Tracking Micromovements May Offer Improved Autism Screen

Deborah Brauser

August 02, 2013

Tracking an individual's random, spontaneous movements may provide an earlier and more objective way to diagnose and possibly even treat autism spectrum disorder (ASD), new research suggests. The new movement-based screening method was discussed in several articles published online July 24 in Frontiers in Integrative Neuroscience.

The first introduces the novel computerized screening and subsequent tracking methodology, which "produces 240 images a second and detects systematic signatures unique to each person," explain the investigators in a release.

They note that this is significantly different from traditional assessments that mostly involve "subjective opinions of a person's social interactions, deficits in communication, and repetitive and restricted behaviors and interests."

"This research may open doors for the autistic community by offering the option of a dynamic diagnosis at a much earlier age and enabling the start of therapy sooner in the child's development," said coinvestigator Jorge V. Jose, PhD, professor of cellular and integrative physiology at the Indiana University School of Medicine in Indianapolis, in the release.

"We can estimate the cognitive abilities of people just from the variability of how they move," he added.

The second study explored how the new method might be applied to interventions — and whether the way children with ASD learn and communicate can be changed by helping them to develop self-motivation.

The participants were exposed to video clips of themselves, cartoons, or a favorite television show on a digital setup that resembled and worked much like a Wii computer program. When a child crossed a certain region of space, a particular clip would come on. After exploring how the program worked, all 25 participants spontaneously learned how to choose their favorite media and then retained the knowledge — even without later practice.

"The children independently learned that they could control their bodies to convey and procure what they wanted. We didn't instruct them," explained principal investigator Elizabeth Torres, PhD, assistant professor of psychology at Rutgers University in New Brunswick, New Jersey.

Evaluating Micromovements

The first article, entitled, Autism: The Micro-Movement Perspective, presents the novel screening method in more detail.

"It factors the importance of changes in movements and movement sensing, thus enabling the identification of inherent capabilities in each child," explained the investigators.

The computerized system measures minute fluctuations in both voluntary and involuntary movements and determines how these patterns differ from those of typically developing peers, "and to what degree they can turn into predictive, reliable, and anticipatory movements."

The researchers note that the method will also help in diagnosing subtypes of autism, as well as differences between the sexes, and might even be able to be applied to infants.

It can also help individuals with autism to develop self-motivation, "rather than relying exclusively on external cues and commands, which are the basis of behavioral therapy" for this patient population.

In the first study, individuals between the ages of 3 and 25 years who did (n = 34) and did not have ASD (n = 44) were assessed, and their movements during a pointing task were measured with a motion caption system and compared. Not only did the screening method distinguish between the 2 groups across all age groups, it could determine how severe those with ASD were affected.

Dr. Elizabeth Torres

"No matter what their age or whether they were girls or boys, we found signatures of corrupted motor output," Dr. Torres told Medscape Medical News.

In the intervention study, the investigators sought to determine whether these patterns of movement could be used to "reteach" behaviors as a way to eventually individualize treatment.

Results showed that the children with ASD, including those who were nonverbal, began to move deliberately once they began to realize the cause-and-effect connection between their movements and the playing of their favorite media clips.

"The action becomes an intentional behavior," said Dr. Torres. "This is exciting because these measures use technology to precisely track a child's capabilities as they evolve and unlock potential that was hidden to the eye."

Unleashing Potential

Dr. Torres noted that it is important for clinicians to realize that cognitive abilities and movement in individuals with autism are closely linked. And the peripheral nervous system, which relays sensory information, is just as important to monitor as the central nervous system.

"The central nervous system includes the brain and spinal cord, and the peripheral system includes all the nerves and controls all the visceral information that comes through. It almost has a brain of its own, with neurotransmitters that mirror those found in the brain," she said.

"Everyone looks at how we think consciously and explicitly about things. But there's a whole lot that goes on unconsciously, including movement such as reflexes."

The investigators note that current computerized technology and cameras can allow others to take advantage of their findings.

"We used sophisticated sensors, but people can use commercial cameras, tablets, and/or smart-phone technology to track a child's natural progression and to see their response to treatment over time," said Dr. Torres.

"These methods are inclusive of the self-discovery abilities and sensory strengths of the individual with ASD. We invite others to try them out and unleash the potential of all children according to the sensory-motor capabilities and predispositions that they already have," add the researchers.

The study was funded by a grant from the National Science Foundation. The study authors have disclosed no relevant financial relationships.

Front Integr Neurosci. Published online July 24, 2013. Study 1, Study 2


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