The overall UW ACE theme centers on a comprehensive developmental model of risk, risk processes,symptom emergence, and adaptation in autism spectrum disorder (ASD). According to this model, earlyautism risk factors (genetic/familial and environmental) lead to risk processes, namely, altered patterns ofinteraction between the child and his/her environment, which contribute to the abnormal development ofneural circuitry and atypical behaviors. This project examines the interaction between genetic and childphenotypic risk factors and family processes in determining outcome in autism. Outcome will be examinednot only in terms of core symptoms, but also in terms of associated symptoms, including repetitive andstereotyped behaviors, hyperactivity, and externalizing and internalizing behaviors. These associatedsymptoms have a significant impact on both the child and family, and are a common focus of therapeuticinterventions. As such, there is a pressing need for longitudinal studies to determine risk and protectivefactors related to the development of associated symptoms. Project V incorporates two longitudinal follow-upstudies of children with ASD to address two broad aims. First, in a prospective longitudinal cohort study ofchildren who are transitioning into adolescence, we will investigate the role of genetic, child phenotypic, andfamily risk and protective factors in development of associated symptoms. Second, in a younger longitudinalcohort, we will conduct a follow-up study of a randomized, controlled trial of early intensive behavioralintervention to examine the long term effects on both core and associated symptoms. We will testhypotheses regarding potential moderators and mediators of long term effects. This proposal directlyaddresses goals outlined in the NIH Autism Research Matrix, including the evaluation of interventionstrategies and the follow-up of early intervention. The identification of risk and protective factors related tolong term outcome, including the development of associated symptoms, will yield important insights intoautism, and will inform the critical targets for therapeutic intervention for affected children and families.
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