Stelios Georgiades Terry Bennett amp Team Lunch amp Learn Offord Centre for Child Studies 18 November 2015 1 The ultimate goal of all research in childhood psychiatric disorders is to provide knowledge that will be useful in treating or preventing illness ID: 524746
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Advancing Autism Care Through Meaningful Research
Stelios Georgiades, Terry Bennett & TeamLunch & Learn - Offord Centre for Child Studies 18 November 2015
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“The ultimate goal of all research in childhoodpsychiatric disorders is to provide knowledge that will be useful in treating or preventing illness.”
Bradley S. Peterson, 20132Slide3
Plan for todayWhat is Autism?Pathways in ASD study
McMaster Autism Research Team Brief video Autism Ontario“Advancing autism care through meaningful research” 3Slide4
What is Autism?
Heterogeneous neurodevelopmental disorder with impairments in social communication and repetitive stereotyped behaviours Prevalence rate 1 in 68 - onset early childhoodPresentation changes with development CausesUnknown (mostly...) Genetics believed to play an important roleCannot ignore environmental factorsTreatmentMostly behavioural interventionsPharmacological treatment trials underway
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Pathways in ASDFunded in 2004, largest longitudinal study of ASDPhase I & II completed - 5 Canadian provinces/sites
Followed a cohort of 423 newly diagnosed children (age 2-4) to age 11, with 8 data pointsDescribe developmental trajectories of children with ASDMillions $$$, 20 publications (many more coming), 76 students/trainees5Slide6
Ecological
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Longitudinal
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Selected FindingsVariability across Provinces in terms of:
Time between first parental concerns and diagnosisAge at formal diagnosisServices received (timing, type, dose, …)…need for a National Autism Strategy
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Selected FindingsASD diagnostic symptoms overlap with emotional/behavioural
Support “clinical specifiers” DSM 5 (Georgiades et al., 2011)Within the autism spectrum there are subgroups of children characterized by different profiles related to:Symptom severity, adaptive functioning skills, emotional/behavioural (Georgiades et a., 2013, 2014)Language impairment, intellectual disability(Bennett et al., 2014)Different developmental interactions between domains (language, social skills) from what would expect in TD kids (Bennett et al., 2015)
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Selected Findings
During the preschool years, there are distinct developmental trajectory groups of children across two domainsAutistic symptom severity (12% notable improvement…)Adaptive functioning skills (20% notable improvement…)Only moderate amount of yoking between these two domains (Szatmari et al., 2015)
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Date of download: 2/26/2015
Copyright © 2015 American Medical Association. All rights reserved.
From: Developmental Trajectories of Symptom Severity and Adaptive Functioning in an Inception Cohort of Preschool Children With Autism Spectrum Disorder
JAMA Psychiatry. Published online January 28, 2015. doi:10.1001/jamapsychiatry.2014.2463
Developmental Trajectories of
Autistic Symptom Severity Slide12
Date of download: 2/26/2015
Copyright © 2015 American Medical Association. All rights reserved.
From: Developmental Trajectories of Symptom Severity and Adaptive Functioning in an Inception Cohort of Preschool Children With Autism Spectrum Disorder
JAMA Psychiatry. Published online January 28, 2015. doi:10.1001/jamapsychiatry.2014.2463
Developmental Trajectories of
Adaptive
Functioning Slide13
Date of download: 2/26/2015
Copyright © 2015 American Medical Association. All rights reserved.
From: Developmental Trajectories of Symptom Severity and Adaptive Functioning in an Inception Cohort of Preschool Children With Autism Spectrum Disorder
JAMA Psychiatry. Published online January 28, 2015. doi:10.1001/jamapsychiatry.2014.2463
Cross-Trajectory
Group Membership for Autistic Symptom Severity and Adaptive
FunctioningSlide14
The Way Forward
Phase III recently funded by CIHR for another 7 yearsExamine the processes that predict variation in Developmental Health (DH) in adolescenceDH is defined as “the social, emotional, cognitive, and physical developmental tasks that all children and adolescents must accomplish”DH can be seen as “both a trajectory and a series of achievements or milestones”
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Phase III – What’s New?
Broader scope – developmental health (parents’ input)KTE plan and $$$Formal training plan ($$$ for 5 post-docs)Economic burden of ASD Study of life transitionsASD Voices studyA mixed-methods studyObjective is to capture the experiences of youthWhat are their goals and aspirations? What does a “good outcome” mean to them?
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Meanwhile ….here at McMaster, we decided to pause and ask ourselves...
As our CVs are getting thicker, are we making a difference? At a minimum, are clinicians around us using our findings?Are we (researchers) asking the right questions? Any others we can join forces with? 16Slide17
MacART
McMaster Autism Research Team
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In their words
“This timely research initiative has the potential to advance our understanding of autism. The work of these McMaster experts has my full support.”Dr. Patrick DeanePresident, McMaster University
“This important work will help bridge the gap between autism research and clinical practice.”Dr. Peter Fitzgerald
President, McMaster Children's Hospital
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In our words
Many of us are interested in autism researchSo far we have been doing well (in silos…)Can we do better if we work together?more interdisciplinary researchmore meaningful research higher (and quicker) impact
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Since June 2014…
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Hypothesis:
‘eating pizza’ leads to better ‘brainstorming’Slide21
Interdisciplinary approach
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Integrated knowledge framework
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Research interests & expertise
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Strategic priorities
Autism Research Stakeholder Symposium 15 Jan 2016 – early interventions (Connie Kasari UCLA, MCYS, Autism Ontario)Strategic Autism Research Agenda McMaster Autism Portal Offer learning and training opportunitiesDevelop innovative and meaningful research studies
Facilitate the timely translation of research into improved healthcare services for individuals with autism
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thanks !
children families
research team
mentors
students
collaborators
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Imagine a community that sees the potential in each and every person with ASDhttp://www.raisetheflagforautism.com/video/
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