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2010 IACC Strategic Plan for Autism Spectrum Disorder Research Budget

In the Combating Autism Act of 2006, (PDF – 49 KB) it is specified that the Interagency Autism Coordinating Committee (IACC) shall "develop and annually update a strategic plan for autism spectrum disorder (ASD) research" including "proposed budgetary requirements."  The budget figures in this document, which are taken from the 2010 IACC Strategic Plan for ASD Research, are professional judgment budget estimates that indicate the potential cost of each project if it were to be done under current funding conditions.  These budget estimates were developed by the IACC in conjunction with other federal and private funders of ASD research.  These estimates, like the strategic plan itself, are recommendations of the IACC and only advisory in nature.  The budget estimates may be used by federal agencies and private organizations to help plan the budgetary aspects of projects and programs recommended as priorities for ASD research by the IACC. The budget estimates may be used by federal agencies and private organizations to help plan the budgetary aspects of projects and programs recommended as priorities for ASD research by the IACC in the 2010 Strategic Plan.

Grand Total for All Years: $1,003,155,000
Annual Total: $220,609,048
Total Number of Objectives: 62

Note: Objectives labeled "old" are unmodified or minimally modified objectives from the 2009 Strategic Plan. Objectives labeled "new" are entirely new objectives developed for the 2010 Strategic Plan, or significantly modified objectives from the 2009 Strategic Plan.

*In Question 7, "old" objectives are objectives that were moved to this chapter from other chapters of the 2009 Strategic Plan.

Question 1: When should I be concerned?

Objective Type 2010 Strategic Plan Objective Total Years Annual Budget Total Budget
Old Short-term A. Develop, with existing tools, at least one efficient diagnostic instrument (e.g., briefer, less time intensive) that is valid in diverse populations for use in large-scale studies by 2011. IACC Recommended Budget: $5,300,000 over 2 years. 2 $2,650,000 $5,300,000
Old Short-term B. Validate and improve the sensitivity and specificity of new or existing screening and diagnostic tools, including comparison of general developmental screening versus autism-specific screening tools, in both high risk and population-based samples through studies of the following community populations that are diverse in terms of age, socio-economic status, race, ethnicity, characteristics of ASD, and general level of functioning by 2012. IACC Recommended Budget: $5,400,000 over 3 years. 3 $1,800,000 $5,400,000
New Short-term C. Conduct at least three studies to identify reasons for the health disparities in accessing early screening and diagnosis services by 2012. IACC Recommended Budget: $2,000,000 over 2 years. 2 $1,000,000 $2,000,000
New Short-term D. Conduct at least two studies to understand the impact of early diagnosis on choice of intervention and outcomes by 2015. IACC Recommended Budget: $6,000,000 over 5 years. 5 $1,200,000 $6,000,000
Old Long-term A. Identify behavioral and biological markers that separately, or in combination, accurately identify, before age 2, one or more subtypes of children at risk for developing ASD by 2014. IACC Recommended Budget: $33,300,000 over 5 years. 5 $6,660,000 $33,300,000
Old Long-term B. Develop at least five measures of behavioral and/or biological heterogeneity in children or adults with ASD, beyond variation in intellectual disability, that clearly relate to etiology and risk, treatment response and/or outcome by 2015. IACC Recommended Budget: $71,100,000 over 5 years. 5 $14,220,000 $71,100,000
Old Long-term C. Identify and develop measures to assess at least three "continuous dimensions" (i.e., social reciprocity, communication disorders, and repetitive/restrictive behaviors) of ASD symptoms and severity that can be used by practitioners and/or families to assess response to intervention for people with ASD across the lifespan by 2016. IACC Recommended Budget: $18,500,000 over 5 years. 5 $3,700,000 $18,500,000
Total     $31,230,000 $141,600,000

Question 2: How can I understand what is happening?

Objective Type 2010 Strategic Plan Objective Total Years Annual Budget Total Budget
Old Short-term A. Support at least four research projects to identify mechanisms of metabolic and/or immune system interactions with the central nervous system that may underlie the development of ASD during prenatal-postnatal life by 2010. IACC Recommended Budget: $9,800,000 over 4 years. 4 $2,450,000 $9,800,000
Old Short-term B. Launch three studies that specifically focus on the neurodevelopment of females with ASD, spanning basic to clinical research on sex differences by 2011. IACC Recommended Budget: $8,900,000 over 5 years. 5 $1,780,000 $8,900,000
Old Short-term C. Identify ways to increase awareness among the autism spectrum community of the potential value of brain and tissue donation to further basic research by 2011. IACC Recommended Budget: $1,400,000 over 2 years. 2 $700,000 $1,400,000
New Short-term D. Launch three studies that target improved understanding of the underlying biological pathways of genetic conditions related to autism (e.g. Fragile X, Rett syndrome, tuberous sclerosis complex) and how these conditions inform risk assessment and individualized intervention by 2012. IACC Recommended Budget: $9,000,000 over 5 years. 5 $1,800,000 $9,000,000
New Short-term E. Launch three studies that target the underlying biological mechanisms of co-occurring conditions with autism including seizures/epilepsy, sleep disorders and familial autoimmune disorders by 2012. IACC Recommended Budget: $9,000,000 over 5 years. 5 $1,800,000 $9,000,000
New Short-term F. Launch two studies that focus on prospective characterization of children with reported regression, to investigate potential risk factors by 2012. IACC Recommended Budget: $4,500,000 over 5 years. 5 $900,000 $4,500,000
New Short-term G. Support five studies that associate specific genotypes with functional or structural phenotypes, including behavioral and medical phenotypes (e.g., nonverbal individuals with ASD and those with cognitive impairments) by 2015. IACC Recommended Budget: $22,600,000 over 5 years. 5 $4,520,000 $22,600,000
Old Long-term A. Complete a large-scale, multi-disciplinary, collaborative project that longitudinally and comprehensively examines how the biological, clinical, and developmental profiles of individuals, with a special emphasis on females, youths, and adults with ASD, change over time as compared to typically developing people by 2020. IACC Recommended Budget: $126,200,000 over 12 years. 12 $10,516,667 $126,200,000
New Long-term B. Launch at least three studies which evaluate the applicability of ASD phenotype and/or biological signature findings for performing diagnosis, risk assessment, or clinical intervention by 2015. IACC Recommended Budget: $7,200,000 over 5 years. 5 $1,440,000 $7,200,000
Total     $25,906,667 $198,600,000

Question 3: What caused this to happen and can this be prevented?

Objective Type 2010 Strategic Plan Objective Total Years Annual Budget Total Budget
Old Short-term A. Coordinate and implement the inclusion of approximately 20,000 subjects for genome-wide association studies, as well as a sample of 1,200 for sequencing studies to examine more than 50 candidate genes by 2011. Studies should investigate factors contributing to phenotypic variation across individuals that share an identified genetic variant and stratify subjects according to behavioral, cognitive, and clinical features. IACC Recommended Budget: $43,700,000 over 4 years. 4 $10,925,000 $43,700,000
Old Short-term B. Within the highest priority categories of exposures for ASD, identify and standardize at least three measures for identifying markers of environmental exposure in biospecimens by 2011. IACC Recommended Budget: $3,500,000 over 3 years. 3 $1,166,667 $3,500,000
Old Short-term C. Initiate efforts to expand existing large case-control and other studies to enhance capabilities for targeted gene – environment research by 2011. IACC Recommended Budget: $27,800,000 over 5 years. 5 $5,560,000 $27,800,000
Old Short-term D. Enhance existing case-control studies to enroll racially and ethnically diverse populations affected by ASD by 2011. IACC Recommended Budget: $3,300,000 over 5 years. 5 $660,000 $3,300,000
New Short-term E. Support at least two studies to determine if there are subpopulations that are more susceptible to environmental exposures (e.g., immune challenges related to infections, vaccinations, or underlying autoimmune problems) by 2012. IACC Recommended Budget: $8,000,000 over 2 years. 2 $4,000,000 $8,000,000
New Short-term F. Initiate studies on at least 10 environmental factors identified in the recommendations from the 2007 IOM report "Autism and the Environment: Challenges and Opportunities for Research" as potential causes of ASD by 2012. Estimated cost $56,000,000 over 2 years. 2 $28,000,000 $56,000,000
Old Long-term A. Conduct a multi-site study of the subsequent pregnancies of 1,000 women with a child with ASD to assess the impact of environmental factors in a period most relevant to the progression of ASD by 2014. IACC Recommended Budget: $11,100,000 over 5 years. 5 $2,220,000 $11,100,000
Old Long-term B. Identify genetic risk factors in at least 50% of people with ASD by 2014. IACC Recommended Budget: $33,900,000 over 6 years. 6 $5,650,000 $33,900,000
Old Long-term C. Determine the effect of at least five environmental factors on the risk for subtypes of ASD in the pre- and early postnatal period of development by 2015. IACC Recommended Budget: $25,100,000 over 7 years. 7 $3,585,714 $25,100,000
Old Long-term D. Support ancillary studies within one or more large-scale, population-based surveillance and epidemiological studies, including U.S. populations, to collect data on environmental factors during preconception, and during prenatal and early postnatal development, as well as genetic data, that could be pooled (as needed), to analyze targets for potential gene/environment interactions by 2015. IACC Recommended Budget: $44,400,000 over 5 years. 5 $8,880,000 $44,400,000
Total     $70,647,381 $256,800,000

Question 4: Which treatments and interventions will help?

Objective Type 2010 Strategic Plan Objective Total Years Annual Budget Total Budget
Old Short-term A. Support at least three randomized controlled trials that address co-occurring medical conditions associated with ASD by 2010. IACC Recommended Budget: $13,400,000 over 3 years. 3 $4,466,667 $13,400,000
Old Short-term B. Standardize and validate at least 20 model systems (e.g. cellular and/or animal) that replicate features of ASD and will allow identification of specific molecular targets or neural circuits amenable to existing or new interventions by 2012. IACC Recommended Budget: $75,000,000 over 5 years. 5 $15,000,000 $75,000,000
Old Short-term C. Test safety and efficacy of at least five widely used interventions (e.g., nutrition, medications, assisted technologies, sensory integration, medical procedures) that have not been rigorously studied for use in ASD by 2012. IACC Recommended Budget: $27,800,000 over 5 years. 5 $5,560,000 $27,800,000
Old Short-term D. Complete two multi-site randomized controlled trials of comprehensive early intervention that address core symptoms, family functioning and community involvement by 2013. IACC Recommended Budget: $16,700,000 over 5 years. 5 $3,340,000 $16,700,000
New Short-term E. Convene a workshop to advance the understanding of clinical subtypes and treatment personalization (i.e. what are the core symptoms to target for treatment studies) by 2011. IACC Recommended Budget: $50,000. 1 $50,000 $50,000
New Short-term F. Launch five randomized controlled trials of interventions including biological signatures and other measures to predict response, and monitor quality of life and functional outcomes, in each of the following groups:
  • Five trials in infants and toddlers by 2013. IACC Recommended Budget: $30,000,000 over 5 years.
  • Three randomized controlled trials of interventions for school-aged children and/or adolescents by 2013. IACC Recommended Budget: $18,000,000 over 5 years.
  • Three trials for adults by 2014. IACC Recommended Budget: $18,000,000 over 5 years.
5 $13,200,000 $66,000,000
Old Long-term A. Complete at least three randomized controlled trials on medications targeting core symptoms in people with ASD of all ages by 2014. IACC Recommended Budget: $22,200,000 over 5 years. 5 $4,440,000 $22,200,000
Old Long-term B. Develop interventions for siblings of people with ASD with the goal of reducing risk recurrence by at least 30% by 2014. IACC Recommended Budget: $6,700,000 over 5 years. 5 $1,340,000 $6,700,000
New Long-term C. Conduct at least one study to evaluate the safety and effectiveness of medications commonly used in the treatment of co-occurring conditions or specific behavioral issues in people with ASD by 2015. IACC Recommended Budget: $10,000,000 over 5 years. 5 $2,000,000 $10,000,000
Total     $49,396,667 $237,850,000

Question 5: Where can I turn for services?

Objective Type 2010 Strategic Plan Objective Total Years Annual Budget Total Budget
Old Short-term A. Support two studies that assess how variations and access to services affect family functioning in diverse populations, including underserved populations, by 2012. IACC Recommended Budget: $1,000,000 over 3 years. 3 $333,333 $1,000,000
New Short-term B. Conduct one study to examine how self-directed community-based services and supports impact children, youth, and adults with ASD across the spectrum by 2014. IACC Recommended Budget: $6,000,000 over 3 years. 3 $2,000,000 $6,000,000
New Short-term C. Implement and evaluate two models of policy and practice-level coordination among state and local agencies to provide integrated and comprehensive community-based supports and services that enhance access to services and supports, self-determination, economic self-sufficiency, and quality of life for people with ASD across the spectrum and their families, with at least one project aimed at the needs of transitioning youth by 2015. IACC Recommended Budget: $10,000,000 over 5 years. 5 $2,000,000 $10,000,000
Old Long-term A. Test four methods to improve dissemination, implementation, and sustainability of evidence-based interventions, services, and supports in diverse community settings by 2013. IACC Recommended Budget: $7,000,000 over 5 years. 5 $1,400,000 $7,000,000
Old Long-term B. Test the efficacy and cost-effectiveness of at least four evidence-based services and supports for people with ASD across the spectrum and of all ages living in community settings by 2015. IACC Recommended Budget: $16,700,000 over 5 years. 5 $3,340,000 $16,700,000
New Long-term C. Evaluate new and existing pre-service and in-service training to increase skill levels in service providers, including direct support workers, parents and legal guardians, education staff, and public service workers to benefit the spectrum of people with ASD and promote interdisciplinary practice by 2015. IACC Recommended Budget: $8,000,000 over 5 years. 5 $1,600,000 $8,000,000
Total     $10,673,333 $48,700,000

Question 6: What does the future hold, particularly for adults?

Objective Type 2010 Strategic Plan Objective Total Years Annual Budget Total Budget
New Short-term A. Launch at least two studies to assess and characterize variation in the quality of life for adults on the ASD spectrum as it relates to characteristics of the service delivery system (e.g., safety, integrated employment, post-secondary educational opportunities, community inclusion, self-determination, relationships, and access to health services and community-based services) and determine best practices by 2012. IACC Recommended Budget: $5,000,000 over 3 years. 3 $1,666,667 $5,000,000
New Short-term B. Evaluate at least one model, at the state and local level, in which existing programs to assist people with disabilities (e.g., Social Security Administration, Rehabilitation Services Administration) meet the needs of transitioning youth and adults with ASD by 2013. IACC Recommended Budget: $5,000,000 over 3 years. 3 $1,666,667 $5,000,000
New Short-term C. Develop one method to identify adults across the ASD spectrum who may not be diagnosed, or are misdiagnosed, to support service linkage, better understand prevalence, track outcomes, with consideration of ethical issues (insurance, employment, stigma) by 2015. IACC Recommended Budget: $8,400,000 over 5 years. 5 $1,680,000 $8,400,000
New Short-term D. Conduct at least one study to measure and improve the quality of life-long supports being delivered in community settings to adults across the spectrum with ASD through provision of specialized training for direct care staff, parents, and legal guardians, including assessment and development of ASD-specific training, if necessary, by 2015. IACC Recommended Budget: $7,500,000 over 5 years. 5 $1,500,000 $7,500,000
New Long-term A. Develop at least two individualized community-based interventions that improve quality of life or health outcomes for the spectrum of adults with ASD by 2015. IACC Recommended Budget: $12,900,000 over 5 years. 5 $2,580,000 $12,900,000
New Long-term B. Conduct one study that builds on carefully characterized cohorts of children and youth with ASD to determine how interventions, services, and supports delivered during childhood impact adult health and quality of life outcomes by 2015. IACC Recommended Budget: $5,000,000 over 5 years. 5 $1,000,000 $5,000,000
New Long-term C. Conduct comparative effectiveness research that includes a cost-effectiveness component to examine community-based interventions, services and supports to improve health outcomes and quality of life for adults on the ASD spectrum over age 21 by 2018. IACC Recommended Budget: $6,000,000 over 5 years. 5 $1,200,000 $6,000,000
New Long-term D. Conduct implementation research to test the results from comparative effectiveness research in real-world settings including a cost-effectiveness component to improve health outcomes and quality of life for adults on the ASD spectrum over age 21 by 2023. IACC Recommended Budget: $4,000,000 over 5 years. 5 $800,000 $4,000,000
Total     $12,093,333 $53,800,000

*In Question 7, "old" objectives are objectives that were moved to this chapter from other chapters of the 2009 Strategic Plan.

