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Mind Matters UC DAVIS M.I.N.D. INSTITUTE SPRING/SUMMER 2009 MEDICAL INVESTIGATION OF NEURODEVELOPMENTAL DISORDERS Irva Hertz-Picciotto: Searching for clues to autism’s increase e’ve all read the headlines about Wdiagnosed cases of autism being on the rise, and we’ve wondered: Why? Could it be due to a broaden- Research ing of diagnostic criteria for autism? Is greater awareness on the part of parents leading to earlier diagnoses? making hope Trying to answer such questions takes one into the realm of epidemiol- a reality. ogy, the study of causes, incidence, and characteristic behaviors of disease outbreaks affecting human popula- tions. M.I.N.D. Institute researcher Irva Hertz-Picciotto, a professor in the Department of Public Health Sciences, chief of environmental and occupa- Irva Hertz-Picciotto tional health in the UC Davis School of Medicine and an internationally recog- nized epidemiologist, is at the forefront be fully explained by changes in how THIS ISSUE: of these efforts. the condition is defi ned or counted. “My ultimate hope is to fi nd envi- Broadening of diagnostic criteria Blythe Corbett: Autism ronmental factors that we can either and younger basic science and intervention through art .......3 remove from the environment through age at diagnosis regulatory policy or limit an individual’s don’t explain “ My ultimate hope is Sense Theatre: Giving exposure by changing personal behav- even half of the kids with autism to fi nd environmental a chance to shine ............... 4 iors, thereby helping to prevent future huge increases cases of autism,” Hertz-Picciotto said. in California factors... helping to Philanthropy: Sally Reed ..... 5 In January, Hertz-Picciotto and cases. The prevent future cases Social skills training ............ 6 co-author Lora Delwiche of the incidence of UC Davis Department of Public Health autism by age 5 of autism.” Profi le: Marjorie – Irva Hertz-Picciotto Solomon ........................... 7 Sciences published a paper in the in California has infl uential journal Epidemiology, which increased from Groundbreaking neuro- found that the seven-fold increase in slightly over 6 in 10,000 for children developmental research of 2007/2008 .................. 9 the number of children born in Cali- born in 1990 to more than 42 in 10,000 fornia with autism since 1990 cannot for children born in 2001. The study’s Q&A with Bob Hendren ....11 Continued on page 2 Newsletter “new look” ......12 Irva Hertz-Picciotto from page 1 methodology revealed that no more ing the potential role of than 56 percent of the estimated 600-to- environmental factors, 700 percent increase – less than one- she says. They’re a clarion tenth of the increased rate of reported call to funding agencies autism cases – could be attributed to the and policy makers who inclusion of milder cases of autism, and have focused attention only 24 percent of the increase could exclusively on under- be attributed to earlier age at diagnosis. standing the genetic Another 120 percent may have occurred causes of autism, because due to the changes in diagnostic the key to increasing criteria. diagnoses may well lie in In-migration to California – as the a combination of genetic population swelled through the last few and environmental Irva Hertz-Picciotto decades (it’s now trending downward) – factors. was controlled in this analysis by exclu- The study’s methodol- sion of children born outside the state. ogy involved analyzing data collected autism cases. It’s also the fi rst major In short, the answer is, ‘yes,’ autism by the state of California Department investigation of environmental chemi- incidence has increased, even when of Developmental Services (DDS) from cals and how they interact with genes all of the other possibilities have been 1990 to 2006, as well as the United in the disorder. A case-control study of accounted for – and the increase shows States Census Bureau and state of 2,000 children with differing patterns of no sign of abating, Hertz-Picciotto said. California Department of Public Health development, it characterizes children “As we pare away, one by one, the Offi ce of Vital Records, which compiles with autism into subgroups to deter- various potential artifactual causes of and maintains birth statistics. The mine whether particular genes and/or the increase in autism, only about one- researchers correlated the number of environmental exposures are associated third of the increase can be explained,” cases of full autism reported between with certain subtypes of this condition. Hertz-Picciotto said in a recent 1990 and 2006 with birth records and interview. excluded children not born in Califor- MARBLES (Markers of Autism Risk Hertz-Picciotto, who has published nia. They used Census Bureau data to in Babies-Learning Early Signs) is a widely on environmental exposure, calculate the rate of incidence in the prospective investigation that follows including exposures to metals, pesti- population over time and examined the women who already have had one child cides, polychlorinated biphenyls (PCBs) age at diagnosis of