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Your Duke Center for Autism News & Updates
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Thank you for signing up for our newsletter! Our fifth edition includes exciting updates and news on our research studies, clinic, and training programs. I am pleased to introduce several new team members who highlight our commitment to excellence, diversity, and a multidisciplinary approach to state-of-the-art care and cutting-edge research. This edition also includes preliminary results and secondary analyses from our studies.
The Duke Center for Autism and Brain Development continues to grow as a dedicated team of faculty, staff, and trainees from different backgrounds, disciplines, and areas of expertise. A mutual vision brings us together-- for each person on the autism spectrum to reach his or her full potential, living a life of meaning, purpose, and dignity.
I am grateful for each of you who partner with us in our mission: families, research participants, self-advocates, community organizations and providers. Without you, the advancements we are able to make across the clinical and research fields in autism and related conditions would not be possible.
We hope you enjoy our newsletter and look forward to staying in touch!
Sincerely,
Geraldine Dawson, PhD
Director, Duke Center for Autism and Brain Development
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Meet Raghav, Exceptional Summer Intern and First Center Team Member on the Autism Spectrum
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Raghav Swaminathan, Summer Intern
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Raghav Swaminathan was hired in May 2017 as a summer intern to work and gain experience in both the clinic and the research program of the Duke Center for Autism and Brain Development. The 22-year-old is the first person the Center has hired who is on the autism spectrum and is open about their diagnosis. The Center recognizes the societal importance of employing individuals with ASD. "We've been very focused on early intervention and helping kids succeed in school. But if we don't help them become adults and productive members of society, we really haven't done our job. Beyond just getting a paycheck, it is an opportunity to continue learning, to socially connect with other people, and to develop a sense of self-worth," said Center Director Geraldine Dawson, PhD.
Raghav's responsibilities included sanitizing toys used for developmental assessments, filing, scanning, shredding papers, and assisting with other office tasks. Raghav worked with research assistants across a number of the Center's research studies. His biggest job at the Center was creating and maintaining a system to send out birthday cards to Center families. The Center sends out over 1,000 birthday cards every year, and in order to ensure timely delivery of the cards, Raghav helped with addressing, writing, labeling, and sending them out. "I really enjoy what I do here," said Raghav. "I love to work independently, and here I am surrounded by just lovely people who care and help and support me."
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Raghav Swaminathan with colleagues at the Duke Center for Autism and Brain Development
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Besides helping in our outreach efforts, supporting our research studies, and assisting in the clinic, Raghav made a strong impression on our staff and had a positive impact on our Center culture. Molly Ruble, a clinical trials specialist at the Center working on the DukeACT study, got to know Raghav well as she worked closely with him on several projects. "Raghav was a wonderful addition to the office because he was always very eager to work and get to know the people around him," said Molly. Working with Raghav gave many of his colleagues, including Ruble, unique insight into what it is like to live as an adult on the spectrum. "We usually see people on the spectrum when they are young and maybe only over a couple of visits. It was great to build a relationship with him over time and really see him for what he is capable of as an adult rather than a patient or subject. I also think his being here shared the message in the ASD and research communities that adults on the spectrum can have really functional and successful lives."
Working in a clinic as well as shared office spaces meant that Raghav was constantly interacting with many different people. His colleagues quickly noticed his charming personality and his interest in figuring out the social dynamics of a workplace. Many described him as a "ray of sunshine" in their day and were uplifted by how he valued and took pride in the work he was doing and genuinely enjoyed the people with whom he was working. Several different research assistants rotated working with him so that he could try out different tasks and find projects that he liked and did well. He did not shy away from talking to people and tried to get to know everyone. His colleagues discovered that Raghav has diverse skills, including in the areas of culture and language. They were especially impressed to learn that he speaks several languages! He was able to speak German with Jurgen, our IT manager, Hindi/Urdu with Rimsha, a clinical trials specialist, and Spanish with Charlotte, our regulatory coordinator.
Staff and faculty at the Center agree that Raghav was a very valuable addition to our team. Said Molly, "
I would love for the Center to continue to implement a program where more adults on the spectrum will work with us."
Echoing Molly's sentiment, we look forward to future opportunities to onboard persons on the autism spectrum and benefit from the skills and talents that they have to offer.
Local CBS News interviewed Raghav and our team - you can watch the story
here.
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Clinic
Spotlight: Meet Drs. Nate Copeland and Saritha Vermeer
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Dr. Nate Copeland, MD, MPH
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What is your professional and training background?
