Category Archives: Educational

EEG Sessions: EEG Journal Club – Cui, et. al. 2016

EEG Sessions presents ‘EEG Journal Club’, where members of the Bernier Lab’s EEG team read and discuss an article of interest and share their thoughts on our blog.  This month, the EEG team discussed the following article:

Cui, T., Want, P. P., Liu, S., & Zhang, Xin. (2016). P300 amplitude and latency in autism spectrum disorder: a meta-analysis. European Child and Adolescent Psychiatry, 2016, 1-14. doi: 10.1007/s00787-016-0880-z

The Bernier Lab EEG Journal Club recently discussed a research article in which Tingkai Cui and colleagues (2016) performed a meta-analysis on existing event-related potential (ERP) research. A meta-analysis aggregates data from previously published papers to produce robust results for a particular research question or topic. This paper integrated work from 32 studies targeted the P300 component, including data from 407 ASD and 457 neurotypical participants. Participants were presented with frequent auditory stimuli (e.g. a beep), interspersed with infrequent stimuli that differed in tone or pitch. In some experiments, a third, novel sound was included. In some experiments, participants were asked to respond to the infrequent stimuli either motorically (e.g. pressing a button) or mentally (e.g. counting silently). P300 is a neural response occurring around 300 milliseconds after the onset of a novel stimuli. P300 responses can be used to make inferences about attention and decision-making. The P300 component can be further broken down into P3a, which is elicited in the novel tone, no-response conditions, and P3b, which appears when a response to stimuli is requested.

Cui and colleagues conducted a thorough literature review using multiple library databases, selecting studies that met a specific criteria. Inclusion required that studies had both ASD and typically functioning participants and used an ERP technique to report P300 amplitude and/or latency. Cui, et al. calculated and used a standard mean difference to compare the ASD group against the typically functioning group. Cui and colleagues found that participants with ASD had reduced amplitude of the P3b component relative to comparison groups. They found no difference in P3b latency, P3a amplitude, or P3a latency between groups. Reduced amplitude of the P3b among children with ASD suggests that these groups displayed abnormal information processing – but only in tasks where they had to discriminate between and respond to various stimuli. There are a number of ways to interpret the decreased P3b amplitude in the ASD group. For example, perhaps children with ASD have fewer neural resources or perhaps they simply focus their attention on different things. In other words, perhaps  children with ASD focus more on details rather than the ‘bigger picture.’ A reduced P3b amplitude may be a result of how participants in the ASD group allocated their attention.

Journal club reactions…

Brianna: As previously mentioned, one of the hallmark features of autism is its heterogeneity. The children in both ASD and control groups could have varying degrees of abilities. For example, there was no mention of IQ, which could be related to the lack of P3a in ASD groups. Cui pointed out the different paradigms used may yield different P3a components. In future replication studies, it would be wise to select one reliable paradigm that works best and test it on a large sample size. Our journal club was also curious to know if there were any correlations between reaction times and P3b effects. Because some children with autism have motor delay, we wondered if reaction time is the best behavioral measure for this type of experiment.

Caitlin: The P300 component is a very valuable asset for characterizing the attention system in autism for both low- and high-functioning children. I really liked this article because it organized potential reasons why different studies may have variable findings, including whether the experiment activated visual or auditory systems, whether the participant was required make a response, and how often “pop-outs” occur. As a scientist, we spend a lot of time trying to figure out how to build our experiments so that we capture the overall brain process, rather than the brain process only in [a specific scenario]. Although there are not enough similar papers to pick the “best” paradigms (more work to be done!), this paper helped me narrow down possible methods for us to use here in the Bernier lab.

Daisy: The result from this article is concord with past findings that ASD individual usually display an aberrant pattern in P300 component than TD. The main reason I like about article is that it nicely laid out some potential reasons of why results vary from study to study. In consideration of the heterogeneity of ASD symptoms, results vary due to the experiment paradigms they use (e.g. whether it is visual or auditory; whether participants were asked to make a response). P300 component happens rather late in the brain response stage and it usually infers the decision-making process. In the future, I think it will be a valuable information to collect when we work with clinical population in combination of social and behavioral features. A potential question that I am wondering is how P300 serve as an indicator of executive function.

