IACC Co-Occurring Conditions Planning Group Conference Call - May 27, 2014
|Date:||Tuesday, May 27, 2014|
|Time:||11:00 a.m. to 12:00 p.m. Eastern|
|Agenda:||The planning group for Co-Occurring Conditions will have a discussion about co-occurring conditions in relation to autism.|
|Place:||No in-person meeting; conference call only|
|Conference Call:||Dial: 877-891-6977
Access code: 3941079 (Listen-only)
|Contact Person:||Ms. Lina Perez
Office of Autism Research Coordination
National Institute of Mental Health, NIH
6001 Executive Boulevard, NSC, Room 6182A
Rockville, Maryland 20852
Phone: (301) 443-6040
|Please Note:||Members of the public who participate using the conference call phone number will be able to listen to the meeting, but will not be heard.
Individuals who participate using this service and who need special assistance, such as captioning of the conference call or other reasonable accommodations, should submit a request to the contact person listed above prior to the meeting. If you experience any technical problems with the conference call, please e-mail HelpDeskIACC@gmail.com or call 415-652-8023 for assistance.
The meeting will be open to the public via conference call. Individuals who participate by using this electronic service and who need special assistance such as captioning or other reasonable accommodations should submit a request to the Contact Person listed on this notice at least 3 days prior to the meeting.
Schedule subject to change.
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No in-person meeting; conference call only. The materials for the meeting can be found here.
Welcome, Roll Call and Opening Remarks
Thomas Insel, M.D.
Susan Daniels, Ph.D.
|11:15 a.m.||Discussion of goals for the Co-Occurring Conditions Planning Group|
|11:45 a.m.||Wrap-up and Next Steps|
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- Roll Call and Opening Remarks
- Neuroimmune/metabolic Issues Potentially Involved in ASD Etiology/Co-occurring Health Conditions or Symptoms
- Under-recognized Co-occurring Health Conditions in Individuals with ASD
- Vote and Next Steps
The Interagency Autism Coordinating Committee's (IACC) Subcommittee for Basic and Translational Research (BTR) Co-occurring Conditions Planning Group convened a conference call on Tuesday, May 27, 2014, from 11:00 a.m. to 12:16 p.m.
In accordance with Public Law 92-463, the meeting was open to the public. Dr. Thomas Insel, Chair, presided.
Thomas Insel, M.D., Chair, IACC, National Institute of Mental Health (NIMH); Susan Daniels, Ph.D., Executive Secretary, IACC, Office of Autism Research Coordination (OARC), (NIMH); Anshu Batra, M.D., Our Special Kids; Sally Burton-Hoyle, Ed.D., Eastern Michigan University; Matthew Carey, Ph.D., Left Brain Right Brain Blog; Judith Cooper, Ph.D. (representing James Battey, M.D., Ph.D.); Jan Crandy, Nevada State Autism Treatment Assistance Program; Geraldine Dawson, Ph.D., Duke University; Alice Kau, Ph.D., Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) (representing Alan Guttmacher, M.D.); Donna Kimbark, Ph.D., U.S. Department of Defense (DoD); Walter Koroshetz, M.D., National Institute of Neurological Disorders and Stroke (NINDS); Hae Young Park, M.P.H., Health Resources and Services Administration (HRSA) (representing Laura Kavanagh, M.P.P.); Lyn Redwood, R.N., M.S.N., Coalition for SafeMinds; Alison Tepper Singer, M.B.A., Autism Science Foundation (ASF)
Roll Call and Opening Remarks
Dr. Susan Daniels began the meeting by calling the roll. Dr. Thomas Insel summarized the purpose of the call, which was to clarify the aims of the Group – topics to be included and end products. Dr. Insel noted that meeting materials had been emailed to the members and were available online.
Dr. Walter Koroshetz said that the Group first needed to decide on its overall goal. He suggested that there were two paths, which seemed to be of interest to various members. One option was to better understand the medical issues that families and individuals with autism were challenged with on a daily basis, and which needed research to improve symptoms. The second option was the biology, particularly with regard to immune, metabolic, and mitochondrial abnormalities. It would not be possible to do both. The Group would need to pick one of these approaches. Dr. Sally Burton-Hoyle said that medical conditions including anxiety, depression, hypertension, and obesity not only affected quality of life for adults with autism, but were significant causes of morbidity for these individuals as well. She wanted to address these issues through this Planning Group.
