CARD June 2014 Newsletter

3901 Greenspring Avenue, Baltimore, Maryland 21211

card.kennedykrieger.org

June 2014 • VOL. 7, ISSUE 3

CARD Staff at IMFAR 2014 We were thrilled that CARD staff were again invited to present at the International Meeting for Autism Research (IMFAR), an annual convention where researchers from around the world specializing in autism spectrum disorders share and discuss their findings. At this year’s convention, which was held in Atlanta from May 14 to 17, Dr. Rebecca Landa participated in a panel titled "Resilience in Infants at High Risk for Developing Autism Spectrum Disorders." Dr. Ericka Wodka and Dr. Stewart Mostofsky’s research was addressed at the oral presentations titled "Relationship Between Repetitive Behaviors and Sensory Functioning in ASD" and "Inhibitory Mechanisms Underlying Vibrotactile Perception Appear Altered in Children with ASD." Research done by Dr. Amy Keefer and Dr. Roma Vasa was discussed at the oral presentation titled "Associations between Aggression and Restricted, Repetitive, and Stereotyped Behaviors and Interests: A Multi-Informant, Multi-Method Study.” In addition, posters highlighted the numerous research projects conducted at CARD, including work by Dr. Rebecca Landa, Dr. Patricia Rao, Dr. Roma Vasa, Dr. Stewart Mostofsky, Dr. Ericka Wodka, Dr. Kaitlyn Wilson, Dr. Elizabeth Stripling, and Dr. Rajneesh Mahajan.

Telemedicine Screening for Developmental Delays and Autism

By Deepa Menon, MD In December 2013, Kennedy Krieger Institute entered into a contract with Atlantic General Hospital in Berlin, Md., to provide twice-monthly developmental consultations using telemedicine technology. Telemedicine is the practice of medicine from a distance, in which intervention and treatment decisions are based on clinical data, documents, images, and information transmitted through telecommunication systems. We currently have a telemedicine suite manned by developmental pediatrician Dr. Paul Lipkin and neurodevelopmental physician Dr. Deepa Menon, who are based in Baltimore at Inside this issue CARD. They provide two-way secure live video consultations with patients who are triaged at the telemedicine suite at Atlantic General Hospital for concerns related to autism Director’s Welcome 2 spectrum disorders, learning issues, ADHD, communication problems, intellectual disability, speech and language issues, and other developmental issues.

Employee Spotlight

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Upcoming STAR

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Trainings

With the advent of this new clinic, Kennedy Krieger and CARD hope to be able to improve access to early developmental consultation and decrease cost and travel time for patients and families. Because the clinic allows patients to receive care closer to their medical home, families and primary care physicians can be more closely involved in their care.

Major hospital systems throughout the U.S. have recognized the benefits of using telemedicine for connecting sub-specialty providers at large tertiary hospitals to rural and remote hospitals and communities that lack specialists. Telemedicine can help improve Continued on page 2

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Telecommunication (continued) access to healthcare and communication between providers and patients, thereby improving the quality of care. In pediatric cases, it is most commonly used for diagnosing illness, managing chronic illness, and handling emergencies in emergency departments and intensive care units.

Many hospitals use secure two-way video conferencing between providers, or between a provider and patient, for consultations and to provide treatment and intervention to patients, either in a hospital setting or in the comfort of the patient’s home. Services provided can include consultations in emergencies, second opinions to help a community provider, or scheduled outpatient visits for diagnosis, prescreening, and ongoing disease management.

In children with neurological or developmental disorders, the literature has shown good use of technology and telemedicine in managing more acute issues like strokes, seizures, sleep disorders, and psychiatric counseling and treatment; it is also useful for monitoring of patients discharged from an inpatient rehabilitation program. Until now, it has rarely been used for providing first line developmental consultation in children with developmental issues.

For more information about the telemedicine program at Kennedy Krieger Institute, please call 410-641-3340.

From left: Dr. Deepa Menon and Dr. Paul Lipkin

individuals with autism and who give so generously of themselves to support the development and well-being of The staff at Kennedy Krieger's Center for Autism individuals with ASD. Some of those people are hosting and Related Disorders (CARD) has been sharing information about autism, advocating for individuals with special fund raisers for CARD, like the event at Trenditions. Others are creating special opportunities for autism spectrum disorders (ASD), helping to create having fun while learning, like the Walter's Art Gallery. community-based opportunities for individuals on the spectrum, helping other countries plan and establish autism Others are providing care, support, resources, and much more. Together, we make Maryland a great place for centers and program (see the article on our visitors from Korea), extending our care to remote parts of the state and individuals with diverse needs and talents. of the world through telemedicine, providing clinical care I hope that you all have a summer filled with your for individuals on the spectrum, and conducting cuttingfavorite things to do, and even perhaps get to visit one of edge science. This takes innovation, compassion, passion, your favorite places. Hopefully I will see you in October at team work, vision, and high levels of expertise. our annual conference.

Dear friends,

We want to thank those of you who supported our ROAR event to help us raise funds for innovative research aimed at understanding how the brain works in individuals with ASD, how to detect autism risk early in life, and how to design interventions that promote optimum outcomes.

