What causes autism?

[lumberjack_jeff]

http://www.huffingtonpost.com/harvey-karp

If a foreign government were suspected of doing something that caused brain problems to 1/166 American children our nation would immediately and vigorously respond...and even go to war! Well, our children are under a mysterious assault that is causing 1/166 to develop autism. And, we must band together and immediately and vigorously make the correction of this problem a true national priority.

As part of our national wake-up call, April was designated National Autism Awareness month and the press repeatedly aired an impassioned debate: Are vaccines a boon or a danger? Do shots protect kids or provoke autism? Unfortunately, all too often the media discussion was highly polarized...creating lots of heat, but shedding little light.

In this 3-part blog, I'd like to discuss in detail the reasons why shots are very safe - and super important - and to present some fresh ideas about a more likely cause of autism: an invisible soup of toxins we're exposed to every day...endocrine disrupting chemicals (EDCs).

[SheilaT]

1. I'm one who is very impatient with the attempt

to blame autism on vaccines or environmental toxins or other such causes.

I sincerely believe that a lot of it is simply better diagnoses, as well as a greatly lowered tolerance for people who are different.

When I finally figured out that my son had Asperger's when he was 18 and half way through his senior year of high school, lots of people started telling me about the odd cousin or uncle they had who had all of the symptoms of Asperger's. People, especially children, are expected to conform in ways that weren't expected even a generation ago. There's no room for or tolerance of a lot of differences.

I'm not suggesting that autism is imaginary. It's very real. But I'm not convinced that there's as much a genuine increase in its incidence as there is an awareness of it.

[lumberjack_jeff]

2. There's clearly a greater increase than can be explained by changing diagnoses.

It is an epidemic, therefore the trigger is environmental.

[SheilaT]

3. I'm not convinced that the increase is greater

than can be explained by changing diagnoses.

I have seen a real change in the willingness to tolerate behavioral differences in the classroom just in my lifetime. There used to be room room for people who are different. And I'm struck by how many stories I get of the odd relatives, people who would today be diagnosed with something or another, but who simply weren't back thirty or fifty or more years ago.

[lumberjack_jeff]

6. From Scientific American

http://www.scientificamerican.com/article.cfm?id=autism-rise-driven-by-environment

California's sevenfold increase in autism cannot be explained by changes in doctors' diagnoses and most likely is due to environmental exposures, University of California scientists reported Thursday.

The scientists who authored the new study advocate a nationwide shift in autism research to focus on potential factors in the environment that babies and fetuses are exposed to, including pesticides, viruses and chemicals in household products.

"It's time to start looking for the environmental culprits responsible for the remarkable increase in the rate of autism in California," said Irva Hertz-Picciotto, an epidemiology professor at University of California, Davis who led the study.

Throughout the nation, the numbers of autistic children have increased dramatically over the past 15 years. Autistic children have problems communicating and interacting socially; the symptoms usually are evident by the time the child is a toddler.

More than 3,000 new cases of autism were reported in California in 2006, compared with 205 in 1990. In 1990, 6.2 of every 10,000 children born in the state were diagnosed with autism by the age of five, compared with 42.5 in 10,000 born in 2001, according to the study, published in the journal Epidemiology. The numbers have continued to rise since then.

To nail down the causes, scientists must unravel a mystery: What in the environment has changed since the early 1990s that could account for such an enormous rise in the brain disorder?

For years, many medical officials have suspected that the trend is artificial--due to changes in diagnoses or migration patterns rather than a real rise in the disorder.

But the new study concludes that those factors cannot explain most of the increase in autism.

[elleng]

4. 'therefore the trigger is environmental?'

I'm not at all certain that this follows; go back and try again.

And include definitions of 'environmental,' please.

[lumberjack_jeff]

5. Given the alternative explanations; a) environmental b) genetic

Anyone who thinks it is entirely genetic must explain the concept of "genetic epidemic".

There's no such thing as a genetic epidemic. It's as silly as an epidemic of children born with blue eyes.

I think it's becoming clear, there is an environmental trigger for autism to which some people are genetically more vulnerable.

"Environmental" meaning "not genetic", and most likely an environmental change which has been created by modern society, i.e. not a virus or bacteria.

[elleng]

7. I think the 'alternative explanations'

should be re-examined. Don't mean to be 'contrary.' Daughters 'studying,'/ observing this. Lots to come, I suspect.

