MU Scientist Links Epigenetic Biomarkers to Gastrointestinal Issues for Kids with Autism

Findings could have future implications for precision medicine, lead to individualized treatments

As a clinician at the University of Missouri Thompson Center for Autism and Neurodevelopmental Disorders, David Beversdorf helps patients with autism spectrum disorder (ASD), many of whom may also be struggling with gastrointestinal or digestive issues, including constipation and diarrhea. These symptoms are experienced by children with ASD at a higher rate than their neurotypical peers, although some individuals might not respond favorably to traditional treatments, such as laxatives.

In a recent study, Beversdorf collaborated with a researcher at Penn State University to identify specific RNA biomarkers linked with gastrointestinal issues in children with autism. The findings could help one day lead to individualized treatments aimed at easing the pain of these individuals.

Saliva samples were collected from nearly 900 children, some of whom had autism and experienced gastrointestinal disturbances, at several academic medical centers across the country. After analyzing the samples, the researchers identified specific RNA biomarkers linked to children who had autism and experienced gastrointestinal symptoms.

“We wanted to understand how a child’s body responds to the various bacteria living in the mouth and determine if these interactions contribute to gastrointestinal symptoms,” said Steve Hicks, an associate professor of pediatrics at the Penn State College of Medicine, who collaborated with Beversdorf on the study. “By identifying these specific microRNAs in the saliva of children with autism, these molecules may serve as future targets for developing novel treatments or tracking medication effectiveness in children with autism-related gastrointestinal conditions.”

Beversdorf added that RNA have regulatory properties throughout the human body, and the specific RNA identified in the study may have regulatory effects on biological pathways related to metabolism, digestion, depression and addiction.

“It’s one of those ‘chicken or the egg’ cases where we still don’t know if it is the RNA potentially contributing to the gastrointestinal issues, or if the gastrointestinal issues are causing the RNA to be expressed differently, but we have identified a relationship, which will be useful to further explore going forward,” said Beversdorf, who also has appointments in the MU College of Arts and Science and MU School of Medicine. “This research can potentially help contribute to precision medicine one day, where we can follow children with autism and gastrointestinal symptoms over an extended period of time and assess how they might respond to personalized treatments, with the ultimate goal of reducing their symptoms and improving their quality of life.”

“Saliva RNA biomarkers of gastrointestinal dysfunction in children with autism and neurodevelopmental disorders: Potential implications for precision medicine” was recently published in Frontiers in Psychiatry. Funding for the study was provided by the National Institutes of Health. Co-authors on the study include Kristin Sohl, David Levitskiy, Priscilla Tennant, Robin Goin-Kochel, Rebecca Shaffer, Alexandra Confair and Frank Middleton.

Highlighting the promise of personalized health care and the impact of large-scale interdisciplinary collaboration, the NextGen Precision Health initiative is bringing together innovators from across the University of Missouri and the UM System’s three other research universities in pursuit of life-changing precision health advancements. It’s a collaborative effort to leverage the research strengths of Mizzou toward a better future for Missouri’s health. An important part of the initiative is its anchoring facility, the Roy Blunt NextGen Precision Health building, opened in October 2021, which expands collaboration between researchers, clinicians and industry leaders in a state-of-the-art research facility.

Story Contributor:
Brian Consiglio, MU News Bureau

The Early Years Study: A New Look Into Infant Cry

Baby in a pink long sleeve with its mouth open

The Early Years Study is the latest project to begin the recruitment phase at the Thompson Center for Autism and Neurodevelopment. This project will utilize audio recordings of infant cries in search of a new way to identify early signs for autism and developmental disabilities.

Researchers have been studying infant cry since the 1950s, but Dr. Stephen Sheinkopf is among the first to focus on it as a predictor of autism. Dr. Sheinkopf, who joined the Thompson Center as its Executive Director in 2021, began studying atypical vocalizations in young children with autism in the late 1990s and released his first paper on the subject in 2000. Following that, he began to use infant cry to study vocalizations in young infants. A paper published in 2012 led to funding from the National Institutes of Health (NIH) to develop the analytical algorithm used for the current iteration of Dr. Sheinkopf’s infant cry research.

