The National Institutes of Health (NIH) has renewed the designation of Marcus Autism Center as a national Autism Center of Excellence (ACE), including an $11M, five-year research grant to Emory University School of Medicine. Only five institutions in the United States are designated ACE centers in the highly competitive program, which supports large-scale multidisciplinary studies of autism spectrum disorder (ASD), with the goal of identifying causes and best treatments. Marcus Autism Center is both a subsidiary of Children's Healthcare of Atlanta and part of the Department of Pediatrics in the Emory University.

"The renewal of our ACE award, which we first received in 2012, is an acknowledgment from the NIH of the groundbreaking results achieved by our dedicated research and clinical teams over the first five years of our ACE program," says Ami Klin, PhD, director of Marcus Autism Center, a Georgia Research Alliance Eminent Scholar and professor of pediatrics in Emory University School of Medicine.

"Our success in delineating the genetic, neural and behavioral mechanisms of autism, the promise of future discoveries that can positively impact the lives of children and their families, and this designation and support from the NIH would not be possible without the unique partnership among Marcus Autism Center, Emory University School of Medicine and Children's Healthcare of Atlanta," says Klin. "We also owe our success to the strong support of community members such as Bernie Marcus and the Marcus Foundation, the Whitehead Foundation and the Georgia Research Alliance."

One in 68 children in the United States, and one in 64 in Georgia, are living with autism spectrum disorder. As the largest center in the United States for clinical care of autism, Marcus Autism Center treats more than 5,000 children each year, offering families clinical care in diagnosis, language and learning, severe behavior and feeding disorders. The Marcus team evaluates and diagnoses nearly 1,000 children a year, and directs patients to appropriate services. Early intervention is essential, as children learn and acquire skills more rapidly early in life while the brain is still developing.

Through pioneering research in the first five years of the ACE designation, investigators at Marcus Autism Center and Emory University School of Medicine have shown that developmental deviations in social communication can be identified as early as two months old, well before reliable clinical diagnoses of autism. These findings resulted from a robust research program including Emory University School of Medicine, Yerkes National Primate Research Center, Florida State University, and collaborators across the United States. For example, their July 2017 publication in the journal Nature demonstrated that these developmental deviations are under genetic control, bridging molecular studies to behavior.

The new ACE grant will expand on previous work by encompassing the Center's most advanced science to date, focusing on behavior and brain studies of babies from birth, as well as infant monkeys from birth. Projects supported by the new grant span genes to neighborhoods, aiming to generate new scientific discoveries and ultimately leading to a new community-based system of health care delivery for infants and toddlers with autism and their families.

"Our goal is to change the narrative of autism from one of potentially devastating disability to one of positive diversity, in which individuals with autism are able to succeed despite their learning differences and because of their unique assets," says Dr. Klin. "We believe the scientific work funded by this grant will have the power to favorably disrupt the current state of early detection and intervention in autism, and has the power to achieve improvements in developmental trajectories with lifelong implications."

The new ACE grant to Marcus Autism Center includes five individual research projects:

• Project 1:  Social visual engagement in infants
  Led by investigators Warren Jones and Sarah Shultz, this project builds on recent research showing those the way in which infants visually explore, engage with, learn from and adapt to their surrounding world is tightly connected to genetic variation. New studies will build on these findings to study pivotal transitions in early infancy that set the stage for future attainment of social-communication milestones.
• Project 2:Spoken communication between infants and caregivers
  Five years of research in the first ACE grant provided compelling evidence for a causal link between early deficits in social engagement and later deficits in speech and language in infants at risk of autism. This project reaches across every stage of vocal development, beginning in the first months of life, and includes developmental progressions in vocal behavior in both infants and caregivers that are disrupted in autism. A team led by Gordon Ramsay and Ami Klin will continue research into treatments targeting social interactions between infants and caregivers that could more effectively promote speech development than treatments targeting speech development in the infant alone.
• Project 3:Neuroimaging of infant brain development
  Investigators Sarah Shultz, Warren Jones, and Longchuan Li will map transitions in brain and behavior over the first six months of life in infants at high- and low-risk for autism. The study builds on earlier results showing that looking at the eyes of others is already in decline in the first six months of life in infants with autism. The investigators will further explore the mechanisms behind findings that infants with autism exhibit a slight increase in eye-movement at two months that later declines, meaning reflex-like predispositions for looking may be initially present but are not integrated into social interaction as the brain matures.
• Project 4:New treatment models for infants
  Using innovative web-based technology, researchers, led by Amy Wetherby, will teach parents to identify early social communications milestones and support their children's early development through a behavioral intervention. The results will be measured to identify and optimize opportunities for learning and to improve outcomes.
• Project 5:Model system of social behavior
  Investigators Jocelyne Bachevalier, Warren Jones, and Mar Sanchez will conduct research with nonhuman primate infants living with their mothers in social groups at the Yerkes National Primate Research Center Field Station. Studies based on earlier ACE research will include behavioral and neural measures similar to those used in human infants to characterize social visual engagement and neuromotor development, including a focus on mother-infant reciprocal behaviors. The studies will help with assessment of how genetic variations alter social development and evaluation of potential therapeutic treatments.

The ACE grant also will promote education and training to disseminate best practices to primary care providers and to present relevant and empowering information to affected families and the community at large.

Visit www.marcus.org/nih to learn more.

Marcus Autism Center

Children's Healthcare of Atlanta

Children's Healthcare of Atlanta has been 100 percent dedicated to kids for more than 100 years. A not-for-profit organization, Children's is dedicated to making kids better today and healthier tomorrow. Our specialized care helps children get better faster and live healthier lives. Managing more than a million patient visits annually at three hospitals and 28 neighborhood locations, Children's is the largest healthcare provider for children in Georgia and one of the largest pediatric clinical care providers in the country. Children's offers access to more than 60 pediatric specialties and programs and is ranked among the top children's hospitals in the country by U.S. News & World Report. With generous philanthropic and volunteer support since 1915, Children's has impacted the lives of children in Georgia, the United States and throughout the world. Visit hoa.org for more information.

Emory University School of Medicine Department of Pediatrics

Faculty-physicians in the Emory Department of Pediatrics provide the highest quality state-of-the-art clinical care, with a commitment to improving treatment for children through scientific research as well as training the next generation of leaders in pediatrics. Web site: pediatrics.emory.edu