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The Effects of Autism on Adolescent Brain Development

Katherine Kutzli Brain Development Michigan State University
Thursday, March 14, 2013

Autism Spectrum Disorder (ASD)

Image created by Katherine Kutzli using Wordle

Thursday, March 14, 2013

What is Autism Spectrum Disorder (ASD)?

ASD is an umbrella term that describes a range of complex disorders that affect the brain development of children, adolescents, and adults. ASD includes: Autistic Disorder, Asperger Disorder, Childhood Disintegrative Disorder, Retts Disorder, and Pervasive Developmental Disorder (PDD). The three main types of ASD include Autistic Disorder, Asperger Disorder, and PDD.
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What is Autism Spectrum Disorder (ASD)? Continued...

ASD is characterized by social, behavioral, and verbal skill decits (Autism Speaks Inc., 2012). This presentation will focus mainly on Autism/Autistic disorder and Asperger disorder/syndrome: Autism is characterized by delays or abnormal functioning before the age of three years in one or more of the following domains: (1) social interaction; (2) communication; and (3) restricted, repetitive, and stereotyped patterns of behavior, interests, and activities... ...Asperger syndrome can be distinguished from autism by the lack of delay or deviance in early language development. Additionally, individuals with Asperger syndrome do not have signicant cognitive delays... (Mental Health Blog, 2012, para. 4-5).

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Who is Affected by ASD?

Adolescents of any race/ethnicity, gender, education, and socioeconomic status, can be diagnosed with ASD. The U.S Centers for Disease Control and Prevention (CDC) reports 1 in 88 youth are affected by ASD (1 in 252 girls and 1 in 54 boys) (Insel, 2012, p. 1). According to the Center for Autism & Developmental Disabilities Epidemiology (CADDE) (2012) ASD affects more boys than girls, with 1 girl for every 4 boys diagnosed (para 8). Insel (2012) with the National Institute of Mental Health (NIMH) reports a 78% increase from 2002 and a 23% increase from 2006 (Insel, 2012, p. 1).

Are we better able to detect these disorders or are more children affected by ASD? Research is found supporting both theories.

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What Causes ASD?

Research suggests that there is no single cause for ASD. The cause of autism is most likely a genetic predisposition that impacts on brain development before birth. The signs and symptoms appear gradually, and can only be fully recognized from about the second year of life (Blakemore & Frith, 2005, p. 95). Genetic factors in addition to environmental factors may largely impact brain development and result in an increased vulnerability to ASD (Autism Speaks, 2012, para. 5). It is important to keep in mind that these factors, by themselves, do not cause autism. Rather, in combination with genetic risk factors, they appear to modestly increase risk (Autism Speaks, 2012, para. 6).

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Symptoms of ASD

In order to be diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders (DSM), one must have all three characteristics of impaired social communication/ interaction and at least two of the characteristics of restricted/repetitive behavior (VeenstraVanderweele & Blakely, 2012, p.1).
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The Brain

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How is the Brain Different From a Non-Autistic Adolescent?

Studies report neurobiological abnormalities of children with autism.

Children with autism appear to have an overgrowth of the brain ...preceeded by 2 phases of brain growth abnormality: a reduced head size at birth and a sudden and excessive increase in head size between 1 to 2 months and 6 to 14 months. Abnormally accelerated rate of growth may serve as an early warning signal of risk for autism (Courchesne, Carper, & Akshoomoff, 2003, p. 337). The parts mentioned as trouble spots most often in recent research are the temporal lobes, frontal lobes, and the cerebellum. Some evidence suggest that it is poor connectivity between different regions that is particularly characteristic of autistic brains (Blakemore & Frith, 2005, p. 101).

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How is the Brain Different From a Non-Autistic Adolescent?Continued...

Connectivity/Wiring

...developmental brain abnormalities in autism would be expected to affect brain circuits and the interaction of brain regions both during behavior and over the course of development (Loveland, Bachevalier, Pearson, & Lane, 2007, p. 49). By age ten, their brains are at a normal size, but "wired" atypically. "The brain is most complex thing on the planet," says Dr. Minshew. "So its wiring has to be very complex and intricate. With autism there's accelerated growth at the wrong time, and that creates havoc. The consequences, in terms of disturbing early development, include problems within the cortex and from the cortex to other regions of the cortex in ways that compromise language and reasoning abilities" (Rudy, 2007, p. 1).

