National Academies Press: OpenBook

Autism and the Environment: Challenges and Opportunities for Research: Workshop Proceedings (2008)

Chapter: Appendix A: Index of Scientific Opportunities

« Previous: Day 2--April 19, 2007
Suggested Citation:"Appendix A: Index of Scientific Opportunities." Institute of Medicine. 2008. Autism and the Environment: Challenges and Opportunities for Research: Workshop Proceedings. Washington, DC: The National Academies Press. doi: 10.17226/11946.
×
Page 283
Suggested Citation:"Appendix A: Index of Scientific Opportunities." Institute of Medicine. 2008. Autism and the Environment: Challenges and Opportunities for Research: Workshop Proceedings. Washington, DC: The National Academies Press. doi: 10.17226/11946.
×
Page 284
Suggested Citation:"Appendix A: Index of Scientific Opportunities." Institute of Medicine. 2008. Autism and the Environment: Challenges and Opportunities for Research: Workshop Proceedings. Washington, DC: The National Academies Press. doi: 10.17226/11946.
×
Page 285
Suggested Citation:"Appendix A: Index of Scientific Opportunities." Institute of Medicine. 2008. Autism and the Environment: Challenges and Opportunities for Research: Workshop Proceedings. Washington, DC: The National Academies Press. doi: 10.17226/11946.
×
Page 286
Suggested Citation:"Appendix A: Index of Scientific Opportunities." Institute of Medicine. 2008. Autism and the Environment: Challenges and Opportunities for Research: Workshop Proceedings. Washington, DC: The National Academies Press. doi: 10.17226/11946.
×
Page 287
Suggested Citation:"Appendix A: Index of Scientific Opportunities." Institute of Medicine. 2008. Autism and the Environment: Challenges and Opportunities for Research: Workshop Proceedings. Washington, DC: The National Academies Press. doi: 10.17226/11946.
×
Page 288
Suggested Citation:"Appendix A: Index of Scientific Opportunities." Institute of Medicine. 2008. Autism and the Environment: Challenges and Opportunities for Research: Workshop Proceedings. Washington, DC: The National Academies Press. doi: 10.17226/11946.
×
Page 289
Suggested Citation:"Appendix A: Index of Scientific Opportunities." Institute of Medicine. 2008. Autism and the Environment: Challenges and Opportunities for Research: Workshop Proceedings. Washington, DC: The National Academies Press. doi: 10.17226/11946.
×
Page 290
Suggested Citation:"Appendix A: Index of Scientific Opportunities." Institute of Medicine. 2008. Autism and the Environment: Challenges and Opportunities for Research: Workshop Proceedings. Washington, DC: The National Academies Press. doi: 10.17226/11946.
×
Page 291
Suggested Citation:"Appendix A: Index of Scientific Opportunities." Institute of Medicine. 2008. Autism and the Environment: Challenges and Opportunities for Research: Workshop Proceedings. Washington, DC: The National Academies Press. doi: 10.17226/11946.
×
Page 292

Below is the uncorrected machine-read text of this chapter, intended to provide our own search engines and external engines with highly rich, chapter-representative searchable text of each book. Because it is UNCORRECTED material, please consider the following text as a useful but insufficient proxy for the authoritative book pages.

A Index of Scientific Opportunities The following index provides a summary of the many scientific opportunities that were identified by individual workshop speakers and participants. These ideas were not prioritized or debated at the workshop and are not adopted, endorsed, or verified as accurate by the National Academies and as such should not be attributed to the National Acad- emies or the Institute of Medicine. They do, however, represent a rich diversity of possible directions for future research. Each research priority is organized into one of five general categories (Scientific Opportunities for Human Subjects Research, Opportunities Identified to Improve and Enhance Epidemiological Studies, Opportunities to Improve the Under- standing of Autism’s Pathology, Tools and Infrastructure Needs, and Opportunities for Public–Private Partnerships). In addition, each research priority is referenced to the specific page(s) of the proceedings (Chapter 2) where the concept was discussed and attributed to the associated workshop speaker or participant. Concepts are not listed in order of pri- ority or importance. Scientific Opportunities for Human Subjects Research Update clinical diagnosic criteria for autism pp. 21, 249 (Swedo) spectrum disorder (ASD) • Base clinical definition on p. 57 (Choi); p. 268 quantifiable measures rather than (Singer) qualitative scores if needed • Establish clinical definitions that pp. 50, 88 (Levitt); p. 89 allow stratification of ASD (Martinez) subpopulations 283

