Autism ?Whats New..Researches and Articles

Autism May Involve Disordered White Matter in the Brain

2011-12-10T23:22:00.001-08:00

ScienceDaily (Dec. 5, 2011) It's still unclear what's different in the brains of people with autism spectrum disorders (ASDs), but evidence from genetic and cell studies points to abnormalities in how brain cells (neurons) connect to each other. A study at Children's Hospital Boston now provides visual evidence associating autism with a disorganized structure of brain connections, as well as defects in myelin -- the fatty, insulating coating that helps nerve fibers conduct signals and that makes up the brain's white matter.Researchers led by Mustafa Sahin, MD, PhD, of the Department of Neurology, Simon Warfield, PhD, director of the Computational Radiology Laboratory, and first author Jurriaan Peters, MD, of both departments at Children's, used advanced magnetic resonance imaging (MRI) to image the brains of 40 patients (infants to age 25) with tuberous sclerosis complex and 29 age-matched, healthy controls. Tuberous sclerosis is a rare genetic condition often associated with cognitive and behavioral deficits, including ASDs about 50 percent of the time."Patients with tuberous sclerosis can be diagnosed at birth or potentially before birth, because of cardiac tumors that are visible on ultrasound, giving us the opportunity to understand the circuitry of the brain at an early age," explains Sahin. "Our ultimate goal is to use imaging in infancy to find which tuberous sclerosis patients are at high risk for autism so we can intervene early. This may have implications for autism in patients without tuberous sclerosis as well."The team used a relatively new MRI technique called Diffusion Tensor Imaging to trace the pathways of nerve fibers by measuring the diffusion of water in the brain. In the January issue of the journal Academic Radiology, they report findings in the corpus callosum, the brain's largest white-matter structure that acts as a highway transferring signals between the left and right cerebral hemispheres.Of the 40 patients with tuberous sclerosis, 24 had clinically significant developmental delays or intellectual disability, and 12 had ASDs. ASDs were diagnosed clinically by a pediatric neurologist, and, in most cases, by the Autism Diagnostic Observation Schedule (ADOS).In general, compared with controls, patients with tuberous sclerosis had higher radial diffusivity values, a measure of water diffusion out of (perpendicular to) the nerve fibers (axons). Radial diffusivity is an indirect measure of how well insulated the axons are: Having higher radial diffusivity means axons are poorly insulated with myelin, suggesting abnormalities in the white matter (which is partly made up of myelin.Patients with both tuberous sclerosis and ASDs not only had increased radial diffusivity -- compared with both non-ASD patients and controls -- but they also had clearly disorganized axon pathways.As shown in the images, axons in the control subjects followed well-defined directions in organized bundles (left panels), while the ASD patients' axons (right panels) tended not to orient together in common directions (referred to in the paper as having lower fractional anisotropy). Tuberous sclerosis patients without ASDs (middle panels) showed only slight disorganization compared to controls."This study shows that we can use diffusion tensor imaging to differentiate tuberous patients with autism from those without autism," says Sahin."Our advances in imaging and in image analysis are enabling us to identify and quantitatively characterize alterations in brain development that are not readily visible in conventional imaging,'' adds Warfield.The findings add to previous human imaging studies by Sahin and Warfield showing similar differences in the brain's visual cortex, and are consistent with brain MRIs in older, high-functioning individuals with ASDs, showing abnormalities in connectivity in the corpus callosum and in areas of brain involved in language and social skills.The findings are also consistent with studies in Sahin's lab using mouse models of tuberous sclerosis. The neurons in these mice grew multiple axons (normal neurons grow just one), causing too many connections being made, and axons originating in the retina failed to land in the right places in the brain and did not respond to navigation cues.Additional studies showed that the axons in these mice had less myelination, identified the biochemical pathway causing these defects, known as the mTOR pathway, and showed that the pathway and the myelination defects could be reversed in mice with the mTOR-inhibiting drug rapamycin.Armed with these data, Sahin has launched a Phase II clinical trial of a rapamycin-like drug called Afinitor® (everolimus; formerly RAD001), sponsored by Novartis, the Tuberous Sclerosis Alliance and Autism Speaks. The trial will enroll 50 patients with TSC to test whether Afinitor improves neurocognition, autism, seizures and sleep disorders. "Specifically modulating neurocognition with a small molecule is only starting to be done," says Sahin."Ultimately, imaging will play a crucial role in identifying who may benefit from treatment, and in seeing the changes in the brain in response to treatment," says Warfield.

Biomarker for Autism Discovered

2011-07-17T02:18:00.000-07:00

ScienceDaily (July 12, 2011) — Siblings of people with autism show a similar pattern of brain activity to that seen in people with autism when looking at emotional facial expressions. Researchers at the University of Cambridge identified the reduced activity in a part of the brain associated with empathy and argue it may be a 'biomarker' for a familial risk of autism.

Dr Michael Spencer, who led the study from the University's Autism Research Centre, said: "The findings provide a springboard to investigate what specific genes are associated with this biomarker. The brain's response to facial emotion could be a fundamental building block in causing autism and its associated difficulties."

The Medical Research Council funded study is published on the 12th of July, in the journal Translational Psychiatry.

Previous research has found that people with autism often struggle to read people's emotions and that their brains process emotional facial expressions differently to people without autism. However, this is the first time scientists have found siblings of individuals with autism have a similar reduction in brain activity when viewing others' emotions.

In one of the largest functional MRI (fMRI) studies
of autism ever conducted, the researchers studied 40 families who had both a teenager with autism and a sibling without autism. Additionally, they recruited 40 teenagers with no family history of autism. The 120 participants were given fMRI scans while viewing a series of photographs of faces which were either neutral or expressing an emotion such as happiness. By comparing the brain's activity when viewing a happy verses a neutral face, the scientists were able to observe the areas within the brain that respond to this emotion.

Despite the fact that the siblings of those with autism did not have a diagnosis of autism or Asperger syndrome, they had decreased activity in various areas of the brain (including those associated with empathy, understanding others' emotions and processing information from faces) compared to those with no family history of autism. The scans of those with autism revealed that the same areas of the brain as their siblings were also underactive, but to a greater degree. (These brain regions included the temporal poles, the superior temporal sulcus, the superior frontal gyrus, the dorsomedial prefrontal cortex and the fusiform face area.)

Because the siblings without autism and the controls differed only in terms of the siblings having a family history of autism, the brain activity differences can be attributed to the same genes that give the sibling their genetic risk for autism.

Explaining why only one of the siblings might develop autism when both have the same biomarker, Dr Spencer said: "It is likely that in the sibling who develops autism additional as yet unknown steps -- such as further genetic, brain structure or function differences -- take place to cause autism."

It is known that in a family where one child already has autism, the chances of a subsequent child developing autism are at least 20 times higher than in the general population. The reason for the enhanced risk, and the reason why two siblings can be so differently affected, are key unresolved questions in the field of autism research, and Dr Spencer's group's findings begin to shed light on these fundamental questions.

Professor Chris Kennard, chairman of the Medical Research Council funding board for the research, said: "This is the first time that a brain response to different human facial emotions has been shown to have similarities in people with autism and their unaffected brothers and sisters. Innovative research like this improves our fundamental understanding of how autism is passed through generations affecting some and not others. This is an important contribution to the Medical Research Council's strategy to use sophisticated techniques to uncover underpinning brain processes, to understand predispositions for disease, and to target treatments to the subtypes of complex disorders such as autism."

Epilepsy Drug Taken When Pregnant May Increase Risk Of Autism In Children

2010-06-22T15:04:00.000-07:00

A new study shows that women who take the epilepsy drug valproate while pregnant may significantly increase their child's risk of developing autism. The preliminary research is published in the December 2, 2008, print issue of Neurology.

A new study shows that women who take the epilepsy drug valproate while pregnant may significantly increase their child's risk of developing autism. The preliminary research is published in the December 2, 2008, print issue of Neurology.

"The potential risk for autism in this study was substantial for children whose mothers took valproate while pregnant, but more research needs to be done since these are early findings," says study author Gus Baker, PhD, FBPsS, of the University of Liverpool in the United Kingdom."However, women who take valproate while pregnant should be informed of the possible risks of autism and are encouraged to discuss them with their doctor. Those who are taking valproate should not stop their treatment without speaking to their doctor first."

Other studies have shown that valproate is more likely to cause birth defects than other epilepsy drugs.

Symptoms of autism include difficulty in language development, a lack of attention, social problems and the inability to understand other people's feelings.

The study was conducted by the Liverpool and Manchester Neurodevelopment Group, a multidisciplinary group consisting of psychologists, geneticists, neurologists, midwives and support staff.

Children With Autistic Traits Remain Undiagnosed

2010-06-15T15:32:00.000-07:00

ScienceDaily (Apr. 12, 2010)

There has been a major increase in the incidence of autism over the last twenty years. While people have differing opinions as to why this is (environment, vaccines, mother's age, better diagnostic practice, more awareness etc.) there are still many children who have autistic traits that are never diagnosed clinically. Therefore, they do not receive the support they need through educational or health services.

In recent studies these undiagnosed children have been included in estimates of how many children have autism spectrum disorder, or an ASD (which includes both autism and Asperger's syndrome). Such studies have estimated that one in every hundred children has an ASD.

A study published in a recent issue of the Journal of Child Psychology and Psychiatry found that a large number of undiagnosed children displayed autistic traits: repetitive behaviors, impairments in social interaction, and difficulties with communication. These traits were at levels comparable to the traits displayed by children who held a clinical diagnosis (all diagnosed between years one and twelve). However, the undiagnosed children were not deemed eligible for extra support at school or by specialized health services.

The lead researcher of the study, Ginny Russell, asks, "ASD diagnosis currently holds the key to unlocking intervention from school systems and health programs. Perhaps these resources should be extended and available for children who show autistic impairments but remain undiagnosed" Russell points out that the study also shows that there is a gender bias in diagnosing children with Autistic Spectrum Disorders -- boys are more likely to receive a diagnosis than girls, even when they display equally severe symptoms.

Gene Variants Lead to Autism and Mental Retardation: Inner Structure of Nerve Synapses Defective in Patients

2010-05-27T14:33:00.000-07:00

ScienceDaily (May 26, 2010) — Researchers working with Professor Gudrun Rappold, Director of the Department of Molecular Human Genetics at Heidelberg University Hospital, have discovered previously unknown mutations in autistic and mentally impaired patients in what is known as the SHANK2 gene, a gene that is partially responsible for linking nerve cells.

However, a single gene mutation is not always enough to trigger the illness. In some cases, a certain threshold of mutation must be exceeded. The researchers conclude from their results that a correct inner structure of the nerve cell synapses is necessary to enable the normal development of language, social competence, and cognitive capacity. Essential for the success of the project were the studies by the Heidelberg research team with the doctoral student Simone Berkel and collaboration with a Canadian research team headed by Steve Scherer.

The study has already been published online in the leading scientific journal Nature Genetics.

Autism is a congenital perception and information-processing disorder of the brain that is often associated with low intelligence, but also with above-average intelligence. The disease is characterized by limited social communication and stereotypical or ritualized behavior. Men are affected much more frequently than women. Autism and mental retardation can occur together but also independently of one another and are determined to a great extent by hereditary factors. Some of the responsible genes have already been identified but the precise genetic mechanisms have not yet been explained.

Genetic makeup of hundreds of patients analyzed

Professor Rappold and her team focused their studies on the SHANK2 gene, which encodes a structural protein at the nerve cell synapses. It is responsible for the mesh structure of the basic substance in the postsynapse. Only when the postsynapse is properly structured can nerve impulses be correctly transmitted. The researchers analyzed the genetic material of a total of 396 patients with autism and 184 patients with mental retardation. They found different mutations in their SHANK2 genes in the area of individual base pairs, but also variants in the number of gene copies. The mutations led to varying degrees of symptoms. None of the observed gene variants occurred in healthy control persons. "Apparently an intact postsynaptic structure is especially important for the development of cognitive functions, language, and social competence," explained Professor Rappold.

Identical mutations as the cause of different diseases

Some of the genetic mutations identified were new occurrences of mutations that were not inherited from the parents, but some of the mutations were also found in one parent. Since there are also healthy carriers of gene variants, we must assume that a certain threshold of gene mutations must be exceeded for the disease to appear. "Moreover, the same mutation can be present in an autistic patient with normal intelligence and in a mentally impaired patient," said Professor Rappold. There is some overlap in the clinical symptoms of mental retardation and autism, which can now be explained by a common genetic cause.

A revised sample coordinates the mod wallet.

Britain bans doctor who linked autism to vaccine

2010-05-24T22:47:00.000-07:00

By MARIA CHENG, AP Medical Writer Maria Cheng, Ap Medical Writer – Mon May 24, 9:30 pm ET

LONDON – The doctor whose research linking autism and the vaccine for measles, mumps and rubella influenced millions of parents to refuse the shot for their children was banned Monday from practicing medicine in his native Britain.

Dr. Andrew Wakefield's 1998 study was discredited — but vaccination rates have never fully recovered and he continues to enjoy a vocal following, helped in the U.S. by endorsements from celebrities like Jim Carrey and Jenny McCarthy

Wakefield was the first researcher to publish a peer-reviewed study suggesting a connection between autism and the vaccine for measles, mumps and rubella. Legions of parents abandoned the vaccine, leading to a resurgence of measles in Western countries where it had been mostly stamped out. There are outbreaks across Europe every year and sporadic outbreaks in the U.S.

"That is Andrew Wakefield's legacy," said Paul Offit, chief of infectious diseases at the Children's Hospital of Philadelphia. "The hospitalizations and deaths of children from measles who could have easily avoided the disease."

Wakefield's discredited theories had a tremendous impact in the U.S., Offit said, adding: "He gave heft to the notion that vaccines in general cause autism."

In Britain, Wakefield's research led to a huge decline in the number of children receiving the MMR vaccine: from 95 percent in 1995 — enough to prevent measles outbreaks — to 50 percent in parts of London in the early 2000s. Rates have begun to recover, though not enough to prevent outbreaks. In 2006, a 13-year-old boy became the first person to die from measles in Britain in 14 years.

"The false suggestion of a link between autism and the MMR vaccine has done untold damage to the UK vaccination program," said Terence Stephenson, president of the Royal College of Paediatrics and Child Health. "Overwhelming scientific evidence shows that it is safe."

On Monday, Britain's General Medical Council, which licenses and oversees doctors, found Wakefield guilty of serious professional misconduct and stripped him of the right to practice medicine in the U.K. Wakefield said he plans to appeal the ruling, which takes effect within 28 days.

The council was acting on a finding in January that Wakefield and two other doctors showed a "callous disregard" for the children in their study, published in 1998 in the medical journal Lancet. The medical body said Wakefield took blood samples from children at his son's birthday party, paying them 5 pounds (about $7.20) each and later joked about the incident.

The study has since been widely rejected. From 1998-2004, studies in journals including the Lancet, the New England Journal of Medicine, Pediatrics and BMJ published papers showing no link between autism and the measles vaccine.

Wakefield moved to the U.S. in 2004 and set up an autism research center in Austin, Texas, where he gained a wide following despite being unlicensed as a doctor there and facing skepticism from the medical community. He quit earlier this year.

Offit said he doubted Britain's decision to strip the 53-year-old Wakefield of his medical license would convince many parents that vaccines are safe.

"He's become almost like a Christ-like figure and it doesn't matter that science has proven him wrong," Offit said. "He is a hero for parents who think no one else is listening to them."

Wakefield told The Associated Press Monday's decision was a sad day for British medicine. "None of this alters the fact that vaccines can cause autism," he said.

"These parents are not going away; the children are not going to go away and I most certainly am not going away," he said on NBC's "Today Show."

Wakefield claimed the U.S. government has been settling cases of vaccine-induced autism since 1991.

However, two rulings by a special branch of the U.S. Court of Federal Claims in March and last year found no link between vaccines and autism. More than 5,500 claims have been filed by families seeking compensation for children they claim were hurt by the vaccine.

Wakefield has won support from parents suspicious of vaccines, including Hollywood celebrities.

McCarthy, who has an autistic son, issued a statement in February with then boyfriend Carrey asserting Wakefield was "being vilified through a well-orchestrated smear campaign."

"It is our most sincere belief that Dr. Wakefield and parents of children with autism around the world are being subjected to a remarkable media campaign engineered by vaccine manufacturers," the actors said.

McCarthy, whose best-seller "Louder Than Words" details her search for treatments for her son Evan, wrote the foreword for a new book by Wakefield about autism and vaccines.

In Monday's ruling, the medical council said Wakefield abused his position as a doctor and "brought the medical profession into disrepute."

At the time of his study, Wakefield was working as a gastroenterologist at London's Royal Free Hospital and did not have approval for the research. The study suggested autistic children had a bowel disease and raised the possibility of a link between autism and vaccines. He had also been paid to advise lawyers representing parents who believed their children had been hurt by the MMR vaccine.

Ten of the study's authors later renounced its conclusions and it was retracted by the Lancet in February.

At least a dozen British medical associations, including the Royal College of Physicians, the Medical Research Council and the Wellcome Trust have issued statements verifying the safety of the measles, mumps and rubella vaccine.

This verdict is not about (the measles) vaccine," said Adam Finn, a professor of pediatrics at the University of Bristol Medical School. "We all now know that the vaccine is remarkably safe and enormously effective... We badly need to put this right for the sake of our own children and children worldwide."

Brain clue may explain condition's 'hug avoidance'

2010-05-13T22:31:00.000-07:00

Delays at crucial points during the development of the brain in the womb may explain why people with a condition linked to autism do not like hugs.

A study in mice with fragile X syndrome found wiring in the part of the brain that responds to touch is formed late.

The findings may help explain why people with the condition are hypersensitive to physical contact, the researchers wrote in Neuron.

It also points to key stages when treatment could be most effective.

Fragile X syndrome is caused by a mutant gene in the X chromosome that interferes in the production of a protein called fragile X mental retardation protein (FMRP).

Under normal circumstances, the protein directs the formation of other proteins that build synapses in the brain.

Boys are usually more severely affected with the condition - which is the leading known cause of autism - because they have only one X chromosome.

In addition to mental impairment, hyperactivity, emotional and behavioural problems, anxiety and mood swings, people with fragile X also show what doctors call "tactile defensiveness", which means they do not make eye contact and do not like physical contact and are hypersensitive to touch and sound.

Connections

By recording electrical signals in the brains of mice, bred to mimic the condition, the researchers found that connections in the sensory cortex in the brain were late to mature.

This "mistiming" may trigger a domino effect and cause further problems with the correct wiring of the brain, they concluded.

The study also found these changes in the brain's connections occur much earlier than previously thought, midway through a baby's development in the womb.

And it suggests there are key "windows" when treatments for fragile X and autism could be most effective, they said.

Professor Peter Kind, who led the study at the University of Edinburgh, added: "We've learned these changes happen much earlier than previously thought, which gives valuable insight into when we should begin therapeutic intervention for people with these conditions.

"It also has implications for the treatment of autism since the changes in the brains of fragile X and autistic people are thought to significantly overlap."

Dr Gina Gómez de la Cuesta, from the National Autistic Society, said research into fragile X syndrome could help understanding of certain aspects of autism.

"Autism is common in people with fragile X syndrome, however there are many other causes of autism, most of which are not yet fully understood.

"Understanding how the brain works when a person has fragile X syndrome could help put some of the pieces together about what is happening in the brain when a person has autism, but it is not the whole story.

"Animal research can tell us a lot about genetics and the brain, but it is only a small part of the picture and further research would be required before we fully understand any links to autism."

Autistic Kids At The Movies Where Shhhh Is'nt Allowed

2010-04-02T18:05:00.000-07:00

On April 10, thousands of children with autism will be able to do something that for many of them was impossible until recently: go to the movies. They'll see How to Train Your Dragon at one of 93 "sensory-friendly" screenings in 47 cities across 30 states. The lights will dim but remain on, the volume will be lowered, the movie will start promptly at 10 a.m. with no previews, families with special dietary needs will be allowed to bring snacks from home, and if the kids yell or even stroll around the theater, no one will complain.

April Autism Awareness Month marks the first anniversary of the Sensory Friendly Films program, a joint venture of AMC Entertainment and the Autism Society. Screenings of the G- or PG-rated movies, all newly released, are held once a month on a Saturday morning. Expansion to other cities is planned.

A regular at the screenings is Marianna Pollock of Virginia Beach, Va., and her 6-year-old son Xander. "We attempted a regular movie a few times," says Pollock. "We always ended up having to leave within the first 15 minutes because Xander gets so excited that he flaps and makes noise. It was very stressful."

Xander's behavior at the movies is typical for many people with autism, which the Centers for Disease Control and Prevention estimates affects 1 in 110 children. "One of the challenges for people with an autism spectrum disorder is coping with strong sensory stimulation," says psychologist Sandra Harris, who runs the Douglass Developmental Disabilities Center at Rutgers University in New Brunswick, N.J. "They may be overwhelmed by loud sounds, bright lights, crowds of people. A person of any age with an ASD may flap his or her hands, twist her fingers, call out or rock when she is excited by an event such as a movie."

Silvia Townsend of San Diego took her 12-year-old son Bailey to a regular movie. Once. "It was horrible," says Townsend. "He was terrified when the lights turned off. And when the loud music started, he was covering his ears and started screaming in obvious pain." Now Bailey loves attending sensory-friendly films.

So does 18-year-old Matthew Kay, who has severe autism and attends the films with other young adults and the staff of the group home he lives in near San Diego. The last time Matthew was able to attend a regular movie, he was 4.

The idea for the films first came about in 2007 when Marianne Ross, of Elkridge, Md., took her then 7-year-old daughter Meaghan, who has autism, to see Hairspray. Ross purposely picked an early matinee, when there would be fewer people. "Meaghan loves Zac Efron, so when he came onscreen, she just danced, twirled, flapped her hands and jumped up and down." Several patrons complained, and the manager asked the Rosses to leave. "I was so frustrated, angry and upset," recalls Ross, "because Meaghan had been so happy. I thought, There's got to be a lot of children in the same situation."

The next day, Ross called her local AMC movie theater in Columbia, Md., and spoke to manager Dan Harris. She asked if he'd be willing to set up a special screening. Harris, who had never known anyone with autism, met with Ross, heard her suggestions and came up with some adaptations to make the screening more sensory-friendly to kids with the disorder.

Ross put the word out about the upcoming screening through her local Autism Society chapter. "We didn't know if we'd have an empty auditorium," says Harris. "We had 300 seats, and we had to turn people away. I knew we were on to something."

Harris held three more monthly screenings, then contacted AMC's national headquarters in Kansas City, Mo., where he spoke with community-relations manager Cindy Huffstickler. She thought it was a great idea and was surprised no one had thought of it before. Huffstickler then contacted the Autism Society's national headquarters, which got its chapters behind a few national test screenings that proved just as successful.

"Attending a film where you know everyone in the theater is either in the same situation as you or is at least informed that the 'Silence is golden' policy doesn't apply today takes the tension away," says Angela Vandersteen of Greenwood, Ind., who takes her 5-year-old son Ray to the screenings. When Marianne Ross takes Meaghan to the movies, she also takes along her 8-year-old son Gavin, who does not have autism; he has developed a network of friends who are siblings of autistic kids at the screenings.

Even families of children without autism but with other special needs, like those with physical disabilities, have started attending the screenings, citing the sense of acceptance they feel there.

"Our children are constantly under scrutiny," says Xander's mother Marianna. "They look normal, so people often think they're just misbehaving. It becomes exhausting trying to validate their right to be themselves. At a sensory-friendly movie, we as a family finally get to go to a movie and relax. Boy, does that feel wonderful."

Brain Imaging May Help Diagnose Autism

2010-01-23T00:55:00.001-08:00

Children with autism spectrum disorders (ASDs) process sound and language a fraction of a second slower than children without ASDs, and measuring magnetic signals that mark this delay may become a standardized way to diagnose autism.

Researchers at The Children's Hospital of Philadelphia report their findings in an online article in the journal Autism Research, published today.

"More work needs to be done before this can become a standard tool, but this pattern of delayed brain response may be refined into the first imaging biomarker for autism," said study leader Timothy P.L. Roberts, Ph.D., vice chair of Radiology Research at Children's Hospital.

ASDs are a group of childhood neurodevelopmental disorders that cause impairments in verbal communication, social interaction and behavior. ASDs are currently estimated to affect as many as one percent of U.S. children, according to a recent CDC report.

Like many neurodevelopmental disorders, in the absence of objective biological measurements, psychologists and other caregivers rely on clinical judgments such as observations of behavior to diagnose ASDs, often not until a child reaches school age. If researchers can develop imaging results into standardized diagnostic tests, they may be able to diagnose ASDs as early as infancy, permitting possible earlier intervention with treatments. They also may be able to differentiate types of ASDs (classic autism, Asperger's syndrome or other types) in individual patients.

In the current study, Roberts and colleagues used magnetoencephalography (MEG), which detects magnetic fields in the brain, similar to the way electroencephalography (EEG) detects electrical fields. Using a helmet that surrounds the child's head, the team presents a series of recorded beeps, vowels and sentences. As the child's brain responds to each sound, noninvasive detectors in the MEG machine analyze the brain's changing magnetic fields.

The researchers compared 25 children with ASDs, having a mean age of 10 years, to 17 age-matched typically developing children. The children with ASDs had an average delay of 11 milliseconds (about 1/100 of a second) in their brain responses to sounds, compared to the control children. Among the group with ASDs, the delays were similar, whether or not the children had language impairments.

"This delayed response suggests that the auditory system may be slower to develop and mature in children with ASDs," said Roberts. An 11-millisecond delay is brief, but it means, for instance, that a child with ASD, on hearing the word 'elephant' is still processing the 'el' sound while other children have moved on. The delays may cascade as a conversation progresses, and the child may lag behind typically developing peers."

A 2009 study by Roberts and colleagues sheds light on how changes in brain anatomy may account for the delays in sound processing. The study team used MEG to analyze the development of white matter in the brains of 26 typically developing children and adolescents. Because white matter carries electrical signals in the brain, signaling speed improves when neurons are better protected with an insulating sheath of a membrane material called myelin.

In this previous study, the researchers showed that normal age-related development of greater myelination corresponds with faster auditory responses in the brain. "The delayed auditory response that we find in children with ASDs may reflect delayed white matter development in these children," said Roberts.

Roberts says his team's further studies will seek to refine their imaging techniques to determine that their biomarker is specific to ASDs, and will investigate other MEG patterns found in children with ASDs in addition to auditory delays.

Grants from National Institute of Health, the Nancy Lurie Marks Family Foundation, Autism Speaks, and the Pennsylvania Department of Health supported this research. In addition, Roberts holds an endowed chair, the Oberkircher Family Chair in Pediatric Radiology at The Children's Hospital of Philadelphia. Roberts' co-authors were from Children's Hospital, including the Hospital's Center for Autism Research.

Recent Rise In Certain Disorders Could Be Explained By Ongoing Human Evolution

2010-01-22T21:19:00.000-08:00

The subtle but ongoing pressures of human evolution could explain the seeming rise of disorders such as autism, autoimmune diseases, and reproductive cancers, researchers write in the Proceedings of the National Academy of Sciences. Certain adaptations that once benefited humans may now be helping such ailments persist in spite of - or perhaps because of - advancements in modern culture and medicine.

"This work points out linkages within the plethora of new information in human genetics and the implications for human biology and public health, and also illustrates how one could teach these perspectives in medical and premedical curricula," says author Peter Ellison, John Cowles Professor of Anthropology at Harvard University.

Ellison's co-authors are Stephen Stearns of Yale University, Randolph Nesse of the University of Michigan, and Diddahally Govindaraju of the Boston University School of Medicine. The research was first presented at the Arthur M. Sackler Colloquium, co-sponsored by the National Academy of Science and the Institute of Medicine.

Colloquium presentations described in the current paper include research suggesting that:

* Autism and schizophrenia may be associated with the over-expression of paternally or maternally derived genes and influences, a hypothesis advanced by Bernard Crespi of Simon Fraser University.

* Maternal and paternal genes engage in a subtle tug-of-war well into childhood with consequences for childhood development, as posited by David Haig, George Putnam Professor of Organismic and Evolutionary Biology at Harvard.

* Humans may be susceptible to allergies, asthma, and autoimmune diseases because of increased hygiene, according to Kathleen Barnes of Johns Hopkins University. Without being exposed to intestinal worms and parasites, as our ancestors were, our immune systems are hypersensitive.

* Natural selection still influences our biology, despite advances in modern culture and medicine. Stearns found that natural selection favors heavier women and reduces the age at which a woman has her first child.

In the final presentation of the colloquium, researchers called for the integration of evolutionary perspectives into medical school curricula, to help future physicians consider health problems from an evolutionary perspective.

"We're trying to design ways to educate physicians who will have a broader perspective and not think of the human body as a perfectly designed machine," says Ellison. "Our biology is the result of many of evolutionary trade-offs, and understanding these histories and conflicts can really help the physician understand why we get sick and what we might do to stay healthy."

Previous work in evolutionary medicine helped explain why disease is so prevalent and difficult to prevent - because natural selection favors reproduction over health, biology evolves more slowly than culture, and pathogens evolve more quickly than humans.

"I think that the main take-home point is that evolution and medicine really do have things to say to each other, and some of these insights actually reduce suffering and save lives," says Stearns.

High Rates Of Birth Defects Found In Autistic Children

2010-01-22T18:44:00.000-08:00

Nearly two-thirds of the children with Autistic Spectrum Disorders recorded in the National Birth Defect Registry (NBDR) also suffer from structural birth defects, according the national nonprofit, Birth Defect Research for Children (BDRC). The group reported that most of the defects affect the face, head and central nervous systems of newborns.

Birth Defect Research for Children, a national nonprofit founded in 1982, maintains the registry to collect data from parents on all kinds of structural birth defects and functional deficits including autistic spectrum disorders. Betty Mekdeci, executive director of BDRC explains, "We designed the registry with a collaboration of prominent scientists. The registry's extensive data allows researchers to identify possible patterns underlying the incidence of birth defects as well as prenatal conditions and exposures. We are asking all parents of children with structural and functional birth defects to contact us to register for our database to continue this study."

"Our current data suggests that genetic and environmental triggers may interact to account for the increase in ASDs. We need to collect more data to confirm the pattern we are seeing."

The new analysis reveals that over 60% cases also had structural birth defects, primarily Central Nervous System (CNS) or Craniofacial Defects. The other 40% of the ASD cases reported associated developmental problems, but no reported structural birth defects.

Most frequent CNS disorders reported were Microcephaly (small head), Cerebral Palsy, Chiari Malformation (a structural defect of the brain) and Absent or Thin Corpus Callosum (the band connecting the two halves of the brain), The most frequent Craniofacial Defects included Low Set Ears, Partial Hearing Loss, Abnormal Teeth and Abnormal Facial Structure.

The registry also collects data on prenatal exposures to medications, illnesses and toxins. The most frequently reported maternal exposure was acetaminophen (AP). AP use has increased in recent years. Recent studies have reported associations between maternal AP ingestion and childhood asthma and a stomach defect called gastroschisis.

Scientific Learning's Fast ForWord Software Approved By Australian Government As Intervention For Children With Autism

2010-01-22T18:43:00.000-08:00

Scientific Learning Corp. (NASDAQ:SCIL) today announced that the Australian Government's Department of Families, Housing, Community Services and Indigenous Affairs has named the Fast ForWord ® family of products as an approved intervention for children under age six who are diagnosed with Autism Spectrum Disorders (ASDs).

Designed to accelerate learning by developing the student brain to process more efficiently, the Fast ForWord educational software consists of scientifically proven, intervention programs that apply neuroscience principles to build the fundamental cognitive skills required to read and learn. The strengthening of these skills results in a wide range of improved critical language and reading abilities, such as phonological awareness, phonemic awareness, fluency, vocabulary, comprehension, decoding, working memory, syntax and grammar.

In Australia, the Fast ForWord program is available to eligible children under the Helping Children with Autism funding package. Through this package, the Australian Government is working to address the need for support and services for children with ASDs. As part of the package, the government offers funding for early intervention services for children ages zero to seven who are diagnosed with an ASD. Eligible families can access the Fast ForWord program from Scientific Learning's two Value Added Representative (VAR) organizations in Australia, LearnFast Australia/Lindfield Speech Pathology & Learning Center in Sydney, New South Wales and Sonic Learning in Perth.

Communication Problems In The Brain

2010-01-22T17:54:00.000-08:00

Maturation disorders of nerve terminals may trigger autism; researchers in Heidelberg publish in the Proceedings of the National Academy of Sciences

For brain cells to communicate, the contacts to each other must function. The protein molecule neuroligin-1 plays an important role in this as it stimulates the necessary maturation processes at the contact sites (synapses) of the nerves. A synaptic maturation disorder is possibly involved in the development of autism. Dr. Thomas Dresbach and his team from the Institute for Anatomy and Cell Biology at the University of Heidelberg, in cooperation with the study group led by Professor Dr. Thomas Kuner at the same institute and Professor Dr. Nils Brose, Max Planck Institute for Experimental Medicine in Göttingen, have published their results in the prestigious international journal PNAS (Proceedings of the National Academy of Sciences).

