Lisa A. Croen, PhD

People

Kaiser Permanente Division of Research
2000 Broadway
Oakland, CA 94612

(510) 891-3463 (phone)
lisa.a.croen@kp.org
Kaiser Permanente Researcher Profiles

Lisa Croen, PhD, is a senior research scientist at the Division of Research (DOR), Kaiser Permanente Northern California (KPNC), and the director of the Kaiser Permanente Autism Research Program. Her research interests include the epidemiology of autism and other neurodevelopmental disorders, environmental exposures and gene/environment interaction, and the delivery of health services to individuals with autism spectrum disorder across the life span. Currently, Dr. Croen is the Co-Principal investigator at Kaiser Permanente of the NIH-funded ECHO study, principal investigator of several NIH-funded studies including Early Markers for Autism study (EMA) and Immune and Metabolic markers during Pregnancy and Child Neurodevelopment (IMPaCT), and site principal investigator on several large federally funded autism studies including the Study to Explore Early Development (SEED), the Early Autism Risk Longitudinal Investigation (EARLI), the Autism Centers of Excellence ACTION Network, and the ECHO ASD-ER study. In collaboration with clinical colleagues, she is conducting mixed methods studies to evaluate autism treatments at KPNC, the transition from pediatric to adult healthcare among KPNC patients with autism, barriers and facilitators of healthcare service use among Latino families affected by autism, and the health status and healthcare utilization of adults with autism. Dr. Croen received her master's degree in public health and her doctorate in epidemiology, both from the University of California, Berkeley.

Current Position(s):

Research Scientist III, Division of Research, Kaiser Permanente Northern California
Director, Autism Research Program

Section Affiliations:

Women's and Children's Health

Primary Research Interests:

Epidemiology of autism and neurodevelopmental disorders
Environmental exposures and gene/environment interactions

Related Website(s):

Autism Research Program

Studies

COVID-19 Response Grant

Adults with intellectual or developmental disabilities may be especially impacted by the ways the COVID-19 pandemic has led to drastic changes in usual daily routines and the way healthcare encounters have been transitioned to virtual (video, telephone) visits. This project will characterize healthcare utilization and health status among adults with autism spectrum disorders (ASD) during the COVID-19 pandemic, comparing to similar indices in the pre-COVID period. Among adults with chronic health conditions that require ongoing management (such as diabetes, heart disease, or mental health conditions), we will also compare healthcare utilization between adults with and without ASD.
Investigator: Croen, Lisa
Funder: Special Hope Foundation

Maternal Inflammation during Pregnancy and Neurodevelopmental Disorders

This study will utilize the Pregnancy Cohort from the Kaiser Permanente Northern California Research Program on Genes, Environment and Health to characterize the maternal immune profile over pregnancy and evaluate whether there are specific longitudinal patterns that are associated with neurodevelopmental outcomes in the offspring. The project will identify factors that are associated with longitudinal patterns of maternal immune markers over pregnancy and examine whether there is variability in risk factors across different neurodevelopmental outcomes. Factors to be examined include maternal demographic, lifestyle, clinical, and genetic factors.
Investigator: Croen, Lisa
Funder: National Institute of Child Health and Human Development

Optimizing Social Communication Measurement with the Social Responsiveness Scale

This project aims to: 1) compare the psychometric characteristics (including distributional properties, agreement with gold-standard diagnostic measures, and sensitivity and specificity) of short versus full Social Responsiveness Scale (SRS) scores, using existing child SRS data from the Environmental influences on Child Health Outcomes (ECHO) study; 2) use existing SRS data in ECHO to compare the performance of short versus full SRS scores in analyses of established risk factors for autism spectrum disorder (gestational age and parental age), as well as in assessment of familiality of scores (previously established for the full scale) in cohorts with available parental scores; and 3) A) develop a computer-adaptive testing (CAT)-based SRS, and B) conduct a separate validation of the 16-item short form administered as a standalone questionnaire (rather than relying on short form scores derived from responses to the full SRS) and of the newly developed CAT-based SRS in separate clinical and general population samples of children aged 3 to 5 years.
Investigator: Croen, Lisa
Funder: National Institutes of Health, Office of the Director

Autism Adaptive Community-Based Treatment to Improve Outcomes Using Navigators (ACTION) Network

