New hearing test may diagnose autism earlier

From The Daily Herald in Chicago:

In many ways, Gloria Fisher (pictured) is a typical suburban 16-year-old.

She loves "High School Musical," the Jonas Brothers, Girl Scouts and little kids. She also struggles to keep up in school and does not make friends easily.

But Gloria's typical teen problems go further. The St. Charles teen has been diagnosed with attention deficit disorder, dyslexia and most recently, Asperger's disorder, a mild form of autism characterized by trouble socializing and communicating.

Her mother, Betty, has spent countless hours and $6,000 on tutoring and special programs to help her daughter.

Though she has high intelligence, Gloria has problems saying the right thing to fit a conversation, an area of language known as pragmatics.

While waiting at an office recently, Gloria lay across a small couch, squeezing a doll and occasionally piping up with a "Yee-hah!" When asked what she cares about, she answered, true to a teenager's heart but apropos of nothing in particular: "Food!"

The key to what Gloria says may lie in what she hears - or can't hear. One doctor at Alexian Brothers Medical Center in Elk Grove Village is about to spend five years and $2 million using a rare kind of brain scan to find out.

Jeffrey Lewine has just launched a program to see if adolescents like Gloria with autism spectrum disorders have trouble processing what they hear. He believes that if he can retrain the brain to process auditory information, he can help kids communicate more effectively.

By doing so, Lewine is wading into the middle of the ongoing controversy over how to treat a national epidemic of autism. With emotional arguments for and against radical new treatments, Lewine hopes to bridge the gap between science and alternative medicine.

Lewine uses magnetoencephalography, or MEG, which he describes as "a giant magnetic stethoscope," to peer into the brain. While certain auditory signals are played for patients to hear, the electrical current in the brain's nerve cells generates a weak magnetic field.

The MEG device detects these magnetic fields and times them to within a thousandth of a second, and can create a 3-D image showing where and when their brains process the sound. A study to be released today at the Radiological Society of America Convention in Chicago used a MEG device to find that children with autism had a split-second delay in processing sound.

Those with autism have trouble, for instance, separating two sounds in rapid succession, so that "ga-da" sounds like "da-ga."

Part of the problem is that the two hemispheres of the brain don't communicate properly. Rather than both sides of the brain responding, one side may be kept out of the loop. People with autism disorders also often find certain noises to be too loud. Gloria couldn't go inside a recent concert, for instance, because it was too loud to talk.
Eventually, researchers hope these brain scans will help diagnose autism in infants and allow earlier intervention.

Working for now with children age 10 to 16 who are already diagnosed, Lewine hopes to match each patient to the proper treatment.

Gloria, for instance, looks like a good candidate for a new treatment called auditory integration training.

It involves listening to tapes of music that sound like a child playing with the bass, treble and speaker balance. It's meant to rewire the two sides of the brain to work together and to hear even in loud conditions, sort of like shaking an Etch-A-Sketch to get a blank screen to start over.

In past research, only a few patients responded to such treatment. But Lewine suspects that those who responded have certain biological markers that make them good candidates for the treatment, and he hopes to pinpoint those characteristics.

He also hopes to see if there's a connection between epilepsy and autism, by searching for signs of epileptic brain activity in kids with autism spectrum disorder.

Lewine, who is a Ph.D., not a medical doctor, describes himself as "a pure science guy," and with tousled graying hair, spectacles, loose tie and clunky black shoes, he looks like it.

He's using one of only 25 MEG devices in the United States, and the first at a community hospital.

Alexian's MEG Center is also being used for pioneering research into dementia, depression, schizophrenia, stroke, learning disorders, attention deficit, PTSD and veterans' brain injuries caused by roadside bombs. It can also be used by surgeons before surgery, to pinpoint tumors and vascular malformations.

"We're going to try things that are a little bit unconventional," Lewine said, "but if they work the payoff could be much greater."

To understand and treat autism, it's important to know that it comes in a wide variety of guises, ranging from mild to severe.

For that reason, autism is now considered the most common in a range of conditions known as autism spectrum disorders.

The other conditions include Asperger's disorder, Rett Syndrome, childhood disintegrative disorder, and PPD-NOS (pervasive developmental order not otherwise specified), a fancy term for "none of the above."

All the disorders are characterized by trouble communicating and socializing, and repetitive or obsessive behaviors.

Current estimates are that one of 150 children in this country have one of those conditions, which are four times more likely to strike a boy.

Experts aren't sure why the disorder has become much more prevalent in the past 30 years, though it may be in part because of better diagnosis.

Parents and advocacy groups have developed many alternative therapies to help autistic children, including diet, play therapy and chelation to remove metals from the body.

While Lewine believes some of the therapies are probably "junk," he was once skeptical of colored glasses to help certain reading disorders, but has become convinced of their effectiveness - so he tries to keep an open mind to see if scientific studies can test a therapy's effectiveness.

While Lewine previously worked at research hospitals where researchers never met a patient, he hopes that at a community hospital like Alexian, his data can be applied to benefit people quickly.

In the meantime, Gloria's mother, Betty Fisher, will keep trying to help her daughter.

"I instilled in her that God makes children in different ways," she said. "She's really wanting to get help, and I'm not giving up. I'm going to keep on looking."