Transcranial Direct Current Stimulation in Children With Autism

Children with ASD experience a wide range of outcomes, and not all children respond effectively to behavioral interventions. This study uses a novel biologic intervention that combines electrical brain stimulation with ABA treatment to target some of the cognitive deficits in ASD that until now have been relatively refractory to treatment.

There is accumulating evidence of tDCS being effective in treating the comorbidities as well as the core symptoms of ASD. tDCS is most effective when used simultaneously with an active intervention. In this study, the effects of tDCS alone and in combination with ABA on the executive functioning skills and the core symptoms of ASD will be examined and monitored using an objective neurophysiological test (EEG).

This is a double-blind, sham-controlled crossover study involving 20 participants. tDCS will be administered while ABA therapy is being implemented. Programs aimed at language and other cognitive functions will be emphasized. tDCS will be applied bi-frontally with the anode at F3 and the cathode at F4. Forty stimulation sessions will be done (20 active, 20 sham) lasting 20 minutes per session, at 1 milliampere.

Inclusion criteria

• Males and females between 5 and 12 years with autism
• Enrolled in an ABA program (school or in-home) supervised by a Board Certified Behavior Analyst (BCBA)
• Stable medical and behavioral treatments for at least 4 weeks prior to, and during the study
• Able to tolerate wearing tDCS as determined during a week-long daily desensitization training.

Exclusion criteria

• Any implanted metal device (heart pacemaker, cochlear implant, surgical clips, etc.)
• Severe neurological disorders such as TBI, brain tumor, intracranial infection
• Seizure disorder with a seizure within the last two years
• Skull defect
• Peripheral blindness or deafness
• Medication that might affect tDCS: There have been a few studies concerning the effect of various medications on tDCS. Some may block and others may enhance the effects depending on many factors. The assay used to test these medications was its effect on the motor cortex after stimulation and this may not apply to our montages, however, in order to minimize the chances of having medication affect our results, participants taking the following medications will be excluded:

• Na or Ca channel blockers which will include all anti-seizure medications
• Medications that affect the NMDA receptors including dextromethorphan, cycloserine
• Serotonin reuptake inhibitors
• Dopamine stimulating or blocking medications including pergolide, bromocriptine and all antipsychotic medications
• Norepinephrine stimulating or blocking agents including propranolol and the stimulants
• Drugs that can lower seizure threshold [imipramine, amitriptyline, doxepin, nortriptyline, maprotiline, chlorpromazine, clozapine, foscarnet, ganciclovir, ritonavir, amphetamines, phencyclidine, ketamine, gamma-hydroxybutyrate (GHB), alcohol, theophylline]
• Barbiturates, benzodiazepines, meprobamate, chloral hydrate in the past 4 weeks
• Acute skin disease
• History of magnetic or electrical stimulation