One hundred billion nerve cells make our brain a thinking machine. Each of these nerve fibers produces a long extension, the axon, which terminates in numerous small knobs. Transmitters are released here that transfer information to the next nerve cell. The contact site between nerve ending and adjacent nerve cell is called a synapse. The number and location of active synapses determine which areas of the brain are especially active at a given time.

Neuroligin-1 protein necessary for maturation

The synapses of young nerve cells must mature before they can release their neurotransmitters to the full extent. Researchers were able to show using genetically modified nerve cells from mice that the postsynaptic nerve cell, the receptor, must form a sufficient amount of a certain protein molecule, neuroligin-1, to allow this maturation process to take place. In addition, the nerve endings from where information is sent must release slight amounts of neurotransmitters to stimulate the neuroligin in the postsynaptic nerve cell.

"A fully functioning contact can develop only if both sides, transmitter and receptor of information, are involved in the maturation process," explained Dr. Dresbach. If no neuroligin-1 is formed, the nerve endings remain at an immature stage and release fewer neurotransmitters; the flow of information is interrupted. The nerve endings can only whisper, so to speak.

Autism caused by a malfunction at the synapses?
"The results are significant for actual concepts about how autism develops," says Professor Dr. Joachim Kirsch, director of the Institute for Anatomy and Cell Biology. Symptoms of autism are first noticed in early childhood as an information processing disorder. The symptoms may be more or less pronounced, but all patients display weaknesses in social contacts and communication. "There are many indications that malfunctions of synaptic molecules are involved in the development of this illness. It has thus far been unclear exactly what these malfunctions are, but we now know what to look for," says Professor Kirsch. The study was funded by the FRONTIER program of the excellence initiative at the University of Heidelberg.

Rate Of Autism Disorders Climbs To 1 Percent Among 8 Year Olds

2010-01-22T17:46:00.000-08:00

Autism and related development disorders are becoming more common, with a prevalence rate approaching 1 percent among American 8-year-olds, according to new data from researchers at the University of Alabama at Birmingham (UAB) School of Public Health and the Centers for Disease Control and Prevention (CDC).

The study is a partnership between UAB, the CDC and 10 other U.S. research sites. It shows that one in 110 American 8-year-olds is classified as having an autism spectrum disorder (ASD), a 57 percent increase in ASD cases compared to four years earlier.

The new findings, published Dec. 18 in the CDC's Morbidity and Mortality Weekly Report (MMWR), highlight the need for social and educational services to help those affected by the condition, said Beverly Mulvihill, Ph.D., a UAB associate professor of public health and co-author on the study.

ASDs are a group of developmental disabilities such as autism and Asperger disorder that are characterized by delays or changes in childhood socialization, communication and behavior.

"This is a dramatic increase in the number of kids classified as autistic or documented on the spectrum of similar disorders," Mulvihill said. "It is not entirely clear what is causing the rise, but we know major collaborative efforts are needed to improve the understanding and lives of people and families impacted."

The MMWR study discusses possible factors that might contribute to the increase in ASD cases. They include a broader definition of autism disorders and a heightened awareness of ASD by parents, doctors, educators and other professionals. The findings do not address whether or not any of the increase is attributable to a true increase in the risk of developing ASD, more frequent and earlier diagnoses, and other factors.

Data comes from the Autism and Developmental Disabilities Monitoring (ADDM) Network, a collection of 11 sites in Alabama, Arizona, Colorado, Florida, Georgia, Maryland, Missouri, North Carolina, Pennsylvania, South Carolina and Wisconsin. ADDM reviewers are uniformly trained to review and confirm cases; some children included in the study have documented ASD symptoms but never received a diagnosis.

The study also found that boys are 4.5 times more likely than girls to have ASD, a finding that confirms earlier studies, says Martha Wingate, Dr.P.H., a UAB assistant professor of public health and study co-author.

"It still is not clear why males more frequently are affected," Wingate said. "One thing we know for sure is that more research is needed to quantify the effects of single or multiple factors such as diagnosis patterns, inclusion of milder cases and other components."

The ADDM sites are not selected based on any statistical pattern, but the 300,000-plus children included in the study represent 8 percent of the nation's 8-year-olds.

The Alabama Autism Surveillance Project, located within the UAB Department of Health Care Organization and Policy, is a member of the ADDM network. Funding for the project is from the CDC's National Center for Birth Defects and Developmental Disabilities Division.

About the UAB School of Public Health

The School of Public Health is a community of scholars and professionals working and teaching in varied arenas of public health with the goal of fostering research and best practices crucial to the health of our nation and its peoples. The school offers more than 20 areas of study and manages dozens of research and community-service centers.

Landmark Consensus Articles Published In Pediatrics Acknowledge The Need To Improve Treatment Of Gastrointestinal Disorders In Individuals With Autism

2010-01-22T17:42:00.000-08:00

A causal relationship between gastrointestinal disorders and the behavioral features of children with autism spectrum disorder has been acknowledged for years by parents caring for those affected, yet dismissed by mainstream medicine. A landmark paper, Recommendations for Evaluation and Treatment of Common Gastrointestinal Problems in Children with ASDs, a consensus report published this week in Pediatrics, is an important step forward in closing this gap. Acknowledging that certain behavioral manifestations of patients with ASD such as self-injury and poor sleep might have a GI basis is the first step toward achieving substantive therapies.

Because it was felt that many individuals with ASD might have undiagnosed medical conditions, often involving the gastrointestinal tract, representatives from the Autism Research Institute (ARI) and other autism advocacy groups worked to convene a gut consensus meeting from which the articles were derived. On May 29-30, 2008, a multidisciplinary panel of 27 clinical and research experts met in Boston, Massachusetts to develop recommendations for the evaluation and treatment of GI disorders in individuals with ASD.

ARI's Director Dr. Stephen Edelson commented, "This is truly a human rights issue; every child deserves proper medical attention--whether or not they have autism. This published report brings much-needed focus to gastrointestinal problems that are commonly associated with the autism spectrum. The conclusions of the report are clear: physicians need to be alert and responsive to such problems when treating these patients; additional research on prevalence, cause, and appropriate treatment is imperative."

Parents and physicians should be on the lookout for the most common GI symptoms reported in people with ASD: chronic constipation, abdominal pain with or without diarrhea, reflux, and abdominal bloating. Problem behaviors such as self-injury and aggression, as well as overall changes such as sleep disturbance or irritability, might be indicators of stomach pain. The authors concluded that "The approach to evaluation and diagnosis of possible underlying medical conditions, in particular GI disorders, should be no different from the standard of care for persons without ASD."

First Step Toward Needed Guidelines For Children With Autism Provided By Pediatrics Gastrointestinal Consensus Statement And Recommendations

2010-01-22T16:26:00.000-08:00

Autism Speaks applauds the consensus statement and recommendations for the evaluation, diagnosis, and treatment of gastrointestinal (GI) disorders in children with autism spectrum disorders (ASD) released online in Pediatrics as one step in advancing physician awareness of unique challenges in the medical management of children with autism. "We are pleased to see the publication of these consensus recommendations. Autism Speaks' current efforts will take this further by creating evidence-based guidelines for physicians. The goal is to develop a comprehensive care model that will guide physicians in addressing a wide range of medical issues, including GI problems, that many individuals with autism suffer from," commented Geraldine Dawson, Ph.D., Autism Speaks chief science officer.

The two reports published today present outcomes of a meeting held in May 2008, sponsored by the Autism Forum, in which working groups participating in the meeting reviewed current evidence on the evaluation and treatment of GI disorders specifically for children with autism. The 2008 meeting from which these consensus recommendations were derived recognized that health care practitioners severely lack solid information to guide care of children with autism and GI problems and there is a need for more research data, including genetic research, as a prerequisite to develop evidence-based guidelines specific to autism.

"The Pediatrics paper represents long-sought recognition by the mainstream medical community that treatment of GI problems in children with autism requires specific and specialized approaches," reacted Dr. Dawson. "Autism Speaks has been actively engaged in the study of GI problems associated with children with autism, working toward enhanced medical community awareness for over five years through its research agenda and the Autism Speaks' Autism Treatment Network (ATN)."

Dan Coury, M.D., ATN medical director, commented, "We are delighted to see the publication of important information that can support clinicians and caregivers in providing better care for children with autism, particularly with GI concerns, as parents unfortunately very often find it difficult to identify physicians who have an understanding of these issues and are able to provide appropriate medical care for their children. GI and pediatric specialists from six of the ATN sites participated in the forum and in the development of these recommendations, which shows the power of interaction among the communities and individuals dedicated to this problem. Autism Speaks is already engaged in the crucial next step which is to move beyond these consensus-based recommendations to develop evidence-based clinical guidelines." In addition to development of evidence-based clinical guidelines for GI issues, the ATN is also currently working on evidence based clinical guidelines for medical management of sleep, and neurologic disorders associated with autism. "Delivery of evidence-based clinical guidelines will serve as excellent opportunities for future training and education of physicians," added Dr. Dawson.

The consensus statement highlights several important themes, the first emphasizing that GI problems are a genuine concern in the ASD population and that these disorders exacerbate or contribute to problem behaviors. The need for awareness of how GI problems manifest in children with autism and the potential for accompanying nutritional complications and impaired quality of life were also emphasized.

In the second paper, the authors make consensus recommendations providing guidance on how current general pediatric standards of care that can and should be applied for children with ASD. George Fuchs, M.D., a co-author on the two papers and chair of the ATN GI Committee remarked, "The recommendations provide important guidance for the clinician to adapt the current practices of care (for abdominal pain, chronic constipation and gastroesophageal reflux) for the child with autism. The recommendations from the Autism Forum meeting complement the ATN's on-going work to develop evidence-based, ASD-specific guidelines. The ATN is currently piloting newly created guidelines and monitoring their effectiveness. We anticipate this data will contribute to an evidence-based foundation to support best practices for GI problems in ASD."

Autism Speaks is committed to the sustained support of efforts that address co-morbid medical conditions in the ASD population. In recognizing that there's not enough evidence in any GI area and more research is needed, the Pediatric papers reaffirm the importance of the recent November 2009, Autism Speaks sponsored symposium and workshop on Gastrointestinal Disorders in Autism Spectrum Disorders. The symposium and workshop represented an important partnership with the American Academy of Pediatrics, and the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) - the largest professional society for GI and nutritional specialists, and a professional authority for the development and implementation of pediatric GI guidelines. The symposium raised awareness and provided the latest scientific information to an audience of 168 researchers, clinicians, and pediatric GI and nutrition specialists, most of whom had limited expertise in autism. The symposium was followed by a workshop that brought together a diverse group of experts in GI, nutrition, pediatrics, pain, ASD, and biological research. Recommendations were developed for an expanded and targeted research agenda for the field that will address current gaps in the knowledge base and aim to advance evaluation and treatment of ASD-GI disorders. Proceedings from the meeting are scheduled to be published in 2010. A unique and important element in both the Symposium and Workshop was the inclusion of parents of children with ASD.

University Of California Davis Researchers Identify Autism Clusters In California

2010-01-22T16:21:00.000-08:00

Researchers at UC Davis have identified 10 locations in California where the incidence of autism is higher than surrounding areas in the same region. Most of the areas, or clusters, are in locations where parents have higher-than-average levels of educational attainment. Because children with more educated parents are more likely to be diagnosed with an autism spectrum disorder, one need look no further for a cause, the authors say. The other clusters are located close to major autism treatment centers.

The clusters are located primarily in the high-population areas of Southern California and, to a lesser extent, in the San Francisco Bay Area. The researchers said that, while children born within the clusters during the study period were more likely to be diagnosed with autism, the majority of the state's children with autism were born in adjacent areas outside the clusters.

For the rigorous study, published online today in the journal Autism Research, scientists examined nearly all of the approximately 2-1/2 million births recorded in the state of California from 1996 through 2000. About 10,000 children born during that five-year period were later diagnosed with an autism spectrum disorder, according to the California Department of Developmental Services (DDS).

After mapping the state's birth cohort based on where the mothers lived at the time when their children were born, the researchers pinpointed birth locations of children who were later diagnosed with autism. The study looked for areas of higher incidence within each of the service zones of DDS's regional centers, which coordinate services for individuals with developmental disorders like autism.

"This is the first time that anyone has looked at the geography of autism births in California in order to see whether there might be some local patches of elevated environmental risk. This method ignores unknown widespread factors (such as a regional pollutant) that could increase autism incidence," said Karla Van Meter, the study's lead author. Van Meter is an epidemiologist and was a doctoral student in the UC Davis Department of Public Health Sciences and at the Center for Animal Disease Modeling and Surveillance when the study was conducted.

"This spatial study was extremely rigorous because we developed a methodology that greatly improved accuracy in identifying areas of higher autism incidence. With so many possible environmental health risk factors, we see this method as generally useful for focusing studies on exposures that are elevated in such clusters," Van Meter said.

However, the researchers said that in this investigation the clusters probably are not correlated with specific environmental pollutants or other "exposures." Rather, they correlate to areas where residents are more educated.

"What we found with these clusters was that they correlated with neighborhoods of high education or neighborhoods that were near a major treatment center for autism," said senior author Irva Hertz-Picciotto, a professor of public health sciences and a researcher with the UC Davis MIND Institute.

"In the U.S., the children of older, white and highly educated parents are more likely to receive a diagnosis of autism or autism spectrum disorder. For this reason, the clusters we found are probably not a result of a common environmental exposure. Instead, the differences in education, age and ethnicity of parents comparing births in the cluster versus those outside the cluster were striking enough to explain the clusters of autism cases," Hertz-Picciotto said.

Autism is a neurodevelopmental disability characterized by impaired social development and communication and restricted, repetitive behaviors. It is considered a lifelong condition that develops by the time a child is 3 years old. The researchers limited their study to the five-year period between 1996 and 2000 in order to allow all of the children born during that time to grow to an age by which they probably would have received a diagnosis - 6 years old.

Van Meter said that the increased risk of autism in these areas is roughly a doubling of the incidence of autism over the incidence in the surrounding zone. For example, for the cluster area located in the service zone of the San Diego Regional Center, the autism incidence was 61.2 per 10,000 births and, in the rest of the Regional Center service zone, 27.1 per 10,000 births. For the Harbor Regional Center the incidence was 103.4 and 57.8, respectively. Van Meter added that it is important to remember that most of the children with autism were not born in the cluster areas.

In Southern California, the areas of increased incidence were located within these Regional Center service zones:

1. The Westside Regional Center, headquartered in Culver City, Calif., which serves the communities of western Los Angeles County, including the cities of Culver City, Inglewood and Santa Monica;

2. The Harbor Regional Center, headquartered in Torrance, Calif., which serves southern Los Angeles County, including the cities of Bellflower, Harbor, Long Beach and Torrance;

3. The North Los Angeles County Regional Center, headquartered in Van Nuys, Calif., which serves the San Fernando and Antelope valleys - two clusters were located in this regional center's service zone.

4. The South Central Los Angeles Regional Center, headquartered in Los Angeles, which serves the communities of Compton and Gardena;

5. The Regional Center of Orange County, headquartered in Santa Ana, Calif., which serves the residents of Orange County; and

6. The Regional Center of San Diego County, headquartered in San Diego, which serves people living in Imperial and San Diego counties.

In Northern California, the areas of increased incidence were located within these regional centers' service zones:

7. The Golden Gate Regional Center, headquartered in San Francisco, which serves Marin and San Mateo counties and the City and County of San Francisco. Two clusters were located within the Golden Gate Regional Center's service zone; and

8. The San Andreas Regional Center, headquartered in Campbell, Calif., which serves Santa Clara, Santa Cruz, Monterey and San Benito counties.

Two areas of increased incidence were located in Central California regional centers' service zones:

9. The Central Valley Regional Center, headquartered in Fresno, Calif., which serves Fresno, Kings, Madera, Mariposa, Merced and Tulare counties; and

10. The Valley Mountain Regional Center, headquartered in Stockton, Calif., which serves Amador, Calaveras, San Joaquin, Stanislaus and Tuolumne counties.

The South Central Los Angeles and Valley Mountain Regional Center autism clusters were listed as "potential clusters" because their clusters met a reduced set of statistical conditions.

All of these areas were identified using a sophisticated new biostatistical testing procedure developed by Van Meter in collaboration with study co-author Lasse Christiansen and constructed on Christiansen's earlier statistical work. This method looked for combinations of events, in this case, autism, within a set of locations, in this case, births, whose occurrence would not be expected to occur at random. This is the first application of that method. UC Davis undertook the epidemiological study as a step toward identifying geographic risk factors for autism in California, Van Meter said.

The study also examined demographic factors recorded on the children's birth records that are known to be associated with both autism and residential location. These included having an older parent - a known autism risk factor. The researchers found a statistically significant but small association of the cluster areas with older parental age at the time their child was born.

Hertz-Picciotto said that the findings do not counter the idea that the environment plays a role in autism, but rather, help to focus attention toward certain types of exposures.

"Because of the strong link between demographics, particularly parental education, and the locations of clusters, other explanations for these pockets of high autism incidence, such as localized sources of exposure, are not likely," Van Meter explained.

"The risk for a child with highly educated parents to be diagnosed with autism is probably not caused by the location of the mother's residence or any local shared environmental exposures," she said. "Our result indicates that the most likely sources of environmental hazards for autism in California are in or around the home or else are widespread."

"The strong link between demographics, particularly parental education, and the locations of the clusters validated the effectiveness of the statistical method that we employed because it successfully identified areas where a known risk factor was concentrated," she added.

Early intervention aids children with autism: study

2009-12-01T18:37:00.000-08:00

A new therapeutical treatment for autism that can be used to treat children as young as 18 months improves their IQ, language ability and social interaction, according to a study published Monday.

"This is the first controlled study of an intensive early intervention that is appropriate for children with autism who are less than two-and-a-half years of age," said Geraldine Dawson, lead author of the study.

"It is crucial that we can offer parents effective therapies for children in this age range," added Dawson, currently chief science officer of Autism Speaks.

"By starting as soon as the toddler is diagnosed, we hope to maximize the positive impact of the intervention."

The research used an approach known as the "Early Start Denver Model," (ESDM) which combines use of applied behavioral analysis and development "relationship-based" techniques, according to the study published in the journal Pediatrics.

The approach is the first to be used on children younger than pre-school age and yielded impressive results in treating autism, a neurodevelopmental disorder believed to affect one in 100 children in the United States.

The study was carried out over five years, and involved 48 children between the ages of 18 and 30 months who suffered from autism but had no other health issues.

The approach is the first to be used on children younger than pre-school age and yielded impressive results in treating autism, a neurodevelopmental disorder believed to affect one in 100 children in the United States.

The study was carried out over five years, and involved 48 children between the ages of 18 and 30 months who suffered from autism but had no other health issues.

The group was divided into two sections, the first of which underwent therapy using the Denver Model, while the second was referred to community-based therapy programs.

University of Washington at Seattle specialists treated the first group for 20 hours a week, in two sessions of two hours each, five days a week.

The children in the first group also received five hours of parent-delivered therapy a week.

At the end of the study, the children in the first group had improved their IQ scores by approximately 18 points, compared to an improvement of approximately 10 points in the second group, the researchers said.

Seven of the children receiving the Denver Model therapy showed enough improvement in their overall skills that their diagnosis was downgraded from autism to a milder condition, while only one child in the second group improved as significantly.

"We believe that the ESDM group made much more progress because it involved carefully structured teaching and a relationship-based approach to learning with many, many learning opportunities embedded in play," said Sally Rogers, a co-author of the study and professor of psychiatry and behavioral sciences at the University of California, Davis.

She also stressed the benefits of beginning the therapy at the earliest possible age.

"Infant brains are quite malleable so with this therapy we're trying to capitalize on the potential of learning than an infant's brain has in order to limit autism's deleterious effects, to help children lead better lives."

Aspergers:A Powerful Identity, a Vanishing Diagnosis

2009-11-07T23:31:00.000-08:00

By CLAUDIA WALLIS
Published: November 2, 2009

It is one of the most intriguing labels in psychiatry. Children with Asperger’s syndrome, a mild form of autism, are socially awkward and often physically clumsy, but many are verbal prodigies, speaking in complex sentences at early ages, reading newspapers fluently by age 5 or 6 and acquiring expertise in some preferred topic — stegosaurs, clipper ships, Interstate highways — that will astonish adults and bore their playmates to tears.

In recent years, this once obscure diagnosis, given to more than four times as many boys as girls, has become increasingly common.

Much of the growing prevalence of autism, which now affects about 1 percent of American children, according to federal data, can be attributed to Asperger’s and other mild forms of the disorder. And Asperger’s has exploded into popular culture through books and films depicting it as the realm of brilliant nerds and savantlike geniuses.

But no sooner has Asperger consciousness awakened than the disorder seems headed for psychiatric obsolescence. Though it became an official part of the medical lexicon only in 1994, the experts who are revising psychiatry’s diagnostic manual have proposed to eliminate it from the new edition, due out in 2012.

If these experts have their way, Asperger’s syndrome and another mild form of autism, pervasive developmental disorder not otherwise specified (P.D.D.-N.O.S. for short), will be folded into a single broad diagnosis, autism spectrum disorder — a category that encompasses autism’s entire range, or spectrum, from high-functioning to profoundly disabling.

“Nobody has been able to show consistent differences between what clinicians diagnose as Asperger’s syndrome and what they diagnose as mild autistic disorder,” said Catherine Lord, director of the Autism and Communication Disorders Centers at the University of Michigan, one of 13 members of a group evaluating autism and other neurodevelopmental disorders for the manual.

“Asperger’s means a lot of different things to different people,” Dr. Lord said. “It’s confusing and not terribly useful.”

Taking Asperger’s out of the manual, known as D.S.M.-V for the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, does not mean the term will disappear. “We don’t want to say that no one can ever use this word,” Dr. Lord said, adding: “It’s not an evidence-based term. It may be something people would like to use to describe how they see themselves fitting into the spectrum.”

But the change, if approved by the manual’s editors and consultants, is likely to be controversial. The Asperger’s diagnosis is used by health insurers, researchers, state agencies and schools — not to mention people with the disorder, many of whom proudly call themselves Aspies.

Some experts worry that the loss of the label will inhibit mildly affected people from being assessed for autism. “The general public has either a neutral or fairly positive view of the term Asperger’s syndrome,” said Tony Attwood, a psychologist based in Australia who wrote “The Complete Guide to Asperger’s Syndrome” (Jessica Kingsley Publishers, 2006). But if people are told they should be evaluated for autism, he went on, “they will say: ‘No, no, no. I can talk. I have a friend. What a ridiculous suggestion!’ So we will miss the opportunity to assess people.”

The proposed changes to the autism category are part of a bigger overhaul that will largely replace the old “you have it or you don’t” model of mental illness with a more modern view — that psychiatric disorders should be seen as a continuum, with many degrees of severity. The goal is to develop “severity measures within each diagnosis,” said Dr. Darrel A. Regier, research director at the American Psychiatric Association and vice chairman of the diagnostic manual’s task force.

Another broad change is to better recognize that psychiatric patients often have many health problems affecting mind and body and that clinicians need to evaluate and treat the whole patient.

Historically, Dr. Regier said, the diagnostic manual was used to sort hospital patients based on what was judged to be their most serious problem. A patient with a primary diagnosis of major depression would not be evaluated for anxiety, for example, even though the two disorders often go hand in hand.

Similarly, a child with the autism label could not also have a diagnosis of attention deficit hyperactivity disorder, because attention problems are considered secondary to the autism. Thus, they might go untreated, or the treatment would not be covered by insurance.

The new edition, by contrast, will list not only the core issues that characterize a given diagnosis but also an array of other health problems that commonly accompany the disorder. For autism, this would most likely include anxiety, attention disorders, gastrointestinal problems, seizures and sensory differences like extreme sensitivity to noise.

Parents and advocates have been clamoring for an approach that addresses the multiple health problems that plague many children with autism. “Our kids will do much better if medical conditions like gut issues or allergies are treated,” said Lee Grossman, president of the Autism Society of America, a leading advocacy group.

The new diagnostic approach addresses another source of confusion: the current labels may change over time. “A child can look like they have P.D.D.-N.O.S., then Asperger’s, then back to autism,” Dr. Lord said. The inconsistent use of these labels has been a problem for researchers recruiting subjects for studies of autism spectrum disorder.

And it can be a problem for people seeking help. In some states, California and Texas, for example, people with traditional autistic disorder qualify for state services, while those with Asperger’s and pervasive developmental disorder do not.

A big challenge for the diagnostic manual team working on autism is how to measure severity in a condition that often causes a very uneven profile of abilities and disabilities. Mr. Grossman gives the example of a woman who serves on an advisory panel to his organization. She is nonverbal and depends on an electronic device to communicate, is prone to self-injury and relies on a personal aide. And yet “she’s absolutely brilliant, she runs a newsletter, and she’s up on all the science,” he said, adding, “Where would somebody like that come out on the rating scale?”

Recent books by people with Asperger’s give insights into the workings of some oddly beautiful minds. In “Embracing the Wide Sky” (Free Press, 2009), Daniel Tammet, a shy British math and linguistic savant, tells how he was able to learn enough Icelandic in a week to manage a television interview and how he could recite the value of pi to 22,514 decimal places by envisioning the digits “as a rolling numerical panorama” of colors, shapes and textures.

In “Look Me in the Eye” (Crown, 2007), John Elder Robison describes a painfully lonely childhood and an ability to look at a circuit design and imagine how it will transform sound — a talent he used to invent audio effects and exploding guitars for the rock band Kiss.

Not all people with Asperger’s have such extraordinary abilities, and some who do are so crippled by anxiety and social limitations that they cannot hold down a job or live on their own.

Dr. Susan E. Swedo, a senior investigator at the National Institute of Mental Health who heads the diagnostic manual group working on autism, acknowledges the difficulty of describing such a variable disorder. Dr. Swedo said the plan was to define autism by two core elements — impaired social communication and repetitive behaviors or fixated interests — and to score each of those elements for severity.

The trick is to “walk the tightrope of truth,” Dr. Swedo said, between providing clear, easily used diagnostic guidance to clinicians and capturing the individual variation that is relevant to treatment. “People say that in autism, everybody is a snowflake,” she said. “It’s the perfect analogy.”

The proposed elimination of autism subtypes comes at the very moment when research suggests that the disorder may have scores of varieties. Investigators have already identified more than a dozen gene patterns associated with autism, but Dr. Lord, of Michigan, said the genetic markers “don’t seem to map at all into what people currently call Asperger’s or P.D.D.”

Nor have many of these genes been linked to distinct sets of symptoms. Until research can identify reliable biological markers for autism subtypes, Dr. Lord and other experts say, it is better to have no subtypes than the wrong ones.

n interviews, people with Asperger’s and mild autism were divided on the prospect of losing the label. Temple Grandin, a Colorado State University animal scientist who is perhaps the best-known autistic American, said Asperger’s was too well established to be thrown overboard. “The Asperger community is a big vocal community,” Dr. Grandin said, “a reason in itself” to leave the diagnosis in place.

“P.D.D.-N.O.S., I’d throw in the garbage can,” she added. “But I’d keep Asperger’s.”

But some younger people involved in the growing autism self-advocacy movement see things differently.

“My identity is attached to being on the autism spectrum, not some superior Asperger’s identity,” said Ari Ne’eman, 21, an activist who founded the Autistic Self-Advocacy Network, a 15-chapter organization he has built while in college, adding, “I think the consolidation to one category of autism spectrum diagnosis will lead to better services.”

All interested parties will have an opportunity to weigh in on the proposed changes. The American Psychiatric Association is expected to post the working group’s final proposal on autism diagnostic criteria on the diagnostic manual’s Web site in January and invite comment from the public. Dr. Swedo and company are bracing for an earful.

The Asperger's diagnosis

2009-11-07T20:38:00.000-08:00

An article in today's New York Times - A Powerful Identity, a Vanishing Diagnosis - reports that the "Asperger's Syndrome" diagnosis may be eliminated from the 2012 diagnostic manual (D.S.M.-V). In its place, would be a single broad diagnosis of "autism spectrum disorder."

According to the article, the American Psychiatric Association is expected to post the working group's final proposal on the diagnostic manual's web site in January and invite comment from the public. That will be a fascinating comment thread to follow. I have not yet met an individual with Asperger's Syndrome who was reluctant to express his or her strongly felt views on a topic.

I first heard the word "Asperger's" from a speech and language teacher when our son was in first grade, in the fall of 1996. She had only recently learned about the Syndrome and thought it might fit - I ran a computer search that night, and she was right. The label didn't lead us to a miracle cure - and we weren't looking for one. It did help connect us with a virtual community of parents of kids with Aspergers and adults with Aspergers so we could start learning what others were doing to help support and compensate for the confusing range of qualities and behaviors that often appear as part of Asperger's Syndrome.

Interestingly, we first suspected that our son might have autism much earlier, and our pediatrician (who thought we were being neurotic first time parents) referred us to a respected developmental psychologist when our son was three. The psychologist tested our son and reported that he could not be autistic because he was "not retarded." Thankfully, the understanding of autism spectrum disorders has advanced significantly since then.

Soon after we discovered the Asperger's Syndrome label a child psychologist explained that, in her view, Asperger's Syndrome describes a cluster of seemingly unrelated skills and deficits that come together for some individuals on the autism spectrum - and, make no mistake, wherever you happen to fit on the autism spectrum, "life is going to be hard." It sounds like the D.S.M-V may be headed in this direction.

Our son attended a high school for kids with high functioning autism, Asperger's Syndrome and non-verbal learning disabilities. There were about 50 students and it was a good laboratory within which to test the saying that - "If you have seen one person with Asperger's . . . you have seen one person with Asperger's." These kids were all unique, and they all identified in different ways. But the truth is, almost all of them faced significant challenges that will make life hard - the two hallmarks were social awkwardness and great difficulties with organization (what psychologists refer to as executory planning). The great joy of the school, was that many of the students also presented unique and fascinating strengths and refreshing honesty.

I am watching these former high school students enter young adulthood now. And, much as I wish it was not true, I think life on the spectrum is hard. But hard does not mean bad - just hard. One of my co-workers shared a story the other day about an accomplishment. She hiked to the bottom of the Grand Canyon in early September. The next morning, as she stood in 97 degree heat in the shade she looked 7,000 feet up at the rim and saw two tiny trees at the top. And she wondered whether she could ever make it to the top. Of course, she did, one step at a time. That image works for me. It is a hard climb, but a beautiful climb, and we are taking it one day at a time.

I am going to be very interested to read and hear what the Asperger's and autism communities have to say about the proposed diagnostic changes. I've always thought that the label doesn't matter - what does matter is understanding the full range of support that might help each individual capitalize on his or her strengths and address his or her challenges. However, I think I may have been wrong. We do, after all, live in a "neurotypical" world and labels, as it turns out, can matter a lot in dealing with the social services maze.

Autism Study Putting Prevalence at 1 in 91 American Children, Including 1 in 58 Boys

2009-10-07T01:47:00.000-07:00

Autism Speaks Responds to New Pediatrics Autism Study Putting Prevalence at 1 in 91 American Children, Including 1 in 58 Boys
New Findings Reinforce the Urgency of Autism as a Major Public Health Crisis, Requiring Intensified Action from the Public and Private Sectors

NEW YORK, N.Y. (October 5, 2009) – Autism Speaks, the nation's largest autism science and advocacy organization, today responded to a new study published in the American Academy of Pediatrics' journal Pediatrics that found a parent-reported autism prevalence rate of one in every 91 American children, including one in 58 boys. The most recent ASD prevalence estimate reported by the Centers for Disease Control (CDC) in 2007 was approximately one in 150 (including one in 94 boys), making autism the most prevalent childhood developmental disorder. Autism Speaks said the new findings reinforced the fact that autism is an urgent and growing public health crisis that affects most individuals across their lifespan and demands a commensurate level of action from both the public and private sectors.

“There is converging evidence that autism spectrum disorders affect about one percent of the population,” said Geraldine Dawson, Ph.D., Autism Speaks Chief Science Officer. “This study further emphasized that autism affects boys at a significantly higher rate. It is imperative that more resources be given to autism research so we can understand the causes and biology of autism and develop more effective treatments.”

“These new numbers should serve as a renewed call to action to take on what is clearly a major public health crisis not only in this country, but around the world,” said Bob Wright, co-founder of Autism Speaks. “People with autism are still not getting the therapies they need and adequate medical care for the medical conditions often associated with this disorder. And our society has yet to come to grips with the fact that this growing population of children with autism will become adults with autism who require a lifetime of services and support. We must act now to address these short and long-term challenges.”

The Prevalence of Parent-Reported Diagnosis of Autism Spectrum Disorder Among Children in the United States, 2007 used data gathered as part of the 2007 National Survey of Children's Health (NSCH), a national survey directed and funded by the Health Resources and Services Administration (HRSA) and Centers for Disease Control and Prevention (CDC). More than 78,000 parents of children aged 3 to 17 years were asked whether their child currently had an Autism Spectrum Disorder diagnosis – including autistic disorder, Pervasive Developmental Disorder – Not Otherwise Specified (PDD-NOS), or Asperger's Syndrome – or whether their child had been given that diagnosis in the past, but was no longer diagnosed with ASD.

PCT apologises for delays over autism diagnosis

2009-09-07T04:36:00.001-07:00

THE dad of an autistic boy has criticised Swindon Primary Care Trust for the time it took to diagnose his three-year-old son.

Iain Counsel was finally told his son was autistic in June – almost two years after he first appealed to Swindon PCT to assess three-year-old Scott for signs of the condition.

Caroline Fowles, chief executive of Swindon PCT, has apologised to the family.

Responding to a letter Mr Counsel sent in January this year, chief executive of Swindon PCT Caroline Fowles apologised for a catalogue of delays between appointments.

In her letter, Ms Fowles said: “I would like to apologise that your experience of the service, both in terms of time delay and then engagement, was not satisfactory and that this added to your anxieties in wanting to achieve the best for Scott.”

Mr Counsel, 37, of Langford Grove, Old Walcot, claimed that delays over the diagnosis has robbed him of two years of vital developmental treatment. He said: “As far as I’m concerned they have robbed my son of his first words.

“With a diagnosis and subsequent treatment I have no doubt we would have seen even small signs in communication from Scott by now. Instead he’s a four-year-old who talks in grunts and screams.”

Mr Counsel started to suspect something was not right with Scott when, at 20 months, he still had not taken his first steps or formed his first word.

“I just noticed he wasn’t developing half as quickly as his peers,” he said. “While other children were saying ‘mamma’ and ‘dadda’, Scott was communicating through noises.”

Mr Counsel waited five months for an appointment with Scott’s paediatrician. The doctor revealed suspicions in her notes that Scott had autism at her first meeting with the family on December 18, 2007, but had not shared them with his concerned parents.

Mr Counsel said: “It is disgusting. As a parent you would sooner have bad news than no news at all and as far as I am concerned it was the doctor’s duty to keep us informed.”

Mr Counsel said he is also furious that Scott’s doctor had discussed his condition with a receptionist, inviting her to make her own comments.

In a paragraph written by Scott’s doctor, she said: “The receptionist reported that Scott was on the go the whole time, with his parent running round after him to try and keep tabs on him.

“He was into everything and explored the room. He came round behind the receptionist’s desk and sat on the floor next to her and as she was talking to him, looked up at her.”

Mr Counsel said he was incensed by the inclusion of the observations in his son’s medical notes. He said: “Is she a doctor? Is she a autism specialist or a child psychologist? No.

“So why the hell are her observations included in my son’s medical history.

In March this year, Scott was given a Sadler Assessment, a process designed to monitor a child for signs of autism. His anxious parents had their suspicions confirmed on June 26 – almost two years after they first flagged up their worries.

Mr Counsel now hopes to meet Ms Fowles to raise wider concerns. He claims that since Scott was diagnosed with autism, the PCT has offered no support or advice regarding potential treatment.

Mr Counsel is now awaiting confirmation for a date to meet Ms Fowles.

Caroline Fowles, chief executive of Swindon Primary Care Trust, said: “The health and well being of our patients is our key focus, and we take all concerns from service users very seriously and conduct thorough investigations.

“In this instance, however, we have apologised to the family that the appropriate care and support for their son and the delay it took to receive an appointment was unacceptable.

“We also recognise there is learning for a number of our professionals involved. We have built this into a forward programme and we are committed to an improvement plan to ensure we learn from this experience.

“We have met with the family on a number of occasions to explore their concerns about their son’s care and the PCT needs to examine these further.

“PCT staff continue to work alongside their other professionals to ensure the right level of support for Scott and this will main our prime focus.”

Autism screening tops Obama’s medical to-do list

2009-09-07T04:30:00.000-07:00

By Nancy Shute U.S. News & World Report

Autism is the only disorder or disease mentioned explicitly in Obama’s 24-point agenda on Whitehouse.gov . Heart disease and cancer don’t get the call. Neither does diabetes, or other chronic diseases.

But there are four hefty bullet points addressing autism. Obama called for:

1. Increased funding for research, treatment, screenings, public awareness and support services for autism spectrum disorders.

2. “Life-long services” for people with autism spectrum disorders, as children and as adults. Many parents struggle to find and pay for screening and treatments for their children, but there is even less coverage and capacity for adults with autism-based impairments.

3. More funding for the 2006 Combating Autism Act, as well as improving state and federal autism programs.

4. Universal screening for all infants for autism disorders, as well as re-screening for all 2-year-olds. This is the biggie; children are currently screened only if parents or pediatricians voice a concern, so too many children aren’t diagnosed until they enter elementary school. The earlier treatment starts, the more effective it is, and a national screening program would help reduce the number of kids falling through the cracks. It would also be a huge undertaking, at a time when both government and privately insured health care is foundering.

That second bullet point would be a huge help for families who are struggling to provide care. In a recent survey, 52 percent of parents of children with autism said their family finances were drained by treatment and care, compared to 13 percent of typical families.

The 2006 Combating Autism act promised almost $1 billion over five years for autism research and development, but Congress hadn’t appropriated $200 million per year, even before the economy hit the skids. The Obama manifesto gives a big fat hint that for autism, at least, the hard times cited in the new president’s inaugural address won’t mean big cuts in funding.

Still, universal screening for autism will be a huge challenge. There’s no blood test that can be used to diagnose autism, as there is for hereditary diseases like galactosemia and sickle cell, which are screened for using a heel stick while a newborn is still in the hospital. With autism, parents and doctors instead need to observe a child and look for delays in language, social interactions, and gross motor skills.

The Centers for Disease Control and Prevention recommends that pediatricians screen children during well-baby visits at 9 months, 18 months, and 24 or 30 months. But many doctors don’t get around to doing those screens, and until very recently the recommended tests weren’t sensitive enough to pick up mild autism spectrum disorders. Early screening for autism is a terrific idea. Making it happen will be a tall order, even for the can-do Obama team.

Disclosing the best kept secret of autism

2009-09-07T04:27:00.000-07:00

What’s the best-kept secret of autism? Well, it may very well be the one that you’re keeping. Whether you’re a parent of a child with ASD, or someone with autism the debate rages on: “Should I tell others about my/my child’s autism, or not?”

From the parent’s perspective – at least upon initial diagnosis – the tendency tends to swing to the “tell” side. In fact, more so than tell, even broadcast to anyone met. This is often the case, as when a parent first receives the diagnostic news there is shock, grief, lack of understanding as to what it might mean for their child, creating a need to outreach to anyone and everyone for support, for answers.

Fast forward a few years, and past the initial shock. While some parents continue to share their family’s news widely, many others begin to pull back, not wanting to generate negative stigma for their child (or themselves). “Sure, my son’s behavior might seem ‘strange’ to others, but it’s none of their business.”

As those children grow into their teen years and adulthood and for those adults diagnosed later in life, there are more difficult decisions. Does disclosure open up the flood of discrimination – whether overt or less seen – among peers? Among fellow employees? To one’s employer?

Some adults are loath to mention anything about their autism in the workplace. “Let them think I’m shy, quirky, not social. But at least I can stick to the job at hand and get it done; who cares about interpersonal interaction.” In some cases, those people taking this stance find that their silence impedes their abilities to get promoted; they find that their self-isolation keep them from any visibility at all to their employers and they’ve become anonymous.

Others opt to disclose to their colleagues or employers and are greeted with a desire to understand and support, making allowances for job responsibilities better suited for their needs. Some even offer to help “practice” social skills or provide mentorship in navigating through the often perplexing NT world. Others, unfortunately, find the invisible stigma once they’ve disclosed follows them throughout their workplace.

There clearly is no one answer, and the success individuals have in any of these options is as varied as the individual.

Inside the autism treatment maze

2009-03-12T03:27:00.000-07:00

No single approach is best for every child

Every child who receives the diagnosis of autism may be different, but the families of those children face the same overwhelming challenge — finding the best treatment for the complex condition.

While there has been significant progress in easing symptoms of autism and educating children diagnosed with the disorder, there is little agreement among doctors, parents and researchers over which type of treatment most effectively helps an affected child grow into an independent adult.

Parents can find themselves confronted with a confusing maze of often expensive strategies and methods, some of them promising miracle cures but backed by little or no medical evidence.

"With autism, the variation in treatments is huge," says Laura Schreibman, an autism researcher and professor of psychology at the University of California at San Diego. "Parents not only have to deal with the emotional impact of the devastating diagnosis, [but] there’s no clear course of where to go. The amount of garbage that's out there and what parents have to sift through is truly astounding."

For many kids, autism treatment involves some combination of intensive behavioral therapy, speech and language therapy and special education in public schools. Anecdotal reports support newer forms of play-based behavioral therapies and alternative methods involving vitamins and dietary restrictions, although many autism experts vigorously disagree over whether these offer benefit.

'The beginning of this journey'
"We do have some important knowledge in treatment of autism, but we’re still very much at the beginning of this journey," says Geraldine Dawson, a professor of psychology at the Center on Human Development and Disability at the University of Washington in Seattle.

Since autism was first recognized in 1943, the search for an effective treatment has been frustrating for those involved. Once promising medical treatments have later been shown in tests to have no benefit. Research supporting newer or alternative treatments is lacking.

The causes of autism are unclear, and the wide range in the type and severity of a patient's disabilities can make it particularly challenging to select a specific therapy.

In 2001, a report from the National Academy of Sciences found that children with autism should receive at least 25 hours a week of intensive training beginning as young as age 2. Early diagnosis, now being given to children as young as 8 months, improves the chances of treatment success, experts say.

"We know that most children, but not all because we can’t guarantee, do well with early intervention," says Dr. Fred Volkmar, a professor of child psychiatry at Yale University and an expert on autism.

But the report stopped short of endorsing any particular treatment beyond education and support for parents, noting that the type of treatment might differ depending on the child.

"There is no one treatment that is going to work for all children or one treatment that is going to do everything for any given child over a long period of time," says Catherine Lord, director of the autism and communication disorders program at the University of Michigan in Ann Arbor and chairwoman of the National Academy of Sciences expert panel.

Many children with autism have additional problems such as gastrointestinal illnesses, sleeping difficulties or anxiety that can complicate treatment, researchers also note.

Click for related information
Guide to treatment options

A treatment program called Applied Behavior Analysis (ABA), which is based upon a rewards system, is widely accepted by parents and doctors largely because it is the most researched and is supported by numerous anecdotal success stories. ABA is considered especially beneficial for children with more severe symptoms.

ABA calls for one-on-one interaction between a teacher and a child for up to 40 hours a week. In the highly structured program toddlers receive positive reinforcement for initially learning simple actions like identifying colors and then gradually working up to more advanced activities that target deficits in learning, language, play-interaction and attention.

Advocates of this behavioral therapy pioneered by Dr. O. Ivaar Lovaas, professor emeritus at the University of California at Los Angeles, point to a study published in 1987 that suggested that with a comprehensive ABA program of 40 hours a week, about half of kids with autism were indistinguishable from other kids at age 7. But even within the field, the research has been questioned.

"No one else has been able to replicate that," says Lord. "That finding was an anomaly."

Study uses music to explore the autistic brain's emotion processing

2009-03-02T14:27:00.000-08:00

Music has a universal ability to tap into our deepest emotions. Unfortunately, for children with autism spectrum disorders (ASD), understanding emotions is a very difficult task. Can music help them? Thanks to funding from the GRAMMY Foundation Grant Program, researchers at UCLA are about to find out.

Individuals with ASD have trouble recognizing emotions, particularly social emotions conveyed through facial expressions — a frown, a smirk or a smile. This inability can rob a child of the chance to communicate and socialize and often leads to social isolation.

In an innovative study led by Istvan Molnar-Szakacs, a researcher at the UCLA Tennenbaum Center for the Biology of Creativity, music will be used as a tool to explore the ability of children with ASD to identify emotions in musical excerpts and facial expressions.

"Music has long been known to touch autistic children," Molnar-Szakacs said. "Studies from the early days of autism research have already shown us that music provokes engagement and interest in kids with ASD. More recently, such things as musical memory and pitch abilities in children with ASD have been found to be as good as or better than in typically developing children."

In addition, he said, researchers have shown that because many children with ASD are naturally interested in music, they respond well to music-based therapy.

But no one has ever done a study to see if children with ASD process musical emotions and social emotions in the same way that typically developing children do.

In this study, Molnar-Szakacs will use "emotional music" to examine the brain regions involved in emotion processing.

"Our hypothesis is that if we are able to engage the brain region involved in emotion processing using emotional music, this will open the doorway for teaching children with ASD to better recognize emotions in social stimuli, such as facial expressions."

The overarching goal of the study, of course, is to gain insights about the causes of autism. Molnar-Szakacs will use neuroimaging — functional magnetic resonance imaging, or fMRI — to look at and compare brain activity in ASD children with brain activity in typically developing kids while both groups are engaged in identifying emotions from faces and musical excerpts.

"The study should help us to better understand how the brain processes emotion in children with autism; that, in turn, will help us develop more optimal interventions," Molnar-Szakacs said. "Importantly, this study will also help us promote the use of music as a powerful tool for studying brain functions, from cognition to creativity."

Approximately 15 children with ASD, ranging in age from 10 to 13, will participate in the study, which is being conducted under the auspices of the Help Group–UCLA Autism Research Alliance. The alliance, directed by UCLA's Elizabeth Laugeson, is an innovative partnership between the nonprofit Help Group, which serves children with special needs related to autism, and the Semel Institute for Neuroscience and Human Behavior at UCLA, and is dedicated to enhancing and expanding ASD research. The project is also being conducted in collaboration with Katie Overy, co-director of the Institute for Music in Human and Social Development at the University of Edinburgh, Scotland.

"The hope, of course, is that this work will not only be of scientific value and interest, but most of all, that it will translate into real-life improvements in the quality of the children's lives," Molnar-Szakacs said.

USC researchers identify gene variant associated with both autism and gastrointestinal dysfunction

2009-03-02T00:07:00.000-08:00

Altered expression of MET gene may contribute to increased risk of co-occurring medical conditions

A study led by researchers at the University of Southern California (USC) and Vanderbilt University have identified a specific gene variant that links increased genetic risk for autism with gastrointestinal (GI) conditions.

The findings suggest that disrupted signaling of the MET gene may contribute to a syndrome that includes autism and co-occurring gastrointestinal dysfunction, says principal investigator Pat Levitt, Ph.D., director of the Zilkha Neurogenetic Institute at the Keck School of Medicine of USC and chair-designate of the Department of cell and neurobiology.

The study will appear in the March Issue of the journal Pediatrics and is now available online.

Autism is a developmental disorder characterized by deficits in communication abilities, social behavior disruption and inflexible behavior. While gastrointestinal conditions are common among individuals with autism, researchers have long debated whether co-occurring GI dysfunction represents a unique autism subgroup, Levitt and lead author Daniel Campbell, Ph.D., say.

"Gastrointestinal disorders don't cause autism. Autism is a disorder of brain development," Levitt says. "However, our study is the first to bring together genetic risk for autism and co-occurring GI disorders in a way that provides a biologically plausible explanation for why they are seen together so often."

In the brain, the MET gene is expressed in developing circuits that are involved in social behavior and communication. Disturbances in MET expression result in alterations in how these critical circuits develop and mature, Levitt explains. Research indicates that MET also plays an important role in development and repair of the GI system.

Researchers analyzed medical history records from 214 families in the Autism Genetic Resource Exchange (AGRE). They found that a variant in the MET gene was associated with autism specifically in those families where an individual had co-occurring autism and a GI condition.

The study brings researchers closer to understanding the complex genetic risks for autism. However, further research is needed, as different combinations of genes are likely to result in different types of autism features, Levitt says.

"We believe that there are other genes that will help identify different subgroups of individuals who have autism spectrum disorder," he says. "We also believe that there needs to be research looking at whether the children with co-occurring GI dysfunction and autism have unique features that will help us predict what treatments will be best for them."

Friendship House Autism Center plans announced

2009-02-27T12:25:00.000-08:00

Muted lighting, soft colors and quiet plumbing — what sounds like interior options for a spa actually will be a carefully calibrated environment for autistic children.

“A lot of children with autism have issues with hypersensitivity, whether it’s a light flicker or the swish of a flushed toilet,” said architect Brian Doran, who conducted research and consulted behavior therapists for a modern vision in designing Friendship House’s $1.4 million Northeast Regional Autism Center expansion.

Friendship House officials on Thursday announced the 14,000-square-foot project, expected to begin in March, with a display of architectural renderings and a short tour of the proposed site, a former warehouse at Friendship House’s Maple Street offices.

Mr. Doran, with the Scran�ton design firm Hemmler & Camayd, also is the father of a mildly autistic child.

“We’re trying to create the right environment for therapists to execute their work,” he said.

Friendship House’s existing autistic program treats 60 children 2 to 21 years old at a building two blocks away on Derby Avenue. The expansion will move the program to Maple Street after the project’s expected completion in October.

According to the National Institute of Neurological Disorders and Stroke, autism is a condition in a group of developmental disorders characterized by impaired social interaction, verbal and nonverbal communication problems and limited activities or interests. It is estimated three to six children of every 1,000 will have autism, and boys are four times more likely to have autism than girls, the institute said.

Computer Game Helps Autistic Children Recognize Emotions

2009-02-22T13:51:00.000-08:00

An interactive computer software program called FaceSay™ has been shown to improve the ability of children with autism spectrum disorders (ASD) to recognize faces, facial expressions and emotions, according to the results of a study conducted by psychologists at the University of Alabama at Birmingham (UAB). FaceSay™, created by Symbionica L.L.C., features interactive games that let children with ASD practice recognizing the facial expressions of an avatar, or software “puppet.” Specifically, the computer games teach the children where to look for facial cues such as an eye gaze or a facial expression.

The study found that the children with Asperger Syndrome who used the FaceSay™ program made significant improvements in their ability to read facial expressions. The children with autism made less improvement. Children in both the autism and Asperger groups, however, both improved their ability to recognize emotions.

Specifically, the children with autism who used FaceSay™ averaged a mean score of 14.8 on a facial recognition test. The control group averaged 12.8. The children with Asperger Syndrome scored much higher with an average score of 18.4 compared to 15.4 by the control group.

On an emotion recognition skills test, the children with autism who used FaceSay™ scored an average of 6.53. The control group’s average score was 5.2. The children with Asperger Syndrome had a mean test score of 8.7 compared with the control group score of 6.79. UAB doctoral student Maria Hopkins, Ph.D., and UAB associate professor of psychology Fred Biasini, Ph.D., conducted the study.

Autism spectrum disorder includes a range of developmental disorders such as autism, Asperger Syndrome and other pervasive developmental disorders. Children with ASD often avoid eye contact with others, which prevents them from perceiving and understanding the emotions of others. Many have problems remembering faces.

Hopkins and Biasini tested 25 children with autism and 24 children with Asperger Syndrome. The children ranged in age from 6 to 15, with an average age of 10 years. The group consisted of 44 boys and five girls. The computer training sessions were held twice a week for at least six weeks for an average of 20 minutes each session. The software featured three interactive games.

Psychologists at UAB plan to conduct more studies to assess the longtime effects of the FaceSay™ intervention.

The study’s results were presented recently at a meeting of the Association for Psychological Science.

Toward A Long-sought Saliva Test For Autism

2009-02-22T13:50:00.000-08:00

Researchers in Italy are reporting discovery of abnormal proteins in the saliva of autism patients that could eventually provide a clue for the molecular basis of this severe developmental disorder and could be used as a biomarker for a subgroup of patients with autism spectrum disorders (ASD).

Autism involves social withdrawal, impaired emotional responses and communication skills, and other symptoms. With no laboratory test available, scientists are searching for biomarkers such as abnormal proteins that appear in the body fluids of individuals with autism that may provide a way to accurately diagnose autism and track its response to potential treatments.

Massimo Castagnola, Irene Messana, Maria Giulia Torrioli and Fiorella Gurrieri, compared proteins in the saliva of 27 children with ASD to those in a control group without ASD. They discovered that at least one of four proteins in 19 children in the ASD group had significantly lower levels of phosphorylation. That key body process activates proteins so that they can work normally.

The results suggest that these abnormal proteins might be the clue for anomalies in the phosphorylation of proteins involved in development of central nervous system in early infancy that are involved in ASD.

Surprising Language Abilities In Children With Autism

2009-02-22T13:46:00.000-08:00

What began as an informal presentation by a clinical linguist to a group of philosophers, has led to some surprising discoveries about the communicative language abilities of people with autism.

Several years back, Robert Stainton, now a philosophy professor at The University of Western Ontario, attended a presentation by his long-time friend Jessica de Villiers, a clinical linguist now at the University of British Columbia. The topic was Autism Spectrum Disorder (ASD). De Villiers explained that many individuals with ASD have significant difficulties with what linguists call "pragmatics." That is, people with ASD often have difficulty using language appropriately in social situations. They do not make appropriate use of context or knowledge of what it would be "reasonable to say." Most glaringly, many speakers with ASD have immense trouble understanding metaphor, irony, sarcasm, and what might be intimated or presumed, but not stated.

Drawing on his philosophical training, however, Stainton noticed less-than-obvious pragmatic abilities at work in de Villiers' examples, which were drawn from transcripts of conversations with 42 speakers with ASD -- abilities that had been missed by clinicians.

Thus began research to more clearly understand and define the conversational abilities and challenges of people with Autism Spectrum Disorder (ASD). Stainton and de Villiers' research, in collaboration with Peter Szatmari, a clinical psychiatrist at McMaster University, has shown that indeed, many individuals with ASD do have "a rich array of pragmatic abilities."

These researchers do not contest the well-established claim that people with ASD have difficulty with non-literal pragmatics, such as metaphors ("Juliet is the sun") or irony/sarcasm ("Boy, is that a good idea"). They have, however, found that many speakers with ASD do not show the same difficulty with literal pragmatics. An example is the phrase, "I took the subway north" from a transcript of a conversation with a research participant with ASD. The use of the word "the" could indicate there is only one subway in existence going north. "The subway" could also be referring to a subway car, a subway system or a subway tunnel. Taking account of the context and the listener's expectations, however, the individual using the phrase was able to convey the specific meaning he intended. That is, he used pragmatics effectively.

In short, Stainton and his colleagues produced surprising evidence to show that speakers with ASD use and understand pragmatics in cases of literal talk, as in the subway example.

Stainton, who is also Acting Associate Dean of Research in the Faculty of Arts and Humanities at Western, says, "It is especially gratifying and encouraging, because this is an Arts and Humanities contribution to clinical research. Without a philosophical perspective, this discovery might not have been made."

Related research allowed de Villiers and Szatmari to develop a rating scale of pragmatic abilities that can be used in the clinical assessment of people with ASD. Stainton says, "In the short term, their new tool will help identify where an individual fits on that spectrum. In the longer term, however, by making use of recent results in philosophy of language, it may contribute to our theoretical understanding of the boundary between knowledge of the meanings of words, and non-linguistic abilities -- specifically pragmatics."

Stainton believes that both clinicians who work with people with ASD, and language theorists who are interested in pragmatics for philosophical reasons, will find these results striking.

ASD affects approximately one in 165 people. The results of the research, conducted from a study of 42 children with autism and Asperger's Syndrome, has been published in the journal, Midwest Studies in Philosophy.

Many Florida teachers may be ill-equipped to handle special-needs students

2009-02-21T17:15:00.000-08:00

By CARA FITZPATRICK

Palm Beach Post Staff Writer

Saturday, February 07, 2009

These were the tools kindergarten teacher Wendy Portillo had to handle an unruly student: 10 tokens to be taken away if he misbehaved, the occasional help of a volunteer and another teacher, and a trip to the principal's office.

The choice she made in May - have students vote on whether then 5-year-old Alex Barton should remain in class at Morningside Elementary in Port St. Lucie - has been debated and reviled.

That Alex was being evaluated, and later was diagnosed with Asperger's syndrome, a form of autism, has only fueled the controversy.

But the incident may point to more than the judgment of one teacher. Parents, educators and disability advocates say it highlights an often overlooked problem with inclusion, the national trend toward placing special needs students in regular classrooms: Many general education teachers receive little to no training in how to manage students with disabilities before they walk into class.

"It's important to recognize that many of our teachers are going to have no training as teachers," said Jack Scott, director of Florida Atlantic University's Center for Autism and Related Disabilities.

Florida has addressed its teacher shortage in recent years by making it easier to join the profession. Teaching certificates can be earned without a degree in education and, with fast-track programs, certificates can be earned within months. That has helped to ease the shortage, but Scott said it also has resulted in uneven levels of training among teachers.

Even teachers who earned degrees in education may have taken just one or two classes in special education, making them aware of their legal responsibilities but unsure of how to manage a class in which one child may not respond the way other children do.

"The trend toward inclusion really has caused some difficulties for teachers because you have to treat (special needs students) differently," said Karen Lyman, a teacher-coach in St. Lucie County schools. "You have to learn how to teach that child without affecting the rest of the children."

'Old school' methods futile

Elementary school teachers may have a difficult time, too, because many younger children, such as Alex Barton, come to school without a diagnosis. The result can be months of limbo for both teacher and child before an appropriate placement is determined.

Melissa Barton, who removed her son from Morningside after the vote, said training seems to occur after a child is placed in a class rather than before.

"They give the child to the teacher and then they see if there are problems," she said.

Few have defended the choice Portillo made the day she asked her students to vote on whether Alex should remain in class, but many say her actions may point to a teacher who needed not only more training but also additional support.

Alex had struggled with behavior since his arrival at Morningside. Portillo said she sent him to the principal's office at least once a week.

On the day of the vote, he flicked crayons and crawled under a table, lifting it with his legs until his classmates' work scattered to the floor, according to the school district's investigation.

Portillo's options, as provided by a school support team, were to take away Alex's tokens, to send him to the classroom of a designated teacher or to send him to the principal's office.

Portillo doesn't remember if she took away the tokens that day. The designated teacher was off campus, as was the volunteer. She sent Alex to the principal's office only to have him returned to her. All before lunchtime.

"I'm not defending her choice of things to do, and I think Wendy's been clear that she regrets it, but nobody knows what being in that class with that constant behavior day after day was like," said Vicki Rodriguez, vice president of the St. Lucie teachers union.

Lyman said teachers often need to be trained to react differently to inappropriate behavior, and the worst reaction, though perhaps natural, is to become angry or frustrated with the child.

"Our automatic reaction is, 'Why are you doing that? Stop doing that' and that's not working," she said. But the attention to the bad behavior actually reinforces it.

Scott said many teachers rely on "old school" punitive methods of discipline, most of which don't work with special needs students, particularly those with autism who may miss social cues.

"You can't punish these kids into behaving well," he said.

Inclusion often is not the cheapest approach to teaching special needs children, Scott said, and with less and less money going to public schools in Florida, it can be difficult to provide the assistance they need.

"A lot of kids really need more and better teaching and that's often hard to pull off," he said.

Mother calls for training

In St. Lucie, the school district's philosophy is one of positive discipline rather than negative, said Deborah Iseman, executive director of professional development.

Both the union and the school district receive frequent requests from teachers for additional training in classroom management, school officials said. One class the union offers, Managing Anti-Social Behavior, always has a waiting list, Rodriguez said.

Eric Graff, who occasionally had Alex in his class at Morningside, said he believes school and state officials may finally be recognizing the need for more teacher training.

"I think the more education we get, the better it is for us," he said. "I don't have a problem saying I don't have all the answers for each child."

With little training or improper placement, both teacher and child may be at risk.

A kindergartner detached the retina of a teacher at Garden City Elementary in Fort Pierce last year, according to police reports. And the year before, a classroom aide at Garden City was fired after she allegedly fractured the arm of an 8-year-old disabled child by improperly restraining him.

Barton, who is searching for a new school for Alex, said such incidents point to a need for greater understanding about disabilities and better use of resources.

She said many teachers she speaks to want additional training, but have little time or opportunity.

"They make it impossible for teachers and impossible for students," she said.

Soaring autism rates in California not an artifact

2009-01-14T12:56:00.000-08:00

NEW YORK (Reuters Health) – The increasing number of autism cases seen in California since the 1990s is in large part real, not simply the result of changes in diagnostic criteria or in how autism cases are counted, new research suggests.

This study is the first to assess whether the autism trends in California might be explained by changes in age at diagnosis or by inclusion of milder cases, Dr. Irva Hertz-Picciotto and Dr. Lora Delwiche, from the University of California, Davis, note.

Using data from the California Department of Development Services, the researchers found that autism rates among children aged 5 years or younger rose steadily from 0.8 per 10,000 children born in California in 1990 to 11.2 per 10,000 children born in 2006.

The cumulative incidence per 10,000 births climbed from 6.2 in 1990 to 42.5 in 2001.

The proportion of cases that were diagnosed by 5 years of age rose only slightly from 54 percent to 61 percent for 1990 to 1996 births, according to a report in the January issue of Epidemiology.

A change in the age at diagnosis could explain 12 percent of the increase in autism rates, while inclusion of milder cases could explain 56 percent.

"With evidence of a leveling off, the possibility of a true increase in (autism) incidence deserves serious consideration," the investigators emphasize.

"It's time to start looking for the environmental culprits responsible for the remarkable increase in the rate of autism in California," Hertz-Picciotto added in a statement.

SOURCE: Epidemiology, January 2009.

New Study: Autism Linked to Environment

2009-01-14T03:27:00.000-08:00

By Marla Cone

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.

Hertz-Picciotto and Lora Delwiche of the UC Davis Department of Public Health Sciences analyzed 17 years of state data that tracks developmental disabilities, and used birth records and Census Bureau data to calculate the rate of autism and age of diagnosis.

The results: Migration to the state had no effect. And changes in how and when doctors diagnose the disorder and when state officials report it can explain less than half of the increase.

Dr. Bernard Weiss, a professor of environmental medicine and pediatrics at the University of Rochester Medical Center who was not involved in the new research, said the autism rate reported in the study "seems astonishing." He agreed that environmental causes should be getting more attention.

The California researchers concluded that doctors are diagnosing autism at a younger age because of increased awareness. But that change is responsible for only about a 24 percent increase in children reported to be autistic by the age

"A shift toward younger age at diagnosis was clear but not huge," the report says.

Also, a shift in doctors diagnosing milder cases explains another 56 percent increase. And changes in state reporting of the disorder could account for around a 120 percent increase.

Combined, Hertz-Picciotto said those factors "don't get us close" to the 600 to 700 percent increase in diagnosed cases.

That means the rest is unexplained and likely caused by something that pregnant women or infants are exposed to, or a combination of genetic and environmental factors.

"There's genetics and there's environment. And genetics don't change in such short periods of time," Hertz-Picciotto, a researcher at UC Davis' M.I.N.D. Institute, a leading autism research facility, said in an interview Thursday.

Many researchers have theorized that a pregnant woman's exposure to chemical pollutants, particularly metals and pesticides, could be altering a developing baby's brain structure, triggering autism.

Many parent groups believe that childhood vaccines are responsible because they contained thimerosal, a mercury compound used as a preservative. But thimerosal was removed from most vaccines in 1999, and autism rates are still rising.

Dozens of chemicals in the environment are neurodevelopmental toxins, which means they alter how the brain grows. Mercury, polychlorinated biphenyls, lead, brominated flame retardants and pesticides are examples.

While exposure to some--such as PCBs--has declined in recent decades, others--including flame retardants used in furniture and electronics, and pyrethroid insecticides--have increased.

Mothers of autistic children were twice as likely to use pet flea shampoos, which contain organophosphates or pyrethroids, according to one study that has not yet been published. Another new study has found a link between autism and phthalates, which are compounds used in vinyl and cosmetics. Other household products such as antibacterial soaps also could have ingredients that harm the brain by changing immune systems, Hertz-Picciotto said.

In addition, fetuses and infants might be exposed to a fairly new infectious microbe, such as a virus or bacterium, that could be altering the immune system or brain structure. In the 1970s, autism rates increased due to the rubella virus.

The culprits, Hertz-Picciotto said, could be "in the microbial world and in the chemical world."

"I don't think there's going to be one smoking gun in this autism problem," she said. "It's such a big world out there and we know so little at this point."

But she added, scientists expect to develop "quite a few leads in a year or so."

The UC Davis researchers have been studying autistic children's exposure to flame retardants and pesticides to see if there is a connection. The results have not yet been published.

