
Identifying Autism from Neural Representations of Social Interactions - WhitneyLand
http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0113879
======
hoopism
There's a saying among those who become familiar with Autism.

"If you've met one kid with Autism, you've met one kid with Autism"

There are certainly clear cases... but the trouble is identifying the non-
traditional and less severe cases. These methods are great, but with early
intervention being so critical it's doesn't help with diagnosing younger
children (from what I read... seems patient would need more cognitive
ability).

As a parent who has recently run the gauntlet of diagnosis the most
frustrating part of the lack of awareness for younger children. Based on all
my reading early intervention can have a tremendous impact of future outcome
(before 3y/o is really the sweet spot).

There's so much stigma on classifying young children early that parents are
often reluctant to seek out diagnosis and treatment. My daughter was diagnosed
at 15 months and has since made amazing strides.

If there was one thing I wish I could pass on to every parent it's that there
is absolutely no harm or shame in doing diligence if you feel something isn't
right. Therapies are play based and are great for even nuerotypical kids. If
you suspect a delay or risk... talk to a specialist ASAP.

~~~
aidos
This is very good advice.

My wife is an Early Years Speech and Language therapist, so she is regularly
exposed to children with autism.

Your daughter is lucky to have a proactive parent. Even when cases are
identified within the system, by nursery staff for example, it seems to be
more common than not that parents become very defensive about the idea of
seeking further help. And actually, as a parent, I can understand it - but
having seen first hand the difference professional help can make, especially
in those early years, I would do everything in my power to get expert advice.

In the UK we have the NHS, and even though the waiting lists can be long
(because these are the areas that tend to be the first to go during budget
cuts), help is freely available. And it's not just autism we're talking about.
There could be all manner of things that can contribute to a delay in those
early years. There are people who can literally make the world of difference
to the rest of child's future, and they really want to help.

~~~
musername
Lacking comprehension of the problem and the causes, it seems reasonably
carefull not to blindly admit your child into care based solely on the
authoritive argument. Possibly, doctors cannot explain it propperly either and
I'm under the impression that the causes aren't really known. Now, if the
parent's lack of proficiency in childcare was responsible, that would be
embareassing indeed, and if the percentage of autism

~~~
hoopism
As my parents said when they saw the therapy my daughter was receiving (and
took part actively): "I wish we had this type of training when raising our
kids".

If we have another child and they are neurotypical... we'll raise them using
the same techniques we've learned in supporting my daughter. I encourage any
parent who wants to build a stronger bond and more thoughtful kid to read up
on play therapies (floor time, speech therapy, OT, PT)... it's been some of
the most rewarding and fun time I have had as a parent.

------
valdiorn
Sensitivity and specificity! That title is a bit misleading :)

I too could write a test that identifies autism 97% of the time:

return Random.Get(0, 100) < 97;

~~~
arjie
What they did is take a control group that's the same size of the autism
group. Then they did what's called leave-one-out cross-validation (which is
exactly what it says, train on the entire set leaving one out, then use that
one for validation and do so all ways). The measure they chose (Accuracy) is
not without its flaws, but it would not be susceptible to the one you mention.

For instance, if you took 100 negative and 100 positive and then ran your
test, you'd expect an accuracy of something a little more than 50%.

~~~
cbhl
Under this methodology, how meaningful would having more data points be with
respect to statistical meaningfulness? The study only appears to use 17 people
in each group (for a total of 34 people).

------
Asparagirl
I would be careful reading too much into one study. If you read their Methods
section, you can see that they only picked adults with "high-functioning
autism" which is so loosely defined as to be meaningless. Is it supposed to
represent Vineland scores, or ADOS scores, or IQ, or "doesn't live in Mom's
basement", or what?

But if you see that they also cut anyone from the study that has a family
history of autism (even though autism is highly heritable), cut anyone with
developmental delays (and almost all people with autism have or had delays in
some realm, from speech to fine motor), cut anyone with anxiety disorder
(extremely common in autistic people), then really you're left with probably a
bunch of almost-entirely-guys with what used to be called Asperger's and is
today (well, as of DSM-5) lumped back in with autism the broader category, for
better or for worse.

Point being, be careful not to think this is a representative sample of a big,
big category.

All that being said, I would love to see how these results stack up against
another recent project based in San Francisco at UCSF that is doing fMRI scans
of kids (not adults) with sensory processing disorder (SPD) but who do NOT
have autism.

The project's lead, Dr. Elsya Marco at UCSF, is studying something similar:
biological evidence of SPD and how it can be distinguished on scans from
autism. The two disorders often go together, but she's trying to tease apart
why some people are hypersensitive to sensory stimuli and yet DON'T have
autism.

Study info: [http://www.ucsf.edu/news/2013/07/107316/breakthrough-
study-r...](http://www.ucsf.edu/news/2013/07/107316/breakthrough-study-
reveals-biological-basis-sensory-processing-disorders-kidsi)

And they're crowdfunding right now to raise money to do a bigger sample size
for the fMRI scans:
[https://crowdfund.ucsf.edu/project/53f230b014bdf718b0b2608d](https://crowdfund.ucsf.edu/project/53f230b014bdf718b0b2608d)

(Each brain scan they do costs $550.)

------
forrestthewoods
As if autism is a "thing" that you "have". HIV is a thing that you can have.
We check your blood and say "yup, you got HIV in there" or "nope, you're
clean". Autism, like many terms, isn't a thing. It isn't even a state. It's a
description of a state. But it's not a complete description of that state.
It's really just a loose description of part of a state. Every case is
different. Every autistic person is unique.