Question 7: What other infrastructure and surveillance needs must be met?

Objective Type 2010 Strategic Plan Objective Total Years Annual Budget Total Budget
Old Short and Long-term A. Conduct a needs assessment to determine how to merge or link administrative and/or surveillance databases that allow for tracking the involvement of people living with ASD in healthcare, education and social services by 2009. IACC Recommended Budget: $520,000 over 1 year. * 1 $520,000 $520,000
Old Short and Long-term B. Conduct an annual "State of the States" assessment of existing state programs and supports for people and families living with ASD by 2009. IACC Recommended Budget: $300,000 each year. * 1 $300,000 $300,000
Old Short and Long-term C. Develop and have available to the research community means by which to merge or link databases that allow for tracking the involvement of people in ASD research by 2010. IACC Recommended Budget: $1,300,000 over 2 years. * 2 $650,000 $1,300,000
Old Short and Long-term D. Establish and maintain an international network of biobanks for the collection of brain, fibroblasts for pluripotent stem cells, and other tissue or biological material, by acquisition sites that use standardized protocols for phenotyping, collection, and regulated distribution of limited samples by 2011. This includes developing fibroblast repositories to produce pluripotent stem cells. Protocols should be put into place to expand the capacities of ongoing large-scale children’s studies to collect and store additional biomaterials, promoting detection of biological signatures. IACC Recommended Budget for establishing biobanks by 2011: $10,500,000 over 2 years. IACC Recommended Budget for maintaining biobanks: $22,200,000 over 5 years. * 2 and 5 $5,250,000 and $4,440,000 $10,500,000 and $22,200,000
New Short and Long-term E. Begin development of a web-based toolbox to assist researchers in effectively and responsibly disseminating their finding to the community, including people with ASD, their families, and health practitioners by 2011. IACC Recommended Budget: $400,000 over 2 years. 2 $200,000 $400,000
New Short and Long-term F. Create funding mechanisms that encourage rapid replication studies of novel or critical findings by 2011. 1 $0 $0
New Short and Long-term G. Develop a web-based tool which provides population estimates of ASD prevalence for states based on the most recent prevalence range and average identified by the ADDM Network by 2012. IACC Budget Recommendations: $200,000 over 2 years. 2 $100,000 $200,000
New Short and Long-term H. Create mechanisms to specifically support the contribution of data from 90 percent of newly initiated projects to the National Database for Autism Research (NDAR) and link NDAR with other existing data resources by 2012. IACC Recommended Budget: $6,800,000 over 2 years. 2 $3,400,000 $6,800,000
New Short and Long-term I. Supplement existing ADDM Network sites to use population-based surveillance data to conduct at least 5 hypothesis-driven analyses evaluating factors that may contribute to changes in ASD prevalence by 2012. IACC Recommended Budget: $660,000 over 2 years. 2 $330,000 $660,000
New Short and Long-term J. Develop the personnel and technical infrastructure to assist states, territories, and other countries who request assistance describing and investigating potential changes in the prevalence of ASD and other developmental disabilities by 2013. IACC Recommended Budget: $1,650,000 over 3 years. 3 $550,000 $1,650,000
New Short and Long-term K. Encourage programs and funding mechanisms that expand the research workforce, enhance interdisciplinary research training, and recruit early career scientists into the ASD field by 2013. IACC Recommended Budget: $5,000,000 over 3 years. 3 $1,666,667 $5,000,000
New Short and Long-term L. Expand the number of ADDM sites in order to conduct ASD surveillance in younger and older age groups; conduct complementary direct screening to inform completeness of ongoing surveillance; and expand efforts to include autism subtypes by 2015. IACC Recommended Budget: $16,200,000 over 5 years. 5 $3,240,000 $16,200,000
New Short and Long-term M. Support 10 "Promising Practices" papers that describe innovative and successful services and supports being implemented in communities that benefit the full spectrum of people with ASD, which can be replicated in other communities by 2015. IACC Recommended Budget: $75,000 over 5 years. 5 $15,000 $75,000
Total     $20,661,667 $65,805,000
Grand Total     $220,609,048 $1,003,155,000
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