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What Parts of the Brain Are Affected by ASD?

Cerebral Cortex Amygdala Hippocampus Brain Stem Cerebellum Corpus Callosum Basal Ganglia

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Cerebral Cortex

The cerebral cortex is the outermost layer of brain tissue... (Blakemore & Frith, 2005, p. 199). ...It is the most highly developed part of the human brain and is responsible for thinking, perceiving, producing and understanding language (Bailey, n.d, p. 1). A lack of communication in the cerebral cortex in youth with autism may begin to explain some of the cognitive symptoms of autism.

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Amygdala

An almond-shaped region in the center of the brain, part of the limbic system and involved in the speedy and automatic processing of emotions, in particular fear and distress (Blakemore & Frith, 2005, p. 198). Shown to be underdeveloped in Autistic individuals (Hellew, 1999, para. 8). The amygdala plays an important role in controlling emotions and aggression. This is signicant in that autistics are often either overly aggressive or passive and may appear emotionless (Hellew, 1999, para.9). A dysfunction of the amygdala might result in difculty detecting information relevant to mental states, emotions, attitudes and intentions of others and their signicance for oneself (Loveland, Bachevalier, Pearson, & Lane, 2007, p. 50).

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Hippocampus

A seahorse-shaped structure deep in the brains temporal lobe and part of the limbic system, involved in storage and retrieval of memories and spatial navigation (Blakemore & Frith, 2005, p. 201). Role in learning and memory. According to Hellew (1999) the hippocampus has shown to be underdeveloped (para. 8). Dr. Bernard Rimland hypothesized that autistic youth have a decit in terms of learning and memory. His hypothesis is supported by the following information: When the hippocampus is damaged or removed, animals demonstrate an inability to store new information into memory and they often display characteristics commonly seen in autism including stereotypic, selfsimulatory behaviors and hyperactivity (Hellew, 1999, para. 9).

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Brain Stem

Located near the cerebellum, the brain stem works to pass messages between parts of the body and the cerebral cortex. Research shows a lessening in the amount of grey matter in the brainstem of autistic youth. This reduction may possibly point to disconnectivity between the brainstem, cerebrum, and cerebellum (Jou, Minshew, Melhem, Keshavan, & Hardan, 2009, p. 6). Nuclei of the vagus nerve, contained in the brainstem, play a role in the weakening of numerous areas of the body. This [vagus] nerve controls varied tasks such as heart rate, gastrointestinal peristalsis, and several muscle movements in the mouth, including speech and eating (Jou, Minshew, Melhem, Keshavan, & Hardan, 2009, p. 5).

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Cerebellum

The cerebellum plays an important role in coordination, learning, and stability (Blakemore & Frith, 2005, p. 199). The cerebellum is a relatively large portion of the brain located near the brain stem that is primarily responsible for motor movements, but may also play a role in speech, learning, emotions, and attention... ...Thus, cerebellar abnormalities may help to explain the aberrant motor activity, impaired cognitive abilities, and apparent lack of emotion that are characteristic of autism (Hellew, 1999, para. 5).

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Corpus Callosum

The mass of bers connecting the two hemispheres of the brain together (Blakemore & Frith, 2005, p. 200). The corpus callosum (CC) has shown to be smaller in the autistic brain (Keary, Minshew, Bansal, Goradia, Fedorov, Keshavan, & Hardan, 2009. Persons with a lack of growth of the CC exhibit several cognitive and clinical characteristics that are similar to the ones observed in autism, such as impairment in abstract reasoning, problem solving, generalization and social decits (Keary, Minshew, Bansal, Goradia, Fedorov, Keshavan, & Hardan, 2009, p. 839).

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Basal Ganglia

A structure found within the cerebral hemispheres that works to regulate instinctive movements (Blakemore & Frith, 2005, p. 199). The basal ganglia contain a structure called the caudate nucleus. The caudate nucleus in children with autism is enlarged. Increased size of the caudate nucleus in the basal ganglia has been associated with compulsive behaviors, difculty with changes in routine, and stereotypical motor movements (Shriber, 2012, p. 5).

