Archive | February, 2010

Coming soon, the DSM-V. No more “PDD-NOS”, no more “Asperger”

11 Feb

Yes, a new version of the Diagnostic and Statistical Manual (DSM) is in the works. You’ve probably heard “DSM-IV” or read it a number of times. It is the manual used to describe the various “mental disorders” and the criteria for diagnosing them. (Pervasive Developmental Disorders or PDD’s are described there. These include Autistic Disorder, Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS), Asperger Syndrome, Rett Syndrome and Childhood disintegrative disorder. If the proposed changes go into place, all that will be left is Autism Spectrum Disorder.

It isn’t that people with diagnoses of Asperger or PDD-NOS will no longer will no longer be recognized as having a diagnosis. It is just that the diagnosis name will be replaced with Autism Spectrum Disorder.

Here is are the proposed DSM-V criteria for Autism Spectrum Disorder (299.00)

Autism Spectrum Disorder

Must meet criteria 1, 2, and 3:

1. Clinically significant, persistent deficits in social communication and interactions, as manifest by all of the following:

a. Marked deficits in nonverbal and verbal communication used for social interaction:

b. Lack of social reciprocity;

c. Failure to develop and maintain peer relationships appropriate to developmental level

2. Restricted, repetitive patterns of behavior, interests, and activities, as manifested by at least TWO of the following:

a. Stereotyped motor or verbal behaviors, or unusual sensory behaviors

b. Excessive adherence to routines and ritualized patterns of behavior

c. Restricted, fixated interests

3. Symptoms must be present in early childhood (but may not become fully manifest until social demands exceed limited capacities)

Compare this to the DSM-IV criteria

299.00 Autistic Disorder

1. A total of six (or more) items from (1), (2), and (3), with at least two from (1), and one each from (2) and (3):
1. Qualitative impairment in social interaction, as manifested by at least two of the following:
1. marked impairment in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body postures, and gestures to regulate social interaction.
2. failure to develop peer relationships appropriate to developmental level
3. a lack of spontaneous seeking to share enjoyment, interests, or achievements with other people (e.g., by a lack of showing, bringing, or pointing out objects of interest)
4. lack of social or emotional reciprocity
2. Qualitative impairments in communication as manifested by at least one of the following:
1. delay in, or total lack of, the development of spoken language (not accompanied by an attempt to compensate through alternative modes of communication such as gesture or mime)
2. in individuals with adequate speech, marked impairment in the ability to initiate or sustain a conversation with others
3. stereotyped and repetitive use of language or idiosyncratic language
4. lack of varied spontaneous make-believe play or social imitative play appropriate to developmental level
3. Restricted, repetitive, and stereotyped patterns of behavior, interests, and activities, as manifested by at least of one of the following:
1. encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus
2. apparently inflexible adherence to specific, nonfunctional routines or rituals
3. stereotyped and repetitive motor mannerisms (e.g. hand or finger flapping or twisting, or complex whole body movements)
4. persistent preoccupation with parts of objects
2. Delays or abnormal functioning in at least one of the following areas, with onset prior to age 3 years: (1) social interaction, (2) language as used in social communication, or (3) symbolic or imaginative play.
3. The disturbance is not better accounted for by Rett’s disorder or childhood disintegrative disorder.

For a good discussion, there is an op-ed piece in the New York Times by Prof. Roy Richard Grinker. Prof. Grinker discusses about how the separate category of Asperger Syndrome really is not necessary in today’s culture. The reduced stigma attached to Autism makes it less helpful to have a separate name for “less severe” autism.

Professor Grinker was also interviewed for the United States’ National Public Radio. You can read or listen on their site.

Autistic Disorder, PDD-NOS, Asperger Syndrome and Childhood Disintigrative Disorder will all be a part of the new “Autism Spectrum Disorder”. Rett Syndrome will not be in the DSM-V at all.

One thing this will change is access to services–or possibly. For example, the State of California has “autism” as an eligibility category in the Department of Developmental Disabilities. This was put in place before the DSM-IV and the diagnosis of Asperger Syndrome was used. The state has interpreted the law to mean that only Autistic Disorder is a qualifying diagnosis, denying people with PDD-NOS and Asperger diagnoses unless they meet the criteria for the “other category”. This has put pressure to diagnose “Autistic Disorder” over PDD or AS.

Given the current budget crisis in the State of California, it isn’t as though having a diagnosis of “autism” is a key to great services anyway.