Ms. Lynn Redwood asked for clarification on the two options described by Dr. Koroshetz. He said that to examine both symptom improvement and the pathogenesis of autism would necessarily limit the scope to a small subset of symptoms. Otherwise the process would become too cumbersome and complicated. If they were to adequately address metabolic and immune symptomology/pathogenesis for example, they would not be able to address other medical comorbidities.
Ms. Redwood said that, based on the discussion at the most recent IACC meeting, it seemed that the goal of this Group was to hold a workshop this summer. The goal of the workshop was to identify research needs and areas with adequate evidence for guidelines. It was her understanding that the action item from the last IACC meeting was to identify experts to attend the workshop. Dr. Koroshetz said that he was unclear as to what the goal and scope of the Group would be, given the exchange of emails following the last IACC meeting. A number of members had expressed interest in understanding the health problems and symptoms of individuals with autism seen in the clinical setting, and that families faced on a daily basis. Dr. Donna Kimbark pointed out that this Group was not a medical body, and therefore it was inappropriate for it to propose guidelines. Dr. Daniels agreed that it was not appropriate for the IACC to develop guidelines. However, they could identify some of the issues related to co-occurring conditions, or develop research recommendations.
The Group discussed the merits and drawbacks of each proposed option for the remainder of the call.
Neuroimmune/metabolic Issues Potentially Involved in ASD Etiology/Co-occurring Health Conditions or Symptoms
Dr. Geraldine Dawson told the Group that she had contacted the Autism Treatment Network (ATN) to find out about their work on immune and metabolic research and guidelines. She spoke with James Perrin, M.D., who heads the Clinical Coordinating Center for the ATN and the Autism Intervention Research Network on Physical Health (AIR-P). She also spoke with Daniel Coury, M.D., who is the Medical Director of the ATN. They told her that neither the ATN nor the AIR-P were currently working on guidelines for metabolic or immune conditions. However, these were active areas of research. ATN and AIR-P also were developing a review of research on a range of medical conditions, including immune conditions. In short, guidelines in these areas would premature, given the early state of research. Dr. Dawson proposed that the Group hold a workshop highlighting some of the ongoing research on immune- and metabolic-related conditions. Of note, the ATN and AIR-P were working on guidelines related to neurologic issues, such as seizures.
Dr. Insel asked Dr. Koroshetz if research on inflammation and oxidative stress was further along for any central nervous system (CNS) disorders. Were there tools that could be translated to autism research? Dr. Koroshetz pointed to very rare conditions (encephalopathies) with antibodies to brain proteins in terms of progress in this area. The immune system had become an active area of research with some limited success. However, mitochondrial disorders posed a more difficult problem. Techniques were not standardized and were not sensitive enough to identify the range of mitochondrial abnormalities, which often had few or no symptoms. In terms of autism, there had been progress on understanding the basic biology of maternal autoantibodies and microglia, but not much on immune and metabolic conditions. Dr. Dawson added that published case studies suggested autoimmune encephalitis as possibly being related to ASD, but these were very early emerging findings. Dr. Insel suggested that it might be useful to hear from experts in neuroimmunology and metabolism, who were not necessarily involved with autism research. This might help the Group to get a sense of the level of evidence needed to define subgroups.
Dr. Dawson added that they should consider including work on animal models of environmental influences on microglial activation, fetal brain development, and ultimately postnatal behavior. They should consider including autoimmune encephalitis research as well. She said that the workshop could focus on the immune system and developing brain. A few experts were mentioned as possible invitees: Beth Stevens, Ph.D. (Harvard University), Staci Bilbo, Ph.D. (Duke Institute for Brain Sciences), Susan Swedo, M.D. (NIMH), and Carlos Pardo-Villazimir, M.D. (Johns Hopkins University). Dr. Insel said that the area of inflammation and brain development was important to include because this was a very rapidly developing area. The IACC should be kept abreast of these advances with the Strategic Plan in mind.
