Geraldine Dawson's arrival on the Duke campus marks a number of different milestones.
The personal landmark will be her return to providing clinical care to children with autism and their families after five years dedicated solely to research as chief scientific officer of Autism Speaks, a post she performed from the UNC campus in Chapel Hill
The professional milestone will be her leadership role in Duke's formal launch of a program dedicated to autism treatment, research and training that brings together many elements of the neurosciences on campus.
"There is already such deep expertise in neuroscience and neuroimaging and the application of neuroscience to treatment at Duke," Dawson said. "That's one of the reasons I was so excited to come here."
A developmental clinical psychologist, Dawson's career path in autism was set by the very first practicum patient she handled in her Ph.D. training at the University of Washington. "Autism was rare, we knew almost nothing about it at that point," she said, in her cozy new research office on the second floor of Brightleaf Square. "First of all, my heart really went out this family, because we had very little we could offer them."
However, autism studies also involves a rich intellectual challenge, she said. How does autism happen and what might be done therapeutically to help patients develop social and cognitive skills and better language development?
"It's amazing to see what has happened," Dawson said. "I never imagined that autism would become one of the most prevalent conditions." Thanks to research by her and others, autism remains much better understood, but still deeply mysterious.
"Autism is many different conditions with many different causes," Dawson said. "It's not going to be an easy answer or one thing that accounts for autism. Rather, a complex mixture of both genetics and the environment influence the risk for autism."
Because it is many different disorders, autism requires different treatment approaches, said Dawson, whose clinical office will be in the Lakeview complex on Erwin Road, near Duke Hospital. The therapeutic program will be aligned with ongoing research, she said. "We hope that families will view themselves as partners in discovering more effective treatments for autism."
The new Center for Autism Diagnosis and Treatment will include medical interventions in its treatment of autism, Dawson said. There are now known to be some medical conditions that seem to be part of the syndrome, including epilepsy, sleep disorders, GI issues, allergies and food sensitivities.
"We're learning that if we can help with the medical conditions that are associated with autism, that not only is quality of life improved, but also that children and adults can take advantage of the behavioral interventions that we know are so effective."
Both Dawson's research and her clinical care will be based on extensive partnerships. At Brightleaf, she shares an office suite with Dr. Helen Egger, head of the division of child and adolescent psychiatry, and they'll work on earlier detection and intervention. Egger is an expert on early childhood anxiety disorders. About 40 percent of individuals with autism develop an anxiety disorder, which can significantly affect quality of life.
Dawson and Egger are exploring early risk factors for the development of anxiety in young children with autism, with the goal of intervening early. Dawson's research over the years has been focused on identifying autism as early as 12 months of age and developing specific strategies for the children and their parents to foster social, emotional and cognitive skills.
With Egger and engineering professor Guillermo Sapiro, she'll work on ways to improve early diagnosis through the use of automated video analysis of home videos of babies and toddlers for subtle indications of autism.
With Sarah Lisanby, chair of psychiatry and behavioral sciences, Dawson wants to investigate trans-cranial magnetic stimulation's (TMS) therapeutic potential. "I'm interested in the potential application of TMS as a way of facilitating language and social development in children and adults with autism."
With Michael Platt, director of the Duke Institute for Brain Sciences, Dawson wants to explore possible molecular and anatomical features of the disorders. "I'm thrilled about Geri coming to Duke," Platt said. "She is the leader we have been looking for to bring together scientists and clinicians working to understand this devastating disorder, and hopefully find better ways to help our patients and their families."
Calling her a "real game-changer," Platt said Dawson's arrival also strengthens the partnership between DIBS and Psychiatry and Behavioral Sciences. Dawson also encouraged members of the Duke community, undergrads to faculty, to consider becoming involved in the new autism center for their research and training.
Dawson lives in Durham with her husband, Joe Coates, a Duke-educated engineer who works for Organic Transit in Durham. Their daughter is a second year pre-med student at Duke, and their son is vice president of operations for Zillow.com. He lives with his wife and children in Seattle.