Middle Childhood - Detailed Overview
Magnetic Resonance Imaging (MRI)
The MRI will be similar to the procedure that you have experienced during your earlier participation in the APP. However, one important change is that these MRIs will be carried out while your child is awake and watching a video. We appreciate that this may be more difficult for some children than others. So, each child will be evaluated by a Behavioral Analyst who will design a process of adaptation, utilizing behavioral reinforcement techniques that will allow the child to comfortably enter and remain still in the MRI scanner. Depending on the needs of each child, this may involve 1-2 practice sessions prior to the actual MRI scan. We will work closely with you to develop an individualized training plan.
We want to remind families that MRI does not use radiation and is perfectly safe for the pediatric population. It is a completely non-invasive procedure, which means that no needles and no chemicals are used to create the detailed pictures of the brain.
As in previous testing, a radiologist will read these scans to insure that there are no medically relevant changes. You may elect to have a copy of the radiologist’s report sent to your physician(s). In the rare case that there were unusual or puzzling results with your child's scan, the APP medical staff will contact you to discuss the findings and make recommendations for follow-up.
As in previous parts of the Autism Phenome Project, additional behavioral testing will be carried out. Testing includes confirmation of your child’s diagnosis and evaluation of your child’s current language, handedness, and attention skills. We have also included additional tests that are designed to look for signs and symptoms of anxiety. We are also evaluating learning, memory and other cognitive skills. Many of these assessments involve a computer game format to make them enjoyable for your child. You will be given questionnaires to complete that provide detailed information about your child and family. The length of time that testing will take varies depending on each child. The range of testing you can expect is 2 - 3 hours per visit. The research team is sensitive to children’s needs, and breaks in testing are provided and planned according to parent’s desires.
This phase of the APP is particularly interested in finding those children that have anxiety. One way to do this is to measure how strongly the child startles when a loud noise is made. During this task, the child is seated and recording electrodes are place near the eyes. He or she will be looking at a computer screen with images from a popular video game to make the task more enjoyable. The "startle" is actually an eyeblink that occurs when the child hears a loud noise through earphones. The child will also get an airpuff to the neck every once and awhile. The air puff will be signaled by a large red square on computer screen placed in front of the child. The experiment determines whether the eyeblink startle is greater when the child expects the air puff. This provides a measure of how the brain is processing startle signals which is associated with the occurrence of anxiety. View the social story handout detailing the step-by-step procedure of the startle response session. »
A pediatrician will collect an updated medical history about your family and conduct a short medical exam on your child. You child’s height, weight, and head circumference will be measured. The pediatrician will also determine whether your child has entered adolescence.
As in previous parts of the APP, we will be doing another blood draw from your child. This allows us to follow up on a number of kinds of testing related to your child's immune system and metabolism. If we have never obtained a blood sample from your child, we would like to obtain a saliva sample that would provide some of her/his DNA. The reason we ask for a blood sample in general, is because beyond DNA, blood contains RNA, immune molecules and all of the other components of a functioning body. This allows a much broader array of analyses that can be carried out with saliva.
We would like to insure that we have blood samples from both biological parents of your child. So, if we have not obtained samples previously, we will ask for parental blood donations as well.
All blood draws are carried out by certified pediatric phlebotomists and the amount of blood obtained is well within limits set by pediatric standards of practice.