Home > Science > Non-verbal Autism Research Highlighted at IMFAR

Non-verbal Autism Research Highlighted at IMFAR

By Leanne Chukoskie, Autism Speaks

In 2008, Autism Speaks kick-started research in the area of non-verbal autism through its High-Risk High-Impact initiative. This year at IMFAR, Autism Speaks-funded research was featured in the Invited Educational Symposium titled Characterizing Cognition in Non-verbal Individuals with Autism: Innovation, Assessment and Treatment.

Geraldine Dawson, Ph.D., Autism Speaks’ Chief Science Officer, chaired the session and set the stage for the audience to appreciate the importance of this particular topic. An estimated 30% of individuals living with autism are functionally non-verbal, yet very little research effort was directed toward helping this group communicate their wants and needs. The inability to communicate leads caregivers and clinicians to the presumption that the cognitive skills in these individuals were low because the tests typically used to assess cognitive skill require verbal or behavioral responses that this group of individuals does not readily produce.

The first speaker was April Benasich, Ph.D. of Rutgers University, who received an Autism Speaks grant for her research. Dr. Benasich presented data on innovative new studies on 3-7 year old non-verbal children with autism. Using tasks that were designed to assess children’s capacity to identify mismatches between sights and sounds. For example, a picture of a frog might be presented with the spoken word “frog” or “cow.”  The latter, obviously incorrect, pairing generates a spark of electrical activity in the brain called a mismatch negativity about 400 ms after the stimulus was presented. This sort of task can also be used to probe contextual understanding in non-verbal children by pairing, for example, the frog with “green” or “pink.”  Even greater complexity can be tested by presenting sentences with errors in syntax. When heard by children who understand language, these syntax errors generate the same kind of brain potential.

Dr. Benasich and her colleagues developed a training protocol to get the children comfortable with the application and wearing of the EEG net as well as exposing them to all of the concepts presented in the experiment. The results revealed some similarities and some differences in the processing of sensory stimuli in the non-verbal children and this is not unexpected as they continue analyzing these data and also new data on older non-verbal children.

However the real power of using EEG techniques for assessing cognitive capacity is that it can tell us for an individual what we cannot get from standardized cognitive tests. Dr. Benasich presented results from individuals, some of whom were picking up the mismatches in the pictures and sounds, or sentence errors and some of whom did not.

This was the launching point for the next presentation from John Connolly, Ph.D., of Mc Master University. Dr. Connolly typically studies individuals who suffered traumatic brain injury and must be assessed to appropriately design rehabilitative therapy. He and his colleagues adapted a standard test for word comprehension called the Peabody Picture Vocabulary test (PPVT) into a tool that can be used by measuring brainwaves – no oral or manual response required. A grant from Autism Speaks allowed him to adapt his methods to work with non-verbal individuals with autism. By learning exactly what these non-responsive adolescents can and cannot understand, one can more appropriately design therapies to help them move to the next stage of learning.

Nicole Gage, Ph.D. of UC Irvine relayed her studies of both speech and sound processing in minimally-verbal children with autism using a different brain measurement tool called magnetoencephalography or MEG. One advantage of MEG for children is that nothing actually touches the child during the measurement. Although they must lie very still, there is no noise and the device resembles a fancy salon hair dryer. Using this technology, Dr. Gage and her colleagues are finding differences in very early in brain processing responses to tones and mature early in human development. These responses occur at the level of the auditory brainstem and may be at least partially responsible for the atypically responses measured to both tone and speech sounds observed by both Dr. Gage and other researchers at the later stages of brain processing in auditory cortex.

Lastly, but perhaps most importantly, Connie Kasari, Ph.D., of UCLA and the organizer of this special session presented her Autism Speaks-funded treatment research specially tailored for non-verbal children between the ages of 5 and 10 years old. Dr. Kasari uses structured play-based methods to build a scaffold and provide context for encouraging communication in these children. Her randomized controlled trial design encompasses treatment sites at UCLA, Vanderbilt, and Kennedy Krieger and involves the play based therapy especially designed for these children and also a treatment arm that includes an alternative and augmentative communication device. Dr. Kasari showed data from the group thus far – after three months of the six-month treatment trial. Not only are some individual children making incredible strides toward initiating functional communication, but overall 75% of the children in the study are responding to the therapy. Interestingly, looking back at the detailed assessments taken on the participating children upon their entry into the study no particular features distinguished the responders from the non-responders thus far.

These studies break new ground in reaching those with autism who cannot speak. However, the next steps will almost certainly be the most exciting. As more researchers and clinicians learn about these studies and are able to take advantage of the results presented, we will be better able to understand and assist individuals who are now non-verbal. These sentiments were perhaps captured best in the enthusiastic response the speakers received from the loved ones of those affected.

  1. Jen
    May 14, 2011 at 9:32 am

    This is GREAT info! Let’s see more of this type of research with RESULTS!

