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This week on Vice:
groundbreaking innovations in managing autism.
Hey! Hey, Rey!
They're trying to shut down channels
'cause the world is really overwhelming.
I just can't take it.
It really was like somebody had turned off a switch.
It was as if he was looking right through me.
So, in our lifetimes, will a child with autism
be able to walk into the hospital,
and walk out without autistic behaviors?
For some of them, I... I believe this is totally possible.
Go, go, go!
We are not animals!
Autism spectrum diagnoses
have been on a steep rise in recent years.
In fact, according to the CDC,
one in 68 American children born today
has autism in some form.
Now because of this, the scientific community
is marshaling major resources to figure out the origins
of the condition and how to treat it.
Back and dinosaur story! Four! Five...
We're in front of the Rebecca School
in the middle of Midtown Manhattan.
And we're here to meet some kids,
all different ages, who all have autism.
One, two! One, two, three, four!
♪ If your name is Colin, ♪
♪ get up and do a dance ♪
♪ If your name is Colin ♪
♪ Get up and do a dance ♪
♪ Run, run, run back to your seat ♪
♪ And give someone else a chance ♪
What's the experience of being in this classroom
or being on the street for these children?
Most of these kids don't have
an integrated sense of the world,
so it's a fractured experience.
So, you wonder why kids walk around with their fingers in their ears...
- Mm-hmm. - ... or they cover their eyes, or...
It's because they're trying to shut down channels
'cause the world is really overwhelming.
If you don't know what the important data is,
everything might be important.
So, a car horn might actually be
the thing you have to pay attention to.
Or the humming of a light bulb
might be the thing you have to pay attention to.
If you can't figure out what's important,
you have to pay attention to everything.
- I can't see! - I can't see!
Oh! Oh, hey! Hey!
- Hey, Rey! - What?
- Look! - Do I sit over here?
No, no, no, no. Look.
- You seen this? - Over here!
No, these!
- Look. - Who are these people?
I actually have no idea.
Sol is one of those guys
who is always regulated up here.
Everything happens quickly.
What he doesn't have a chance to do
is really process what he's gonna put back out.
I can't believe I need to be on the show.
What would your show be called, Sol?
I have no idea.
What would it be called?
Have you seen the movie called Kubo and the Two Strings?
I haven't seen that movie.
What about Iron Man 3?
Oh, yeah. That's a good one.
Did you see that movie?
I did. Did you?
- Yes! - The movie guru.
I'm not movie guru!
Like the expert.
I am not a mo...
I am not an expert, okay?
Don't call me that!
- I just can't take it. - I know you can't take it.
_
Can you please help me? I'm stuck.
Are you ready? Grab on, grab on.
Grab on, grab on.
Grab on.
You're free.
Oh. Way to go.
Thank you! You did it!
Man, you did so great!
Thank you for letting me out.
You're welcome.
Autism Spectrum Disorder,
or ASD,
has seen a 3,000 percent increase in diagnoses
in the last 30 years.
You can't talk about autism as a disease.
It's many, many different things,
and it's a range within each of those things.
We sat down with Dr. Jeremy Veenstra-Vanderweele,
or Dr. V, a psychiatrist at Columbia University,
where he devotes most of his time
to pursuing new treatments for autism.
Autism Spectrum Disorder captures
difficulties with social communication,
and restricted repetitive behaviors
that sometimes have this sensory quality,
that when they are occurring in the same person,
can be approached with common assessments.
Why has there been an increase in identified cases?
So, we don't completely know.
And I mean, that's one of the things about being in science...
that you have to admit when you don't have complete knowledge.
Honestly, I think part of the increase is a real increase.
And that may be
kids who are surviving neonatal intensive care units...
- Hmm. - ... who wouldn't have,
- Wow. - 20, 30 years ago.
We know that those kids are at higher risk.
It may be things like, uh, advanced paternal age,
which we know is a risk factor.
Uh, some of it is a decrease in stigma.
So, when I first started sitting in with people,
families didn't want to hear autism.
- Mm. - They wanted to hear anything but autism.
And now because people understand
that early intervention can make a substantial difference,
families are more willing to hear it,
and more likely to hear it for that reason.
Griffin! Good morning!
Griffin Jaccoma was diagnosed with autism five years ago
at the Center for Autism and the Developing Brain,
where Dr. V treats children with ASD.
Come. Let's go. Let's wash up.
No?
Come on, let's go have some breakfast.
It's okay.
Look up. Ready.
What do you want to do, bubbles?
No. We're not standing.
Okay, lift up.
Wanna brush your teeth?
Let me see the bottom.
Yeah! Good job.
What's wrong?
You know what we can do? We can go outside later.
Would you like to go outside?
Here's your talker.
Okay.
What do you want?
- Bagels. - Oh, great.
What would take a typical family 10 minutes,
it takes us 45 minutes.
You know, and so, these kind of things are difficult,
but it's getting better.
You know, at least now he can put his head through his shirt,
which may not seem like a big deal to a typical family,
but to an autistic child
it's like, you know,
trying to have an 8-year-old, 7-year-old do algebra.
It's incredibly difficult.
Watch this. This is sort of fun.
Wanna play ball?
- All the sounds and all this vibration. - Yeah.
And he's like in heaven now with that.
He's got the sunshine.
- He's got his Ring Pop. - Yeah.
When did you first see signs
that something was different about Griffin?
For me, it really was like somebody had turned off a switch.
I left the house one morning, and I came back after work,
and I went to have an exchange with my child,
and, um, it was as if he was looking right through me.
From that point, I really knew that something was not right.
A friend encouraged me to go and have him tested,
because she had had challenges with her own son,
and I took her advice, and I'm...
I thank God that I did.
The first signs of autism can be terrifying for parents,
but they can also vary greatly from one child to the next.
Griffin was diagnosed at age two
by the Autism Diagnostic Observation Schedule,
or ADOS,
which involves therapists observing
and scoring different behaviors,
and sets a numeric threshold,
for an autism diagnosis.
Standardized tests, like ADOS,
have created more reliable and earlier autism diagnoses,
better assessment methods are a key reason
for the rise in autism cases.
And that rise is pushing the scientific community
to develop a whole new set of ways to treat the condition.
Angry. Surprised.
Sad.
- Scared. - Good.
The Autism Glass Project
is one effort from the tech sector
that builds on Google's technology
to teach children with ASD
how to perceive basic emotion,
they often miss in social interactions.
Autism Glass uses artificial intelligence
to analyze facial expressions,
and then visually and verbally describes the emotion.
- Happy. - Good.
We went to Stanford University
to meet its creator, Catalin Voss.
What's running behind us is a computer vision system
that recognizes emotions.
It's based on a face tracker
that tracks up to 100 fiducial points within your face,
and then use a machine learning classifier
to predict whether you're happy
or sad or something like that.
So this is, essentially,
how you developed Autism Glass.
Yeah, exactly.
I was working on, you know,
emotion recognition and face tracking software.
And we realized, "Hey!
"This could help people who struggle
to identify social cues."
You know, we're spending time
building software that can teach machines
how to recognize emotions.
There happen to be people
who struggle to identify social cues in people's faces.
The Glass Project is focusing on these fundamental emotions
that everybody must know, must learn.
Kids with autism don't necessarily look to faces.
They're not getting those neurons developed,
those layers of the onion peeled back
so they can proceed
into more complex social scenarios on their own.
Why was it so important to create a device
that parents could take home with them
as opposed to use in a therapy session?
It creates these opportunities for natural engagements
between parent and child, care provider and the child,
in ways that we almost didn't initially anticipate.
Moms and Dads of children with autism
are, by far, the best suited to teach their kids.
The changes that I have seen...
night and day differences!
Sarah, you're up! Dice!
I mean, almost immediately,
I would tell her, "Hey, can you look at me?" and she'd look at me.
Before... short answers.
