2017 Gatlinburg Conference Symposium Submission

Overview: Children with autism spectrum disorder (ASD) exhibit pathognomonic deficits in social communication, and 40% of children with ASD also experience clinical levels of anxiety. While evidence-based behavioral treatments can lead to improved social communication skills and reduced anxiety, no singular treatment is universally effective. Advances in the identification of biological markers and neurobiological predictors of treatment response offer the promise of improved, personalized treatment for people living with ASD. Facilitated by Dr. Jennifer Frey, an experienced BCBA-D clinician with expertise in behavioral interventions to improve social communication, and Dr. Kevin Pelphrey, a neuroscientist and expert in brain development and neuroimaging in ASD, this symposium presents developmental neuroimaging findings – both fMRI and EEG of the neural mechanisms and biological markers of treatment response in children and adolescents with ASD. The presenters (all leading experts in their areas of research and clinical work) and discussant will speak about the implications of this work for designing and evaluating treatments, including the use of new technology to enhance treatment effects. The first presentation describes the results of an intervention study using pivotal response treatment (PRT) to improve the social communication skills of young children with ASD. Dr. Pamela Ventola and her team identified changes in neural systems that correlated strongly with improvements in social communication skills following PRT, thereby improving our understanding of the neural mechanisms by which PRT is effective for some children. Even more importantly, this team has discovered neuroimaging-based, biologically informed stratification biomarkers that predict the magnitude of response to PRT. The second presentation, by developmental scientist, Dr. Michael Crowley, describes findings from parallel EEG studies to identify practicable pre-existing biomarkers in the timing of brain activity to predict which children will benefit most from PRT. In the third presentation, a clinical psychologist, Dr. Denis Sukhodolsky, will present fMRI data collected before and after implementation of cognitive behavioral therapy (CBT) in a randomized, controlled trial. This talk will illustrate the neural mechanisms of successful response to CBT for anxiety in adolescents with ASD and identify ways in which CBT can be adapted to more precisely address individual neural profiles. Armed with a mechanistic understanding of the neural circuits that predict and reflect treatment success for core symptoms in ASD (PRT) and associated anxiety (CBT), our final presentation, by biomedical engineer, Dr. Chung-Hyuk Park, will illustrate the use of social robots to “prime” neuropredictive circuits in children with ASD, thereby enhancing the effectiveness of existing evidencebased treatments.