In order for great science to be done, there need to be great scientists. Dr. Matthew Maenner is one of those scientists and a former ASF grantee, as well as the first spotlight in our new series Getting to Know ASF Grantees. In 2010, ASF funded his study, Phenotypic Heterogeneity and Early Identification of ASD in the United States. More information about that study can be found here. Read on to see our Q&A with Dr. Maenner and the work he does in the autism science field.
What originally inspired you to begin research in your field?
I first learned about autism when I was an undergraduate in college; I worked with children with ASD that had very challenging behaviors. I really enjoyed spending time with the kids, but I also realized that parents frequently had to make difficult decisions regarding treatments or interventions and they usually had very little information to guide their decisions. And I remember feeling frustrated when a family would be talked into buying into an unproven—but very expensive—therapy or treatment. At the time, I didn’t know what epidemiology was, but I thought we should be studying large groups of people to know whether something was effective or not.
Can you describe the work that you did in 2010 with the ASF grant?
Clinical studies have shown certain behavioral “warning signs” to be useful for early ASD diagnosis, and public health campaigns focus on these behaviors to promote earlier ASD identification. However, there was very little evidence whether these behaviors actually lead to earlier diagnosis in everyday clinical practice. Our study examined whether the behavioral symptoms indicated by research studies were associated with earlier ASD identification in community settings.
We found that children tended to be identified earlier if they were observed to have repetitive motor behaviors, inflexibility in routines, or impairments in nonverbal communication. In contrast, children that were observed to have problems getting along with peers, holding a conversation, or had idiosyncratic speech were more likely to be identified later, compared to children without these symptoms. The results also suggest that increasing the intensity of ASD screening practices will likely lead to increased ASD identification at both earlier and later ages if some symptoms are difficult to detect before a child reaches a certain developmental level.
Some scientists focus on clinical studies, while you are an epidemiologist. In what ways are both types of studies important?
Epidemiological studies and clinical studies can offer complementary insights into a particular question. An epidemiological study may observe an association between an exposure and ASD in the population; then, a focused clinical study could examine the hypothesized mechanism in much greater detail. The exchange of ideas can also go in the other direction—epidemiological studies can examine whether a finding from a clinical study “holds up” outside of a laboratory setting. Epidemiological studies can estimate what proportion of all ASD may be attributable to a mechanism identified in a clinical study, or it may indicate that a biological pathway is more complex than initially recognized. Evidence from both clinical and epidemiological studies help us better understand potential ASD causes and treatments, and both kinds of studies can help inform public health policy decisions.
Can you describe what you’re doing now at the CDC?
This summer, I became an Epidemic Intelligence Service (EIS) Officer, so I will be at the CDC for at least the next two years. It’s an incredible opportunity to learn about how the broader public health system works, how decisions are made, and how to better communicate scientific or public health messages to the public.
What would you like to see studied more in the field of autism research?
I would love to see the development of more high-quality and freely-available screening/diagnostic tools for ASD. One of the barriers to research and early ASD diagnoses—especially in low-resource settings—is the availability of free instruments and screening tools. This year I created www.disabilitymeasures.org, which we hope becomes a collaborative platform for disseminating diagnostic, screening, and research tools. Based on the reactions we’ve heard from others (like this recent article: http://www.scientificamerican.com/article.cfm?id=a-call-for-open-access-to-autism-diagnostic-tools), we think researchers want their work to be more accessible, and we want to make it easier to accomplish this.
Of our 2013 grantees, is there a study that you are most excited about?
All of the funded studies have the potential to make important contributions. If I had to choose, I would say I am especially interested in Russell Port’s project with Dr. Roberts. When I was a postdoc at the Waisman Center last year, Dr. Roberts gave a compelling talk on electrophysiological signatures of language impairment in ASD, and I am eager to see where this work leads them.
Lastly, what do you like to do when you’re not working?
As a scientist in the early stages of my career, the line between my hobbies and professional work is quite blurred. However, my wife grows orchids and I’ve learned a lot from helping her grow and breed them over the past few years. The amount of diversity is incredible—it is easy to see why Charles Darwin was so interested in them!