The Autism Intervention Research Network on Physical Health (AIR-P) Research

December 29, 2014

The Autism Intervention Research Network on Physical Health (AIR-P) conducts research on evidence-based interventions to improve the physical health and well-being of children and adolescents with autism spectrum disorders (ASD) and other developmental disabilities. The network also works to disseminate main findings to parent and professional communities. Network activities include developing evidence-based guidelines and tools; disseminating critical information on network research findings, guidelines developed, and tools to health professionals and the public; and developing and mentoring new investigators in the field of ASD and other developmental disabilities. The AIR-P has been highly productive in all of these areas.

In 2014, with support from AIR-P, network members developed six ASD toolkits on the following topics: sleep in adolescents, pica, vision exams, delivering feedback to families, and feeding behavior. Two evidence-based guidelines on the topics of treating children with irritability and ASD and treating children with anxiety and ASD were also developed. The AIR-P Network published 9 manuscripts in peer-reviewed journals in 2014, adding to the 47 manuscripts published since the inception of the Network. Three additional papers have been submitted and are under review. Many manuscripts are also in process using data from two signature AIR-P research projects, various other AIR-P research projects, as well as from secondary data analysis of the patient registry, built as part of the Autism Speaks Autism Treatment Network (ATN). The main topics of our papers include co-morbidities for children with ASD, more specifically, nutrition and obesity, sleep problems, gastrointestinal concerns, anxiety, and quality of life. Currently, 16 of our 56 published manuscripts had junior faculty or fellows as lead authors, and 11 of our 25 research projects have/had junior faculty serving in the role of site Principal Investigator, demonstrating our progress in developing the next generation of autism researchers.

A key goal of the AIR-P Network is to provide opportunities to develop collaborations and partnerships with clinicians and researchers who are external to the current AIR-P centers. The Network provides a variety of mechanisms to encourage involvement in AIR-P activities and has demonstrated particular interest in supporting junior investigators in developing their research efforts to improve the medical care of children with autism. One of these mechanisms provides support to investigators interested in mining existing Network Registry data. We have developed a Request for Data (RFD), which allows individuals to submit a formal request to obtain summary data from the ATN Registry, which is supported in collaboration with AIR-P. Past analyses by external investigators have led to dissertations and manuscripts by trainees in pediatrics and psychology as well as other junior faculty members at various institutions. Individuals interested in learning more about the registry data should visit www.asatn.org.
AIR-P recently funded three new research projects, some from junior faculty, to conduct secondary analyses utilizing the existing ATN registry data: "Effectiveness of Early Intensive Behavioral Intervention Services for Children with Autism Spectrum Disorders" by Nalin Payakachat, PhD, University of Arkansas for Medical Sciences; "Communication Deficits and the Motor System in ASD: Dissecting Patterns of Association and Dissociation Between Them" by Maria Mody, PhD, Mass General Hospital for Children (MGHfC) Lurie Center for Autism; and "Relationship Between Subtypes of Restricted and Repetitive Behaviors and Sleep Disturbance in Autism Spectrum Disorder" by Rachel Hundley, PhD, Vanderbilt University Medical Center.

Similarly, AIR-P has recently supported three new innovative pilot proposals: "Bone Accrual Rates in Boys with Autism Spectrum Disorder" by Ann Neumeyer, MD, Lurie Center/MGH. This study proposes to re-examine boys with ASD and controls from an earlier AIR-P research study and evaluate changes in the bone mineral density (BMD) over time, and examine volumetric BMD, micro-architecture and strength estimates. "Expanding Capacity of Primary Care to Care for Children with Autism Spectrum Disorder" by Jeanne Van Cleave, MD, MGHfC. This study proposes to develop a system to support primary care clinicians in caring for children with ASDs - to incorporate an evidence-supported toolkit and clinical pathway for identifying and managing associated physical problems. "Improving Hospitalizations for Children with ASD: Testing the Cost and Clinical Efficacy of Integrated Behavioral Intervention" by Kevin Sanders, MD, Vanderbilt University Medical Center. This study proposes to implement and test a specific brief Applied Behavior Analysis model for assessing and responding to severe challenging behavior during acute medical and behavioral hospitalization for children with ASD. All new AIR-P funded research projects are scheduled to be completed no later than August 31, 2015.

As part of our Network research planning, we've actively worked to engage our Family Advisory Committee (FAC) members in various research RFA discussions as sites worked to develop their research proposals. In August 2014, we held a series of three calls - mainly focused on emerging priorities reported by the FAC, including anxiety, sleep, and gastrointestinal issues. This series helped to bridge the gap between our Network researchers and our family partners across the sites. Similarly, as part of our anticipated AIR-P renewal submission in the spring 2015, we will engage our FAC members in the development of the Network's core signature research proposals, under the direction of Karen Kuhlthau, PhD. To do that, Dr. Kuhlthau and the Network Coordinating Center will work with interested members from the FAC to implement strategies for more effectively expanding and improving our model for family partnerships in our Network research program.

This year, AIR-P is coordinating a special supplement to Pediatrics with a timeline for publication in the Fall 2015. Dr. Marji Erickson Warfield, director of the Starr Center on Intellectual and Developmental Disabilities at the Heller School for Social Policy and Management at Brandeis University, and Dr. Lonnie Zwaigenbaum, Associate Professor and Director of Autism Research at University of Alberta, are co-editors for the supplement. The supplement will include: an overview of the AIR-P network, evidence-based guidelines, research studies arising from Registry analyses, reports from AIR-P clinical research studies, and reports from CAAI research grantees including R40s, Healthy Weight Research Network, and DBPNet.
For more information, and a full listing of our published manuscripts, please visit our website: www.airpnetwork.org.