Innovative Technologies for Autism

I would probably never truly understand what it feels like having a child with autism unless I experience it first handed, but from reading a bit from the book Strange Son and also the article Guardian Story online, I see the frustration and the pain of parents when professionals tells them there isn’t anything they can do and should move on with their lives. Reading this makes me wonder if there are adequate support groups for parents of children with autism to share their stories, therapies, and other valuable information, since they are by far the most important people in treatment/therapy where they spend the most time with the children.

Relating it with the article about pervasive computing technologies, I was impressed to see their design considerations and thoughts that went into it. They stated that they spent up to a whole year interviewing parents, caregiver, therapist and teachers.

I think all of their ideas were very novel and innovative, but I think the wearable sensors technology needs more refinement because I question their realistic benefits where it might be very difficult to truly detect their thoughts/feeling through sensors. Overall, I thought the article was very helpful for our own team project where they outline the design considerations and different challenges that might be common to ours.

Given the fact that autism has a broad phenotype, it is no surprise that the neurological descriptions of the condition vary and contradict one another. I seem unable to find the exact article, but recent work suggests that the neural deficit in autism lies in the connectivity (i.e. the synapses). I believe Ms. Iverson eluded this. Interestingly, the autistic population is disproportionately represented in micro- and macro-cephally (small and big heads, respectively). It appears that autism is characterized by a period of rapid overgrowth, followed by truncated development. I conjecture that this is the result of disrupted synapse elimination (the pruning of neuronal connections).

Synapse elimination is a developmental phenomenon and autism is a developmental disorder. Most people say that when we learn, we form new connections. Actually, it is the opposite; we prune them. How this happens and how it is controlled is not only beyond my knowledge, but it is beyond modern scientific knowledge (although great strides have been made). While the 90’s was the decade of the brain, I think we should acknowledge that our understanding of how the brain works is limited. In disease, it is often more so.

When we move to the level between the neuron and the mind—the neuro-cognitive level—we can get lost quickly. Everything is connected in there! Moreover, we still don’t know how it all cross-talks. Cognitive/social neuroscience is still in its infancy. Even though experiments are conducted, it is still a descriptive science. Neuromodulation is a reality, but so often the module implicated in autism is not supported by the next study.

In doing the readings, I was overwhelmed by the great array of different neurological explanations for the different aspects of autism.  One of the readings said the major lesions were in the amygdala, and another compared the differences in the brainstem.  One of the readings claimed similarities between people with autism and senior dementia.  These differences might make future differentiation within the autism spectrum disorder possible.  In my opinion, this is the track of scientific research, further specificity. And with further specificity, there can be more specific treatments.

This phrase taken from the Hirstein article really intrigues me. He offers it as a way to explain some of the claming behaviors those with autism most often engage in (clapping, flapping, rocking, etc.) to avoid stressful situations or certain sensory overload. But this held a lot more interest on a more conceptual level. It’s so simple and so obvious, I wonder if it is often times over looked when analyzing autism itself and researching new therapies? The symptoms of autism are simply a person’s way to consciously do what their brain can’t do subconsciously.

Take the galvactivator, for instance. Though initially penned as something to map arousal, it could easily be tooled to further analyze how often people with autism have to self-regulate. This combined with fMRI data could lead to new avenues of treatment that focus on the neurological aspects of autism. And in the mean time, by focusing on therapies or perhaps even drug therapies that provide alternative mechanisms for processing and regulation, we might be able to socially reduce the adverse impact autism can have in the community.

This week’s articles looked at autism from a different scope with neurological and biological links where we have looked at it from anthropology and psychology before. I think maybe because I am an engineer or just more or a math/science person, this approach to autism was much more appealing and interesting to me. The article by Iversen about the amygdala and the temporal lobe of the brain and its connection to autism was especially interesting to look at, where autism and some of the main behaviors like the self stimulatory behaviors are thought to be caused by defects in a specific region of the brain. My thoughts from reading this article is that when people in the media are treating autism like it’s something that you can just cure, which I disagree, I think children with autism learned to deal and cope with their behavior better by going through therapies, but it’s definitely not something that’s completely curable. I think this article confirms my thoughts where brain malfunctions are not simply curable.

In connection to the first reading, the article about the galvactivator I thought was a genius idea. It involves only a few electronics and fairly cheap looking at the electronic parts that goes into it. Also, I think this was the first product that solely used electronic parts without any programming or software design that we read about. Even though the product wasn’t developed solely for children with autism, it can come very useful in communicating with non-verbal children with autism in trying to understand what they could be feeling by making their level of arousal visible.

It seems to me that the lack of communication, not only communicating with others but also communicating information about one’s own feelings, was perhaps the motivation for most of these studies this week. These studies help to identify the physiological workings behind emotions including stress and comfortable recognition (i.e. recognizing someone’s face, although I am not sure what emotion that might be.. comfort?).

