Moderating Effects of Autism on Parent Views of Genetic Screening for Aggression Michael E. May, Rachel C. Brandt, and Joseph K. Bohannan Abstract Advances in gene–environment interaction research have revealed genes that are associated with aggression. However, little is known about parent perceptions of genetic screening for behavioral symptoms like aggression as opposed to diagnosing disabilities. These perceptions may influence future research endeavors involving genetic linkage studies to behavior, including proactive approaches for parents to avoid events leading to aggression. The purpose of this study was to solicit the perspectives of parents who have children with autism about screening for genes associated with aggression, compared to responses from those who have children without disabilities and those planning to have children. Parents of children with autism were more likely to support screening and the use of the results to seek treatment if necessary. Results are discussed in the context of surveillance screening and systematic early intervention for behavioral symptoms related to autism. The results may provide insight for clincians, researchers, policymakers, and advocacy groups related to diagnosing and treating aggression in people with autism. Key Words: aggression; autism; parents; genetic screening The core diagnostic features of autism consist of delayed communication, limited social behavior, and stereotypic behaviors (American Psychiatric Association, 2000; APA). Although the direct causal mechanisms have not yet been identified, researchers suggest that chemical or anatomical perturbations in the brain occur at a very early age (Hill & Furniss, 2006; Holden & Gitlesen, 2006). Furthermore, severity of the core symptoms of autism is considered a risk factor for developing psychopa- thologies and problem behaviors such as physical aggression (e.g., Matson & Rivet, 2008; McClintock, Hall, & Oliver, 2003). Aggression toward oneself and/or others occurs in up to 68% of children with autism aged 6 to 14 and is associated with a variety of environmental influences, including neglect, poor nutrition, caregivers who act aggressively or display low emotional attachment, communication prob- lems, and/or operant behavioral processes (Brown & Radford, 2007; Farmer & Aman, 2010; Tremblay, 2000). In many cases, problem behavior results in more stress for parents than the core features themselves (Hastings, 2003; Lecavalier, 2006). Recent research has focused on gene– environment interactions to explain the contribution of each of these variables to the emergence of aggression in a variety of populations. Generally speaking, 42% of the variance can be explained by environmental influences, whereas 56% can be explained through genetic predisposition (Moffitt, 2005; Rhee & Waldman, 2002). Two genes in particular have been investigated for their association with aggression. The gene encoding monoamine oxidase A (MAO-A) has been correlated with aggression in people with autism and intellectual disability (e.g., Cohen, 2003; May et al., 2009; Taylor & Kim-Cohen, 2007). For example, a recent study found that 43% of adult males with intellectual disability and aggression had the short-allele MAO- A polymorphism, compared to 20% of matched controls without aggression (May et al., 2009). Positive associations have also been found between the short MAO-A alleles and changes in cortex volume in children with autism, increased autism severity, and decreased communication skills (Cohen et al., 2003; Davis et al., 2008). In contrast, a study assessing aggression in males with Fragile X syndrome did not find a positive MAO-A association (Hessl et al., 2008). Interestingly, Hessl et al. found an association between the severity of aggression and INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2012, Vol. 50, No. 5, 415–425 ’AAIDD DOI: 10.1352/1934-9556-50.5.415 M. E. May, R. C. Brandt, and J. K. Bohannan 415