Sarah Spence

Year of Graduation: 
Penny Brant and Christine Robson Weaver

"It's not that people didn't want to address these things before, they just didn't know how."

Ever since Sarah Spence ’80 was little, she’d dreamed of becoming a doctor. Then a class in psychobiology at Harvard got her thinking about life as a research scientist. “The professor talked about patients who have had the pathway between the two sides of their brain disconnected as a treatment for epilepsy and what impact that has behaviorally,” Spence recalls. “I was hooked.”

In the end, Spence became both a researcher and a doctor. She earned a Ph.D. in neuropsychology from UCLA and an M.D. from the University of California at San Francisco.

A compelling postdoctoral stint at the Autism Genetic Resource Exchange helped channel Spence’s focus into one particular area — improving the lives of children with autism spectrum disorder, or ASD. “I did home visits for the autism gene bank where I’d spend days with families with two or more affected kids, testing the kids, interviewing the parents,” Spence says. “In neuroscience, we do not always get to fix things or solve the puzzles we are faced with. Working with children and their families to really explain things and help them through what can sometimes be a difficult journey is an incredibly rewarding privilege.”

That formative experience, which combined research with hands-on care, laid the groundwork for a post at the National Institutes of Health and her role at Boston Children’s Hospital. In 2010, she helped to create — and continues to shape — the hospital’s first Autism Spectrum Center, a comprehensive facility that diagnoses, treats and supports children with ASD.

“When I got here, autism care was fragmented,” Spence says. “Lots of the kids were seen in neurology, some were seen in developmental medicine, others in psychiatry, but nobody was working together.” She and her team established a single point of entry for patients and standardized their care, fundamentally changing how children with autism are treated at the hospital.

Implementing this holistic approach benefits not just kids and parents, but Spence’s colleagues as well. “We connect with researchers to help them translate the cutting-edge science being done at Children’s into clinical trials,” Spence explains. “And we’re making the hospital more autism-friendly, to accommodate the special needs of the kids as much as possible.”

Spence helps her peers understand how some common medical practices are more difficult for patients with autism. “Many kids with autism have intense reactions to tactile stimulation,” Spence says. “If we let providers know that checking blood pressure is going to be super hard for this patient, maybe that procedure doesn’t have to be done quite as often. It’s not that people didn’t want to address these things before, they just didn’t know how.”

And while mental illness and behavioral challenges are ever-growing epidemics in today’s world, Spence is positive about the future. “When I was at Exeter — and Exeter is where I learned to think — some of my classmates probably had autism and I am sure we did not do well supporting them,” she says. “There’s much greater awareness and acceptance of people with differences now.”

Exeter, too, is where she experienced the kindness that defines her own work. One of her favorite teachers was Latin Instructor David Coffin. “I overslept once,” she remembers. “He’d taken the class outside because it was a beautiful day, and sent someone to wake me up so I wouldn’t miss it — that was very sweet.”

And, some might say, an early lesson in empathy and engaging in someone else’s world.

— Daneet Steffens ’82

Editor's note: This profile first appeared in the summer 2019 issue of The Exeter Bulletin.