The Galvactivator is definitely something I would have fun with. And if I can remember correctly, it is now reduced to something of a large wristband device (similar to a thick watch) so it is even less of a disturbance than the glove. I am not sure how this wristband picks up on the pressure points that Picard labels as the sensor information points. But regardless, this technology can certainly be of use in classrooms and in the workplace.

Goodwin and colleagues mention that “educators have to make sense sometimes about internal states from overt behaviors”, and perhaps if the child was wearing a Galvactivator, the educators might be able to more quickly predict when “overt behaviors” might begin. The educator gets a peek into what emotions the child might experiencing from the outside. Not only is this a huge advantage, but it also serves to more accurately teach a child about emotions. When the Galvactivator is lit very brightly, the child could recognize this emotion as happiness or even as a comfortable recognition of a familiar face (maybe even in the case of recognizing a mother’s face vs. a paper cup [Hirstein, Iversen, and Ramachandran]). “The light is bright, so I am happy!” And that comment was not meant to be facecious (I’m not kidding). I love that this technology takes a huge amount of information from our inner workings and reduces them to a light scheme of different intensities and colors. This might be the type of “guiding” therapy, Matt, that I was trying to understand in your explanation. Sure, it doesn’t categorize every emotion and in turn every behavior, but it helps because it gives an accurate account of what is actually going on under the surface. This identification of emotion is key in helping an individual with autism (or without autism, really) begin to understand the workings of our human behavior. Because behavior is a direct result of how our body reacts to the surrounding environment (i.e. elevated SCR’s in autistic individuals), they could develop a sense of predictability because the light brightness/color would be the same for the same emotions even when the individual is in a different setting. We know that happiness doesn’t just occur in our homes, but rather we can be happy wherever we go. Because our environments change, knowing that certain emotions elicit predictable behavior might serve as a comfort to the autistic individual.

I did have one question about both the HR and the SCR study. In the HR study, it was mentioned that the participants were un-medicated, but some of the results may have been a result of “carry-over” stress or the stress created by placement in an artificial setting. In the SCR study, the authors attribute the hyporesponsive results of two of the participants to anti-epileptic medication. How might these studies have been different if the participants were medicated just as they might be daily? Is there any medication that tries to attack the abnormality of the amygdala? Would this even be safe/worthwhile?

In “Autonomic responses of autistic children to people and objects” and “Cardiovascular Arousal in Individuals with Autism”, the authors go over the observable neurological and cardiovascular differences between people with autism and normally developing peers. While I did find the perspectives to be refreshing and different than our previous readings, the difference in the perspective of the research was somewhat jarring at first. The most notable difference is the increased explicit use of comparisons between normal children and children with autism. In prior readings, the focus was mainly on the behaviors exhibited by children with autism and how children with autism think. The fact that these behaviors were not normative was always implied but they weren’t worded in such a way that in your mind you would first picture a normal child’s responses and then how a child with autism would react to the same stimuli.

I understand that for this kind of research the aim is to determine how people with autism are different from normally developing people, which makes the comparisons the focus of such a work. However, I wonder how different people react to these different perspectives. Is there a group of people that would find this more biological perspective offensive?

The readings this week seemed to be very interconnected (despite the comments I present below being rather disjointed). I constantly found myself thinking of implications of some of the articles while reading the others. For example, the discussion of SCRs within “Autonomic responses of autistic children to people and objects” as well as the closing statements of “Cardiovascular Arousal in Individuals with Autism” both triggered thoughts of Picard’s galvactivator.

Goodwin’s article served as a great example of a study that reveals important results while disproving its original hypothesis (which I believe to be a very common occurrence, particularly in autism research). The study was very well meditated, the analysis easy to read, the counsel for future studies thorough, and the result significant. 

Although I found “Autism in search of a home in the brain” less informative than the other readings, I was intrigued by one of the last points Rapin makes. I think understanding neurological research on autism can be very difficult and perhaps the reason is the one offered here–that many studies have too low of statistical power to present clear findings. The argument also made me wonder about more current research, as this article is from almost 10 years ago, and whether or not this has become more or less of a problem. I know that sample size is still an issue in autism research today, but I would like to know more about the confusion–for lack of a better word–that currently exists among neurologists studying autism.

The galvactivator piece was really interesting, especially in its potential application in the nonverbal domain. I wish the explanation of its possible implementation with children with autism would have been more specific, but its use in nonverbal expression was communicated effectively. I thought about the ramifications of such a technology within my own family. I would love for my sister to try it  (even though I’m pretty certain she would take it right off) and to see what things, what faces, and what situations made her “light up.” I may have 20 years of experience with her and a good idea of what stimuli she responds more to, but you never know…!

As far as real human versus virtual human goes, I still don’t know what to think. I struggle with it because there are things about one agent that makes me think it is more suitable for children with ASD, and then there are things about the other that lead to the same conclusion. The results of the “Neural Basis of Social Perception of a Human Versus Virtual Human” show that virtual humans are harder to interpret socially, maybe due to their unfamiliar nature. Does this very reality that the subjects are working more rigorously cognitively have anything to do with the success of ECAs? Furthermore, we already know that they are definitely not perceived as real humans by children with autism. This consideration, however, does not seem to outweigh the notion that virtual humans are–by the very fact that they are not real humans–more appropriate for the generation of peer interaction in these children, despite not being as generalizable.

