New Objective Autism Inventory to Quantify Peripheral Plasticity During Standardized ADOS-2 Social ExchangeShort Title
The main goal of this project is to create a new type of diagnosis of autism spectrum disorders. The project combines the strengths of the ADOS-2 with a new statistical platform that enables real time analytics of the naturalistic behaviors of the individual. The new platform permits extraction of the micro-structure of statistical patterns from spontaneous motions occurring largely beneath the examinee's and the examinerâ€™s awareness. Such patterns escape the conscious human eye and cannot be detected by observation alone. However, wearable sensing instrumentation (e.g. smart phones) combined with our new real-time personalized analytics can detect such hidden patterns, track them in real time and intervene to shift their statistical signatures towards more typical regimes.
The patterns of peripheral motor output variability are important because they continuously feed back to the central nervous system. They typically help in the development of self-control, self-modulation and self-autonomy. In autism however, we have discovered that the deliberate segments of natural behaviors are very random and excessively noisy. This is particularly so during instructed or prompted behaviors. The peripheral motor output variability that is being fed back to the CNS through kinesthetic sensors at the periphery is noisy and random. This therefore impedes proper integration of movement sensing with other forms of sensory inputs. This is particularly the case during explicitly prompted behaviors that require goal determination, central planning, modulation and control. However, when the behavior is spontaneous and uninstructed such patterns in individuals with ASD are not only closer to typical regimes, they are also very malleable. We can extract indexes of plasticity and adaptability in these more spontaneous patterns of naturalistic behaviors. We can track them as they evolve in real time and longitudinally over longer periods of time, so as to provide a new type of diagnosis in autism: (1) A dynamic diagnosis that tracks individual changes over time; (2) An enabling (rather than a disabling) diagnosis; one that does not exclusively focus on a qualitative description of what the individual cannot do. Rather, one that provides an objective quantification of the peripheral plasticity of the system of that individual. Our research has precisely quantified in a series of papers the impact that the peripheral plasticity has on the central capacity for decision making, and on the development and enhancement of control strategies connecting intention and action. The proposed research has the potential to reveal at a very early age hidden capabilities and predispositions that the autistic individual already possesses and that may be conducive of the development of social competences. We believe that the combination of the ADOS-2 standardized prompts and the new technology and framework will provide a more comprehensive assessment of the person suffering from this disorder. This comprehensive assessment raises the likelihood of alleviating the burden of this disorder and empowering the affected person with augmented feedback along functional sensory-motor channels detectable by the new methods but hidden to the human eye. Because this project is centered on the individual and provides a more comprehensive assessment of the internal sensing unique to each person, and of the real time rates of change of these sensations in response to both exogenous and endogenous stimuli, the proposal has the potential to transform the ways in which diagnosis, research and treatments of autism are currently provided. Although its administration is rather late in the early life of the child, the ADOS-2 is an excellent avenue to begin paving the way for this transformation. It is a highly standardized and reliable instrument. It already has a national infrastructure for administration and training. More importantly, it leaves out critical aspects of the naturalistic behaviors that our objective instrument can capture soon after birth. Combining these complementary approaches could enable a very early diagnosis and an unprecedented fast and dynamic intervention with precise, objective quantification of intervention effectiveness (whether behavioral or pharmacological) in their transfer and generalization to common activities of daily life.