That all said, it will be interesting to hear the discussion of this change. One point that is interesting is the removal of the age 3 limit. Before, there had to be onset of symptoms before age 3. Now it is a more general statement: “Symptoms must be present in early childhood”. I find it interesting that the lack of imaginary play statement is gone as well.

The DSM is not a checklist. In the end, it will be the diagnostic instruments like the ADOS that will determine whether someone qualifies for a diagnosis. I wonder how they will modify these instruments? The “imaginary play” requirement seems to be in the ADOS as it stands now, with the birthday party section for example.

Maternal age affects autism development?

10 Feb

A new study that looked at a large birth cohort (almost 5 million participants) over a 10 year period has announced that maternal age is an indicator of developing autism with an approximately 50% higher risk for a woman in her forties than a woman in her twenties.

The researchers looked at the records for all births in California between Jan 1990 and Dec 1999. Cases of autism were identified from this cohort using the records from the Early Start Report (ESR) for children under three, and the Client Development and Evaluation Report (CDER) for children over three.

A diagnosis of autism was defined as either positive for Developmental Disabilities on the ESR, or an autism level of one a CDER record/ICD code for autistic disorder. After excluding children from multiple births and those with missing data there were 12,159 cases and 4,935,776 controls.

Thats an interesting autism rate of 0.2% which might indicate more than maternal age that ESR or CDER is not that good at catching autism diagnoses as its a very low rate compared to the US national 1%.

This paper also lacks strength when looking at confounding factors – admittedly a tricky proposition as we don’t know what causes autism – but it may be of interest that the confounding factors that they _did_ account for were mainly ethnocentric i.e. race, gender etc and that they found that yep – whites were mainly very well represented. It seems very likely therefore that of possibly more interest that maternal age might be that not enough efforts are being made by local authorities to go into non-white enclaves.

Stem Cell Therapy for Autism

10 Feb

There are many unproven therapies being used by alternative medicine practitioners on autistic kids. One newer “therapy” is the use of stem cells.

I have yet to see even a good explanation of why stem cells should work. Not even a fully thought out bad reason. And, yet, kids are being “treated” with stem cells.

For those who would like a rundown of stem cells, their use and the potential problems, I refer you to Promtheus’ A Photon In The Darkness blog and his post, Stem Cell Therapy for Autism.

Not to steal his thunder, but here is the part that I am having trouble getting out of my mind. A child was given multiple stem cell “treatments”. Later he developed recurring headaches. On testing…well, Prometheus says it:

In short, this lad had two separate brain and spinal cord tumours. Under the microscope, these tumours were not cancerous, but looked like disorganized neural tissue. When they were tested genetically, the tumours did not match the patient’s genetic markers. They were, in fact, from two separate donors.

Many alternative medical therapies appear to be basically harmless. Give a kid some extra vitamin, or change his/her diet. Stem cell therapy does not fall into that category. When a risk/benefit calculation is done, what can you say but there is significant risk and no discernible benefit.

Autism Science Foundation announces 2010 Doctoral Training Award Recipients

10 Feb

The Autism Science Foundation has awarded six student/mentor teams grants to further research.

The teams and projects are listed below:

Sarita Austin/Dr. Rhea Paul; Yale Child Study Center:
Enhancing Understanding and Use of Conversational Rules in School-Aged Speakers with Autism Spectrum Disorder

Karen Burner/Dr. Sara Jane Webb; University of Washington, Seattle:
Observational and Electrophysiological Assessments of Temperament in Infants at Risk for Autism Spectrum Disorders

Rhonda Charles/Dr. Joseph Buxbaum; Mount Sinai School of Medicine:
A Preclinical Model for Determining the Role of AVPR1A in Autism Spectrum Disorders

Sarah Hannigen/Dr. Mark Strauss; University of Pittsburgh:
Defining High and Low Risk Expression of Emotion in Infants at Risk for Autism

Matthew Maenner/Dr. Maureen Durkin; University of Wisconsin, Madison:
Phenotypic Heterogeneity and Early Identification of ASD in the United States

Michael Sidorov/Dr. Mark Bear; MIT:
Investigation of Postnatal Drug Intervention’s Potential in Rescuing the Symptoms of Fragile X Syndrome in Adult Mice

The awards total $180,000.

Awards such as these serve a dual purpose. Yes, they get specific research projects support. More important in the long run is helping to recruit and keep good researchers studying autism.

Wakefield’s Lancet study is like cold fusion?

