Earlier and more accurate diagnoses of ASDs will help patients and their families manage the disorders with the best possible results. iTARGET Autism aims to guide an individualized approach to the detection, management and treatment that is more effective than the currently available methods.
The Autism Spectrum Disorders (ASDs) are defined by significant challenges with communication, social reciprocity, and structured behavior. ASDs are currently the most common childhood developmental disabilities, and they are becoming increasingly common at an alarming rate.
In North America, 1 in 68 individuals is currently diagnosed with ASDs, impacting more than 1 in 20 people indirectly, including parents, siblings, and grandparents. The lifetime cost for educational, healthcare, and social services averages $3.2 million per patient, and Canadian government is contributing hundreds of millions of dollars to intensive behavioral intervention programs. While beneficial, these programs are not enough to address the various causes and changing symptoms of patients on the spectrum as they mature from children to adults. The growing numbers of those diagnosed with ASDs are alarming and present serious social and economic implications globally.
Despite significant evidence that early intervention greatly improves behavioral outcomes, children with ASDs are often not diagnosed until they are three to four years old or older. Furthermore, an ASD diagnosis does not determine a person’s needs and capabilities, at present or during their lifetime; they may be high functioning with possible savant qualities, or low functioning and non-verbal with an intellectual disability.
It is clear that we need strategies to identify children with or at risk for ASDs much earlier, along with a framework to classify patients that will lead to more effective and personalized treatment.
A collaborative research initiative, iTARGET Autism consists of a core team of 21 researchers at the University of British Columbia and Western University, bringing together experts in clinical, genetic, neuroscience, and microbiome research.
For the first time, this initiative will create a highly beneficial partnership between clinicians and families in BC by working with the Pacific Autism Family Center (PAFC) and the Ministry of Child and Family Development (MCFD).
A family-centric approach that integrates community and research makes iTARGET Autism Canada’s first fully integrated initiative to uncover the underlying causes, life-course changes, and treatment outcomes of ASDs. This initiative aims to define the most effective therapies for children and understand why those therapies work.
Currently, most global research to identify the common genetic link to ASDs is limited by focusing on autistic behaviors. No matter how readily observed or reproducible, ASD behaviors represent the endpoints of complex biological systems that are constantly changing, creating a “moving” target.
As with all diseases, ASDs have molecular triggers that are altered by both the environment and the patient’s response to that environment. For example, more than 50% of individuals with ASDs also have gastrointestinal issues, and the diversity of microorganisms in the gut can significantly influence their behaviors. With current genomics technologies, it is possible to capture molecular profiles of patients through their genetic makeups, gut and organ microbes, metabolomic byproducts, and the physical outcomes caused by the interaction of these factors with the environment.
iTARGET Autism will become Canada’s first fully integrated initiative to uncover underlying causes, life-course changes and treatment outcomes of ASDs.
Unlike other research, iTARGET Autism explores the patterns and interactions between these whole-body features and aims to understand their impact on brain development and function, eventually identifying the key factors that cause ASDs. This information is essential for developing the most beneficial treatment pathway for each unique patient.
Most importantly, the data will be collected from the same patients over a period of many years and linked to a single dedicated database, ASDBase. This data will enable researchers to unlock a wide range of collected genetic information and compare it across populations and years.
By combining patients’ treatment and outcome data with their molecular data (such as genetic, metabolic, and microbiological information), researchers will be able to discern patterns within each bodily system that will determine specific subgroups of individuals with ASDs. Researchers will then compare unique genes from each subgroup with the behavioral changes observed during their treatment.
Through this interconnected data and analyses, an autism screening test and risk scoring tool (ASDx) will be created to enable earlier and more accurate diagnosis, identify the risk of certain symptoms, and guide the most effective treatment plan, as well as refine and develop new treatment methodologies.
Suzanne Lewis, MD (Chair of Project Operations Board)
Shernaz Bamji, PhD
Derrick MacFabe, MD
Bill Mohn, PhD
Change in clinical practice: Early diagnosis and classification of autism leading to appropriate therapy
Benefits: Earlier and more accurate diagnosis of autism, while developing the most effective management and treatment plans for each individual
Website: iTARGET Autism