One of the greatest challenges in autism treatment is how to bridge the health care science-to-service gap and address disparities in access to evidence-based early intervention for children with autism spectrum disorder. This project will establish a new interdisciplinary network of eight institutions to blend implementation and clinical effectiveness research designs, with an overarching aim to study the individual and combined effects of three intervention components: 1) Infusing mobile technology for professional development and family education using the Autism Navigator collection of web-based courses and tools; 2) Engaging families to access resources and support when they first learn their child has autism spectrum disorder, using a brief engagement intervention by community healthcare workers as family navigators to accelerate access to care; and 3) Coaching families to embed evidence-based intervention strategies in everyday activities using the Early Social Interaction Parent Coaching model to improve outcomes for toddlers with autism spectrum disorder.
Investigator: Croen, Lisa
Funder: National Institutes of Health

Barriers to Health Care in a Latino Population with Autism Spectrum Disorder

This study will identify barriers to the use of recommended assessment, diagnostic, and treatment services among Latino children and adolescents with autism spectrum disorder. The study population will comprise Kaiser Permanente Northern California Latino members, and comparisons will be made between commercially insured versus federally insured (Medicaid) patients, and English versus Spanish speakers.
Investigator: Croen, Lisa; Gordon, Nancy
Funder: Northern California Community Benefit Programs

Prenatal Exposure to Metals and Risk for Autism Spectrum Disorder in MARBLES and EARLI

The peri-conceptual and prenatal periods of gestation are the most likely window of susceptibility for ASD; thus, maternal exposures and maternal genetic susceptibility are critical targets of investigation. Maternal exposure to heavy metals has been recognized for many years as a cause of fetal harm, particularly neurodevelopmental. In this study, we combine two prospective, enriched risk, pregnancy cohorts with available pregnancy and birth biosamples for metals and genetic measurement, with early-life developmental phenotype data, with age 3 ASD diagnosis status assessed by ASD researchers, and enough outcomes to provide adequate power given the enriched design. Further, we consider the utility of epigenetic measures in the study of these environmental risk factors, given evidence of the susceptibility of DNA methylation changes from metals exposure and the potential role of DNA methylation as a mediator of ASD risk or as a post-natal biomarker of metals exposure.
Investigator: Croen, Lisa
Funder: National Institute of Environmental Health Sciences

Health System Integration of Tools to Improve Primary Care for Autistic Adults

The objective of this project is to use a CBPR approach to understand how to best integrate the AASPIRE Healthcare Toolkit, an online healthcare toolkit aimed at improving primary care services for autistic adults, into the KP Northern CA healthcare system as we prepare for the larger effectiveness-implementation trial. We will do so by achieving the following specific aims: 1) To determine how to integrate use of the toolkit into the Kaiser systems. 2) To assess the acceptability and feasibility of both the intervention and the research protocols. 3) To further explore potential mechanisms of action.
Investigator: Croen, Lisa
Funder: National Institute of Mental Health

Understanding Family Economic Impact of Chronic Child Health Conditions

This study will address an important knowledge gap by estimating financial and time costs for families of children with autism. We will recruit 1,500 families of children 3-17 years old from geographically and ethnically diverse integrated health systems: Kaiser Permanente Northwest, Kaiser Permanente Northern California, Kaiser Permanente Georgia, Kaiser Permanente Hawaii and the OCHIN network of federally qualified health plans. Using the Family Economic Impact Interview, we will follow participating families for one year to collect information on family costs and examine what factors contribute to these costs.
Investigator: Croen, Lisa
Funder: National Institute of Child Health and Human Development

Prenatal SSRI Exposure, Maternal and Child Genotype, and Autism Spectrum Disorders

The prevalence of Autism Spectrum Disorders (ASD) has increased rapidly over recent decades. Among many environmental exposures that have also increased in frequency is the use of anti-depressant medications during pregnancy. Approximately 10% of pregnant women are prescribed selective seratonin reuptake inhibitors (SSRIs) SSRIs and other anti-depressant medication cross the placenta and are secreted in breast milk, thus raising concerns about adverse effects on the fetus or infant. This study will expand upon previous findings of an association between prenatal SSRI exposure and autism risk by utilizing data and biospecimens already collected in the SEED study to explore main and joint effects of maternal antidepressant use, maternal psychiatric disease history, and maternal and child genetic susceptibility.
Investigator: Croen, Lisa
Funder: National Institute of Child Health and Human Development

Prospective Evaluation of Air Pollution, Cognition and Autism from Birth Onward

This study will examine the relationship between perinatal and early life air pollution exposure and early longitudinal measures of cognitive ability and ASD in two prospective samples - Markers of Autism Risk in Babies, Learning Early Signs (MARBLES) and Early Autism Risk Longitudinal Investigation (EARLI). Aim 1 is to assign air pollutant exposure using geographic information systems (GIS) technology and novel biomarker measurements. Aim 2 is to examine the effect of air pollutant exposure on the trajectory of cognitive development. Aim 3 is to evaluate the effect of air pollution exposure on cross-sectional and longitudinal measures of autistic traits and ASD diagnoses.
Investigator: Croen, Lisa
Funder: National Institute of Environmental Health Sciences

Neurodevelopment of Cognitive Control in Autism: Adolescence to Young Adulthood

This study compares the developmental trajectory of behavioral measures of cognitive control from adolescence into young adulthood in typical individuals (TYP) and individuals with Autism Spectrum Disorder (ASD). We predict that approximately 2/3 of those with ASD will show a persistent lag in performance on cognitive control tasks through young adulthood, and that in those with ASD, cognitive control abilities will predict performance in complex information processing. We will also examine the development of the neural mechanisms of cognitive control from adolescence to young adulthood. We hypothesize that those with ASD will employ more reactive cognitive control than their TYP counterparts. Lastly, we will investigate relationships between the two modes of cognitive control, and functional and mental health outcomes between adolescence and young adulthood in the ASD group.
Investigator: Croen, Lisa
Funder: National Institute of Mental Health

Folic Acid Prevention Pathways for ASD in High Risk Families

Autism spectrum disorders affect 1 in 68 children in the US. There is evidence for a potentially large role for the early in-utero environment, including gestational nutrition, in ASD etiology. Maternal folic acid is one of the first modifiable factors with the potential to reduce occurrence of ASD. In addition to being essential for neurodevelopment, folate is a primary methyl-donor for methylation reactions. The time near conception is an especially critical period for adequate methyl supply during cycles of active de-methylation and re-methylation during embryogenesis, interactions with genetic and environmental risk factors, and the greatest reduction in ASD risk associated with higher maternal folic acid intake. Using data and samples from mother-child pairs in two large prospective studies, this study proposes to examine specific pathways for prevention of ASD through maternal dietary and supplemental folate intake.
Investigator: Croen, Lisa
Funder: National Institute of Environmental Health Sciences

Early Life Exposure to Endocrine Disrupting Chemicals and Child Growth, Adiposity, and Neurodevelopment

We hypothesize that in-utero exposures to commonly used endocrine disrupting chemicals, such as PFCs and PBDEs, individually and/or in combination, have adverse effects on child obesity and neurodevelopment through possible common pathways. Our aims are: Aim 1. To evaluate whether in-utero exposures to maternal PFCs and PBDEs, individually and/or in combination, are associated with infant growth, adiposity and neurodevelopment. Aim 2. To evaluate whether in-utero PFCs and PBDEs exposures are associated with metabolic determinants of obesity and neurodevelopment . Aim 3. To explore whether in-utero PFCs and PBDEs exposures are associated with infant patterns of DNA methylation. Aim 4. To identify infant, maternal and paternal factors that modify the association of exposure to in-utero PFCs and PBDEs exposures and with infant growth, adiposity and neurodevelopment.
Investigator: Croen, Lisa; Ferrara, Assiamira
Funder: National Institutes of Health

Role of Pre-natal Vitamin D and Gene Interactions in Autism Spectrum Disorders: Leveraging an Existing Case-Control Study

This study is the first to investigate the role of perinatal vitamin D deficiency or insufficiency in ASD etiology, as modulated by race and genes involved in vitamin D metabolism and receptor activity, in a large, racially-diverse cohort. The role of vitamin D in a number of health conditions has gained recent attention, concurrent with high frequency of vitamin D deficiency/insufficiency being documented, attributed to changes in lifestyle. Evidence indicating higher risk of autism by factors shown to be related to lower vitamin D levels and recent advances in the understanding of the role of vitamin D on brain and immune function support a potential role in autism etiology that warrants rigorous investigation. A few studies of children with autism (or their mothers) have found lower vitamin D levels, but they all were limited by small samples and measurement of levels after the critical period of brain development.
Investigator: Croen, Lisa
Funder: National Institute of Child Health and Human Development

California CADDRE-SEED Phase II

The goal of this project is to continue the SEED study, a case-control study of genetic and environmental risk factors for autism. The major goal of the project is to conduct a multi-site collaborative epidemiologic study to investigate risk and causal factors for Autism Spectrum Disorders (ASD) and phenotypic subgroups of ASD using a population-based case-cohort study design.
Investigator: Croen, Lisa
Funder: Centers for Disease Control and Prevention

Highlighted Publications

No results found matching criteria

Publications

Association between self-reported caffeine intake during pregnancy and social responsiveness scores in childhood: The EARLI and HOME studies

Author(s): Patti MA; Croen LA; Braun JM; et al.

PLoS One. 2021;16(1):e0245079. Epub 2021-01-15.

Current Position(s):

Section Affiliations:

Primary Research Interests:

Related Website(s):

Studies

COVID-19 Response Grant

Maternal Inflammation during Pregnancy and Neurodevelopmental Disorders

Optimizing Social Communication Measurement with the Social Responsiveness Scale

Autism Adaptive Community-Based Treatment to Improve Outcomes Using Navigators (ACTION) Network

Barriers to Health Care in a Latino Population with Autism Spectrum Disorder

Prenatal Exposure to Metals and Risk for Autism Spectrum Disorder in MARBLES and EARLI

Health System Integration of Tools to Improve Primary Care for Autistic Adults

Understanding Family Economic Impact of Chronic Child Health Conditions

Prenatal SSRI Exposure, Maternal and Child Genotype, and Autism Spectrum Disorders

Prospective Evaluation of Air Pollution, Cognition and Autism from Birth Onward

Neurodevelopment of Cognitive Control in Autism: Adolescence to Young Adulthood

Folic Acid Prevention Pathways for ASD in High Risk Families

Early Life Exposure to Endocrine Disrupting Chemicals and Child Growth, Adiposity, and Neurodevelopment

Role of Pre-natal Vitamin D and Gene Interactions in Autism Spectrum Disorders: Leveraging an Existing Case-Control Study

California CADDRE-SEED Phase II

Highlighted Publications

Publications

Association between self-reported caffeine intake during pregnancy and social responsiveness scores in childhood: The EARLI and HOME studies

Gastrointestinal Symptoms in 2- to 5-Year-Old Children in the Study to Explore Early Development

Maternal immune response and air pollution exposure during pregnancy: insights from the Early Markers for Autism (EMA) study

Prenatal Multivitamin Use and MTHFR Genotype Are Associated with Newborn Cord Blood DNA Methylation

Meconium androgens are correlated with ASD-related phenotypic traits in early childhood in a familial enriched risk cohort

Maternal Vitamin D Levels During Pregnancy in Association With Autism Spectrum Disorders (ASD) or Intellectual Disability (ID) in Offspring; Exploring Non-linear Patterns and Demographic Sub-groups

Psychometric testing of a set of patient-reported instruments to assess healthcare interventions for autistic adults

Prenatal Air Pollution Exposure and Neurodevelopment: A Review and Blueprint for a Harmonized Approach within ECHO

Cord blood DNA methylome in newborns later diagnosed with autism spectrum disorder reflects early dysregulation of neurodevelopmental and X-linked genes

Distributional Properties and Criterion Validity of a Shortened Version of the Social Responsiveness Scale: Results from the ECHO Program and Implications for Social Communication Research

Factors Influencing Participation in Biospecimen Research among Parents of Youth with Mental Health Conditions

The Association Between Maternal Prenatal Fish Intake and Child Autism-Related Traits in the EARLI and HOME Studies

Healthcare service utilization and cost among transition-age youth with autism spectrum disorder and other special healthcare needs

Transitioning youth with autism spectrum disorders and other special health care needs into adult primary care: A provider survey

Community-based service use in preschool children with autism spectrum disorder and associations with insurance status

The Association Between Parental Age and Autism-Related Outcomes in Children at High Familial Risk for Autism

Genetic Contributions to Maternal and Neonatal Vitamin D Levels

Neonatal Thyroid Stimulating Hormone and Subsequent Diagnosis of Autism Spectrum Disorders and Intellectual Disability

A meta-analysis of two high-risk prospective cohort studies reveals autism-specific transcriptional changes to chromatin, autoimmune, and environmental response genes in umbilical cord blood

Early Life Exposure to Air Pollution and Autism Spectrum Disorder: Findings from a Multisite Case-Control Study

Air pollution, neighborhood deprivation, and autism spectrum disorder in the Study to Explore Early Development

Prenatal Opioid Exposure: Neurodevelopmental Consequences and Future Research Priorities

Neonatal jaundice in association with autism spectrum disorder and developmental disorder

Infection and Fever in Pregnancy and Autism Spectrum Disorders: Findings from the Study to Explore Early Development

An Exploratory Examination of Neonatal Cytokines and Chemokines as Predictors of Autism Risk: The Early Markers for Autism Study

Meta-analysis of epigenome-wide association studies in neonates reveals widespread differential DNA methylation associated with birthweight

Maternal diabetes and hypertensive disorders in association with autism spectrum disorder

Newborn vitamin D levels in relation to autism spectrum disorders and intellectual disability: A case-control study in california

Epigenetic marks of prenatal air pollution exposure found in multiple tissues relevant for child health

Prenatal exposure to endocrine disrupting chemicals in relation to autism spectrum disorder and intellectual disability

Infections in children with autism spectrum disorder: Study to Explore Early Development (SEED)

Cross-genetic determination of maternal and neonatal immune mediators during pregnancy

Placental gross shape differences in a high autism risk cohort and the general population

Brief Report: Maternal Opioid Prescription from Preconception Through Pregnancy and the Odds of Autism Spectrum Disorder and Autism Features in Children

Brief Report: Low Rates of Herpesvirus Detection in Blood of Individuals with Autism Spectrum Disorder and Controls

Case-control meta-analysis of blood DNA methylation and autism spectrum disorder

Psychiatric and Medical Conditions in Transition-Aged Individuals With ASD

Cord blood buffy coat DNA methylation is comparable to whole cord blood methylation

Associations Between the 2nd to 4th Digit Ratio and Autism Spectrum Disorder in Population-Based Samples of Boys and Girls: Findings from the Study to Explore Early Development

Prenatal Maternal Serum Concentrations of Per- and Polyfluoroalkyl Substances in Association with Autism Spectrum Disorder and Intellectual Disability

Autism risk classification using placental chorionic surface vascular network features

Autism spectrum disorder and birth spacing: Findings from the study to explore early development (SEED)

Cross-tissue integration of genetic and epigenetic data offers insight into autism spectrum disorder

Maternal BMI at the start of pregnancy and offspring epigenome-wide DNA methylation: findings from the pregnancy and childhood epigenetics (PACE) consortium

Scaling of the surface vasculature on the human placenta

Maternal and Paternal Infertility Disorders and Treatments and Autism Spectrum Disorder: Findings from the Study to Explore Early Development

Prenatal Alcohol Exposure in Relation to Autism Spectrum Disorder: Findings from the Study to Explore Early Development (SEED)

Prenatal Serum Concentrations of Brominated Flame Retardants and Autism Spectrum Disorder and Intellectual Disability in the Early Markers of Autism Study: A Population-Based Case-Control Study in California

Demographic and Clinical Characteristics Associated with Engagement in Behavioral Health Treatment Among Children with Autism Spectrum Disorders

A Survey of Parents with Children on the Autism Spectrum: Experience with Services and Treatments

Medical Conditions in the First Years of Life Associated with Future Diagnosis of ASD in Children

Independent Maternal and Fetal Genetic Effects on Mid-gestational Circulating Levels of Environmental Pollutants

Umbilical cord blood androgen levels and ASD-related phenotypes at 12 and 36 months in an enriched risk cohort study

The Changing Epidemiology of Autism Spectrum Disorders

The Kaiser Permanente Northern California research program on genes, environment, and health (RPGEH) pregnancy cohort; study design, methodology and baseline characteristics.

Association Between Influenza Infection and Vaccination During Pregnancy and Risk of Autism Spectrum Disorder

Differences in testosterone and its precursors by sex of the offspring in meconium

Psychotropic Medication Use among Insured Children with Autism Spectrum Disorder

Maternal mid-pregnancy C-reactive protein and risk of autism spectrum disorders: the early markers for autism study