I am a proud graduate of the University of Georgia where I majored in psychology and genetics. I then received my MPH at University of Michigan in Epidemiology with a concentration in Public Health Genetics. I completed medical school at University of Tennessee, General Psychiatry Residency at University of North Carolina at Chapel Hill, and Child and Adolescent Psychiatry fellowship at UNC Chapel Hill. I finished training in June 2017 and jumped at the opportunity to commute 15 miles east to join Duke's Department of Child and Family Mental Health and Developmental Neuroscience in August.
What is your current role here at the Center?
I am a child and adolescent psychiatrist who focuses on medication management in kids and adults with autism. Additionally, within the department, I work on mental health systems and related projects. At this time, my projects include coordinating a telephone consultation program to pediatric providers with mental health and IDD/autism questions, identification of youth at high risk for worsening mental health conditions, and making transportation from emergency departments to hospitals more humane for kids with mental illness.
What brought you to the Center?
Lin Sikich! I worked with Lin at UNC and enjoyed working with the families and kids affected by autism. When I was looking for positions, I reached out to Lin Sikich, she was looking for psychiatrists, and here I am.
What do you enjoy about the work that you do?
So much. The opportunity and privilege to meet with so many families and kids and getting to know what makes them special is such an amazing experience. Also, in my work with mental health systems and large projects, I get to take everything my patients and patients' families teach me and share it with the community in the hopes of improving the lives of many more North Carolinians.
I also feel very fortunate to have such intelligent and compassionate colleagues at the Duke Center for Autism! I'm always learning from them, and I think it's our multi-specialty team that truly provides patients the care that they deserve.
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Dr. Saritha Vermeer
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Dr. Saritha Vermeer, PhD
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What is your professional training/background?
I am a clinical psychologist who works with children, adolescents and their families. When I first entered my graduate program, I was certain that I wanted to work with adults. Over the course of my training, I realized that I most enjoyed working with children and adolescents. My internship and postdoctoral fellowship focused on young children with a variety of challenges including developmental delay, ADHD and autism spectrum disorders. Since then, I have worked in academic, hospital, and community settings, but always with young people and their families.
What's your role and what brought you to the Center?
Over three years ago, I joined primary care mental health here at Duke. I worked closely with a talented team of mental health providers and with our primary care pediatricians to provide an integrated approach to patient care. I joined the Duke Center for Autism this past September and am thrilled to be part of a growing multidisciplinary team committed to supporting children with autism spectrum disorders and their families.
What do you enjoy about the work that you do?
Working directly with children and adolescents providing evaluation and therapy, and providing guidance to caregivers as they learn how to support and encourage their children's progress and development. I also enjoy participating in ground-breaking research projects. It's great to be in a place that provides specialized evaluation and treatment to help current patients, while also pursuing research and approaches that can lead to real breakthroughs in the future.
Any other fun fact, aspiration, or pastime?
When I'm not at work I most enjoy spending time with my family. This past summer, we went on a six-day rafting trip on the Salmon River in Idaho - the country's longest undammed river. Feel free to ask me about the joys of spending almost a full week out in nature without access to technology - there's nothing better than unplugging and focusing on connecting with each other and the outdoors.
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Trainee Spotlight: Dr. Latasha Woods
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Dr. Latasha Woods
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Dr. Latasha Woods, PhD
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What is your professional training/background?
I obtained my doctoral degree from the University of North Carolina at Chapel Hill in school psychology and completed my predoctoral clinical internship at the Marcus Autism Center/Children's Healthcare of Atlanta. Before engaging in clinical practice, I was employed as a school psychologist; however, I began my professional career as an elementary and middle school teacher. I spent 15 years in public schools serving in various roles in general and special education settings.
What's your role and what brought you to the Center?
I am completing my clinical postdoctoral fellowship in psychology. My work at the Duke Center for Autism is focused on conducting comprehensive diagnostic assessments with children, adolescents, and young adults who are at-risk for ASD. I also deliver evidenced-based treatment to individuals who have been diagnosed with ASD, including helping parents learn strategies to manage challenging behaviors. I am excited to support families served by the Center in our clinic and through various research projects. I am also looking forward to extending this work to the broader community in hopes of raising awareness about developmental disabilities including ASD.
What do you enjoy most about your postdoctoral fellowship at the Center?
Working with families is the most enjoyable part of my job. I love building alliances with parents and watching their excitement as their child develops new skills. Every day presents a new and exciting adventure with our unique patients.