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Modules in the Brain

Blakemore and Frith (2005) discuss the potential for malfunctioning modules in autistic youth in terms of start-up mechanisms. These mechanisms include ways for people to learn concepts at a fast pace (Blakemore & Frith, 2005, p. 96). Example: learning language, music, etc. How does this connect to social difculties in adolescents with autism? One theory which attempts to explain the indicators of adolescents with autism includes the theory of mind-blindness (p. 97).

Children with autism are unable to understand that other people can have different beliefs from their own (Blakemore & Frith, 2005, p. 99). Because autistic children to not attribute intentions or desires to other peoples actions and speech, they often take things literally (Blakemore & Frith, 2005, p. 99).

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Modules in the Brain Continued...

Non-autistic individuals attempt to explain others behavior by mentalizing. Is this because we have a module for mentalizing and or empathizing? Blakemore and Frith (2005) suggest that this module may be malfunctioning in individuals with autism (p. 98).

The medial prefrontal cortex, the temporal poles next to the amygdala, and the superior temporal poles are three regions of the brain in which non-autistic individuals utilize to decipher others wishes, forethoughts, and convictions (Blakemore & Frith, 2005, p. 100). Some evidence suggests that it is poor connectivity between different regions that is particularly characteristic of autistic brains (Blakemore & Frith, 2005, p. 100).

With the idea that a module may be faulty or malfunctioning, could it be possible to focus on that particular module and make reconnections because at this point in development, the brain is still plastic?

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Plasticity

Plasticity in the brain refers to its ability to continually adapt to a changing environment. In addition, brain plasticity may also allude to the ability to learn in new ways after trauma (Blakemore & Frith, 2005, p. 123). Dawson (2008) notes the range of brain plasticity as a factor in the outcomes of youth with autism in addition to the level of early intervention and the impact of negative inuences (p. 793). While it is important to educate and support children and youth at a young age, it is possible for adults to learn new skills and information as well. Alterations in the brain normally materialize as a result of use (Blakemore & Frith, 2005, p. 123). Is it possible for the brain of an adolescent with autism to adapt to a changing environment, learn new skills/behaviors, and strengthen connections? Can various areas of the brain compensate for weakened connections between different areas of the brain?

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Implications for Youth Development Professionals

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Social Perception of Autism

It is essential that youth development professionals understand how autism is viewed within society. To have this understanding may help youth development professionals understand how to avert stereotypical words and behaviors that can be harmful towards youth with autism. Test your knowledge: 1) T/F: Autism is an epidemic 2) T/F: Autism is the result of passionless parenting 3) T/F: Adolescents with autism always have extraordinary talents 4) T/F: Adolescents with autism are able to build social connections Society is inundated with myths about autism. It is necessary to educate other and work towards combating these myths and stereotypes.
Answers found on slide 32
Questions pulled from ABC News

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Preparing Adolescents for the Future

Becoming an adolescent/young adult holds many distinctive periods of transition, in which this group of young adults may face numerous challenges within their changing selves in terms of mind and body. A clear understanding of autism and the challenges they may face is necessary component toward fostering a successful development. Adolescents with autism commonly rely on predictability. It is because of this that puberty can be an even more difcult time for this group of young adults. Without the right support, adolescents on the autism spectrum retreat into themselves during this period. They express extreme loneliness and confusion, and are at risk for acting out behaviorally. There is an increased right of depression and suicide during these years as well (Frea, 2010, p. 26).

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How Can Youth Development Professionals (YDP) Support Autistic Adolescents?

Focus on their STRENGTHS and their potential! It is important for YDP to become well educated, not only about autism in general but about areas like social aspects as well.

For example: The range in which autistic adolescents engage and socialize or lack thereof with others and how autistic adolescents perceive others emotions are two very important characteristics.

Be open minded. Not all youth with autism are the same. Learn from a wide variety of sources in order to receive varying perspectives including youth, parents, staff, teachers, etc.

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How Can Youth Development Professionals (YDP) Support Autistic Adolescents?

Continued...

Blakemore and Frith (2005) discuss the importance of an enriched environment (p. 32) It is benecial for YDP to understand the complexity of the environment and the potential is has to support and foster a healthy youth development. Incorporate the youth development framework into programs designed to support youth and adolescents with autism. Create safe, age-appropriate activities in a positive learning environment. Create appropiate opportunities for socialization. Engage youth in the process whenever possible.