"If we're going to stop the rise in autism in California, we need to keep these studies going and expand them to the extent possible," Hertz-Picciotto said.

Funding for studying genetic causes of autism is 10 to 20 times higher than funding for environmental causes, she said. "It's very off-balance," she said.

Weiss agreed, saying that "excessive emphasis has been placed on genetics as a cause. "The advances in molecular genetics have tended to obscure the principle that genes are always acting in and on a particular environment. This article, I think, will restore some balance to our thinking," he said.

Research links soaring incidence of the mysterious neurological disorder to fetal and infant exposure to pesticides, viruses, household chemicals

Some issues related to whether the increase is merely a reporting artifact remain unresolved. There could be other, unknown issues involving diagnosis and reporting, scientists say.

The surge in autism is similar to the rise in childhood asthma, which has reached epidemic proportions for unexplained reasons. Medical officials originally thought that, too, might be due to increased reporting of the disease, but now they acknowledge that many more children are asthmatic than in the past. Experts suspect that environmental pollutants or immune changes could be responsible.

Autism has serious effects, not just on an individual child's health but on education, health care and the economy "Autism incidence in California shows no sign yet of plateauing," Hertz-Picciotto and Delwiche said in their study.

Testosterone linked to autism

2009-01-14T00:27:00.000-08:00

“A prenatal screening test for autism comes closer today,” says The Guardian. It reports that scientists have found links between high testosterone levels in the womb and autistic traits in children. It says this could lead to tests that can identify autistic children before birth.

The findings are based on a scientific study of 235 children aged between eight and 10, whose mothers had amniocentesis, a test analysing fluid taken from around a foetus. None of these children were autistic, but those exposed to higher testosterone levels showed higher levels of “autistic traits”, such as poor verbal and social skills.

While this research gives us further insight into the biology behind autistic-like traits, it is important to remember that none of the children in this study were autistic. The researchers must now confirm that their findings apply to children with the condition. Should this prove to be the case, the ethical issues surrounding prenatal screening for risk of autism would need to be debated before any testing could be introduced.

Where did the story come from? This research was conducted by Dr Bonnie Auyeung and colleagues from University of Cambridge, two Cambridge hospitals, and a university in the US. It was funded by the Nancy Lurie-Marks Family Foundation and the Medical Research Council. The study was published in the peer-reviewed British Journal of Psychology.

What kind of scientific study was this?

This was a cohort study looking at the relationship between levels of the male hormone testosterone in the womb and levels of autistic traits in children.

Studies have suggested that exposure to testosterone in the womb may affect some aspects of cognition and behaviour that differ between males and females. Autism is more common among males, and some people have suggested that the condition is an extreme form of typical male traits.

The researchers identified records from 950 women who had routine amniocentesis in the Cambridge region between 1996 and 2001. The children from these pregnancies would have been aged six to 10 years old at the time of the study.

The researchers excluded certain types of pregnancy from the study. These included pregnancies in which a chromosomal abnormality was identified, pregnancies that ended in termination or miscarriage, pregnancies where there were significant medical problems after birth, or the mother was carrying twins. Cases were also excluded where there was incomplete information, or if medical practitioners felt that contacting the family would be inappropriate.

The remaining 452 women were sent two standard questionnaires, which assessed their children’s levels of autistic traits. These were the Childhood Autism Spectrum Quotient (AQ-Child) and the Childhood Autistic Spectrum Test (CAST).

Of the 452 women contacted, 235 completed and returned both questionnaires and were included in this study. The researchers measured IQ using a standard test in a subgroup of 74 children whose mothers agreed to bring them in for cognitive testing.

The researchers then looked at the levels of testosterone found in the amniotic fluid taken during amniocentesis. The researchers used statistical tests to assess whether there was any relationship between testosterone levels in the womb, and the children’s IQ and levels of autistic traits.

The researchers also looked at girls and boys separately to see if gender had any effect. The researchers also took into account various factors that might affect their results, such as the mother's age, duration of the pregnancies when the amniocentesis was carried out (usually between 14 and 22 weeks), parental education, having an older sibling, and the child's age at the time of the questionnaire.

What were the results of the study? The researchers found that, as expected, the amniotic fluid in pregnancies carrying males had higher testosterone levels than in pregnancies carrying girls. At age six to 10 boys, showed higher levels of autistic traits than girls.

Children whose amniotic fluid contained higher levels of testosterone had stronger autistic traits, as indicated by higher scores on the CAST and AQ-Child questionnaires. The researchers found similar results if they looked at boys and girls separately on the AQ-Child measure, but on the CAST measure, foetal testosterone levels were only associated with levels of autistic traits in boys, not girls.

There was no relationship between IQ and testosterone levels or level of autistic traits in the subset of children who were tested for IQ.

What interpretations did the researchers draw from these results? The researchers concluded that their findings fit with the theory that exposure to testosterone in the womb is related to higher levels of autistic traits.

They add that they need to repeat their study in a much larger sample to see if these findings extend to children with autism.

What does the NHS Knowledge Service make of this study? This study indicates an association between higher levels of testosterone in the womb and levels of autistic traits at age six to 10 years.

There are a number of points to consider:

* As the authors acknowledge, the association between testosterone levels and autistic traits does not necessarily mean that high levels of testosterone in the womb directly “cause” an increase in autistic traits. Other factors could have an effect. For example, genetic variations might affect both the levels of testosterone in the womb and levels of autistic traits.
* The samples of amniotic fluid tested were taken at different points in pregnancies, and at different times of day. As testosterone levels are likely to fluctuate over time, it is unclear whether one measurement of testosterone is representative of the foetus’ overall exposure to testosterone.
* Women who undergo routine amniocentesis are often older than the general childbearing population. The average age of women in this study was 35 years old. Although the researchers took maternal age into account, these results may not be representative of younger pregnant women.
* None of the children in this study had autism, therefore the authors note that “caution needs to be taken when extrapolating these results to individuals with a formal diagnosis of [autistic spectrum conditions]”. They report that they are currently working on obtaining a larger sample so that they can determine whether their results apply to children with autistic spectrum conditions.
* The current sample of 235 children was still relatively small. When considering that there was only a 52% response rate among those who were sent the questionnaires, the children may not be representative of the whole group. For example, some parents who had concerns about their child’s development may have felt less inclined to answer a questionnaire about it than those who were happy with their child’s level of development.

Although many newspapers describe the potential for a prenatal test for autism, the authors did not aim to develop such a test. Instead, their aim was to further understand how testosterone may affect development of autistic traits.

Even if such a test were possible, it is important to note that this would be a screening test and not a definitive diagnostic test, i.e. it would identify foetuses more or less likely to develop autism rather than identify those who would definitely go on to develop autism.

Screening tests are rarely 100% accurate, and the many ethical issues surrounding prenatal screening for risk of autism would need to be debated before any test could be offered. Also, there are currently no ways to prevent a child from developing autism. Therefore, it is unclear whether identifying children at greater risk of autism would benefit the child or the parents.

Minneapolis and the Somali Autism Riddle

2008-11-14T16:10:00.000-08:00

Tomorrow, a few hundred very concerned citizens of Minnesota will gather to discuss a baffling and heartbreaking riddle: Why is the reported rate of autism among children of Somali refugees so alarmingly high (now an estimated 1-in-28 schoolchildren)?

When I first heard about this phenomenon, which Somalis call the "Minnesota Disease," my reporter's instinct told me it could be a very big story; that a key piece of the puzzle that is autism might well lie within the bloodstreams of these poor children of the Twin Cities - whose families had already suffered through so much.

If it can be demonstrated that US-born children of Somali refugees are more prone to autism than the other kids of Minneapolis - or Somalia - then it shouldn't take too long to discover what it is about them (their genes) that clashed so terribly with the way they were conceived and raised (their environment).

It won't explain every case of autism, of course, but it might open new doors of understanding and knowledge that can be applied to combating autism worldwide.

The daylong conference on Saturday is a tribute to progressive public health and a responsive local government (plans include Somali translators, Somali food, breaks to allow time for Islamic prayer, and child care). The meeting is sponsored by a variety of Somali, autism and other community groups, as well as several State and City agencies, including the Minnesota Departments of Health,

"The Somali community expressed a need for information on autism, and our duty is to respond to that, to provide as much information as possible, and in a culturally context," said state health department spokesman Doug Schultz. "The concern in the community is real, and if they have the perception that there is a high rate, then we need to talk about that."

But is there really a "high rate?" A written survey I conducted with some 25 refugee parents of autistic children certainly revealed their strong belief that there is - and nearly all of them blame the vaccine program of their adoptive country.

In August, the online newspaper MinnPost first reported that 12 percent of kindergarten and pre-school children with autism in Minneapolis speak Somali at home, and more than 17 percent of the kids in the early childhood autism program are Somali speaking.

The Minneapolis Star tribune published other staggering figures: Among Somali students in the district, 3.6 percent had autism - a rate of 360-per-10,000, (or 1 in 28). The paper said this was about twice as high as the already burgeoning district average of some 180-per-100,000 kids (or 1 in 56), and more than five times the national rate of 66-per-10,000 (1 in 150).

Virtually all of the children of Somali refugees were born in the United States, and they appear to be among the most severely affected children with autism in the district: Last year, one-in-four children in the preschool class for the most severe cases was Somali.

Reports of elevated autism rates among children of immigrants is nothing new. A small study this year showed that Swedish-born children of Somali immigrants to that country were far more likely to have autism than the general population, (Somalis there call autism the "Swedish Disease"), and another small study in 1995 found an autism rate of 15% among children in one Swedish town born to mothers from Uganda - 200 times more than the national average.

Higher than normal autism rates among children of immigrants have also been reported in Ireland, the UK and several cities in North America, especially Montreal.

Meanwhile, none of the refugees that I surveyed had ever heard of autism back in Somalia, where there isn't even a name for the disorder. In fact, no one had ever seen nor heard of a single child who displayed any of the common symptoms of autism -- though a few did report knowing kids with speech delay that eventually resolved itself.

Not everyone is convinced that there is a problem, however.

"These reports are interesting and need further review, but you don't just take something off the news as facts," cautioned Judy Punyko, an epidemiologist for the state department of health. "We need to obtain the actual data and analyze it, so I am not sure there is much of a story here at this point."

Punyko has assembled a team of experts to determine if the Somali autism rates are in fact higher than average in Minneapolis, and she was expected to release at least preliminary results at Saturday's meeting.

But on November 12, Dr. Punyko sent me an email saying she is not able to present any results yet, "only study aim, objectives, and progress to date. I am still in the process of gathering existing data and this is taking a lot more time than I had anticipated," she wrote. "These data are tough to work with."

The delay will not be welcome news to any of the Somali parents I spoke with. They know that, without proof that their children are being afflicted more than others, officials will not intervene to investigate.

One mother (who asked not to be identified due to the tremendous stigma of autism among Somalis), first approached state and city officials in April of 2007, beseeching them to look into the apparent problem. It wasn't until local reporters started snooping around, the mother said, that government stepped up to respond.

The parent refugee-activists even secured a teleconference meeting with health staffers in the DC office of Minnesota Senator Norm Coleman. They told the Somalis that, if the prevalence was shown to be higher in their community, they would urge the CDC and other Federal agencies to "look under every rock" to find out why - including environmental factors like mercury, thimerosal and vaccines.

Many Somali parents began to suspect vaccines as a possible cause on their own, and well before they encountered any American media or autism groups who could put the idea in their head.

In fact, one of the most obvious "environmental" differences between Minnesota and Somalia is mass vaccination (another is sunlight, but more on that later).

There are an estimated 15,000-40,000 Somalis living in Minnesota, which has the largest Somali population outside of East Africa. Most fled during or after the 1993 phase of the bloody Civil War in that country. Most spent years in often wretched refugee camps in Kenya and elsewhere, waiting for a chance to emigrate to Europe and North America.

Many got their chance in 2000, when the majority of Somalis arrived in Minneapolis, hoping to finally build a new life in peace and dignity.

Along the way, vaccines became an almost routine part of their life: They were given in the camps, they were given before leaving Africa, and they were given in the first year of arrival in the US (which requires a series of 10 vaccinations for all refugees, including women of child bearing age - many of those vaccines contain thimerosal).

Once they arrived in Minnesota, most refugees were welcomed by a progressive "Blue" state with a good public health infrastructure and a bureaucracy ready and willing to help. Refugees were given about a year or so of free medical and dental care, and special effort was made to ensure full compliance with the childhood vaccine schedule (though many mothers failed to keep well-baby visits, requiring lots of "catch up" vaccinations when they did bring their children in to the pediatrician).

Of the 25 refugee mothers who answered the questionnaire, most were vaccinated in refugee camps, and all but two were fully vaccinated after arriving in the US. About a third reported receiving vaccines while pregnant or shortly before becoming pregnant.

When asked what they thought was causing autism in their community, 22 respondents said that vaccines were at least partly to blame, while two were unsure, and only one said vaccines were uninvolved.

Many parents told me the same story of regression I have heard a thousand times before.

"He met all the normal milestones until he hit 18 months," lamented Abdulkadir Khalif, speaking of his three-year-old son with autism. "He was a beautiful baby, running around, saying a few words, until about the winter of 2006, right when he got his MMR (measles-mumps-rubella) shot. He got sick and we went to the hospital, and he stopped talking immediately around that time."

"Do I know it was the vaccines?" Khalif asks. "All I know is he stopped talking right around the time of those shots."

Neither Khalif nor his wife (who was given a thimerosal-containing flu shot while pregnant, even though the label instructed the doctor to administer the shot during pregnancy, "only when medically necessary"), had ever heard of autism until the day their son was diagnosed.

Khalif says, it is "not possible" that autism could be this common in Somalia. "I've been living with it on a daily basis, with my own child. And I lived in Somalia and Kenya for a long time. If it was this common, we would have had a name for it, and we don't. That tells me it does not exist."

"And these symptoms? I had never seen anything like it before. We have names for mental retardation or Down syndrome. But the mannerisms, the loss of speech, the tantrums and violence and running out of the house that comes with autism - I think we would have noticed those things. But we've never seen them before in Somalia or Kenya."

Hodan Hassan, mother to four children including four-year-old Jenny, who has autism, said she had been "a little lax and lazy" with vaccinating her first two kids, "and the doctors got mad at me." With Jenny, she vowed to get all shots on time (and dutifully got the flu shot while pregnant). But there seemed to be a problem with the record keeping, because Jenny was clearly over-vaccinated (for example, she received five Hepatitis B shots, when only three are required).

Soon after giving birth, Hassan started work at a hospital, where she received several mercury containing vaccines, even while breast feeding Jenny.

Jenny had several terrible, feverish reactions to some of her vaccines, twice requiring visits to the ER, where she was given IV fluids and Tylenol.

On Valentines Day, 2006, Hassan brought Jenny in for her 18-month well baby visit, right on time. "she was saying 'mommy' and 'daddy' and 'juice' and 'go, go let's go!'" Hassan recalls. "She was a very happy and attentive baby. She would look at you when talked to her, she would come when you called.

Then Jenny got five vaccines at once (M-M-R, Prevnar and chicken pox) at the doctor visit. She spiked a fever and returned to the hospital. "She never spoke again," Hassan said. "It was all gone right after those shots. I know the doctors don't believe it. They think we must be crazy. But these are our kids, and we were there when everything happened to them. The doctors were not."

Many of the parents I spoke with said they plan to stand up and speak out at the meeting, where Khalif and Hassan are both scheduled panel members.

"I have gathered information on 149 Somali families in Minneapolis with autistic children, and I plan on asking the experts why it is so much," Hassan said.

But she doesn't expect a ready answer. "I think they will try to cover it up at the meeting, avoid the issue, and say 'It is not what you guys think, you can trust us, this is not what it is,'" she said. "But that is not acceptable. Word of mouth went out and people are panicking, and they don't know who to trust. One American doctor told me he will not vaccinate any of his own kids, but has to vaccinate all the others. You have no idea what kind of message that sends to our community."

Khalif also plans on posing tough questions.

"I am going to make all those education and health officials feel very guilty," he said. "Where did this come from? This is a disease that's been acquired by our kids here. In each and in every case, all the children, with one exception, that have been identified with autism were born in this country. I want them to tell me directly that the vaccines are safe. I want someone to stand up and say that. And then, I want to ask that same person two years down road the same thing, and see what the percentages are like."

Khalif also wants to propose "a rescheduling of the vaccines for our Somali children, because I think there is something in our immune system that cannot handle that number of vaccines at one time. The rate is so high, that something will be found in our genes or systems. Science now has a window to find out the actual cause, and therefore the remedy, for autism."

Some doctors and researchers in Minneapolis that I spoke with were extraordinarily sympathetic toward the Somalis. "Vaccines have to be playing a role," said one very prominent pediatrician and researcher, who is working quietly behind the scenes to change attitudes at the University of Minnesota and elsewhere, and did not want to be named.

"Maybe if we start talking about the individual toxins in vaccines, and not the vaccine program as a whole, others in the medical profession will find it easier to come around," the doctor said.

Another local doctor, who did speak on the record, was willing to speculate on one possible variable that might make Somali kids more prone to autistic regression - with or without vaccines: Vitamin D deficiency.

Dr. Gregory A. Plotnikoff, medical director for the Institute for Health and Healing at Abbott Northwestern Hospital, said a colleague had noticed an "exceedingly high" rate of morning sickness among pregnant Somali women in Minneapolis, often requiring hospitalizations.

The doctor began checking Vitamin D levels and found that, on average, they were far below what is considered to be normal and healthy.

Somalis, he said, may start out with naturally low abilities to produce vitamin D from sunlight, (as is the case with many people with Middle Eastern blood in them). That is compounded by the fact that dark-skinned people require far more sunlight to produce vitamin D than light-skinned people and, when Somalis move to areas of higher latitude, with far less sunlight - their vitamin D stores may be virtually depleted, at least for part of the year.

"Vitamin D is crucial for normal brain development, because there are receptors for it throughout the brain," Plotnikoff said. "Vitamin D also plays a role as an anti-inflammatory agent and, besides cutting down on inflammation, it increases concentrations of glutathione, which better supports the brain's capacity to handle heavy metals and oxidative stress."

Glutathione has been found to be low or depleted in many children with autism. A lack of glutathione would make children more vulnerable to the effects of mercury and other heavy metals.

"Another problem is that Tylenol depletes glutathione, and regretfully, most kids who get a shot also get Tylenol," Plotnikoff said. "It's routinely given without considering that it can increase the risk of heavy metals, like mercury, causing oxidative injury in the brain."

"Glutathione has antioxidant properties, and it also chelates, or removes heavy metals in the body. We want a lot of it around. We need it, and we depend upon it," he added.

So, could there be a possible connection between vitamin D deficiency, glutathione depletion, heavy metal accumulation and autism?

"It's a hypothesis that absolutely needs to be tested," Plotnikoff said. "Vitamin D deficiency is crucial to study, because of its many roles in normal brain development -- including the capacity to handle oxidative stress and handle heavy metal loads. The data we have now can't say if this s the case, but it is a compelling hypothesis that deserves national attention."

"My sense is that autism is likely to be a result of a combination of many important factors," he continued. "The gift that the Somali community is giving us is about a significant awareness of the role of low vitamin D levels and other environmental issues, including immunizations and heavy metals, in autism. Severe Vitamin D deficiency could be what is behind all this. And that is what the Somali community did for us: They get no sun in Minnesota, and they have extremely low levels of vitamin D."

Finally, vitamin D deficiency in pregnant animals can lead "dramatic" defects in mitochondrial function in offspring, according to at least one study. The role of mitochondrial dysfunction and autistic regression is only now beginning to be explored. But some researchers believe that poor mitochondrial health (perhaps exacerbated by vitamin D deficiency?) is a precursor to autistic regression in at least one subgroup of children.

All of this, of course, is speculation. There is no proof that any Somali autism cases were caused by vitamin deficiency, lack of sunlight, mercury or vaccines. But if you look for major differences between life in Somalia and life in Minnesota, you will find that one has lots of sunlight and very few vaccines -- and the other has less sunlight, but lots of vaccines.

Is it possible that vitamin D deficiency caused glutathione depletion and mitochondrial damage to these Somali children, setting them up for regression into autism after receiving multiple simultaneous vaccines containing heavy metals (as was the case in the famous Hannah Poling Vaccine Court claim)?

No one knows. And sadly, some refugees are not waiting around for US doctors to find out.

"Some autism families have returned to Somalia," said one mother, who did not want to be identified. "They were angry and disgusted with the United States. The nation that offered them refuge was the same nation that made their children so sick," she said.

"They think that, by returning home, maybe they can make their children better."

UIC joins international research effort to study autism

2008-11-14T16:05:00.000-08:00

UIC joins international research effort to study autism

Researchers at the University of Illinois at Chicago are taking part in an international effort to gather DNA samples from 2,000 autism patients and their families over the next three years.

The initiative, called the Simons Simplex Collection, is the first coordinated effort to create a database of information about families with only one autistic child.

"This collection of DNA will allow researchers at UIC and at other centers to identify genetic factors that increase the risk of autism and to potentially develop interventional therapies and new drugs for the treatment of autism spectrum disorders," said Dr. Edwin Cook, professor of psychiatry, director of the UIC Autism Center of Excellence, and principal investigator of the study.

Autism is an often devastating and lifelong disorder that appears during the first three years of life. Children and adults with autism often have difficulty communicating and forming relationships. The variation of behaviors and level of functioning among people with autism differ greatly.

The national Centers for Disease Control and Prevention estimates that about one of every 150 eight-year-old children is diagnosed with some form of autism spectrum disorder. Autism spectrum disorders occur in all populations and socioeconomic groups and are four times more likely to occur in boys than in girls.

Families eligible to participate in the study include those with only one child with an autism spectrum disorder, age four or older; one or more siblings without an autism spectrum disorder, age four or older; and unaffected biological parents who are willing to participate.

Eligible children with an autism spectrum disorder will receive a behavioral assessment and all family members will donate blood, a source of DNA. A small number of families with no siblings or siblings under the age of four may be eligible to participate in the study.

DNA gathered through the Simons Simplex Collection will be stored at a central repository.

Data gathered from the research will aid scientists from around the world who are searching for the causes of autism.

In addition to UIC, the Simons study is being conducted at Baylor University, Columbia University, Emory University, Harvard University, McGill University in Montreal, the University of California, Los Angeles, the University of Michigan, the University of Missouri, the University of Washington, Vanderbilt University, Washington University, and Yale University.

Obama Would Let Her Die

2008-08-25T12:51:00.000-07:00

It was a bright summer day in Chicago when a woman confirmed that she was pregnant with her first child. The telling of the families ensued, followed by the announcement to friends. The days began to speed up, her body began to change, and eventually the pressing question was finally asked. To know or not to know the gender of the baby, what would they choose?

Eventually they decided to go for the ultrasound and prepare themselves for her arrival.

Only what they discovered was not what they had expected.

With the conclusion of the ultrasound pending, the technician left the room with a worried look on her face. A few minutes later, a senior doctor entered and relayed the sad news.

The ultrasound showed an echo-genic condition. This particular cause for concern was due to the lungs of the unborn child showing up brighter on the ultrasound reading than the medical doctors felt they "should be" at that point in the pregnancy. Bright lungs on the ultrasound, they were informed, indicated a high probability of Down's syndrome. Understanding the repulsion that disabled children were in a state that Barack Obama served in, the conclusion was clear: this child must be aborted. So with all the grace of a semi-truck hitting a brick wall at top speed, the doctor flatly informed the baby's mother that in the state of Illinois, there were only a limited number of days to have an "induced labor procedure" (abortion). They strongly suggested that the mother and father consider and pursue this "solution" to the "Down's question."

The parents chose instead to pursue additional and frequent ultrasounds roughly every two weeks for a period of time to see if there were any further developments.

You see, in Barack Obama's twisted world, not to mention that of the medical and abortion industries in his home state, the push was on--test for Down's, and do an "induced labor procedure" (abortion). Additionally, in this messed up universe, Obama specifically and single handedly saw to it that if the child had struggled with the chemical process of the "induced labor procedure" (abortion) and survived, she would not have been allowed any medical care to save her life.

But that is the way of the world for Barack Obama, the medical practitioners that terminate pregnancies, and the hospital named "Christ" that performs these procedures. Oh and did I mention that it is Obama's own religious denomination that operates said hospital?

But I can't help but ask the question: "Why does Obama pursue such outcomes?"

Perhaps it's because neither of his children have had anything but a beautiful life, and a pleasurable home to experience. But do handicapped children deserve less from life because of some mental or physical limitation? The Paralympics are just around the corner. Does Obama believe we would have been a more just society if those athletes had each been aborted, or left to die in a soiled utility closet even if born?

Last week, Barack Obama called those of us who have told the truth about his position on this issue "liars." He said that we were misrepresenting this issue and he attempted to claim confusion and "multiple bills" and "procedures" to cloud the issue of his voting record.

All of which itself was a lie.

The record is clear: Barack Obama voted then, and remains now the only elected U.S. Senator to have voted in favor of denying life saving medical care to children who had been born.

PERIOD!

Last week, David Brody of CBN carried Obama's water for him when he said that saying such things amounted to over the top rhetoric. But what is over the top about being as specific as possible in telling the truth? Barack Obama voted in favor of infanticide. End of story. But why does it matter?

In a society that has continued to diminish the value of human life, perhaps Obama believes it won't matter. But for me it is very personal.

Because that little girl, who could have been denied life saving medical care, is named Eliza.

I've held her. I've hugged her. And I've kissed her forehead when she called me "Uncle Kevin."

She is three and half years old, and she is one of the healthiest, happiest, non-disabled children I've ever seen.

See, it turned out that the ultrasound machine and the readings it produced (which in turn had been the primary overriding reason why the abortion suggestion had been made so forcefully) was miscalibrated. Eliza's lungs were perfect, and her parents had a relatively normal delivery. And they have given her a wonderful childhood.

Barack Obama's indiscriminate political pandering may be a good enough reason to pick a running mate in Joe Biden, who openly thinks Obama's not ready to be president. But pandering is not a good enough reason for him to have been willing to let Eliza die. Not nearly good enough realizing now that there never was anything wrong with her. Not good enough at all!

But actually "not good enough" sums up Obama... pretty much... all the way around.

Genetic testing of kids could pose a dilemma

2008-07-31T03:59:00.000-07:00

Would you want to know if condition is incurable?

By PAUL NYHAN
P-I REPORTER

Would you want to know if your toddler is more likely to develop Alzheimer's?

In the next two decades, parents are expected to have new options to test their children for genetic traits that raise the odds they will contract any number of conditions, such type 2 diabetes, depression and possibly autism, experts suggested last week.

Those breakthroughs are expected to push parents deeper into the ethically fuzzy world of genetic testing, where there appear to be more questions than answers.

Do you test a newborn for a disorder that has no cure? Does a child, or her parent, need to know she carries the gene that makes her susceptible to breast cancer?

A "core piece of advice is you shouldn't do genetic testing just because it's available," said Dr. Douglas Diekema, who works on pediatric bioethics at Seattle Children's Hospital and Regional Medical Center. "If there is a test (that) came back positive, what would be the benefit for my child? Is there something we could do?"

Children's Hospital is near the center of this debate because it's home to one of the country's few organized centers for pediatric bioethics.

It sponsored a conference on the topic last weekend.

At the center, doctors work with geneticists, genetic counselors and policymakers to understand the rapidly evolving area and help with specific cases.

Researchers across the country are grappling with emerging challenges of genetic testing.

Six years ago, most states screened newborns for a handful of disorders,and today most screen for 29.

Washington screens for 24 disorders, including phenylketonuria and cystic fibrosis, and will add a 25th by the end of August.

While tests are largely mandatory – some parents may opt out for religious reasons – in coming years parents may face decisions of what or whether to test for other disorders, if testing is expanded.

It will create yet another level of knowledge for a generation of parents already coping with a mother lode of information.

"There is so much information out there, there is the danger of misinformation and information overload," said Mirtha Wilkens, a media project manager for Children's Hospital, who is expecting her second child this fall.

In the next couple of years, doctors may begin expanding tests by adding disorders that can't currently be treated, such as Duchenne muscular dystrophy and spinal muscular atrophy.

The move would represent a major shift because babies currently are mainly tested for treatable genetic disorders.

As parents of two adopted children, Andy and Pam Heyman see the benefit and ambiguity of pediatric genetic tests.

When the South Seattle couple adopted their two children, they had to decide if they would accept a child with sickle cell anemia – a tested condition – during the process.

They said yes and their 9-year-old daughter, Josie, has sickle cell, while 4-year-old Adam does not.

Yet, Andy Heyman, 38, isn't not sure he would embrace tests that may emerge unless there is compelling evidence that parents can do something about the condition.

Heyman also worries about how institutions would use genetic test results.

"If choice rests with individuals, I am much more comfortable than if it's (in the) hands of institutions," he said.

Expanded newborn testing could create a new set of worries and opportunities for parents. They will receive more false positives if there are more tests and get called back for anxious second tests.

Some parents may want to know about incurable disorders so they can adjust their lives, and more diagnoses might create more research opportunities and potentially treatment breakthroughs, experts said at last weekend's conference.

If parents are going to be confused, scientists already are grappling with their own ethical confusion.

For example, researchers are uncovering genetic flaws that might be evidenceof cystic fibrosis. And they may not be.

In a child with no symptoms, they see genes that are not quite normal, yet not typical evidence of cystic fibrosis, according to Dr. Beth Tarini, a research investigator at University of Michigan's Child Health Evaluation and Research Unit.

"You are left telling the parents 'I am not sure if your child has cystic fibrosis,' " Tarini told a room full of researchers during last weekend's conference.

If doctors and researchers are conflicted, what are parents supposed to do?

In the information age, parents have resources, but they should beware because the quality of online genetic testing guides varies.

"I think as a general rule that (sites) either sponsored by NIH (National Institutes of Health) or academic institutions are the most likely to be reliable," said Children's Hospital's Diekema.

Of course, your best source often is your family's doctor, Diekema suggested.

In the uncertain field of pediatric genetic testing one thing appears certain: It will add another level of worry to the often anxiety-ridden job of parenting.

"Becoming a parent there is enough to worry about," Andy Heyman said.

Children's Development Center helps autistic children develop

2008-07-31T03:58:00.001-07:00

It was more than a year ago that Megan Ruth first realized her son Kaeden Badger wasn't "doing things a normal 2-year-old should do."

"We had tremendous communication issues," Ruth recalled.

When she was told her son had autism, she enrolled him in Reaching Beyond Limits, a pre-school class at the Children's Development Center for autistic children and children with severe language delay.

"Within two months of him being at the CDC, it went from him falling on the ground and crying, to taking my hand and walking me somewhere," Ruth said.

She learns about her son's school day from a report sent home daily, documenting what he eats, says, plays with and more.

"When I ask him if he did this or that, he doesn't give me a response. He's nonverbal," Ruth said.

About a month ago, the students in Kaeden's class went on a field trip to a therapeutic horse-

riding facility. When Ruth asked her son about his day, "he stood up in his chair and started to clap. That was the first time I had gotten any feedback."

One day she visited the class to see her son spelling out his name with Scrabble tiles.

"I was blown away," she said.

On a typical school day, Kaeden joins five other preschool-aged boys. Their day begins with large headphones over their ears and a compact disc player strapped around them as they sit at the small table, waiting for snacks and juice.

Sounds and music at alternating volumes, changing from ear to ear, help engage different parts of the brain, teacher Christine King explained.

From King, therapeutic support staff member Gina Mostoller, occupational therapy assistant student Melissa Good, speech language pathologist Joan Dice and certified occupational therapy assistant Renee Cerney, the students receive personalized attention each day to help them build relationships.

"Our goal is to get the kids to interact with us," King said, while asking a student if he would like a cracker.

She and the other instructors use simple sign language while speaking about the food.

"Most of them are very low verbal," King said.

"If they don't talk, they have to have some way to communicate," Good said.

The students have to work for their snacks and toys. The instructors wait for a child to request an item.

"Sometimes it's a matter of requiring them to use their language," King said.

Autism is "a spectrum disorder," Mostoller said, which means each child's symptoms are different, ranging from verbal skills, sensitivity to different touches, lack of awareness of their body and more.

Throughout the day, the children do "heavy work" such as dragging a bag full of corn and wearing weighted vests during therapy sessions. Instructors also apply "deep pressure" by pressing against the boys' shoulders and arms.

"It gives them a sense of their bodies," Mostoller said.

Before lunch, the students rotate through "centers," each one focusing on a separate function.

In the "boxes" center, the goal is for children to work independently by sorting colors and shapes.

In the gym, Cerney activates different muscle groups with swings, scooter boards, puzzles and a climbing wall. During floor time on this day, students play, jump, laugh and discover toys one-on-one to develop "circles of communication."

