CARE Research Project: Early Detection of and Early Intervention for Autism Spectrum Disorders

Dr. Rebecca Landa is the Director of the Center for Autism and Related Disorders (CARD) and the REACH research program at KKI, and an Associate Professor of Psychiatry at the Johns Hopkins University School of Medicine.

Brief Description of Summary Research, including Goals and Objectives:

Dr. Landa’s interests are relevant to early diagnosis of ASD in a number of ways. On the surface level, and the level most ripe for immediate discovery, is the need to identify behavioral markers that signal ASD, and that differentiate it from language impairment. Identification of these markers and how they manifest qualitatively, quantitatively, and in synchrony with other behavioral systems will enable us to develop better screening and assessment instruments and diagnostic guidelines for infants and toddlers with ASD. Study into learning mechanisms in infants and toddlers at risk for ASD and language impairment will shed light on core neuropsychological deficits, possibly on neurobiological processes, and on how and what to treat in intervention programs.

Specific Aims of Current Early Detection Study:

Specific Aim #1: To identify behavioral profiles that enhance diagnosis of ASD in the first two years of life.

Specific Aim #2: To test hypotheses about the relationship between joint attention, shared positive affect, and communication in infants later diagnosed with ASD (at 3 years of age) and in those without ASD.

Specific Aim #3: To test hypotheses about atypical sensory and motor functions in infants later diagnosed with ASD and the relationship between sensory and motor disruptions and social-communication development.

Specific Aim #4: To test hypotheses about key features that differentiate toddlers with ASD from those who are language impaired.

Specific Aim #5: To better understand stability of autism symptoms from infancy through the third birthday.

Specific Aim #6: Identify and characterize neurochemical differences between groups and examine whether biochemical patterns: a) differ in children with autism compared to those with non-autism language delay; b) suggest testable hypotheses concerning mechanisms of neurobiology in autism; and c) change over time in affected and non-affected children, especially in response to treatment. 

Early Intervention Study:

Aim: To investigate the impact of early intervention targeting interpersonal synchrony on the process of communication development in toddlers with non-familial autism.

Hypothesis: Early intervention that directly targets joint attention, shared positive affect, and socially-contingent imitation will positively impact communication development to a greater degree than intervention not specifically targeting these domains, but which is otherwise identical (e.g., instructional methods, non-interpersonal synchrony goals). In typical development, skills contributing to interpersonal synchrony are reportedly precursors to language development. If this is true for toddlers with autism, treatment directly targeting these skills may differentially enhance communication development.

Early detection research in autism is needed to enable infants to gain access to early intervention, and to reveal key deficits that should be emphasized as treatment targets for infants and toddlers with autism. Targeting core deficits early in life could have a profound impact on language and communication development and, perhaps, outcome in autism. Two intervention conditions (one emphasizing IS goals, and the other not emphasizing these goals) will be implemented to test the hypothesis that toddlers with autism will show greater language and communication improvement if intervention specifically targets JA, contingent imitation, and shared positive affect. A new group of toddlers with non-familial autism is added to participate in the intervention study. Data from typically developing toddlers will be used to index the degree to which IS-related behaviors reach ‘typical’ levels after treatment. By placing the treatment study in the same proposal with the Early Detection component, we will be able to examine the developmental trajectory of toddlers with ASD who do and do not have family histories of autism from 24 to 36 months. This will be important as we incorporate information about neurobiological profile with the behavioral data.

Scope of Duties for Research Student:

Students would be able to observe testing sessions with children aged 3 months to 8 years of age, who fall into one of the following groups: typically development, language delay, socially impairment, mental retardation, and autism. The primary activities would involve coding data from developmental assessments involving tasks that tap social, imitation, language, play or other developmental domains. You would learn a lot about typical, delayed and atypical development.