[lumberjack_jeff]

12. I'd be glad to hear any possible sources of illness.

With the possible exception of divine intervention, I'm pretty sure there are only two; genes and environment.

[Odin2005]

8. There is no god-damn "epidemic".

More individuals are being diagnosed as being on the spectrum, that doesn't mean there are actually more people on it. I wasn't diagnosed with Asperger's until I was 15, in 2001. Asperger's has only been a official diagnosis in the US since 1994. There are more diagnoses because there are more people getting correctly diagnosed with an spectrum disorder instead of mental retardation, ADD, "Childhood Schizophrenia", Schizoid Personality Disorder, etc. and more people getting diagnosed that wouldn't have been diagnosed years earlier.

In other words more people are diagnosed because "Autism" is now understood to be a wider phenomenon than originally understood, it's not just Rain Man and the non-verbal kid that rocks and hand-flaps.

Oh, and HuffPo is not a valid source our medical news, they have Deepak "Quantum BS" Chopra as a commentator for Christ's sake.

[lumberjack_jeff]

9. Read the link in post #6. n/t

[Odin2005]

10. I don't agree with something just because it's in Sci-Am.

A lot of such research is funded and promoted by "curebie" groups like Autism Speaks and Defeat Autism Now us in the Aspie community really dislike, to put it very mildly, groups that have a vested interest in whipping up hysteria about an "autism epidemic" and portraying us autistics in what we consider a insulting and demeaning way.

[lumberjack_jeff]

11. You haven't convinced me.

I can see it with my own eyes, and the research validates what I see.

I do not understand why this offends you, but I really don't need to. Something is affecting humans neurologically and science needs to determine what it is.

BTW I've been an advocate for the DD community for many years. IMHO, You throw around "we" pretty liberally.

[Odin2005]

13. In other words, you are a victim of confirmation bias

I can see it with my own eyes, and the research validates I see.

:eyes: :eyes: :eyes: :eyes: :eyes:

It offends me because such groups like Autism Speaks that pushes the hysteria portray us people on the spectrum as damaged and poisoned and need to be "cured". They prey on the psychology of parents of autistics that are upset that they didn't get their "normal kid" when those parents need to be taught instead that we are worthy human beings that deserve tolerance and acceptance and respect, not pity.

http://aspiesforfreedom.com

A lot of you "advocates" are functionally more like mouthpieces for groups like Autism Speaks and the parents whipped up into hysteria by such groups. The voices of actual autistic people, like the outspoken British "low-functioning" Autistic lady Amanda Baggs, are often ignored

[lumberjack_jeff]

15. It is grossly insulting to say that parents of children on the spectrum...

... don't consider their children to be worthy human beings deserving of respect. It is also inaccurate.

For every person on the spectrum who resents the "pity", there is another who has a poor quality of life because of it. In other words, speak for yourself.

I am ambivalent about groups like Autism Speaks largely because you have raised my awareness about them. Self determination is vitally important, but aspiesforfreedom has it fundamentally wrong. Autism is a disabling disorder and it is not entirely genetic. Further, members are the victims of selection bias. They believe that autism is relatively benign because unlike more profoundly affected citizens who can't, they have the ability to participate in self-advocacy.

I agree with and advocate for many of the principles in the link you posted. But I won't reject science. Autism is a disability as is hearing impairment, and although many in the deaf community feel the same way you do about their disability, thousands of people have had their quality of life (not to mention their safety) improved by cochlear implants.

Beliefs
Rejection of cochlear implants
Within Deaf communities, there is strong opposition to the use of cochlear implants and sometimes also hearing aids and similar technologies. This is often justified in terms of a rejection of the view that deafness, as a condition, is something that needs to be 'fixed'.
Others argue that this technology also threatens the continued existence of Deaf culture, but Kathryn Woodcock argues that it is a greater threat to Deaf culture "to reject prospective members just because they used to hear, because their parents chose an implant for them, because they find environmental sound useful, etc."<5> Cochlear implants may improve the perception of sound for suitable implantees, but they do not reverse deafness completely.
Rejection of oralism as a teaching method
There is strong opposition within Deaf communities to the oralist method of teaching deaf children to speak and lip read with limited or no use of sign language in the classroom. The method is intended to make it easier for deaf children to integrate into hearing communities, but the benefits of learning in such an environment are disputed. The use of sign language is also central to Deaf identity and attempts to limit its use are viewed as an attack.

http://en.wikipedia.org/wiki/Deaf_culture

Many thousands of americans such as you and Dr Temple Grandin are able to function, care for themselves, and be productive members of society despite being on the spectrum. Many thousands more suffer grievously because of it. It is an epidemic, and finding the environmental cause is more important than the sensitivities of those least affected.

