Apr 23, 2014

Interview Transcript

Interviewer: How does autism affect the brain, and what are some of the signs of symptoms of autism? We'll talk about that more on The Scope.

Recording: Medical news and research from University of Utah physicians and specialists you can use for a happier and healthier life. You're listening to The Scope.

Interviewer: We're talking with Dr. Jeff Anderson from Neuroradiology at the University of Utah.
Dr. Anderson, first of all, what are the signs and symptoms? How does a parent know that their child has autism?

Dr. Jeff Anderson: What a great question. There are a couple classic symptoms that are associated with autism. One is that individuals have difficulties with social interaction and communication. They tend to keep to themselves. They may have trouble making eye contact. They aren't able to talk at as early of an age, and may have abnormal intonation or poor communication skills. That's one big group of symptoms.

Interviewer: When do these symptoms start happening? What age, about, do you think?

Dr. Jeff Anderson: Often, parents can track abnormalities even before a child's first birthday.

Interviewer: Oh, really! That early?

Dr. Jeff Anderson: Yeah. Usually a diagnosis is made around age three.

Interviewer: When the child is so young, maybe you just think that's normal that they're not really communicating.

Dr. Jeff Anderson: Yes.

Interviewer: How do you tell?

Dr. Jeff Anderson: Well, there are subtle differences. Sometimes, when parents will look back at their child's behavior, they'll have repetitive movements or specific types of difficulties in making eye contact or bonding or other types of social behaviors that sometimes you can even see before a child learns to talk.

Interviewer: So, they can't communicate very well, or they can't communicate because they're so young, what are some of their senses that affects the brain, like speech? Let's talk about speech first.

Dr. Jeff Anderson: Speech is often delayed, not always, but often delayed in autism, and there are often some peculiar or idiosyncratic types of ways of talking. So some children will often parrot back specific phrases, or they may perseverate on certain words that they say over and over again. Sometimes the intonation is off. It just sounds . . . right now, when you're a toddler, everything sounds a little funny.

Interviewer: Right, of course. Yes.

Dr. Jeff Anderson: But different, or odd. Sometimes there are peculiar words that they make up and ascribe different meanings to.

Interviewer: I read that they kind of take everything literally.

Dr. Jeff Anderson: Yes, often that's true. They have difficulty with figurative speech, and they tend to not see the forest. They see the trees.

Interviewer: What's going on in the brain that makes them view words like that?

Dr. Jeff Anderson: Well, one of the things that we think might be going on is there are networks in the brain that process attention to yourself, when you're talking to yourself, when you're thinking about yourself, and other brain networks that process attention to the outside world. We believe that in autism, sometimes when you're in your own thoughts, you can have outside sights and sounds that are intrusive, that come in when they're not wanted. Vice versa, you can be paying attention to the outside world and you can't shut off that voice in your head.
With autism, some individuals have a hypersensitivity to sights and sounds and textures, and other individuals, or in other conditions, may actually have less sensitivity for certain sights and sounds. In other words, they can't discriminate different sights or sounds as well as somebody without autism. You can see both in the same individual.

Interviewer: So how is a parent supposed to distinguish between this is normal, this is just the toddler versus my child has autism? Obviously, we say each child's different. They're just different, but. . .

Dr. Jeff Anderson: When there's enough of these little differences, you start to wonder about autism in not only language and social function, but also some specific behaviors, like rocking, an inability to. . .

Interviewer: So the physical behaviors?

Dr. Jeff Anderson: That's right.

Interviewer: Okay.

Dr. Jeff Anderson: Specific motions, repetitive motions of hands or body. Sometimes they'll play abnormally with toys, like they'll look at the parts of toys rather than play with the whole thing as it was designed. Or they might take a number of toys and just line them up along the floor. Those are classic type symptoms. You know, any one by itself isn't going to be a diagnosis of autism, but when you start having lots of these different types of symptoms, then you start to think about autism.

Interviewer: What happens in the case that the parent doesn't pick it up?

Dr. Jeff Anderson: Well, that's really common. You know, autism is not a single condition. It's many different conditions, probably with different genetic causes and different environmental causes. They have some similarities, and we group them all together as autism, or an autism spectrum, but that autism spectrum goes all the way from a child who sits in the corner rocking and can't speak to a very bright child that may have higher than normal intelligence, but is socially odd. So you have this wide spectrum of what you can see with autism.

Interviewer: Let's say that the parent now can kind of see something different in their child. They bring them to the physician. They do the clinicals, make sure that it is autism that they're diagnosed with. What is the next step?

Dr. Jeff Anderson: That's a great question. We are hopeful that the treatments that have been developed in social function, in speech therapy, in teaching children social boundaries and rules, in helping them to communicate in their own way; that these kinds of interventions may be more effective if they're started earlier. So we want to learn about a child as early as possible so that we can plug them into the resources that we have.

Interviewer: So it's very important to diagnose a child with autism at an early age if they have it?

Dr. Jeff Anderson: When it's possible. You know, sometimes it's just not picked up until a child starts school, or not picked up at all.

Interviewer: Do you think there is any harm to a child diagnosed, maybe, earlier on in life, versus, maybe, later on in life?

Dr. Jeff Anderson: Well, sometimes we worry more when we have a label or a diagnosis.

Interviewer: Right.

Dr. Jeff Anderson: I hope that that comes with some counseling and ideas that autism may not always be a disease. In some children it's a gift.

Interviewer: Huh. Explain a little bit about that.

Dr. Jeff Anderson: Well, I had a letter the other day from a graduate student in psychology with autism who said, "You really shouldn't be calling autism a disease. In individuals like myself, I feel like it's a blessing," that it's a peculiar or different personality, but that often individuals are very bright with autism. They are honest. They tell it like it is. They're very refreshing in many ways. Those are an important part of our society and can be thought of as a personality.
Now, on the other hand, we also see children that just can't talk, that are really disabled, and so there has to be some perspective about to what extent does something need treatment, and what can we offer a child with autism to leverage their strengths.

Interviewer: That's such a nice way to look at autism, as a gift. Any final thoughts on this?

Dr. Jeff Anderson: I just would encourage individuals that think their child may have autism to get some good advice because there are so many interesting developments that happen as a child ages and grows. Oftentimes, we worry as parents so much, and having a really trusted clinician or physician offer a perspective can sometimes make a world of difference in putting your mind to rest, or offering some resources to help.

Recording: We're your daily dose of science, conversation, medicine. This is The Scope. University of Utah Health Sciences Radio.

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