WHY AREN’T WE THERE YET? Valuable but incomplete measures of brain changes in babies with autism

Blog by Martha Herbert on www.autismWHYandHOW.org :

In my opinion the recent research paper, Differences in White Matter Fiber Tract Development Present from 6 to 24 Months in Infants with Autism (Am J Psychiatry 2012 ; 169 :589-600), reports a very important finding and represents a huge amount of work, but the study is quite incomplete both in what was chosen to be measured and how the findings are interpreted by the investigators, Jason Wolff et al.  Moreover, even though this study has been touted in the news as a way of detecting autism early, it really isn’t ready for prime time as a clear indicator of the autism diagnosis. I think this finding is about things that occur downstream of other biological factors that are driving these changes.  – And because these changes are downstream, they are fuzzier in that they reflect a mixture of lots of other influences.   This makes it hard for them to clearly demarcate risk from lack of risk.  Measuring what’s upstream might bring us closer to a clinically useful brain measure of autism risk in young infants.

Because I am a brain researcher, I spend a lot of time thinking about different techniques to measure things in the brain.  Let me explain to you why people study things like this, what was measured in this study, and what it means. Then I’ll be able to explain to you why this study is both important and incomplete.

Why people study babies at risk for autism with brain imaging

Autism is a neuro-developmental – and many would say also chronic – condition that is presently defined by behavioral criteria.   But these behavioral features don’t emerge in babies – they only become detectable when a baby becomes old enough to perform these behaviors.  The “holy grail” of autism research prominently includes being able to detect signs of autism, or autism risk, at a younger age than when current gold-standard tests can diagnose autism.  …

Concluding questions:

  1. Is this study’s measure robust enough for us to march our 6 month old babies down to the local MRI scanner and test them for “autism”?  No, it is not.
  2. What’s missing from this study
  3.  Why did these highly trained, dedicated investigators design a study that did not look at these upstream factors that probably are driving these FA changes?  Two reasons:…
  4.  What can we do about this?        READ MORE…

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