Under-recognized Co-occurring Health Conditions in Individuals with ASD
Dr. Burton-Hoyle said that the health issues faced by adults with autism received very little attention. She referred to data from a study1 of psychiatric and medical conditions among adults with ASD in the Kaiser Permanente database, which was presented at the 2014 International Meeting for Autism Research (IMFAR). In this study, adults with ASD had significantly greater rates of depression, anxiety, obesity, and hypertension among other comorbidities. She said that these conditions could greatly affect quality of life. She emphasized that the health of adults with ASD was often overlooked. Ms. Alison Singer noted that Dr. Lisa Croen (Kaiser Permanente) had presented data on psychiatric comorbidities in children with ASD2 at IMFAR. Dr. Insel said that there was also available data on physical comorbidities in children with ASD from a different study. Ms. Redwood said that studies based on large databases could be problematic because there were no ICD -9 (International Statistical Classification of Diseases and Related Health Problems Nine) codes for some underlying conditions, such as mitochondrial disorders. Therefore, these would not be captured in administrative databases. Dr. Anshu Batra said that pediatricians were seeing a subgroup of children with mitochondrial disorders, who presented with ASD or ASD-like symptoms. She said that she noted this in the medical chart, but agreed that there was not an appropriate code. Dr. Insel said that it might be difficult to address mitochondrial disorders in the clinical setting because there weren't any tests that are specific enough.
Dr. Dawson said that a workshop with a clinical focus could include natural course, prevalence rates of medical comorbidities, and adults with ASD. Dr. Croen and Anjali Jain, M.D. (The Lewin Group) were mentioned as possible experts. Dr. Matt Carey said that regardless of whether immune, metabolic, and mitochondrial comorbidities were underdiagnosed, there were other comorbidities that had very high prevalence rates. These conditions more urgently needed to be addressed. Ms. Redwood said that many of these conditions already had diagnostic codes and guidelines. Therefore, the Group should focus on conditions that lacked these – and even lacked clinical recognition. However, Dr. Burton-Hoyle said that new studies presented at the recent IMFAR meeting and other recent work, added to and possibly changed the clinical picture of psychiatric and medical comorbidities. She added that clinicians were often unaware or under-educated about conditions that co-occurred with ASD. This was particularly true for adults.
Ms. Singer proposed a third workshop option, which was to better quantify the magnitude of comorbid psychiatric conditions, such as suicide, depression, and anxiety. They could build upon the work by Dr. Croen that was presented at IMFAR.
Dr. Carey said that he imagined this Group as one that could potentially take on a series of projects. However, Dr. Insel said that they could not assume that the IACC would be reauthorized by Congress. If the IACC were to be reauthorized, the next Committee would need to decide on future directions.
Vote and Next Steps
Dr. Daniels summarized the two proposed approaches – a workshop on a range of co-occurring health conditions in individuals with ASD that were under-recognized in clinical and services settings or a workshop on neuroimmune/metabolic issues that might be involved in ASD etiology, and might result in co-occurring health conditions or symptoms. The Group took a vote on which approach to adopt.
Six members voted for a workshop on several groups of comorbidities and next steps for research and clinical practice/services(Dr. Batra, Dr. Burton-Hoyle, Dr. Carey, Dr. Cooper, Dr. Kimbark, and Ms. Park) and three voted to focus the workshop specifically on the role of neuroimmune/metabolic issues in etiology of ASD (Ms. Redwood, Dr. Kau, and Ms. Singer). Dr. Daniels said that she would follow up by email with the members, who had to leave the call early. She would then send out an email to the Group with the final vote, work with members to schedule a call to identify experts for the workshop, and plan a date for the workshop.
After the call, additional votes were received via e-mail:
Dr. Batra, Dr. Burton-Hoyle, Dr. Carey, Dr. Cooper, Dr. Kimbark, Ms. Park and Ms. Abdull (7) were in favor of the workshop on multiple under-recognized co-occurring conditions.
Ms. Redwood, Dr. Kau, Ms. Singer and Dr. Insel (4) were in favor of the immune/metabolic etiology-based workshop.
The majority of the group voted for the workshop on multiple under-recognized co-occurring conditions, which would be discussed on a future conference call.
The conference call was adjourned at 12:16 p.m.
I hereby certify that this meeting summary is accurate and complete.
/Susan Daniels/ June 5, 2014
Susan A. Daniels, Ph.D.
Executive Secretary, Interagency Autism Coordinating Committee
1 Croen, L.A. et. al. Psychiatric and Medical Conditions Among Adults with ASD. Paper presented at oral session, Adult Outcomes. International Meeting for Autism Research. Accessed June 9, 2014.
2 Croen, L.A. et. al. A Multi-Site Study of Prevalence, Incidence, and Age at First Diagnosis for Autism Spectrum Disorders: Findings from the Mental Health Research Network Autism Registry Study. Paper presented at oral session, Early Development II. International Meeting for Autism Research. Accessed June 12, 2014.
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Below you will find links to the materials for the meeting.
