Determining the Long-Term Impacts of Infant Motor Impairments in Autism

There is a critical need to understand how motor impairments drive development and predict outcomes in autism. Using an infant siblings research design, infants from 6 months of age will be tracked for 2 years to determine how specific motor impairments lead to social deficits that accompany an autism diagnosis. This study will utilize both home video observation and data gathered from activity sensors worn by the infant to examine specific motor abilities that are linked to later social skills in toddlers. The results of this study may identify potential areas of early intervention to improve developmental outcomes and possibly ameliorate autism symptoms.

There has been a strong push to test new gene therapies in autism, including use of new antisense oligonnucleotide therapy, which targets working copies of genes to increase production of its associated protein. This highly innovative approach could remove a major bottleneck in the development of gene therapies for autism by developing a new way to test genetic therapy targets genome-wide.

Many lines of evidence have shown that brain regions do not communicate well in people with autism, leading to symptoms of ASD.  This can include too much or too little connectivity between brain regions, causing decreased or misdirected connections. Applying a technology new to autism, individual neurons will be labeled with bar codes and then tracked to determine where and how brain cells connect. This novel approach will allow scientists to better understand the nature of connectivity problems in autism, and potentially provide clues to new druggable targets.

The autism genome is comprised of genes that directly regulate protein expression and genes that indirectly regulate activity by turning on or off genes that affect protein expression. The latter genes are described as  “epigenetic” and are influenced by both genetic mutations and environmental factors. What is not known is whether epigenetic mutations affect downstream processes related to autism like altering connections or function of brain cells. This project will use human induced pluripotent stem cells, or iPSCs, with a mutation of a gene called SETD1A that controls epigenetic gene regulation to examine the effects of mutations on gene expression in different types of cells. In addition, this fellow will examine how these mutations affect brain cell shape and functionality. Finally, they will investigate whether these effects are reversible, leading the way to new therapies that can help those with ASD.

Females are less likely to receive an autism diagnosis than males and several studies are examining the biological, psychological, and developmental reasons for this disparity. One theory is that language abilities and patterns in females are superior to males, possibly reflecting better social ability, which may contribute to lower diagnostic rates. This study will look at a measure of language called prosody, or the rhythm, tone and pattern used during spoken language. Studies around prosody in autistic females are lacking, mostly because there are fewer girls with an autism diagnosis who can participate in research on prosody. This fellow will examine prosody in males and females with and without autism, and compare prosody to assessments of social function and interest. These results will inform caregivers, educators, and clinicians when considering a possible autism diagnosis for girls.

Individuals with a mutation in ASH1L exhibit symptoms of profound autism, as well as several medical comorbidities. Building on this fellow’s expertise in pre-clinical models of ASH1L-related autism, the fellow will advance to a natural history study of human patients with this mutation, and their families. In addition, the fellow will collect EEG data from families and identify potential biomarkers of this gene mutation. These are critical steps that enable future drug development and seizure treatment. When the study is complete, the findings have potential to guide development of new drugs to treat symptoms of profound autism, including those with and without an ASH1L mutation.

Executive functioning is the ability to manage daily life, follow directions and handle emotions — and has been reported to be significantly impaired in individuals with ASD. This project will take advantage of an existing longitudinal study to examine the specific role and active ingredients of early intervention from ages 2-4 on executive functioning. The fellow will also examine whether demographic factors, including race and ethnicity, play a role in the effectiveness of the intervention.

The UBE3A gene is thought to be responsible for Dup15q Syndrome, one of the genetically derived autism spectrum disorders (ASD). Despite its clinical importance, we know very little about UBE3A distribution in the human brain. Most researchers assume it closely mirrors that of the rodent brain. This lack of knowledge could be catastrophic if the distribution of UBE3A in the human brain is improperly inferred from rodent studies and leads to inappropriate delivery and treatment strategies for autism. To assure the safe targeting of therapeutic approaches to normalizing UBE3A levels in individuals with Dup15q Syndrome, this fellow will study UBE3A developmental expression in the closest proxy we can get to the human brain – the brain of the rhesus monkey.

Given the historically higher prevalence of white males in autism research studies, many autism diagnostic and outcome instruments have not been specifically validated in people of color or in females. This study will recruit women and individuals from racially and ethnically diverse communities to understand how a measure of treatment outcome, called the BOSCC (Brief Observation of Social Communication Change), can be used more effectively in these communities.

Many autism referrals in low-resource settings originate from community mental health care clinics. Unfortunately, many mental health care providers are not trained in autism interventions and do not have the appropriate resources to provide support to parents or provide parent training for early developmental interventions. This fellow will work directly with ABA agencies that contract with Medicaid to determine how clinicians can better support parents participating in parent- mediated interventions.

Hypersensitivity to auditory stimuli, including even regular sounds and voices, is seen in a high percentage of people with autism. This project will expand on existing research at Vanderbilt looking at brain activity in autistic and non-autistic individuals with different levels of sound tolerance to understand the factors that play a role in the brain’s response to noise.

Early intervention is vital for children on the autism spectrum but is often only available after a formal diagnosis. Because of the COVID- 19 pandemic, many assessments are now conducted online. This change has sometimes occurred without studying whether modifications made to support online assessments affect the outcomes of the assessments. Researchers at the University of Massachusetts Boston, the University of Washington, Rush University Medical Center, and Michigan State University recently adapted an assessment protocol (the Communication Play Protocol; CPP), to be conducted as an online assessment of ASD (RISE-CPP). ASF’s funding will allow researchers to determine if clinicians can diagnose ASD online using the RISE-CPP protocol as accurately as they can using traditional in-person assessments. An online version has the advantages of possibly reaching a more diverse community and improving opportunities for early intervention.