Zack Warren, Vanderbilt TRIAD director, works with a young patient. Photo by Michael Hopkins, Gerlinde Photography.

Vanderbilt University remains an Autism Treatment Network site after receiving a three-year, $420,000 renewal grant from the Autism Speaks board of directors earlier this year. One of just 17 centers in the United States and Canada, Vanderbilt was first accepted into the ATN in 2008.

The nation’s first network of academic medical centers related to autism in children and adolescents, ATN coordinates multi-site research and “really pushes for developing higher standards for medical care for individuals on the autism spectrum,” explained Zachary E. Warren, PhD, director of the Vanderbilt Treatment & Research Institute for Autism Spectrum Disorders (TRIAD). Critical to that care is recognizing that those on the spectrum are far more likely to face medical co-morbidities, from related neurological problems to propensities for gastrointestinal difficulties and disrupted sleep. Much of the work is about “establishing standards,” Warren said, as well as indexing and measuring the behavioral changes in this ever-growing population.

A part of the Vanderbilt Kennedy Center, TRIAD boasts researchers and clinicians who spend time at the Monroe Carell Jr. Children’s Hospital at Vanderbilt working in clinics and staffing research protocols in genetics, neuroimaging and intervention. On the intervention side, TRIAD employs specialists in education, psychology, and speech and language, who train teachers to develop individualized programs for students. “That remains a huge focus of TRIAD’s activities,” Warren said.

The beauty is the marriage of research, treatment and education. “We’re really focused on furthering research that is going to help children, families and schools in the communities where individuals with autism and spectrum disorders live. That’s our mission across all of those programs,” said Warren, who took the TRIAD helm about a year ago after four years as a member of the TRIAD team.

A child psychologist by training, Warren was born and raised in Blacksburg, Va., the son of a clinical psychologist and a preschool teacher. “So I didn’t fall too far from the tree,” he quipped. An assistant professor of pediatrics and psychiatry, he completed his doctorate in clinical psychology at the University of Miami and postdoctoral work at Harvard Medical School and the Medical University of South Carolina. While still at South Carolina, Vanderbilt and the University of Miami received a collaborative grant from the Marino Autism Research Institute, and Vanderbilt scooped up Warren because of his Miami connections.

Warren said several autism research consortiums are realizing promising breakthroughs when it comes to neurogenetics. “With new gene discoveries, individuals start to translate those genes into fundamental biological expressions which affect the brain, and then pinpoint the areas of the brain that are then implicated in specific behavioral manifestations. There’s work all along those chains right now,” he said. “We’re now approaching that point where with each new identification, we’re able to think about how we’re able to translate that finding into something that will be meaningful in terms of intervention for a particular individual.”

Also promising, Warren said, are effective interventions for very young children. “Some of the most promising work has come from really pushing to identify autism at earlier and earlier ages through complex methods,” he said. “Not just simple growth checklists or rough evaluations, but really coming up with paradigms that blend biological and behavioral observations to be able to identify the earlier differences.” Where is such research headed? The words “recovery” and “prevention” sometimes come up in those discussions. He acknowledged

TRIAD is engaged in critical research related to studies of high-risk infant siblings and is working to establish a study engaging children at Fort Campbell near Clarksville. TRIAD also is working with the Vanderbilt Evidence-Based Practice Center to synthesize the literature already available on autism intervention.

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