9 Feb

Hey, I didn’t say it. Mike Adams, “The Health Ranger”, out at NaturalNews.com said it in a blog post called, The Lancet retraction of vaccine autism paper condemned as Big Pharma conspiracy to discredit Dr. Wakefield.

I’ll do the geek stuff below, but let’s just say, Cold Fusion is synonymous with weak (or bad) science touted followed by a press conference that made claims which were amazing if true…but they weren’t.

For most of the world, comparing research to cold fusion is not a compliment. But NaturalNews.com doesn’t see it that way. After the announcement of Cold Fusion:

The conventional physics community went berserk. They attacked Fleischmann and Pons relentlessly, attempting to destroy their character and any scientific credibility they might have held. They paraded a gang of “hot fusion” scientists through the mainstream media, telling everyone it was “impossible” to create nuclear fusion at tabletop temperatures. Through a repetition of lies, they convinced the world that Fleischmann and Pons were frauds.

Yep. Just like Big Physics killed cold fusion, Big Pharma is out to kill the MMR/Autism link.

As I said recently, just when I think the Wakefield/MMR story can’t get stranger, it does.

For the geeks:

Fusion is the process where nuclei are, well, fused together to form the nuclei of new atoms. For example, one can fuse two duterium (hydrogen nuclei with a proton and a neutron) nuclei and get helium. People study fusion because it might give us a huge source of energy. Fusion reactors are big, expensive creations that raise the temperature of the nuclei very high, and have yet to become a viable energy source.

Cold fusion was an idea that under the right conditions, fusion could be induced near room temperature. Two of the researchers who “discovered” cold fusion held a large press conference and touted their study well beyond what their data could support.

Wakefield’s research: from The Lancet to Medical Veritas?

9 Feb

The Lancet is one of the medical community’s premier journals. As such, tetting a paper into such a journal is a big accomplishment for any medical researcher. When Dr. Andrew Wakefield chose to submit his 1998 study to The Lancet, it is likely he wanted to put it in as high a profile journal as possible. One can speculate how the Andrew Wakefield of 1998 would have viewed publishing his work in Medical Veritas, a newer journal which, well, is not generally highly regarded. Somehow, this observer thinks Dr. Wakefield would not have welcomed a suggestion to submit to Medical Veritas had it existed at the time.

Frequent readers to LeftBrainRightBrain, or most places autism is discussed for that matter, will know that Dr. Wakefield’s study has been retracted by the editors at The Lancet.

Frequent readers here may be also familiar with the magazine, Medical Veritas as it has been the home for a number of questionable autism/vaccine articles. If you aren’t familiar with Medical Veritas, let’s just say that Medical Veritas is not in the same league as the Lancet, to put it mildly.

Why bring these two very disparate journals into this blog post? Well, Medical Veritas has offered to republish Dr. Wakefield’s study:

So with zero confidence in The Lancet, Dr. Horton, those paying his salary, and those criticizing him for his actions, Medical Veritas editors are inviting Dr. Wakefield to re-publish his controversial paper in their next issue.

Wow. What a strange move, and on so many fronts. The most obvious being–what sort of standards does Medical Veritas show when it is willing to publish a paper that has been found to be so fatally flawed? It is really hard to consider that this offer was serious. The Royal Free Hospital, Dr. Wakefield’s employer, assigned the copyright to his paper to The Lancet. The study, even retracted, likely remains the property of The Lancet. Also, it isn’t Dr. Wakefield’s right to decide for his coauthors whether to submit to another journal.

The strangeness goes on and on. Let me just pick out one more oddity of this offer by “the editors” of Medical Veritas. Dr. Wakefield is one of the editors. Yes, one read is that Dr. Wakefield has basically invited himself to reprint “his” paper in Medical Veritas.

Just when you thought the story of the Wakefied/Lancet paper couldn’t get stranger.

Jim Carrey Jenny McCarthy Definitely not anti-vaccine

6 Feb

In the recent statement released by Jim Carrey and Jenny McCarthy regarding Andrew Wakefield, the twosome made a number of references that clear up once and for all how they feel about vaccines. Because as we all know they’re not anti-vaccine.

Dr. Andrew Wakefield is being discredited to prevent an historic study from being published that for the first time looks at vaccinated versus unvaccinated primates and compares health outcomes, with potentially devastating consequences for vaccine makers…

Dr. Wakefield and parents of children with autism around the world are being subjected to a remarkable media campaign engineered by vaccine manufacturers…

The retraction from The Lancet was a response to a ruling from England’s General Medical Council, a kangaroo court where public health officials in the pocket of vaccine makers…

The fallout from the study for vaccine makers and public health officials could be severe. Having denied the
possibility of the vaccine-autism connection for so long while profiting immensely from a recent boom in vaccine sales around the world, it’s no surprise that they would seek to repress this important work.

No, definitely not anti-vaccine.

Is Wakefield being shut up, or are Jenny and Jim trying to get publicity for his research?

5 Feb

In a public statement, Jenny McCarthy and Jim Carrey claim that “Dr. Andrew Wakefield is being discredited to prevent an historic study from being published”. Readers of LeftBrainRightBrain are already well aware that Dr. Andrew Wakefield was recently found to be “dishonest” and to have acted in a manner against the clinical interests of the children who were his research subjects. This recent statement is in support of the now discredited doctor.

Or, is it? A cynical mind might consider that this is a public relations ploy to get Dr. Wakefield’s current research in front of the media. His last paper was much hyped by Jenny McCarthy’s organization, but got little if any actual press coverage. But now, with the media focused on Dr. Wakefield, what better time to promote his research in hopes of getting some play in the media?

Ms. McCarthy and Mr. Carrey are prominent members of Generation Rescue (“Jenny McCarthy and Jim Carrey’s Autism Organization”) and have posted their statement on the Generation Rescue website with the full version on the blog sponsored by Generation Rescue, the Age of Autism.

This reader is somewhat amazed at the language used and the ignorance of the history of the General Medical Counsel proceeding that Ms. McCarthy and Mr. Carrey have shown.

The language puts the team well into the world conspiracy-theory:

It is our most sincere belief that Dr. Wakefield and parents of children with autism around the world are being subjected to a remarkable media campaign engineered by vaccine manufacturers reporting on the retraction of a paper published in The Lancet in 1998 by Dr. Wakefield and his colleagues

We are to believe that the news reporting on the retraction of the paper in The Lancet is orchestrated by vaccine manufacturers. That’s worth considering a moment–two actors, people who depend on their public image for their livelihood–are claiming that the reporting on a major news event is “engineered by vaccine manufacturers”.

The fact is that Dr. Wakefield thrust himself into the limelight with a press conference to publicize the paper. This and the fact that he has kept himself in the public’s eye for 12 years appears to have been lost on the McCarthy/Carrey team. After over a decade of promoting his research well beyond its importance or scientific merit, of course the media would take to the story that Dr. Wakefield had been found guilty of misconduct and that his paper had been retracted.

If there is any doubt as the conspiracy-theory theme of the statement, phrases like “Kangaroo court” and “in the pocket of vaccine makers” should put that to rest:

The retraction from The Lancet was a response to a ruling from England’s General Medical Council, a kangaroo court where public health officials in the pocket of vaccine makers served as judge and jury.

The article goes on:

Despite rampant misreporting, Dr. Wakefield’s original paper regarding 12 children with severe bowel disease and autism never rendered any judgment whatsoever on whether or not vaccines cause autism, and The Lancet’s retraction gets us no closer to understanding this complex issue.

This is a very strange statement to have made by representatives of Generation Rescue. Generation Rescue states on their own website, in reference to Dr. Wakefield’s paper in The Lancet, “”This study demonstrates that the MMR vaccine triggered autistic behaviors and inflammatory bowel disease in autistic children”.

Much more to the point, the press release for Dr. Wakefield’s press conference on the release of his study in The Lancet states that “Their [Wakefield et. al] paper, to be published in The Lancet 28 February, suggests that the onset of behavioural symptoms was associated with MMR vaccination”

If the defense now is that there is a difference between “proven” and “associated with” in the minds of the public, the importance of that is lost on me. Dr. Wakefield himself put the idea in the public’s mind that the MMR was causing autism.

In a video interview about his 1998 study, Dr. Wakefield stated that the link was not proven. However, he went on to claim that the “risk of this particular syndrome developing is related to the combine vaccine”:

Again, this was very contentious and you would not get consensus from all members of the group on this, but that is my feeling, that the, the risk of this particular syndrome developing is related to the combined vaccine, the MMR, rather than the single vaccines.

If there is rampant misreporting of the notion that Dr. Wakefield’s study in The Lancet promoted the idea that vaccines cause autism, then it is the fault of Jenny and Jim’s own organization, together with Dr. Wakefield himself.

