March 9, 2012
NIH Podcast Episode #0154
Balintfy: Welcome to episode 154 of NIH Research Radio. NIH Research Radio bringing you news and information about the ongoing medical research at the National Institutes of Health – NIH. . .Turning Discovery Into Health®. I’m your host Joe Balintfy, and coming up in this episode some stories about kids: how training peers of kids with autism may work better than training autistic children directly; and how bilingual kids may have some advantages over their peers; also, brain implants shed light on how seizures happen, and other resources for you to get news and information about medical research: NIH Research Matters and NIH News in Health. But first, this news update. Here’s Craig Fritz.
Fritz: Infants and toddlers who have been treated for cancer tend to reach certain developmental milestones later than do their healthy peers, say researchers at NIH. The findings show that delays may occur early in the course of treatment and suggest that young children with cancer might benefit from such early interventions as physical or language therapy. Compared to children who had not had cancer, children treated for cancer before age 4 progressed more slowly in vocabulary, cognitive functions such as attention and memory, and motor skills. However, having cancer did not appear to affect children’s social and emotional development. Their ability to respond to their parents was comparable to that of their peers who did not have cancer. Also unaffected by cancer was the ability to engage in make-believe play, which typically develops between 12 and 18 months of age. The current study is the first to document the potential effects of having cancer on young children’s development, enrolling the children after their diagnosis and testing them after they had received treatment. Previous studies have attempted to discern the influence of childhood cancer many years later-in adolescence or beyond.
In recognition of World Kidney Day, NIH is promoting efforts to reduce disparities in organ transplantation. This is particularly important among African-Americans, Hispanics, and American Indians, all of whom are disproportionately affected by kidney failure, yet are less likely to receive organ transplants. More than 20 million adults in the United States have chronic kidney disease, with an additional 400,000 people currently depending on dialysis to treat kidney failure. Of the more than 80,000 people on the national waiting list for a kidney transplant, 35 percent are African-American and nearly 19 percent are Hispanic, although they make up only 13 and 16 percent of the population, respectively. Scientists say part of the solution to the disparity in transplantation is to ensure that providers refer appropriate patients for transplant evaluation as soon as they’ve been diagnosed with kidney failure. It’s also important that more African-Americans and Hispanics register as organ donors and talk with loved ones about doing the same to increase the pool of kidneys available for transplantation.
For this NIH news update – I’m Craig Fritz
Balintfy: News updates are compiled from information at www.nih.gov/news. Coming up, who’s smarter a child that speaks one or two languages? Insights on seizures. Other sources of NIH information, and a way to better train kids with autism spectrum disorder. That’s next on NIH Research Radio.
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Training peers improves social outcomes for kids with ASD
Balintfy: Autism is a group of developmental brain disorders, collectively called autism spectrum disorder or ASD. The term "spectrum" refers to the wide range of symptoms, skills, and levels of impairment, or disability, that children with ASD can have. Some children are mildly impaired by their symptoms, but others are severely disabled. While there's no proven cure yet for ASD, treating it early, using school-based programs, and getting proper medical care, can greatly reduce symptoms and increase a child's ability to grow and learn new skills. Now a new NIH study is finding that a type of treatment focused on training peers may be more helpful for children with ASD than the most common type of intervention, which focuses on training the child with ASD directly. Wally Akinso has this report.
Akinso: Peer training could lead to more effective and long lasting improvements in social skills than interventions directed at children with mild autism spectrum disorder or ASD
Kasari: Just to work with our children with autism on social skills trying to help them get those skills that they need to engage with other children is really just not enough.
Akinso: Dr. Connie Kasari is from UCLA and is the principle investigator for this NIH funded study.
Kasari: The teachers who work with the children the peers who interact with the children, we don't have those environments as very supportive environments then our children can't execute the skills that they've learned. I think using the peers in the classroom is probably the most important finding.
Akinso: The most common type of social skills intervention for children with ASD is direct training of a group of children with social challenges.
Kasari: A very common social skills invention is one that's done off campus in a clinical setting. And that's a social skills group that usually has children from lots of different places that don't really know each other and they follow a set format. And they mostly try to hit on those common social interaction problems that most children will have.
Akinso: Other types of intervention focus on training peers how to interact with classmates who have difficulty with social skills. Both types of intervention have shown positive results in studies, but neither have been effective in community settings. Researchers compared different interventions among 60 children, ages 6-11, with relatively mild ASD. The children were randomly assigned to one of four intervention groups.
Kasari: We tried to test very common interventions that you might see in a school setting. So in one situation we had a skilled adult or therapist work with the child on particular skills that they were having difficulty with. Or we chose three typical peers in the classrooms to actually help all children in the class who might be having social difficulties. So one condition had both of those conditions, both the one on one and the peer and one of the conditions had neither of those conditions.
