Our world is a busy, stimulus-filled
place. We have information blaring at us
from our laptops, from our smartphones,
from our tablets, everywhere. I, it can be
really overwhelming and if you have
autism it can be downright paralyzing.
Our next speaker is John Foxe. He's the
Chair of our Department of Neuroscience here
at the University and his research
focuses on how all of that information
streaming in from our senses connects to
our ability to communicate. He's here
to share a little bit about what he's learned
recently and how that can help
people with autism thrive in their own
social interactions.
Please join me in welcoming John Foxe. Thank you. Thanks.
Well, hello. Thank you for that nice
welcome. It's a real privilege to be
here to share a little bit about
something that I'm very passionate about
and the folks in my lab have been very
passionate about researching over the last
ten to fifteen years and that is how the
sensory systems are knit together. How do
sight, sound, touch, smell, balance—
How does the brain integrate those and
what happens in individuals where this
doesn't work appropriately? So when
a scientist like me gets you know, four, five hundred
people in room like this
best thing to do is to run an experiment.
So let's give that a go. So you're
going to hear in a moment, ah, something
quite noisy it's not just because we
make, we're very poor at making videos it's
because, they're actually purposely noisy
and buried in that noise with a "Shh"
you'll hear a monosyllabic word, a
single syllable word. See if you can
recognize it, maybe don't call it out if you do.
Okay, can I have the first. "Flush" So you heard the
noise. You heard the sound in there. The
word, maybe a little bit indiscriminate,
difficult to recognize, so now I'm going to
play exactly the same a, soundtrack.
No tricks but this time you can watch
Vicki saying the word, "flush" and I think you'll
have noticed they're just how much it
pops, right? It pops out nicely so the
folks know that was "flush," class
participation time, thank you. So, so flush
right and difficult to recognize first
time quite clear the second time and of
course what, what do you've got? You've got access to
the visual information
and your brains knitting those two sources of information together. There are specialized
neurons in the brain that allow for this to happen.
Our brain is an information scavenger.
It's grabbing as much information as,
as it can to help you to navigate your environment.
Let's give another a quick go there.
I completely recognize this every time
because I've heard a million times. I don't know about you guys?
How about try it again with the video. The bottom right,
thank you. Right, you see it pop again so, so
let's do some data. So you guys just
participated in just two instances of,
of this experiment that I'm going to
describe to you now. There are about
five hundred monosyllabic words in the English
lexicon and they're great words because
pretty much everybody knows all of them.
They're the simple words, right? So
that means you can use them with kids or folks who have a disease and
they'll, they get them. They know. So here's, let's look
at this, this graph over here. A long the
right here is zero.
This is auditory alone performance and
these are adults now, folks like
yourselves and what you see is that zero
here is when there's quite a lot of noise
but folks are recognizing eighty, ninety
percentities but as we add noise
minus four, minus eight, you can see performances
dropping until at minus twenty four here it is minus
twenty, minus twenty four decibels, not a single person
recognizes a single one of these words.
So we've got a nice assay, a nice test of
multisensory speech processing here and
this is auditory long performance. You throw the video in just like you
saw and performance goes way up. So the only
math I'm going to ask you to
perform today as University of Rochester
graduates is subtraction. [laughter] Let's subtract
this curve here from this one up here
and you end up with this down here and
this is the difference right, the
difference and you can see here at
this minus twelve mark that there's a huge improvement.
What actually happens here as you go from
recognizing one word in five
to recognizing about four words in five and
that's the difference between
not being able to tell what somebody's saying to you and being completely able
to interpret what they're saying. Four out of five you'll get there. You'll,
you'll understand and so now let's have a look
at what happens when we do this in
children. So the same kinds of graphs, here's
auditory alone and what we have
here are adults in this light gray. We have
teenagers or preteens, eleven and twelve year
olds in this darker gray and here are a
bunch of five, six and seven year olds
and so by in large the five
six and seven-year-olds. "NN" means
no noise are performing pretty good, you know.
They're getting eighty percent of these words
correct, pretty much like
adults and you can see again you get
all the way down here, nothing
recognized. Put the video track in. There are the
adults, the eleven-year-olds, the
six-year-olds so real dissociation. Let's
perform our complex computation again.
We're going to subtract those two curves
and here are the adults, here are the
preteens and here are the kids. So the first
thing to notice here is that even
in children as old as ten, eleven, twelve years of age,
this isn't fully mature. This is, this
this multi-sensory speech integration
ability takes a long time to come online
and certainly the six and seven year olds they're not getting anything like
the benefit from watching
a speaker that an adult is. So the next
time you're screaming at the kids at
home, remember this curve. It might not
just be as dire as you think, okay. So now
we have a good way to test multi-sensory
speech integration with this, this
experiment you participated in
and why would we study it, in autism
spectrum disorder and that's it's pretty straight forward.
I'm probably self evident really.
