August, 2004, by Sue Bennett

The analogy of autism as a puzzle has taken on new meaning as a team of researchers at Carnegie Melon University and the University of Pittsburgh examined the brains of people in the autism spectrum using functional magnetic resonance imaging (fMRI) scans.  The researchers believe that abnormalities in the white matter of the brain that makes up the "cables" conecting the parts of the brain to each other, have resulted in a lack of coordination between brain areas. The new findings have led the researchers to propose a new theory of the basis of autism, called the Underconnectivity Theory, which proposes that autism is a system-wide brain disorder limiting coordination and integration between brain areas.

This theory and its supporting research corroborate my own long-standing theory of autism as stated in intervention basics that the underlying issue in autism is lack of connection and that an effective autism protocol works toward connecting a child together.    The different therapies that help to strengthen and integrate processing of hearing, vision, bilateral coordination, touch, movement and balance help to promote greater cross-connection in the brain.  The more neurological connections we help build for our children, the better their outcome.  As in the analogy of autism as a puzzle, our children are fragmented like the pieces of a puzzle and our goal as parents is to connect as many of the pieces together as possible with the ultimate goal of helping our children become as whole and integrated as possible.  Parents of young children in the spectrum frequently race to connect as many of the pieces of the puzzle together as they can, before critical phases of brain development are complete.  

The Underconnectivity Theory helps explain why some people with autism have normal or even superior skills in some areas, while many other types of thinking are disordered. The team's study will be published in the August edition of the British journal Brain and is available online at www.brain.oupjournals.org.

Marcel Just, one of the study's authors and director of Carnegie Mellon's Center for Cognitive Brain Imaging, compared the brain of a normal person to a sports team in which the members cooperate and coordinate their efforts. In a person within the autism spectrum, though some "players" may be highly skilled, they do not work effectively as a team, thus impairing a person's ability to complete broad intellectual tasks. Because this type of coordination is critical to complex thinking and social interaction, a wide range of behaviors are affected in autism.

The research team believes these are the first findings in autism of differences in the brain activation patterns in a cognitive (non-social) task. The study produced two important new findings that help make sense of previous mysteries: The autistic participants had opposite areas of activation (compared to a neurotypical control group) in the brain's two main language areas, known as Broca's and Wernicke's areas. There was also less synchronization of activation among key brain areas in the participants within the specturm compared to the control group.

To obtain technically acceptable fMRI data from  participants who are high-functioning within the autism spectrum, the researchers flew in people from all over the eastern United States. According to the researchers, high-functioning people autism (with IQ scores in the normal range) are rare, accounting for about 10 percent of all people with autism. Using non-invasive fMRIs, the team looked at the brains of 17 people with autism and 17 control subjects as they read and indicated their comprehension of English sentences. In both the brains of the control and in the brains of people with autism, language functions were carried out by a similar network of brain areas, but in the brains of people with autism, the network was less synchronized, and an integrating center in the network, Broca's area, was much less active. However, another center, Wernicke's area, which does the processing of individual words, was more active.

The researchers theorize that the brain likely adapts to the diminished inter-communication in autism by developing more independent, free-standing abilities in each brain center. This means that abnormalities in the brain's white matter communication cables could lead to adaptations in the gray matter computing centers, sometimes resulting in superior free-standing abilities or superior ability in a localized skill.  There is a significant portion of people within the autism spectrum who have are gifted or extremely knowledge in in a specialized area, such as music, art, or acquisition of information in an area of interest.

These findings provide for a new way for researchers to view and develop treatments for autism, approaching autism as a distributed system-wide disorder rather than trying to find a localized region or particular place in the brain to focus on.  The researchers believe that this approach might lead to the development of a cognitive behavioral therapy might be to stimulate the development of connections in these higher order systems, focusing on the emergence of conceptual connections, interpretive language and so on. The researchers also believe that eventually, pharmacological or genetic interventions will be developed to stimulate the growth of this circuitry once the developmental neurobiology and genetics of these brain connections are clearly defined by research studies such as these.  

In my opinion, the most effective treatments currently available actively promote connecting our kids neurologically, such as applied behavior analysis and integrative therapies.  The more we stimulate our kids, the more neurological connections they will make.   We should also address the underlying biological reasons why our children aren't making sufficient connections during their early development and support them nutritionally to optimize their brain development.  While we wait for researchers to develop new therapies, we must make the most of the therapies currently available to us, to help our children in the here and now.