Measuring Sound in Cries
Fundamental Frequency: also known as pitch, the highness or lowness of a sound
Force: the loudness of a sound, commonly referred to as volume
Resonance: secondary vocal vibrations that cause the sound to be louder or last longer
Phonation: amount of tension in the vocal tract

The Rhode Island Neurobehavior Observation Study (RhINOS) was funded by the National Institutes of Mental Health (NIMH) in late 2019 and with the goal of following children in a longitudinal study starting in March 2020. Dr. Sheinkopf, the principal investigator, was at Brown University and Women and Infants Hospital in Rhode Island at the time. He partnered with researchers at the University of Rhode Island on the project.

The original methodology involved recording cries in a clinical setting; however, the onset of the COVID-19 pandemic forced the research team to redesign the study so parents could submit recordings using a smartphone. While allowing for remote recording posed some technical challenges, the data collection process became more convenient for participants, thus creating the opportunity to gather even more audio samples for the study.

After completing a postpartum survey with demographic information and family history, parents are asked to create recordings of their infant’s cry when they are 2-6 weeks old. The recordings are submitted to the research team via a mobile app for analysis. The team then uses specialized software to measure a large number of features for each cry sample, some of which are indistinguishable to the human ear.

Researchers ultimately hope their analysis will show patterns in the cries that can be used to identify infants with a high risk of autism. “We want to know how we can translate our findings into care,” said Dr. Sheinkopf. The sooner autism is diagnosed, the faster children and their families can be connected with therapies and support services.

The RhINOS and Early Years studies plan to follow 2,700 children from birth to age three. Nine hundred mothers of infants and pregnant women have been recruited in the first year.

Research Spotlight: Dr. Stephen Sheinkopf

Dr. Stephen Sheinkopf joined the Thompson Center as Executive Director and Thompson Endowed Chair in Child Health in September 2021.

What brought you to the Thompson Center?

I came to the Thompson Center last September for the opportunity to lead an integrated team focused on the population that I have spent by career caring for and about.

What are your research interests?

My research is focused on autism as well as neurodevelopment more broadly. A lot of my work has been about studying the differences in development and outcomes amongst children with autism and those without autism. Currently I lead the Early Years Study here at Mizzou that is testing ways to identify likelihood for autism beginning in infancy. But I am also interested in the experiences of people with autism across development. We have additional research that is following adolescents into early adulthood.

What is something you hope to better understand by the end of your career?

There are two major things I want to explore. First, I want to understand how we can predict autism from the earliest stages of development so we can provide supports as early as possible. Intellectually, I am fascinated by the way autism presents differently as children age. I want to know more about why signs of autism are often so subtle in infants but grow to be more pronounced in toddlerhood and beyond.

What’s the best thing about working in this field?

The type of relationships I get to develop with my patients and their families is unique in this population. With the nature of my research and clinical practice, I often work with the same patients for many years through the course of their development. It is truly gratifying to create these ongoing connections.

What study have you been most excited about?

I love infancy. The Early Years study allows me to bring together my two passions of studying infants and studying autism.

Now that you have been with the Thompson Center for a year, what is your vision for moving forward?

After immersing myself in the Thompson Center’s work firsthand, I have an even deeper commitment to making our center a model for team-based care that brings together research, training, and clinical service to have the greatest impact for our patients and their families.

Trainee Spotlight: Dr. Erin Andres

Dr. Erin Andres joined the team at the Thompson Center in July 2022 as a postdoctoral fellow. In this role, she will primarily focus on the research projects brought to the Thompson Center by Dr. Stephen Sheinkopf, including the Early Years Study.

Tell us about your educational background.

After earning my BS in Neuroscience from Regis University in Denver, I entered the Child Language program at the University of Kansas-Lawrence, where I completed by master’s and Ph.D. The doctoral program used a multidisciplinary lens to study child language acquisition, including approaches from the fields of linguistics, psychology, genetics, and speech/language pathology.

What’s the biggest milestone you’ve achieved in your career so far?

As part of my Ph.D. program, I was involved with a longitudinal, family-based study that focused on Specific Language Impairment (SLI). We compared the genetic profiles of family members with and without SLI. A pattern emerged in the data I analyzed for one of the families and I was able to identify three genes for follow-up analysis in the larger sample. In the larger sample, variants were identified in 15 additional families on the gene BUD13. Given this finding, we can now look to this gene and its function as a focus for future investigation of the biological basis of language. The goal of this is ultimately to predict someone’s likelihood of having SLI and more quickly connecting high-risk individuals with early intervention services.

What’s your favorite thing about research?

I like developing research questions and coming up with ways to answer those questions. My goal for my career is to continue answering questions about early development.

What are your research interests?

Thus far, I have focused on investigating language development through the lens of genetics. The larger question guiding most of my research is “Is language innate to humans?” As I take this next step in my career at the Thompson Center, my ultimate goal is to contribute to developing strategies for earlier identification of autism and developmental delays, and therefore earlier intervention. We know that early intervention leads to improvements in academic outcomes, which are linked to overall quality of life; so, this work is really all about making peoples’ lives better

What do you hope to gain from your time at the Thompson Center?

The Thompson Center is known for its interdisciplinary collaboration and I hope to incorporate this approach into my future work. As a researcher, having a partnership with a clinic is invaluable. Not only does is the clinic a source for study recruitment, but it also serves as an avenue to connect directly with our biggest stakeholders: patients and their families.

Therapy Dogs Aren’t Always the Answer to Help Children with Autism

MU Study Finds Some – But Not All – Children with Autism Respond Favorably to Therapy Dogs as a Motivator to Complete Tasks, Learn New Skills.

Some children with autism spectrum disorder struggle with anxiety or have difficulty communicating in certain social situations. To help alleviate those struggles, researchers have studied various interventions, including therapy dogs, which are often cited as a popular social catalyst or stress reliever for children with autism.

But a study at the University of Missouri found that while some children with autism enjoy interacting with dogs, they are not preferred by all children with autism. The finding highlights the importance of first identifying the preferences of individual children before investing heavily in an intervention, such as a therapy dog, that might not be in a child’s best interest.

Emma Keicher, an applied behavior analyst at the MU Thompson Center for Autism and Neurodevelopment, collaborated with former MU faculty member and primary investigator Casey Clay, to see if children with autism preferred to interact with Rhett, a black Labrador retriever who served as the Thompson Center’s facility therapy dog.

In the study, boys with autism between the ages of four and nine were told that if they completed certain tasks, their reward would be a choice to play with Rhett or some other form of entertainment, such as playing with various toys. The researchers found that after completing the tasks, some boys enjoyed interacting with Rhett far more than playing with the toys, while some were indifferent toward the dog and mainly played with the toys, and others did not want to interact with the dog at all.

“People often assume that dogs are positive reinforcers for kids with autism, and while that may be true for some kids, the research shows that not all kids with autism spectrum disorder respond favorably to dogs,” Keicher said.

While the children in the study were familiar with the tasks they were asked to perform, the research shows that identifying what motivates a child with autism — whether it’s time to play with a therapy dog or a favorite toy — can be used as a reward to motivate that same child to practice new skills, such as communicating effectively in social situations.

“We like to say in the autism research community that if you have met one child with autism, you have really just met one child with autism, and it is important not to paint with a broad brush and assume that all kids with autism will respond favorably or unfavorably to the same stimuli,” said Clay, who now works as the director of the Behavior Program at the Thompson Autism Center in Orange County, California. “The key takeaway from this study is to tailor interventions according to the specific individual, because the autism spectrum is incredibly broad, and applied behavior analysis, or ABA, is the best evidence-based approach to do this.”

“Advancing Methods in Animal-Assisted Intervention: Demonstration of Starting Points in Clinical Practice for Children with Autism Spectrum Disorder” was published in Behavior Analysis in Practice. Co-authors on the study include Brittany Schmitz, Anna Hogg, Anne Clohisy and SungWoo Kahng.

Story Contributor:
Brian Consiglio, MU News Bureau

Fall 2022 Research Newsletter

The Fall 2022 issue of DISCOVERY, the Thompson Center’s research newsletter, is now available for digital viewing! Access the newsletter here.

Name Change: Thompson Center for Autism and Neurodevelopment

We are pleased to announce that the Thompson Center for Autism and Neurodevelopmental Disorders has changed its name to the Thompson Center for Autism and Neurodevelopment.

This name change aligns with the scope of work at the Thompson Center, work that encompasses autism, ADHD, cerebral palsy, Down syndrome, and other influences on development from infancy to adulthood. As leaders in this field, our family-centered services, cutting edge research, and training programs have impacts beyond the clinical definition of a “disorder.”

The University of Missouri System Board of Curators approved the name change on June 23; the change is effective October 4, 2022.

STRIVE Staff Receive Access Mizzou Award

Cortney Fish and Jaclyn Benigno were awarded the Lee Henson Access Mizzou Award on September 28 for their work on the Thompson Center’s STRIVE program. Self-Determined Transition Readiness Through Individual Vocational Experiences (STRIVE) is a post-secondary education program offering two semesters of non-credit employment skills development at the University of Missouri for 18- to 30-year-olds with autism or a similar diagnosis.

Fish has worked on STRIVE since its beginning in 2016 and Benigno joined the following year. The program is currently in its seventh cohort and has had 27 participants over the years.

The Lee Henson Access Mizzou Award is given to individuals who have had an impact on accessibility and disability at the University of Missouri. Lee Henson, for whom the award was named, was the ADA Coordinator at Mizzou who passed away in 2014 after 20 years of service to the University.

Congratulations and thank you to Cortney and Jaclyn for their hard work!

Left to right: Cortney Fish; Jaclyn Benigno; Amber Cheek, MU Director of Accessibility & ADA Coordinator. Photo by Sam O’Keefe, University of Missouri.

Thompson Center Launches Foster Care Clinic

There are several parts to any autism evaluation at the Thompson Center for Autism and Neurodevelopmental Disorders. Our providers gather and review information about the patient’s history. They interview the parents and the child. They observe the patient playing and administer a diagnostic screening tool. Information gathered from all of these sources is analyzed by a dedicated team to determine if and what diagnosis is appropriate.

This involved process is often made more challenging when the patient is a child in the foster care system. The average foster child is placed in an average of three households, but can range from 1-16 placements. Lack of continuity makes it difficult to keep track of records, follow through with scheduled appointments, stay in touch with healthcare providers, and observe long-term patterns of behavior and socializing. Foster children typically have more medical needs compared to their peers because of lack of screening and delayed treatment. All of these factors can contribute to a delayed diagnosis or a misdiagnosis. In some cases, our providers have found that foster children often come to our clinic with a diagnosed attachment disorder, while the underlying cause of attachment problems and other issues is actually autism.

As part of evaluation appointments at the Thompson Center, providers interview and interact with patients to observe patterns in behavior.

There are more than 400,000 kids in foster care in the United States and more than 20,000 in Missouri; the majority of these children are placed in the system because of neglect. Kids with disabilities are three times more likely to experience abuse and neglect, and therefore are more likely to end up in the foster system.

Because of the high demand for neurodevelopmental evaluations for kids in foster care and the complexity of their cases, the Thompson Center launched its Foster Care Clinic as a pilot program in June 2022. On the surface, these appointments are similar to any other autism evaluation; providers review files and records, interview involved parties, and observe the child. However, appointments for this clinic typically require much more preparation before the appointment. Our providers spend an average of eight hours compiling and analyzing information for foster children, as opposed to just one hour to prepare for most other evaluations.

After launching the Foster Care Clinic in June, the Thompson Center collaborated with Veteran’s United Home Loans to collect bags for children in foster care throughout the month of July. Foster kids often resort to using trash bags to move their belongings from one home to another.

To simplify the process of gathering needed information, the Thompson Center put together a checklist of Children’s Division forms and other documentation that would have relevant details about a foster child’s history. The Thompson Center team that created this checklist and developed the protocol for the Foster Care Clinic included specialists in the areas of psychology, neuropsychology, social work, nursing, developmental pediatrics, occupational therapy, speech/language therapy, and applied behavioral analysis. They collaborated with Children’s Division, judges, guardians ad litem, juvenile officers, biological and foster families, ParentLink, the MU Department of Human Development and Family Science, patients, and others to be sure that all perspectives were considered in the process.

