Teaching children with autism how to perceive the world

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Teaching children with autism how to perceive the world

Western University’s Ryan Stevenson will launch the first longitudinal study to determine if training will help kids with autism better process the outside world
April 1, 2019

The brain is a powerful computer wired to gather, organize and interpret a multitude of sensations from the outside world. It combines those bits of sensory information into a comprehensive whole, which is what allows us to interact with our environment and make sense of it.

People with Autism Spectrum Disorder (ASD) often struggle with processing these external stimuli. Their brains perceive either too much, or too little sensory information and they can have a hard time creating cohesion among all these sensations.

A new research project at Western University’s Brain and Mind Institute — the first longitudinal study of its kind — will look at whether children with autism can learn to process external stimuli more accurately. And if so, will the training help develop their cognitive abilities as they grow, or will the impact only be temporary?

Ryan Stevenson, the researcher leading the study, explains that finding ways to address sensory processing issues is important because they could be contributing to or exacerbating some of the more classic symptoms associated with autism, including problems communicating and relating to others.

[STEVENSON] So there are two categories of issues that kids have to have to get a diagnosis of autism. The first is issues with social communication, and then the second, the umbrella term for that is restricted interest and repetitive behaviours.

A lot of times kids with autism will have a very restricted interest. Trains are a very common one, where you can have a kid with autism that can recite the entire train schedule of the New York subway system, or things like that. And they are super interested in it to the exclusion of other things in their life that, maybe, they typically would or should be interested in.

And then the repetitive behaviour side of that is, what’s often referred to as stimming, where you see things like hand flapping, moving your fingers in front of your eyes, rocking or rubbing your arms. Things like that.

A lot of information that we have, both from experiments but also from self-advocates with autism who have the linguistic ability to tell us why they do things, is that a lot of this has to do with controlling their sensory input.

So, if you are hypersensitive to light and sounds, and instead of perceiving my face and my voice as one thing, if you’re perceiving all of these things as separate multiple perceptions, you end up with this overly intense world.

By doing these repetitive behaviors, or stimming, you’re able to drown out that world. So, you have a repetitive, reliable input that you’re in control of, and you know it’s coming, and it’s predictable, and that can kind of drown out the outside world.

At a lot of the research, even throughout the 80s and 90s, was focused primarily on the higher-level issues with autism, so things like social communication and theory of mind, and things like that.

It wasn’t until the late 90s and early 2000s that people started looking at what we call lower level issues with autism, including things like sensory processing.

And now, what we’re focusing on a lot is the implications that these lower-level sensory processing issues have on the high-level issues that are the more commonly thought about issues with autism, like restricted interests and repetitive behaviours and social abilities and things like that.

“As you’re developing, the only external input your brain receives that it can use to figure out how to interact with the world is sensory information,” he says. “Speech perception, memory, attention — all of those processes are dependent upon how you perceive incoming information to begin with. If your perception is different than everybody else’s, it’s not a huge logical leap to realize that all of your other cognitive abilities that rely on sensory perception are also going to be impacted.”

But if children with autism can be taught at an early age to make more reliable sensory connections, Stevenson is hopeful that this will have a positive cascading effect on their other cognitive abilities.

“We know that sensory perception is malleable and plastic,” he says, adding that people can learn to perceive particular things through training.

With recent funding from the CFI, Stevenson will acquire a suite of research tools that will allow him to track the evolution of sensory perception in people with autism, from infancy to adulthood.

Using an advanced electroencephalogram (EEG) — what looks like a swimming cap covered with electrodes — Stevenson will be able to identify when and where brain neurons are firing.

By measuring neuron activity before and after training sessions, his research team can determine whether any changes have occurred in the brain, and as a result, whether children with autism are better able to perceive and process the world around them.

The study will follow people with autism from two- to 22-years-old for at least five years and will look at hypersensitivity to audio and visual stimuli, as well as how those stimuli are combined in the brains of the research subjects. The latter is called “multisensory integration.”

One example of how our brains do this is when a person is speaking, the listener automatically integrates their voice, lip movements and facial expressions to derive the true meaning of what is being said. It may be more difficult for people with autism to put those pieces together.

[STEVENSON] So the way that we generally test somebody’s temporal processing abilities, or how they perceive things in time, is it’s a really simple paradigm: you see a flash on the screen, and you hear a beep, right? Just as simple as that. And you respond telling us either, did the flash come first? Did the flash and beep come at the same time? Or did the beep come first?

And you can vary the alignment of them, so how in sync or out of sync they are, and you can get a measurement of how sensitive they are to timing offsets. Kids with autism are more likely to say things are in sync even when they’re really out of sync.

So, the perceptual learning paradigm that we’re just kicking off right now in kids with autism is a very simple adaptation of that. So, essentially, we present things that are either in sync or out of sync by varying levels, and ask the kid to respond, and we give them feedback. So, we tell them if they were correct or incorrect.

It actually doesn’t take very long to see the perceptual learning effects. It only takes a day or two of training. Then you start to see where they’re better able to say when things were in sync and better able to accurately say when things are out of sync. So, we’re increasing the reliability of that cue to bind pieces of sensory information together.

So, before and after doing that training paradigm, we actually test them at how much benefit they get. And we know in folks without autism, that boost that you get will go up after you increase the reliability of this cue, this timing cue, to put the two pieces of information together.

The research team will also use an eye-tracking system to record where a participant is looking and what they’re noticing.

“This will allow us to passively see what’s happening in kids with autism who have trouble communicating,” says Stevenson.

Stevenson also plans to make the lab portable in the coming months. Since children with autism are often sensitive to new environments, acquiring portable hardware that will allow researchers to set up their lab where the child feels more comfortable, such as in their own home, might increase the number of kids and families able to participate in the study.

In the meantime, he is eager to find out if this approach will increase quality of life for kids with autism.

“If we can give them a little bit of a nudge, a perceptual boost, will it have long-lasting downstream implications that help improve their social competency? That’s the million-dollar question.”