"You have to get into their space and have them look at you and respond," Dice said. "A lot of the activities we do to help them organize the sensory input, helping them make sense of the world around them."

Five-year-old Jordan Kiessling is preparing to enter his second year in the program. His mother, Deborah Kiessling, said her son has made more progress in the Reaching Beyond Limits class than in other programs.

"Now he's beginning to say a lot of words. His eye contact has been a big leap for him ... When you call his name, he's responding," she said.

She credits the sensory stimulation as part of Jordan's success.

"At CDC, it's the first time I've seen more progress and results as far as eye contact, interaction with others and wanting to try things. It's really helped him a lot," Kiessling said. "I give it five stars."

Gabriel Walter, 5, has been in the class since October and is preparing to soon graduate from Reaching Beyond Limits. His father, Joe Walter, said Gabriel has become more independent, his vocabulary has improved and he now forms whole sentences.

"We have come a long way. You can carry a conversation with him now. It just kind of happened overnight," Walter said.

Although he admitted to being skeptical about the program at first, Walter said the individualized attention is helpful.

"I'd recommend it for anyone," he said of the program. "It's just awesome."

Children's Development Center helps autistic children develop

2008-07-31T03:58:00.000-07:00

Parents concerned about autism are watching and wondering

2008-07-31T03:30:00.000-07:00

What is normal behavior and what are the early signs of autism? Today’s concerned parents are swamping medical experts with questions and concerns.

By KATHLEEN O'BRIEN
Newhouse News Service

Sandra Devlin cradles her newborn daughter, Delilah, with the same devotion she lavished on her four older children.

"De-li-lah," she coos in a singsong voice, holding the 4-month-old baby close to her face. As she did with her other kids, she hopes to elicit a smile, a laugh or a gurgle of recognition.

It’s a time-honored mother’s gesture — but one that now comes with a twist: This time, Devlin is also checking for autism.

Every generation of parents has a worry unique to its era. In the ’40s, the specter of polio made mothers frantic about any trip to the neighborhood swimming pool. The ’80s brought the sense that every child risked abduction, his photo ending up on the side of a milk carton.

For today’s parents, that fear is autism.

"In my office, that’s the big elephant in the room. They’ll ask about something else, but what they’re really asking is, 'He doesn’t have autism, does he?’ It is the question for this generation," said Dr. Ari Brown, a Texas pediatrician and spokeswoman for the American Academy of Pediatrics.

With autism spectrum disorders now diagnosed in 1 out of 150 children nationally, rare is the parent who isn’t aware of autism. And with that awareness can come a new wariness of vaccines, which a vocal minority of autism activists blame for the jump in cases. Pediatricians report seeing more parents question, delay or even shun altogether the traditional round of childhood immunizations.

Such worries never crossed the mind of Devlin, of Denville, N.J., with her first two children, now 19 and 13. Autism arrived on her radar screen for the next two kids, now 9 and 3. With Delilah, born 11 weeks prematurely, that concern is front and center.

"I never did that with my older kids," she said of her new habit of checking for eye contact from Delilah. "But now I’m looking specifically for autism."

Parents noticing milestones

Pediatricians say this worry has its benefits: Parents are more aware of crucial child-development milestones and as a result, they are quicker to pick up on lags. That may mean some cases of autism — maddeningly difficult to catch in the youngest toddlers — are diagnosed earlier.

"If you have a child who doesn’t talk, I think in other generations they would’ve said, 'Oh, he’s a late bloomer.’ It wasn’t a big deal," said Mary Jean Wick, a mother of five. "Now it’s definitely a fear for this age of parent."

However, it can make some parents see autism behind every bush.

"Thirteen years ago, parents wouldn’t be able to answer the question, 'How does your child play?’ " Brown said of her early years in practice. "Now you hear, 'Oh my God, my child lines up his trains. Does he have autism?’ There are these extreme parents who think every little thing is autism. I have to say to them, 'Sometimes kids can be quirky.’ "

Autism spectrum disorders are developmental disabilities marked by an impairment of social interaction combined with communication problems and restricted or repetitive behaviors and interests. The spectrum encompasses a wide variety of thinking and learning abilities, from gifted to severely challenged. While its prevalence has soared in recent years, experts are unsure whether more cases are occurring or simply more cases are being diagnosed.

Some parents will single out one small trait or habit of their children as a "symptom" of an autism spectrum disorder, said Michael Segarra, president of the New Jersey chapter of the American Academy of Pediatrics.

When a parent voices concern that a child plays with only one toy, for instance, Segarra will ask a checklist of questions about the child’s social interaction. This helps the parent see the big picture.

Some parents accept their pediatrician’s reassurances. Others don’t — leading to more referrals to specialists.

The question of immunizations

Apprehension about autism shows up most dramatically with the issue of child immunizations, which some parents view as a culprit in the recent rise in autism.

A major study released last year in the New England Journal of Medicine shows no association between long-term neurological and psychological problems and early exposure to thimerasol — which contains mercury — in shots. (Use of thimerasol in routine vaccines was stopped in 2001.)

However, that has not reassured everyone.

A poll of parents of autistic children showed 54 percent believe autism is caused by vaccination shots, according to Harvey Bennett, director of Child Neurology and Development Medicine at Goryeb Children’s Hospital in Morristown, N.J. At a recent talk before a group of family physicians, he called that finding worrisome and "astounding."

Pediatricians report more parents are delaying shots, asking that they be spaced out or refusing them altogether.

"They don’t listen to me. They don’t believe a word I say," said Naomi Grobstein, a pediatrician with the Family Health Center of Montclair, N.J. "They say, 'He’s not ready!’ or 'He’s too young!’ "

She reminds parents of the lethal risk posed by diseases like measles, diphtheria and tetanus.

"It’s easy to believe these shots aren’t necessary, because we don’t see these diseases anymore," she said. "I ask them, 'What if your child is the one who spreads measles around?’ "

Complicating the picture are celebrities who either blame or suspect vaccines, such as actress Jenny McCarthy and radio talk show host Don Imus. Doctors complain that the celebrities get an unquestioning ride in the media.

Wick, the mother of five children ages 1 to 11, said she has worried about immunizations but decided to get her kids vaccinated. "I can see that there are people who just panic," she said. "But maybe that’s something in the culture, that we just want to control everything."

It’s important to address that anxiety, said Brown, the Texas pediatrician who is also author of Baby 411(Windsor Peak Press, $11.95), an advice book. "If there is something that is keeping you up at night with worry, then you need to go to the pediatrician to check it out," she said. "That peace of mind is worth the co-pay."

There are these extreme parents who think every little thing is autism."

Dr. Ari Brown,
Texas pediatrician and spokeswoman for the American Academy of Pediatrics

Leading Dr.: Vaccines-Autism Worth Study

2008-07-30T16:30:00.000-07:00

CBS News Exclusive: Former Head Of NIH Says Government Too Quick To Dismiss Possible Link

CBS) CBS News correspondent Sharyl Attkisson wrote this story for CBSNews.com.

Jordan King was a typical baby. His parents called him vocal and vivacious.

Then just before age 2, after a large battery of vaccinations, he simply withdrew from the world.

"The real scary thing was when I noticed he wasn't looking at us any more in the eyes," Mylinda King, Jordan's mother, said.

William Mead was a Pottery Barn baby model and met all the typical milestones. Then, also at age 2, after a set of vaccinations, William became very ill and he, too, changed forever.

At first, both sets of parents suspected hearing problems.

"The reason we had him tested for a hearing deficit was 'cause he wouldn't respond to us," Mead said. "He no longer used any of his language."

"We had him tested for deafness, it was that bad," King said. "I mean, you could slam a book on the floor and he wouldn't turn around to see what the sound was. It was like he was in this bubble of somewhere else, like he'd left the planet or something."

Doctors said it wasn’t a hearing problem … it was the brain disorder autism.

In both children, batteries of tests revealed dangerous levels of the brain toxin mercury in their systems. Their only known exposure: the mercury preservative once widely used in childhood shots.

"Our doctor, Dr. Green, said 'you can stop looking for sources'," King said. "I know where it came from and it was … when he told us it was the vaccines, you just can't believe it."

Now, William and Jordan are two test cases among nearly 5,000 autism claims filed in federal vaccine court. Most claim that mercury, or MMR shots, or both, resulted in their children’s autism.

Government officials and many scientists insist there’s nothing about vaccines that can lead to autism.

"I think it's important for the average parent to know that the government hasn't made a link between vaccines and autism," said Dr. Anne Schuchat of the Centers for Disease Control.

Dr. Bernadine Healy is the former head of the National Institutes of Health, and the most well-known medical voice yet to break with her colleagues on the vaccine-autism question.

In an exclusive interview with CBS News, Healy said the question is still open.

"I think that the public health officials have been too quick to dismiss the hypothesis as irrational," Healy said.

"But public health officials have been saying they know, they've been implying to the public there's enough evidence and they know it's not causal," Attkisson said.

"I think you can't say that," Healy said. "You can't say that."

Read more about the "open questions" of autism at Couric & Co.

Healy goes on to say public health officials have intentionally avoided researching whether subsets of children are “susceptible” to vaccine side effects - afraid the answer will scare the public.

"You're saying that public health officials have turned their back on a viable area of research largely because they're afraid of what might be found?" Attkisson asked.

Healy said: "There is a completely expressed concern that they don't want to pursue a hypothesis because that hypothesis could be damaging to the public health community at large by scaring people. "First of all," Healy said, "I think the public’s smarter than that. The public values vaccines. But more importantly, I don’t think you should ever turn your back on any scientific hypothesis because you’re afraid of what it might show."

As an example, Healy points to the existing vaccine court claims.

CBS News has learned the government has paid more than 1,300 brain injury claims in vaccine court since 1988, but is not studying those cases or tracking how many of them resulted in autism.

The branch of the government that handles vaccine court told CBS News: “Some children who have been compensated for vaccine injuries…may ultimately end up with autism or autistic symptoms, but we do not track cases on this basis.”

"What we’re seeing in the bulk of the population: vaccines are safe," said Healy. "But there may be this susceptible group. The fact that there is concern, that you don’t want to know that susceptible group is a real disappointment to me. If you know that susceptible group, you can save those children. If you turn your back on the notion that there is a susceptible group… what can I say?"

Government officials would not respond directly to Healy’s views… but reiterated, vaccines are safe.

Like Healy, the Kings and the Meads support vaccination, but say it can be made safer.

At age 10, William’s life is full of intensive therapy.

"Horrifying is a good word," his father George said. "It was horrendous to watch your own child become, in effect, a zombie. It's something I wouldn't wish on my worst enemy. It was awful."

Jordan, also 10, can't even communicate as well as he did as a toddler.

"Oh yeah, he doesn't talk at all anymore" said Jordan's father, Fred.

Public health officials insist there’s no connection to their shots. Thousands of families are hoping for a different answer in vaccine court.

WINA drops show over autism cracks

2008-07-30T16:21:00.000-07:00

After comments blasting autism as just another over-diagnosed American problem, controversial radio personality Michael Savage has been dumped by a Charlottesville station. And for at least one local talk-radio host, the dismissal of “The Savage Nation” comes none too soon.

“As the father of a six-year-old boy who has been diagnosed with autism,” says WINA personality Coy Barefoot, “I was outraged. He clearly is spreading what I know to be outright lies about autism.”

“I’ll tell you what autism is,” Savage boomed in his July 16 broadcast. “In 99 percent of the cases, it’s a brat who hasn’t been told to cut the act out. That’s what autism is. What do you mean they scream and they’re silent? They don’t have a father around to tell them, ‘Don’t act like a moron. You’ll get nowhere in life. Stop acting like a putz. Straighten up. Act like a man. Don’t sit there crying and screaming, idiot.’”

“Quite honestly, it came down to common decency,” says WINA program director Rick Daniels. “Although he was trying to make a bigger point, he didn’t clarify it at all. We took into account our listeners and some feedback we’ve gotten, and we wanted to do what was best for our community.”

While Savage’s syndicator, Talk Radio Network, found the comments merely “inartful,” Media Matters, a D.C.-based organization “dedicated to correcting conservative misinformation” agrees with WINA that the comments were out of line.

“I think he and the people who use the airwaves have an ethical responsibility not to be lying and not to be so hatefully offensive that they cause this much controversy,” says Ben Fishel, a spokesperson for Media Matters.

However, Charlottesville resident and long-time “Savage Nation” listener Linda McRaven disagrees. “Media Matters is looking for bombs,” says McRaven. “They’re not really valid critics.”

McRaven says that she’s a fan of Savage because of his fearlessness. “I call him a flame-thrower because he’s so passionate about what he feels,” she says. “He pulls no punches, and I really admire that. We are entirely too politically correct, and he just says what he thinks. In my opinion, a lot of things he says are right on.”

Both Aflac Insurance and Home Depot have reportedly pulled their sponsorships of his show in reaction to Savage’s comments, but according to Daniels, none of WINA’s local advertisers had made such a move— or even any comment— by the time of Savage’s removal.

Fishel is especially baffled by the way Savage’s comments might come across to parents of autistic children.

“Disciplining your child can cure autism?” he asks. “That is absurdly false and hateful, especially to these parents who have committed their whole lives to children with special needs.”

“Where do we draw the line with what is done with our public airwaves?” asks Barefoot. “What’s next, these kids with cancer should get up and walk it off?”

On his afternoon program “Charlottesville, Right Now,” Barefoot played excerpts of the controversial comments and shared his perspective. But the decision to remove Savage was the program director’s, not his.

“I think they did the right thing,” Barefoot says, noting that since Savage’s removal, WINA has received emails from around the country applauding the action.

In an email of his own, Savage tells the Hook, “The drug companies are very powerful and have worked very hard to silence any voice critical of the misdiagnosis of our children and the drugging of vulnerable minds. Sad the station manager is such an ignorant man.

Daniels says he has received what he called “overwhelmingly positive” reactions to the ouster, and only a handful of complaints, most of which he characterizes as freedom of speech concerns.

“There are hundreds of syndicated talk shows out there,” says Daniels, “and each one has the right to be heard, but we can’t run them all. We pick the best ones for Charlottesville, our listeners, and the community.”

On WINA— at 1070 AM— Savage’s program has been replaced with David Ramsey, who deals with get-out-of-debt and money management issues. “I think just about all of us,” Daniels says, “could use good financial advice these days.”

Savage added in his email that Charlottesville listeners could soon continue to hear his program on a station “across the street,” though Julian Hudson, Talk Radio Network’s affiliate director, could not confirm that any Charlottesville station is poised to pick up “The Savage Nation.” Dennis Mockler, general manager of Monticello Media, the other major radio group in Charlottesville, says his stations have no plans to pick up the show.

Is Autism an "American Disease?" Somali Immigrants Reportedly Have High Rates

2008-07-27T05:28:00.000-07:00

A very interesting article was published today by Elizabeth Gorman on MinnPost.com that should be researched further: It might shine new light on genetic, and possibly environmental factors in autism.

The article reports that an unusually large proportion of Somali-speaking children in Minnesota have autism, something that has also been noted in Sweden, where Somali immigrants call autism "the Swedish Disease," because they did not see it back in East Africa.

According to the report, almost 6 percent of the Minneapolis school district's total enrollment is made up of Somali-speaking students. But in the city's early childhood and kindergarten programs, "more than 12 percent of the students with autism reported speaking Somali at home," and over "17 percent of students in the district's early childhood special education autism program are Somali speaking," the article said.

Somali kids with autism seem to be doing worse, on average, than their school mates: "About a quarter of all autism children who attend autism classrooms for students functioning too low to be mainstreamed in regular schoolrooms are Somali."

The statewide autism rate in Minnesota is already quite high -- at 100 per 10,000 children, as compared to the national average estimate of 67 per 10,000. In the Somali immigrant community, however, it could be much higher than either of those figures.

Why would that be? There is almost certainly a strong genetic connection at play here, but there may be other factors as well, including a lack of vitamin D from sunlight, (see the Swedish study in article) or, yes, vaccinations.

I do not know if vaccines are playing a role at all here. In fact, this report says that the Somali children were all born and vaccinated in the United States (though it seems to me that some must have immigrated here).

The "American Disease" idea comes from Somali parents themselves, and from some of the experts who work with them.

Anne Harrington, an early childhood special education coordinator for the Minneapolis school district and a specialist on the topic, told Gorman that Somalis "Are given more [vaccines] than we get, and sometimes they're doubled up. Then their children are given immunizations. In Somalia, their generations have not received these immunizations, and then suddenly they're getting just a wallop of them in the moms and then in the babies. That's certainly a concern that's been expressed to me by the Somali population."

I have never heard that before, and there may be nothing to it. On the other hand, the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices recommends that refugee adults receive at least 10 vaccines -- including pregnant women. Some of them contain thimerosal.

In addition, any of these kids who are older than five -- meaning they were born in 2002 or earlier -- could have received thimerosal in their vaccines.

Whatever the reason for the apparent higher rates of autism (ie, genes, sunlight, vitamins, vaccines, all of the above, none of the above) it is an interesting phenomenon and, it seems to me, an intriguing avenue of research.

There are data out there to suggest that elevated autism rates may not be limited strictly to immigrants from Somalia:

# A study of pervasive developmental disorder (a form of ASD) prevalence in Montreal school districts in 2003-2004 showed that the average PDD rate in the city's five predominantly French-speaking school districts (ie, largely Canadian-born) was 42.3 per 10,000 students, but in the largely English-speaking school district, where many immigrant children live, the rate was 69.2 per 10,000.

# In the English-speaking district, although the overall PDD rate was 69.2 per 10,000, among foreign-born children it was 106.6 per 10,000, and among Canadian-born children it was 67.6 per 10,000 - or 58% higher in the foreign born population.

# In Sweden, researchers reported that the incidence of autism among Somali immigrant children is far higher than among children living in Somalia (though better medical care and diagnostics would play a role, I'd think). Swedish media report that Somalis living in Sweden have dubbed autism, "The Swedish disease," because it is so common among Somali immigrants.

# These data might support reports that autism rates are also higher in immigrant communities in North America. On June 6, 2007, the Canadian Broadcasting News reported that, "autism rates are higher in immigrant families." Health-care specialists in Montreal, it said, were, "trying to understand why such a high number of autistic children come from immigrant families, a phenomenon seen in major cities across North America."

# This information MIGHT also help explain why autism numbers in California (and Minnesota, for that matter), are still high. In California, between 2003 and 2007, the rate of autism among black and white children enrolled in the state's DDS program increased by 50%. But the rate among Asian children in the same period went up by 79%, and the rate among Hispanic kids increased by 84.2%. The growth rate was about 58% higher among Asian and Hispanic children than black and white children.

# One in four California residents are foreign born. The majority are from Mexico, Central America, China, Korea, the Philippines and other countries with high vaccination rates (Mexico's is about 92%) and that still use the full amount of thimerosal in shots. Many if not most of these children are routinely revaccinated upon entry into the United States.

It would be very interesting, I believe, to look at autism rates in high and low immigration states. Not to implicate vaccines, but to find out if children of immigrants are more at risk than our native born population -- and why.

Radio jock’s words about autism send local man flying

2008-07-27T04:41:00.000-07:00

As soon as Wayne and Shea Adair learned about the words spoken by radio “shock jock” Mike Savage about autism on July 16, the couple knew they too needed to take to the air.

The Adairs are parents to six chidren, including a 4-year-old son with autism. Wayne, who is a full-time dad and part-time pilot running a small business flying advertising banners over Reno, and Shea, a nurse at Renown Medical Center, were angry when they read the transcript of Savage’s comments in an e-mail from the Reno Autism Information Network.

“As soon as I read my e-mail at work I called (Wayne) and said, ‘OK, we have a banner to fly,’ ” Shea said.

In his broadcast, Savage called autistic children “brats” and that the condition is the “illness du jour.” He said autism is the result of bad parenting.

So, Wayne put together a few choice words of his own that he pulled behind his plane across the sky above Reno and Sparks on Wednesday.

“My son has autism. Mike Savage is an idiot.”

“Guys like Mike need to use their mouthpiece for positive change,” Wayne said outside the hangar where he keeps his plane at the Reno-Stead Airport. “But he’s using it for propaganda. He’s trying to shock people and he did.”

"This shock jock guy can reach 8.2 million people across the nation,” Shea said. “We can reach at least a few thousand.”

Wayne said Savage’s “ignorant comments” have resulted in a positive backlash. The National Autism Association demanded an apology and some groups called for Savage to be fired.

“Autism is a very serious condition that greatly impacts the lives of those affected,” said NAA board member Lori McIlwain in a written statement online at www.nationalautismassociation.org. “Many children with autism experience tremendous physical pain from underlying pathologies, which accounts for the screaming this person callously dismisses. To have an uneducated opinion about autism is perfectly within one’s right, but to earn a living by shock-value exploitation of children’s suffering, while suggesting they should be called ‘idiots,’ is disgraceful.”

On his own Web site, http://michaelsavage.wnd.com/, Savage posted comments in his own defense: “My comments about autism were meant to boldly awaken parents and children to the medical community’s attempt to label too many children or adults as ‘autistic.’ ... Just as some drug companies have overdiagnosed ‘ADD’ and ‘ADHD’ to peddle dangerous speed-like drugs to children as young as 4 years of age, this cartel of doctors and drug companies is now creating a national panic by overdiagnosing autism, for which there is no definitive medical diagnosis!”

Wayne said that if there seem to be more cases of autism it is because other mental illnesses are finally being properly put in the category. He also said that in order to be diagnosed as autistic, a neurologist and a behavioral psychologist both must agree on the diagnosis. According to the NAA, there are five disorders under the Pervasive Development Disorder umbrella, which include Autism, Aspergers, Rhett’s Syndrome, Childhood Disintegrative Disorder, and PDD-NOS (not otherwise specified).

Wayne described his own son’s condition as “not high-functioning, and not severe.” He said that when he saw at a conference in Seattle what other parents of autistic children deal with it made his own son, Wayne, Jr., “look like a cakewalk.”

He pointed to his own family as proof that Savage’s comments about autism being the result of bad parenting are false.

“If I was a lousy parent, (all of my six children) would be messed up,” he said.

Autism Rates Soaring For Somalis In U.S.

2008-07-26T23:33:00.000-07:00

MINNEAPOLIS, Minn. (CBS) ― Their colorful shops line the streets, catering to their own culture and drawing in ours. Beginning in 1993, Somali people began arriving in Minnesota from refugee camps in Kenya. By that time, Somalia's political chaos had led to the killing or starvation of many of its people.

For refugees, Minneapolis offered a place to start a new life, a new business, or a new family.

"Many things attracted Somalis to Minnesota to stay. Good health cover and good education," said Huda Farah.

Farah works on refugee resettlement with the Minnesota Department of Health. It's through her work that she's noticed something troubling within her community.

"We're seeing (an) increased number in autism," she said.

Reporter Amelia Santaniello asked her, "Is there autism in Somalia?"

"Not many, not many," replied Farah.

The Minneapolis School District is seeing a higher than expected rate of autism in its early childhood special education classrooms too.

"It's so glaring here in Minneapolis, I couldn't not see it," said Anne Harrington.

Harrington has been identifying kids on the autism spectrum for Minneapolis Schools for over 20 years.

"We have seen a tremendous number of children that are Somali, but born here in the United States or in Minneapolis who have autism," she said.

Out of 100 children in the Minneapolis Schools early childhood special education classroom program for autism, 25 percent of them are Somali. The district as a whole has only about 6 percent of students who speak or hear Somali language at home.

"They are showing the more severe forms of autism, not the broad spectrum of autism that we see in our general population," said Harrington.

Shaimake Osman is one of these kids.

"I knew it (was) something wrong, but I didn't know (what) was wrong. I never heard anything about 'autistic' or 'autism,'" said his mother, Farah Osman.

Osman said when he was 18 months old, he would bang his head all the time. He wouldn't sleep. He couldn't talk.

"They tested for school first. In school. Then after that, they said he has autism. And I never heard, what does that mean, 'autism'? What kind of sickness?" said Osman, describing when she first received her son's diagnosis.

Perhaps the most troubling is that all of the Somali children the Minneapolis Schools have identified with autism were born here in Minneapolis, like Shaimake. The district doesn't have a single child born in Somalia who immigrated here receiving special education services for the disorder.

"I believe (it) is vaccination," said Osman when asked what she thinks is the reason for her son's autism.

"In rural Somalia, there's no immunizations," said Farah.

She said parents like Osman in the Somali community all have questions about immunizations. She said they worry not only about the vaccinations their kids receive, but about the immunizations they themselves received before entering the U.S.

"When Somali parents come from the refugee camps, some of them get immunizations within those camps regardless of whether it's in Ethiopia or Kenya or other countries," said Farah.

She added that because of poor recordkeeping in those camps, some Somalis receive the same vaccinations three and four times.

"That's very worrisome. We need to find out what's going on," said Farah.

In the United States, the Centers for Disease Control said that research so far has shown no link between vaccinations and autism, but a number of studies are still underway.

Doctors in Sweden are calling for research on another possible cause of autism that could hold answers for the Somali community in Minnesota. Sweden has a high incidence rate of autism in its Somali children as well.

Doctors there are wondering if, for Somali people, a lack of sunlight in the winter, the widespread use of sunscreen, and efforts to avoid sun exposure are resulting in too little vitamin D being absorbed through their dark skin.

They theorize that a lack of vitamin D, possibly in conjunction with genetic or environmental factors, could be a cause of the disorder. They're calling for an official study.

"I think it's something that is interesting and should be pursued through research," said Judy Punyko, a maternal and child health epidemiologist for the Minnesota Department of Health. She said we're not currently set up to do that kind of research here.

"We are attempting to develop a data system that will collect data that is reliable and valid so that we can identify cases and track them over time," she said.

The Department of Health is just in the beginning stages of setting up that system, but in response to the high Somali autism rates reported in Minneapolis, the Department has formed a small study group made up of school representatives, epidemiologists and U of M medical experts to look at possible causes.

"It's very concerning. It's astounding to hear the numbers are so large," said Punyko.

For now, the questions in the subset of our community continue.

"At least every week, I hear about (a) new family that have a child with autism," said Farah. "We need to really investigate and find out what's going on."

Researchers look for autism links

2008-07-26T02:35:00.000-07:00

By Laura McFarland

Rocky Mount Telegram

Kristina Day's gut tells her that her youngest son does not have autism.

In his short, 6-month life, William Day has not shown any of the symptoms, but she is not willing to rule it out. She said she was burned too badly before her oldest son, Matthew, 4, was diagnosed with the disorder.

"If (William) does have autism, it is high-functioning. I haven't seen the sensory issues, and I haven't seen the developmental delays ... but I don't know right now," said Day of Durham.

It wasn't the fear of having another autistic child that convinced Day to have William participate in a study about infants at risk for the disorder. Her motivation was more about helping doctors learn everything they can about autism.

William is one of a handful of babies already participating in a study to look at their brain development and behavior, said Dr. Heather Cody Hazlett, a co-investigator of the study and an assistant professor of psychiatry at the University of North Carolina-Chapel Hill. He and the other infants involved in the study have been deemed at high risk for autism because they have an older sibling who already has been diagnosed.

The national study will look at 400 infants across the nation during the next five years – 100 of them at UNC-Chapel Hill, Hazlett said. The university already has enrolled 10 children and is looking for other families who would like to participate.

"The first thing that we would hope to accomplish is to get a better understanding of what is going on in early brain development in children with autism. Ultimately, we would hope to find biological features associated with brain growth that might help us with earlier identification or diagnoses of autism," Hazlett said.

Autism is a developmental disability that usually appears during the first three years of life and affects a person's ability to communicate and interact with others, Hazlett said.

The disorder is typically characterized by the presence of repetitive behaviors or restricted interests. It is a lifelong condition with no cure and no single known cause.

The study looks at the infants at their 6-, 12- and 24-month-old marks, Hazlett said. If a child misses the 6-month tests, the study is enrolling some for the next stage.

Participating in the study means bringing the infant to UNC-Chapel Hill for developmental and behavioral testing and an MRI that is done while the child is sleeping, Hazlett said.

There is no sedation. The tests are repeated at all three age marks.

"It is the only study that I am aware of that is trying to take such a comprehensive look at very early brain development in autism. Because we don't know the cause of autism, we are looking for ways to better identify children who may develop autism early so that we can start intervention as early as possible," Hazlett said.

Day would have appreciated the benefit of early detection. She was suspecting something was wrong with Matthew when he was 5 months old.

He was diagnosed with a sensory-based feeding disorder and a sensory integration dysfunction at 13 months. At 18 months, doctors suspected autism, but they wouldn't confirm it until he turned 2, despite a growing list of signs.

"He can't tolerate certain textures, certain smells. He used to not be able to tolerate certain colors of food. He still eats a 50 percent puree diet. He cannot chew some hard food, and he can't actively swallow because of the way it feels in his mouth," Day said.

Day believes autism is a biological condition children are born with, not something they contract from a vaccine. That is part of what she hopes the study will help prove.

People who participate in the study are reimbursed for travel and lodging during the three visits, Hazlett said. There is also a small compensation for participating.

The study will be enrolling infants with older siblings with autism for at least a few more years, Hazlett said.

Autism May Be More Genes Than Environment, Studies Say

2008-07-26T02:09:00.000-07:00

Three Separate Studies Point to Abnormal Gene as Cause of Autism

By AUDREY GRAYSON

ABC News Medical Unit

When Ann Hotez's third child Rachel was diagnosed with autism at the age of 2, the mother's first reaction was to believe something she had done while pregnant had brought about the condition.

"I was blaming myself terribly, like it was something I did wrong during my pregnancy," Hotez said.

She began racking her brain for a possible explanation for possible causes of the condition. This was 1994 and comparatively little information was available about autism. Many doctors still believed the disorder was caused by environmental factors.

Hotez, desperate to find a reason for her daughter's disorder, landed upon the fish industry.

"For a while I was furious at all the fish companies for letting me eat tuna fish while I was pregnant with Rachel," she explained.

But as more research became available on the genetics of autism, Hotez reconciled her pain with the understanding that the disorder doesn't have one simple external cause. Indeed, for years now, scientists have suspected that autism is a complex genetic disorder, the development of which depends on a constellation of genes working together rather than the work of one single gene.

Now, three different laboratories across the country have identified the same gene abnormality as a possible cause of autism — adding to the growing body of evidence that the disorder is primarily genetic.

The gene — known to scientists as contactin-associated proteinlike 2 (CNTNAP2) — has been a prime autism suspect among scientists. The gene is a blueprint of sorts for an important protein involved in the ability of brain cells to communicate with each other properly.

Today, a group of studies published in the American Journal of Human Genetics not only confirmed the link between this gene and autism, but they begin to identify the specific role this gene plays in the development of the disorder.

Three Studies, Similar Findings

While each of the studies found that this genetic variant increases the risk of developing autism, one of them also revealed that the gene variation is especially risky when inherited from mothers rather than fathers.

In the first part of the study, researchers analyzed data from 145 children with autism whose families had two or more children with the condition. They found by chance that the subjects had a higher rate of the abnormal gene.

To validate these findings, researchers studied a separate group of participants, which included 1,295 autistic children and their healthy parents. They found again that the subjects had higher rates of the variant gene than would have occurred by chance.

When researchers combined the data from the two studies, they found that children with autism were about 20 percent more likely to have inherited this genetic variant from their mothers than from their fathers.

According to Aravinda Chakravarti, primary investigator and a professor at Johns Hopkins School of Medicine, this research may take us one step closer to a better understanding of the genetic causes of autism and how large a role environmental factors truly play in the development in the disorder.

"Environmental factors might be important, but we don't know which or how much they affect the development of this disorder," Chakravarti said. "But I'm very confident that this is a first step in a series of steps we need to take to study autism with some measure of comprehensiveness before we can estimate the totality of meaning for the role of environmental factors."

In another lab across the country, researchers at UCLA landed upon the same gene — CNTNAP2 — as a possible candidate for autism. But the UCLA researchers identified the specific role this gene might play in affecting language, thought and behavior for people with autism.

Taking a different approach, these investigators used data from the Autism Genetic Resource Exchange and studied the DNA of 291 families nationwide who had at least one autistic child. They also found that an unusually high number of the autistic subjects had this gene variant.

To verify their findings, researchers studied the DNA of a new group of 304 families and found that the CNTNAP2 gene variant showed up consistently in the autistic subjects.

Moreover, researchers took a closer look at the gene to see how it might bring about autism. Daniel Geschwind, principal study investigator and director of the UCLA Center for Autism Research, said they discovered that in young children, the gene was most active in language and thought.

"We found that the longer the language delay an autistic child had, the more likely they were to have the CNTNAP2 variant," Geschwind explained. "So having this variant at least partially explains amount of language delay in autism."

A third study released in the same journal identified specific mutations on the same gene, which were individually rare for each autistic patient. Researchers at Yale University sequenced the entire gene and found that autistic patients often had unique mutations on the gene, which were not found in any members of the healthy control group.

