Can a baby’s brain waves predict the chance of autism?
New research that looked at brain wave patterns of babies and toddlers showed the answer is likely yes.
A research group in Boston crunched data on brain activity from a group of 188 infants, between 3 months and 3 years old, to see if the reports showed what lead investigator Dr. William J. Bosl described as a "pattern of numbers that distinguished children who would develop autism from those who did not."
The goal was to find a way to help diagnose autism spectrum disorders much earlier, by using simple and available tools to look at the electrical signals of the brain.
What is autism spectrum disorder? Autism spectrum disorder (ASD) is a developmental disorder that affects a child’s language, behavior, and social skills. Recent data from the Centers for Disease Control (CDC), estimates that 1 in 59 children have autism.
Because there is no physical "test" for autism, it can be a difficult diagnosis to make. Right now, doctors have to rely on how a child behaves and interacts with other people.
Ideally, children are diagnosed with autism before 3 years old and have already started appropriate therapies before 4 years. Unfortunately, according to that new data from the CDC, the average age of autism diagnosis is older than 4 years.
This study from Boston University, Harvard Medical School and Boston Children’s Hospital suggests that electroencephalography, or EEGs, may help doctors diagnose autism earlier.
What is EEG? An electroencephalography, or EEG, is an easy and low-cost way to measure the electricity of the brain and is historically used to diagnose seizure disorders. During an EEG, technicians fasten tiny wires all over the scalp and brain waves are projected on a computer screen. Specialists are then able to interpret the brain’s activity.
Improved technology has expanded the amount of data that scientists can extract from EEGs, which is considered a safe and painless tool.
The idea the researchers in this study had was that EEGs would be able to detect abnormalities in a child’s brain before the child started to display symptoms of autism.
"We know that any changes in behavior, emotion or cognition ultimately result from changes in the brain," according Bosl, the director of health informatics at the University of San Francisco and visiting faculty at Boston Children’s Hospital computational health informatics program. "In general, brain changes precede changes that manifest in the symptoms that define neurodevelopmental, mental or neurological disorders.
Bosl said that part of the reason his team wanted to do this study was to discover "the neural correlates of autism behaviors as early as possible."
What did they learn about autism and brain waves? In this study, scientists performed EEGs on 188 children between 3 and 36 months old, repeating the scans every few months. The children were divided into "high risk" and "low risk" groups, based on their presumed, underlying susceptibility to develop autism. Children were categorized as "high risk" if they had an older sibling with autism, as the disorder can run in families.
Of the 188 participants, 35 were ultimately diagnosed with autism spectrum disorder, almost 19 percent. The majority of these children had already been in the "high risk" group and diagnosed at 3 years.
All participants had a minimum of two EEGs between the ages of 3 and 36 months. Scientists conducted complex mathematical equations to interpret the EEG signals and identity patterns that might correspond to abnormal brain function. Based on these values, a computer algorithm was able to predict "ASD" or "not-ASD."
This algorithm predicted autism in children as young as 3 months old with nearly 100 percent accuracy.
Can brain waves predict mental health? This is new and still-developing research. Children with autism typically do not display symptoms until they are at least 18 months old and many children are not diagnosed with autism until after 4 years.
"Our hope is that this approach can be developed into an early screening tool," Bosl said. "If our results are replicated in much larger clinical studies, and can be implemented in a routine primary care setting, then the information obtained from early EEG measurements might be useful."
With earlier diagnosis, treatment can also begin earlier. There is no "cure" for autism, however multiple randomized-controlled trials, including a recent study published in April, 2018, have shown that early language and behavioral therapy is linked to better results. Early intervention can be key to improving the quality of life for children with autism.
In this study, researchers said they were able to predict the diagnosis of autism -- and also the severity of autism.
"Our approach may be useful for helping to guide the development of early interventions," Bosl said, "by enabling continual, easy measurement of the developing brain and its response to new interventions -- or 'brain exercises.'"
In other words, regular brain monitoring could help guide therapies and help measure whether there's improvement.
The researchers believe this sort of brain monitoring could help with not only early detection of autism, but possibly with a range of neurological or psychiatric disorders over a person's entire life.
"Our vision is that brain measurements will be taken at every checkup, much like a blood pressure measurement," Bosl said, "and monitored for changes that indicate that problems are developing, long before the changes become serious."
Laura Shopp, M.D. is a third-year pediatrics resident affiliated with Indiana University who works in the ABC News Medical Unit.