284 AUTISM AND THE ENVIRONMENT Identify and stratify biologically meaningful pp. 31, 88 (Levitt); pp. 38, subpopulations 234 (Pessah); p. 48 (Herbert); p. 89 (Martinez); pp. 191, 249 (Bernard); p. 240 (Redwood); p. 256 (Falk); p. 267 (Singer); p. 279 (participant) • Perform genetic sequencing to p. 32 (Levitt); p. 258 identify functional variants (Goldstein) • Analyze biological samples, p. 46 (Herbert); p. 57 including blood and urine (see also (Choi); p. 144 (Redwood); “expand tissue repositories” below in p. 279 (participant) Tools and Infrastructure Needs section) ƒ Perform metabolic profiling p. 44 (Herbert) • Establish metabolic profiles of p. 44 (Herbert); p. 281 vulnerability and treatability (participant) • Separate individuals with genetic p. 37 (Pessah); p. 80 etiology from those with a (Martinez) predominately environmental etiology (that may have some genetic susceptibility) to aid in epigenetic sampling • Perform genetic analysis comparing p. 137 (Swedo) distinct ASD subpopulations and similar disorders, for example, Asperger’s disorder, Fragile X Identify biomarkers to examine ASD onset, p. 82 (Lipkin); p. 141 progression, treatment efficacy, metabolic (Leshner); p. 191 (Wilcox); changes, and subpopulations (see also Tools p. 240 (Redwood); p. 242 and Infrastructure Needs section) (Pessah); p. 248 (Blaxill); pp. 268, 271 (Colamarino and Bono); p. 275 (Herbert) Perform scientifically rigorous analysis of novel pp. 12, 146, 234, 271 and purported treatments (Bono); pp. 13, 51, 141 (Leshner); pp. 19, 21 (Swedo); p. 90 (Herbert); p. 144 (Blaxill); p. 235 (participant); p. 239 (Noble); p. 269 (Bernard); p. 276 (Zimmerman)

APPENDIX A 285 • Use randomized clinical trials p. 21 (Swedo); p. 243 (Pessah) • Investigate responses to medication p. 53 (James); p. 148 or other forms of treatment (Swedo); p. 154 (Herbert); individuals are currently undergoing p. 235 (participant); p. 268 (Redwood); p. 271 (Bono); p. 277 (Zimmerman) ƒ Perform further analysis on “n of p. 21 (Swedo); p. 45 1” studies including serial (Herbert); p. 141 (Insel); analyses to capture which p. 256 (Falk); p. 275 biomarkers change with (Landrigan) treatment progression • Examine individuals’ medical pp. 12, 271 (Bono); p. 238 records (Pessah); p. 263 (Redwood) • Establish metrics by which to p. 90 (Herbert); pp. 91, measure onset and recovery 269 (Bernard); p. 234 (Bono); p. 249 (Swedo) • Perform medical and genetic p. 276 (Swedo) workups on all known and suspected cases of ASD • Explore treatment strategies p. 263 (Redwood) dependent on autism phenotype • Investigate comorbidities and cases p. 268 (Bernard); p. 273 of abnormal onset, for example, de (Beaudet) novo defects • Examine ASD throughout an p. 223 (Insel); p. 249 individual’s life span, including (Bernard); p. 251 (Wilcox); adolescence and adulthood p. 270 (Hertz-Picciotto) Opportunities to Improve and Enhance Epidemiological Studies Expand analysis of longitudinal studies utilizing pp. 73, 229 (Susser); birth cohorts p. 232 (Fombonne); p. 233 (Insel)

