Last spring, Bill and Nancy Thompson announced they would donate $8.5 million to the University of Missouri-Columbia for a new autism research center. As one of the largest donations the university has received from an individual, the funds will bring together researchers from across campus to untangle the phenomena of autism, says Janet Farmer, PhD, a health psychology professor and now director of the effort, called the Thompson Center for Autism and Neurodevelopmental Disorders.
"Because of this gift, we are going to be able to target people all along the autism continuum in order to determine causes and treatments and prevention," says Farmer.
The new center-which officially launched on June 1 but hasn't yet moved into a central location-will house about 20 faculty members and staff who will assess and treat up to 400 people with autism and other developmental disorders each year. Many faculty will also work as researchers, seeking to define subgroups of autism-spectrum disorders, she notes.
Farmer is among a growing number of psychologists heading such centers and showing that psychologists-and psychology research-can bring in big money to university coffers, says Catherine E. Lord, PhD, a psychologist and director of the University of Michigan Autism and Communication Disorders Center. "That kind of contribution is more typical of a medical center," Lord says.
Under Farmer, researchers at the new center will seek to develop ways to identify different subcategories of autism, which could allow clinicians to tailor interventions and make predictions about a child's future functioning, says Judith Miles, MD, PhD, the center's associate director of biomedical research. As head of the University of Missouri's existing autism clinic, Miles has been tackling that question for about a decade from a genetic and brain-structure standpoint. But as part of the larger Thompson Center, she soon will be able to work more closely with psychologists and educators to take a look at biological and behavioral variations in autism.
Research suggests that autism has no single cause and many different possible outcomes, Miles notes. People with autism-spectrum disorders show an array of symptoms, including problems interacting with other people and repetitive behaviors. Some people with autism have almost no ability to communicate, while others can speak almost normally, she notes. Some have normal or even above-average intelligence, while others show severe mental retardation.
And even people with similar-seeming impairment to begin with sometimes show different rates of improvement, Farmer adds. With treatment, some children with autism become well-functioning adults, while others are never able to live on their own, she says.
"The difficulty right now is that we hope for children to get better, but we don't understand who gets better and we can't predict outcomes for individual children," she says. "It is frustrating for families and for us."
That's why researchers at the center are studying how to make fine-grained distinctions between different forms of autism, which may have different causes and developmental trajectories, says Miles.
Miles's research team is already working toward that goal. In a study recently published in the American Journal of Medical Genetics (Vol. 135, No. 2, pages 171-180), Miles and her colleagues found evidence that autism can be divided into two categories: complex and essential. Twenty percent of people with autism have complex autism, characterized by abnormal brain development and sometimes an unusually small head, according to the study. Such children are more likely to have seizures and are less likely to respond to treatment than children with autism who have apparently normal brains-what she terms "essential" autism.
While Miles is sorting out forms of autism using brain imaging and genetics, Janine Stichter, PhD, a professor of special education, is categorizing children based on their preferred learning environments. For instance, some children with autism require absolute quiet to concentrate on a task, while others need a level of background noise, says Stichter. As a new member of the Thompson Center and its associate director, Stichter hopes to connect her findings with those of Miles.
"If we can define subtypes, we might understand some key features of a child, what kind of treatments are likely to be effective, what environmental and instructional variables lead to better learning," says Stichter. "There will always be individual differences, but narrowing that down off-the-bat would be tremendously helpful."
The Thompson Center will bring together researchers like Miles and Stichter under one roof, and the resulting collaborations could lead to breakthroughs in autism classification and treatment, says Farmer.
"The nice thing about being a psychologist and being in a leadership position here is that our center will really be balanced in terms of the focus," she says. "There is a tendency to have a medical focus as a predominant thing in autism….We will be starting out with medicine, education and behavior being on an even keel."
In addition, the center may attract scholars from fields not traditionally associated with autism research. Members of the engineering department are talking about developing computer models of autistic brains, and faculty from the university's College of Human Environmental Sciences are examining the ways autism affects the economic lives of families and communities.
Clinical services, as well as research, can be enhanced by a cross-disciplinary approach, because children with autism often have medical problems as well as behavioral and educational ones, says Geraldine Dawson, PhD, a psychology professor and director of an autism center at the University of Washington.
"Interventions require expertise in applied behavior analysis," says Dawson. "Speech and language pathologists and occupational therapists also play an important role."
The Thompson Center hopes to soon pull all of these services under one roof, Farmer says.
"With comprehensive and coordinated care, families are less stressed and have fewer unmet needs," says Farmer. "How you deliver your services makes a difference."
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