Autism 210: Benefits and Mindfulness

October 20, 2016, the Autism 200 Series presents will host it’s next class, “Autism 210: Benefits of Mindfulness.”

Autism 210: Benefits of Mindfulness
October 20, 2016
Instructor: Felice Orlich, PhD

Mindfulness involves “paying attention in a particular way: on purpose, in the present moment, and non-judgmentally” (Kabat-Zinn, 1994). It is practiced by focusing on the present moment and being aware of one’s feelings, thoughts, and sensations. Mindfulness has been shown to have benefits in reducing stress and improving people’s quality of life. Dr. Felice Orlich will discuss the benefits of mindfulness for children with ASD and their families. Her presentation will include “mindful moment” exercises that are: 1) easy to do, 2) have practical application, and 3) promote self-care.

Classes are open to the general public. There is no need to register in advance to attend. Lectures are held the third Thursday of the month, 7 to 8:30 p.m., at Seattle Children’s Hospital’s main campus in Wright Auditorium. Park free in Lot 1. Enter the hospital through the River entrance, located straight across from the parking garage. Get an entrance badge from the Greeter Desk (bring photo ID).  Lectures are available through Seattle Children’s video and teleconferencing outreach program and can be viewed at various locations throughout Washington, Alaska and Oregon. View Seattle Children’s video teleconferencing site information (PDF). Lectures are also recorded. View past lectures.

How to Navigate the Diagnosis and Treatment of Autism: Tips for Families from Culturally and Linguistically Diverse Backgrounds

How to Navigate the Diagnosis and Treatment of Autism: Tips for Families from Culturally and Linguistically Diverse Backgrounds.

By: Megan Frye, PhD, Licensed Psychologist

multicultureObtaining a diagnosis and treatment for Autism Spectrum Disorder (ASD) can be an overwhelming process. Complications with long waitlists for initial diagnosis particularly in rural areas, confusing policies regarding insurance billing and navigating a multitude of appointments, and difficulties coordinating care between therapeutic and educational settings can create an isolating and confusing experience for many children and families. These issues often add additional stress to the daily ups and downs of caring for an individual with ASD.

The situation is only made more complex for families from culturally and linguistically diverse backgrounds for whom English is a second language. The ability to communicate information about your child, your family culture, and your concerns and hopes as a parent is valuable and important in ensuring you receive the support you need and your child receives the highest quality of care possible. Thankfully, many professionals, legislators and families are working together in efforts to improve the system of diagnosis and treatment.

Below are several tips that linguistically diverse families may find helpful in navigating the process of diagnosis and treatment for autism:

1.Ask for an interpreter. It is your legal right to access care in your first language for free. You may request a provider that speaks your language. If one is unavailable the services of an interpreter can be provided to help you communicate with your child’s care team. All major hospitals provide these services. For assistance with making appointments at Seattle Children’s Hospital call: 1-866-583-1527. Mention your first language, your child’s name, the provider with whom you’d like to speak.

2.Confirm what your insurance will and will not cover. Visits with a psychologist, psychiatrist, mental health therapist or behavioral consultant are usually billed as mental health services. Some insurance companies cover mental health services the same as medical services, others do not. Important questions to ask your insurance company include:

  • How many mental health visits are allowed per year?
  • Can my child see any provider or do I have to choose from a list?
  • Are there any diagnoses that are not covered?

3.Share about your family and culture. Communicate your family’s beliefs and cultural understanding of what is happening for your child. Share what you believe are your child’s strengths and challenges. Remember, you know your child better than anyone else.

4.Ask for clarification. If you don’t understand what the provider is asking or if you have questions about what they are saying, it’s ok to have the doctor slow down and clarify or give examples.

5.Ask if there are materials and resources available in your first language. Many resources are available in Spanish and other languages and providers will be able to point you in the direction of books and other resources. The Autism Speaks website provides resources in several languages. Resources in Spanish can be found here.

6.Use parent education and support resources. Getting an autism diagnosis and navigating treatment is life-altering. You are not alone. Speaking with other families who may be facing the same challenges and gaining support for yourself is essential in better supporting your child. Ask your provider about connecting you with other families from your language/culture through groups and other supports.

