Adam Guastella

October is mental health month and the University of Sydney’s Brain & Mind Research Institute is Australia’s most significant contribution towards the prevention or cure of disabling brain and mind disorders. Adam Guastella’s multidisciplinary approach to developing new treatments for autism is at the forefront of the global effort to improve outcomes for people with autism.

By Ruth Gordon

Adam Guastella

Adam Guastella

“’Current treatments just aren’t good enough’ is something I often hear from the parents of children with autism and I have to agree with them” said Associate Professor Adam Guastella, who heads up the Social Anxiety and Autism Research Program at the University of Sydney’s Brain and Mind Research Institute (BMRI).

“Existing treatments for autism may result in some degree of improvement but currently no treatment gives a really satisfactory outcome”.

Most existing medications, such as antidepressants that are prescribed to people with autism to reduce arousal and irritability have mixed effectiveness. These medications may reduce irritability but they don’t increase a person’s understanding of social interactions, which is the main impairment of autism.

Research has shown that behavioural interventions may show some improvement but they can be incredibly time consuming – requiring up to 40 hours per week – and are very costly, putting them out of reach of a lot of families, especially for long-term treatment.

It is this lack of satisfactory treatment that drives Guastella, who is working in collaboration with social neuroscience researchers in the US and medical imaging researchers at the University of Sydney to develop interventions that will provide a significant treatment for autism.

“Oxytocin has a significant impact on social cognition. It improves trust, altruism, emotion recognition and increases sensitivity to eye gaze” said Guastella, who has completed the world’s largest trials of oxytocin to treat autism.

Guastella is collaborating with the US National Institute of Mental Health, experts in animal behaviour, geneticists, imaging physicists and mental health service providers to find effective treatments and improve the quality of life for young adults with autism.

Guastella and his team have been chosen as one of only six sites world-wide, and the only non-US site to participate in a US National Institute of Mental Health study looking at novel compounds for autism treatment.

The collaborative study is based on a “fast fail” approach where medications already being used to treat other human conditions can be rapidly assessed for their effectiveness in treating autism. “This approach means we can cut down the time it usually takes for new treatments to become available” said Guastella.

In collaboration with renowned animal behaviour scientist Dr Larry Young in the US, Guastella is assessing the effectiveness in animals of compounds related to oxytocin. “We are using the discoveries from Dr Young’s animal studies to examine only the most promising candidates for their effect on autism in humans” said Guastella.

Understanding the genetic pathways involved in autism is another important aspect to developing truly effective treatments for the disease.

“There have been a number of genetic studies in autism that highlight important pathways in the disorder. For example there’s a gene controlling a calcium channel that we think is especially important in autism” said Guastella, who is collaborating with researchers from Monash University to further investigate this genetic pathway.

The BMRI’s molecular imaging facility is providing an important platform for Guastella’s research, which aims to shed light on the differences in brain function between people with and without autism. “Through MRI scanning we can look at neurobiology over time. This could give important insights into how people with autism develop strategies to mask the symptoms of the disorder, and even identify early markers of autism” said Guastella.

Guastella is also working in collaboration with headspace national youth mental health foundation to assess and provide treatment for young people with autism aged 17 to 30 years. At this age young people have left school and there are very few community-services available to support them as they enter university or the workforce. “We know that young people with Asperger’s have great difficulty holding down jobs, partly because they have unrealistic expectations about their needs and skills and partly because of a lack of awareness and support from employers and the community.

“We also know that with support these young people have dramatically improved outcomes. Support for the young people in job selection, for their employers and families, helping them with social tasks in university tutorials and to have realistic expectations of their success at uni or at work could be the difference between earning a degree and working long-term or withdrawing from society” said Guastella.

“The best chance we have of developing truly effective treatments for autism is interdisciplinary collaboration. I’m grateful to be part of an international team of experts in animal behavioural neuroscience, molecular biology and genetics, clinical psychologists, primary health providers and imaging physicists, all working together to find a treatment and enable better outcomes for people with autism” said Guastella.