Tuesday, May 15, 2012

IMFAR 2012 Press Conference

Alison Singer of the Autism Science Foundation introduced the speakers in her role as co-chair of IMFAR public relations committee. She noted that INSAR has encouraged autistic people and other community stakeholders to participate at IMFAR, as volunteers, etc.

TPGA coverage of IMFAR will start in the morning! Don't forget to follow us on @thinkingautism, and check back here for updates.

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The first speaker was the president of INSAR, Helen Tager-Flusberg:

This conference's goal is focusing on the very best science, and the immediate dissemination of it.

INSAR, the International Society of Autism Research, is moving into second decade. The first conference had approximately 200 attendees, and was tagged onto neuroscience conference in Orlando, Florida. This year's conference will be the largest ever, with well over 1800 people in main the main conference. (There is also a pre-conference on disseminating IMFAR 2012 work to parents, clinicians, and other stakeholders in Canada and the greater Toronto area.)

INSAR is not just a small scientific club any more. Its work is seamlessly integrated with the community's stakeholders, and would not be possible without people with autism and their families.

At this year's IMFAR conference, we'll be hearing the newest research conducted over last year. At the same time, we have to keep in mind that these presentations have not undergone the rigorous review as when papers are submitted for publication. This is preliminary, might not be complete, haven't yet undergone peer review as per part of the very best science process. So keep this context in mind when hearing about latest autism research findings.

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Stephen Scherer, University of Toronto, co-chair of IMFAR 2012 Scientific Program Committee:

The advisory committee had submissions from folks from all over the world, spent a long hard time looking over the proposals for presentations. Each abstract was reviewed by at least two people from the advisory committee, many of them will lead to scientific publications. This is the first glimpse  of this data in many cases, and everything will be presented in a research format.

In selecting the theme, in this 11th year of IMFAR, the goal was to look forward 10 years and see where autism science will be in 10 years, that guided the selection process for the speakers and presenters.

Discovery, treatment, dissemination are IMFAR 2012's primary themes. Sub-themes include behavioral science, application of particular drugs, gender bias -- studying the 4:1 male/female ratio among autistics and the genetic implications for autism research, biomarkers toward treatments and therapeutics, etc. The committee really tried to bring scientists from outside autism-specific research to the conference, as they bring a unique perspective to field of autism research , eg. genome scientists, behavioral scientists, etc. They've also included a lot of imaging science.

What's different in autism research over last decade is that autism is a model for studying other disorders. Not uncommon to see autism papers in major journals like Nature; we didn't see that 10 years ago. But now autism is pushing the whole field of medicine forward, e.g., many genome studies focus on autism first.

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Dan Messinger, University of Miami, Baby Siblings Research Consortium (BSRC)

Autism spectrum disorders (ASDs) tend to run in families but there is little info on high risk siblings. Last year, the BSRC  reported 19% of siblings of ASD kids will have autism at age three. Now the BSRC is examining the remaining 81%. At three years, used gold standards to assess these children.

There was definitely a difference bewteen high risk siblings (HRSs) & controls. HRSs had slightly more difficulty than peers using language, sorting objects, for instance. All showed slightly higher rates of autism-related behaviors: lower levels of back-and-forth play, lower levels of pointing.

Next used grouping analysis: 2/3 of high risk children fell into a group with low-level autism related behaviors and typical development. The remaining 1/3 fell into 3 groups (see slide below):
  1. Moderate ASD behaviors & high typical development
  2. Moderate ASD behaviors & low typical development
  3. Low ASD behaviors & slight delay

They also compared these factors to typical differences between girls and boys at that ages. Overall -- girls tend to be typical more often. So boys are doubly at risk. But high-risk girls may face additional challenges because of different social expectations for girls.

If we combine high risk siblings already identified with groups facing challenges, this comprises 50% of high risk siblings.

1 out of 3 high risk siblings had higher autistic behaviors, low typical development. However 3 yrs old is early, and we don't know how things will change, so follow up is necessary to evaluate high risk

Takeaway: Many infant siblings of autistic people/kids could still benefit from early intervention even if they don't have an ASD diagnosis.

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Dr. Ilanit Gordon, Yale Child Study Center

The focus of Dr. Gordon's work is oxytocin and autism. This is the first study to be approved on subjects at such a young age (7 - 18). Is an international collaboration.

Large-scale study targets the impact of oxytocin on social behavior and brain function in kids and adolescents with ASDs.

