From Cells to Service: Dr. Geschwind at the Center for Autism Research and Treatment
Micaela White
Under the umbrella of the Semel Institute at UCLA, Dr. Daniel Geschwind and his team at The Center for Autism Research and Treatment (CART), are conducting groundbreaking research and formulating treatment plans for individuals with autism. CART is recognized as the leading autism center in the United States, and has earned numerous funding awards from the NIH. At a time when medical misinformation is on the rise, it is imperative that we continue to rigorously pursue a greater understanding of Autism Spectrum Disorder. The collaborative team at CART is composed of clinicians and scientists that integrate their research, clinical and treatment programs to provide a unique multidisciplinary approach to ASD. They describe their process as one that encompasses autism “from cells to service,” and it represents what can be done today to make an impact.
Dr. Geschwind, the director of CART and a developmental neurobiologist, is a distinguished researcher in his field. As a Yale MD PhD trainee specializing in adult neurology, he was left feeling he had gained little to no experience with autism. When he came to UCLA, he became involved with Cure Autism Now (CAN), which was founded by Portia Iverson and John Shastak in 1995. It was then that he realized how much unmet need there was, and the breadth of research that still needed to be done. In the late 1990s, when Dr. Geschwind was just starting his lab as a junior assistant professor at UCLA, he was intrigued that autism presented as a highly variable genetic condition. Through this exposure, he began to realize how he might substantially improve the lives of these underserved individuals through research and treatment.
In 2003 Peter Wybrow, the then-chair of psychiatry and the director of the Semel Institute, asked Dr. Geschwind to start an autism center. He partnered with his esteemed colleague Dr. Marion Sigman, who was a developmental psychologist and recognized leader in this field. It was the perfect combination of molecular and cellular biology and genetics on Dr. Geschwind's end, and the expertise in clinical manifestations and developments of autism on Dr. Sigman's end. Together, they created CART and a partnership between scientists, led by Dr. Geschwind and the Cure Autism Now foundation that started the Autism Genetic Resource Exchange (AGRE). This was the first autism gene bank and it made a myriad of data available to the field. Dr. Geschwind describes this as “the beginning of the modern era of autism genetics.” Researchers illustrated that autism exhibited a strong genetic susceptibility while identifying genes that cause the disorder. This gave them a starting point for conducting studies to understand how these genetic mutations contribute to the condition, and from there researchers began developing mechanistic treatments for autism. CART embodies “cells to service”, as it emphasizes two things that are not competing, but are complementary. It conducts evidence-based research and develops treatments, therapies, and ways to support autistic students transitioning into adulthood, a key part of its services. Genetics research, the mechanics of cell biology, therapeutic developmental research, as well as neurobiology, will create the knowledge of the future. “Cells to service” illustrates these different scales of research from genetics, cell biology, and brain circuits, through optimizing the kinds of treatments and behavioral services that they offer for children, adults, and families. What makes CART so unique is that it is a diverse and multidisciplinary center, with scientists studying and integrating perspectives across all aspects of ASD. These innovative researchers are working with young children and adults, and offering services in-office and in schools to autistic patients and their families throughout their lifespan. The aim is filling this immense void with applicable, supportive services to the growing number of adults with autism.
Dr. Geschwind mentioned the various supports offered through CART including a program for UCLA students with autism called Peers for Careers. This evidence-based program assists these students in making the transition from college to career. Treatments developed by Connie Kasari’s group include behavioral therapies for infants, toddlers, and school aged children. Programs like Baby Jasper and others are used internationally. Dr. Elizabeth Laugeson’s PEERS Clinic at UCLA utilizes evidence-based research to help autistic individuals with social skills. Dr. Geschwind's lab is developing strategies for those with profound autism, living with higher levels of intellectual disability, among other comorbidities, many of whom have single gene mutations they can now identify. His research in cellular and developmental biology is shaping the interventions and behavioral treatments utilized. These can be very effective in some children and adults, and continue to be refined and developed along with pharmacological drug therapies for those that need it. Dr. Geschwind mentions there could also be circuit approaches. There are several groups at UCLA working on brain imaging to identify what circuits are disrupted or different in individuals with autism. These groups include, but are not limited to, Mirella Dapretto, Shula Green, Lucina Uddin and Leanna Hernandez. Specifically, Shula Green is working to develop therapies targeting sensory hypersensitivity, a common symptom of autism. Identifying this and possibly using circuit based treatments down the road, like transcranial magnetic stimulation, could have a profound impact. Dr. Geschwind is also optimistic about nucleic acid therapeutics, in which scientists deliver DNA and RNA to an individual that affects a therapeutic response. These therapies are highly effective for individuals with single gene disorders. He and his team are currently working on methods to circumvent the single gene mutations by prioritizing the expression of the healthy gene.
Students looking to become involved in ASD research and treatment, and the wide ranging careers available and on the horizon, should consider adding a developmental disabilities major, or even just a course from this discipline. It is important to note that Dr. Geschwind reassures students that many disciplines are represented at CART, and this collaboration is essential. There are research opportunities in the various labs within or affiliated with CART. This includes clinically directed work, neuroimaging, as well as molecular and cellular research. CART is always looking for students to join these research projects, and offers a summer program named after Marion Sigman, called Sigman Scholars. Sigman Scholars funds 2-3 students to work over the summer in CART laboratories in an 8-10 week long rigorous program. Dr. Geschwind emphasizes that the labs at CART are busy and can be demanding, and it is expected that students will work at least 15 hours per week during the school year. There are also numerous volunteering opportunities in the community, and these may be a better fit for some. Students interested in research and volunteering opportunities at CART, should email info@autism.ucla.edu for more information regarding how to get involved.
