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Immunizations and the Impacts of Virtual Reality: Two New Findings on Autism

New studies on autism offer insight into the potential for virtual reality to improve social behavior—and brain activity—in young adults with autism, and show how pervasive myths about the causes of the disorder could put children and their families at greater physical risk.

Even though claims linking autism with childhood immunization have been roundly and repeatedly debunked, a new study in the journal JAMA Pediatrics suggests parents may still worry about autism when it comes time to immunize their children.

Researchers from the Kaiser Permanente health group's research division tracked more than 3,700 children diagnosed with autism spectrum disorders by age 5, as well as nearly 600,000 children without autism, and the younger siblings of both groups in California, Colorado, Oregon, Washington, and Wisconsin

They found that after an older sibling was diagnosed with autism, parents were significantly more likely to refuse at least one scheduled immunization in their younger child's first year of life. At every age from 1 to 12 years, siblings of children with autism were less likely to be fully up to date with all the immunizations recommended by the American Academy of Pediatrics. 

autism immunization.JPG

"Numerous scientific studies have reported no association between childhood vaccination and the incidence of autism spectrum disorders," said co-author Frank DeStefano, a medical researcher with the Immunization Safety Office of the Centers for Disease Control and Prevention, in a statement on the study. "Nonetheless, this new study suggests that many children with autism and their younger siblings are not being fully vaccinated. We need to better understand how to improve vaccination levels in children with autism spectrum disorder and their siblings, so they can be fully protected against vaccine-preventable diseases."

The study comes as more schools look to tighten vaccine requirements to avoid outbreaks of the measles and other childhood illnesses, while health experts work to convince the Trump administration not to change the pediatric vaccination schedule based on concerns about autism.  

How Boosting Social Skills May Change the Brain

A separate study published online this week in the journal Autism Research provided early evidence of how supports for students' social skills may change parts of the brain associated with challenges in those areas due to autism. 

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As part of a pilot program, researchers from the University of Texas at Dallas, George Washington University, and Yale University developed a virtual reality simulation for young adults with autism. In the 10-hour training, the participants with autism used digital avatars to practice scenarios such as interviewing for a job, talking about colleges, or dating, while a coach provided feedback through another digital avatar. 

Before and after the five weeks of the intervention, researchers measured participants' brain activity using an MRI. They found that after the intervention, participants showed better ability to recognize different emotions on another person and improved their "theory of mind,"— the ability to understand that others have thoughts, emotions, and motivation different from their own. But the researchers also found changes in the participants' brain activity in areas associated with differences for people with autism. 

For instance, the right posterior superior temporal sulcus, which is associated with the ability to understand social tasks like joint attention and theory of mind, responded more to social cues than non-social ones after the intervention than before it.

After the intervention, participants also showed significantly less activity in an area of the brain associated with visual attention when they were shown nonsocial cues, and more activity in response to social cues. That's significant because students with autism can become distracted during conversations or other social situations by other things in the environment.

"Since the brain can be made plastic during this short-term intervention, I believe continued stimulation will make the effect last longer," said Y.J. Daniel Yang, the lead author of the study and a researcher with the Autism and Neurodevelopmental Disorders Institute at George Washington University and the Children's National Health System. "The same goes to muscle training. If the participant is willing to explore similar opportunities after the intervention, then yes, it will certainly be lasting long."

The study provides some early hints about how educators and researchers might develop future interventions for those with autism, but the researchers admitted it's just the tip of the iceberg. The virtual reality intervention is still in its pilot stage, and this study, like many using brain imaging, focused on a small and homogenous group: 17 young adults, nearly all of them male. Prior studies have suggested autism symptoms—particularly those associated with social skills—may show up differently in men and women or in elementary-age children.

Moreover, "[Autism spectrum disorder] is a neurodevelopmental disorder that changes as a function of age," Yang said, and so the researchers think there may be differences if the intervention is used on young children. However, the area of the brain that changed as the participants developed better theory of mind, the right posterior superior temporal sulcus, has been associated with autism-related differences in children, adolescents, and adults alike, he said, "so I'm willing to bet on a higher possibility that [the findings] will generalize and hold well in different age groups."

Photo: Students with autism practice responding in social situations. Source: Y.J. Daniel Yang


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