Horse therapy offers new path for autism research

By Edward Ortiz Sacramento Bee

SACRAMENTO, Calif. – On a thoroughbred ranch in Vacaville, a 3-week-old foal gallops close to its mother. Their bond seems natural, but it didn't start out that way.

When the foal was born, it completely ignored its mother.

University of California, Davis veterinary specialist John Madigan intervened moments after the birth with a novel treatment he calls "the squeeze." It's attracting attention from researchers studying autism in children, who see a possible parallel between Madigan's work with horses and a similar technique — called kangaroo care — that's often used on pre-term infants.

"The phenomenon that Madigan has observed in foals is interesting and dramatic," said David Stevenson, professor of pediatrics at Stanford University.

Over the past five years, a dozen foals at Victory Rose Thoroughbreds in Vacaville have been born with neonatal maladjustment syndrome, or NMS, in which they are emotionally detached from their mothers. In each case, horse farm owner Ellen Jackson called Madigan, a UCD veterinary professor.

First identified in the 1950s, neonatal maladjustment syndrome affects roughly 5 percent of newborn horses.

To counteract the condition, Madigan ties a soft rope harness around the foal's body and gently squeezes it to increase pressure. The squeeze causes the foal to drop over and go to sleep.

After several minutes, the pressure is released and the foal awakens. Madigan said that in all cases where he has intervened with a foal with NMS, the foal has shed its detached behavior and run to its mother to interact and feed. "We've had a dramatic improvement in 12 foals," he said.

The technique is part of body of research that Madigan and others at UC Davis are pursuing to see if there's a connection between high levels of neurosteroids in the blood and the later development of autism. Madigan said the foals born with NMS he has studied had high levels of neurosteroids in their blood, whereas foals that readily interacted with their mothers had normal neurosteroid levels.

Neurosteroids are brain steroids that can cross the blood-brain barrier and dampen the central nervous system. Further study into their effect at certain birth stages may offer a clue as to why some infants later develop detached behavior or symptoms associated with Autism Spectral Disorder, or ASD, Madigan said.

"The behavioral abnormalities in these foals seem to resemble some of the symptoms in children with autism," Madigan said.

Madigan said he believes that if a foal passes too rapidly through the birth canal or is delivered via cesarean section, it loses the pressure on its body that signals the body to drop neurosteroid levels. He sees a potential parallel in human infants. Three studies conducted in the past two years suggest that pre-term babies are at higher risk for developing autism. One Finnish study found that babies weighing less than 3 pounds were three times as likely to develop ASD compared with normal-weight babies.

As in horses, neurosteroids are emerging as a potential culprit in human autism. A 2013 study by Polish scientists found that autistic children tested at ages 3 and 9 had higher salivary concentrations of a group of steroid hormones than control children.

The success of Madigan's squeeze technique has prompted him and other researchers to begin studying whether kangaroo care — a common treatment to improve the health of premature infants in which a parent or caregiver places a mostly naked baby on their chest, skin to skin — could also help prevent disorders on the autism spectrum.

Stanford University's Stevenson has joined Madigan in applying to the Bill and Melinda Gates Foundation for a $100,000 grant to fund research on kangaroo care and neurosteroids. The question is whether infants who receive kangaroo care will experience a drop in steroid levels.