  • More information about Parent-to-Parent support groups in Spanish.
  • The group Padres Unidos is a support group in Spanish for parents who have children with special needs. This group meets the third Friday of every month from 6-8pm at Child Strive 14 E Casino Road, Bldg. A Everett, WA 98208.

7.Request assistance with making scheduling more convenient if possible. Ask your provider if there are appointments available in the early mornings or evenings or if several visits with different providers can happen during one day to limit the need to take several days off of your own work schedule.

8.Prioritize Interventions. Request that your provider help you prioritize interventions and treatments that are the most important first, if your ability to attend multiple weekly appointments is limited.

9.Connect with school. Inquire if there are services that might be provided at your child’s school or in the home setting to limit the need to travel to clinic for services.

10.Encourage provider collaboration. Request that providers communicate directly with each other rather than you having to pass along the message. Encourage community-based providers to connect with your child’s school.

11.Be an active part of your child’s treatment. Ask questions, speak up, advocate. You’re the number one expert on your child. Your involvement and expertise is a key component to their care. They are lucky to have you and they will benefit from having you involved!


¿Cómo enfrentar el diagnóstico y tratamiento del Trastorno del Espectro Autista? Consejos para las familias de diversos orígenes culturales y linguisticos

Por: Megan Frye, PhD, Psicóloga Infantil


La obtención de un diagnóstico y tratamiento para el trastorno del espectro autista (TEA) puede ser un proceso abrumador. Las complicaciones con largas listas de espera para el diagnostico inicial sobre todo en las zonas rurales, confundiendo las políticas con respecto a la facturación del seguro y la navegación por una multitud de citas, y dificultades para coordinar la atención entre los ajustes terapéuticos y educativos pueden crear una experiencia de aislamiento y confucion para muchos niños y familias. Estos problemas suelen anadir tensión adicional a las subidas y bajadas diarias de cuidar a una persona con TEA. La situación solo se hace mas compleja para las familias de diversos orígenes culturales y linguisticos para quienes el ingles es un segundo idioma. La capacidad de comunicar información sobre su hijo, su cultura familiar, y sus preocupaciones y esperanzas como padres es valiosa e importante para garantizar que reciba el apoyo que necesita su hijo y su que reciba la mas alta calidad de atención posible. Agradecidamente, muchos profesionales, legisladores y familias trabajan juntos en los esfuerzos para mejorar el sistema de diagnóstico y tratamiento.

A continuación se presentan algunos consejos que las familias de habla hispana pueden encontrar útiles en la navegación del proceso de diagnostico y tratamiento de TEA.

1.Solicite un intérprete. Es su derecho legal para acceder a la atención en su primer idioma de forma gratuita. Usted puede solicitar un proveedor de habla española. Si uno no está disponible los servicios de un intérprete se pueden proporcionar para ayudarle a comunicarse con el equipo de atención de su hijo en español. Todos los grandes hospitales ofrecen estos servicios. Para obtener ayuda con hacer citas en el Hospital de Niños de Seattle (Seattle Children’s Hospital): Llame Nuestra línea gratis de Interpretación Telefónica 1866-583-1527. Menciónele al interprete el nombre de la persona o departamento que necesita.

2.Confirmar lo que debe y no debe cubrir su seguro. Visitas con un psicólogo, psiquiatra, terapeuta de salud mental o consultor de comportamiento suelen ser facturados como servicios de salud mental. Algunas compañías de seguros cubren los servicios de salud mental lo mismo que los servicios médicos, otros no lo hacen. Las preguntas importantes para hacerle a su compañía de seguros incluyen:

  • ¿Cuántas visitas de salud mental se permiten por año?
  • ¿Puede mi hijo ver a cualquier proveedor o tengo que elegir de una lista?
  • ¿Hay algunos diagnósticos que no están cubiertos?

3.Compartir acerca de su familia y la cultura. Comunicar las creencias de su familia y la comprensión cultural de lo que está sucediendo a su hijo. Compartir lo que usted cree son las fortalezas y desafíos de su hijo. Recuerde, usted conoce a su hijo mejor que nadie.

4.Pida una aclaración. Si usted no entiende lo que el proveedor está pidiendo o si tiene preguntas acerca de lo que están diciendo, que está bien tener el médico reduzca la velocidad y aclarar o dar ejemplos.