"Yeah, I'm fine." After...
she was able to have confidence to speak back
without feeling like...
what she was gonna say was wrong.
And now she actually will have a conversation with us.
That's so priceless.
Autism Glass could provide much-needed relief to families,
and several other promising experimental treatments
are already well under way in clinical studies.
Harvard neurologist, Dr. Alvaro Pascual-Leone
pioneered a technique called
Trans-Cranial Magnetic Stimulation,
or TMS.
TMS is a way to inject current in the brain
without having to do surgery and open up the skull.
A coil of wire outside the head generates a magnetic field,
and that magnetic field reaches the brain unimpeded.
It makes those cells that are targeted
fire in a different way.
It can either make them fire more
or be suppressed for some period of time.
And that allows us
to figure out what causal role
a given brain area has for a given behavior.
So, we're gonna go into the TMS room here.
At Bradley Hospital, Dr. Lindsay Oberman,
performs a TMS procedure on 16-year-old Evan Theilig,
a high school student at the high-functioning end
of the autism spectrum.
Help us to understand what's going on in your mind
in, uh, in a social situation.
Every... like, if... well, every time I ask a question,
I, like, before, like, talking, I ask myself,
do I really care about the outcome of this?
Like if... if I asked if someone...
if someone's having a good day or not,
do I actually care whether they say yes or no?
Is it kind of like you over-analyze
what could be a very simple question
- that would start a conversation? - Always.
It works great with math,
because you can... there's only...
there's, like, a logical limit
to how much you can over-analyze
before you already have the answer, but...
with an English class, since... I have...
you'd have to... I'd have to...
Like the assignment, like the book that we were...
not book, but, like, the play we were, like, looking at,
was the, uh, The Crucible. Have you heard of that?
Yeah.
Yeah, I was having... have a, uh,
hard time reading, like, reading it, because...
I guess the person who put it in the, uh, the uh, textbook
didn't know the first thing about actual formatting.
So, they used, like, a stupid Serif font.
So I couldn't really get over that.
I'm gonna adjust this so that
it's comfortable for you, all right?
I believe you.
The brain is influenced by everything we do...
by every experience we have,
by every thought we have,
by every action we take.
The concept of plasticity
is the idea that the brain intrinsically is changing,
is modified by experience.
But also because of plasticity,
we may develop symptoms of disease.
If you have a more plastic brain,
well, you should be able to acquire skills quicker,
to learn things faster.
But if you're influenced too much by the experiences you have,
you run into this chain reaction
where the brain becomes progressively noisy,
rather than progressively better structured.
The benefits of TMS vary greatly between participants,
but it's already shown some extraordinary results.
One of Dr. Pascual-Leone's first participants was John Robison,
who credits TMS with changing his life.
They were gonna do a half-hour stimulation
and the effects would last about half that long.
And they kept me there another half hour or so
to make I didn't, like, just roll over
and die after the experiment.
And then they let me loose.
And... and I pulled out onto the highway,
and I turned on the music.
I could hear every individual voice,
all the singers and the chorus.
I could hear each instrument.
I could... I could all see them in my mind moving around the stage.
It was like I was transported from the car
right into the concert.
And it was just, uh, just staggering.
And it was just so overwhelming,
it made me cry all the way home.
And I... I wrote the doctors,
I said, "That's some powerful mojo
you guys have in that thing."
After a series of TMS sessions,
Robison, like a number of others,
was able to gain a cognitive perspective
that has greatly broadened his ability
to read and recognize emotions.
Imagine that you are a color-blind person,
and all your life,
you listen to people talk about the beautiful blue sky,
and the pretty red dress,
and the deep green lawn.
And, um, and you saw the world in different shades of gray,
and you... you looked at that, and you said,
"This is bullshit. They're just baiting me."
And imagine you go into a scientists' lab,
and they do something to you
and they turn on color and you walk out,
and you say, "Holy shit. This is real.
They weren't lying to me.
