Highlights from Day One: Thursday, May 15, 2008
Scientists from around the world are in London for the annual International Meeting for Autism Research (IMFAR) sharing their latest research information. The goal of those in attendance is to help individuals around the world living with autism, and their families, have a better quality of care and life.
Themes of the first day's sessions included multiple new intervention approaches, epidemiological studies searching for risk factors during pregnancy, improved diagnostic abilities, and a focus on development of potential blood biomarkers.
Thursday, May 15
The 2008 IMFAR was kicked off on Thursday morning when Francesca Happé, Ph.D., a neuroscientist who has conducted years of clinical autism research, gave the first keynote address. Dr. Happé proposed that the three core diagnostic symptoms of autism – abnormal social behavior; communication difficulties; and restricted, repetitive behaviors and interest (RRBI) – are actually separable traits arising from different biological causes and neural mechanisms. Her work studying large sets of twins with autism has found that while all three domains are quite heritable, each of them can occur independently of the others. "Autism represents an extreme of individual behaviors that are present even in unaffected family members. Although the diagnostic triad of symptoms has a tendency to present together, each aspect of the triad can occur alone," concluded Dr. Happé.
As children with autism enter adolescence the challenges of social interaction increase significantly, leading many children with this disorder to develop low self-esteem and depression. A team of researchers from UCLA, led by Dr. Elizabeth Laugeson, presented a "friendship training" model, which was adapted from a program originally developed for typical children facing social challenges. This new intervention for 13-17 year olds with autism targets conversational skills, social networks, sportsmanship, teasing and arguing. The researchers concluded that social abilities significantly improved after the interventions. There were more reported get-togethers with friends, more meaningful relationships, and parents reported less conflict than prior to the intervention. The researchers have "manualized" the program which will allow it to be more easily replicated in other locations.
Developing treatments for autism will require an in-depth understanding of the cognitive abilities of individuals with autism. Unfortunately standard testing to collect the necessary data is often quite long and challenging, and important information can be lost because children with autism get bored and may become unwilling to participate. Researchers at Cornell explained how they have turned to developing innovative computer games that can more effectively engage the children while at the same time collecting a multitude of data about their cognitive processing abilities. Designer of the games, Matthew Belmonte, Ph.D., feels that the same games will be effective to teach the children the skills they are missing "If we can use video games to research cognitive skills in autism spectrum conditions, we can also use that same method to train those skills," said Dr. Belmonte. "Essentially, it is building on what people with ASD are already interested in instead of demanding that they learn on our terms."
Another computer intervention was presented by researchers at Yale University, who hope to teach facial recognition skills using a game in which children practice matching expressions and emotions. The data suggests it is effective at improving face processing.
Identification of prenatal risk factors
Another set of oral presentations focused on projects that employed epidemiological methods to investigate the role of environmental and/or genetic risk factors in the etiology of autism. Presentations addressed a number of potential risk factors including pre- and peri-natal exposure to hormones and household pesticides, as well as to obstetrical practices such as ultrasound and labor induction/augmentation. Among the most notable findings were results from a case-control study investigating the role of household pesticide use in relation to autism, in which Irva Hertz-Picciotto, Ph.D. reported that mothers of ASD children were twice as likely to report using pyretherin-containing pet flea/tick shampoos, either prenatally or in early life, as compared with control mothers. Interestingly, while pyretherin is used in insecticides to compromise the insect central nervous system, lab tests have shown that in rodents, pyretherin may compromise blood-brain barrier function, thus implicating a biological basis for its potential role in autism.
In another report, Judith Grether, Ph.D. used detailed data from California's Kaiser medical system to show that exposure to ultrasound during pregnancy did not increase a child's risk of developing autism, easing previous worries that fetal exposure to ultrasound may be associated with autism incidence.
Yet another prenatal environmental factor receiving increased attention is maternal immune activation. An educational symposia highlighted immunology in autism and how potentially relevant immunological findings may alter brain development. Among the topics discussed were detailed studies of a mouse model of maternal immune activation created by Paul Patterson, Ph.D., which has allowed identification of a single immune signaling molecule that may trigger behavioral abnormalities in exposed offspring.
Improving Autism Diagnosis
Recent studies suggest that, in most cases, autism symptoms emerge during the second half of the first year of life. To date, however, autism diagnostic tools have not been validated for children below 2 years of age. Dr. Catherine Lord presented a modified ADOS (Autism Diagnostic Observation Schedule) for toddlers. ADOS-T is a valid observational and interview method that will allow clinicians to identify 12-month-old babies who are at risk for autism. By detecting autism at a very young age, it is hoped that autism symptoms can be reduced, resulting in more positive outcomes.
Besides such improved behavioral diagnostic tools, several research groups presented preliminary studies aimed at developing biological markers to help autism diagnoses. Researchers from UC Davis and the MIND Institute, led by Frank Sharp, Ph.D, used peripheral blood cells to profile gene expression, finding that expression of genes associated with a specific type of immune cell may be different in individuals with autism. Other blood gene expression profiling studies by researchers at George Washington University, Valeria Hu, Ph.D, found patterns of disrupted gene expression that clustered in individuals with similar phenotypic presentations. Although extremely preliminary, these studies hold the promise that biological tests to diagnose autism, and potentially even autism subtypes, may become possible.
Presentations at IMFAR may represent unpublished and preliminary data and do not necessarily reflect the position of Autism Speaks or INSAR.
View a recap of day three, Saturday, May 17 here.
View the full press release for IMFAR 2008 here.