Until recently scientists have struggled to get good MRI scan data from severely autistic children and adults because the process of obtaining the scans is too traumatic. An MRI typically requires the subject to lie absolutely still for more than 40 minutes inside a claustrophobic tunnel.
A prospect is daunting enough for most of us, an absolute nightmare for some autistic and low verbal and cognitive performance (LVCP) patients.
Now, researchers from Brigham Young University and the University of Utah have managed to complete structural and functional MRI scans of 37 children and adolescents with autism, including 17 with less-developed language skills and an average IQ of 54.
Researchers aimed to reduce the potential anxiety of patients
The researchers used a range of behavioral support procedures to minimize fear and anxiety in the patients which allowed the scans to be completed. Previous to this most MRI scans completed on patients with autism were done while the subject was sedated.
"This is such an overlooked group of kids and adults," said Ryan Kellems, BYU assistant professor of counseling psychology and special education. Kellems also co-authored the study, just published in the top academic journal Molecular Autism.
"We don't know very much about their brains because people say they are challenging to study."
New approach needed to gain critical data
The collaborative research team was determined to obtain information about autistic brains while they were alert and working.
They realized they needed to take a different approach to get autistic children to understand the procedure and so created lots of support material that aimed at educating and preparing the children.
They first created a video explaining the step-by-step process of the MRI process. The children were encouraged to watch the video multiple times at home with their family. The children were also given audio files to help them prepare for the sounds they could hear inside the machine. Once the big day of the scans arrived.
Children are given more control over the procedure
The children were introduced to the MRI and were allowed to push button that moves it around. Once they were inside the machines tunnel researchers stayed in physical contact with them.
"If they were getting antsy, we reassured them. We could hold their hand. We could remind them to stop moving. We were focused on giving them more than what they might need to be successful in the scanner,” said BYU assistant professor of school psychology Terisa Gabrielsen.
The successful scans allowed the researchers to compare the subjects from the LVCP group compared to higher performance children with autism, as well as neurotypical children. They found that in the LVCP group, a number of the patient's brain networks weren’t working in sync as much as the other groups.
"And we also found decreased activity between the left and right hemispheres,” added Gabrielsen.
They were also able to observe that the brain network connectivity was higher for the LVCP group than for the neurotypical group. A finding that has been found clinically but never seen via MRI scans.
"You might see a kid without very much language, and you might guess that his brain is underactive. But sometimes it's more active. Sometimes the attention is too much, and sometimes the attention is too little. We see different patterns of what the brain is attending to,” study co-author Mikle South, BYU associate professor of psychology and neuroscience explained.
The research will ultimately improve quality of life for individuals with nonneurotypical brains scientist as well as the individuals and their families understand how their brains work and "We don't want to change the brain, we want to accept folks with autism," said South, who is also an autism scholar.
"This is a way cool way to be, and we just want to help you get along in your world."