Much of the trouble resulting from Dr. Wakefield’s work (and by that I mean trouble caused to the world and the autism communities in particular, not trouble to Dr. Wakefield), stems from Dr. Wakefield overplaying the importance or the quality of his research. Even had the study been done as claimed in the publication, it was not a very strong study. It has been reported that four referees recommended rejecting the paper before publication. I don’t know the policy at The Lancet, but often 2 or 3 referees total are used to screen a paper for a journal.

Those who forget history are doomed to repeat it. In this case, overplaying the importance of research well beyond its scientific merit. In their statement, Jenny McCarthy and Jim Carrey promote Dr. Wakefield’s ongoing research as though it is so earth shattering that it must be stopped at all costs. They discuss a series of studies Dr. Wakefield’s new group is undertaking. This research has been discussed by Medical Researcher David Gorski in an article Monkey business in autism research.

We are to believe that there is a media campaign afoot to keep Dr. Wakefield from making his new research public. In the internet age, there is no way to keep information from the public. Dr. Wakefield and his colleagues are even editors of a new pseudo-journal for autism research.

At no point to Ms. McCarthy and Mr. Carrey address the ethical violations that Dr. Wakefield was found guilty of. No mention of whether it is appropriate for medical researchers to perform invasive procedures on disabled children when there is no clinical reason to do so.

In other words, Ms. McCarthy and Mr. Carrey never actually defend Dr. Wakefield for his actions. They never address the serious ethical lapses found proved by the General Medical Counsel.

I am left thinking that this is in reality a pre-release promotional event to get press coverage for Dr. Wakefield’s upcoming paper. The study is “on the brink” of being published. In other words, it is likely already in-press. The faux outrage that his work is being suppressed in light of this is painful to read.

U.S. Government Committee recomends increased research into the needs of autistic adults

5 Feb

The Interagency Autism Coordinating Committee is a group representing government agencies that research autism and some segments of the autism community. It was reenacted as a result of the Combating Autism Act. The main product, if you will, of the IACC is the Strategic Plan, which lays out a suggested framework for the U.S. government’s autism research activities.

The main section of the Plan is divided into seven sections, framed around questions. I think it unfortunate that the questions are voiced as though they are posed by a parent. Be that as it may, here are the sections/questions:

1. When Should I Be Concerned?
2. How Can I Understand What Is Happening?
3. What Caused This To Happen And Can This Be Prevented?
4. Which Treatments And Interventions Will Help?
5. Where Can I Turn For Services?
6. What Does The Future Hold?
7. What other Infrastructure and Surveillance Needs Must be Met?

It is my belief, and that of many others, that the most important section is number 6: what does the future hold? This section covers research into understanding autistic adults. This is an area that has been woefully neglected in my opinion.

The goals below have a projected total budget of over US$50 million. I’d like to see a lot more. I’d like to see it now. But this is a good step forward.

Short-Term Objectives

1. New objective
Launch at least two studies to assess and characterize variation in the quality of life for adults on the ASD spectrum as it relates to characteristics of the service delivery system (e.g., safety, integrated employment, post-secondary educational opportunities, community inclusion, self-determination, relationships, and access to health services and community-based services) and determine best practices by 2012. IACC Recommended Budget: $5,000,000 over 3 years.
2. New objective
Evaluate at least one model, at the state and local level, in which existing programs to assist people with disabilities (e.g., Social Security Administration, Rehabilitation Services Administration) meet the needs of transitioning youth and adults with ASD by 2013. IACC Recommended Budget: $5,000,000 over 3 years.
3. New objective
Develop one method to identify adults across the ASD spectrum who may not be diagnosed, or are misdiagnosed, to support service linkage, better understand prevalence, track outcomes, with consideration of ethical issues (insurance, employment, stigma) by 2015. IACC Recommended Budget: $8,400,000 over 5 years.
4. New objective
Conduct at least one study to measure and improve the quality of life-long supports being delivered in community settings to adults across the spectrum with ASD through provision of specialized training for direct care staff, parents, and legal guardians, including assessment and development of ASD-specific training, if necessary, by 2015. IACC Recommended Budget: $7,500,000 over 5 years.

Long-Term Objectives

1. New objective
Develop at least two individualized community-based interventions that improve quality of life or health outcomes for the spectrum of adults with ASD by 2015. IACC Recommended Budget: $12,900,000 over 5 years.
2. New objective
Conduct one study that builds on carefully characterized cohorts of children and youth with ASD to determine how interventions, services, and supports delivered during childhood impact adult health and quality of life outcomes by 2015. IACC Recommended Budget: $5,000,000 over 5 years.
3. New objective
Conduct comparative effectiveness research that includes a cost-effectiveness component to examine community-based interventions, services and supports to improve health outcomes and quality of life for adults on the ASD spectrum over age 21 by 2018. IACC Recommended Budget: $6,000,000 over 5 years.
4. New objective
Conduct implementation research to test the results from comparative effectiveness research in real-world settings including a cost-effectiveness component to improve health outcomes and quality of life for adults on the ASD spectrum over age 21 by 2023. IACC Recommended Budget: $4,000,000 over 5 years.

