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Illuminating Motor and Language Capacities in Minimally Speaking Autistic Individuals with Wearable Imaging

Award Number: R56DC023878
ORGANIZATION: NATIONAL INSTITUTE ON DEAFNESS AND OTHER COMMUNICATION DISORDERS
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 09/17/2026
PERIOD OF PERFORMANCE END DATE: 08/31/2027

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Illuminating Motor and Language Capacities in Minimally Speaking Autistic Individuals with Wearable Imaging - The primary goal of this project is to use high-fidelity functional neuroimaging to understand the brain basis for disrupted motor and language functioning in autistic individuals who are minimally speaking (MS-AUT). Autism affects roughly 1/31 individuals and roughly one-third of autistic individuals are minimally speaking — they do not primarily communicate using spoken language — yet there is little research of their brain physiology, leaving major gaps in understanding how to provide targeted interventions that would improve their quality of life, empower their contributions to society, and lower the significant cost of care. This scientific gap is particularly profound for understanding the underlying brain function, as existing systems (e.g., functional MRI - fMRI) are extremely challenging for MS-AUT individuals, as well as for many speaking people with autism (“S-AUT”). Our proposal addresses this major gap, leveraging recent innovations in wearable high-density diffuse optical tomography (HD-DOT), which enables mapping of cortical activation with spatial resolution comparable to fMRI yet in a more comfortable and naturalistic setting that is well-tolerated by MS-AUT and supports motor movements that are not possible with the MRI bore. Given the extreme challenge with reliable clinical assessment of MS-AUT, brain imaging could provide novel information that will be revolutionary for these individuals: the severe challenges with speaking in MS-AUT may not reflect limited intellect or comprehension, but rather a profound disconnect between cognitive and motor abilities. Indeed, some MS individuals who employ alternative forms of communication have described being “locked in” - trapped in bodies that do not obey their intentions. Sensorimotor difficulties are a common feature of autism, with a large literature revealing motor planning and coordination deficits consistent with dyspraxia. It follows that for some with MS-AUT, this dyspraxia may be so profound that it derails both spoken (oromotor) and nonverbal (limb-motor) communication. In these cases, identifying the brain basis of speech deficits could be essential to developing alternative communication strategies tailored to individual motor and cognitive profiles. We therefore propose to use wearable HD-DOT to assess neural representations of oromotor (Aim 1) and limb-motor (Aim 2) function in MS-AUT young adults and matched control groups of S-AUT and neurotypical (NT) young adults. Additionally, we propose (Aim 3) to explore use of HD-DOT to better assess language processing in MS-AUT, which might otherwise be underestimated with existing clinical tests. In close collaboration with stakeholder partners, our multi-disciplinary team has designed and successfully piloted an imaging protocol with wearable HD-DOT that addresses all three Aims with motor and language tasks that are well-tolerated by MS-AUT and have established preliminary feasibility with data that support our hypotheses. We are now well-positioned to pursue this first-of-its-kind brain imaging study of MS-AUT, which could have a profound impact on how we understand limitations and capacties in MS-AUT and provide a crucial foundation for targeted interventions to help improve their lives.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $668,561 )
2026	2026	HUGO W. MOSER RESEARCH INSTITUTE AT KENNEDY KRIEGER, INC.	707 N BROADWAY	BALTIMORE	MD	21205	BALTIMORE CITY	USA	Research Related to Deafness and Communication Disorders	000	1	9/17/2026	NEW	$668,561
														Subtotal = $668,561

Grand Total All Awards = $668,561

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Illuminating Motor and Language Capacities in Minimally Speaking Autistic Individuals with Wearable Imaging

Award Number: R56DC023878

ORGANIZATION: NATIONAL INSTITUTE ON DEAFNESS AND OTHER COMMUNICATION DISORDERS

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 09/17/2026

PERIOD OF PERFORMANCE END DATE: 08/31/2027

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