Federal Support for Autism Research

The Politics of Autism includes an extensive discussion of federal support for autism research.  The Government Accountability has a new report on the topic.  The summary:

Although federal funding for autism research fluctuated from fiscal years 2008 through 2012, it increased overall during this period, from approximately $169 million in fiscal year 2008 to $245 million in fiscal year 2012—about a 45 percent increase (about a 37 percent increase when adjusted for inflation to fiscal year 2012 dollars). Over this time period, the National Institutes of Health (NIH) consistently provided the majority of autism research funding—between about 76 and 83 percent of the total funding awarded each fiscal year. The highest funding levels were in fiscal years 2009 and 2010, in part, as a result of additional funds appropriated to NIH under the American Recovery and Reinvestment Act of 2009. While overall funding increased, federal funding varied by each of the seven research areas specified in the Interagency Autism Coordinating Committee’s (IACC) strategic plan. These research areas are biology, treatments and interventions, causes, diagnosis, infrastructure and surveillance, services, and lifespan issues. The following figure shows the changes in funding by fiscal year for each of the seven research areas, as well as the overall average annual percent change in funding for each research area.

Medications and Autism

The New York Times reports:

With the diagnosis of autism on the rise and drug companies facing major setbacks in developing successful treatments, the University of California, Los Angeles will lead a $9 million effort financed by the National Institute of Mental Health to find effective drugs, officials said Wednesday.

Under a contract with the institute, U.C.L.A. will form a network of researchers at other academic centers that will try to identify promising new and older drug compounds quickly, and conduct early tests to see if they merit additional investment.

The program, part of the “Fast Fail” initiative at the institute, aims to determine within weeks whether a drug works, rather than the years it traditionally takes to evaluate a new drug.

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Several major drug companies, including GlaxoSmithKline and AstraZeneca, have scaled back their research in the neurosciences because of the high failure rate, Dr. McCracken said.
Developing drugs to treat neurological disorders is difficult, in part because brain science is still evolving. The field is littered with drugs that scientists had hoped would be effective against diseases like Alzheimer’s and schizophrenia but that performed poorly in clinical trials.

Despite the setbacks, scientific advances in understanding the genetic underpinnings of autism have accelerated, leaving the door open for new drug discoveries, said Robert H. Ring, vice president of translational research at Autism Speaks, a patient advocacy group.

The Four Kingdoms

NIMH director Thomas Insel writes:

In the spirit of mapping the autism landscape and finding some common ground, I suggest four perspectives that currently separate the communities interested in the autism spectrum. The language, assumptions, literature, and societies that have grown up around each of these perspectives are so distinct, they have begun to represent different countries or kingdoms. Each has its own truths. And each too often fails to understand or even recognize that their truths may not apply to all kingdoms.

Illness
Autism was first described as a developmental disorder by Leo Kanner, a child psychiatrist, in 1943. In the 70 years since, research on autism has largely focused on autism as an illness. The illness kingdom is largely populated by clinicians, researchers, parents, and some people with autism. They view autism as a brain disorder in which the language of medicine applies, with a focus on improving diagnosis and interventions, and cure as the ultimate goal.
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Identity
Self-advocates with autism, like self-advocates in the deafness community, have replaced the medical model of illness with the language of diversity and identity. They, along with many in the educational and disability communities, view autism as a difference in need of accommodation, not a disorder in need of cure.
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Injury
One of the more heated arguments surrounding autism has been on the purported role of vaccine injury as a cause. This kingdom was founded by parents who report marked regression after the 18-month vaccination series, when their previously interactive, communicative toddler withdraws and stops speaking.

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Insight
Just as scientists have studied blindness to understand the visual system, scientists in the kingdom of insight assume that the study of people with social and communication deficits is a remarkable opportunity to understand the social brain. This kingdom belongs to social neuroscientists, using tools from cognitive science, neuroimaging, and neuroanatomy.

Insel on CARA

On Monday, NIMH director Thomas Insel testified about the Combating Autism Reauthorization Act before the House Energy & Commerce Subcommittee on Health. Dr. Insel's testimony begins 21 minutes into the video: