Tackling the big problems of Autism
"If all you can focus on is how things will change and
upset you, then you can’t focus on everything else
that’s positive. That’s the daily struggle for too many
families with autistic children."
—Ed Cook, MD, Director, Academic Center of Excellence, IJR
Research Opportunities at PSADC
For many autistic children, proper medications and behavioral interventions can make a world of difference. But for about one-third of autistic children, success remains stubbornly elusive. For Dr. Edward Cook, the Prediatric Stress and Anxiety Disorders Clinic is his mission.
“It’s so disappointing for these families when the medications don’t help,” says Cook. “For the kids, it’s even worse. They’re getting kicked out of everything, they don’t have friends, it’s totally disruptive.
“Their insistence on sameness can create all kinds of problems.” One family, for example, regularly took the same exit off the highway to avoid an outburst by their son. That type of accommodation is not unusual in families with autistic children. However, Cook said, “Something about their tone made me ask, ‘Just how long has it been since you’ve taken another exit?’ 10 years! It was easier to take the same exit for 10 years than to risk a meltdown by their son. That’s disabling.” The Academic Center of Excellence, funded by the National Institute of Mental Health and led by Cook, is focusing some of the best minds in child mental health on unraveling the mystery of why children with autism respond so differently to the same treatments.
“When we first started treating kids with the medications we have now, it was fantastic for the kids, for families, because before that there was nothing,” says Cook. “Now I want to bring that same relief to that small group that doesn’t yet respond. The advantage of being at IJR is being able to bring a diverse set of talents together to tackle the big problems. We’ll look at this problem from all angles.”
Cook and his team are pushing beyond current practices to join brain chemistry with genetics to better understand this insistence on sameness that autistic children share. That, says Cook, can lead directly to better treatment.
Finding the Genetic Fingerprint
Advances in pharmacology have done wonders for children suffering from mental disorders such as autism or attention deficit hyperactivity disorder (ADHD). Yet, not all children respond similarly to the prescribed drugs. Some, in fact, suffer side effects or struggle with the correct dose.
Drs. Tom Owley and Mark Stein believe the reason for the varied responses lies in our genetic makeup. Owley, working with autistic children, and Stein, working with children with ADHD, are monitoring how children react to various drugs and identifying their individual genetic markers that may be contributing to their particular reaction.
“With this information,” says Owley, “we can better tailor the doses and prescriptions. We usually have an idea what will work, but it’s really individualizing the medication for kids.”
With this more precise understanding of a drug’s effect, many more children will benefit. “The hope,”
says Stein, “is that in the future we will be able to personalize treatment and that this approach will
lead to improved outcomes for youth.”