This finding exemplifies the complexity of the findings on this gene as well as the disorder itself, said Dr. Matthew State, principal investigator of the study and director of the Program on Neurogenetics at Yale University. He noted that even though his team took a different approach to unlocking the possible genetic causes of autism than the other two teams, "we still landed on the same gene which is quite interesting, but more work needs to be done to sort out what's going on here."

Could Genes Trump Environmental Factors?

Many experts support Chakravarti's belief that this research adds to the evidence that genetic factors play more of a role in the development of autism than environmental factors.

"Environmental factors in autism is a separate issue," said Carla Mazefsky, assistant professor of pediatrics and psychiatry at the University of Pittsburgh School of Medicine. "Given autism's strong genetic basis, identification of genes that play a role is of critical importance. This study further emphasizes the complexity of the genetics underlying autism."

"Autism is a disorder of fetal or early postnatal brain development with a genetic origin," agreed Vittorio Gallo, director of the Center for Neuroscience Research at the Children's National Medical Center in Washington, D.C.

Margit Burmeister, associate director of the Molecular and Behavioral Neuroscience Institute at the University of Michigan, said that "this study adds to the evidence that genetic factors play a role and adds strong results to the idea that cell adhesion in the brain plays a role in autism." However, she said she believes that environmental factors still play a role in the development of the disorder.

"This is similar to risk for diabetes, which is very strongly affected by exercise, weight and sugar consumption, but some people can be coach potatoes and eat what they want and don't get sick. Those with a more resilient genetic predisposition for autism may get the same environmental factors without ill effect," Burmeister explained.

But the findings that suggest genetics may play a stronger role than environmental factors may be a small measure of comfort for parents like Hotez, who may have blamed themselves for their child's condition.

"In my heart now I know it's a genetic disorder," she said. "I don't think it's caused by any of the environmental [factors] they talk about in the news."

Savage's Comments Infuriate Autism Community

2008-07-26T01:58:00.000-07:00

Autism Researchers, Groups Find Common Ground in Condemning Radio Jock

By DAN CHILDS

ABC News Medical Unit

As autism organizations and medical professionals alike voice their outrage at inflammatory comments made by controversial talk radio host Michael Savage, about most autistic children simply being "brats," the head of the network that employs him appears to be taking measures to pull out of a public relations tailspin.

Savage, who in the past, has taken aim at the legitimacy of attention deficit hyperactivity disorder (ADHD) and other behavioral disorders, called autism a "fraud" and a "racket" during his July 16 broadcast, adding that "[i]n 99 percent of the cases, it's a brat who hasn't been told to cut the act out."

In light of strong public reaction to his statements, Savage issued a statement, further explaining his comments.

"My comments about autism were meant to boldly awaken parents and children to the medical community's attempt to label too many children or adults as 'autistic'," the statement read.

"Just as some drug companies have overdiagnosed 'ADD' and 'ADHD' to peddle dangerous speed-like drugs to children as young as 4 years of age, this cartel of doctors and drug companies is now creating a national panic by overdiagnosing 'autism,' for which there is no definitive medical diagnosis!"

In a response to ABC News' request for comment, Mark Masters, the CEO of Talk Radio Network, sent the same statement that had been posted on Savage's Web site.

The statement has done little to blunt reactions to his strong comments, which have forged an unlikely alliance between a number of autism groups that claim doctors are overlooking the true causes of the disorder, and autism researchers in the mainstream medical community.

"I would say it is the lowest form of attention-seeking, and the best response is silence," said Dr. Nancy Minshew, director of the Center for Excellence in Autism Research (CeFAR) at the University of Pittsburgh. "Tune out and his sponsors will turn him off. Declare a day of mourning for those who suffer and a day of prayer for those who care by not calling or responding."

"I think we're seeing a trend within talk radio -- anger toward people with autism," said Kim Stagliano, managing editor of the popular blog Age of Autism. "As we learn more about autism, there seems to be an acceptable level of tolerance within society, but within talk radio, the sympathy has turned into scorn."

And Rebecca Estepp, national manager of the autism advocacy group Talk About Curing Autism (TACA) says Masters has e-mailed her organization and invited them, along with the National Autism Association, to be guests on Savage's show to "make amends with the autism community."

But it is unclear whether the autism community is ready to bury the hatchet.

"Michael Savage is spectacularly uninformed about this major national health crisis," Estepp said. "His comments were beyond insulting and are tantamount to blaming parents for their child's cancer.

"Perhaps 99 percent of his listeners should stop tuning in."

Groups Differ on Appropriate Response

Autism experts say Savage's statements threaten to alter the public's understanding of the disorder.

"It is unfortunate that, just as the public is beginning to be better informed about autism and related disorders, a prominent individual in the media with a wide audience should spread misinformation," said Katherine Loveland, professor of psychiatry and behavioral sciences and pediatrics at the University of Texas Medical School in Houston. "Although it's his right to believe and to say what he wishes, his statements should not go un-challenged by the medical, scientific and advocacy communities."

But, while those in the autism community overwhelmingly disagree with Savage's viewpoint, there is as yet no consensus as to what action, if any, should be taken.

Some say that ignoring the comments is the best approach.

"Mr. Savage is obviously a complete ignoramus, who knows not the first thing about autism," said Deborah Fein, autism researcher and professor of psychology at the University of Connecticut. "However, I doubt he believes what he said; he is obviously just trying to get media and public attention, which he has succeeded in doing."

"The less attention given to Mr. Savage, the better," agreed Marguerite Kirst Colston, spokeswoman for the Autism Society of America.

But, the nation's other major autism groups have suggested that a stronger response is needed. In a statement issued today, the National Autism Association said that representatives from the organization have agreed to be on a panel on Savage's show to respond.

"We've asked for an apology, a retraction, and a chance to get to our side on this issue," the statement read. "We don't want to respond with an attack, we want to educate him and his listeners."

The advocacy group Autism Speaks urged a response in the interest of further educating the public about the nature of autism.

"One important goal of increasing awareness about autism is to foster a greater level of acceptance and understanding of the very real and significant challenges it poses to individuals with the disorder and their families," read a statement issued today by Autism Speaks. "[T]here are those who are apparently incapable of feeling compassion. They deserve our pity, not our scorn."

Stagliano disagreed: "We don't need to 'pity' Mr. Savage, like Autism Speaks suggests; we need to educate him."

Looking Inside Kids' Minds Can Open the Future

2008-06-15T04:17:00.000-07:00

Doctor Uses Brain Imaging to Diagnose and Treat Kids' Cognitive Disorders
By CLAIRE SHIPMAN and ARIANE NALTY
May 20, 2008

Two million American children have been diagnosed with attention deficit hyperactivity disorder, according to the National Institute of Mental Health. It's so common now that one child in a classroom of 25 or 30 will have the disorder. But parents often struggle a long time to figure out exactly what's going on in their child's head. Is he tired? Is she confused? Is he just acting up? Does she need help?

Dr. Fernando Miranda, a neurologist at the Bright Minds Institute in San Francisco, says diagnosing children with behavioral disorders like ADHD and autism without looking at their brains is like trying to diagnose heart problems without actually looking at the heart. Click here to read a story about Miranda's autism research.

On the other hand, some of Miranda's patients have found they had an attention deficit problem and didn't even know it. Miranda, and many other doctors, believe more objective tools for figuring out these puzzles are critical.

From an early age, 9-year-old Danny Rodgers had trouble speaking.

Danny's words were in his head; they just couldn't seem to find a way out. Embarrassed, he avoided talking altogether and stopped trying to make friends.

Danny's grandparents, Jeanne and Howard Rodgers, who have been raising him and his sister, Meghan, since their mother died, said the school system recommended speech therapy, and patience.

"They kept saying, 'He'll grow out of it. He'll grow out of it '," said Jeanne Rodgers.

But he never did .

"He'd cry a lot and say, 'I don't' like my life. I don't like what I'm doing. I don't want to go to school,'" said Danny's grandmother.

They went to see Miranda at the Bright Minds Institute, and Miranda took a different approach to treating Danny.

Danny was wired for a qunatitative electroencephalography, or EEG, a very sophisticated test that measures a brain's electrical output in response to certain stimuli. He also underwent a comprehensive neuropsychological exam, and magnetic resonance imaging of the brain.

Those tests revealed a lot of surprises.

"This child's IQ was 138," Miranda said. "And that's huge. That's so bright."

One EEG measurement, called a P300, showed normal and abnormal electrical impulses in Danny's brain with a series of bright colors.

Reading the scan, Miranda said Danny was not "perceiving" speech in the superior temporal gyrus.

Translation: Danny has what's known as an auditory processing issue. It wasn't so much that he was having trouble speaking or pronouncing things -- his brain wasn't understanding speech correctly.

Danny's problem was not a standard speech issue at all, and his years of conventional therapy were off target.

Miranda pointed out a group of squiggly lines on the scan, showing Danny was likely to have an attention problem.

In a normal EEG, those squiggly lines would not be there in the frontal lobe section of this recording. Using those tests and other physical and behavioral information, Miranda diagnosed Danny with ADHD.

"The areas of the brain that are involved in attention deficits are many, and unless you know which one specifically is the one that you're addressing, that is not functioning very well, you cannot prescribe the right medication for it," Miranda said.

For Danny, that meant the puzzle was solved in ways his grandparents never would have guessed.

"He wasn't a hyper child at all," Jeanne Rodgers said

Now on ADHD medication and specific therapy for his decoding problem, Danny has a lot to say.

"I didn't like learning. I thought it was boring ," Danny admitted in Miranda's office.

But now "it's kind of fun," he said.

"He got nine out of 10 'outstandings' on his report card! " his grandmother marveled.

Danny's unhappiness used to tear up his grandparents. Jeanne Rodgers and her husband, Howard, are spending all they can on his special therapy, and have also spent a bundle on the tests with Miranda, almost none of which were covered by insurance. But both of them said the costs have been well worth it.

Still, some leading doctors say it's too soon to use sophisticated tests like these clinically, and that people might be wasting their money on them.

Dr. Bradley Peterson, director of the Pediatric Neuropsychiatry Research program at Columbia College of Physicians and Surgeons, said the technology is not there yet.

"No test can tell you that this child has ADHD and that one doesn't," Peterson said. "At least at present day. Hopefully, in the next year or coming years, we might have that, but we don't yet."

Others who work with the technology routinely, such as Dr. Sandlan Lowe, a professor in the departments of psychiatry, physiology and neuroscience at New York University School of Medicine, said it can help in reaching a diagnosis.

"In Europe, for instance, EEG and quantitative EEG is routinely done," Lowe said. "In this country, I think there are a lot of neurologists who have the idea that it's just not that helpful. And I have to tell you that in the right hands, it's a very useful tool."

So why isn't it used more often? A number of doctors said reading the MRIs and EEGs is complicated, and not every neurologist is properly trained to read them. The tests are also expensive, and are often not covered by insurance.

Many scam artists have also claimed they could read these brain imaging tests when they could not, bilking people out of thousands of dollars.

But Miranda, as well as many patients, believe they are on the cutting edge of a new frontier in diagnosing and treating children's cognitive problems.

Jan Jensen, a nurse whose husband is a surgeon, worried about the attention problems she sawin her three children. But she wasn't happy that her family practictioner suggested prescribing Ritalin without doing any tests.

Lindsey, 12, always seemed restless and unfocused, Jensen said. Meagan, 8, was having significant trouble reading. But Jensen was especially worried about 9-year-old Zach.

"He's like the energizer bunny on crack. I'm telling you, this kid is constantly going," she said, adding he has almost no fear and little ability to understand the consequences of his actions.

All three had MRIs and quantitative EEGs, in addition to neuropsych workups. Lindsey's results weren't a surprise; she showed clear signs of attention deficit problems, Miranda said. But he recommended a different medication than Ritalin.

But the other children's data yielded some surprises. Zach's tests showed signs of ADHD but also structural problems in his brain.

"He has an area of lack of development of the hypocampus here. This is a finding that explains some of the problems that he does have sometimes remembering or paying attention," Miranda said.

That information led Miranda to suggest not only medication but targeted therapy, in this case music lessons, to help teach the other side of Zach's brain to pick up the slack.

Miranda contends specialized memory excercises that appeal to one particular side of the brain can train it to take over for the slower side.

Megan showed no signs of attention deficits or other brain issues.Miranda suggested simply helping her with her reading. Without this puzzle piece Megan would likely have been put on medication. Mom had assumed that Meagan, the youngest, likely had the same issue as her siblings.

Controversial New Movement: Autistic and Proud

2008-06-15T04:06:00.000-07:00

Activists Say Stop Looking for a Cure and Accept Autistic People as They Are
By DEBORAH ROBERTS, MICHELLE MAJOR and JONANN BRADY
June 10, 2008

Ari Ne'eman and Kristina Chew say they are the faces and voices of autism's future.

They're part of a controversial group hoping to radically change the way others look at autism. Their message: Stop the search for a cure and begin celebrating autistic people for their differences. It's a message that has some parents of autistic children bewildered and angry.

Ne'eman, 20, is the founder of the Autistic Self Advocacy Network, a non-profit group aimed at advancing autism culture and advocating for "neurodiverse" individuals.

"We believe that the autism spectrum and those on it, are important and necessary parts of the wide diversity present in human genetics," Ne-eman says on the ASAN Web site.

Ne'eman was diagnosed with Asperger's syndrome, a less severe form of autism, as a child.

"I think the others around me knew I was different from as early as I can remember," he told "Good Morning America."

When Ne'eman says that looking for a cure for autism is the wrong approach to take, he understands why some parents are upset -- especially those with very low-functioning, non-communicative autistic children.

"I think that one of the key issues to remember is that anti-cure doesn't mean anti-progress," he said.

'Ransom' Ad Sparks Action

Kristina Chew, a professor at St. Peter's College in New Jersey, is one of the growing number of parents involved the movement.

When her son, Charlie, was diagnosed with severe autism, Chew said, "I was completely in a gulf. I didn't believe it for months."

Chew now believes that autism treatments and so-called cures are a waste of time. She said she'd rather see Charlie, now 11, benefit from better support services and education.

"My son is who he is. He's not going to change; he's always going to be Charlie. And at the same time, I loved him just for what he was," Chew said.

Parents like Chew and autistic adults like Ne'eman joined forces several months ago, after seeing an edgy new campaign to fight autism from the New York University Child Study Center that implied children with autism are held hostage by the disorder.

The NYU Child Study Center says the ads were about creating awareness, but Ne'eman says that instead, the ads reinforce prejudices about people with autism.

"Where does disability come from? It comes, in many respects, from a society that doesn't provide for an education system that meets our needs. From people who often discriminate or bully or even injure us, and from a society that is largely intolerant," Ne'eman said.

Ne'eman and his supporters protested so loudly, that the ads were cancelled three weeks after they were released.

Wouldn't Change Diagnosis

Many parents of autistic children say that Ne'eman and his group's views don't reflect their reality and should essentially be ignored.

Lenny Shaffer, a writer with an autistic son, says of the movement, "You're a handful of noisy people who get a lot of media attention, but you don't represent a broad swath of the autism community."

Ne'eman believes history is on his side.

"I can't think of the civil rights movement throughout history that hasn't been faced with resistance and misunderstanding on the part of its detractors," he said.

And the young activist says if he could go back and change his Asperger's diagnosis, he wouldn't.

"If there was a magic pill that would make me neurologically typical, normal, I wouldn't take it," Ne'eman said.

But a number of experts say his path might not be the answer for many others dealing with autism.

New test to spot autism at 9 months of age on the horizon

2008-06-06T03:43:00.000-07:00

Washington, May 21 : An early diagnostic test for autism is on the horizon, thanks to researchers at McMaster University, who are developing a new test for detecting autism as early as nine months of age.

The Early Autism Study, led by Mel Rutherford, associate professor of psychology in the Faculty of Science, has been using eye tracker technology that measures eye direction while the babies look at faces, eyes, and bouncing balls on a computer screen.

"What's important about this study is that now we can distinguish between a group of siblings with autism from a group with no autism - at nine months and 12 months," said Rutherford.

"I can do this in 10 minutes, and it is objective, meaning that the only measure is eye direction; it's not influenced by a clinician's report or by intuition.

Nobody's been able to distinguish between these groups at so early an age," she added.

Currently, the earliest diagnostic test for autism is reliable around the age of two, and most children in Ontario are diagnosed around age three or four.

The earlier the diagnosis the better the overall prognosis, said Rutherford.

"There is an urgent need for a quick, reliable and objective screening tool to aid in diagnosing autism much earlier than is presently possible," she said.

"Developing a tool for the early detection of autism would have profound effects on people with autism, their parents, family members, and future generations of those at risk of developing autism," she added.

Rutherford presented her peer-reviewed research at the 7th Annual International Meeting for Autism Research in London.

Autism program helps parents, officials and children to deal with emergency situations

2008-06-06T03:23:00.000-07:00

By AARON SANBORN
asanborn@fosters.com
Article Date: Friday, June 6, 2008

DOVER — It's a scenario that every parent of child with autism dreads.

Suddenly you're involved in some sort of accident, and your child is alone and confused and could be easily startled by the presence of emergency personnel.

It's a scenario that many in the community with autistic children are beginning to prepare for.

Six area families, including four from Dover, signed up for the Easter Seals Autism Awareness 911 program during an open house last Thursday night outside of the McConnell Center. The program allows for parents to fill out a profile of their child, which is then forwarded to the city or local dispatch centers so those homes with autistic children can be flagged for police, fire and emergency personnel.

Information also is forwarded to New Hampshire 911 to flag the phone number.

During Thursday's event, several autistic children had a chance to interact with firefighters and police officers, along with some of their equipment and apparatus.

Dover resident Marie Berman said the event was the perfect opportunity to familiarize her 6-year-old daughter with firefighters and their equipment.

"It's good for her to learn that if she is in danger, these are the people that can help," Berman said.

Berman's daughter has sensory issues and gets scared by loud noises and crowded places. Berman said it's good for her to be around the fire trucks and police cars, so she could hear the sirens.

"It helps her to not be afraid," Berman said.

Elizabeth Webster, who founded the program with her partner Dawn Brady, said the two have worked with police in Manchester and Concord. They hope to spread the program throughout the state.

The next autism event is scheduled for Saturday, Sept. 13 from 3:30 p.m. to 5:30 p.m. at the McConnell Center.

UW researchers seek better clues to autism

2008-05-27T19:30:00.000-07:00

When her toddler son seemed not to notice a door slamming nearby during his checkup, Jo James thought nothing of it. Her husband, a Microsoft manager, also has an uncanny ability to block out his surroundings.

A check of Ben's hearing after a nurse's prompt found nothing amiss. It wasn't until two years and one perceptive Montessori teacher later that his parents finally learned the cause of Ben's obliviousness: autism.

"He didn't mix terribly well socially," Jo James, of Sammamish, recalled ruefully. "But then, what 2- 1/2-year-old boy does?"

Autism typically isn't diagnosed until after age 2. Yet it may be detectable even in infancy before a baby is old enough to display telltale traits such as social ineptitude and compulsive preoccupations. Pioneering research at the University of Washington during the 1990s, for example, found that trained observers can spot, with remarkable accuracy, kids who were later diagnosed with autism by viewing videos of their first birthdays.

Now UW researchers are aiming to decipher those early clues in hopes of short-circuiting autism before it becomes full-blown.

In January, they began a $11.3 million trial to identify latent signs of autism in infants for intensive behavioral therapy. It is the nation's first attempt to test a hypothesis that early intervention may actually prevent autism in high-risk infants by rewiring their brains.

"We know the brain has a lot of potential to respond" to the right stimulation, said Sara Webb, a research assistant professor of psychiatry and behavioral sciences and the principal investigator for the study at UW Autism Center.

The goal is "to teach parents to give the child that missing piece that he's not getting on his own."

The study's very premise that autism may need not be destiny has stirred unease and skepticism among some parents. They also fret that it may rekindle the discredited notion that autism is triggered by detached and unloving mothers.

"I object to the message that if parents don't rush out like headless chickens before the child is X age, they've lost them," said Lisa Rudy, a mother and autism advocate from Falmouth, Mass.

The implication is that "if only the mother spent more time bonding with the infant, that child will never develop autism," Rudy added.

But UW researchers say they're not laying any blame on parenting. The goal is akin to averting diabetes through vigilance in a person with a family history of the disease, said Annette Estes, associate director of the Autism Center and a study investigator.

"If you are at risk for diabetes, you look for signs," Estes said. With autism, the genetic "risk factors are present at birth. What we are doing is heightening the parents' awareness."

Though some parents report concerns early on, tiny babies by definition don't have autism. That's because they can't manifest such diagnostic symptoms as language deficits and repetitive rituals.

Yet researchers suspect that babies exhibit subtle clues that precede overt symptoms. For instance, healthy babies react visibly to changes in a person's expression, such as switching from cooing to a sad face. A baby who doesn't seem to register the change may warrant watching, Estes said.

"At 6 months, a baby has a limited repertoire of signs" of autism, she said. "The question is 'What are the real early signs?'"

To answer that, UW researchers will track 200 infant siblings, 6 months or younger, of kids with autism. The disorder's strong hereditary nature means that 10 or more of those babies will develop autism themselves. The odds for a typical American child are a little greater than 1 in 200.

The infants in the study will be randomly separated into two groups. Mothers in one group will be coached on engaging with their babies. Later, the children will receive up to 25 hours a week of a type of developmental intervention called the Denver Model that uses play to teach appropriate behaviors.

The other group will be monitored but not given treatment. All children will undergo regular brain imaging to measure brain activity during tasks.

In the UW researchers' view, autism is both congenital and perhaps avoidable.

Genetics is the main cause of autism, yet there are cases where one identical twin has it and the other does not. That leaves room for possible environmental causes, but none has yet been definitively isolated.

At the same time, researchers are learning that the brain is a dynamic organ, capable of forging new neural networks well beyond the womb. Just as playing the piano might form particular synaptic connections, Webb said, environmental manipulation could help calm a brain that is threatening to go haywire.

"The unknown is the family environment," Webb said. "We do not know if the amount or the quality of stimulation is the culprit."

That some families with autism reacted warily to the UW's study does not surprise Laura Schreibman, an autism investigator at the University of California, San Diego. Since it was first described in 1943, autism has largely remained a baffling challenge for parents and researchers alike.

In her book, "The Science and Fiction of Autism" (Harvard University Press, 2005), Schreibman debunks popular speculation about origins of and treatments for autism. They include the link to the measles/mumps/rubella vaccine (rejected by scientific consensus), chelation therapy, which is ridding the body of mercury and other metals (ineffective and potentially toxic) and the myth of the frigid "refrigerator" mother.

No cure has been found for autism. And only one type of therapy, behavioral intervention, has shown measurable, albeit mostly anecdotal, success in curbing outward signs of the disorder, Schreibman said.

"I feel so much for these poor parents," she said.

James, the Sammamish mother, wonders how she could have missed it.

As a first-time parent, she didn't know that healthy babies instinctively look up to share a laugh. She didn't notice that Ben never uttered the toddler's universal refrain: "Why?"

Ben, now 4 1/2, began behavioral therapy shortly after his diagnosis. He made quick strides. He has become more engaging and inquisitive, and sometimes even offers hugs.

Ben's brother, 15-month-old Hugh, is enrolled in the UW study to track whether he might share his sibling's affliction. That seems unlikely. Hugh loves to lock gazes with visitors, and expectantly crawls toward any interest that beckons.

Still, James said of her younger son, "You always have it in the back of your mind, 'Could it happen to him, too?'"

James is reassured that although Ben still has autism, his condition has become much less obvious. She doesn't know whether researchers can find a way to cure autism instead of merely masking it. But the distinction may not matter.

Crist signs autism health insurance coverage bill for Fla.

2008-05-27T19:26:00.000-07:00

With the hope that early diagnosis and treatment of autism will lead to better lives for thousands of children and families, Gov. Charlie Crist signed legislation Tuesday that could force many large insurance plans to cover the increasingly diagnosed condition.

Former Miami Dolphins star and autism activist Dan Marino watched as Crist signed a bill that advocates have pushed for more than a decade - and said he hopes that it will lead other families without an NFL star's income to get some of the treatment that his son benefited from.

Marino's son Michael is now 20.

"He's in college, doing very well, and he's a direct result of early intervention," Marino said. "He's a direct result of occupational therapies, speech therapies, the things that you need to do at an early age."

He added: "It's given me chills actually, just thinking about the opportunity this is going to give so many children in Florida and so many families that have to deal with autism."

The new law calls for health insurance companies to negotiate agreements with the state on how they will cover diagnosis and treatment of autism-related disorders. If companies don't enter into such agreements, the state will require certain coverages by July of next year.

The coverage is capped at $36,000 a year, or $200,000 over a lifetime.

That's meant to help families like Ron Watson's. His 4-year-old son Dylan has autism.

For the next year until the coverage starts, his family will pay for the child's care out of pocket. But eventually, the program will be a huge help for Watson, who works as a lobbyist in Tallahassee for the Florida Dental Association.

"It will probably prevent me from having to sell my home or a car or max out my credit cards," Watson said. "Fortunately, we have stuck aside enough money where I think we should be good for a year. But I can't imagine all these families that for five, six, seven years have been spending $20,000, $30,000, $40,000 a year on medical services."

"This is a very happy day for an awful lot of people," said Crist.

But the measure only applies to large group insurance plans. That means families whose insurance is provided through a small employer, or who have an individual plan, may not benefit.

Sharon Wilpon still won't be able to afford the $600-a-week behavioral therapy for her 5-year-old son Benjamin because she has an individual insurance policy.

"It's a great first step and I'm glad it's going to help some," said Wilpon, of Cooper City, who attended an event with Crist at a Davie preschool. "The majority of people, it's not going to help. We still have a lot of work to do."

The bill's sponsor, Sen. Steve Geller, D-Cooper City, said the bill will only help about half of the people with insurance who need the coverage - and won't help anyone who doesn't have insurance at all. He's leaving the Legislature because of term limits, but hopes lawmakers will expand the initiative.

The measure also has a provision that allows insurers to negotiate deals with the state on how they might increase coverage for other developmental disabilities, but the provision doesn't carry any penalties for those that don't.

The bill is unusual in that the Republican-dominated Legislature has been largely unwilling in recent years to create new requirements on what insurance companies must cover. Insurers have argued, successfully, against such mandates by pointing to them as one of the main drivers of health costs.

Ironically, another bill Crist will sign this week is aimed at making cheap health insurance available to more people - precisely by removing such mandates. That bill, which Crist intends to sign Wednesday, will make cheap plans that aren't required to cover many of the current 50 or so mandates, such as coverage for mammograms, or certain cancer treatments.

Crist has battled with property insurance companies extensively in his year and a half in office. He said insurance companies should be covering autism because "it's the right thing."

"Many companies in our country do very, very well, and there's a time to give back," Crist said. "And this would be that time."

Ga. family challenges federal vaccine law

2008-05-27T19:23:00.000-07:00

Stefan Ferrari's parents say he was a talkative toddler until he got a round of booster shots with a mercury preservative. Now age 10, he hasn't spoken since those shots.

The Ferrari family asked the Georgia Supreme Court on Tuesday to rule that vaccine maker American Home Products Corp. can be held liable for damages in a civil case. The family believes they can prove that thimerosal, the mercury-based preservative, caused Ferrari's disability.

Attorneys for American Home Products argued that a 1986 federal law bans vaccine manufacturers from being held liable in civil courts for vaccine-related injuries or deaths if they were spurred by "unavoidable" side effects, properly prepared and accompanied with directions and warnings.

The case has drawn the ire of the vaccine industry as well as powerful right-leaning lobbying groups from the U.S. Chamber of Commerce to the conservative Pacific Legal Foundation.

Seven other state courts have ruled that the federal laws pre-empt any state law that might give families the power to challenge the vaccine manufacturers. But the Georgia Court of Appeals became the first appellate court in the nation to rule that the federal law doesn't take precedence over state tort law.

An attorney for the vaccine maker told Georgia's high court that the federal law has helped make vaccines available throughout the U.S. Attorney Daniel Thomasch told the justices that other courts have concluded Congress wanted the law to pre-empt state law, in part so that manufacturers aren't subjected to a mishmash of different state standards.

Ferrari's attorney, Lanny Bridgers, contended the federal law was meant to "supplement, not displace, state tort law," and asked the court's seven justices not too be swayed by earlier legal decisions.

Families of autistic children have claimed in court that thimerosal is linked to autism, although government lawyers say the Centers for Disease Control and Prevention has rejected any link.

Thimerosal has been removed in recent years from standard childhood vaccines, except flu vaccines that are not packaged in single doses. The CDC says single-dose flu shots currently are available only in limited quantities.

Charges dropped against U.S. doctor accused of killing autistic British boy by giving him wrong drug

2008-05-27T19:18:00.000-07:00

Criminal charges have been dropped against a U.S. doctor accused of causing the death of a British five-year-old autistic boy by giving him the wrong drug.

Dr Roy Kerry was trying to use chelation therapy on Abubakar Tariq Nadama in 2005 after his parents moved to the U.S. to seek treatment for his autism.

Chelation therapy, approved in the U.S. for treatment for acute heavy metal poisoning, is regarded by some as a promising treatment for autism.

The U.S. drugs authority disagrees and Kerry was charged last year with involuntary manslaughter, endangering the welfare of a child and reckless endangerment

However, yesterday a judge in Pittsburgh, Philadelphia, allowed the district attorney of Butler County to drop charges.

Kerry, 70, still faces a civil lawsuit from Abubakar's parents, Mawra and Rufai Nadama, who have returned to Britain since their son's death.

In a petition, prosecutor William Fullerton asked that the charges be dropped after reassessing the merits of the case and "given the existence of additional and more germane judicial avenues for addressing the conduct of Dr Kerry".

Kerry had surrendered his license during the case, but it will now be reinstated, a U.S. State Department spokeswoman said.

The boy went into cardiac arrest in Kerry's office on August 23, 2005, immediately after receiving chelation therapy.

The Centres for Disease Control and Prevention (CDC), which investigated Abubakar's death, has said he was given a synthetic amino acid called Disodium EDTA instead of Calcium Disodium EDTA. Both are odourless, colorless liquids and may have been confused, the CDC found.

The Department of State also contended Kerry prescribed an IV push - giving the drugs in one dose intravenously instead of over a period of time - despite warnings that it could be lethal.

Kerry's lawyer, Al Lindsay, denied the drug caused the boy's death.

He said yesterday that the drug given was not the wrong drug, as prosecutors contended, though he said it was not the "preferred" drug. He also said it was not administered incorrectly.

Mr Lindsay said Abubakar died of a lack of oxygen to the brain, caused by a heart problem not associated with the drug.

"There was a lot of misinformation that was out there and we were anxious to present it to a jury," he said. "But the truth of the matter is, we're obviously grateful that the district attorney took this position."

John Gismondi, who represents the family in the civil case, said, "I don't agree with the decision and we're disappointed. But I respect that the district attorney is the boss of the criminal case."

He maintains Kerry acted improperly. "It was the wrong drug, given the wrong way," Mr Gismondi said.

Autism's mysteries remain as numbers grow

2008-05-22T02:31:00.000-07:00

ELLICOTT CITY, Maryland (CNN) -- It remains one of the greatest mysteries of medicine. Although autism will be diagnosed in more than 25,000 U.S. children this year, more than new pediatric cases of AIDS, diabetes and cancer combined, scientists and doctors still know very little about the neurological disorder.

Unlike childhood diabetes or pediatric leukemia, there is no blood test, no scan, no image that can detect autism. Diagnosis relies totally on behavioral observation and screening. And that's not easy.

According to the National Institute of Neurological Disorders and Stroke, three distinctive behaviors characterize autism: lack of social interaction, problems with verbal and nonverbal communication, and repetitive behaviors or narrow, obsessive interests. But children with autism display these symptoms in many different ways, some as mild as avoiding eye contact, while others are totally immersed in a world of their own.

Dr. Gary Goldstein, president of Kennedy Krieger Institute, one of the leading U.S. facilities for autism research and treatment, says although doctors know more about autism than ever, plenty of questions remain unanswered. Over the past few years, it has become clear that genetics play a big role in the development of autism. But researchers believe something -- a trigger -- sets off autism in a child.

"It's a combination of being genetically vulnerable, and then having some kind of social or toxic exposure that tips you over," Goldstein says. If scientists find that trigger, they could find the missing piece of the autism puzzle.

It's that missing puzzle piece that frustrates families with autistic children. When the Gaston triplets of Ellicott City, Maryland, were born seven years ago, their parents, Lynn and Randy, were thrilled. For years, they had been trying to have children. After in vitro fertilization, Lynn gave birth to identical twins, Hunter and Nicholas, and a fraternal brother named Zachary. Though they were born prematurely, they grew to be healthy, happy babies. Then something changed.