Autism Co-occurring Conditions Guidelines and Publications
Gastrointestinal and Eating Behaviors
- ATN/AIR-P Exploring Feeding Behavior in Autism: A Parent's Guide
- ATN/AIR-P Guide for Managing Constipation in Children: A Tool Kit for Parents
- Buie et al. Evaluation, Diagnosis, and Treatment of Gastrointestinal Disorders in Individuals With ASDs: A Consensus Report. Pediatrics Supplement. January 2010.
- Furuta et al. Management of Constipation in Children and Adolescents With Autism Spectrum Disorders. Pediatrics Supplement. November 1, 2012.
- Beighley et al. Food selectivity in children with and without an autism spectrum disorder: investigation of diagnosis and age. Res Dev Disabil. October 2013.
- Buie T. The relationship of autism and gluten. Clin Ther. May 2013
- Coury et al. Gastrointestinal Conditions in Children With Autism Spectrum Disorder: Developing a Research Agenda Pediatrics Supplement. November 1, 2012.
- Douglas-Escobar et al. Effect of intestinal microbial ecology on the developing brain. JAMA Pediatr. April 2013.
- Hsiao et al. Microbiota modulate behavioral and physiological abnormalities associated with neurodevelopmental disorders. Cell. December 19, 2013.
- Huke et al. Autism spectrum disorders in eating disorder populations: a systematic review. Eur Eat Disord Rev. September 2013.
- Hyman et. al. Nutrient Intake From Food in Children With Autism Pediatrics Supplement. November 1, 2012.
- Kral, T, Eriksen W, Souders M, Pinto Martin J. Eating Behaviors, Diet Quality, and Gastrointestinal Symptoms in Children With Autism Spectrum Disorders: A Brief Review. J Pediatric Nursing. March 24, 2013.
- Lau et al. Markers of Celiac Disease and Gluten Sensitivity in Children with Autism. PLoS One. June 2013.
- Rastam et al. Eating problems and overlap with ADHD and autism spectrum disorders in a nationwide twin study of 9- and 12-year-old children. ScientificWorldJournal. April 15, 2013.
- Ruskin et al. Ketogenic diet improves core symptoms of autism in BTBR mice. PLoS One. June 5, 2013.
- Williams et al. Impaired carbohydrate digestion and transport and mucosal dysbiosis in the intestines of children with autism and gastrointestinal disturbances. PLoS One. September 2011.
- D A Rossignol, R E Frye. A review of research trends in physiological abnormalities in autism spectrum disorders: immune dysregulation, inflammation, oxidative stress, mitochondrial dysfunction and environmental toxicant exposures. Mol Psychiatry. Apr 2012; 17(4): 389–401. Published online Dec 6, 2011. doi: 10.1038/mp.2011.165 PMCID: PMC3317062
- Gehan A Mostafaand Laila Y AL-ayadh. Increased serum levels of anti-ganglioside M1 auto-antibodies in autistic children: relation to the disease severity. Journal of Neuroinflammation. 2011, 8:39 doi:10.1186/1742-2094-8-39 Published: 25 April 2011
- Onore C1, Careaga M, Ashwood P. The role of immune dysfunction in the pathophysiology of autism. Brain Behav Immun. 2012 Mar;26(3):383-92. doi: 10.1016/j.bbi.2011.08.007. Epub 2011 Aug 28.
- Gamsiz ED, et al. Intellectual disability is associated with increased runs of homozygosity in simplex autism. Am J Hum Genet. 2013 Jul 11;93(1):103-9.
- Lundvall et al. Aetiology of severe mental retardation and further genetic analysis by high-resolution microarray in a population-based series of 6- to 17-year-old children. Acta Paediatr. January 2012.
- Moskowitz et al. A multimethod assessment of anxiety and problem behavior in children with autism spectrum disorders and intellectual disability. Am J Intellect Dev Disabil. November 2013.
- Srivastava and Schwartz. Intellectual Disability and Autism Spectrum Disorders: Causal Genes and Molecular Mechanisms. Neurosci Biobehav Rev. April 4, 2014.
- Tureck et al. An examination of the relationship between autism spectrum disorder, intellectual functioning, and comorbid symptoms in children. Res Dev Disabil. March 20, 2014.
- Turygin et al. Prevalence of co-occurring disorders in a sample of adults with mild and moderate intellectual disabilities who reside in a residential treatment setting. Res Dev Disabil. March 20, 2014.
- Adams et al. Nutritional and metabolic status of children with autism vs. neurotypical children, and the association with autism severity. Nutr Metab (Lond). June 2011.