The science made possible by ROAR is being shared at the International Meeting for Autism Research (IMFAR), at national scientific conferences, and through our peerreviewed publications, with the world. I also want to thank individuals in the community who care so deeply about

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Best wishes, Rebecca Landa

Questions or Comments? Please email: CARDnewsletter@kennedykrieger.org

Demystifying the Brains of Children on the Spectrum

By Rebecca German, research assistant Determined to learn more about the origins of autism, Dr. Rich Stoner of the UC San Diego Autism Center of Excellence enlisted the expertise of fellow specialists from across the country. With the help of these researchers, Dr. Stoner conducted a scientific study comparing brains of children with autism to brains of children without autism. Their article, “Patches of Disorganization in the Neocortex of Children with Autism,” appeared in The New England Journal of Medicine in March of this year.

Dr. Stoner and his colleagues predicted they would find evidence of abnormal brain development in children with autism. To substantiate their theory, they examined postmortem brains of children ranging from two to 15 years of age.

Eleven of these children had autism, and the other 11 did not. The investigators collected tissue samples from several regions of the brains and inspected all six layers of tissue, paying particular attention to genes that are typically located in each layer and genes that have been linked to autism.

They noticed that 10 of the 11 children with autism had unusual neurons (nerve cells that relay messages back and forth between different parts of the brain). These unusual neurons were scattered throughout all layers of the brain. In comparison, the brains of the children without autism generally did not show signs of this abnormality.

Think of the brain as a huge grocery store and the neurons as canned goods in that grocery store. The neurons are supposed to be marked with certain labels (i.e., genes), and they are supposed to be found on specific shelves (i.e., layers of the brain). Picture a grocery store where there are bunches of cans with missing or mixed-up labels on them—it would be pretty unclear exactly what the cans are or whether they’re on the right shelves. That’s what the brains of children with autism were like.

The mislabeled, disorganized neurons were present in the prefrontal cortex and the temporal cortex—parts of the brain that help regulate language, communication, social behavior, and emotional processing. The researchers suggest that the locations of the patches could account for at least some of the deficits seen in individuals with autism. They also note differences in the presentation of the irregularities from one child’s brain to the next, which may explain why autism symptoms tend to vary in type and severity from person to person.

The authors believe that their findings corroborate possible prenatal origins of the disorder. In light of this discovery, one thing remains clear: it is important to detect and treat autism spectrum disorder as early as possible.

Ideally, intervention should start in early childhood, while the brain is still developing, for the greatest impact.

Employee Spotlight—Cait Hanley, MSW, LGSW Cait Hanley, MSW, LGSW, is a social worker who serves in a clinical capacity at CARD. She earned a BA in psychology from the University of Michigan. During her undergraduate studies, she served as a research assistant at Cathryn Lord’s University of Michigan Autism and Communications Disorder Center (UMACC). Cait then joined Teach for America and taught first and fourth grade in low-income schools in the Bay Area. She loved working with children and families—especially the ones who had the greatest needs. After teaching for four years, Cait joined Teach for America’s National Recruitment Team. She missed working directly with children and families, so she eventually decided to return to the University of Michigan to pursue her Master of Social Work degree. She studied interpersonal practice and specialized in children and youth in families and society. Cait completed her clinical internship at the University Center for the Child and Family (UCCF), where she did therapy with a wide range of children and adults. She also participated in Michigan’s attachment-based research program for high-risk mother-child dyads called “Mom Power” and worked part-time as an applied behavior analysis therapist. Cait currently works at CARD’s Greenspring Campus, and she will begin at CARD’s Odenton site when it opens this summer. In Odenton, she will see children with autism, along with their parents and siblings, for therapy. Cait will still spend one day per week at the Greenspring campus seeing ongoing therapy clients. She is thrilled to be a part of the CARD family.

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Registration is now open for CARD’s 14th Annual Autism Conference!

The conference will take place on October 16-17, 2014 at the North Baltimore Plaza Hotel in Timonium.

Visit http://www.autismconference.kennedykrieger.org or scan the QR code for more information!

Thank You for ROARing with Us! We would like to thank everyone who participated in the 10th annual ROAR to help break the silence surrounding autism.

This year, we raised over $165,000 for autism research! We appreciate all of your support and dedication to this cause!

2nd Annual Cut-A-Thon is a Success!

For the 2nd consecutive year, Rebecca Lowry organized a cut-a-thon at Trenditions hair salon in Parkville to benefit CARD. On April 13, stylists generously volunteered their services, offering haircuts and styling in exchange for donations. Local businesses also contributed items for the salon’s raffle and 50/50 contest, with 100 percent of the proceeds going to Kennedy Krieger. The salon raised over $1,800, exceeding its goal and last year’s total.

Thank you to Rebecca and Trenditions for organizing this wonderful event!

We would like to congratulate Natalie Newman, winner of the first annual ROAR for Autism Cara Becker Youth Fundraising Award. Natalie raised more than $11,000 for Kennedy Krieger Institute!

Free Upcoming STAR Trainings for June and July Getting an Autism Spectrum Disorder Diagnosis: Where Do I Go from Here? - Monday, June 23, 9:30 a.m. to 11:00 a.m., presented by Cathy Groschan, LCSW-C What is Transition Planning for a Teen with an ASD Diagnosis? - Monday, June 23, 1:00 p.m. to 2:30 p.m., presented by Cathy Groschan, LCSW-C Finding Your Voice: A Primer for Caregivers - Wednesday, July 16, 11:30 a.m. to 12:30 p.m., presented by Diane Bark, parent and caregiver advocate For more information or to register, visit kennedykriegercard.eventbrite.com.

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Did you know that all of our previous STAR trainings can be viewed online? To access the archive, visit the Outreach & Training section of the CARD website and click on “STAR Parent Trainings.”