Drexel University’s A.J. Drexel Autism Institute was awarded a $2.1 million National Institutes of Health Environmental Influences on Child Health Outcomes (ECHO) Program grant to continue follow-up of children enrolled in three cohort studies dedicated to understanding outcomes among younger siblings of autistic children. This study will be the first of its kind to follow children from these families from gestation all the way into early adulthood. Importantly, the study will add to the critical and under-studied period of adolescence and early adulthood.
This grant will continue follow-up that began during Drexel’s prior award under the first seven-year cycle of the ECHO program. In addition to following families, Drexel’s work under that project examined chemical exposures in shed baby teeth, assessed ways to acceptably shorten questionnaires, and contributed to research on environmental exposures and child neurodevelopment. Drexel also worked collaboratively in the first cycle of ECHO with over 60 other ECHO cohorts to assist development of a common research protocol aimed at capturing information on a broad range of environmental influences on child health and development.
Through the ECHO program, researchers are committed to understanding how environmental exposures affect children across five main outcome areas: airways, obesity, neurodevelopment, pre- and peri- natal outcomes, and positive health. During the first phase of ECHO, children in Drexel’s cohort were invited to participate in one study visit assessing outcomes across these five main areas.
Colleagues at Johns Hopkins University and co-investigators at several U.S.-based sites, worked with Drexel’s cohort, led by Kristen Lyall, ScD, an associate professor in the Autism Institute, and Heather Volk, PhD, an associate professor at Johns Hopkins. The team is also supported by lead coordinator Bridget Toroni, a research associate in the Autism Institute. Drexel is one of only 31 cohorts continuing from the first cycle of ECHO, and as a longitudinal investigation following younger siblings of autistic children from the womb to adulthood the study presents highly unique opportunities. The team seeks to advance understanding of modifiers of environmental risk factors and characterize neurodevelopmental trajectories across childhood into early adulthood to support positive outcomes, including in autistic adolescents.
“We’ll be implementing the ECHO Phase 2 protocol to ensure an expanded set of research possibilities in this important population, and ultimately, optimize outcomes for autistic individuals and their families,” said Lyall.
In the next phase of ECHO, researchers will re-contact families who previously enrolled in the study and invite them to continue participation in research assessing these outcome areas. Because prior studies have indicated increased rates of autism, attention-deficit/hyperactivity disorder (ADHD), and other neurodevelopmental conditions among younger siblings of an autistic individual, follow-up of these siblings will allow researchers to understand how these conditions develop or change over time.
Moreover, information gained from individual ECHO cohorts will be combined, allowing researchers the unique opportunity to address these research questions using data from a large and diverse sample of participants from across the country.
More specifically, Drexel’s project builds from prior work following families and learning more about risk and protective factors related to child neurodevelopment. This prior work has demonstrated the adverse effects of prenatal air pollution exposure and beneficial effects of certain prenatal dietary factors like folate. Moving forward, the project will seek to understand whether and how diet during pregnancy may offset impacts of exposure to air pollutants on child neurodevelopment and the likelihood of developing neurodevelopmental conditions.
In addition, making use of the novel longitudinal follow-up, the project also seeks to examine how different neurodevelopmental conditions and related health outcomes evolve over time, in trajectory analyses assessing both mental and physical health.
Finally, together with the entire ECHO program and participating sites across the U.S., the project seeks to maximize diverse recruitment and retention of cohort participants, with the ultimate goal of following participants for another seven years. Across the project’s aims, Drexel’s research team hopes to further develop support for adolescents with neurodevelopmental conditions, transition-age autistic youth, and their families.
“Because of COVID-19, ECHO has been at the forefront of trying to validate new methods for remote collections and our team previously was involved in validating abbreviated measures to try and reduce participant burdens or trying to find ways to make research participation easier for families,” said Lyall.
The team is excited to have the opportunity to continue working with families, learn more about these children’s development, and support the families who have been dedicated research participants. “Our participants are really essential to this research. They have been with our study for years and have put a lot of time and effort into sharing their experiences with us. Their contributions are invaluable,” notes Toroni.
Drexel is one of five institutions in this cohort and is working with researchers at Johns Hopkins University, Kennedy Krieger Institute, Kaiser Permanente, and the University of California, Davis.