Project Description:
AUTISM RESEARCH
CEDD faculty are currently involved in three autism research studies. Research findings have been presented in 18 professional or community forums this year to date; 1,520 professionals and para-professionals and 86 family members attended. Fifteen journal articles have been published.
> Partners in Autism Intervention Research (PAIRS) Project
The CEDD is providing support for information dissemination to CEDD faculty member Dr. Sally Rogers on her grant entitled ?The Effects of Parents as Therapists on Social ?Communicative Development of Toddlers with Autism: A Community Effectiveness Study.? A user-friendly training package on how to use the Early Start Denver Model (ESDM), a developmentally based comprehensive intervention for very young children with autism, has been developed. The training uses both written and video material and is intended for both professionals and parents. The effectiveness of the interventions was evaluated using a single subject design, and the results have been published (Vismara and Rogers, 2009).
In the first year, eight families received twelve weekly one hour intervention sessions in the form of parent training. Families were recruited from diverse backgrounds (different ethnicities, single income parents and two parent providers) in order to learn how to best meet the needs of culturally and economically diverse families.
This year (the second year), we examined the effectiveness of distance learning procedures to train therapists to deliver ESDM by comparing two local sites, who received all training in person, and two distant sites, which received all training via distance technology. We examined fidelity of implementation before any instruction and after each training phase. We found that all teams learned to deliver the ESDM directly to children at acceptable levels of fidelity, and we did not find site differences based on live versus distant delivery, thus supporting the effectiveness of distance learning procedures to teach this interactive intervention approach.
> Markers of Autism Risk in Babies-Learning Early Signs (MARBLES) Project
The MARBLES Project studies how autism unfolds during its earliest phases, beginning with pregnancy. The goals of the project are to 1) identify early signs of autism, 2) understand the earliest possible causes of autism, and 3) develop diagnostic tests and interventions that can limit the effects of autism or prevent it altogether. The MARBLES Project is the core clinical project of the Center for Children?s Environmental Health, which was launched in 2007 and is funded under grants from the National Institute of Environmental Health Sciences and the U.S. Environmental Protection Agency. Dr. Hansen is the PI for the Community Outreach and Translation Core of the MARBLES Project, and she has leveraged community outreach activities related to environmental contributors to risk for developmental disabilities broadly, including autism. CEDD trainees have contributed to methodologic design; data collection, including home visits; training research staff on evaluations; data analysis; and manuscript preparation.
Since the beginning of MARBLES we have enrolled 136 families, 69 of whom have been enrolled since July 2008. To date, over 375 home visits have been completed. Over 135 telephone interviews have also been completed, and we have had 70 deliveries and obtained specimens from 64 of them. Our oldest babies are now two years old and will be completing their study follow-up in December 2009. This past year we also began immunologic studies in mothers and their offspring.
Plans for the coming year include: Continuing to recruit families into the study, with a goal of having 200 families enrolled by June 2010; and adding urine metabolite variability analyses for a sample of our population.
> Childhood Autism Risks from Genetics and the Environment (CHARGE)
The CHARGE Study, under the clinical leadership of Robin Hansen, MD as a co-Investigator, is a case-control study of over 1,000 children with differing patterns of development. These include children with autism, children with developmental delay but not autism, and typically developing children. Subject groups are compared with regard to a broad array of exposures and physiologic factors. Autism cases are characterized into more homogenous subgroups to determine whether particular genes or environmental exposures are associated with certain subtypes of this condition. The CHARGE Study was launched in 2003 and is funded under a grant from the National Institute of Environmental Health Sciences and the U.S. Environmental Protection Agency. CEDD trainees participate in clinical evaluations, data collection and analysis, manuscript preparation and dissemination of results through conference presentations.
To date, we have enrolled 1117 children and their families. To increase our capacity for engaging monolingual Spanish-speaking families in CHARGE, we applied for and received a supplement for Partnerships in Environmental Public Health to collaborate with community organizations and clinics to identify and train bilingual-bicultural clinicians in neurodevelopmental assessment and pediatric environmental health screening.
Plans for the coming year include: Examination of phenotypic subsets (regressive vs. early onset, high vs. low cognitive functioning) or subgroups defined by immune markers or metabolizing genes in relation to current blood mercury; examination of interactions between mercury and genetic polymorphisms associated with mercury metabolism; multivariate analyses of the concentrations of mercury in newborn blood spots, with adjustment for confounders; and evaluation of pesticides, including pyrethrin and pyrethroid-containing products, in relation to phenotypic subsets and immune subgroups.
Target Audience:
Students/Trainees (long or intermediate trainees), Community Trainees / Short term trainees, Professionals and Para-Professionals, Family Members/Caregivers, Adults with Disabilities, Children/Adolescents with Disabilities/SHCN, Legislators/Policy Makers, General Public
Unserved or Under-served Populations:
Racial or Ethnic Minorities, Disadvantaged Circumstances, Limited English, Geographic Areas, Rural/Remote
