Center for Autism & Developmental

Disabilities Epidemiology

Research in pursuit of answers about autism

Michelle Landrum

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What I want to share with you today:

• What are Autism Spectrum Disorders?

• How common are ASDs? What are the signs?

• What causes ASDs?

• EARLI: A research study for pregnant moms, looking for risk factors

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What are Autism Spectrum Disorders (ASD)?

Referred to as “autism spectrum,” to reflect the variability.

Wide range in symptoms, behavior, ability

Classic autism

Pervasive Developmental

Disorder –NOS

Asperger

syndrome

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How common are ASDs? May 9, 2011

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What are the signs?

• Sensitive to noise, tactile sensation

• Easily overwhelmed• Talked early but

oddly• Rigid play. Toys lined

up, focus on parts • ‘Selective hearing’• Lost among other

children • Misunderstood

other kids’ intentions

Late motor milestones. Didn’t walk alone until 19 months

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Other ‘red flags’ …

• Difficulty with transitions

• Frequent “meltdowns”

• Fixation on odd things

• May be particularly knowledgeable about one topic – ‘little professor’

•Repeating TV episodes – ‘echolalia’ or ‘scripting’

My nephew, who also has ASD,was fixated on doors, Sharpie markers, Interstates.

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What do we know about causes?

• Many factors are at play: Higher incidence is seen among males, in multiple births, babies who have gestational or birth problems, mothers who take certain uncommon pharmaceuticals.

• Host of other factors being examined: proximity to highways, parental age, fever/virus during certain windows of pregnancy

• Genetics play a role, but they don’t tell the whole story.

• Link to vaccines is unproven. British study was discredited as fraudulent.

But because some parents notice problems around the time of vaccines, it remains a controversial topic.

In rare sets of identical twins, one has ASD, one does not. They are genetically identical and share the same uterine environment, so what could the cause be?

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Current thinking in autism research

Biologically: Epigenetics: Could there be an interaction between genetics and environment (ie. maternal immune status, diet, chemicals, stress) that creates a tipping point for some children?

Behaviorally: How early can we spot signs of ASD and other developmental delays? How does that differ among children overall – as well as among the very different presentations of children with ASD

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EARLI’s importance

• National, longitudinal effort. Prospective, to reduce bias.

• Babies followed from fetal life until age 3, with biological sampling and data on health and environmental exposures

• New babies receive 3 years of free autism assessments by Kennedy Krieger researchers. Results shared with families, giving them chance to seek early intervention elsewhere.

• Families compensated about $600. EARLI staff tries to minimize burden.

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An overview of the EARLI study

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EARLI autism pregnancy study

Who is eligible for EARLI?• Mothers who already have

a biological child with Autism Spectrum Disorder

• Are no more than 28 weeks pregnant -- or may become pregnant in the next several years

• Live within 2 hours

of Baltimore City.

www.earlistudy.org

Study is funded by National Institutes of Health, with supplement from Autism Speaks

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Questions?

Thank you!