~~~
baldfat
Autism is a catch all just like Cancer is a catch all. It works to get you
into the ball park.

Yes you are 100% right BUT also 100% wrong (just semantics I don't know if we
really disagree) there are subsets of Autism and Autism is a thing
scientifically and medically. Just like depression is a thing that you can't
get a specific test for doesn't mean it isn't a thing. Having adopted two boys
with a very mild form of Autism called Aspergers, most doctors use to use the
term High Functioning Autism. You can also have sever Autism, AKA low
functioning Autism. When working with children or parenting I can specifically
look at where they are. So while every person is unique you can be categorized
as high functioning or low functioning autism and given many other sub-
categories. The only reason why I say this is that many people dismiss early
diagnosis and then their child doesn't get early intervention. The earlier the
interventions start the better the outcomes.

Interesting note is Korea was saying they have almost no cases of Autism. Then
the medical and scientific research conducted in Korea showed they had just as
many children with Autism they just went undiagnosed medically.

~~~
forrestthewoods
I agree with all the things you've said.

Gonna throw a similar but slightly inverted anecdote out there as well. My
sister is a PhD psychologist who works with children. She had to significantly
reduce the number of children she forwards for ADHD testing because 100% of
the time the result was "positive" and they were medicated. And she was
sending in really borderline cases "just to be sure". Thinking she was being
safe and responsible for the child's well being. Now she has to act as a
blocker and only forward children who she is really, truly confident need it.

~~~
darkarmani
> ADHD testing because 100% of the time the result was "positive" and they
> were medicated.

They actually have a qEEG test that does a very good job highlighting
differences between the ADD brain and a neurotypical brain. This is at least
10 year old research, so i have no idea where it is today.

------
iandanforth
Is autism hard to diagnose? It seems that if anything the important thing
about this study is the factors it discovered that allowed the populations to
be separable.

~~~
mikecb
The purpose of this study would seem to be more to validate the utility and/or
robustness of fMRI than a novel diagnosis scheme for Autism.

~~~
Toenex
I've not read the paper fully but it does look an interesting piece of work. I
did notice that the controls were aged and IQ matched which doesn't suggest
they we looking to differentially diagnose Autism from other disorders which
is likely to be the more useful clinical technique. Also, the subjects were
adult and I would expect most diagnosis to be performed in a much younger age
group. This isn't the first attempt to apply fMRI techniques to the
understanding of autism, plenty of prior work here
([http://goo.gl/oW41Vm](http://goo.gl/oW41Vm)).

Earlier in my career I did some fMRI and, whilst an interesting technique,
I've never been convinced that it quite delivers on the claims. Firstly, you
aren't looking at an electrical signal but rather changes in blood flow which
are (reasonably) assumed to be coupled with areas of increased neural
activity. This felt to me a bit like trying to debug a computer program by
pointing a heat sensitive camera at your motherboard.

Also all fMRI experiments are characterised by a block design - periods of
activation and inactivation - and the response is expected to correlate with
these in some way. However, the brain is pretty busy and thus how does one
select a baseline; what about the parts of the brain that just stay on?

~~~
Houshalter
>Earlier in my career I did some fMRI and, whilst an interesting technique,
I've never been convinced that it quite delivers on the claims. Firstly, you
aren't looking at an electrical signal but rather changes in blood flow which
are (reasonably) assumed to be coupled with areas of increased neural
activity. This felt to me a bit like trying to debug a computer program by
pointing a heat sensitive camera at your motherboard.

It's pretty crude but it works. fMRI has been useful for a ton of things, it's
even possible to read people's minds with it (from seeing what words they are
thinking to an entire video reconstruction.)

