Studies to Advance Autism Research and Treatment (STAART) Network

What is the STAART Network?

Congress passed the Children's Health Act of 2000, legislation that mandated many activities, among them the establishment of a new autism research network—at least five centers of excellence in autism research. In response, the five Institutes of the NIH Autism Coordinating Committee (NIMH, NICHD, NINDS, NIDCD, & NIEHS) have implemented the Studies to Advance Autism Research and Treatment (STAART) network program. Each center will contribute to the autism research base in the areas of causes, diagnosis, early detection, prevention, and treatment.

Are there other centers on autism at NIH?

In 1997, the NICHD started an international network of ten Collaborative Programs of Excellence in Autism (CPEA). This network is currently funded by NICHD and NIDCD. In addition, two of the Children's Environmental Health Centers funded by NIEHS focus on autism.

Who is in the STAART Network?

The STAART Network is comprised of eight centers across the country. Most of these centers are evaluating and treating patients, as well as enrolling them into clinical trials. Summary information about each center are included below, including contacts for more details:

• University of North Carolina, Chapel Hill
• Yale University
• University of Washington
• University of California, Los Angeles
• Mt. Sinai Medical School
• Kennedy Krieger Institute
• Boston University
• University of Rochester

Featured STAART Treatment Studies

Early Characteristics of Autism.
Treatment study; outpatient. This study will identify factors that distinguish children with autism from children with developmental delay and those with normal development and study the efficacy of intensive behavioral therapy in children with autism . Ages 18-24 months. Seattle, WA.

Diet and Behavior in Young Children with Autism.
Treatment study; outpatient. This study will determine whether a gluten- and casein-free diet has specific benefits for children with autism. Ages 30-54 months. Rochester, NY.

Citalopram for Children wit Autism and Repetitive Behavior.
Treatment study; outpatient. This study will determine the efficacy and safety of citalopram compared to placebo in the treatment of children with autism. Ages 5-17 years. Locations across the U.S.

University of North Carolina, Chapel Hill, directed by Joseph Piven, M.D.

The North Carolina STAART Center for Autism Research includes five projects and three cores that bring together a wide range of research expertise and perspectives to address the major theme of this Center—the elucidation of gene, brain, and behavior relationships in autism. Projects include: (1) a family study of the neuropsychological basis of autism and the broad autism phenotype; (2) fMRI and longitudinal MRI (DTI) studies of social/affective processes and executive function/ritualistic-repetitive behaviors in adults and very young children with autism; (3) a molecular genetics study employing computational bioinformatics, high-throughput molecular technology, and novel phenotypic approaches, for use in identifying autism disease genes; (4) DNA microarray and cluster analysis to identify gene expression profiles predictive of severity of social and cognitive behavioral deficits, using selected brain structures in a panel of genetically diverse inbred mouse strains and mutant mouse models with relevance to core features or autism; and (5) a pharmacologic treatment study.

For more information about this center, please contact Kathy Ellis at Kathy_Ellis@unc.edu

Yale University, directed by Fred Volkmar, M.D.

The focus of the center is on integrating advances in neuroscience and genetics in understanding specific neurodevelopmental processes and risk factors and using this understanding in treatment studies. Objectives include: (1) characterization of visual scanning patterns of social stimuli; (2) development of simple behavioral screening methods for young children at risk for autism, to determine whether young children with symptoms of autism display distinctive listening preferences as compared to developmentally delayed children; and (3) to assess the potential utility of computer assisted face training in autism with a goal of improving face perception skills and enhancing fusiform face area activity as seen on fMRI facial expression and normalization of visual scanning. In addition, the center proposes to characterize the nature of anxiety disorders, particularly social anxiety disorder, in children and adolescents with PDD and to evaluate the effects of psychopharmacological treatment of autism. Projects include:

• Eye tracking studies of social engagement in infants and toddlers with autism
• Behavioral indices of joint attention in autism in young children
• Precursors to social communication in autism and related disorders
• Behavioral and neural plasticity in face recognition
• Psychopharmacological treatment of autism

For more information about this center please contact Kathleen Koenig at (203) 785-2510 or by email at: kathy.koenig@yale.edu.