Tell us about a fun fact, aspiration, or pastime!
My favorite pastimes are reading/ listening to audiobooks, dancing, and watching college basketball. I also enjoy spending time with my family, including my husband and two children.
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Research at Duke Center for Autism - Partner With Us!
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The Duke Autism Center of Excellence ("Duke ACE Center") is a
new research
program within the Duke Center for Autism and Brain Development that is funded by the
Eunice Kennedy Shriver
National Institute of Child Health and Human Development. We are partnering with the Duke ADHD program to accomplish our overall goal of better understanding the overlap between ASD and ADHD in young children. More specifically, our research studies will evaluate and improve early detection and screening for ASD and ADHD, characterize developmental trajectories, identify unique and shared neural signatures between the two conditions, and test novel therapeutic approaches to inform current practice. An important component of our program is connecting and dialoguing with the community of ASD and ADHD providers, families, and self-advocates, to inform our research and apply what we learn in practical and meaningful ways.
The Duke ACE Center will begin recruiting for studies soon. Please check our website for updates or email us at autismresearch@duke.edu to find out more.
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Join Our Autism Research Family
Through our registry, we have been pleased to connect families and individuals with research opportunities.
We also host events and activities to connect with the community.
To date, over one thousand families and more than two thousand unique participants have joined our registry.
The registry is open to individuals of all ages with and without autism. Your participation is always voluntary, and you may withdraw at any time. To learn more about the registry and sign up, you may read the consent form, enroll, and submit your information through our secure online enrollment survey.
You may also call us at 1-888-691-1062 or send an email to autismresearch@dm.duke.edu. We will answer any questions you may have and help you get registered!
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Sensory Processing and Anxiety in Preschool Children with ASD
- Preliminary Findings
"The risk for additional difficulties among those with autism is higher than the general population," explains Dr. Carpenter. In fact, anxiety disorders are four times more common among individuals with ASD, and the presence of another disorder like anxiety can have negative impacts such as difficulties with social, academic, and family functioning. Although anxiety has already been found to be linked to sensory over-responsivity in previous research, the field has not focused on this relationship in early childhood, when anxieties first appear.
"Looking at anxiety at this age and how it relates to other areas of functioning and behavior will help us better understand how anxiety develops and potentially give us clues as to how to detect and prevent the development of an anxiety disorder. This information can also help us improve existing anxiety interventions for individuals with autism by identifying target symptoms or areas that are found to be most strongly related to poorer outcomes," says Dr. Carpenter.
The study is still ongoing, but Dr. Carpenter has conducted preliminary analyses.
"The study has found a strong relationship between sensory over-responsivity and anxiety in preschoolers with and without autism." Specifically, the team has found that among children with ASD, the likelihood of having an anxiety disorder is 5 times greater with every increase in scores on assessments which measure sensory over-responsivity behaviors. According to the researchers, this suggests that preschoolers who have more difficulty tolerating sensory input carry a risk for having an anxiety disorder that is 5 times greater than those with less severe sensory difficulties. The study is also collecting information on how the brain processes sensory input and how visual attention may vary in relation to different types of sensory input.
"Once the data is analyzed, it may help us understand how attentional brain processes contribute to the development of anxiety in children that have difficulties processing sensory input. Our hope is that by understanding this process from a brain-behavior perspective, we will be able to identify brain patterns that indicate a risk for difficulties with processing sensory input and/or the development of anxiety. The ability to identify these brain patterns would allow for the development of early interventions that could prevent the development of these issues," says Dr. Carpenter.
Participating in this type of research is important for families because sensory processing difficulties and anxieties are common in individuals with autism. This research will allow for an understanding of how these symptoms develop and support the development of more individualized interventions that target these symptoms. Because sensory difficulties create greater impairments in behavioral functioning, the researchers hope to use these results to improve existing interventions, which are critical to promoting the well-being of individuals who are affected by or at risk for autism and related conditions.
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Studying Language in the Home Environment: Dr. Sabatos-DeVito Discusses Findings from the DukeABCs study
Dr. Sabatos-DeVito was part of the Duke ABCs study research team who published the study's main outcomes article earlier this year in the journal Stem Cells Translational Medicine. A Developmental Psychologist by training, DeVito took special interest in the LENA system (the Language Environment Analysis system)-- a measure used in the Duke ABCs study to assess language at home.
