04/17/2009 05:12 am ET Updated May 25, 2011

Dear Mr President: Bold Leadership Now Could Change the Course of Autism

(On behalf of Dr. Phil Landrigan)

Dear Mr. President,

Please accept my sincere congratulations on your inauguration as President of the United States. National leadership in Washington that is forward thinking and infused with optimism restores my own enthusiasm for discovery and dedication to progress. I join you in celebrating a renewed and energized America.

I am writing to express my support for your Autism Agenda and to recommend a new direction within existing research strategies to discover the cause of Autism Spectrum Disorders (ASD). ASD now affects 1 in every 150 children born in this country, and is a devastating condition not only for those diagnosed, but also for the families struggling to treat and rehabilitate them. During your tenure in the Senate, you interacted with families affected by autism and advocated on their behalf. Thus, I need not press upon you the gravity of this illness.

As a pediatrician, epidemiologist, and established voice for preventive medicine, I have focused my work on protecting children against environmental threats to health, most notably lead and pesticides. My research on lead toxicity at low levels persuaded the government to mandate removal of lead from gasoline and paint, actions that have produced a 90% decline in incidence of childhood lead poisoning over the past 25 years. I've been one of the leaders in developing the National Children's Study, the largest study of children's health and the environment ever launched in the US. As part of my advocacy for preventing exposure to synthetic chemicals, I work closely with Healthy Child Healthy World, a national children's non-profit that educates communities about environmental health risks.

During the presidential campaign, ASD was acknowledged as a top health priority for the next administration. Today, I believe firmly that your endorsement of large-scale and well-funded research will push us closer to finding the cause.

Your administration's Autism Agenda is robust and promising. I applaud your commitment to increase federal research funding to $1 billion annually by the end of your first term, re-examine the Combating Autism Act of 2006, and mandate insurance coverage of developmentally-based and behavioral treatments for autism.

The debate around ASD is complex, obtuse, and exceptionally emotional. The cause remains largely a mystery. Genetic factors are clearly implicated, but none accounts for more than a small fraction of the cases. Your administration's assessment of autism accepts its genetic roots but also implicates environmental triggers.

We know that the developing brain is exquisitely sensitive to external exposure, and there is powerful evidence linking autism with exposure to synthetic chemicals in early pregnancy.

I believe strongly that early environmental exposures may contribute to causation, perhaps through interaction with a child's genetic susceptibility. This arena of study has been largely overlooked, though it may yield findings that create a clearer, more cogent understanding of ASD. Expanding on your stated platform, I recommend a thorough investigation into environmental triggers to ASD that is as heavily weighted and highly prioritized as previous research into suspected causation.

I am currently seeking funding for a new research project through Mount Sinai's Children's Environmental Health Center, called the Autism Discovery Project, to explore environmental causation of autism. The project would follow an interdisciplinary strategy that combines toxicological screening, neurobiological research, and prospective epidemiological study. The Autism Discovery Project seeks to confirm that research exploring the interaction between our genes and our environments is the next frontier of discovery.

If the rates of autism, currently at epidemic proportions, are to be slowed, public awareness must be brought to prevention and early intervention. If the rates of diagnosis are to diminish entirely, we must launch boldly into less charted areas of research that examine the synergy between our bodies and our environments.

Leadership that is open and willing to think outside of conventional norms will propel research to new levels. Now is our moment for new thinking and bold action. I commend your commitment to ensuring ASD receives the priority and attention it so deserves.

Many thanks and best wishes,

Philip Landrigan M.D.

Ethel Wise Professor, Chair of the Department of Community and Preventive Medicine,
Director of the Children's Environmental Health Center, Mount Sinai School of Medicine, and Founding Board Member of Healthy Child Healthy World

As cross-posted on Healthy Child Healthy World's BLOG.