Autism researchers at the UC Davis MIND Institute have received a prestigious $13 million award from the National Institutes of Health to establish an Autism Center of Excellence and Treatment Network, making the MIND Institute one of only nine such centers in the United States.
Announced on World Autism Awareness Day, the Autism Center of Excellence, or ACE, award underwrites a research program aimed at advancing the quality, pace and coordination of autism research and is led by Sally J. Rogers, professor of psychiatry and behavioral sciences and principal investigator. Rogers will collaborate with scientists at Vanderbilt University, Nashville; the University of Washington, Seattle and Harvard to conduct the research. The award will support two separate treatment studies designed to provide the most up-to-date data possible on the most effective methods of treating very young children with autism.
"While progress in research on autism spectrum disorder has been rapid, complex questions remain about the causes of these disorders, how to detect them very early, and how to intervene most effectively," said National Institute of Mental Health (NIMH) Director Thomas Insel. "Centers receiving ACE funding have marshaled the interdisciplinary expertise and technical resources needed to move the science forward as quickly as possible."
Rogers said that supporting and improving the outcomes of young children with autism and other disabilities is a national commitment and health priority, and a community and family necessity.
"The number of children who develop autism now overshadows all other early childhood disabilities and represents more than 1 percent of all the children in our country. The funds from the National Institutes of Health, and the support of the MIND Institute and UC Davis, will allow us to identify the best treatments for autism early in life and mitigate as much as possible the disabling effects of this all-too-prevalent and lifelong condition."
The efficacy of early intervention for improving children's functioning may be the biggest treatment success story in autism. The most widely used therapy is an approach called applied behavioral analysis (ABA), pioneered by O. Ivar Lovaas during the 1980s. Discrete-trial therapy modeled after Lovaas-style intervention is widespread and is offered by school districts nationwide.
A highly successful alternative therapy uses play as the treatment context. Rogers, with her colleague Geraldine Dawson of the University of North Carolina and Autism Speaks, created the Early Start Denver Model (ESDM) method of early autism intervention, a form of therapy that fuses play-based, developmental, relationship-based approaches with the teaching methods of ABA. ESDM has been found to result in IQ, language and adaptive behavioral gains that equal those of discrete-trial approaches.
The ACE Award will provide funds for a new study that will include 108 very young, diverse, male and female children at three different study sites: 36 at the MIND Institute in Sacramento, Calif., 36 at the University of Washington in Seattle and 36 at Vanderbilt University in Nashville.
The study's participants will at the outset range in age from 15 to 30 months. Each child will receive either 15 or 25 hours per week of one of either ESDM or discrete-trial training. The therapies will be by delivered one-on-one by trained interventionists in the children's homes for one year. In addition, the children's parents also will receive 1- hours of monthly coaching in the methodologies; parent-delivered intervention will be measured via a small camera, about the size and weight of a finger, which they will wear as they interact with their children.
"This study will provide answers to two critical questions that parents and interventionists ask: 'How many hours of intervention are necessary for my child?' and 'What type of early intervention should my young child with autism receive for the best possible outcome?' Up until this point, no study has been designed to directly answer these questions," Rogers said.
"This study is the first to test directly the effects of the number of hours and type of early intervention approach on the progress of a large group of very young children with autism. The results should provide some practical answers for parents, interventionists and policy makers, all of whom are committed to supporting as much progress as possible for young children with autism."
The second study will continue Rogers' earlier ACE Treatment Network research at UC Davis and the University of Washington on the long-term effects of the efficacy of the ESDM play-based approach to autism early intervention. In an earlier trial, toddlers receiving the intervention showed major improvements in IQ, language, adaptive behavior, and severity of their diagnosis over the two-year study period. The current study will follow participants up to 6 to 7 years of age. The participating centers include UC Davis, Harvard McLean Hospital, Belmont, Mass., and the University of Washington. Researchers at Harvard will provide data analysis for both studies.
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