Akinso: All interventions were given 20 minutes two times a week for six weeks. A follow-up was conducted 12 weeks after the end of the study. Dr. Kasari describes the findings from before and after the follow up.
Kasari: Generally we found that children were less connected to their classmates before the intervention. But afterwards if they received the peer intervention they were more likely to be connected to a peer group. And those connections stayed pretty close to the same even after we had left the school situation.
Akinso: According to Dr. Kasari, the findings suggest that peer-mediated interventions can provide better and more persistent outcomes than child-focused strategies. She added that child-focused interventions may only be effective when paired with peer-mediated invention. For more information, visit www.nimh.nih.gov. For NIH Radio, this is Wally Akinso.
Bilingual kids may have a cognitive advantage over monolingual kids
Balintfy: More on educating children. In this case, an NIH study compared the cognitive abilities of kids who speak one or two languages. Here’s Wally Akinso with the results.
Akinso: An NIH funded study in Toronto, Canada, shows children who are bilingual – speaking two languages – do better on a cognitive test compared to children who are monolingual, only speak one language, in this case English.
McCardle: Basically bilingual and monolingual children follow the same milestones of language development.
Akinso: Dr. Peggy McCardle specializes in bilingualism here at the NIH.
McCardle: Where they differ, researchers have pointed out both advantages and disadvantages. Some of the disadvantages are that if you look at just one language for a bilingual child, their vocabulary is probably smaller in that language than that of a monolingual child. But that’s true in each of their languages, so it kind of balances out.
Akinso: The researchers compared about 106 six year olds to measure their cognitive growth. Dr. McCardle says Canadian researcher Ellen Bialystok compared four groups in the study.
McCardle: She had English monolingual students, and then she had three different sets of bilingual students. One set was Chinese-English bilingual, one was French-English and one was Spanish-English. And she chose those languages so that she could maximize the contrast between the types of languages. She found that the bilingual children had better ability to flexibly switch task. For example if you give them a rule and say classify all of these pictures based on a certain characteristic or certain rule and then you change the rule how quickly can they pick up on that and change with you. And the bilingual children were really more cognitively flexible, better able to do that than the monolingual children were.
Akinso: Dr. McCardle emphasizes the importance of understanding bilingualism.
McCardle: English learners, kids whose first language at home is not English, are the most rapidly growing group of children in the US educational system. And we need to know how they learn and whether it’s worth keeping them bilingual or should we just forget about their native language and only teach them in English and make them switch sort of to English. And the hope from research like this is that educational and national policies would be informed by this work.
Akinso: She adds that this study demonstrates that the advantage is really tied to bilingualism and how valuable bilingualism can be for kids. For more information on this topic, visit www.nichd.nih.gov. For NIH Radio, this is Wally Akinso.
Ultrathin flexible brain implant offers unique look at seizures in NIH-funded research
Balintfy: In our last episode, there was a story about auto-injectors and seizures. And there was a tease about this next story that also has to do with seizures which are a symptom of epilepsy. With more than 20 drugs on the market and a number of surgical procedures, the options for treating epilepsy are better than ever. Still, these treatments don't work for everyone. Now NIH-funded researchers have developed a flexible brain implant that could one day be used to guide surgery with greater precision – or perhaps even to control seizures by delivering electrical stimulation to the brain. Dr. Jonathan Viventi, an engineer and neuroscientist at New York University, earned his Ph.D. working on this kind of technology.
Viventi: So I started working on this project with Brian Litt at the University of Pennsylvania. He’s a clinical neurologist and he treats patients with epilepsy, and when we were working together on this, I was a PhD student in his lab and his motivation was we really need better technology to understand epilepsy on a much finer scale.
Balintfy: Litt and Viventi set out to improve a device called an electrode array. These arrays contain tiny sensors – or electrodes – that can be used to record seizure activity in the brain. They're useful when anti-epileptic drugs have failed and doctors are considering surgery. With an array, doctors can assess where seizures are occurring in the brain and whether it's safe to remove the offending areas. But Viventi says current arrays also have some major drawbacks.
Viventi: So the currently available technology that we use to perform mapping of epileptic seizures in patients relies on some very old technology. There are individual pieces of metal that are wired with one wire for each contact, so that requires that we place these devices very far apart with very limited coverage of brain activity we're interested in.
Balintfy: Viventi and Litt have developed electrode arrays that have compact wiring embedded into a flexible material. With these arrays, it's possible to get broader coverage over the brain, and to reach into its grooves and folds. To make the arrays, Viventi and Litt needed some materials science expertise from John Rogers and his lab at the University of Illinois.