- Burrage et al. Branched-chain amino acid metabolism: from rare Mendelian diseases to more common disorders. Hum Mol Genet. 2014 Apr 1 (epub ahead of print)
- Celestino-Soper et al. A common X-linked inborn error of carnitine biosynthesis may be a risk factor for nondysmorphic autism. Proc Natl Acad Sci U S A. 2012 May 22;109(21):7974-81.
- Frye et al. Metabolic effects of sapropterin treatment in autism spectrum disorder: a preliminary study. (PDF – 1.3 MB) Transl Psychiatry. March 2013.
- Frye et al. Redox metabolism abnormalities in autistic children associated with mitochondrial disease. (PDF – 2 MB) Transl Psychiatry. June 2013.
- Frye et al. Unique acyl-carnitine profiles are potential biomarkers for acquired mitochondrial disease in autism spectrum disorder. (PDF – 1.4 MB) Transl Psychiatry. January 2013.
- García-Cazorla et al. Two Novel Mutations in the BCKDK (Branched-Chain Keto-Acid Dehydrogenase Kinase) Gene Are Responsible for a Neurobehavioral Deficit in Two Pediatric Unrelated Patients. Hum Mutat. 2014 Apr;35(4):470-7.
- Goh S, Dong Z, Zhang Y, Dimauro S, Peterson BS. Mitochondrial Dysfunction as a Neurobiological Subtype of Autism Spectrum Disorder: Evidence From Brain Imaging. JAMA Psychiatry. 2014 Apr 9. doi: 10.1001/jamapsychiatry.2014.179. [Epub ahead of print]
- Napoli E, Wong S, Hertz-Picciotto I, Giulivi C. Deficits in Bioenergetics and Impaired Immune Response in Granulocytes From Children With Autism. Pediatrics. 2014 Apr 21 (epub ahead of print)
- Novarino et al. Mutations in BCKD-kinase lead to a potentially treatable form of autism with epilepsy. Science. 2012 Oct 19;338(6105):394-7.
- Rose S1, Melnyk S, Pavliv O, Bai S, Nick TG, Frye RE, James SJ. Evidence of oxidative damage and inflammation associated with low glutathione redox status in the autism brain. Transl Psychiatry. 2012 Jul 10;2:e134. doi: 10.1038/tp.2012.61.
- Rossignol and Frye. Mitochondrial dysfunction in autism spectrum disorders: a systematic review and meta-analysis.Molecular Psychiatry. January 2011.
- Zecavati and Spence. Neurometabolic Disorders and Dysfunction in Autism Spectrum Disorders. (PDF – 388 KB) Current Neurology and Neuroscience Reports. March 2009.
Neurological and Motor Impairments
- Amiet et al. Does epilepsy in multiplex autism pedigrees define a different subgroup in terms of clinical characteristics and genetic risk? Mol Autism. December 1, 2013.
- Christensen et al. Prevalence of cerebral palsy, co-occurring autism spectrum disorders, and motor functioning - Autism and Developmental Disabilities Monitoring Network, USA, 2008. Dev Med Child Neurol. January 2014.
- Galizia et al. Array comparative genomic hybridization: results from an adult population with drug-resistant epilepsy and co-morbidities. Eur J Med Genet. May 2012.
- Kakooza-Mwesige et al. Catatonia in autism: implications across the life span. European Child and Adolescent Psychiatry. September 2008.
- Nicholl et al. Epilepsy with cognitive deficit and autism spectrum disorders: prospective diagnosis by array CGH. Am J Med Genet B Neuropsychiatr Genet. January 2013.
- Shorter and Wachtel. Childhood catatonia, autism and psychosis past and present: is there an 'iron triangle'? Acta Psychiatr Scand. July 2013.
- Tuchman and Cuccaro. Epilepsy and Autism: Neurodevelopmental Perspective. Current Neurology and Neuroscience Reports. August 2011.
- Mahajan et al. Clinical Practice Pathways for Evaluation and Medication Choice for Attention-Deficit/Hyperactivity Disorder Symptoms in Autism Spectrum Disorders. Pediatrics Supplement. November 1, 2012.
- Bradstreet et al. Biomarker-guided interventions of clinically relevant conditions associated with autism spectrum disorders and attention deficit hyperactivity disorder. Altern Med Rev. April 2010.
- Cochran et al. "Autism-plus" spectrum disorders: intersection with psychosis and the schizophrenia spectrum. Child Adolesc Psychiatr Clin N Am. October 2013.
