Autism Centers of Excellence (R01)

Article excerpt

Autism spectrum disorders (ASD) are complex neurodevelopmental disorders with early childhood onset. ASD prevalence may be increasing, and ASD is more common than previously thought. These disorders, for which there is presently no cure and only limited treatments, generally have lifelong effects.

The NIH currently supports a vast array of projects in autism research. Centers such as the STAART (Studies to Advance Autism Research and Treatment) and CPEA (Collaborative Programs of Excellence in Autism) programs support some of these investigations. The CPEA program, an international program begun in 1997, now includes nine centers. These Centers focus research on the possible causes of autism, including genetic, immunological, and environmental factors. The CPEA program resulted from a congressionally mandated conference on the State of the Science in Autism. The attendees identified gaps in the knowledge of autism and directions for future research. Both NICHD and NIDCD sponsor the current CPEA program. As a result of the efforts of researchers affiliated with the CPEA, data now exist on the genetics and outward characteristics of the largest group of well-diagnosed persons with autism in the world. After the establishment of the CPEA Centers program, Congress enacted the Children's Health Act of 2000. This legislation mandated the establishment of a new autism research program. In response, the five Institutes of the NIH Autism Coordinating Committee (NIH-ACC; represented by NICHD, NIDCD, NIEHS, NIMH, and NINDS) implemented the STAART program. Each of the eight currently funded STAART Centers contributes to the autism research base in the areas of causes, diagnosis, early detection, prevention, and treatment. Collaborations among the STAART centers include a multisite psychopharmacological clinical trial. The CPEA and the STAART programs interact extensively through a shared data coordination center.

Consolidation of funding from the CPEA and STAART programs is now needed to maximize coordination and cohesion of NIH-sponsored efforts in autism research. The new autism centers and networks will be called the Autism Centers of Excellence or ACE.

The focus of the ACE must be on the causes and best treatment of autism (as listed in the autism research matrix hrtp://www.nimh.nih.gov/autismiacc/researchmatrix.pdf). In February 2003, Congress requested that the Department of Health and Human Services (DHHS) develop a set of autism research goals and activities for the next several years (House Report 10910). Input into this activity included a meeting of autism investigators with a range of scientific expertise as well as input from community members. Preparation for specifying this matrix involved a two-day meeting of an expert panel of scientists; public presentation and discussion of a draft matrix at the Autism Summit Conference in Washington DC on 20 November 2003; and adoption of the matrix by the Federal Interagency Autism Coordinating Committee (IACC).

Research projects should focus on finding causes and preventive intervention for autism as well as improved treatment. Applications should incorporate the latest techniques and propose studies to advance key goals related to causes and best treatment on the autism research matrix. Examples include, but are not limited to 1) identification of individual characteristics that predict response to behavioral, pharmacologic, and other treatments; 2) identification of environmental factors (e.g., viruses, medication, lifestyle factors, environmental chemicals) that contribute to the development of autism and their associated developmental windows; 3) identification of the biologic and/or behavioral markers to develop indices of risk for the development of autism in infants; 4) intervention methods for infants and toddlers developed to lower the age for which there are efficacious interventions; 5) multisite randomized clinical trials to identify moderators and effective ingredients (e. …