Audio-visual speech perception is
important for communication. We don't
usually sit in an environment like this
where everybody's being very polite and
very quiet most of the time and we
typically are interacting in very noisy
environments. Now I don't know what the dinner table at your
household is like but at my household
there's usually seventeen or eighteen different conversations going on
across each other and that's what the playgrounds like,
that's what the cafeteria is like, the sidewalk in the
street with the cars whizzing by most of
the time we're trying to hear things
while there's a lot of other information, auditory information,
out there. So it's
important for speech communication and
of course as you well know impairment
in communication is one of the hallmark symptoms
of an autism spectrum in autism
spectrum disorder. You in fact have to
have an impairment in communication to
pick up a diagnosis of autism and
actually this ideas been around for a
very long time. It's been around since the 1970's. There
were a lot of very popular books written at
the time, one by Jean Ayres, The
Out-of-Sync Child. You might remember
that a, sort of a terminology and
parents will often say I think my child
doesn't put the sensory systems together
and even folks on the spectrum, high,
high-functioning folks in spectrum will say the same thing about themselves so that's quite anecdotal.
So let's see, is that what actually happens? So here are a
group of seven, eight and nine year olds at a
good few of them on the spectrum here
with a diagnose autism spectrum
disorder. A "TD" here means typically developing so
these are your average kids from the school, the local school.
There's the auditory alone performance.
In no noise they're performing just the
same basically and as we add the noise
they go down to zero just like the
typically developing kids and I think you'll appreciate
that there's no difference here between the kids on the
spectrum and the kids at who are
developed, developing typically. Let's
throw in that video track and you can see
where this is going.
Let's perform our complex computation,
will subtract the curves and there you
have these young kids now eight years of
age, seven, eight, nine years of age with
their multi-sensory gain the benefit
that they're getting from having the
integration of the two systems and as
you can see the kids on the spectrum are
no where near that performance and you'll
recall that I told you already that seven, eight and nine
year olds don't really have a very mature
multi sensory system
but boy these kids on the spectrum are way
behind. Let's move up the age bracket.
What's happening at ten, eleven and twelve years
of age? Auditory alone, so when they don't
have the video. We'll put in the video
track - maybe - and you can see the
separation again when we do our
subtraction the children on the spectrum,
these preteen children, are way behind
their typically developing peers.
Let's step up another age bracket, thirteen, fourteen,
fifteen years. So now these kids who've entered and
got into puberty, we have a look at their
auditory alone performance, put in the
video track and I think you'll
appreciate that that's very different.
Let's do our subtraction and the kids
have completely caught up. Now this was a
huge surprise to us. We were really stung
by this. We absolutely assumed
that the teenage kids would have the
deficit. So there's something going on here and of course as
a scientist I'd like to be able to stand here and tell you I've
got the answer but I don't. We
don't know what this is about.
We do know, well let me just add one
other thing because I know somebody's going to say to me, well wait a minute.
I know that children on the spectrum don't like
to look at faces so that's all you got
here. They, they weren't looking at
those faces you were presented to them so of course they didn't
get a multi-sensory speech integration but what we
do is we use it an infrared eye tracker
to make sure that they're looking at the
stimuli and indeed they do and they look
at it in exactly the same way as folks -
as typically developing children. So what
is going on in this older group and I
said I don't really know. What I do know
and what we've known for quite some time is
that there are massive changes in brain
organization as children enter puberty.
I've gone through them with two of my own
children and it's not always pleasant.
So, for example here's just one set of
data from another group where you can
see that actually blood flow into the
brain around the age of twelve, thirteen years of
age really drops in typical development.
Do we know if that's occurring in autism
spectrum disorder? We also know that
there are, there's massive myelination,
this massive amount of - of - of coding of
the wires in the brain if you will
around this age bracket as well. So we,
we're busy trying to figure this out at
this moment in time. So let me conclude
here. What do we know? We know that
multi-sensory speech integration
abilities are severely impaired in
school-aged children with an autism spectrum
disorder. These multi sensory
integration abilities are crucial for
interacting effectively with peers
especially when they're multiple
speakers or this background.
There's a background noise involved. It is, it is
possible that this contributes to the social
communication deficits that are a
hallmark of autism and I'd say it's
almost certain that they do, frankly
There's a dramatic recovery of this
function in adolescence perhaps due to
major brain changes that occur during
puberty. We need to explicitly measure that.
Now here's the thing. The fact that
the ability can be
recovered is, I take it as an extremely
hopeful sign because what it means is
that there's not the, it's unlikely that
there's something fundamentally wrong with the brain. The brain
ultimately figures out this task, important task.
So what that says to me is if we could start training these children at a much
earlier age maybe we could bring them
online with disability and maybe by
doing that we might be able to improve
their social skills. So that's, that's the
thesis and we currently have a
three-million-dollar NIH grant we're
working very hard delivering multi-
sensory integration therapy to children on the spectrum
to see if that is what pans out.
So stay tuned. Hopefully I'll be able to
tell you about that again at some other time.
Thank you very much.