- Johnston et al. Attention deficit hyperactivity disorder symptoms in adults with autism spectrum disorders. Autism Res. August 2013.
- Mazefsky et al. Emotion Regulation Patterns in Adolescents With High-Functioning Autism Spectrum Disorder: Comparison to Typically Developing Adolescents and Association With Psychiatric Symptoms. Autism Res. March 7, 2014.
- Musser et al. Shared familial transmission of autism spectrum and attention-deficit/hyperactivity disorders. J Child Psychol Psychiatry. January 21, 2014.
- Rao and Landa. Association between severity of behavioral phenotype and comorbid attention deficit hyperactivity disorder symptoms in children with autism spectrum disorders. Autism. April 2014.
- Richa et al. Suicide in Autism Spectrum Disorders. Altern Med Rev. April 8, 2014.
- Russell et al. Cognitive behavior therapy for comorbid obsessive-compulsive disorder in high-functioning autism spectrum disorders: a randomized controlled trial. Depress Anxiety. August 2013.
- Sikora et al. Attention-Deficit/Hyperactivity Disorder Symptoms, Adaptive Functioning, and Quality of Life in Children With Autism Spectrum Disorder. Pediatrics Supplement. November 1, 2012.
- Talisa et al. Autism and anxiety in males with fragile X syndrome: An exploratory analysis of neurobehavioral profiles from a parent survey. Am J Med Genet A. May 2014.
- Autism Speaks/Autism Treatment Network/AIR-P Sleep Toolkit
- Malow et al. A Practice Pathway for the Identification, Evaluation, and Management of Insomnia in Children and Adolescents With Autism Spectrum Disorders. Pediatrics Supplement. November 1, 2012.
- Adkins et al. Effects of a Standardized Pamphlet on Insomnia in Children With Autism Spectrum Disorders. Pediatrics Supplement. November 1, 2012.
- Malow et al. Parent-Based Sleep Education for Children with Autism Spectrum Disorders. Journal of Autism and Developmental Disorders. June 2013
- Schwichtenberg et al. Behavior and sleep problems in children with a family history of autism. Autism Res. April 2013.
- Sikora et al. The Relationship Between Sleep Problems and Daytime Behavior in Children of Different Ages With Autism Spectrum Disorders. Pediatrics Supplement. November 1, 2012.
- Carlsson et al. Coexisting disorders and problems in preschool children with autism spectrum disorders. ScientificWorldJournal. April 23, 2013.
- Coury et al. Use of Psychotropic Medication in Children and Adolescents With Autism Spectrum Disorders. Pediatrics Supplement. November 1, 2012.
- Curtin et al. The prevalence of obesity in children with autism: a secondary data analysis using nationally representative data from the National Survey of Children's Health.BMC Pediatr. February 23, 2010.
- Doshi-Velez et al. Comorbidity clusters in autism spectrum disorders: an electronic health record time-series analysis. Pediatrics. January 2014.
- Garcia et al. Self-directedness and cooperativeness, psychosocial dysfunction and suffering in ESSENCE. ScientificWorldJournal. April 28, 2013.
- Kohane et al. The Co-Morbidity Burden of Children and Young Adults with Autism Spectrum Disorders. PloS One. April 2012.
- Kohane et al. The co-morbidity burden of children and young adults with autism spectrum disorders. PLoS One. April 2012.
- Lajonchere at al. Leadership in Health Care, Research, and Quality Improvement for Children and Adolescents With Autism Spectrum Disorders: Autism Treatment Network and Autism Intervention Research Network on Physical Health. Pediatrics Supplement. November 1, 2012.
- Lundvall et al. Common neurological co-morbidities in autism spectrum disorders. Curr Opin Pediatr. December 2011.
- National Autism Association: Medical Comorbidities Report.
- Perrin et al. Complementary and Alternative Medicine Use in a Large Pediatric Autism Sample. Pediatrics Supplement. November 1, 2012.
- Pettersson et al. Different neurodevelopmental symptoms have a common genetic etiology. J Child Psychol Psychiatry. December 2013.
- Russ et al. Hearing difficulties in children with special health care needs. J Dev Behav Pediatr. September 2013.
- Link to March 17, 2014 SFARI webinar on finding treatable forms of autism (related to metabolic issues)
- Link to April 21, 2014 SFARI webinar by Lisa Croen on adult comorbidities
- Link to video from Marsha Mailick's presentation at IMFAR May 2014 that discussed outcomes, including health conditions, in adults
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- Meeting Transcript (PDF – 188 KB)
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