Viventi: They’ve developed a technique for making silicon that is flexible and stretchable and making active circuitry. And we worked with them to develop medical applications of their technology. The device we make is now…it’s a thin sheet of plastic that integrates active circuitry – the same kind of transistors and devices that you would have in your MP3 player or cell phone – and is made out of a flexible material that we can bend and conform to match the curvature of the brain. This allows us to get a very detailed and high resolution picture of the activity in the brain in a way that’s not currently possible with existing technology.
Balintfy: Viventi, Litt and Rogers recently published some of their first efforts to test these devices. They did the research on cats, which have brains that are anatomically similar to the human brain, but with more simple grooves and folds.
Viventi: We did three different examples of neural activity in our paper to show varied uses the technology can be used for. We looked at some basic neuroscience type questions. We looked at recording sleep spindles, which are naturally occurring events that occur while you’re sleeping or while you’re under anesthesia. We also looked at the visual system – how can this technology be used to better understand how the visual system works and how we could study large areas of that system simultaneously. And then finally we looked at an epileptic seizure induced on the brain and we found different spatial patterns. We found waves moving across the brain during the seizure that we haven’t been able to observe before.
Balintfy: Viventi is quick to point out that the seizures he and his collaborators recorded in cats are not epilepsy per se. But he thinks that the patterns of electrical activity seen in these experiments could hold clues for how seizures begin and how to control them.
Viventi: We’ve found that during seizures, there appear to be waves that look like they are spiraling across the surface of the brain. And that gives us interesting options for potentially treating that that seizure. We could potentially stimulate at the correct place and the correct time with the correct spatial pattern and try and abort that epileptic pattern from occurring.
Balintfy: More studies are in the immediate future, and Viventi notes human trials are the ultimate goal.
Viventi: We’re looking to scale the technology up to larger sizes to record from larger areas of brains in larger animals and eventually transition to being able to take this technology into humans for preliminary studies to see if these same patterns occur in human epilepsy patients.
Balintfy: For more information on this research, visit www.ninds.nih.gov. And thanks to Daniel Stimson for putting together this report. Coming up: There are more ways to get information and insight from NIH. That’s next on NIH Research Radio.
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NIH Research Matters and NIH News in Health
Balintfy: Welcome back to NIH Research Radio. You know, this program is just one way to get information about all of the research and discovery happening here at the NIH. Today, we’re bringing back Dr. Harrison Wein who was a regular on the program in past years. Harrison is editor of both NIH Research Matters and NIH News in Health. And what are those publications?
Wein: Well, NIH Research Matters is an online weekly where we review interesting papers that have come out that NIH scientists have done, or scientists funded by NIH have done.
Balintfy: And NIH News in Health?
Wein: NIH News in Health is a monthly newsletter…
Balintfy: Back to NIH Research Matters. As an on-line publication, it can go into a lot more detail on health and research topics. But it’s not just designed for researchers and health-care professionals – a lay audience can read it, right?
Wein: Absolutely, I think it help to have some science knowledge…
Balintfy: And the format of NIH Research Matters is to have three stories each week. What was covered in the most recent edition Harrison?
Wein: Well this week our lead story was about egg-producing stem cells…
Balintfy: And the third NIH Research Matters story?
Wein: The third story is about how certain bacteria…
Balintfy: Now that’s what’s already available, but there’s more coming out next week. What can you tell about those stories?
Wein: Next week we have a really interesting story about…
Balintfy: And what other stories are coming up Harrison?
Wein: We’ve got a study looking at lung cancer in minors who are exposed to diesel exhaust…
Balintfy: And there’s a third story next week as well, but let’s get back to NIH News in Health. Harrison, you said this is a newsletter. What’s the format of this monthly publication?
Wein: We usually have one feature story…
Balintfy: And what’s the cover story for the March issue of NIH News in Health?
Wein: The cover story’s about chronic pain…
Balintfy: If someone is interested in the stories you talked about or the publications, how can they get them?
Wein: Well you can read NIH News in Health…
Balintfy: Dr. Harrison Wein, editor for NIH Research Matters and NIH News in Health. Thank you very much Harrison.
Wein: It’s always a pleasure.
Balintfy: You can find Quick Links to both those publications, plus the NIH Radio at www.nih.gov/news.
Balintfy: And that’s it for this episode of NIH Research Radio. Please join us again on Friday, March 23 when our next edition will be available. If you have any questions or comments about this program, or have story suggestions for a future episode, please let me know. Send an email to NIHRadio@mail.nih.gov. Also, please consider following NIH Radio via Twitter @NIHRadio, or on Facebook. Until next time, I'm your host, Joe Balintfy. Thanks for listening.
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