Tuesday, November 2, 2010

Babies, toddlers get assessment for possible autism

From The NY Times:

SACRAMENTO, Calif. — In the three years since her son Diego was given a diagnosis of autism at age 2, Carmen Aguilar has made countless contributions to research on this perplexing disorder.





“What you ultimately might be doing is preventing a certain proportion of autism from ever emerging,” said David Mandell, the associate director of the Center for Autism Research at the Children’s Hospital of Philadelphia. “I’m not saying you’re curing these kids, but you may be changing their developmental trajectory enough by intervening early enough that they never go on to meet criteria for the disorder. And you can’t do that if you keep waiting for the full disorder to emerge.”



“Patty-cake and peekaboo or tickle games, those are people games,” she explained to Carmen and Saul Aguilar during their first session with their son Emilio at 7 months old. Ms. Rogers talked about the next 12 weeks and how they would focus on getting Emilio to exchange smiles, to respond to his name, to babble with them, starting with single syllables (“ma”) and moving on to doubles (“gaga”) and more complex combinations (“maga”).

“Most babies come into the world with a built-in magnet for people,” Ms. Rogers said. “One thing we know about autism is that it weakens that magnet. It’s not that they’re not interested, they have a little less draw to people. So how do we increase our magnetic appeal for his attention?”



“He’s just staring at that object even though her face is three inches away,” she said. “He has that flat, very sober-looking face.”

Mr. Aguilar tried next. He put Emilio in a red beanbag chair and folded the sides together over the baby. “Squish, squish, squish!” he said. No response.


Mr. Aguilar put the baby back in the beanbag and picked up a stuffed wolf toy. He put it on his head and let it drop into his hands. “Pschooo! Uh-oh!” Finally, Emilio was watching.

“That was great,” Ms. Rogers told the father. “You put that toy on your head and he was drawn to your face. You were using the toy to enhance the social interaction. When you bring it up to your face, he’s with you.”


“Experiences shape babies’ brains in a very physical way,” Ms. Rogers said. “Experience carves synapses; some are built, some are dissolved.”

If a baby starts focusing on objects instead of faces, the theory goes, a “developmental cascade” can begin: brain circuits meant for reading faces are used for something else, like processing light or objects, and babies lose their ability to learn the emotional cues normally taught by watching facial expressions. The longer a baby’s brain runs this developmental course, the harder it becomes to intervene.



Emilio’s parents are happy to have their son in the first wave of the pilot program. They saw their older son, Diego, make so much progress in behavioral therapy between ages 3 and 5 that they’re very hopeful about what might happen with Emilio.


“I’m the first in my family to go to college, and grad school,” Mrs. Aguilar said. “My thought was, ‘Now I’ve set the bar for my son.’ ”

But after learning that Emilio too may have autism, “you stop looking that far into the future,” she said. “We’re forced to think day by day.”