Children with autism often have problems learning language, recognizing social cues and understanding social relationships. Dr. Sara Jane Webb is exploring the mechanisms beneath these problems with research that could illuminate how the brain in children with autism functions, and could improve how physicians understand and treat the disorder.
“We’re looking beyond autism’s symptoms to see if there is something different about the cognitive processes that drive these kids’ brains and behavior,” says Webb, a principal investigator at Seattle Children’s Research Institute’s Center for Child Health, Behavior and Development.
Webb’s main project, called Studying the Physiology of Attention and Regulation in Children (SPARC), investigates how children with autism learn language and social skills. The goal is to pinpoint how different types of attention and perception influence these aspects of a child’s development. For this research, Webb is monitoring how well a child can pay attention to their environment by measuring physiological processes in addition to watching a child’s behavior. This is important because we don’t know if a child with autism doesn’t register social cues, such as whether a person is smiling or looks angry, or is ignoring them in favor of other non-social items.
Researchers typically measure how children register cues by simply watching how they react. But that paints an incomplete picture – if a child doesn’t look at someone who’s talking to them, it doesn’t mean they’re not paying attention.
Webb’s team might show a child a picture of a smiling person, watch the child respond, and simultaneously measure their heart rate or their brain’s electric pulses. Sometimes these measurements show that the child registers the picture even if they don’t react – if a child’s heart rates slows down in response to a cue, it means that is the child is paying attention to it. Sometimes there’s a larger disconnect and the child doesn’t notice the cue at all.
“We’re learning that a child’s behavior may be showing us one thing but their physiological state is showing us another,” Webb says. “From a treatment standpoint, that can tells us more about what we need to do to get their attention and how to get their physiological attention state aligned with behavior so the child can start interacting in a meaningful way.”
As part of a previous study at University of Washington, Webb’s team recently finished a clinical trial that used another physiological measure – electroencephalography (EEG), which tracks the brain’s electrical activity – to study how a treatment approach called the Early Start Denver Model (ESDM) impacts brain functioning. The researchers were able to measure not only whether the treatment improved children’s behavior, but also whether it improved how their brains registered facial expressions and other stimuli.
"The ESDM intervention resulted in greater language and adaptive outcomes, but also increased attention and cognitive brain activity to social stimuli, and these brain function patterns were more similar to the typical developing group of children," Webb says. “Measuring brain function or cardiac functioning allows us to look at the millisecond by millisecond responses that lead up to a behavior. This may give us more basic measures of change and could help us understand a child’s basic information processing ability as well as quickly modify a treatment when the patient does or doesn’t show an expected physiological response.”
In addition to SPARC, Webb will be launching a new study in January 2013 that could revolutionize the medical community’s understanding of autism in girls. Because the condition is far more prevalent in boys, research results are skewed toward understanding how autism affects them. Webb is working with collaborators at Yale, UCLA and Harvard to investigate whether autism impacts girls differently by looking at factors including their brain structures and functioning, genetic patterns, and their ability to learn language and respond to social cues.
“There’s good reason to believe that girls with autism have a different profile in terms of their physiology and their symptoms,” Webb says. “If that’s true, physicians need to know that and treat them differently.”
It’s all part of Webb’s mission to answer some of autism’s key questions and improve the lives of children with autism worldwide.
“Ultimately, our work is about helping physicians and parents get better information about how a child is doing,” Webb says. “We want to know which treatments are working, how they are working and how we can get kids on the road to being successful.”