We have the joy and privilege of working with parents who ask great questions as they are considering an ABA program. As we answer these questions to the best of our abilities, we often need to do more research so that we can be resourceful as we aim to serve our learners and their caregivers exceedingly well. Given that we're always answering very thoughtful questions, we thought it would be helpful to also write a blog posts in response to certain questions that probably are shared by many! In an effort to answer questions both individually as they come up, but also build a library of resources through our blog, we decided to tackle this question – ?
As a starting point, we wanted to provide a definition of autism so that readers have context as they are reading this post. Autism spectrum disorder (ASD) is a lifelong neurodevelopmental disorder that affects the whole brain. There are no blood tests or biomarkers for ASD, so diagnosis is based on caregiver interview, observation, and standardized assessments such as the Autism Diagnostic Observation Schedule, Second Edition (click here for more info).
Among others, trailblazing neuroscientists Eric Courchesne, Karen Pierce, and their colleagues at the Autism Center of Excellence in San Diego, California have made extraordinary progress towards understanding atypical brain development in ASD.
Based on their work based on “early brain overgrowth theory” these researchers’ work has shown that toddlers with ASD experience a rapid period of brain overgrowth that begins prenatally and is characterized by an excess of neurons in the cortex. As a result, the ASD brain experiences disruptions in the structure and function of neural networks thereby producing associated ASD symptoms.
For example, studies have shown young male children with ASD exhibit a large excess of prefrontal neurons.
This pattern of brain overgrowth appears to gradually taper off with maturation beginning around age 2. Differences in brain size between individuals with ASD and typically developing individuals seem to disappear around age 16.
By understanding the nature and pattern of atypical brain development, researchers can work backward to identify potential genetic causes and prenatal triggers that could be the target of innovative new therapies.
The large differences in brain size in early childhood highlight the critical role of intervention in early childhood when brain structure and function are likely to be most sensitive to systematic changes in the environment to maximize learning with applied behavior analysis (ABA).
“Early interventions and services may improve an ASD child’s developmental outcome and help parents at a crucial time in human brain development. During the first post-natal years, the human brain undergoes a profound period of establishing and refining neural connections, and this is the basis for the emergence of higher-order social, language and cognitive networks and behavior. This important developmental step of the construction of functional and adaptive neural circuits is dependent on adaptive neural response to input from the environment. If an infant or toddler with ASD is identified and behavioral treatment begun before or while early brain connections are being actively established, then brain function for that toddler stands the best chance of being improved” say Dr. Courchesne and his colleagues.
Decades of research on behavior intervention based on ABA clearly indicate ABA therapy reduces symptoms of ASD and increases intellectual functioning and adaptive behavior through systematic behavior change and skill building.
If behavior is the result of interactions between the brain and the environment, and ASD is manifested through behavior, then it stands to reason changes in behavior should be associated with changes in brain activity.
This reasoning has led researchers to wonder just how behavioral interventions impact atypical brain development in children with ASD.
Research in this area has primarily focused on the use of two very common and noninvasive neuroscience techniques: functional magnetic resonance imaging (fMRI) and electroencephalography (EEG).
A systematic review of the research on neuroscience outcome measures for ASD behavioral interventions by Dr. Katherine Kuhl-Meltzoff Stavropoulos at the University of California, Riverside, suggests the research on this topic is sparse and really has only started to emerge over the last roughly 10 years. In fact, this review published in 2017 in the peer-reviewed journal Research in Autism Spectrum Disorders only found 4 fMRI studies of the brain before and after behavioral intervention targeting symptoms of ASD!
Most of the reviewed studies used fMRI or EEG to examine potential changes in brain functioning before and after exposure to standardized or manualized behavioral intervention packages such as the Early Start Denver Model (ESDM), and Pivotal Response Treatment (PRT), both of which rely on the same fundamental principles of behavior and learning that are the foundation for ABA therapies at Maraca.
Overall, these studies found that behavioral intervention can produce changes in ASD brain development in line with more “typical” brain development. But these studies have many limitations and replications are needed to establish confidence in the findings.
For more about research on the neuroscience of ASD, check out this video interview of Dr. Karen Pierce from UCTV.
We hope that this was a helpful overview! Please interact with us by letting us know what we missed, what you would like to learn more about, or what remaining questions you have! Our Maraca Team is comprised of humans who love the science underlying ABA and want to steward it well when it comes to loving and serving our learners and their parents! We are always more than thrilled to have an opportunity to create resources like this blog post!
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