NIH Funds New Program to Investigate Causes and Treatment of Autism
• Science Update
The National Institutes of Health will intensify its efforts to find the causes of autism and identify new treatments for the disorder, through a new research program.
The Autism Centers of Excellence (ACE) program represents a consolidation of two existing programs, the Studies to Advance Autism Research and Treatment (STAART) and Collaborative Programs of Excellence in Autism (CPEA) programs into a single research effort.
"The consolidation was needed to capitalize on the gains made by the NIH research effort in autism," said Elias Zerhouni, M.D., Director of the National Institutes of Health. NIH autism program officials hope to expand on earlier discoveries made by research previously supported by the NIH.
The NIH Institutes providing funding and expertise for the effort are the National Institute of Child Health and Human Development, the National Institute of Deafness and other Communication Disorders, the National Institute of Environmental Health Sciences, the National Institute of Mental Health and the National Institute of Neurological Disorders and Stroke.
Autism is a complex brain disorder involving communication and social difficulties as well as repetitive behavior or narrow interests. Autism is often grouped with similar disorders, all of which may be referred to collectively as autism spectrum disorders (ASD). The underlying causes of ASD are unclear. Currently, there is no cure for the disorders and treatments are limited.
The ACE program will encompass research centers and research networks. The research centers will foster collaborations between teams of specialists, who share the same facility so that they can address a particular research problem in depth. For example, specialists in brain imaging might collaborate with behavior researchers to determine if a particular behavior is associated with a difference in brain structure. They might also consult with a team of genetics experts to find a hereditary basis for their observations.
ACE networks consist of researchers at many facilities in locations throughout the country, all of whom work together on a single research question. Because networks encompass multiple sites, they can recruit large numbers of participants with a particular disorder.
Initially, five centers and two networks received funding in 2007 to study ASD. Funding for a second set of ACE research programs will be announced in 2008.
All ACE award recipients will contribute their data to the National Database for Autism Research (NDAR). Housed at NIH, NDAR is a Web-based tool that autism researchers around the world can use to collect and share information on autism.
The 2007 ACE program Center award recipients are:
— Edwin H. Cook (University of Illinois at Chicago): Researchers at the University of Illinois at Chicago ACE Center will focus on understanding the repetitive behavior seen in ASD. Known as "insistence on sameness," this behavior is a hallmark of ASD. Examples of insistence on sameness include wanting to wear the same clothes every day, taking the same route to work or school, or becoming fixated on certain subject matter, such as buildings or cars. Center researchers will focus on genetic factors as well as brain chemicals and brain functions that could account for repetitive behaviors in people with ASD, and test whether genetic differences influence how individuals respond to certain medications intended to reduce the occurrence of these behaviors.
— Eric Courchesne (University of California, San Diego): Researchers at the UCSD ACE Center also will use brain imaging to track brain development in children believed to be at risk for autism spectrum disorders. Unlike other ACE program projects, which will attempt to identify forerunners of ASD in the siblings of children with ASD, the UCSD researchers will study infants who have been referred by their physicians. The physicians will make the referrals on the basis of a checklist of behaviors that are similar to those of older children with ASD. The primary goal of this center is to identify brain or other physical differences that might predispose a child to autism. The UCSD Center will collect some of the first information ever obtained on how the brains of very young children with autism process and respond to information.
— Geraldine Dawson (University of Washington). Researchers at the University of Washington ACE Center will seek to identify genes and other potential factors that may predispose an individual toward ASD, as well as factors that might protect against them. In addition to genes, the researchers will try to determine the risk of ASD by examining communication difficulties, early behaviors, patterns in the sounds babies make, and brain structure and activity patterns. Researchers will also try to determine whether certain types of interactions between the parent and baby can decrease the chances for ASD.
— Nancy J. Minshew (University of Pittsburgh): Researchers at the University of Pittsburgh ACE Center will study how people with ASD learn and understand information. Research shows that the ability to organize information into categories is critical to language development. The Pittsburgh researchers will use brain imaging techniques to study how infants at risk for autism and toddlers diagnosed with the disorder place information into categories. Researchers will also use brain imaging techniques to study which parts of the brain are activated in people with and without ASD when processing information and emotions.
— Marian D. Sigman (University of California, Los Angeles): Researchers at the UCLA ACE Center will seek to understand how ASD affects the ability to communicate. The researchers will try to find clues to language-related communications problems by looking at genes, behavior and brain structure and functioning. The researchers also are interested in disorders that affect the mirror neurons. Mirror neurons are brain cells that become active either when a person performs an action or watches the action performed by someone else. When many patients with ASD are asked to imitate behaviors, images of their brains show that their mirror neurons are less active than those of other people. The researchers will try to stimulate the mirror neurons of people with ASD by having them follow a set of instructions to complete a task.
The 2007 ACE program Network award recipients are:
— Joseph Piven (University of North Carolina at Chapel Hill): In hopes of identifying brain differences in children who develop ASD, researchers at this Network of sites operating under the direction of the University of North Carolina will use brain imaging techniques to compile images of the brains of very young infants. Some of these children may go on to develop ASD. Their brain images will be compared to those of other infants, to identify differences between children who develop autism and those who do not. While previous studies have documented the enlarged brains often seen in ASD patients, little is known about the abnormal processes during early brain development in children with ASD. The research could offer new insights that lead to earlier diagnosis of ASD.
— Sally Rogers (University of California, Davis): To address the need for controlled studies of treatments for autism in very young children, researchers at this Network of sites operating under the direction of UC Davis will compare an intensive behavioral intervention to standard community-based treatment in 18-24-month-old children with autism. This work builds on previous research by Rogers and colleagues, which, in early studies, suggests that the intensive early treatment provides better outcomes than standard community-based treatment. This new research will examine factors that can inform efforts to provide the best treatment outcomes for very young children with autism.