5.Pregunte si hay materiales y recursos disponibles en su lengua materna. Muchos recursos están disponibles en español y los proveedores serán capaces de señalar en la dirección de los libros y otros recursos. Un recurso útil Sobre el autismo en Español es el sitio de web de ‘Autism Speaks.

6.Utilizar los recursos de educación y apoyo para padres. Conseguir un diagnóstico de autismo y la navegación por el tratamiento altera la vida. Usted no está solo. Hablando con otras familias que pueden estar enfrentando los mismos desafíos y la obtención de apoyo para usted es fundamental para apoyar mejor a su hijo. Pregunte a su proveedor acerca de que la conexión con otras familias de la lengua / cultura a través de grupos y otros soportes.

  • Puede encontrar más información sobre los grupos de apoyo de padre a padre en español accediendo.
  • El grupo de Padres Unidos es un grupo de apoyo en español para los padres que tienen niños con necesidades especiales. Este grupo se reúne el tercer viernes de cada mes de 6-8 pm en Child Strive 14 E Casino Road, Bldg. A Everett, WA 98208.

7.Solicita ayuda con la fabricación de programación más conveniente si es posible. Pregunte a su proveedor si hay citas disponibles por la mañana temprano o por la noche o si varias visitas con diferentes proveedores pueden suceder durante un día para limitar la necesidad de llevar varios días fuera de su propio horario de trabajo.

8.Prioriza Las intervenciones. Solicita que su profesional medico le ayudara a priorizar las intervenciones y tratamientos que podría ser la primera más importante si su capacidad de asistir a varias citas semanales es limitada.

9.Conectar con la escuela. Preguntar si hay servicios que pueden ser proporcionados en la escuela de su hijo o en el hogar para limitar las necesidades de viajar a la clínica para recibir servicios.

10.Fomentar la colaboración proveedor. Solicita que los proveedores se comunican directamente entre ellos en lugar de tener que usted transmita el mensaje.  Formenta a los proveedores basados en la comunidad para conectar con la escuela de su hijo también.

11.Sea una parte activa del tratamiento de su hijo. Hacer preguntas, hablar, defender. Usted es el número uno experto en su hijo. Su implicación y la experiencia es un componente clave para su cuidado. Son muy afortunado de tenerte y que se beneficiarán de tener que participar!

Autism 209: Multicultural Issues and ASD

September 15, 2016, the Autism 200 Series presents will host it’s next class, “Autism 209: Multicultural Issues and Autism Spectrum Disorder.”

Autism 209: Multicultural Issues and Autism Spectrum Disorder
September 15, 2016
Instructors: Robin Tatsuda, MSW, ARC of King County, and Sayaka Omori, MEd, Open Doors for Multi-Cultural Families

Research has indicated that autism impacts individuals equally across cultures. However, families from culturally and linguistically diverse backgrounds often face obstacles to accessing information, support and treatment across systems (e.g., educational, medical, state agencies). Tatsuda and Omori will identify and discuss the structural and cultural barriers for families of linguistically and culturally diverse backgrounds. This includes barriers for the family to access information and services and barriers for professionals to effectively support families. Real family stories and tips/strategies will be integrated throughout the presentation.

Classes are open to the general public. There is no need to register in advance to attend. Lectures are held the third Thursday of the month, 7 to 8:30 p.m., at Seattle Children’s Hospital’s main campus in Wright Auditorium. Park free in Lot 1. Enter the hospital through the River entrance, located straight across from the parking garage. Get an entrance badge from the Greeter Desk (bring photo ID).  Lectures are available through Seattle Children’s video and teleconferencing outreach program and can be viewed at various locations throughout Washington, Alaska and Oregon. View Seattle Children’s video teleconferencing site information (PDF). Lectures are also recorded. View past lectures.

Genes Underlying Autism

The Scientist published a great article this August 1, 2016 about Dr. Raphael Bernier’s and Dr. Evan Eichler’s work on identifying gene mutations associated with Autism, including CHD8.  The article by Megan Scudellari, titled ‘The Genes Underlying Autism Are Coming into Focus,’ addresses the history of the research performed by Raphe and Evan’s labs from 2008 until the present day. The article also highlights the advances of other Autism researchers around the world whose contributions focus on non-genetic factors that contribute to autism.

Follow the link to read the full article!