Health Science Reviews

by Talya Kebonte

Can you imagine a world where you aren’t able to pick up on the emotions of people around you? What would it be like if you couldn’t sense the sombre mood of a vigil and burst out into belly laughs while everyone around you was mourning? What if every piece of clothing you wore felt like sandpaper against your skin? How lonely would you feel if people labelled you as ‘weird’ and chose to avoid you? These are some of the things that a person with autism experiences.

Autism Spectrum Disorder, commonly referred to as autism, is a lifelong disability that affects one’s ability to communicate with people. It also causes problems in how one senses things [1]. Autism can be diagnosed as early as 18 months but is not usually diagnosed earlier than the age of 3 [2]. The timing of diagnosis is critical for treatment – an infant brain is more able to change according to experience than an adult brain, in other words, it has greater neuroplasticity [3].

To better understand neuroplasticity, picture the brain as a pastel pink ball of soft clay. When you are born it has a distinguishable shape, but it is still mouldable. The older you get, the more the clay hardens until you can’t change its shape anymore. The idea is to diagnose autism ‘while the clay is mouldable’ so that children can receive therapy and avoid social and sensory challenges that would otherwise be lifelong.

A randomised control trial on a group of Australian infants was done to test whether early therapy improved signs of autism. About half of the infants received 10 sessions delivered in their homes by a trained therapist while the other half received placebo care. After two years, it was found that the infants who received therapy had lower chances of having deficits in social-emotional interactions, repetitive movements, and unusual sensory interests compared to those that received placebo care [4].

Though these results are promising, the effects were small in extent. Hence, the clinical significance thereof is uncertain. It should be noted, however, that these small effects were enduring. Perhaps in the future we will have a more robust understanding of how the brain is ‘moulded’ in this condition and tailor more sensitive therapies for infants with autism.

References

[1]       L. Naithani et al., “Early Autism Intervention Components Deliverable by Non-specialists in Low- and Middle-Income Countries: A Scoping Review,” Frontiers in Psychiatry, vol. 13. Frontiers Media S.A., Jun. 29, 2022. doi: 10.3389/fpsyt.2022.914750.

[2]       M. van ’t Hof et al., “Age at autism spectrum disorder diagnosis: A systematic review and meta-analysis from 2012 to 2019,” Autism, vol. 25, no. 4. SAGE Publications Ltd, pp. 862–873, May 01, 2021. doi: 10.1177/1362361320971107.

[3]       B. Kolb and R. Gibb, “Brain plasticity and behaviour in the developing brain.,” J Can Acad Child Adolesc Psychiatry, vol. 20, no. 4, pp. 265–76, Nov. 2011.

[4]       A. J. O. Whitehouse et al., “Effect of Preemptive Intervention on Developmental Outcomes among Infants Showing Early Signs of Autism: A Randomized Clinical Trial of Outcomes to Diagnosis,” JAMA Pediatr, vol. 175, no. 11, Nov. 2021, doi: 10.1001/jamapediatrics.2021.3298.