"LENA is a unique tool in that it allows us to capture the child's use of and exposure to language in his or her home environment,"
explains DeVito. "The lab allows us to standardize how we capture certain skills across children, but it is still a limited snapshot
." DeVito studied the LENA device in other studies before coming to Duke, so she has experience with analyzing the data and using it in ASD populations.
In addition to evaluating the feasibility and tolerability of cord blood infusions, Duke ABCs researchers were interested in finding measures that can provide valuable and reliable information about changes in children's abilities and quality of life over time.
"One of the challenges facing autism researchers is that individuals on the spectrum have varying skills, especially in the area of language. Additionally, children often demonstrate very different abilities and behaviors depending on their environment. So we have a responsibility to ensure that the tools we use to measure treatment effects consider the impact of these differences and measure children's skills across varying environments, including the home." DeVito sought to determine if LENA's automated measures of language in a natural environment reflected
children's social-communication abilities that parents reported on standardized questionnaires and that clinicians observed in lab-based measures, including eye-tracking and a parent-child free play session. By comparing how well these various assessments correlate with each other, researchers can better understand how the measures that researchers are currently using in autism studies are capturing the very diverse skillsets and abilities of children on the autism spectrum.
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Maura Sabatos-DeVito, PhD at the American Academy of Child and Adolescent Psychiatry 2017 Conference
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DeVito presented her work on the LENA at a recent meeting of the American Academy of Child and Adolescent Psychiatrists (AACAP) on October 26.
"We looked at the relationship between LENA data - including adult and child vocalization rates at the home- and parent-reported child social communication skills in the Duke ABCs study. One of the main findings was that across four different time points, child vocalization rates of preschoolers with ASD were positively associated with parent-reported child receptive/expressive communication skills. At baseline, child and adult vocalization rates were also associated with lab-based parent-child interaction measures of child social attention, and adult vocalization rates were associated with children's attention to social stimuli as measured by eye tracking technology. These findings support LENA outcomes as valid measures of social communication skills."
Dr. Sabatos-DeVito's team also found that changes in vocalization rates captured by LENA did not reflect changes in parent report, indicating that additional research is needed to determine the use of LENA in capturing changes in language over time. Using the technologies available at our Center, researchers hope to continue exploring how certain biomarkers and behavioral measures can capture improvements in skills and outcomes in children with ASD.
"At Duke, we have cutting edge technology and a team of experts in various disciplines that allows us to tackle this challenge and continue to discover and adapt tools that will accurately tell us if a treatment is making a positive impact on children's skills and behaviors, especially in the area of social communication."
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Events: What We've Been Up To, What You Won't Want To Miss
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Duke Men's Baseball and Duke Center for Autism to Host Sports Clinic in Spring 2018
The Duke Center for Autism is excited to announce that we will be partnering with the Duke Men's Baseball Team to host an event for youth on the autism spectrum and their families on May 5th 2018. After hosting two incredibly successful basketball clinics with the Duke Women's and Men's Basketball teams, we have been motivated to continue this tradition of bringing together sports and families affected by autism in a fun event that creates a relaxed and accepting environment for all.
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ASNC Triangle Walk
The Triangle Walk is the Autism Society of North Carolina's (ASNC) biggest event of the year. Runners and donors raised over $200,000 that goes directly toward ASNC programming for area individuals on the autism spectrum. Duke Center for Autism staff joined the walk this year on Saturday, October 14th to answer questions as well as participate in the walk and 5K run. Several staff members also walked with their furry friends!
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Autism Speaks Walk
The Triangle Walk Now for Autism Speaks was held on Duke's East Campus on Saturday, April 29th. The Duke Center for Autism walked in support of
Team Vanilla Ice
, which is in its 5th year of fund raising and is led by Duke Professor Scott Kollins, PhD, and his wife Katharine. Since 2013, Team Vanilla Ice has raised over $60,000 and has been the top fundraising team for the Triangle Walk event every year! This year the group raised over $20,000! We are already looking forward to next year!
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Summer Fun! Golf Clinic for Youth on the Autism Spectrum
The Duke Center for Autism and the Ernie Els Foundation partnered earlier this year to host our third golf clinic. The event was held on June 12th, 2017 at the Washington Duke Golf Club, and was attended by over ten youth and their families. The 90-minute clinic included warm-up, stretching, snacks, and tailored instruction on golf skills for individuals on the autism spectrum of a range of ages and abilities. Participants learned golf techniques from Ernie Els Foundation coaches who worked in collaboration with the First Tee of The Triangle. The Duke Golf athletics team was also in attendance.
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