286 AUTISM AND THE ENVIRONMENT • The National Children’s Study pp. 64, 66, 73, 84, 90, 91, 159, 172, 201, 202, 206, 227, 256 (Landrigan, Susser, Schwartz, Alexander, Hertz- Picciotto, Bernard, participant, Schendel, Needham, Pessah, Falk); p. 80 (Martinez); p. 90 (Hertz-Picciotto); p. 233 (Susser) • MARBLES (Markers of Autism Risk p. 201 (Hertz-Picciotto) in Babies Learning Early Signs) Review and assess on going and completed pp. 145, 200 (Schwartz); epidemiological studies for gaps and p. 202 (Falk); p. 231 opportunities (Schendel) Collect data and examine time trends to p. 21 (Swedo); p. 142 determine if the incidence of ASD has increased (Beaudet); p. 176 (Newschaffer); p. 250 (Susser); p. 267 (Singer); pp. 271, 273, 274, 278 (Bono, Blaxill, Susser, Insel) • Examine incidence data from p. 192 (Wilcox); p. 230 populations with distinct risk factors (Newschaffer) • Read retrospective studies that may p. 247 (Blaxill); p. 270 offer insightful information on time (Singer); p. 267 trends (Newschaffer) Improve pooling and sharing of data and pp. 182, 188, 202, 232, resources 270 (Schendel); pp. 189, 245 (Leshner); p. 197 (Bono); pp. 200, 270 (Hertz-Picciotto); p. 245 (Schwartz); p. 258 (Goldstein) • Standardize criteria used to define p. 180 (Newschaffer); cohorts p. 182 (Schendel); p. 276 (Swedo) • Improve and standardize screening p. 182 (Schendel); p. 236 criteria (Martinez); p. 270 (Newschaffer)

APPENDIX A 287 Perform epidemiological analysis using cohorts p. 73 (Susser); pp. 73, 75, established through “natural experiments” 80, 85, 228, 247, 248, 273 (Susser, Martinez, Schwartz, Fombonne, Blaxill); p. 229 (Fombonne); p. 239 (Swedo); p. 278 (Insel) • Examine potential similarities and p. 87 (participant); p. 91 differences in specific ethnic groups, (Bernard); pp. 181, 228 e.g., Hispanic versus non-Hispanic, (Martinez) The Amish • Examine specific occupational p. 228 (Schendel) exposures • Study populations that were exposed p. 229 (Fombonne) prenatally to infectious diseases, toxins from industrial disasters, etc. • Compare vaccinated and pp. 12, 198, 271 (Bono); unvaccinated children p. 198 (Redwood) • Compare effect of RhoGAM p. 162 (participant) exposure Examine potential increases of associated p. 234 (Pessah) comorbidities Consider adding genetic analysis to all p. 140 (Noble); p. 145 epidemiological studies examining (Falk) environmental risks Consider expansion of analysis of concordance p. 54 (Insel); p. 561 studies in monozygotic and dizygotic twins (Susser); p. 278 (Fombonne) Examine cohorts from international countries, p. 21 (Swedo); pp. 178, especially developing countries 179, 180, 270 (Newschaffer); p. 250 (Falk); p. 278 (Insel) • Norwegian cohort p. 82 (Lipkin); p. 82 (Schendel); pp. 116, 201 (Lipkin, Hertz-Picciotto); p. 194 (Wilcox)

288 AUTISM AND THE ENVIRONMENT Examine cohorts with an elevated risk of autism, p. 91 (Bernard); p. 258 e.g., AGRE and Baby Sibs (Goldstein) Coordinate efforts with the toxicology field p. 172 (Hertz-Picciotto) Opportunities to Improve the Understanding of Autism’s Pathology and Etiology Examine potential impact of convergence of p. 44 (Herbert); p. 115 multiple types of stressors (Lipkin); p. 131 (Slotkin) Elucidate the potential role of immune system pp. 12, 271 (Bono); pp. and immunological susceptibilities 38, 242 (Pessah); pp. 259, 269 (Goldstein); p. 272 (Noble); p. 277 (Cohen) • Expand current efforts in p. 118 (Lipkin); p. 278 microbiomics (Insel) • Investigate the role of biopathogens p. 251 (Bono) on organ systems, including nervous and digestive Focus on toxicology • Examine effects of subtoxic pp. 38, 276 (Pessah) exposure levels on different organ systems • Collect data on neurodevelopmental p. 66 (Landrigan); p. 205 toxicity of major priority pollutants, (Needham) including toxokinetic study • Examine the potential impact of p. 12 (Bono); p. 87 heavy metals and cosmetics (participant); p. 240 (Hertz-Picciotto) ƒ Perform toxokinetic studies pp. 250, 271 (Bono), ƒ Develop distribution and p. 239 (Noble); p. 257 excretion profiles (Falk) • Examine potential effects of toxicant p. 34 (Pessah); p. 244 synergies (Noble) Examine the potential role of oxidative stress p. 237 (Needham) Investigate the potential role of metabolism and pp. 44, 128 (Herbert) metabolic responses/dysfunctions

APPENDIX A 289 • Explore impact on modulating brain p. 281 (participant) function and vice versa Generate gene expression profiles, both time p. 32 (Levitt); p. 258 and topology (Goldstein) Examine the potential impact of genetic pp. 29, 32 (Levitt); p. 41 mutations and environmental toxicants on the (Herbert); p. 98 (Beaudet); development and maintenance of neuronal p. 241 (Insel); p. 275 circuitry (Pessah) Examine autism pathology p. 41 (Herbert); p. 258 (Goldstein) • Explore changes over time in p. 21 (Swedo) nervous system function, neurotransmitter profiles, and neuronal circuitry • Examine impact on germ-line cells p. 278 (Fombonne) Expand development and use of imaging as a pp. 41, 45 (Herbert); mechanism to examine progression of autism p. 276 (Spence); p. 277 pathology (Cohen) Develop chelators p. 271 (Hertz-Picciotto) • Formulate chelators that can cross p. 12 (Bono) the blood–brain barrier • Examine efficacy of glutathione as a p. 87 (participant) chelator • Investigate impact of detoxification of p. 271 (Bono) organ systems and its possible impact on inflammation and gastrointestinal problems Expand efforts to perform epigenetic analysis p. 80 (Martinez); pp. 98, 273 (Beaudet); p. 241 (Insel); p. 250 (Bono) Expand development and use of models to pp. 30, 32 (Levitt); p. 243 study ASD (Pessah); p. 252 (Martinez); p. 272 (Noble) • Develop high-throughput models, p. 112 (Slotkin) e.g., cell culture methods

290 AUTISM AND THE ENVIRONMENT • Create animal models that reflect p. 243 (Pessah) pathology in specific organ systems • Establish primary cell lines from p. 276 (Pessah) autistic individuals • Study related disorders, e.g., cystic p. 237 (Swedo); p. 277 fibrosis and Fragile X (Coetzee) Tools and Infrastructure Needs Expand tissue repositories p. 150 (Insel); pp. 150, 250, 265, (Schwartz); pp. 171, 224 (Hertz- Picciotto, Falk, Schendel); p. 268 (Needham); p. 271 (James); p. 279 (participant) • Require standardized sample p. 215 (Walt); p. 227 procurement and storage (Pessah); p. 269 (Goldstein) Establish programs to expand the number of p. 66 (Landrigan); pp. 221, investigators trained in environmental biology 265 (Schwartz); p. 221 (Goldstein) Establish incentive programs to attract p. 270 (Newschaffer) individuals from other fields to study ASD Develop biomarkers of exposure, susceptibility, p. 82 (Lipkin); p. 134 state, outcome; biomarkers studies that are (Insel); p. 172 (Hertz- replicable; biomarkers to spot the effects of Picciotto); p. 240 environmental neurotoxicants (Redwood); p. 247 (Blaxill); p. 250 (Newschaffer) Invest in the development of improved tools to p. 216 (Walt) analyze and multiplex data, including environmental sampling, biological samples, and potential metabolic changes Develop a large clinical trial network p. 265 (Schwartz); p. 276 (Swedo) • Expand autism patient and family p. 54 (Insel); p. 73 (Susser); registries pp. 235, 236 (participants); p. 237 (Beaudet); p. 269 (Goldstein); p. 276 (Swedo)

APPENDIX A 291 Establish and expand autism centers of p. 66 (Landrigan) excellence to study children’s environmental health Expand resources to identify potential p. 82 (Lipkin); p. 208 environmental factors (Needham); pp. 215, 221 (Walt); p. 238 (Pessah); p. 241 (Hertz-Picciotto); p. 252 (Martinez) • Develop and implement environmental sensor and biosensor technology ƒ Take advantage of continuous p. 211 (Walt) sampling • Use strategies that prioritize p. 207 (Needham); p. 215 potential environmental stressors or (Walt); pp. 268, 271 use an unbiased strategy (Singer) • Expand use of technologies that p. 205 (Slotkin) allow high-throughput analysis ƒ For example, HPLC, mass p. 207 (Needham); spectroscopy, two-dimensional pp. 213, 214 (Walt) gas chromatography, “lab-on-a- chip”/microfluidics Opportunities for Public–Private Partnerships Increase coordination and integration of each p. 246 (Blaxill); p. 269 stakeholder’s ongoing and planned efforts (Redwood) Establish enhanced methods of coordination p. 188 (Schendel); p. 259 and data-sharing policies for public–private (Goldstein); p. 269 partnerships (Schwartz) • Establish collaborations with small, p. 221 (Walt); p. 277 innovative biotech companies (Coetzee) Improve public engagement in the development p. 260 (Insel); pp. 262, 269 of research priorities (Redwood); p. 267 (Leshner)

Next: Appendix B: Workshop Agenda--Autism and the Environment: Challenges and Opportunities for Research »
Autism and the Environment: Challenges and Opportunities for Research: Workshop Proceedings Get This Book
×
Buy Paperback | $75.00
MyNAP members save 10% online.
Login or Register to save!
Download Free PDF

Autism spectrum disorders (ASD) constitute a major public health problem, affecting one in every 150 children and their families. Unfortunately, there is little understanding of the causes of ASD, and, despite their broad societal impact, many people believe that the overall research program for autism is incomplete, particularly as it relates to the role of environmental factors.

The Institute of Medicine's Forum on Neuroscience and Nervous System Disorders, in response to a request from the U.S. Secretary of Health and Human Services, hosted a workshop called "Autism and the Environment: Challenges and Opportunities for Research." The focus was on improving the understanding of the ways in which environmental factors such as chemicals, infectious agents, or physiological or psychological stress can affect the development of the brain.

Autism and the Environment documents the concerted effort which brought together the key public and private stakeholders to discuss potential ways to improve the understanding of the ways that environmental factors may affect ASD. The presentations and discussions from the workshop that are described in this book identify a number of promising directions for research on the possible role of different environmental agents in the etiology of autism.

  1. ×

    Welcome to OpenBook!

    You're looking at OpenBook, NAP.edu's online reading room since 1999. Based on feedback from you, our users, we've made some improvements that make it easier than ever to read thousands of publications on our website.

    Do you want to take a quick tour of the OpenBook's features?

    No Thanks Take a Tour »
  2. ×

    Show this book's table of contents, where you can jump to any chapter by name.

    « Back Next »
  3. ×

    ...or use these buttons to go back to the previous chapter or skip to the next one.

    « Back Next »
  4. ×

    Jump up to the previous page or down to the next one. Also, you can type in a page number and press Enter to go directly to that page in the book.

    « Back Next »
  5. ×

    To search the entire text of this book, type in your search term here and press Enter.

    « Back Next »
  6. ×

    Share a link to this book page on your preferred social network or via email.

    « Back Next »
  7. ×

    View our suggested citation for this chapter.

    « Back Next »
  8. ×

    Ready to take your reading offline? Click here to buy this book in print or download it as a free PDF, if available.

    « Back Next »
Stay Connected!