1. Center for Autism & Developmental Disabilities Epidemiology Research in pursuit of answers about autism Michelle Landrum

2. 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 2

3. What are Autism Spectrum Disorders (ASD)? Referred to as “autism spectrum,” to reflect the variability. 3 Wide range in symptoms, behavior, ability Classic autism Pervasive Developmental Disorder –NOS Asperger syndrome

4. How common are ASDs? 4 May 9, 2011

5. 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 5 Late motor milestones. Didn’t walk alone until 19 months

6. Other ‘red flags’ … 6 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.

7. 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. 7 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?

8. 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 8

9. 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. 9

10. An overview of the EARLI study 10

11. 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. 11 www.earlistudy.org Study is funded by National Institutes of Health, with supplement from Autism Speaks

12. Questions? Thank you! 12