This week’s readings were very interesting. First because it enabled me to get inside the head of someone with autism, but also, because it enabled me to better understand the way in which I myself can communicate with them. Hiersten et al’s article on the “Autonomic Responses of Children with Autism” used the example of testing a child’s emotional response when seeing a plastic cup with the response of  seeing their own mother’s face. While this seems like a petty reaction to test, it was shocking to understand how the emotional triggers between the two were sometimes be almost the same in children with autism. It was also interesting to learn how this happens because people with autism have emotional sensors that either vastly exceed the normal amount or on the contrary, are vastly less than the normal amount.
This information was also very useful in learning about the technology to better understand people with autism’s emotional reactions. Goodwin’s article extended on some of these concepts. Goodwin explains that one way to test people with autism’s arousal state is through testing their heart rate. He also confirmed that people with autism usually experience a very active or non active arousal rate during new social situations. I felt he also gave some really good solutions to adjusting these arousal states such as breathing exercise to calm an active state or wearable sensors to generally be aware of their inactive or overly active stressors. I felt that the “Galvacitavotor” Glove was another useful technology to test and understand arousal rates. The best thing about this glove was that since it is worn on the inside of your hand, it is up to the wearer whether they want to share their emotional state or rather just keep it a personal way of informing themselves. Though, the problem with such a glove is 1) the sensor can be ignited by several different types of situations, not necessarily all stress related and 2) only the person wearing the glove knows the exact context of the stressful situation; therefore, it can be hard for an outsider to read such a glove.
Finally, I felt it was interesting to read about the perception of a real versus virtual human, especially in this week’s context because it allowed me to understand how someone with autism not only could relate to a virtual human but appear like a virtual human themselves since they are affected differently by social situations. Generally, people believed that real humans felt more social than virtual humans; people with autism often can also appear less sociable due to their different ways of communicating emotion. In general though, the article acknowledged how people had to get used to virtual humans in order to feel more comfortable around them. Does this mean that people need to also get used to people with autism in order to accept their social patterns? If so, then why do people with autism need to learn how to be more sociable rather than us learn how to just be more accepting?

I have to say when I first read the abstract for this article, I was blown away.  It makes so much sense in so many ways - an effective way to eliminate potential biases that may crop up during diagnostic observations using real-time group interactions.  I also really liked the fact that the results of this survey were detailing the exact ways that children with ADHD-C and ADHD-I interacted differently, and that they addressed the issue of comorbidity.

I was trying to find research out there, and wasn’t seeing anything - but this made me think of the Second Life project that group 2 has been working on (in some ways).  This project focused on the use of chatrooms to illuminate the developmental challenges a particular child faced, but could this project be retooled into a therapy that was aimed at reducing those challenges?

Also, we’re looking at children who have received classical and clinical diagnoses for their disorder.  What about those children who have never been diagnosed?  Maybe there’s a way to make this a widely accessible tool that can be used in schools, etc., to see if a child merits further testing?

I’m just overall very impressed with the concept of this study and wonder how else it might be used in terms of diagnosis and therapy.

I would first like to comment on something that Dawn Prince-Hughes clearly points to in Songs of a Gorilla Nation. I find it very interesting that she wrote narratives as part of her diagnostic assessment. We spoke about the inability for individuals with autism to compose narratives, and while knowing that from last week, “If you’ve seen one child with autism, you’ve seen one child with autism,” (Kientz, Hayes, Westeyn, Starner, Abowd), I thought that the lack of narrative was a more common deficit. Obviously we have read narratives written by individuals with autism (i.e. Tim Page’s narrative and now Dawn Prince-Hughes’s), but I couldn’t help to think of the irony in assessing her autism with the help of her volunteered narratives.

But what I still run into confusion with is the concept of autism as an epidemic. Is it really more common than in the past? After reading some opinions and hearing Sharon Rosenbloom’s very stern “yes”, I would almost just be more comfortable if I heard a definite “yes” or “no” from hard medical evidence. I guess that’s wishful thinking. I was slightly more comfortable with Grinker’s comment about now is the best time to have autism (considering this comment is overly dated:2007). He can’t mean that there’s absolutely no stigma attached to autism.

I was watching “E!’s Top Ten Mommy Scares” (while working-out…. don’t judge, okay you can if you want), and Jenny McCarthy was up there for her “traumatizing” story about her son with autism. This was even rated higher than a story of a news anchor’s near death (actually, several near death) pregnancy complications. Hmmm…. death of a mother and her twins vs. child with autism? I am not sure if that’s a fair comparison. The shock came before Jenny knew what was not “normal” with her son. He would violently skae (a seizure), foamed at the mouth (I thought this was at the time of a seizure, but it was not clear), and “routinely” demonstrate other scary not-so-normal habits. I guess that was the medical scare. I can admit that if my child were to do this, I would be extremely scared.