Oxytocin is a naturally occuring substance in the human brain and body. The synthetic form, pitocin, helps speed along births.

Lately has been having big media coverage for its role in social function, also lots of attention from the autism community as a mechanism in the etiology of ASDs, and as a possible treatment for social dysfunction in autism. Currently there is a huge gap between what's actually known about ASD and oxytocin, and the interest in that relationship.

This is first double blind placebo-controlled autism and oxytocin study to use fMRI (functional magnetic resource imaging). 

7 - 18 year olds were given nasal spray; the image below compares days of placebo spray vs. those of oxytocin administration -- the researchers are seeing very big changes in fMRI images.



These images show the kids going through multiple tasks, so really highlighting potential of oxytocin beyond single task.

Hoping this is a first step in developing interventions with oxytocin administration, hoping this will lead to treatment for social dysfunction in ASDs.

After a question from the audience about "refrigerator mother" implications or correlations from the study, Gordon clarified that all studies include men & women, oxytocin is not a "female" hormone, fathers show similar amount of social engagement when parenting compared to mothers. It's a human hormone, has to do with many processes, not just social -- our hearts, GI tract, etc. The researchers are interested in learning more about it and devising best treatments.

None of the researchers feel like they are seeing or looking for oxytocin/autism cause-and-effect at the moment. Goal is to devise treatment options.

Tager-Flusberg also added that there were no difference in the oxytocin levels between mothers of ASD and non-autistic kids, nor the fathers. So even if oxytocin has a role in ASD, it's not due to the parents.

BSRC doesn't see difference in how mothers of high-risk babies interact with their babies compared to typical controls. Biology may involve risk levels of higher oxytocin. But those are clearly not being transmitted through parents' interactions with the babies.

Scherer: Underlying message with autism in last few years: heterogeneity. 100s of forms of a disorder that looks the same in general clinical attributes. While there are some specific genes involved in brain development, there's still no single answer or cause. It's very heterogeneous. When we learn about one specific aspect -- like the role of oxytocin -- it gives us more answers, but not a definitive answer.

Families who want to participate in the study should contact Dr. Gordon.

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Teresa Bennett, McMaster University

Study of over 400 kids throughout Canada, regarading developmental trajectory of kids with ASD of all abilities (The idea came out of a stakeholder's conference: study's lead investigator asked families in particluar what they wanted to know. And the main thing that came out was they wanted to know how will to know as early as possibly how kids will fare over time: they wanted predictors & pathways.)

We often think of kids with ASD in terms of commonalities. But the trajectories developmentally vary quite a lot -- in terms of level of support and ability. It's general thought that how well a young kid with ASD can use language in early years is primary predictor of eventual outcome.

But the researchers wondered if early social competence (evaluated using Vineland Adaptive Behavior Scales) might be more important than language as predictor (see slide):


Social competence at time of ASD diagnosis has a high correlation with language development. However strong social language was not a strong predictor of social competence.
Initial advantage of social competence: led to better language, which then led back to increased social competence. Preschoolers with ASD who also have social competence tend to have improved language. Kids without social competence tend to have delays.

Findings from this cross-Canada study -- if we can focus on social competence, we can start "cascade" effect to support/improve other competencies.

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Rebecca Landa from Kennedy Krieger and Johns Hopkins

Infant sibs are at increased risk for ASD, as well as mild social and communication delays. Those are areas that are typical re: what we think defines autism. But literature shows that ASD folk oft have motor development issues as well.
In typical kids, early motor development is important indicator for development -- because babies use their bodies to learn about the world, e.g., they reach out to engage with people.

Study conducted regular evaluations from 6 to 36 months of age. Kids were three groups: ASD, non-ASD but with mild social & communication delays (Broad Autism Phenotype, or BAP babies), & typical. Studied whether or not babies were able to keep head aligned with back when pulled to seated position, at age 6 months.
  • At 6 mos, of the babies who went on to have ASD, 93% had "head lag." (14 out of the 15 babies who went on to have ASD.)
  • Of the BAP babies, 53% had head lag.
  • Of the non-autistic, non-BAP babies, 30% had head lag.
Take home: we have extended the findings of motor difficulties of older ASD individuals into infancy. Important, because can't really use social markers at this age -- many ASD kids have typical social behaviors, e.g., eye contact.

So if a baby has head lag AND an older sibling with ASD, this may provide an opportunity for early intervention and support.