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Additional Resources

Quick Autism Test Video Autism Speaks Website Research Autism Website How Autistic Children Read Faces Video Top Ten Myths About Autism 2008 Video Journal of Autism and Developmental Disorders:

Autism and Abnormal Development of Brain Connectivity

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References

ABC News. (2008). Health: Cold and Flu News. Retrieved from http:// abcnews.go.com/Health/ColdandFluNews/story? id=6089162&page=3#.UBikfHDRA7A Autism Speaks Inc. (2012). What is autism? Retrieved from http:// www.autismspeaks.org/what-autism Bailey, R. (n.d.). Cerebral Cortex. About.com. Retrieved from http://biology.about.com/ od/anatomy/a/aa032505a.htm Blakemore, S. J., Frith, U. (2005). The learning brain: Lessons for education. Malden, MA: Blackwell Publishing Ltd. Center for Autism & Developmental Disabilities Epidemiology (CADDE). (n.d.) Fact sheet. Johns Hopkins Bloomberg School of Public Health. Retrieved from http:// www.jhsph.edu/research/centers-and-institutes/center-for-autism-and-developmentaldisabilities-epidemiology/Facts/autism.html/#what_are_symptoms_ASDs

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References

Courchesne, E. (2004). Brain development in autism: Early overgrowth followed by premature arrest of growth. Mental Retardation and Developmental Disabilities Research Reviews, 10, 106-111. doi:10.1002/mrdd.20020 Dawson, G. (2008). Early behavioral intervention, brain plasticity, and the prevention of autism spectrum disorder. Development and Psychopathology, 20, 775-803. doi: 10.1017/ S09545794088000370 Frea, W.D. (2010). Preparing adolescents with autism for successful futures. The Exceptional Parent. (40) (4) pp. 26-30. Retrieved from www.eparent.com/EPMagazine Hellew, L. (1999). Neurological perspectives on autism. Serendip. Retrieved from http:// serendip.brynmawr.edu/exchange/node/2040 Insel, T. (2012). Autism prevalence: More affected or more detected? National Institute of Mental Health. Retrieved from http://www.nimh.nih.gov/about/director/2012/autismprevalence-more-affected-or-more-detected.shtml

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References

Jou, R. J., Minshew, N. J., Melhem, N. M., Keshavan, M. S., Hardan, A. Y. (2009). Brainstem volumetric alterations in children with autism. Psychol Med, 39, 1347-1354. doi: 10.1017/ S0033291708004376 Keary, C. J., Minshew, N. J., Bansal, R., Goradia, D., Fedorov, S., Keshavan, M. S., & Hardan, A. Y. (2009). Corpus callosum volume and neurocognition in autism. Journal of Autism and Developmental Disorders, 39(6), 834-841. doi: 10.1007/s10803-009-0689-4 Kutzli, K. (2012). Wordle - Beautiful Word Clouds. Retrieved from http://www.wordle.net/ Loveland, K. A., Bachevalier, J., Pearson, D. A., Lane, D. M. (2008). Fronto-limbic functioning in children and adolescents with and without autism. Neuropsychologia, 46, 49-62. doi: 10.1016/j.neuropsuchologia.2007.08.017 Mental Health Blog. (2012). Oxytocin may effectively treat autism spectrum disorder. Retrieved from http://www.mentalhealthblog.com/2012/05/oxytocin-may-effectively-treatautism.html

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References

Rudy, L. J. (2007). Autism and the brain. About.com. Retrieved from http:// autism.about.com/od/causesofautism/a/AutismBrain.htm Shriber, L. (2010). Autism: A neurological and sensory based perspective. Center for International Rehabilitation Research Information and Exchange (CIRRIE), 2-14. Buffalo, NY: The State University of New York. Veenstra-VanderWeele, J.,Blakely, R. D. (2012). Networking in autism: Leveraging genetic, biomarker and model system ndings in the search for new treatments. American College of Neuropsychopharmacology. Retrieved from http:// www.nature.com/npp/journal/v37/n1/g_tab/npp2011185f1.html

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Test Your Knowledge Answers

1)F 2)F 3)F 4)T ABC News. (2008). Health: Cold and Flu News. Retrieved from http:// abcnews.go.com/Health/ColdandFluNews/story? id=6089162&page=3#.UBikfHDRA7A

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