs about 15 stone so you can imagine containing her is difficult.

But no one seems to want to try to unravel her head!!! it's so frustrating. she has also have psychosis which was very scarey!!

I know that a childs brain is still developing but there must be indicators, I know alot of teenagers are diagnosed with bpd when infact if they were an adult they would get the dx of schitzophrenia( dont know how to spell sorry) My DD is also very paranoid!!

 

Hopefully scans will help people like my DD but may be too late for her.

 

Whoa, that's a lot to contend with SuzyQ.

 

The difficulty with brain scans is that they can tell us which parts of the brain that might be 'different', but don't tell us how to resolve the problems those differences cause. A great many behavioural issues are caused by chemical imbalances in the brain, but those chemicals are involved in a lot of different functions, so even if the imbalance is found, any drugs that could correct it might affect other parts of the brain and body and give rise to unwanted side-effects.

 

Brain scans will help with research into brain function but it could be a while yet, because brains are so complex. In other words, it's unlikely that no one wants to get your daughter sorted out, they just don't know how to do it.

 

I know it's not much comfort but quite a lot of serious mental health problems in teenagers do resolve in time. I hope you have some support to help pull you through.

 

cb

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He's spot-on. So's Gerd Gigerenzer.

 

Thanks Jaded.

 

cb

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Hey cheers guys.

 

I hate rollercoasters, but I know I dont ride alone, we are all on it!!

 

I guess I would just like my DD to have a scan, really so people can see that her brain works differently and the way she is is not

 

A: Because she is a teenager... ( dont think we really reached that stage yet)!!

 

B: Because she has in the past smoked cannabis

 

C: Because she is bad and naughty and manipulative!

 

Social Services see a teenager in total control and it worries me that they will move her from her school into a setting where there are knives and too many people together and she will harm some one or herself, because they don't know her her social worker has met her now about 4 times!!! they don't realise she needs at least 1:1 and often its 2:1 to keep her safe and other people!!

 

I myself would love a scan to see if I have AS as I have alot traits, which i am startng to learn as i am learning who i am... worst rollercoaster of all!! I know I dont like people and dont know how I ever done my job because the thought of doing it terrifies me now.

 

 

So thanks again for words that help, and give hope.

I have grown some veg this year, i find gardening so theraputic...hated it before tho lol

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Hey cheers guys.

 

I hate rollercoasters, but I know I dont ride alone, we are all on it!!

 

I guess I would just like my DD to have a scan, really so people can see that her brain works differently and the way she is is not

 

A: Because she is a teenager... ( dont think we really reached that stage yet)!!

 

B: Because she has in the past smoked cannabis

 

C: Because she is bad and naughty and manipulative!

 

>>>>>

I have grown some veg this year, i find gardening so theraputic...hated it before tho lol

 

Ah, proving that there is a physical reason for her behaviour is a different matter. Now I see where you are coming from.

 

Veg growing is brilliant. It really centres you.

 

cb

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