TBI Regressive Autism

Ameliorating Hemianopia with Multisensory Training (Rowland et al., 2023)

Quick Summary of paper . An  visual-auditory stimulation therapy was used on two older males  who has loss of vision in the left hemifield (hemianopia). The cause was brain trauma (TBI) rather than lesion.  Prior to joining the study both had been referred to PT and OT as rehabilitation measures. 

• 64 year old JM joined the study 14 months after stroke  (2 infracts)
• 74 year old CW joined the study ~18 months after 1 infract (better sighted field compared to JM). 
• Therapy took place over 8 months /10 sessions 

The results were dramatic. Both patients recovered the ability to detect and describe visual stimuli throughout their formerly blind field within a few weeks. They could also localize these stimuli, identify some features, and perceive multiple visuals simultaneously in both fields. (more detail on paper here link)

Relating all this back to Autism

So impressive about being able to restore sight in a matter of 8 months, given therapy was started 14-18 months after infract and not immediately and it was in older adults. 

Why is regressive autism not thought to be TBI at 18 mo, where there is a sudden loss of learned skills. 

• If TBI --> can those lost skills not be regained through targeted therapy. If you can restore skills in 60-70 yr old, should be able to, in a younger more plastic brain. 
• If TBI -->  is this related to CW & JM having practice with vision for 60-70+ years vs toddlers who only have practice with the skills for 18 mo.

Rethink Traditional Therapies

• CW & JM  had PT/OT for 14-18 mo before joining study; implication these therapies not that useful for regaining lost skills. 
• Autistics kids are in insane amounts of therapy (childhood stuffed with ABA/speech/OT every waking hr with little advances to show for it other than the $$$ spent and lots of career advancement for therapists). 
•  Maybe we need rethink early childhood therapy to be more targeted to restore lost skills. Even regaining that level of lost skills improves quality of life, let alone moving beyond.