At around 18 months, the boys began to display unusual behaviors. Zach became compulsive, lined up cereal boxes and toys; he wouldn't socialize and kept to himself. Hunter would roam the house at night and scream at the top of his lungs. Nick just stopped talking.

Lynn asked her pediatrician about it. Her sons' doctor said she was overreacting and they should wait and see. But Lynn and Randy were sure there was something wrong with their children. It was frustrating for Lynn, who watched her children change every day before her eyes. "It was almost as if somebody turned the switch off. It was like the first 18 months of their lives didn't happen."

As months passed, the Gastons became frustrated as doctor after doctor told them to wait. That was unfortunate, because doctors now know that the sooner autism is diagnosed, the better chance the child has for getting successful treatment.

"Early intervention is key, because brain development starts before birth," says Dr. Pat Levitt, director of the Vanderbilt Kennedy Center for Research on Human Development in Nashville, Tennessee.

"During the ages of 0 to 5 years, there is a tremendous amount of change that occurs in the brain and brain chemistry."

In October, the American Academy of Pediatrics set up new guidelines to help pediatricians recognize the early signs of autism, in order to diagnose the disorder and get children into treatment as soon as possible.

Unfortunately, that didn't happen for the Gastons. Their boys were 4 years old before doctors at Kennedy Krieger confirmed the family's fears. All three sons had some variation of autism.

The Gastons had never heard of autism before their sons were born. Now they were raising three autistic children. That was tough enough, but even after the diagnosis, it was hard to find any information on the condition. That's because until recently, very little information on autistic children has been widely available. The Centers for Disease Control and Prevention have been collecting data only since 2001, the year the Gaston triplets were born.

Lynn expressed her frustration: "It's not like you can look up autism in the phone book. I couldn't go to the Yellow Pages and find a doctor, and didn't even know what doctor to go see. I thought my pediatrician was going to handle all this."

The Gastons keep asking themselves, "Where is the trigger?" They've each looked into their family history and found no autism.

Some parents believe that thimerosal, a preservative found in childhood vaccines that virtually every child gets, causes autism, because many children were diagnosed after they were vaccinated. But most medical experts increasingly doubt that theory, because even though the chemical has been removed from virtually all vaccines, the number of cases of autism is rising.

"You remove thimerosal from all but the flu vaccine, which isn't given to children under 6 months of age, and the incidence of autism only increases. So you just have piece of evidence after piece of evidence after piece of evidence that really disproves this notion," said Dr. Paul Offit, chief of the Infectious Diseases Division at Children's Hospital of Philadelphia, Pennsylvania.

Although the Gastons don't express their opinions on vaccines, Randy makes a point: "There's something that's affecting these children at that age, and it's unfortunate that families are left to their own devices to find out what is going on."

For now the Gastons remain dedicated to getting their sons the best care possible, which can be expensive. They sold their house in order to pay bills for therapy and doctors that total in the hundreds of thousand of dollars.

They are also involved in autism awareness groups and try to help other parents of autistic children understand what their children are going through. Just recently they shot a public service announcement to promote a new project developed by the Kennedy Krieger Institute, called IAN, or interactive autism network, an online project that can help autism researchers link with families of autistic children as well as with other scientists. The hope is that IAN will alert families to local and national autism research projects they can participate in.

But minus the projects and the doctors and the therapists, the Gastons, like many families with autistic children, believe it all comes down to the attention they give their children that makes the real difference.

To say it's been difficult for the Gastons is an understatement. But above all, they love each other and work to give their children as much happiness as possible.

As Randy Gaston says while Zach turns to give him a hug and a smile, "The one thing he has to know for the rest of his life is that I did everything for him. That's what it comes down to. I love him."

Families will make case for vaccine link to autism

2008-05-11T21:22:00.000-07:00

WASHINGTON - Families claiming that a mercury-based preservative in vaccines triggers autism will challenge mainstream medicine Monday as they take their case to a federal court.

They seek vindication and financial redress from a government fund that helps people injured by shots.

Two 10-year-old boys from Portland, Ore., will serve as test cases that determine whether the children and their families in similar situations should be compensated. Attorneys for the boys will attempt to show the boys were happy, healthy and developing normally. But, after being exposed to vaccines with thimerosal, they began to regress and show symptoms of autism.

Thimerosal has been removed in recent years from standard childhood vaccines, except flu vaccines that are not packaged in single-doses. The CDC says single-dose flu shots currently are available only in limited quantities. In 2004, a committee with the Institute of Medicine concluded there was no credible evidence that vaccines containing thimerosal caused autism.

Overall, nearly 4,900 families have filed claims with the U.S. Court of Claims alleging that vaccines caused autism and other neurological problems in their children. Lawyers for the families will present three different theories of how vaccines caused autism.

The Office of Special Masters of the claims court has instructed the plaintiffs to designate three test cases for each of the three theories — nine cases in all — and has assigned three special masters to handle the cases. Three cases in the first category were heard last year, but no decisions have been reached.

The two cases beginning Monday are among the three that focus on the second theory of causation: that thimerosal-containing vaccines alone cause autism. The plaintiff in the third case originally scheduled for hearing this month has withdrawn and lawyers and court officials are working to agree on substitute case.

Hearings in the test cases for the third theory of causation are scheduled in mid-September.

Lawyers for the petitioning families in the cases being heard this month say they will present evidence that injections with thimerosal deposit a form of mercury in the brain. That mercury excites certain brain cells that stay chronically activated trying to get rid of the intrusion.

"In some kids, there's enough of it that it sets off this chronic neuroinflammatory pattern that can lead to regressive autism," said attorney Mike Williams.

In the end, the families' attorneys hope to convince the special master hearing their case that thimerosal belongs on the list of causes for the inflammation that leads to regressive autism.

To win, the attorneys for the two boys, William Mead and Jordan King, will have to show that it"s more likely than not that the vaccine actually caused the injury.

Many members of the medical community are skeptical of the families' claims. They worry that the claims about the dangers of vaccines could cause some people to forgo vaccines that prevent illness.

"I think that what's so endearing to me about the anti-vaccine people is they're perfectly willing to go from one hypothesis to the next without a backward glance," said Dr. Paul Offit, director of the Vaccine Education Center at the Children's Hospital of Philadelphia.

Autism is a developmental disability that typically appears during the first three years of life and affects a person's ability to communicate and interact with others. Dr. Andrew Gerber, a psychiatrist, said that medical experts don't have a comprehensive understanding of what causes autism, but they do know there is a strong hereditary component.

Toxins from the environment could play a role, but currently, data does not support that they do, Gerber said.

Arguments are scheduled to go on throughout the month. A final decision could take several more months. Claims that are successful would result in compensation taking into account lost earnings after age 18 and up to $250,000 for pain and suffering.

The families or the federal government can also appeal the decision of the special master to the Court of Federal Claims or to a federal appeals court.

The court Web site says more than 12,500 claims have been filed since creation of the program in 1987, including more than 5,300 autism cases, and that more than $1.7 billion has been paid in claims. It says there is now more than $2.7 billion a trust fund supported by an excise tax on each dose of vaccine covered by the program.

SPECIAL REPORT: Life After An Autism Diagnosis; Special Diets Pt. 3

2008-05-09T23:05:00.000-07:00

The cause of most cases of autism remains a constant source of friction between doctors and parents of autistic children. A small percent of cases - between 2 and 6 percent-- are believed to be caused by a genetic condition called fragile x-syndrome. Researchers are also looking into the possibility that vaccines can trigger the disorder in some children.

The case of 9 year old Hannah Poling has re-ignited the debate surrounding a possible link between Autism and common childhood vaccines. In march, a Federal Court ruled that vaccines did cause the Autism of the 9 year old Georgia girl who had an underlying cell disorder.

Doctor Kyle Vandyke has a child with severe Autism. He's been a doctor for nearly 15 years and is a trained a DAN Practitioner. "DAN Practitioners are traditional doctors that have gone through the Defeat Autism Now Training Course," says Dr. VanDyke. Doctor Vandyke says DAN doctors focus on treating Autism. Many of his patients have expressed concern about vaccines. "Just from talking with dozens and dozens of parents certainty it is a factor in a lot of kids. A lot of parents had normally developing kids, they had certain shots and saw their kids regress after that."

Tracy Graveen of Edgar believes an ingredient in a vaccine may have contributed to her 4 year son Jaxon's Autism diagnosis. She says at 16 months old he suddenly stopped talking. "It was like someone flipped the switch after he got his MMR, he woke up the next morning a completely different child" says Graveen.

Doctor Vandyke says researchers are still exploring the possible link between vaccines and Autism but until someone figures out how to prevent autism - he's focusing on *treating* it - with a Bio-Medical Approach that removes certain foods from a child's diet. "90% of the children I’ve seen in my clinic have chronic diarrhea and chronic constipation. When you take away the gluten and the casein those problems get better or are completely resolved and as their GI problems get better their behavior gets better."

Doctor Vandyke recommends parents try the GFCG Diet because children with autism often have problems digesting the gluten found in wheat products and the casein found in dairy. He says he has seen positive results first hand with his son. "On my way home I bought a gallon of soy milk and gave him a bottle instead of regular milk and with in 24 hours he was aware and alert. It was a remarkable change and that was the only thing I had done"

Doctor Vandyke is not Jaxon's doctor but the Graveen's are trying the biomedical approach. Jaxon's mom says they noticed a change in Jaxon after two weeks. "The few weeks were really tough but two weeks later we actually able to see him say sentences things we never imagined would happen for years."

Jaxon's mom says right now he only eats about 6 things-- mainly peas and hamburgers but he continues to develop. "I do believe that there is a cure and I see it happening everyday in our own house and it's the best feeling in the world." As research continues into the possible link between immunization and autism - many pediatricians worry families will skip vaccines in hopes of avoiding autism.
But they warn that could lead to a resurgence in many dangerous diseases those vaccines prevent.

SPECIAL REPORT: Life After An Autism Diagnosis; Special Diets

2008-05-09T23:03:00.000-07:00

Learning that your child has autism can be heartbreaking news.
Since cases of autism are on the rise - it's a diagnosis many families in our area are dealing with.
But the good news is that many autistic kids are having great success with alternative therapies. A Weston family trying a bio-medical approach to their autistic son's diet.

Two year old Troy is the Esker's only child and his father Cory Esker, describes him as a daddy's boy.
Troy's parents say they noticed his speech delay and learned about his autism diagnosis in December of 2007. "First it was a little bit of a shock but after a while you just get used to it and it's just another challenge in life," says Esker.

The Esker's say doctors told them to immediately put troy in therapy. They tried to, but several programs they applied for had waiting lists with wait times as long as two years. "when you talk about early intervention some times i don't think those programs are really effective because of the waiting... Early intervention is like now." Says Troy's Mom Jamie.

The Eskers are trying a special diet and alternative therapy. He is on the Gluten Free, Casein Free Diet. He is also in an alternative therapy program called DIR Floor-time. Troy's mom says he is a blessing. To pay for his alternative therapy she says they've cut back on household items and delayed family vacation plans.

Troy's dad says like most fathers, he dreams of playing sports with his son someday. No matter what the future holds, autism won't stop him from enjoying time with his son. "I make time for him, and when I get into it, I enjoy it more than anything in the world."

Seven's On Call with Dr. Jay Adlersberg

2008-05-09T20:48:00.000-07:00

By Dr. Jay Adlersberg

NEW YORK (WABC) -- What are the best methods for teaching autistic children? Hundred of research projects are underway, looking for those answers.

One researcher here in New York is looking to the eyes for answers.

Seven's On Call with Dr. Jay Adlersberg.

The research is going on right now, and it is open to people who might want to take part, both people on the autism spectrum and anyone else simply interested in the subject.

The investigation might one day help educators and therapists learn more about how the brain of an autistic person works.

Faces tell us if someone appears happy, angry or sad, and they cue us how to act or react. But many children on the autism spectrum cannot read faces. Facial recognition and interpretation is a challenge.

Ten-year-old Phillip Cohen is helping Dr. Nim Tottenham find how and possibly why developmentally-challenged children have trouble reading faces. He is part of a study that is looking in how the brain works when someone looks at a face.

Phillip has a diagnosis that's on the autism spectrum.

"When he speaks to people, he doesn't focus," his mother, Marsha Rubin, said. "He gazes off in another direction, and especially for learning and academics, he has to be able to concentrate better and communicate better."

In the study, subjects like Phillip are quickly shown faces and prompted where to look, while a camera records where their eyes are looking.

But more information will come from their brain.

Phillip and people in the study will also be shown face pictures while in a functional MRI machine. In the test, the study subjects will look at faces while the MRI records their brain activity.

Dr. Tottenham will get information from the brain of autism spectrum people and ordinary people.

"The purpose of the study is to really ask, in childhood, what's going on between typical and atypical development in face processing," she said.

Dr. Tottenham hopes this research will answer question about possibly early intervention in children with autism, particularly, is there a window in which the brain could perhaps be trained.

Learning to read faces is an integral part of our social interaction with each and a difficult problem for many children who are developmentally different. Anyone between age 6 and age 40 can take part in the study.

Adults with autism to be audited

2008-05-09T20:47:00.000-07:00

For the first time the government is to calculate the number of adults with autism in England.

Announcing the £500,000 project, Care Services Minister Ivan Lewis said autistic adults are too often abandoned by health and social services.

The National Autistic Society welcomed the move, saying it hopes it will mark a turning point in the way the needs of adults with autism are met.

The statistics will be used to form a national strategy.

The challenge for the researchers will be to make sure people whose autism has not yet been diagnosed are not overlooked.

In making the announcement, Ivan Lewis highlighted how limited the understanding of the condition still is.

"We still don't know enough about autism, but we do know that left unsupported, it can have a devastating impact on those who have the condition and their families.

"One of the key gaps in our knowledge is simple - we don't know how many people have the condition in any given area.

"That is why I am ordering a study to address this."

Lifelong disability

The National Autistic Society describes the condition as a complex disability affecting someone's development and a defect in the way the brain functions.

Asperger Syndrome is a form of autism where people sometimes have high intellectual and verbal abilities, but it is still very disabling, and people with it can find many ordinary daily activities such as cooking, shopping, handling money, making phone calls almost impossible.

Autism is often associated only with children, but it is a lifelong disability with no cure.

There has been academic research into the prevalence of autism amongst children in the UK and that suggests it is one in every 100.

Adults with autism told us they feel isolated and ignored
Mark Leve
National Autistic Society

Your experiences of autism

But until now, there has been no specific study into how many adults have the condition.

The group has been hard to measure partly because so many people have grown up before improvements in recognition and diagnosis; and some may have been labelled inappropriately as having mental health problems or learning difficulties or not acknowledged at all.

Academics at the University of Leicester will lead the research which will include a study of a sample of the adult population - a sort of mini census .

Their challenge will be to find some way of taking account of those adults who have not been diagnosed to achieve as much accuracy as possible.

Once the work is complete, the government will use the statistics to craft the first national strategy for adults with autism to be published next year.

The National Autistic Society has long campaigned for this research to be done and is enthusiastic about the move.

Chief Executive Mark Lever said: "This is great news for the thousands of adults with autism who told us they feel isolated and ignored.

"We are delighted that the government has listened and is taking decisive action. Today's announcement should mark a sea change in the way that the needs of people with autism are recognised and met.

"However, we will keep campaigning to ensure real change happens at ground level."

Geoffrey Maddrell, chairman of the charity Research Autism added: "This is an important first step towards understanding the scale of autism in the UK and will help to decide what next steps need to be taken to ensure people with the condition are supported and signposted toward approaches that will enhance their quality of life."

Making strides for autism school in Southborough

2008-05-09T20:41:00.000-07:00

SOUTHBOROUGH - When Linda and David Shaffer moved to Southborough 14 years ago, they knew nothing about the New England Center for Children (NECC), a nonprofit education center for children with autism.

But when their son, Harrison, was diagnosed with autism and eventually needed services beyond what public schools could provide, the Shaffers discovered that the best place for Harrison to go to school was virtually in their backyard.

"It was a pretty weird twist of fate," said Linda Shaffer. "But I could go on and on about the gains my son has made in the years he's been at NECC."

Harrison, 9, has spent three years at the school, just off Rte. 9, and has flourished in that time, his mother said. Tomorrow, his family and about 750 other supporters will give back to the school by participating in NECC's second annual 5K Walk/Run for Autism.

The event raised $140,000 last year, and NECC special events director Jennifer Eames expects it will pull in a similar amount this year. Money will go toward the school's annual fund to pay for gym and playground equipment, computers, residence upgrades and safety equipment for the school's aquatic center.

The Shaffer family has created a 10-person team for tomorrow's event, including Harrison's older sister, Alexandra, 11, and a set of grandparents from New Hampshire. The team has raised $4,100 so far.

More important, said Linda Shaffer, is to spread the word to other Southborough residents about NECC.

"So many people drive by the school and don't know what it's about," she said. "People should come out and meet these kids and their families."

For the Shaffer family, NECC has been a place where Harrison has responded to applied-behavioral analysis teaching techniques. He has learned how to tie his shoe, read, write, add and subtract.

"Harrison has done beautifully because of the school," Linda Shaffer said.

When Harrison started at NECC at age 6, he was at the skill level of an 18-month-old, she said. Now, at 9, he has the abilities of a five-year-old.

"Never in my wildest dreams did I envision him doing homework," said Shaffer. "If you saw Harrison three years ago you'd be like, 'Wow, this is amazing.' "

Harrison loves the outdoors, and recently won two Special Olympics medals for running and the softball shot-put. He'll probably enjoy walking the 3.1-mile loop tomorrow, his mother said.

"He can't really express himself with words," she said. "But his face says it all."

The 10 a.m. race starts and finishes near Town Hall, at 17 Common St., and will be followed by a celebration cookout with a band and an awards ceremony. It will be held rain or shine, and registration will start at 8:30 a.m.

Autism 'Epidemic' Follows Increase in Special Education Funding, Shift in Diagnosis

2008-05-03T23:54:00.000-07:00

A few decades ago, people probably would have said kids like Ryan Massey and Eddie Scheuplein were just odd. Or difficult.

Both boys are bright. But Ryan, 11, is hyper and prone to angry outbursts, sometimes trying to strangle another kid in his class who annoys him. Eddie, 7, has a strange habit of sticking his shirt in his mouth and sucking on it.

Both were diagnosed with a form of autism. And it's partly because of children like them that autism appears to be skyrocketing: In the latest estimate, as many as one in 150 children have some form of this disorder. Groups advocating more research money call autism "the fastest-growing developmental disability in the United States."

Indeed, doctors are concerned there are even more cases out there, unrecognized: The American Academy of Pediatrics last week stressed the importance of screening every kid — twice — for autism by age 2.

But many experts believe these unsociable behaviors were just about as common 30 or 40 years ago. The recent explosion of cases appears to be mostly caused by a surge in special education services for autistic children, and by a corresponding shift in what doctors call autism.

Autism has always been diagnosed by making judgments about a child's behavior; there are no blood or biologic tests. For decades, the diagnosis was given only to kids with severe language and social impairments and unusual, repetitious behaviors.

Many children with severe autism hit themselves or others, don't speak and don't make eye contact.

Blake Dees, a 19-year-old from Suwanee, Ga., falls into that group. For the past eight years, he has been in a day program with intense services, but he still doesn't talk, he's not toilet-trained, and he has a history of trying to eat anything — even broken glass.

But he's not a typical case.

In the 1990s, the autism umbrella expanded, and autism is now shorthand for a group of milder, related conditions, known as "autism spectrum disorders."

The spectrum includes Asperger's syndrome and something called PDD-NOS (for Pervasive Developmental Disorder-Not Otherwise Specified). Some support groups report more than half of their families fall into these categories, but there is no commonly accepted scientific breakdown.

Gradually, there have been changes in parents' own perception of autism, the autism services schools provide, and the care that insurers pay for, experts say.

Eddie, of Buford, Ga., was initially diagnosed with obsessive-compulsive disorder, attention deficit hyperactivity disorder and other conditions. But the services he got in school were not very helpful.

His mother, Michelle, said a diagnosis of autism brought occupational therapy and other, better services.

"I do have to admit I almost like the idea of having the autistic label, at least over the other labels, because there's more help out there for you," said Scheuplein.

"The truth is there's a powerful incentive for physicians and schools to classify children in a way that gets services," said Dr. Edwin Trevathan of the U.S. Centers for Disease Control and Prevention.

Many with Asperger's and PDD-NOS succeed in school and do not — at first glance — have much in common with children like Blake Dees.

At a recent gathering of families with Asperger's children in the Atlanta area, parents told almost comical stories about kids who frequently pick their noses, douse food in ketchup or wear the same shirt day after day.

Such a frank, humorous exchange was once a rarity. Doctors for many years believed in the "refrigerator mom" theory, which held that autism was the result of being raised by a cold, unloving mother. The theory became discredited, but was difficult to dislodge from the popular conscience.

Even in the early 1980s, some parents were more comfortable with a diagnosis of mental retardation than autism, said Trevathan, director of the CDC's National Center on Birth Defects and Developmental Disabilities.

Today, parents are more likely to cringe at a diagnosis of mental retardation, which is sometimes equated to a feeble-mindedness and may obscure a child's potential.

And increasingly, professionals frown at the term: The special education journal Mental Retardation this year changed its name to Intellectual & Developmental Disabilities.

The editor said that "mentally retarded" is becoming passe and demeaning, much like the terms idiot, imbecile and moron — once used by doctors to describe varying degrees of mental retardation.

In contrast, autism has become culturally acceptable — and a ticket to a larger range of school services and accommodations.

In 1990, Congress added the word "autism" as a separate disability category to a federal law that guarantees special education services, and Education Department regulations have included a separate definition of autism since 1992.

Before that, children with autism were counted under other disabling conditions, such as mental retardation, said Jim Bradshaw, an education department spokesman.

The Social Security Administration also broadened its definition of disability to include spectrum disorders, like Asperger's.

Something else changed: The development of new stimulants and other medicines may have encouraged doctors to make diagnoses with the idea of treating them with these drugs.

Perception of the size of the problem changed, too.

Fourteen years ago, only 1 in 10,000 children were diagnosed with it. Prevalence estimates gradually rose to the current government estimate of one in 150.

That increase has been mirrored in school districts. Gwinnett County Public Schools — Georgia's largest school system — had eight classrooms for teaching autistic youngsters 13 years ago; today there are 180.

Some researchers suggest that as autism spectrum diagnoses have gone up, diagnoses of mild mental retardation have fallen.

U.S. Department of Education data show that the number of students with autism rose steadily, from about 42,500 in 1997 to nearly 225,000 in 2006. Meanwhile, the number of students counted as mentally retarded declined from about 603,000 to about 523,000.

CDC scientists believe education numbers are misleading, because they reflect only how kids are categorized for services. They say there's no clear evidence doctors are substituting one diagnosis for the other.

Some parents believe environmental factors — ranging from a preservative in vaccines to contaminants in food or water — may be important contributors. (The last doses of early childhood vaccines containing the preservative thimerosal expired in 2002, although some children's flu shots still contain it.)

Dr. Gary Goldstein, scientific adviser to the national advocacy group Autism Speaks, said the explanation for the rising autism prevalence is probably complex. Labeling and diagnosing probably play a role, as do genetics, but he believes the increase surpasses those two explanations.

"I'm seeing more children with autism than I ever would have expected to see," said Goldstein, who is chief executive of the Kennedy Krieger Institute, a treatment center for pediatric developmental disabilities in Baltimore.

Autism Speaks budgets more than $4 million each year to research the causes of autism, and about 90 percent of that has gone to genetics research. But organization officials recently have been talking about changing that mix, and spending as much as 50 percent of that money on potential environmental triggers, Goldstein said.

Whether it's because of genes or the environment (or both), autism has hit the Massey family hard. Chuck and Julia Massey, of Dacula, Ga., have three sons with Asperger's.

The youngest, Ryan, was first diagnosed after he was slow to develop speaking ability. His brothers — Trevor, 14, and Morgan, 16 — had learning and behavior problems and were later diagnosed with Asperger's, too.

All got special education services and were treated with medications. Morgan has improved, or matured, or both, and is now a social kid in mainstream classes at a Gwinnett County high school. Trevor seems to be making the same transition, his mother said.

Ryan is the most extreme. He still has uncontrollable tantrums and must attend an Asperger's-only sixth-grade classroom that teaches social skills along with traditional subjects.

In a recent interview at the family's home, Ryan acknowledged he still has anger control issues. One of the three other students in his class is particularly irritating. Ryan said the way he reacts is by "grabbing his throat."

But on this night, Ryan was calm. He described himself as happy, and paced the room telling jokes, like a nervous stand-up comedian. ("Why didn't the skeleton go to the party? He didn't have the guts," he said, eyes fixed on his audience.)

Having three Asperger's boys under one roof has at times been very intense, Massey said, noting a replaced dining room window.

Ryan acknowledged it's been educational living in a house full of Asperger's kids. Asked to name something he's learned from his brothers, he replied, "Swears."

Pa. Doctor to Stand Trial in Boy's Death

2008-05-03T23:45:00.000-07:00

SLIPPERY ROCK, Pa. — A doctor was ordered to stand trial on charges he caused the death of a 5-year-old autistic boy by incorrectly administering a controversial chemical treatment.

Dr. Roy Kerry, 69, used the wrong drug and administered it incorrectly while trying to use chelation therapy on Abubakar Tariq Nadama, another physician testified at Kerry's preliminary hearing Thursday.

The boy went into cardiac arrest in Kerry's office on Aug. 23, 2005, immediately after receiving the therapy, which is meant to remove heavy metals from the body.

Chelation is not approved by the federal government for treating autism, though the Food and Drug Administration has approved it for treating lead poisoning.

Some people link autism to a mercury-containing preservative that was once common in childhood vaccines. Those who believe this is a possible cause of autism advocate chelation as a remedy.

A district judge on Thursday determined prosecutors had enough evidence to proceed with the case and ordered Kerry to stand trial for involuntary manslaughter.

Kerry's Lawyer, Al Lindsay, argued there was not enough evidence that the doctor had committed a crime.

Dr. Mary Carrasco, a pediatrician who testified for the prosecution, said Kerry used the wrong drug and administered it incorrectly. She called his actions "extremely reckless."

The Centers for Disease Control and Prevention reviewed Abubakar's autopsy in January 2006. The agency said the boy died because the doctor administered a drug that removes calcium from the blood, disodium EDTA, rather than calcium EDTA, which is FDA-approved to treat heavy metal poisoning.

Carrasco also said Kerry administered the drug in one intravenous "push," but should have given the drug over several hours.

Theresa Vicker, a certified medical assistant who worked for Kerry and administered the drug to Abubakar, said he was the first child she had treated with chelation. She also said she had never been instructed to do so in one "push" before, but rather over a period of more than three hours.

"When I was finished with the administration of the mixture, I was switching syringes to push in the saline and Tariq quit breathing," Vicker said.

After removing the IV line, Vicker and the assisting physician checked the boy's vitals, called the paramedics and began administering CPR. When paramedics arrived, Vicker left the exam room and "we cried," she said.

The boy's parents, Mawra and Rufai Nadama, had moved from Plymouth, England, to the Pittsburgh area so he could receive the autism treatment. They have filed a wrongful death suit against Kerry. The parents, who have returned to the United Kingdom, did not attend Thursday's hearing.

Kerry has argued that the boy's autism symptoms improved after the first two treatments. He acknowledged there may have been "miscommunication" about which medicine to administer during the third treatment, but said it did not amount to gross negligence.

Kerry also will stand trial on charges of endangering the welfare of a child and reckless endangerment. The doctor has no prior conviction, so is unlikely to face the maximum sentence of decades in prison.

John Gismondi, the family's attorney, welcomed the district judge's decision.

"It was obviously reckless conduct. He did something no doctor in the world would do," Gismondi said.

California Autism Cases Continue to Grow

2008-05-03T23:26:00.000-07:00

OS ANGELES — Autism cases in California continued to climb even after a mercury-based vaccine preservative that some people blame for the neurological disorder was removed from routine childhood shots, a new study found.

Researchers from the state Department of Public Health found the autism rate in children rose continuously during the 12-year study period from 1995 to 2007. The preservative thimerosal hasn't been used in childhood vaccines since 2001, but is used in some flu shots.

Doctors say the latest study adds to existing evidence refuting a link between thimerosal exposure and autism risk and should reassure parents that the disorder is not caused by vaccinations. If there was a risk, they said, autism rates should have dropped between 2004 and 2007.

The findings show "no evidence of mercury poisoning in autism" since there was no decline in autism rates even after the elimination of thimerosal, said Dr. Eric Fombonne, an autism researcher at Montreal Children's Hospital who had no role in the research.

Some advocacy groups blame thimerosal for the impaired social interaction typical of autism. Nearly 5,000 claims alleging a vaccine-autism link have been lodged with the federal government, which is deciding whether victims should receive compensation from a government fund.

Dr. Daniel Geschwind, a neurologist at the David Geffen School of Medicine at the University of California, Los Angeles, said the focus now should be on exploring the causes of autism such as possible genetic links.

"Something else must be at play and we need to know what that is if we're really serious about preventing autism," said Geschwind, who had no connection with the study.

For their study, California public health officials calculated the autism rate by analyzing a database of state-funded centers that care for people with autism and other developmental disorders.

They found the prevalence of autism in children aged 3 to 12 increased throughout the study period. For example, 0.3 per 1,000 children born in 1993 had autism at age 3 compared with 1.3 per 1,000 children born in 2003. Similar trends were found in other age groups.

"These time trends are inconsistent with the hypothesis that thimerosal exposure is a primary cause of autism in California," the researchers wrote.

Results were published in January's issue of the journal Archives of General Psychiatry. The study did not explore why there was an increase in autism cases.

Federal statistics show about one in 150 children in the United States have autism, higher than previous estimates. Researchers say it's unclear if the increase is due to changes in how the disorder is classified or whether it's an actual spike.

Autism is characterized by impaired social interaction and communication skills. There is no cure, but early therapy can lessen the severity.

Geraldine Dawson, the chief science officer for the advocacy group Autism Speaks, called the California research "a very important study," and said all possible causes _ genetic and environmental _ need to be explored aggressively.

"The bulk of the evidence thus far suggests that mercury is not involved, but I think parents still have many questions," said Dawson. "I think until parents are satisfied, we need to continue to examine the question."

Pediatricians Group Wants Show Canceled

2008-05-03T23:19:00.000-07:00

By LINDSEY TANNER, AP Medical Writer

CHICAGO — The nation's largest pediatricians' group on Monday said ABC should cancel the first episode of a new series because it perpetuates the myth that vaccines can cause autism.

ABC's new drama, "Eli Stone," debuts on Thursday. It features British actor Jonny Lee Miller as a prophet-like lawyer who in the opening episode argues in court that a flu vaccine made a child autistic. When it is revealed in court that an executive at the fictional vaccine maker didn't allow his own child to get the shot, jurors side with the family, giving them a huge award.

The show's co-creators say they're not anti-vaccine and would be upset if parents chose not to immunize their children after seeing the show.

But, said Dr. Renee R. Jenkins, president of the influential American Academy of Pediatrics, "A television show that perpetuates the myth that vaccines cause autism is the height of reckless irresponsibility on the part of ABC and its parent company, The Walt Disney Co."

"If parents watch this program and choose to deny their children immunizations, ABC will share in the responsibility for the suffering and deaths that occur as a result. The consequences of a decline in immunization rates could be devastating to the health of our nation's children," Jenkins said in a statement.

Autism is a complex disorder featuring repetitive behaviors and poor social interaction and communication skills. Scientists generally believe that genetics plays a role in causing the disorder; a theory that a mercury-based preservative once widely used in childhood vaccines is to blame has been repeatedly discounted in scientific studies.

The academy released the text of a letter Jenkins wrote on Friday, addressed to Anne Sweeney, president of Disney-ABC Television Group. In the letter, Jenkins writes that many viewers "trust the health information presented on fictional television shows, which influences their decisions about health care. "

Jenkins noted that erroneous reports in the United Kingdom linking the measles vaccine to autism prompted a decline in vaccination and the worst outbreak of measles in two decades.

Greg Berlanti, a co-creator of the show, said the episode is fictional but designed "to participate in what is a national conversation" about a controversial subject. He said the boy who plays the autistic child has autism, but that the show's producers have no connection with advocates involved in the autism debate.

"We would be deeply upset" if parents opted against vaccination because of the episode, Berlanti said.

Marc Guggenheim, who helped create the show, said the first episode shows how a fictional company covered up a study that raised questions about its product, and that the message is really about "the downside of the corporatization of America."

Government Concedes Vaccine Injury Case

2008-05-03T22:57:00.000-07:00

Wednesday, March 05, 2008

By MARILYNN MARCHIONE, AP Medical Writer

Government health officials have conceded that childhood vaccines worsened a rare, underlying disorder that ultimately led to autism-like symptoms in a Georgia girl, and that she should be paid from a federal vaccine-injury fund.

