Trajectories and Environments in Autism: a Multi-cohort Study (TEAMS) following autism families in ECHO Phase 2

自闭症谱系障碍（ASD）是最常见的神经发育障碍之一， 儿童，患病率为2%或更高。ASD沿频谱呈现沿着，并且根据 定量测量表明核心性状的连续分布延伸到一般 人口虽然ASD诊断和ASD相关特征都已被证明具有高度遗传性，但证据表明， 还支持环境风险因素的贡献，包括产前暴露于空气污染和摄入 某些营养素。为了解决先前在理解自闭症的环境风险因素方面的差距， 我们的团队开发了自闭症谱系障碍富集风险（ASD-ER）“队列队列”。在第一阶段 在ECHO，我们的队列为饮食，空气污染和神经发育的协调努力做出了贡献， 高级使用ASD相关表型的简化测量，同时利用独特的数据， 自闭症研究由ECHO提供。在此，我们建议在继续落实《行动纲领》的同时， ASD-ER ECHO 1期儿童通过青春期和早期的关键和研究不足时期 自闭症的轨迹和环境：多队列研究（TEAMS）项目。的目标 该项目的目的是：1）研究生命早期暴露于空气污染和饮食的联合影响， ECHO范围内的数据中的神经发育结果，解决叶酸，鱼类/脂肪酸和其他 饮食因素可能在减轻空气污染方面发挥作用， 相关的数量性状（ASD，ID和ADHD）; 2）评估青少年的多领域健康轨迹 在ECHO范围内的数据中的神经发育结果，并确定积极轨迹的预测因素 和结果。我们将使用通过ECHO努力收集的独特纵向数据， 在精神和身体健康方面，并研究这些在神经发育诊断中的差异， 性状我们还将寻求进一步描述我们的神经发育专业成果领域， 孤独症，特别是通过进行心理测量分析的尺寸措施。最后，我们将3）最大化 通过实施ECHO方案招募和保留我们的队列参与者。我们将 实施统一的征聘和留用战略，辅之以奖励措施和支助网络， 有神经发育问题的青少年、过渡期自闭症青少年及其家庭。球队将 第一次纵向研究自闭症的弟弟妹妹儿童从子宫到成年。在 这样做，我们的项目提供了独特的机会，以促进对环境预测因子的理解， 修饰符，进行神经发育障碍及其潜在特征的交叉结果比较， 描述自闭症青少年的多领域轨迹并确定积极结果的预测因素， 实施ECHO第二阶段协议，以确保在这一重要领域扩大研究可能性。 人口，并最终优化自闭症患者及其家庭的结果。

Autism spectrum disorder (ASD) is one of the most common neurodevelopmental disorders diagnosed in childhood, with a prevalence of 2% or higher. ASD presents along a spectrum, and characterization according to quantitative measures demonstrates continuous distribution of core traits extending into the general population. While both ASD diagnosis and ASD-related traits have been shown to be highly heritable, evidence also supports contributions of environmental risk factors, including prenatal exposure to air pollution and intake of certain nutrients. In order to address prior gaps in the understanding of environmental risk factors for autism, our team developed the Autism Spectrum Disorder Enriched Risk (ASD-ER) “cohort of cohorts.” In the first phase of ECHO, our cohort contributed to harmonization efforts of diet, air pollution, and neurodevelopment, and advanced use of abbreviated measures of the ASD-related phenotype, while capitalizing on the unique data for autism research presented by ECHO. Here, we propose to build off of these efforts while continuing follow-up of ASD-ER ECHO Phase-1 children through the critical and under-studied period of adolescence and early adulthood in the Trajectories and Environments in Autism: a Multi-cohort Study (TEAMS) project. The goals of this project are to: 1) Examine joint effects of early life air pollution exposure and diet on neurodevelopmental outcomes in ECHO-wide data, addressing the role that folate, fish/fatty acids, and other dietary factors may play in mitigating air pollution associations across neurodevelopmental diagnoses and their related quantitative traits (ASD, ID, and ADHD); 2) Evaluate multi-domain health trajectories of adolescents across neurodevelopmental outcomes in ECHO-wide data, and identify predictors of positive trajectories and outcomes. Using the unique longitudinal data collected through ECHO efforts, we will examine trajectories across mental and physical health and examine how these differ across neurodevelopmental diagnoses and traits. We will also seek to further characterize our specialized outcome area of neurodevelopment, and autism specifically, by conducting psychometric analyses of dimensional measures. Finally, we will 3) Maximize recruitment and retention of our cohort participants via implementation of the ECHO protocol. We will implement a unified recruitment and retention strategy facilitated by incentives and a network of support for adolescents with neurodevelopmental conditions, transition-age autistic youth, and their families. TEAMS will be the first longitudinal study of autistic younger sibling children followed from the womb to adulthood. In doing so, our project presents unique opportunities to advance understanding of environmental predictors and modifiers, conduct cross-outcome comparisons of neurodevelopmental disorders and their latent traits, characterize multi-domain trajectories and identify predictors of positive outcomes in autistic adolescents, and implement 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.