IACC calls for $175 million in autism and the environment research

5 Feb

The Interagency Autism Coordinating Committee has posted the revised Strategic Plan. I blogged it recently here on LeftBrainRightBrain. I made a note of the large commitment to environmental causation research. I thought it worthwhile to highlight that section, since this is the cause of so much criticism of the IACC.

Strangely, the criticism doesn’t come from those who are supposedly “It’s all genetic” types. No, the “it’s all environmental” groups seem to be very loud in complaining that all the research funding is going into genetics.

The Plan is divided by a number of questions. Research into causation is listed in Question 3: “What Caused This To Happen And Can This Be Prevented?”

Under that category, there are seven projects on environmental or gene-environment research. Seven out of 10 projects. The estimated budget for all these projects? $175,900,000.

In other words, 70% of the projects and, if I did my math right, nearly 70% of the funding for causation is estimated to be going to environment and gene-environment projects.

This would seem like a great victory for those who have lobbied for more environmental research. I have yet to see anyone from that group even mention the new Strategic Plan, much less the large commitment to environmental research. Where are the statements from SafeMinds (who have a very vocal member who sits on the IACC proper and another who is on a working group)? How about Generation Rescue? The National Autism Association?

In my opinion, these groups really don’t care much about environmental causation unless it is either mercury or vaccines. Hey, I could be wrong. Let’s see if they surprise me with some acknowledgment of this effort by the US Government.

Here are the objectives if you would like to read for yourself.

Short-Term Objectives

1. Coordinate and implement the inclusion of approximately 20,000 subjects for genome-wide association studies, as well as a sample of 1,200 for sequencing studies to examine more than 50 candidate genes by 2011. Studies should investigate factors contributing to phenotypic variation across individuals that share an identified genetic variant and stratify subjects according to behavioral, cognitive, and clinical features. IACC Recommended Budget: $43,700,000 over 4 years.
2. Within the highest priority categories of exposures for ASD, identify and standardize at least three measures for identifying markers of environmental exposure in biospecimens by 2011. IACC Recommended Budget: $3,500,000 over 3 years.
3. Initiate efforts to expand existing large case-control and other studies to enhance capabilities for targeted gene – environment research by 2011. IACC Recommended Budget: $27,800,000 over 5 years.
4. Enhance existing case-control studies to enroll racially and ethnically diverse populations affected by ASD by 2011. IACC Recommended Budget: $3,300,000 over 5 years.
5. New objective
Support at least two studies to determine if there are subpopulations that are more susceptible to environmental exposures (e.g., immune challenges related to infections, vaccinations, or underlying autoimmune problems) by 2012. IACC Recommended Budget: $8,000,000 over 2 years.
6. New objective
Initiate studies on at least 10 environmental factors identified in the recommendations from the 2007 IOM report “Autism and the Environment: Challenges and Opportunities for Research” as potential causes of ASD by 2012. Estimated cost $56,000,000 over 2 years.

Long-Term Objectives

1. Conduct a multi-site study of the subsequent pregnancies of 1,000 women with a child with ASD to assess the impact of environmental factors in a period most relevant to the progression of ASD by 2014. IACC Recommended Budget: $11,100,000 over 5 years.
2. Identify genetic risk factors in at least 50% of people with ASD by 2014. IACC Recommended Budget: $33,900,000 over 6 years.
3. Determine the effect of at least five environmental factors on the risk for subtypes of ASD in the pre- and early postnatal period of development by 2015. IACC Recommended Budget: $25,100,000 over 7 years.
4. Support ancillary studies within one or more large-scale, population-based surveillance and epidemiological studies, including U.S. populations, to collect data on environmental factors during preconception, and during prenatal and early postnatal development, as well as genetic data, that could be pooled (as needed), to analyze targets for potential gene/environment interactions by 2015. IACC Recommended Budget: $44,400,000 over 5 years.

Read more: https://leftbrainrightbrain.co.uk/2010/02/iacc-strategic-plan-is-up/#ixzz0edI3Pe8h

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