University of Washington, directed by Geraldine Dawson, Ph.D.

This STAART Center will address the following overall objectives: (1) To determine social, linguistic, neuropsychological, and electrophysiological and structural and chemical brain characteristics that distinguish very young children with autism from children with developmental delay and those with typical development. Such research will enhance our ability to recognize autism early in life so that children with autism can be helped as early as possible, and their long-term outcome can be improved. (2) To assess the efficacy of early intensive behavioral intervention for improving outcomes for children with autism, and to determine whether child neurocognitive and other biological factors moderate the effects of early intervention. Such knowledge will inform decisions regarding individualized interventions, elucidate brain mechanisms, and shed light on questions related to brain plasticity. (3) To increase our understanding of the neurobiological bases of autism by studying abnormalities in brain structure (via magnetic resonance imaging) and brain chemistry (via magnetic resonance spectroscopy) in very young children with autism, as compared to children with developmental delay and those with typical development. (4) To enhance our understanding of the cognitive neuroscience of autism by studying core social cognition impairments in high-functioning individuals with autism using event related brain potentials and functional magnetic resonance imaging. This information is relevant for early identification, development of more refined interventions, and measurement of quantitative genetic traits.

For more information about this center, please contact Cathy Brock at (206) 543-5153 or by email at cbrock@u.washington.edu.

University of California, Los Angeles, directed by Marian Sigman, Ph.D.

The goal of the UCLA Center for Autism Research and Treatment (CART) is to conduct basic research on the developmental and biological bases of autism, as well as experimental interventions in order to better understand the core deficits in autism. The central theme of the CART is on the elucidation of the etiology of social, communicative, and language deficits in autism, and the second theme is on the design and testing of experimental interventions. The specific aims of the CART research are to (1) Identify the abilities and characteristics, both behavioral and genetic, which differentiate the infant siblings of children with autism from siblings of developmentally delayed and typically developing siblings and predict the later manifestations of autistic symptoms; (2) Implement and compare the effects of intervention projects aimed at ameliorating behavioral disturbances and improving interactions with family members, peers, and friends; and (3) Define the genetic contributions to autism by studying component cognitive and behavioral endophenotypes and performing specific genotype—phenotype correlations, thereby, laying the groundwork for future pharmacogenetic studies.

For more information about this center, please contact info@autism.ucla.edu or visit the website: http://www.autism.ucla.edu/index.html.

Mt. Sinai Medical School, directed by Eric Hollander, M.D.

The Greater New York Autism Research Center of Excellence (a collaborative effort of the Mount Sinai School of Medicine, New York State Psychiatric Institute/Research Foundation for Mental Hygiene, University of Toronto, State University of New York at Stony Brook, and North Shore-Long-Island Jewish Health System) will aim to better understand the functions of the serotonin system in autism, specifically in its relation to repetitive behaviors, by combining methodologies from genetics, functional imaging and neuropsychopharmacology. By investigating core symptom domains of autism and linking this information to etiological factors, the multidisciplinary center's basic science and clinical research will facilitate development of novel or improved strategies for diagnosis, early detection and treatment of autism spectrum disorders. In achieving these goals, the center will be comprised of three integrated cores that will facilitate three interrelated research projects as well as multi-center collaborative endeavors. Projects include: (1) Identification of Autism Susceptibility Genes—This study aims to identify 150 families with at least two family members affected with autism, to genotype samples and analyze the data for linkage to autism and repetitive behaviors. The center is looking for overlap between areas of linkage for repetitive behaviors and candidate genes of the serotonin system. (2) Imaging Serotonin Function in Asperger's Disorder—Forty adult subjects with Asperger's disorder and forty controls will undergo an MRI scan and two PET scans with [11C] DASB and [11C] MDL 100907. The hypothesis is that patients with Asperger's disorder will show reduced density of SERT and a compensatory upregulation of 5-HT2A receptors in several areas of the limbic system. The relationship between regional 5-HT abnormalities and symptom clusters will also be assessed. (3) A multicenter collaborative psychopharmacology project to target the repetitive behaviors domain in autism spectrum disorders.