[Odin2005]

17. It is the attitudes of the rest of society that causes many autistics to have a poor quality of life

Autism is not a "disease", it's part of who we are as individuals. I have no problem with things like behavioral therapy and treating co-morbid conditions (I go to cognitive behavioral therapy every other Thursday, and take Ritalin and Paxil), but to try to "cure" me is an attack on my self-identity.

No autism = no Einsteins, Jeffersons, and Wittgensteins.

[lumberjack_jeff]

18. That is undoubtedly true for many.

It is also true that the disorder itself causes a poor quality of life for many others.

[KamaAina]

28. I believe that other people with autism are more like me than they are different

Many thousands of americans such as you and Dr Temple Grandin are able to function, care for themselves, and be productive members of society despite being on the spectrum. Many thousands more suffer grievously because of it.

I have often wondered just what it is that separates my Ivy League-educated self, posting from a policy analyst's cubicle 5,000 miles from home, from the many who languish in day programs (basically like second grade for grownups, complete with pictures of fluffy clouds, etc.) or in their family homes. If I had the answer, I'd have a nice office somewhere with a corner view, and I'd be raking in some serious coin on the lecture circuit!

The point is that children with autism will grow up to be adults with autism. There is no "cure", and cannot be, because autism isn't a "disease" per se, but rather, as one of the top researchers in the field explained it to me, "a behaviorally defined syndrome with multiple etiologies". (that is, a common set of behaviors that can stem from any of several different causes). What we need is to make sure that they grow up to be like me, Odin, or Temple (who co-presented with be back in CT years ago), not to try to turn them into "neurotypicals".

[Odin2005]

30. Excellent post, KA!!!

:hug:

[lumberjack_jeff]

32. The syndrome is almost conclusively shown to be inflluenced by environment.

It is my hope (and expectation) that my son will be able to live independently, participate in community life and have a family of his own one day.

Many other children are not going to be so lucky. There are no proven interventions or therapies which will guarantee that the most profoundly affected will have a good quality of life. It is vitally important to future generations that we understand the non-genetic triggers.

"Don't make us into neurotypicals" is a solipsism. All I know is all I know. I don't know what it's like to be able to play music, so I resent anyone telling me that my tone-deafness makes me inadequate. What's damaging is when I argue that an epidemic of real deafness is not a problem because I resent the implication that my partial deafness constitutes a disability.

I don't want to turn anyone into anything. I want to help guarantee the best possible quality of life, and greatest degree of independence and self-determination possible for those who are affected by the syndrome, but especially for those most profoundly affected who don't have the tools to advocate for themselves. Simply raising awareness among neurotypicals isn't enough.

Hundreds of thousands languishing in institutions is the most likely result of our collective denial that an epidemic exists.

[KamaAina]

25. Amanda Baggs isn't British

she's from New England (VT), not Merrie Olde England.

Recently I've run across a surprising number of people who use augmented communication who make me and my Ivy League-educated spoken voice sound like Gee Dubya Boosh by comparison. (I just chatted with a female one yesterday for over an hour... :loveya: ) Add Amanda to that list, regardless of which side of the pond she's on1

[Odin2005]

27. DOH, my bad!

[Left coast liberal]

33. I agree with you LumberJack. Nt

[SheilaT]

29. Thank you. I keep on trying

to say exactly this thing. My son was also not diagnosed until 2001, but he's three years older than you.

NO ONE was diagnosed with Asperger's before 1994. That doesn't mean that it wasn't around before that date, which is what some seem to think. I still maintain that there's not a genuine increase, but far more diagnosis. And intolerance of "odd" people.

[Odin2005]

31. Exactly.

And there is also the simple fact that Autism is far more recognized by people now days, and so-called "low functioning" individuals are getting the correct diagnosis instead of mental retardation or "childhood schizophrenia".

