The Search for Autism’s Origin Heads to the Womb
Morgan Firestein, a core member of the Rutgers Brain Health Institute and resident scientist at the Child Health Institute of New Jersey, is leading an innovative search for a prenatal genesis of autism spectrum disorder
In the decades-long search for autism’s origin, researchers have tested a range of theories, some dubious – such as bad parenting – others more plausible, such as pollution.
Despite billions of dollars spent on research since the first diagnosis in 1943, science has made limited progress isolating the precise biological mechanisms that contribute to the disorder’s development.
Morgan Firestein, a core member of the Rutgers Brain Health Institute, said it’s time to go back to the beginning – all the way back, to the womb.
In the early 2010s, when Firestein began studying autism as an undergrad at Columbia University, research was primarily focused on identifying genetic risk factors. What struck her was the potential for prenatal influence.
“It just seemed biologically probable that the origin of autism could be traced back to pregnancy,” said Firestein, who joined Rutgers in September 2025.
Today, that hunch is paying off. Funded by a highly competitive Pathway to Independence Award from the National Institutes of Health, Firestein, who is an assistant professor of pediatrics at Rutgers Robert Wood Johnson Medical School, is at Rutgers to investigate whether maternal-fetal-placental signaling through extracellular vesicles influences the development of autism.
Morgan’s work on extracellular vesicles containing RNA as vehicles for communication among the fetus, mother and placenta is particularly novel and exciting and has implications not only for child health but could also be relevant to a variety of other domains in brain function.
Gary Aston-Jones
Director, Rutgers Brain Health Institute
It is a question that has generated significant interest among her peers. Last month, at the 11th annual Rutgers Brain Health Institute Symposium at the Busch Student Center in Piscataway, N.J., Firestein presented an update on her research to hundreds of academic leaders, researchers, trainees and industry professionals. Following her 10-minute talk, she fielded questions for more than five minutes – an unusually long discussion for a session of that format.
“Morgan’s presentation was one of the most exciting at our BHI symposium,” said Gary Aston-Jones, director of the Brain Health Institute. “Her work on extracellular vesicles containing RNA as vehicles for communication among the fetus, mother and placenta is particularly novel and exciting and has implications not only for child health but could also be relevant to a variety of other domains in brain function.”
As with hormones, extracellular vesicles circulate through the bloodstream and interact with distant cells and organs, inducing changes in recipient cells. In recent years, researchers have found emerging evidence linking alterations in extracellular vesicles to adverse pregnancy outcomes. Separately, extracellular vesicles have been implicated in psychiatric conditions such as depression, bipolar disorder, schizophrenia and autism.
Firestein’s work seeks to bridge these two previously separate lines of research. The goal is to determine whether changes in extracellular vesicles during pregnancy could serve as early biomarkers of autism spectrum disorder or provide insight into the biological mechanisms underlying its development.
There is no blood test for autism and no definitive universal genetic marker. While there are a handful of genetic mutations that nearly always result in an autism diagnosis, these represent a small fraction of total autism spectrum disorder cases. Diagnosis is based almost entirely on behavior and the earliest a reliable assessment can be conducted is about 12 months of age (though diagnosis is typically made later in childhood).
Early intervention has been shown to improve social skills and cognitive development – making earlier detection a critical need. Thus, the development of a biologically based diagnostic tool for autism would be a gamechanger, and the potential for extracellular vesicles to serve as a reliable biomarker has Rutgers researchers watching Firestein’s work with great interest.
“Morgan’s research is incredibly innovative and synergistic,” said Wayne W. Fisher, the Henry Rutgers Endowed Professor of Pediatrics at the Robert Wood Johnson Medical School and the former inaugural director of the Rutgers Center for Autism Research, Education and Services. “It has already generated new collaborations among autism researchers and clinicians across multiple Rutgers units and Children’s Specialized Hospital.”
Firestein’s interest in autism research began long before she entered a laboratory. Raised in New York, she attended Bronxville High School before enrolling at Columbia University as a film major. A few semesters in, she discovered psychology and philosophy and changed course, graduating in 2013 with a bachelor’s degree in both fields.
While at Columbia, Firestein volunteered at NYC Autism Charter Schools, where she worked in a classroom with 7- to 9-year-old students – an experience she describes as transformative.
“I fell in love with the kids and became enthralled with the completely different way that they saw the world,” she said.
Firestein also grew up immersed in science. Her father, Stuart Firestein, is a professor of biological sciences at Columbia, and her mother, Diana Reiss, is a professor of animal behavior at Hunter College.
She earned her doctorate in psychology from Columbia in 2020 and received a National Science Foundation Graduate Research Fellowship as a graduate student.
Morgan’s research is incredibly innovative and synergistic. It has already generated new collaborations among autism researchers and clinicians across multiple Rutgers units and Children’s Specialized Hospital.
Wayne W. Fisher
Henry Rutgers Endowed Professor of Pediatrics, Rutgers Robert Wood Johnson Medical School
Firestein completed her postdoctoral training in the Department of Psychiatry at Columbia University Medical Center, where she investigated relationships between extracellular vesicles of maternal, fetal and placental origin and child neurobehavioral outcomes.
At Rutgers, her lab uses clinical and translational approaches to study childhood neurodevelopmental disorders, with an emphasis on identifying early biomarkers that can inform future therapeutic strategies.
Firestein traces her fascination with autism to around 2007, when she read Born on a Blue Day by Daniel Tammet. The memoir chronicles Tammet’s life as a mathematical savant with autism. “It’s a story about what it is like to live with autism and how the author experiences the world. I was fascinated,” she said.
The arrival of Firestein at Rutgers comes at a pivotal moment for autism research. Rates of diagnosis continue to rise in the United States, even as misinformation and pseudoscientific theories – from vaccines to, more recently, Tylenol – proliferate.
Still, Firestein sees opportunity in the increased attention.
“Having the public focused on a topic like autism is good,” she said. “It brings more funding, both private and federal, and greater awareness also means reduced stigma for people with an autism diagnosis.”
For Firestein, the goal now is to help reshape how autism is understood and researched in the laboratory – starting at the very beginning of life.
Explore more of the ways Rutgers research is shaping the future.