For more information about this center, please contact Kate Esposito at (212) 241-2993 or by email at katherine.esposito@mssm.edu.

Kennedy Krieger Institute, directed by Rebecca Landa, Ph.D.

This Baltimore-Washington STAART Center will study the neurobiological origins of motor planning and communication impairments in autism. The goal is to identify fundamental biologic alterations of brain development that underlie the core manifestations of autism and to translate these insights into effective therapies through early identification and intervention. In order to accomplish this goal, the Center has assembled a group of 22 investigators representing 7 disciplines (psychiatry, neuropsychology, psychology, speech-language pathology, developmental pediatrics, neuroscience) in a consortium involving the Kennedy Krieger Institute (lead agency), Children's National Medical Center, Johns Hopkins University, Morgan State University, and Georgetown University. The first project addresses the role of 5-HT afferents in the initiation and progression of synaptogenesis in the cortex during postnatal development in a neonatal 5-HT depleted animal model of autism. The second project addresses origins of symptoms, early neurobiological mechanisms, and treatment of key deficits near the time of their emergence through studies of toddlers at high-risk for autism. The third project extends understanding of autism provided by the other projects to a point later in life: in school-aged children. It will focus on motor execution and its relationship to cognitive functioning. This project will use structural and functional MRI procedures to elucidate the neurobiological basis of attention, motor planning, and executive function in individuals with high functioning autism. Taken as a whole, the projects should add significantly to our knowledge of the ontogeny of autism and thereby lead to the development of novel treatment approaches.

For more information about this center, please contact Terrylynn Tyrell (443) 923-7559 or by email at: tyrell@kennedykrieger.org.

Boston University, directed by Helen Tager-Flusberg, Ph.D.

This multi-site STAART Center focuses on the central theme of social and affective processes in autism. Major institutions in Boston (Boston University School of Medicine, Tufts New England Medical Center), northern New England (Dartmouth Medical Center) and Wisconsin (Waisman Center/University of Wisconsin) will collaborate on four projects that explore the early developmental course viewed within the context of family influences, brain pathology and functioning, and treatment of the core symptoms of social emotional impairment, and co-occurring affective disorder and problem behaviors in autism.

For more information about this center, please contact Gretchen Shuman at 617-414-2358, or email: gshuman@bu.edu or visit the Web site: http://www.bu.edu/anatneuro/dcn/autism/staart.htm

University of Rochester, directed by Patricia Rodier, Ph.D.

The objectives of this center are to look at the individual differences in response to treatments of autism spectrum disorders (ASDs). The STAART Center will fund studies of children's response to two of the most commonly used treatments of ASDs: early intensive behavioral intervention and the gluten-free, casein-free diet. In the study of behavioral intervention, investigators will try to identify characteristics of children that predict their response to this treatment by extensive pretreatment characterization and repeated testing for outcome of treatment in a large sample of children. The diet study will involve placing all participants on the diet and then challenging them with gluten- or casein-containing snacks in a double blind cross-over design. During the study, all participants will receive intensive behavioral therapy and monitoring of both diet compliance and nutritional status. Responders and non-responders to various treatments are likely to represent different subsets of the spectrum that may be genetic in origin. Along with other characteristics of children with ASDs, response to treatment is a dimension that could lead to a way to stratify the spectrum for genetic research. A third project will examine facial expression in children with ASDs. There is evidence that the deficits observed by many investigators arise from dysfunction of brain stem and/or cortical control of the facial musculature. These competing hypotheses will be tested by using quantitative assessment of many kinds of facial movement.

For more information about this center, please contact Jane Halpin at jane_halpin@URMC.rochester.edu.