Wednesday, March 14, 2007

Keys to detecting autism - important research areas:

Consider the following statistics from the Autism Society of America about the prevalence of autism in our society:

-Occurs once in 150 births
-Affects 1 to 1.5 million Americans
-During the 1990's U.S. population increase by 13% where cases of autism increased by 172%
-$90 billion annual cost
-90% of costs are in adult services
-Cost of lifelong care can be reduced by 2/3 with early diagnosis and intervention
-In 10 years, the annual cost will be $200-400 billion

I had been working on a ‘autism research list’ sometime back using resources on the internet and have summarized here research areas that require a high degree of innovation (and which bear chances for failure) here. Bear in mind that some of these are of such importance that it would warrant repeated attempts to achieve goals of treating autism effectively.

Over the next 1 - 3 years:
1. Development of biomarkers (e.g. blood tests that produce a gene expression assay of specific marker molecules that could tell us if the individual shows a proclivity to show autistic traits later in her/his life) to provide the biological characterization of autism
2. Develop repeated randomized and controlled studies that document the efficiencies gained out of pharmacological, behavioral and other treatments that target symptoms associated with autism (what works and what does not)

Over the next 4 - 6 years:
1. Studies investigating the benefit of specific treatments and factors that will help explain why certain treatments work for some individuals with autism and not for others.
2. Identification of genes most susceptible to characteristics of autism including the development of animal models of autism (After specific genes are determined that conclusively tell us the individuals susceptibility to autism, researchers can then study the expression of these genes to determine how these genes work at various levels to “turn on” symptoms of autism)
3. Community based studies to identify environmental factors (e.g. viruses, medications, lifestyle factors, environmental chemicals) that contribute to the development of autism and their associated developmental windows identified. This should include studies of the specific mechanisms by which environmental factors work to contribute to specific neurodevelopment difficulties

Long term (7 - 10 years)
1. Development of criteria and methods to improve the number of young children with autism that develop meaningful, functional speech by the time of entry into elementary school.
2. Genetic and non-genetic causes of autism and their interactions identified (genes that increase vulnerability to autism will need to be identified, and environmental factors will need to be determined, along with findings that indicate the increased risk and mechanisms of each of these identified determinants.)
3. Molecular neurobiology and neurochemistry research that will help inform scientists about brain molecules that may be appropriate targets for drug therapies (this will include multi disciplinary research into involving other research areas like targeted drug delivery and disrupted neuron network identification using techniques like diffusion tensor imaging).

Of most importance, if there was some magic bullet by which we could detect signs of impending autism in our children (specifically in the one to three year olds), it would mean a whole lot to compensating for the disabilities that are manifested later in life. This can be very effectively done by taking advantage of the growing brain’s plasticity. It is very well known that neurological insults suffered during very early years can virtually be erased if the insult occurs during early formative years of age one to three. Researchers like David Amaral Ph.D at the U.C. Davis's Medical Investigation of Neurodevelopment Disorders Institute are doing precisely some of these things. Dr. Amaral seems to think that not all individuals who have autism are 'doomed at birth' (as is commonly believed), in fact he believes that certain hidden vulnerabilities (like an abnormal gene) could trigger the disorder due to specific environmental occurrences that the child must have been subjected to earlier.

Read about some of his research here and here and here.


Anonymous said...


Sunflower Optimism said...

Thanks. It was thought that my son had a disorder on the autism spectrum. I'm still not convinced he doesn't - I suspect Asperger's - but he is doing wonderfully so it really doesn't matter.