  2. May 14, 2011 at 9:58 am

    Focusing on non verbal autism for study is a positive and important step in increasing our understanding of the challenges faced by many persons with autism disorders. There is also a need for greater research of persons with autism disorders and intellectual disabilities. Persons with autism and intellectual disability were once the “vast majority” as described by CDC Autism Expert Dr. Yeargin-Allsopp. Even today, with the expansion of the autism “spectrum” to include Asperger’s Disorder two recent CDC surveys indicate that more than 40% of all persons on the autism spectrum have intellectual disabilities. Congratulations for the research focus on non verbal autism. We still need much more research too on autism and intellectual disability.

  3. Lisa Ollivier
    May 14, 2011 at 10:13 am

    I have an 8 year old son with Down Syndrome & an Autism Spectrum Disorder. He is non-verbal. Is there any therapy available in regards to these studies or do you just recommend speech therapy with a SLP?

  4. Nancy
    May 14, 2011 at 11:36 am

    This information is very refreshing to hear. My son had been diagnosed with severe mental retardation by “specialists”. The fact is is that he is non-verbal. I do not, nor does anyone who is around my son believe he is severely mentally retarded (or having low self esteem as one other test/specialist said). We need this kind of research to contimue so that we parents can then access the findings to show to the “specialists” that as parents we do know what we are talking about and to give our children credit for the cognitive skills that they have.

  5. Mia
    May 15, 2011 at 8:56 pm

    Interestingly enough, they mention using “augmentative communication device” along with this therapy. What was used? Dynawrite, Ipad, etc.? Is it possible that these non-verbal children are 100 percent receptive and able to fully process incoming language and that they were given a tool that they were taught to communicate effectively with? How do they explain all the blogs, “speeches”,etc. written by completely nonverbal autistics?

    • Leanne Chukoskie
      May 16, 2011 at 1:08 pm

      Mia, thanks for your question. Dr. Kasari and colleagues used a device from Dynavox. Interestingly the iPad was too distracting (kiddos kept trying to get on the internet and use the other apps!). These results do suggest that some children have the cognitive capacity to communicate when given the means, as you suggest, but don’t for reasons that are as yet unclear (possible due to the considerable motor coordination needed to produce functional speech). However, as some of the other speakers noted, this does not appear to be the case for all non-verbal individuals. Future research connecting the cognitive testing with the therapeutic intervention is the goal and the participants in this symposium are moving in that direction.

  6. kourtnee
    May 20, 2011 at 1:16 pm

    Okay what do i need to do… My son is 5 non verbal regressing autistic . How can i get him the help he needs! becuase every speech therapist says they cannot help him. I have been doing everything on my own for 3 yrs. Private school Pecs, now a speeking device, tried sign laungage he does not show any interest but i have not given up.. He makes noises and he does say moma moma moma repedivatly… Please im begging give me any advice… Ill take anything!….

  7. marve1
    May 20, 2011 at 6:49 pm

    This is truly exciting that funding is being used for practical issues such as communication for nonverbal individuals who are autistic. In what journal have these preliminary findings of this study been published? I would love to read more about this. Thank you.

  8. Mia
    May 20, 2011 at 8:04 pm

    Kourtnee, my son is also nonverbal autistic. We are currently working with an Ipad and plan to use the informative pointing method.You don’t need an Ipad with this method, we are just choosing to go that route because it holds my sons interest. The manual can be found on http://www.strangeson.com. I hear that there has been much success getting nonverbal autistics to communicate although as with everything it can take time to see results. Good luck to you!

  9. August 2, 2011 at 6:59 am

    I have a 6 year old niece with Down Syndrome and cannot communicate properly yet. Is there any therapy available for her?

  10. Andreas Schapitz
    September 26, 2011 at 1:24 am

    Interesting research. We have a non verbal autistic child who is deemed severe on the CARS score) and is also deemed to be suffering from ID, who has gone from a semi vegetative state at 19 months (looking at overhead lights while doing bicycle riding on his back) to a semi functional boy at 7, he still does not speak functionally but his functional communication at all other levels is exceptional. We still have the body tremors, the obsessive compulsive behaviour, the frustrated tantrums, the lack of speech (athough he says, mum, dad, and more) he vocalises extremely consisentantly. What have we done to achieve this end? We have harrassed and hounded politicians for action on support services, but this is only a long term goal.

    The real gem is the positive engagement we get from him when we initiate communication or he does. Its all about getting down to his level, developing trust, being consistent and genuine. These kids know what is going on around them they just can’t relay that in a manner we understand in the general community.

    People told us to give him up and told us we could not do anything with him. We thank a team of private therapists (speech, occupational (using floortime) and his special school teachers for pushing him.

    It took me 3 years to get him ready for a theme park, but apart from the tantrum of a lifetime on the first ride before getting on it, he was an angel for the rest and went on rides his typically developing brother refused to go on.

    We need to develop testing protocols for these children that focus on what spark is their, not what spark is missing.

  1. May 14, 2011 at 12:53 pm
  2. May 14, 2011 at 1:57 pm
  3. May 14, 2011 at 1:58 pm
  4. May 14, 2011 at 9:01 pm
  5. May 14, 2011 at 9:12 pm
  6. May 15, 2011 at 6:04 am
  7. January 15, 2012 at 10:28 pm

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