Multidisciplinary evaluations are the standard at the Thompson Center, but the approach is especially helpful for our patients in foster care. Looking at a case from multiple perspectives can help fill in gaps where information is missing from a child’s history. The team recently evaluated a young child whose scores on several tests were highly inconsistent over time. A provider specializing in neuropsychology on the team recognized that this was not indicative of autism, but rather a brain injury. They were able to refer the patient for an MRI to explore the injury further.

The Thompson Center Foster Care Clinic pilot clinical team, from left to right.
Top row: Dr. Connie Brooks, Associate Clinical Professor of Psychology; Dr. Chris Prickett, Postdoctoral Resident in Neuropsychology; Meg Cloud, Patient Navigator
Bottom row: Lauren Sapp, BS, Psychometrist I; Rylee Park, Graduate Clinician; Jenny Huynh, Graduate Clinician

The Foster Care Clinic pilot program is currently scheduled to evaluate two patients per month with plans to double that capacity in 2023. When a formal waitlist is created for this program in August, the team expects to have 50-70 potential foster care patients from the existing autism evaluation waitlist. The Thompson Center will be seeking grant funding to offset the costs that are unique to these special cases, since insurance reimbursements do not factor in the additional time it takes to obtain and review files from Children’s Division.

The vision for the Foster Care Clinic goes beyond conducting evaluations. The team hopes to add a research component that will help answer questions about rates of diagnosis for autism and other neurodevelopmental disorders and best practices for foster care populations. The existing research in this area is scarce because it is often difficult to obtain consent for foster children to participate in studies. Additionally, the Thompson Center plans to train other autism service providers and therapists across the state in strategies for serving children in the foster care system and collaborate with them to continue care in their local communities for those who receive a diagnosis at the Thompson Center.

BCBA Spotlight: Meet Ali Cooper

After receiving an autism diagnosis, there are many different services available to serve the spectrum of needs that vary from person to person. One intervention offered at the Thompson Center is Applied Behavior Analysis (ABA). Over the next few weeks, we’ll introduce the Board Certified Behavior Analysts (BCBAs) that make up our Applied Behavioral Intervention Services (ABIS) division. Read our latest spotlight to meet Ali Cooper!

How long have you worked for the Thompson Center?

I have worked at the Thompson Center since 2015. I was a Registered Behavior Technician (RBT) from 2015-2017 before I started in my full-time position as a Behavior Analyst.

What are your main job duties?

As a Behavior Analyst, I am responsible for designing, implementing, and monitoring behavior analytic programs to improve socially significant behavior for clients in our clinic. I also supervise students in the Master of Applied Behavior Analysis program through the University of Missouri.

Where are you from?

I grew up in Quincy, IL and currently live in Columbia, MO.

What is your educational background?

I have an undergraduate degree in health sciences, a master’s degree in special education, and received a master’s certificate of applied behavior analysis, all from the University of Missouri.

Where did you work before you came to the Thompson Center?

I worked several jobs before becoming a behavior analyst. I worked as a barista at Lakota Coffee Company, and I was a direct support professional and a job coach at Alternative Community Training (ACT).

What is your favorite thing about working at the Thompson Center?

I enjoy seeing my clients make progress the most. I also love all my coworkers and the support we provide each other.

What got you interested in working with people with autism?

I completed an internship in my senior year of undergraduate school and became interested in working with people with autism through that.

What do you wish more people knew about ABA?

ABA a scientific approach to understanding behavior. It is not one specific intervention but a variety of procedures that can be individualized to suit the needs of clients and families. There are a so many ways to use and apply ABA-based principles.

What is the most valuable thing you’ve learned in your time working at the Thompson Center?

It’s so important to have collaboration and variety of perspectives in this work. I appreciate that this easy to do here at the Thompson Center.

When you’re not working, what do you enjoy doing?

I like spending time with my dogs, walking or running, playing tennis, and reading.