I see that blue sky,
and I, now, I see the green lawn,
and... and... that must be a... a red dress she has,
and a blue shirt, and a yellow shirt.
And they are beautiful."
And then it fades away.
But you know what, for the rest of your life,
you're gonna know that was real,
and you're gonna always react differently
than the day before it happened.
You'll never go back.
While emerging therapies are already showing results,
many scientists believe that focusing
on the underlying biology of the condition
will lead to the most transformative treatments.
So far, scientists have discovered
hundreds of genes implicated in ASD,
and researchers are tracking their effects
in an unexpected place.
We're headed toward Monkey Island,
which is just right off the mainland of Puerto Rico.
There are over 1500 monkeys that are roaming freely there.
The rhesus monkeys of Cayo Santiago
descend from an original colony
brought over from India for research in 1938.
Today, the world's first wild primate research facility
has become a genetics goldmine
for scientists studying autism.
What we've got here is
a kind of variation in behavior
that would be very difficult to approximate
in any other kind of place.
Dr. Michael Platt is a neuroscientist
at the University of Pennsylvania.
He and his research team study
how the genetic makeup of each macaque
leads to unique behavioral traits.
How do you match genetics to behavior?
Each animal is unique in the genes that they possess.
We are extracting DNA.
We then decode the genome of these animals,
and then, at the same time,
we are doing intensive behavioral observations.
If we can decode those genes, and we can find those monkeys,
we can track, say, the behavior of an animal
who's carrying a certain set of genes
that we think might be implicated
in various disorders like autism.
We can see whether their behavior is
systematically different than other monkeys.
Now, we've identified a few of the monkeys
who possess variance in the number of genes
that the rest of the population does not,
and these monkeys tend to not fit in well in societies.
Behind us, sitting in this tree,
is a female named 42-L.
She tends to live on the outskirts of groups.
She's never really fit in.
Uh, she has a daughter
who has also had difficulty fitting into groups.
And the two of them both share
a variance in a number of genes
that we don't see in the rest of the population,
and these genes have been implicated
in studies of autism in people.
Ultimately, to really test it experimentally,
you would have to manipulate that gene
and demonstrate that you had
an effect on behavior...
- Mmm. - ... down the line.
But now, there are efforts
to use very, you know, cutting-edge
techniques to actually genetically alter these animals.
Scientists have been modifying genes for some time now.
But the technology took a giant leap forward
with the advent of CRISPR,
which allows them to actually cut and paste genetic information
with pinpoint accuracy.
At MIT, Dr. Guoping Feng
is studying one of the more common genes
Shank3.
Shank3 is a very important gene
for developing neuron-neuron connections.
If neuron do not connect properly,
the brain cannot function normally.
Clinical scientists discovered that deletion of this gene
is linked directly to Autism Spectrum Disorders.
In what ways are you using CRISPR technology today?
CRISPR allows you to do
any kind of genetic mutations.
So, we can put in the human mutation
into that animal model to mimic the human condition.
If you put two mice together, normal mice,
they will immediately find each other...
sniffing, cuddling.
But if you put two Shank3 mutant mice together,
when they're getting close to each other,
they will suddenly separate.
If we put a toy into their cages,
normal mice, then they will go play with it.
They even will get on top of it.
Mutant mice, they were suddenly startled.
They never will touch it.
They have a very hyper-sensitivity
of their whisker system, which is their...
one of their primary sensory organs.
Dr. Feng observes
how the mice's outward behavior changes
and how the gene affects the brain at the cellular level.
But he has goals beyond understanding
the mechanisms that cause autism.
How will this translate to creating treatments for humans?
You can imagine people are very excited
about using CRISPR to correct the mutations.
If we know the mutation,
now you supply a normal copy of DNA template,
then that normal copy will go in
and replace the mutant.
Now, you correct the mutation.
Basically, you permanently corrected the problem.
That's called a cure.
So, in our lifetimes, will a child with autism
be able to walk into the hospital
for gene therapy,
and walk out without autistic behaviors?