Medical and legal experts say the narrow wording and circumstances probably make the case an exception _ not a precedent for thousands of other pending claims.

The government "has not conceded that vaccines cause autism," said Linda Renzi, the lawyer representing federal officials, who have consistently maintained that childhood shots are safe.

However, parents and advocates for autistic children see the case as a victory that may help certain others. Although the science on this is very limited, the girl's disorder may be more common in autistic children than in healthy ones.

"It's a beginning," said Kevin Conway, a Boston lawyer representing more than 1,200 families with vaccine injury claims. "Each case is going to have to be proved on its individual merits. But it shows to me that the government has conceded that it's biologically plausible for a vaccine to cause these injuries. They've never done it before."

A lawyer for the 9-year-old girl has scheduled a news conference in Atlanta on Thursday. Her parents have declined to comment in the meantime because the case is not final and the payment amount has not been set.

Nearly 5,000 families are seeking compensation for autism or other developmental disabilities they blame on vaccines and a mercury-based preservative, thimerosal. It once was commonly used to prevent bacterial contamination but since 2001 has been used only in certain flu shots. Some cases contend that the cumulative effect of many shots given at once may have caused injuries.

The cases are before a special "vaccine court" that doles out cash from a fund Congress set up to pay people injured by vaccines and to protect makers from damages as a way to help ensure an adequate vaccine supply. The burden of proof is lighter than in a traditional court, and is based on a preponderance of evidence. Since the fund started in 1988, it has paid roughly 950 claims _ none for autism.

Studies repeatedly have discounted any link between thimerosal and autism, but legal challenges continue. The issue even cropped up in the presidential campaign, with Republican John McCain asserting on Friday that "there's strong evidence" autism is connected to the preservative.

The girl has a disorder involving her mitochondria, the energy factories of cells. The disorder _ which can be present at birth from an inherited gene or acquired later in life _ impairs cells' ability to use nutrients, and often causes problems in brain functioning. It can lead to delays in walking and talking.

Federal officials say the law bars them from discussing the case or releasing documents without the family's permission. However, The Associated Press obtained a copy of the concession by U.S. Department of Health and Human Services officials.

According to the document, five vaccines the girl received on one day in 2000 aggravated her mitochondrial condition, predisposing her to metabolic problems that manifested as worsening brain function "with features of autism spectrum disorder." In the 1990s, the definition of autism was expanded to take in a group of milder, related conditions, which are known as autism spectrum disorders.

The document does not address whether it was the thimerosal _ or something else entirely in the vaccines _ that was at fault.

The compensation fund lists problems with brain function as a rare side effect of certain vaccines. Such problems are enough on their own to warrant compensation, even without autism-like symptoms, and the fund has made numerous payouts in such cases.

The Health Resources and Services Administration, which is in charge of the fund, said: "HRSA has maintained and continues to maintain the position that vaccines do not cause autism."

A Portuguese study suggested that 7 percent of autistic children might also have the mitochondrial disorder, versus one in 5,000 people _ or 0.02 percent _ in the general population, said Dr. Marvin Natowicz, a Cleveland Clinic geneticist.

"Even if they're off by a factor of seven" and only 1 percent are afflicted, "it's still a striking statistic," he said.

Others said they doubt the Georgia case will have much effect.

"No link between mitochondrial disorders and autism spectrum disorder has been made in mainstream medicine," said Dr. Michael Pichichero of the University of Rochester in Rochester, N.Y., who has consulted for the government on vaccines and has received speaking fees from vaccine makers.

A decision is expected this spring on the first test case for a larger group of autism-vaccine claims, which are being heard in the U.S. Court of Federal Claims.

Reported cases of autism have been rising in the U.S., even after thimerosal was removed from most childhood vaccines. However, some experts believe the rise is due to an expansion of the definition of autism and related conditions, and a desire to diagnose children so they qualify for special services and aid.

Federal report says preservative in vaccine may be linked to disease

2008-04-29T16:36:00.001-07:00

A vaccine preservative may have contributed to a case of autism, the federal government conceded after years of denying a link.

In its written concession statement, the government said the child had a pre-existing mitochondria disorder that was "aggravated" by her shots, resulting in an autism spectrum disorder (ASD) diagnosis.

Mitochondria are the powerhouses of the cell, converting oxygen and food into energy for every life function.

The news site Huffington Post at www.huffingtonpost.com reported in November that federal officials had confirmed the link to thimerosal Nov. 9.
The government then sealed records of its statement, the Web site reported.

"The vaccinations received on July 19, 2000, significantly aggravated an underlying mitochondrial disorder, which predisposed [the child] to deficits in cellular energy metabolism, and manifested as a regressive encephalopathy [brain disease] with features of ASD," the concession obtained by Huffington Post states.

Mitochondrial disorders are rare, affecting one in every 2,000 to 4,000 people, according to the United Mitochondrial Disease Foundation.
Symptoms include lethargy, poor coordination and problems eating or digesting food.

However, the number of children with autism affected by mitochondrial disorders is around one in five.

With 4,900 thimerosal cases pending in the federal courts, a distinct connection among thimerosal, mitochondrial disorders and autism would have far-reaching implications.

Most vaccines today do not use thimerosal as a preservative, according to a survey by the Johns Hopkins Bloomberg School of Public Health in Baltimore City.

The exceptions include large-batch adult flu vaccines made by some manufacturers.

Autism spectrum disorders are a group of developmental disabilities marked by impaired social interaction and communication and the presence of unusual behaviors and interests, according to the Centers for Disease Control and Prevention.

Many people with ASDs also have unusual ways of learning, paying attention or reacting to different sensations.

In about 10 percent of cases, genetics are a factor, said Dr. Harvey Singer, director of pediatric neurology at Hopkins Children's Hospital in Baltimore City, but the rest remain a mystery.

Doctors make advances against autism

2008-04-24T00:01:00.000-07:00

Fourteen years ago, Eric Hollander was one of the psychiatrists who founded the Seaver and New York Autism Center of Excellence at the Mount Sinai School of Medicine to offer specialized care for autism patients and conduct cutting-edge research on the disease.

The big story

April is Autism Awareness Month and a good time to provide the public an overview of a disease that affects one in 150 individuals in the United States.

Who's at risk

Siblings of autistic children seem at higher risk, because autism sometimes runs in families. Recent research suggests that fathers above age 40 are at higher risk of having children with autism, and that birth-related complications and in vitro fertilization may also increase risks for autism.

Children at highest risk are those who fail to develop by certain milestones: those who don't respond when you call their name, who don't share interest in things with others, who have lots of early rituals and routines, and those who fail to develop language.

The demographic group at highest risk is boys. Autism studies show a 4-to-1 ratio of males to females.

"It's not fully known why," says Hollander, though some have suggested that autism is an extreme form of brain function in males. "At a young age, girls are empathizers, more interested in looking people in the eye and responding to social signals," Hollander explains. "Little boys tend to be systemizers who look out and put the world into certain organized patterns."

Signs and symptoms

Currently there isn't a medical test for autism; screening is done through a combination of observing behavior and educational and psychological testing.

Doctors have developed a standard for diagnosis. Before the age of 3, an autistic child must show substantial impairment in the three core symptom domains: profound social deficits, language-based problems, and narrow interests and repetitive behaviors.

Some of autism's associated symptoms include EEG abnormality (seizures), mood swings or irritability, aggression, self-injury, inattention and elements of attention deficit hyperactivity disorder.

Autism can vary greatly from person to person. "Some patients with Asperger's syndrome (an autism spectrum disorder) have a high IQ and language facility," says Hollander, "while other people with autism may have mental retardation and severe deficits in language."

Traditional treatment

"We usually don't talk about cure," says Hollander of the disease, "but we can help people function and reduce their distress."
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Doctors have a wide variety of treatments that can help make the symptoms of autism more manageable. "It's important to get not a single treatment but a package of treatments," says Hollander. "People do best if they can get the right educational setting, the right medicine and social skills coaching." The standard treatments include early intervention, behavioral approaches, educational approaches like specialized schools, social training and support groups that help autistic individuals, their parents and siblings.

Doctors have also made strides in developing medicines. "We're figuring out ways to help patients with social cognition, which allows them to recognize emotion and interact more efficiently with other individuals."

These medicines don't eradicate autism, but "they can decrease overall distress and improve functioning."

There's great variability in what autism patients can do. Some hold important jobs, because they have great math skills for example, but others function at a much lower level. "It's hard for people with autism to live independently, but we try to help them do so as much as possible."

Research breakthroughs

At Mount Sinai, investigators found that several genes contribute to put individuals at higher risk for autism. On the treatment side, researchers are developing medicines that reduce disruptive behavior or help people better understand social interactions. Some of this knowledge comes from observations in animals. For instance, "[the hormone] oxytocin seems to determine social bonding in animals," explains Hollander, "and we're looking to apply this knowledge to humans."

Questions for your doctor

The first question is, "Have you screened my child for developmental delay?" Hollander is a strong advocate for regular and comprehensive screening: "Every child should be screened twice by age 2, even if they're not showing symptoms."

Some parents wonder: "Is autism caused by vaccinations?" Most studies show that vaccines aren't an important factor.

When a child is diagnosed with autism, Hollander advises parents to ask a trio of questions: "What are the other alternatives? What are the peaks and valleys, strengths and weaknesses, of my child? What's the evidence that this particular treatment will work for a child with my child's symptoms?" There isn't only one way to treat autism, and your child may need to try more than one treatment before he or she finds the right one.

*
Get a diagnosis. "If there's a delay in the child's development," says Dr. Eric Hollander, "the parents must advocate for the right evaluation."
*
Get information - and get connected. "Advocacy groups like Autism Speaks [autismspeaks. org] have increased awareness, raised money for research and connected families with the resources," says Hollander. He also recommends parents check the autism pages available through the National Institute of Mental Health (www.nimh.nih.org).
*
See experts in autism and receive specialized treatment. Autism Speaks has a Family Services directory that allows you to search for specialists by zip code and to find clinical trials.
* Take the long view. "A lot of parents get caught up in this whirlwind that they have to do everything immediately," says Hollander, "but it is a developmental process, and parents have to see this as a long-term proposition. Parents have to try to take care of themselves as well, and keep some sort of general balance."

By the numbers

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1 in 150 children have autism
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1% of boys have autism
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Autism symptoms manifest before the age of 3
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Autism's ratio of boys to girls: 4-to-1
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The CDC estimates that 560,000 children under 21 have a form of autism

Act Seeks To Get Accurate Count Of Autism Epidemic

2008-04-23T22:42:00.000-07:00

While a federal study has compiled figures on the autism rate in America, officials are concerned that New York State was left out of the equation. In response to this issue, the Autism Identification and Education Act of 2008 recently was introduced by New York State Assemblyman Jim Conte (R-Huntington Station).

By first identifying all children throughout New York who have autism - a developmental disorder that affects a child's ability to appropriately and effectively communicate - this new legislation aims to help fill in the gaps in services needed for children with autism, provide better training for school district personnel, and offer community organizations financial assistance to provide recreational programs for children with autism and respite for their caregivers.
According to the Centers for Disease Control, autism currently affects one in 150 children. A federal study that was done several years ago attempted to get a more accurate number of children with autism, explained Conte, however, New York State was not a part of that calculation.

"This new legislation will provide for a comprehensive study to identify children that are on the spectrum throughout New York State," said Conte. "Everyone is trying to find ways where we can help families and children and school districts who are caring and working with children with autism." Conte said that the study would be completed by a team from various agencies, including the New York State Health Department, the NYS Office of Mental Retardation and Developmental Disabilities and the NYS Education Department.

"It's hard to get funding for autism if you don't know how many people have autism on Long Island," said Christine Heeren, director of the Long Island Autism Conference. "We keep using the one in 150 number, but that is a national average. We could have one in 50 in Suffolk County for all we know. It's criminal that we don't know for sure. There are four boys on my block with autism alone. That's a rate of about one in 25. We should not be playing a guessing game with our children's lives."
The current data on the number of children with autism is insufficient, said John Gilmore, executive director of the Hicksville-based Autism United, a coalition of service providers and advocacy groups on Long Island and New York City. "You will find two school districts that are approximately the same size and are two miles apart and one may report eight times as many children with autism," he said.
In many cases, but not all, he added, "you really find out that higher income districts tend to have much higher autism rates than lower income districts, which is pretty evident from the statistics we get from the New York State Department of Education and we know the rates are going up, although we have no real accurate idea of how much."

According to Gilmore, without a more accurate count of the number of children with autism, it will continue to be challenging to meet their needs. "It is really impossible to make rational plans - affording the appropriate number of classrooms, hiring therapists, etc.," he explained. "All residential facilities have huge waiting lists. There is clearly an inadequate amount of services and support being provided and it is going to continue to be that way unless we get a better idea of how many children with autism there are."

After much dialogue with parents of children with autism, as well as community organizations that deal with children with developmental disabilities, Conte, who is a member of the New York State Assembly Republican Task Force on Autism, said it was apparent that the school districts require assistance in meeting the needs of autistic students.

"In talking to parents, I have seen that teachers aren't properly trained to deal with autism in general," Conte stated. "But more importantly, you have to know how to deal with that autistic child in particular as an individual - whether the child has high or low functioning autism."

Depending on what students' needs are, which may include anything from having sensory issues to food allergies, training is done more informally with school district personnel "and some do it better than others," he said. "Realize that the school building is not just the classroom teacher, not just the special education or inclusion class; it also includes the bus driver, school cafeteria personnel, and the custodians, who all have to be trained on how to interact with your child."
"I am a very strong supporter of any kind of help that we can give to children with autism and their parents, as well as community organizations, bus drivers and teachers, for example, who work with children who have autism," said NYS Assemblywoman Pat Eddington (WF-Medford). "I think some of the most important work we can do today is to learn more about autism and respect those children who have autism by being able to work with them so we can help them."

The legislation, said Conte, would provide grant money to all school districts so that they could hire individuals who are specifically trained to work with personnel within the school district and the child with autism in the beginning of the school year so that everyone would understand the particular needs of that child.
And finally, said Conte, the legislation would offer some grant money for community organizations to be able to provide for recreational activities and social networks during the summer. "A lot of [the] time, some of these children have a hard time interacting with their peers," he explained, "and it would help if we could get them onto the soccer field or baseball field or involved in other types of recreational activities."

Caring for a child with autism, said Conte, tends to put a lot of strain on the parents and siblings. "We want to be able to help families deal with that and we also want to make sure that the child gets educated to the best of their ability ... not just the reading and the writing but in dealing with total life circumstances because some of these children are going to be able to function and develop typically so we have to make sure they are given the tools they need to live and work in our community successfully," he noted. Ascertaining how many children there are with autism, Conte said, will help to better address the growing needs of children with autism and the community.

The Autism Identification and Education Act of 2008 currently is in the New York State Assembly's Education Committee, and senators from Long Island are being sought to sponsor the bill in the New York State Senate.

Gene for brain connections linked with autism

2008-04-19T19:01:00.000-07:00

By Maggie Fox, Health and Science Editor

WASHINGTON (Reuters) - A gene that helps the brain make connections may underlie a significant number of autism cases, researchers in the United States reported on Tuesday.

Disruptions in the gene, called contactin 4, stop the gene from working properly and appear to stop the brain from making proper networks, the researchers reported in the Journal of Medical Genetics.

These disruptions, in which the child has either three copies of the gene or just one copy when two copies is normal, could account for up to 2.5 percent of autism cases, said Dr. Eli Hatchwell of Stony Brook University Medical Center in New York, who led the study.

"That is a significant number," said Hatchwell.

"Generally the mistake that people make is they are looking for one unifying cause for autism, and there is no such thing and there never will be," Hatchwell said in a telephone interview.

He said his finding adds to the list of potential tests for autism, and perhaps treatments for a range of conditions known as autism spectrum disorders.

Hatchwell's team tested 92 patients from 81 families with autism spectrum disorder and compared them to 560 people without autism.

They did a whole genome analysis, looking at the entire DNA map, and found three of the patients had deletions or duplications of DNA that disrupted contactin 4.

They were all inherited from fathers without a history of autism, which can cause severe social and developmental delays and even mental retardation.

This may seem like a small number but millions of people have some type of autism, Hatchwell noted. The U.S. Centers for Disease Control and Prevention estimates that 1 in every 150 children has autism or a related disorder such as Asperger's syndrome, which is marked by often mild social awkwardness.

"Autism is a syndrome. These individuals have all been grouped together as having the same thing. There will be many, many dozens if not hundreds of different causes," he said.

MUTATION PRESENT AT BIRTH

Contactin 4 is involved in the development of axons, which are the long strings that connect one neuron to another. Other

disruptions of this gene are known to cause developmental delay and mental retardation.

The genetic mutation is present at birth, Hatchwell said.

"In each case a father who was reported as normal had the same thing," he added.

"This happens in genetics all the time. Often there are cases in which someone is reported as normal. They pass it on to their child, who has severe disease."

It could be the fathers had mild Asperger's or some other condition that was never diagnosed when they were children. Hatchwell noted that parents today in the United States are far more likely to seek a diagnosis for autism spectrum disorder in their children than parents were in past generations.

This is controversial, with some advocates and experts saying autism and related disorders have become more common in recent years, and others saying there is no evidence this has occurred.

"My personal view is that it is not becoming more prevalent," said Hatchwell. "If a parent has a child with some sort of learning problem, if they get labeled as autism they get all sorts of help at school," he added.

Hatchwell has helped found a biotechnology company called Population Diagnostics Inc. to develop DNA based pre-symptomatic and early detection tests for autism, Alzheimer's, Parkinson's, Type 2 diabetes and other genetic diseases.

In 2004 researchers at Yale University found one child with developmental delays who had a deleted copy of contactin 4. In January, they and two other teams linked a gene called contactin associated protein-like 2 with some cases of autism, and a third team found a stretch of DNA on chromosome 16 that they said may cause 1 percent of autism cases.

Tracing autism's roots

2008-04-19T18:58:00.000-07:00

Move over vaccines. The most promising research into the disorder is emerging from the quest for the genes that underlie it.

By David Stipp, contributor

Do vaccinations cause autism?

Despite the fact that one major study after another has answered no since the issue came to the fore around 2000, 54% of parents of autistic children in a 2006 survey said the answer is yes. In fact, the parents named vaccines more frequently than any other suspected cause.

It's likely that even more parents blame vaccines now in the wake of the recent brouhaha about 9-year-old Hannah Poling. The government agreed that her family was entitled to a settlement from a federal vaccine injury fund based on their claim that childhood vaccinations aggravated a rare metabolic disorder in Hannah, triggering autism symptoms.

Anti-vaccine advocates hailed the decision as unprecedented support for their view that either thimerosal, a mercury-based preservative once widely used in vaccines, or the vaccines themselves, are behind many cases of the brain disorder.

Federal health officials countered that the Poling case says nothing in general about autism and vaccines - they're concerned about parents refusing immunizations for their kids. Hannah, they noted, has been diagnosed with a genetic defect in her mitochondria - energy dynamos within cells. The mitochondrial disorder can cause a form of autism, and its symptoms often aren't apparent until stress, such as a fever, overtaxes energy-deficient cells. Vaccinations occasionally induce fever, hence the ones Hannah got as a toddler may have combined with her disorder to bring on signs of autism. Or they might not have - Hannah had a history of ear infections, and the associated fever might have aggravated her mitochondrial disorder.
Complex genetics

The ruckus highlights one of the great ironies surrounding autism: While anti-vaccine groups and thousands of anxious parents are fixated on a single environmental factor - vaccines - as a possible cause of autism, most of the exciting insights on its causes in recent years have come from the study of its complex genetic underpinnings.

The quickening quest for genes underlying autism promises both to improve diagnosis and treatment, and to help resolve burning questions about the disorder, such as why surveys suggest it is three times more prevalent in New Jersey than in Alabama.

The central role genes play in autism became manifest after scientists realized about two decades ago that there are different forms of the disorder involving varied sets of genes. Called "autism spectrum disorders," or ASDs, they include Asperger's syndrome, which causes social deficits but not the cognitive delays usually associated with autism.

Using this broad definition in studies of twins, researchers have repeatedly shown that if one identical twin is diagnosed with autism, the other has about a 90% chance of developing an ASD. Geneticists have concluded from such studies that most, and perhaps the great majority, of ASDs involve a genetic component.

There is a new wrinkle to the genetic research however. Based on family studies, scientists have long characterized autism-linked genes as "heritable." But recent research shows a surprisingly large number of mutations tied to autism are "de novo" glitches that arise spontaneously in children whose parents don't carry them.

Such spontaneous mutations have come to light by studying so-called "structural changes" in the genome, which, if DNA's chemical letters were arranged in book form, would consist of largish mistakes such as duplicated and missing pages. A recent study that got much less attention than the Poling story showed that 7% of kids with autism carry structural changes not found in their parents, compared with less than 1% of such glitches seen in the general population.

"This is really exciting, and a lot of people haven't picked up on it yet," says geneticist Stephen Scherer, a co-author of the study at the Hospital for Sick Children in Toronto.
Spontaneous mutations

It's likely that many more such changes will be linked to ASDs as researchers examine a wider array of cases with new gene-scanning tools. Some researchers even theorize that the majority of autism cases stem from such spontaneous mutations.

Why would genes linked to autism be so mutation-prone?

Consider a mutation on chromosome 16 recently tied to autism. The glitch is in a DNA region containing so-called "morpheus" genes, which changed very rapidly as evolution produced ever brainier apes. The genes may well help shape cognitive capacities specific to apes and humans, including ones affected by autism.

Since fast mutation goes hand in hand with fast evolution, it's likely that the new autism-linked gene lies in a DNA "hotspot" prone to spontaneous mutation. In short, the same phenomenon that helped to rapidly evolve our braininess may contribute to autism.

For all geneticists' excitement about such discoveries, few if any of them rule out environmental contributors to autism, such as exposure to certain drugs, chemicals or infections during pregnancy. As Hannah Poling's case suggests, environmental factors may conspire with predisposing genes to bring on autism.

But pinpointing the culprits among the tens of thousands of possible environmental factors - everything from air pollutants to ultrasound examinations during pregnancy to multiple immunizations given to kids all at once - is a monumental problem that could take decades to solve with traditional human studies. Parents of autistic children can't wait that long.

But gene research is helping on this front too, by speeding the quest for environmental contributors. For instance, researchers are developing various mouse models of autism by mimicking mutations linked to the disorder in the rodents. Such animals are very useful for testing suspected environmental contributors to autism.
Early intervention

Genetics research should also help explode the myth that the effects of ASD-susceptibility genes are set in stone. By helping to identify the disorder during infancy, genetic tests promise to enable early intervention that wards off some of autism's worst effects. (Autism usually isn't diagnosed until speech delays or social deficits surface after infancy.)

By teaching parents how to bolster social engagement in babies with ASD-susceptibility genes - for instance, by removing distracting objects so that a parent's face is the most salient object in a baby's visual field - "you might even be able to prevent the full syndrome from emerging," says Geri Dawson, chief science officer of Autism Speaks, an advocacy group based in New York. Toronto's Scherer adds that his team's genetic research has already led to early interventions in several cases involving families participating in studies.

Tricky questions remain about interpreting tests for autism-linked genes. But several companies, such as Mukilteo, Wash.-based CombiMatrix, France's IntegraGen SA and Melville, N.Y.-based Population Diagnostics Inc., have already introduced such diagnostics or announced plans to develop them.

Over time such tests will enable ever more precise classification of autism cases according to underlying causes. Among other things, that should help researchers sort out what's driving the extraordinarily high prevalence observed in areas such as New Jersey. Even better, it will provide a way to detect the special vulnerabilities of kids like Hannah Poling before symptoms appear - and perhaps even keep such children out of harm's way.

Autism Campaign Launches In The South East, UK

2008-04-18T18:52:00.000-07:00

Thousands of adults with autism in the South East are isolated and ignored, unable to access the support they need, and are often completely dependent on their families. These are the findings of The National Autistic Society (NAS) I Exist report, which has its South East launch on Thursday 17th April at the BT Centre in London. Media are welcome to attend.

Hosted by the South East regional Partners in Autism, the launch of I Exist signals a new phase in the NAS think differently about autism campaign. The report reveals that nearly two thirds (63%) of adults with autism in England do not have enough support to meet their needs.

Sarabjit Singh, an adult with Asperger syndrome from Hounslow said: "I had a lot of trouble when I was younger trying to 'fit in' and learn the rules; I was finally diagnosed when I was 31, but it's still a struggle to get the help and support I need on a day-to-day basis. The professionals I turned to for help weren't trained in autism and this lack of understanding just makes the situation worse - why should anyone have to get to the point when they are in crisis before health and social services will acknowledge them? Adults with autism have so much to offer, they just need to be given the support and the opportunity - the right help can make a world of difference"

Speakers at the event include Sarah Hewitt, an adult with Asperger syndrome; Murial Zeffert, mother of an adult with autism from Harrow; Jean Rose of the Sussex Autistic Community Trust; and Richard Lane of the Bromley Autistic Trust. London artist David Downes, who has Asperger syndrome, will also be displaying some of his work.

Based on the largest ever survey on the experiences of adults with autism and their families in England, the I Exist report found that:

- Nearly two thirds of adults with autism do not have enough support to meet their needs.
- 92% of parents are worried about their son or daughter's future when they are no longer able to care for them.
- 61% of adults with autism rely on their family financially and 40% live with their parents.
- 60% of parents believed that a lack of support has led to higher support needs later on.
- At least 1 in 3 adults with autism are experiencing severe mental health difficulties due to a lack of support.

Robert Pritchett, NAS South East regional director, who will be introducing the event said: "Autism is a serious, lifelong and disabling condition. Without the right support, it can have a devastating effect on individuals and their families. It does not have to be like this - 'I Exist' is the message from adults with autism who want their needs understood and the barriers to support removed. The right help at the right time can have a profound effect - we are calling on the government to think, act, and transform lives".

The launch event will take place from 4pm - 6pm on Thursday 17th April at BT Centre, 81 Newgate Street, London EC1A 7AJ

Notes

- South East regional Partners in Autism includes: Autism London, Berkshire Autistic Society, Bromley Autistic Trust, Brookdale Care, Cygnet Health Care, Eagle House Group, Essex Autistic Society, Hampshire Autistic Society, Hillingdon Manor School, Hill Park Autistic Trust, Jigsaw School, Parents of Autistic Children Together, Prior's Court Foundation, Priory Group, Sussex Autistic Community Trust, and Sussex Autistic Society.

- The statistics are for England only. Separate reports were produced for Scotland and Wales. In England, 1,412 adults with autism (18 or over) and their families/carers responded to the survey.

- Autism is a lifelong developmental disability that affects how a person communicates with, and relates to, other people. It also affects how they make sense of the world around them. It is a spectrum condition, which means that, while all people with autism share certain difficulties, their condition will affect them in different ways. Some people with autism are able to live relatively independent lives but others may have accompanying learning disabilities and need a lifetime of specialist support. People with autism may also experience over- or under-sensitivity to sounds, touch, tastes, smells, light or colours.

- Asperger syndrome is a form of autism. People with Asperger syndrome are often of average or above average intelligence. They have fewer problems with speech but may still have difficulties with understanding and processing language.

The National Autistic Society is the UK's leading charity for people with autistic spectrum disorders and their families. Founded in 1962, it continues to spearhead national and international initiatives and provide a strong voice for all people with autism. The NAS provides a wide range of services to help people with autism and Asperger syndrome live their lives with as much independence as possible.

The NAS relies on the support of its members and donors to continue its vital work for people with autism. To become a member, make a donation or to find out more about the work of the NAS, visit the NAS website http://www.autism.org.uk or call the NAS donation line 08702 33 40 40, (national rates apply).

The NAS Autism Services Directory is the UK's most comprehensive directory of services and events for people with autism. Visit http://www.autism.org.uk/autismdirectory to find autism services and support networks in your area.

Training People With Autism To Recognize Faces

2008-04-18T18:50:00.000-07:00

Researchers might have gained insight into why people with autism have difficulty remembering faces and distinguishing facial emotion. In an ongoing study, Dr. Nim Tottenham, assistant professor of psychology in psychiatry at Weill Cornell Medical College, is examining how normal and autistic brains behave when viewing a face.

While their brain is scanned in an fMRI machine, subjects look at a computer screen displaying different faces with various facial expressions. Each subject is motivated by a visual cue -- a star symbol -- to draw his or her attention to either the eyes or mouth on each face.

Facial recognition areas in the brain are recorded by the fMRI, and eye movements are tracked with a camera. Early data in both healthy and autistic subjects show that only when a subject looks at the eyes does the facial recognition area of the brain become active.

The research team hopes that early intervention with this behavioral technique in autistic children might help to train the brain to focus on others' eyes in order to improve facial recognition and facial emotion early in life.

Sticky Blood Protein Yields Clues To Autism

2008-04-11T05:37:00.000-07:00

Many children with autism have elevated blood levels of serotonin -- a chemical with strong links to mood and anxiety. But what relevance this "hyperserotonemia" has for autism has remained a mystery.

New research by Vanderbilt University Medical Center investigators provides a physical basis for this phenomenon, which may have profound implications for the origin of some autism-associated deficits.

In an advance online publication in the Journal of Clinical Investigation, Ana Carneiro, Ph.D., and colleagues report that a well-known protein found in blood platelets, integrin beta3, physically associates with and regulates the serotonin transporter (SERT), a protein that controls serotonin availability.

Autism, a prevalent childhood disorder, involves deficits in language, social communication and prominent rigid-compulsive traits. Serotonin has long been suspected to play a role in autism since elevated blood serotonin and genetic variations in the SERT have been linked to autism.

Alterations in brain serotonin have also been associated with anxiety, depression and alcoholism; antidepressants that block SERT (known as SSRIs, or selective serotonin reuptake inhibitors) block SERT's ability to sweep synapses clean of serotonin.

Working in the lab of Randy Blakely, Ph.D., Carneiro was searching for proteins that interact with SERT that might contribute to disorders where serotonin signaling is altered.

"Levels of SERT in the brain are actually quite low, so we decided to see what progress we could make with peripheral cells that have much higher quantities," said Blakely, the Allan D. Bass Professor of Pharmacology and director of the Vanderbilt Center for Molecular Neuroscience. "This took us to platelets."

In platelets, SERTs accumulate serotonin produced in the gut. SSRIs or genetic deletion of SERT in animals prevents serotonin uptake in the platelet.

"Prior research had fingered the integrin beta3 gene as a determinant of blood serotonin levels and, independently, as a risk factor for autism," Blakely said.

In the current study, Carneiro identified a large set of proteins that "stick" to SERT, presuming they might control SERT activity. One of these turned out to be integrin beta3.

Once they confirmed a physical relationship between the two proteins, Blakely's team investigated whether the interaction can change SERT activity. They found that cells lacking integrin beta3 exhibit reduced serotonin uptake and that integrin beta3 activation or a human integrin beta3 mutation greatly enhances serotonin uptake.

"We found that integrin beta3 can put the serotonin transporter into high gear," said Blakely. Notably, Edwin Cook, M.D., at the University of Illinois at Chicago and a co-author on the study, had shown that the same integrin beta3 mutation that elevates SERT activity also predicts elevated blood serotonin.

"Most investigators studying this integrin beta3 mutation have focused on how its high activity state changes platelet clotting and never looked at its impact on serotonin levels or SERT function," explained Carneiro. "Now they have a reason to."

"We don't think the platelet itself contributes to autism," said Blakely, "but rather we believe that the brain's serotonin transporter may be controlled by integrin proteins in a very similar manner."

Carneiro and Blakely believe that too much SERT activity imposed by abnormal integrin interactions could restrict availability of serotonin in the brain during development, as well as in the adult.

"What is even more striking is that this is the second time we have found elevated SERT activity associated with autism," said Blakely. In a 2005 study, Blakely and Vanderbilt collaborator James Sutcliffe, Ph.D., identified mutations in the SERT gene that triggered elevated SERT activity.

Carneiro is now hot on the trail of integrin interactions with brain SERT as well as engineering mice that express human integrin beta3 mutations.

At a February Keystone Conference, Blakely described preliminary studies with mice that his lab has engineered to express hyperactive SERT mutations. "Together, these new animal models offer an unprecedented opportunity to peel away the complexity of autism and possibly develop new therapies," he said.

This research also may uncover new ways of treating depression. "Current antidepressant mechanisms still essentially work in the same way they did 25 years ago -- by targeting transporter uptake of neurotransmitter directly," Carneiro said. "Now we may have a completely new way to go about it."

These new studies represent an early success of Vanderbilt's recently established Silvio O. Conte Center for Neuroscience Research, an NIMH-sponsored program designed to investigate the genes and proteins that control serotonin signaling during development and in the adult, Blakely noted. The research was also supported by the National Alliance for Research on Schizophrenia and Depression (NARSAD).