all children ages 2 to with autism, beginning early in or and air pollution and their effects on 10 years old. even before a subsequent pregnancy, child health and development, argues Hertz-Picciotto, who serves as to search for early exposures, maternal that more effort should be put into deputy director of the Center for conditions and biochemical or other looking for environmental factors Children’s Environmental Health at markers that might predict autism in that might cause autism, particularly UC Davis, now turns her attention to the younger sibling. in genetically susceptible children. two studies looking specifi cally at the Although it’s not yet possible to deter- relationship between environmental Taken together, these studies mine how much of the increase is a true exposures and the incidence of autism. epitomize the M.I.N.D. Institute’s broad increase, a serious and careful look at based and holistic approach to uncover- environmental exposures is warranted. CHARGE, short for Childhood Autism ing the various risk factors and causes “Genetics doesn’t explain it all, even in Risks from Genetics and the Environ- for autism and the many other neu- twins,” said Hertz-Picciotto. ment, was launched in 2004 as the rodevelopmental disorders that affect The study results provide support for largest epidemiological study of envi- an increasingly larger number of our the proposition of more closely examin- ronmental contributions to confi rmed children. 2 UC DAVIS M.I.N.D. INSTITUTE • M.I.N.D. MATTERS Blythe Corbett: Autism basic science and intervention through art lythe Corbett’s insights may be functioning before, during and after Bunique among researchers devel- social interactions,” said Corbett, an oping new interventions for children assistant professor of clinical psychiatry with autism spectrum disorders – at the in the Department of Psychiatry and M.I.N.D. Institute or elsewhere. Cor- Behavioral Sciences. “The ultimate hope Blythe Corbett bett’s Social Emotional NeuroScience is that these results will give us a better Endocrinology (SENSE) lab focuses understanding of autism in order to chiefl y on analysis of the behavioral and develop individualized biological and their behavior, a child with autism and biological effects of the stress hormone behavioral treatments.” a typically developing child are teamed cortisol on children with autism. But In her quest for enhanced assessment with a “confederate” child who works her work is informed by the eclectic and treatment of the social-emotional with the researchers. They’re given professional experience of someone capabilities of children with autism, various play opportunities, with their with a background in autism diagnosis, Corbett has focused on responses of the cortisol levels checked before and after- brain analysis, behavioral intervention – stress hormone cortisol during various wards to assess their level of stress. and acting. potentially stressful settings, including “Although there is a great deal of “Results from my studies are reveal- playground interactions. With playtime variability in stress levels among chil- ing associations between a child’s periods discreetly videotaped for later dren with autism, many of our subjects behavior, biological profi le and brain moment-by-moment documentation of seem to fi nd playground interactions stressful–even kids who appear to be enjoying themselves,” explains Corbett. Her cortisol studies have also revealed that children with autism often have elevated cortisol levels toward the end of the day, in contrast to typically developing children. These studies of cortisol rhythms and responses raise many questions: Do those with autism have heightened sensory sensitivity, leading to heightened stress? Do they have a genetic predisposition to stress? What are the characteristics of the chil- dren who show high versus low levels of stress? “Research is ongoing in my lab to answer these questions,” Corbett said. “It’s clear that understanding the biology beyond the behaviors can help lead directly to new, more effective interventions for our kids with autism, a priority for so many of us in this fi eld.” Niles Ryan and Blythe Corbett Continued on page 4 UC DAVIS M.I.N.D. INSTITUTE • M.I.N.D. MATTERS 3 Sense Theatre: Giving kids with autism a chance to shine n the evening of February 6, functioning of children with autism and breaking number of performances in O16-year-old Esteban Marchant related neurodevelopmental disorders, it touring productions of “Phantom of the received a thunderous, standing ovation provides these youngsters with unique Opera.” He performed a show-stopping with his rendition of Elton John’s Your opportunities to perform side by side medley of songs from “Oklahoma!” Song at a heart-warming benefi t marking with typically developing actors. and “Phantom,” along with a poignant the founding of the SENSE Theatre. The The effort is based on co-founder closing song, High Hopes, performed with response from the more than 200 audi- Blythe Corbett’s research and clinical the SENSE Theater Youth Ensemble.
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