[elleng]

14. FYI

"Individuals affected by autism are like snowflakes," says Professor of Health Services Michelle Rowe, Ph.D. "No two are alike."

Executive Director, The Kinney Center for Autism Education and Support

http://www.sju.edu/academics/centers/autism/director.html

Current research is focusing on the relationship between genetic and immune responses in children with autism. "Most experts agree that there is a genetic predisposition to autism," Dr. Rowe says. "Yet, several studies have now shown that in many cases the autism, especially the regressive form, is likely triggered by some environmental factor producing an inflammatory response in the body." Family members of individuals with autism often have a history of diseases, such as rheumatoid arthritis, that produce an autoimmune response and cause inflammation in parts of the body.

Other studies on brain imaging have shown areas in the brain of individuals with autism that respond differently than those without autism.

"Clearly, autism is a brain disorder," she notes, "and research should focus on brain functioning of individuals with autism and how best to develop interventions that target the affected areas of the brain."

http://www.medicalnewstoday.com/articles/66717.php

[lumberjack_jeff]

16. Personally, I think that we should also consider possible prenatal environmental insults.

Someone once said that "Once you know one person with autism... you know one person with autism." Everyone has a different experience.

Because ASD is so often correlated with digestive, allergic, skin and skeletal problems, I'm not sure I agree that focusing on anything, including brain function is the right way to go until more is known.

... I also think treatment is a secondary issue to understanding the cause.

[elleng]

19. Unless your child has the condition.

.

[lumberjack_jeff]

20. As mine does. n/t

[elleng]

21. Isn't focusing on 'anything' also focusing on 'everything?'

Maybe you should contact Dr. Rowe for thoughts.

edit:

This is almost like 'students' of education saying things like, 'Oh, MONEY won't do it; the PARENTS have to be involved; discipline is key; testing is key.' There are no simple or single answers to difficult problems.

[lumberjack_jeff]

22. Yes, actually.

Focusing on the neurological effects of autism implies that research on the other markers is neglected. It is very possible that investigating why people with autism often have similar digestive problems may very well lead to insights that neurological research may miss.

[elleng]

23. I am not at all clear about your point.

I hope that you have read the information I've provided about Dr. Rowe and her work, and suggest that you contact her if you have questions about or are unsatisfied with the research that is being done.

[lumberjack_jeff]

24. My point is very simple.

I think it's premature to "focus" our research dollars on any one thing.

Certainly, neurologists should focus on their area of expertise, but that doesn't mean that dieticians and biochemists have no equally important research to do.

[lumberjack_jeff]

26. Here's the third segment of his essay.

http://www.huffingtonpost.com/harvey-karp/cracking-the-autism-riddl_b_221202.html

Over the past 30 years, toxic chemicals, like Teflon, plastics, and formaldehyde have increasingly invaded our homes. We used to think these substances were harmless, but a rising tide of evidence has turned the spotlight on chemical exposures as a possible poison to our children's developing brains.

One group of substances of particular concern is a ubiquitous family of hormone twisting compounds, known as endocrine disrupting chemicals (EDCs). These substances are the focus of intense scrutiny because: 1) they're found in every home in America 2) they're increasingly linked to human disease 3) our exposure to them has risen in parallel with the surge in autism diagnoses and 4) they may theoretically affect the developing fetal brain.

In recent years, research has mounted against a virtual police lineup of EDCs, like BPA (in food cans, hard plastic water bottles), phthlates (in soft plastics, cosmetics) and fire retardants (in sofas, computers, flame-resistant clothing). Multiple animal and human studies have linked EDC exposure (during or after fetal development) with a host of hormone-related disorders, like low sperm count, cancer (breast, ovarian, prostate, testicular), congenital malformation of the genitals and even obesity.

In 1996, pediatricians and other concerned scientists convinced Congress to order the Environmental Protection Agency (EPA) to test hundreds of chemicals for endocrine disrupting effects. The Clinton administration began the process of designing these tests, but the Bush administration defied the law. It ignored this mandate to protect the public health...and organized medicine watched impotently from the sidelines. Today, ten years and tens of millions of dollars later, not a single chemical has been evaluated for endocrine disrupting effects!

[Odin2005]

34. Well that crap removed any bit of respect I had for the HuffPo.

:eyes: