Yale University is emerging as a leading brain imaging and research center for autism.
What is autism and autistic spectrum disorders?
Autism spectrum disorders (ASD) are also called Pervasive Developmental Disorders because they involve delay in many areas of a child’s development. They are a form of developmental brain disorder, characterized by impaired social interaction and communication skills (use of language) as well as a limited range of activities and interests.
These conditions include Autistic Disorder, Asperger Syndrome, Rett Syndrome, and Pervasive Developmental Disorder (PDD)-Not Otherwise Specified (PDD-NOS).
PDD-NOS is really just a category that includes many different areas of developmental delay and of differing severities and refers in a general way to a child’s lack of appropriate development of socialization and communication skills.
In ASD the typical age of onset is before 3 years of age. Symptoms can include problems such as: using and understanding language, difficulty relating to people, unusual playing with toys, difficulty with changes in routine or familiar surroundings, and repetitive body movements or behavior patterns. There are many more individual problems and symptoms not listed here because each child is unique.
What is the cause of autism?
The cause of autism is still unknown. Research here at Columbia University suggests that abnormalities in the development of the brain and central nervous system cause autism. Although others are involved in research on possible genetic, infectious, immunological, and environmental causes and mechanisms of autism, at the functional MRI center at Columbia University Medical Center we focused on the assumption that autism spectrum disorder results from atypical neural circuitry that will be evident in the neural systems that mediate language functions. Finding the defect in these neural circuits of the brain related to the processing of language is at the core of ASD. We shall continue to investigate and discover the defect in connectivity that is related to language processing and social contributions to this process.
How is autism diagnosed?
Parents of children with autism often suspect a problem with their child as early as 18 months, sometimes sooner. We suggest that those parents who do suspect a problem go with their gut feeling, no matter what a doctor may initially say. Language and hearing concerns are the most commonly the usual first signs. If your child is not developing language or is losing language, does "not hear you" a lot of the time, or does not share an interest in things with you, you should have your child evaluated. Parents often consult their child’s pediatrician, pediatric psychiatrist, or pediatric neurologist.
Dr. Harry D. Schneider is one of the investigators of brain research in developmental and behavioral disorders such as autism at Columbia University Medical Center. His medical office in Long Island offers parents pre-requisite language testing: a specialized diagnostic, neuro-psychological behavioral evaluation of your child and a consultation with Dr. Schneider to see if your child qualifies for the research program at Columbia. The sooner this is done, the sooner we can try to complete the imaging process at Columbia and subsequently begin individualized language therapy at the Long Island office.
Dr. Schneider’s credentials include:
Advanced degrees in language and linguistics
Doctorate in Speech Language Pathology: Dissertation not completed due to time constraints. Nova Southeastern University. To be completed in NY when able.
An excellent conventional medical specialist and diagnostician, having attended Columbia University’s College of Physicians and Surgeons for his medical degree
A neuroscientist at Columbia University Medical Center, where he has specialized in understanding the language circuits of the brain (www.fmri.org) and is about to publish his research on these topics.
Specialized training in diagnosing and managing autism at the Neurologic and Psychiatric Institute in New York, NY
Fellowship in Neuroscience and Neuroimaging, Columbia University, Program for Imaging and Cognitive Sciences, 2004.
Dr. Schneider is now at The Brain Function Laboratory in the Departments of Psychiatry and NeuroBiology at theYale University School of Medicine where he will continue is research of the brain in ASD
More about Advanced Behavioral Testing at Dr. Schneider’s Office.
We recommend to you what many patients have already told us: be wary of very short exams, often under 10 minutes, in which the diagnosis of ASD is given to a child. A good examination of your child’s condition often lasts 1-2 hours, sometimes more. Although many good diagnostic assessments are available, we have developed a comprehensive exam that may lead to better treatment. . Even if your child has been tested before, it is essential that your child takes the more comprehensive assessment we have developed. The test lasts from 1-3 hours and is very extensive. Your child will be observed, undergo one-on-one interaction and be questioned during activities. Dr. Schneider will use this advanced diagnostic test to provide a standardized rating of your child’s development.
This test will provide uniform results of all aspects of your child’s language condition. Most importantly, this was the only test that WAS used to put your child on the waiting list to be tested at Columbia University functional MRI center. This test is no longer necessary. We are in the process of developing a new functional imaging test at Yale that can be used in an office setting. We will notify you as soon as it is available.
Advanced Brain Testing with Functional MRI and Diffusion Tensor Imaging (DTI): Scanning your child at Columbia University with Dr. Schneider.
The research investigations at Columbia are dedicated to finding the atypical neural circuitry that underlies autism. The subsequent language intervention attempts to use that information to form a unique language intervention to re-build a child’s language impairment. The immediate goal is to formulate individualized therapies for each child in our program.
- The program begins in the Long Island office of Harry D. Schneider, MD, one of the principal investigators of this study. The parents and child will undergo a two-hour neurolinguistic evaluation, the results of which will be used to correlate with the functional MRI scan of their child.
- After language testing, parents schedule to meet with Dr. Schneider and the Director of Columbia’s functional MRI lab, Dr. Joy Hirsch, at the Columbia University Medical Center, NY. Dr. Hirsch will explain the mission at Columbia in more detail and answer any question parents may have concerning the imaging program. After the meeting, Dr. Schneider will take the parents on a tour of the lab, answering all questions before the parents return home. Although patients may elect to participate in research on autism, their subsequent treatment is guided by standard medical procedures by Dr. Schneider in his Long Island office.
- Practice and play times in the scanner…: These practice sessions help to acclimate your child to the MRI environment. They are strictly supervised by Dr. Schneider to maximize your child’s comfort and to ensure safety.
- Scheduling scanning for your child… There are many options available. Dr. Schneider will explain all of them and answer your questions when you contact him.
- Review of the findings… Because there are many components to the brain scan of your child, Dr. Schneider will review the brain images and their interpretations with you at his office.
These functional images demonstrate what parts of the brain are involved in your child’s language. They will be discussed at length and a treatment plan will be formulated together. This is a team effort.
Dr. Schneider’s Treatments and Interventions for ASD.
All or any of this treatment protocol may be selected and customized for your child’s individual needs:
- Language interventions consist of specially-developed teaching methods. They include explicit, implicit, attention, motivation and theory of mind (joint-attention). These constructs are not the same as used in conventional speech therapy.
- The language protocol may be combined with melodic intonation therapy or musical themes.
- Verbal production may be enhanced by carefully-selected organic nutritional supplements and herbal products to increase neurotransmitters involved in this type of learning.
- Conventional medications now known to increase language function will be explored with each family.
- To help restore language function, a portable brain stimulator will be used at the Long Island office of Dr. Schneider. This is not part of the research being done at Columbia or Yale, rather research being conducted by Dr. Schneider. This simple to use device attaches easily to your child’s scalp over brain areas that may benefit verbal production, painlessly stimulating select brain areas using a small amount of direct current.
- We are in the process of developing functional brain scanner for use in the offices. With this new device, we will be able to see the results of the language therapy with and without the use of TDCS – and track changes over time during the course of therapy.