For some of them, I... I believe this is totally possible.
For many families, a cure for autism
is their greatest hope.
But a growing number of advocates,
within the autistic community, think differently.
Autistic rights are human rights!
These voices call upon the scientific community
to recognize neurological differences
as part of natural human diversity,
not as medical afflictions that must be eradicated.
In 2010,
NIH spent about $217 million on autism research.
Of that, only one and a half percent
went towards research on autistic adults and our needs.
I believe this is a civil rights issue,
and I believe that the United States of America
can guarantee the civil rights of all of its citizens.
One of those self-advocates is John Robison.
Long before his autism diagnosis
and TMS treatment,
Robison had a successful career as an audio engineer.
I got to working for, uh...
Pink Floyd's sound company, Britannia Row.
And, um, this is one of the bass amps from our system.
It's still got the old markings.
Pink Floyd Mark III amplifier.
Rock and roll relics now, anyway.
This was, uh, this was me with KISS.
♪ I wanna rock and roll all night ♪
So I built a bunch of stuff
for the 1980 KISS tour.
Really, every guitar in those years
that shot fire, shot rockets,
blew up, if it... if it did something wild,
we kinda made it.
Sometimes people look at me, and they think,
"Oh, well, Robison, he's just a natural-born
electronic genius or something"
but that's not true.
What happened was,
I was rejected by people,
and I was, I felt, accepted by electronics.
And... and I dropped out of school,
and I spent 10, 12, 15 hours a day studying electronics,
and by the time I was 18 years old,
that was, you know, thousands and thousands of hours.
So, the autism was the thing that really hurt me as a boy,
but it also gave me my freedom.
Now Robison owns an auto repair shop
for luxury cars,
which he uses to run a mechanics school
for students with developmental disabilities.
All this leather paneling and woodwork and all?
All this is gonna come out.
We're gonna put racing seats in.
It's gonna be completely gutted and bare.
It's gonna be a race car inside.
And while he credits TMS
for giving him the social skills necessary
to be a public advocate for the autistic community,
he lectures about the benefits of neuro diversity.
What is neuro diversity?
Neuro diversity is the recognition
that there is a range of neurological difference
that is a part of humanity.
We could take any other population.
We could take the Jewish population,
the Native American population,
the white male population,
and within that group,
we could find some people
who are really intellectually challenged,
and some people who are brilliant geniuses,
and most people who are somewhere between.
And autistic people are the same.
We have some significant challenges,
but we have some significant gifts,
and it's time to move beyond the model
of autistic people as broken normals
and recognize us as what we are.
Thanks to this community activity,
we have scientists coming out of the closet.
For us, this is like gay rights in the '60s and '70s.
We now have scientists that stand up and say,
"I'm autistic and I'm proud of it.
And I'm gonna help autistic people
because of my difference.
Not in spite of it, but because of it."
What advocates like Robison are asking for,
is not to wipe autism off the map,
but to focus on developing solutions
for patients' day-to-day needs.
Where do you hope autism research goes from here?
We need to shift towards delivering benefit to us today.
And it's great to think that we can head off
really profound disability at some far future date,
but we have the ability to solve problems right now
if we deploy the resources to do it.
And that's what I push scientists to do.
There are people with autism
who can speak for themselves,
and say what would improve their lives,
and I think we need to listen to that.
And I think we need to think about ways to help.
At the same time, I work with a lot of people who can't say that,
who can't speak up for themselves
and say what they would like.
What we have to do then is to listen to their families,
and also, imagine ourselves in their shoes
and what would improve their lives.
Ultimately that, at this point, means
research based in biology,
trying to understand what's happening that leads to autism risk,
what we can do to lead to better outcomes,
not just for people who are able to speak for themselves.
Ten years ago, we have no clue what causes autism,
now we have many genes to work on.
My feeling is that in the next 10 to 15 years,
we will have some much better treatment...
for the drug treatment, for can cure some of the symptoms.
It's a still long way,
but I think the progress is actually incredible.
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