For US $59 per month you can subscribe to the lite version of a new online therapy offered by Mendability.com. The therapy is apparently the protocol used in a recently published article in Behavioral Neuroscience by Woo & Leon titled “Environmental enrichment as an effective treatment for autism: A randomized controlled trial” [ungated PDF here]. They report in the abstract that:
Severity of autism, as assessed with the Childhood Autism Rating Scale, improved significantly in the enriched group compared to controls. Indeed, 42% of the enriched group and only 7% of the control group had what we considered to be a clinically significant improvement of 5 points on that scale. Sensorimotor enrichment also produced a clear improvement in cognition, as determined by their Leiter-R Visualization and Reasoning scores. At 6 months, the change in average scores for the enriched group was 11.3 points higher than that for the control group. Finally, 69% of parents in the enriched group and 31% of parents in the control group reported improvement in their child over the 6-month study.
This reminds me of the recent coverage in Time of a similar study by Elizabeth Torres of Rutgers whose work began by diagnosing autism via analysis of micro-movement [abstract with ungated PDF here], but has apparently moved to include therapeutic intervention. Time reports that after interacting with
a Wii-like digital workspace with a computer screen loaded with short snippets of cartoons, videos or television shows that the children could choose and activate by waving a hand that was attached to a sensor… The kids were able to both learn the movements and remember them for several weeks until the next session. By the end of the study, they were better able to control their bodies and understand their environment.
I confess, I am dubious, but this is not the first time I have been dubious. When my ex, Kathy Berger, first started telling me that all nonverbal autistic kids had receptive speech and that those without expressive speech, like our son Kris, suffered from sensory motor deficits that prohibited their ability to speak, I frankly treated it as ridiculous. All medical science treats non-verbal autistics as developmentally delayed / mentally retarded (the tests require either speech or writing, so anybody with severe sensory motor issues is going to fail due to inability to write or speak). But by the late 90s it was terribly clear to me that she and the therapists with whom she worked at Kris’ Camp and the ACT School and NMTSA in Phoenix are correct and medical science is wrong. Kathy has written a pretty accessible recent article that summarizes the state of knowledge with respect to movement (aka praxis) and psycho-motor regulation in those with autism [ungated here]. The field is moving quickly, though, and her essay may be dated by next summer or fall.
In any case, I guess these therapies make me apprehensive. Please, please, please let them not be snake oil! So many human beings (including my son, myself, my ex, and our daughters and extended family) have been proper-fucked by the APA and their horse-shit proclamation in the 1990s against facilitated communication. I am going to let that 3rd rail lie (perhaps I’ll post on it someday), and note only that it is one hell of an experience to learn that the child who has been diagnosed as severely and profoundly developmentally delayed and will grow to become severely and profoundly mentally retarded actually taught himself to read (via sing along videos and “Wheel of Fortune,” his favorite television) well before neurotypical kids generally do. But goodness knows we would not want to offer any sensory input to an arm and assume competence when our standard tools for measuring expressive language produce a zero score.
Researchers like Woo & Leon and Torres Many doing this sort of research work primarily with aspie kids (high functioning autistics) rather then non-verbal kids. So the risk of running into the buzzsaw that the facilitated communication crowd ran across is quite limited. But whenever there is an absence of a well articulated neural basis for why a therapy would work, it makes me nervous. On the other hand, the potential for this research, and the use of the web to deliver therapy, is very, very exciting.
Correction: Torres draws from the full spectrum in her work.