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TWO SIMPLE TESTS COULD HELP IDENTIFY CHILDREN WITH ASPERGER'S SYNDROME AND AUTISM MUCH EARLIER!
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| Babies with Asperger's keep their straight up when their body is tilted! |
| It is expected that babies at age 4-6 months start "helping" when being lifted by their underarms. Babies with autism fail to aid in this activity and may feel like "lifting a sack of potatoes". |
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| This web page is also available in the following languages: |
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| PLEASE! If you are a parent, caretaker or a relative of a child with autism we would very much appreciate it if you would take time and fill out our anonymous survey. This survey has been designed specifically for the children with Autism. Since there has been no nation-wide survey targetting parents of children with Autism, your anonymous input would be extremely important. Thank you for your time. Go to survey! |
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| Autism and Autistic Spectrum Disorders |
| The recent "explosion" of news regarding autism may be a hopeful sign that this serious health condition in children is finally getting the attention it deserves. Ever since it was described by Leo Kenner in 1943 all efforts to elicit the true nature of this puzzling syndrome have failed. The incidence of this disorder in the United States has been increasing at an alarming speed, including the recent reports of "clusters" of autism in California and New Jersey. With the final outlook for the majority of patients remaining bleak, Autism is quickly becoming a national health emergency. |
| What is Autism? Is it a disease, a disorder, or is it only a symptom of a not-yet-specified disease or disorder? |
| Applying strict scientific standards (McGuire & Troisi's evolution of medical knowledge), current definition of autism and Autistic Spectrum Disorders (ASD) does not meet the acceptable standards for a separate and distinct disease. It is indeed nothing more than a mere symptom or syndrome (group of characteristic symptoms) of a not-yet-defined disease or diseases. |
| What are Autistic Spectrum Disorders (ASD)? |
| Disorders other than "classic" autism exhibit to a various degree the same behavioral defects but with the different course of the disease and different degrees of social adaptation and speech development. The common denominator for all of these disorders remains the significant and detrimental defect in socialization, almost invariably resulting in poor social adjustments, and inadequate or completely absent social interaction. In addition to so-called classical Autism, the group of these disorders includes Pervasive Developmental Disorder, Asperger's syndrome, Heller's syndrome (Childhood Disintegrative Disorder), and Rett's syndrome. |
| What could be the possible causes of Autism? |
| Genetic origin: is there an "autism" gene? Even though certain number of cases autism can be clearly linked to a possible genetic cause (demonstrated increase of autism and Autistic Spectrum Disorders in siblings, especially in monozygotic twins, autism in "Fragile-x Syndrome"; also note more recent report on presence of a mutation of X-linked genes encoding neuroligins NLGN3 and NLGN4 as a cause of autism in one family), the true genetic cause in the majority of patients with autism is unlikely. Since the majority of patients with autism do not marry and are unlikely to have offspring, one would expect that the incidence of the presumed gene in the general population would decrease with time. However, the incidence of autism in the population (and not only in the US!) has been increasing instead, making the likelihood of a single genetic cause extremely remote. |
| What about metabolic abnormalities and/or defects as a cause of autism? Various bowel-related problems (chronic diarrhea, food intolerances, chronic constipation, etc.) have been frequently reported in patients with autism. Since there are (anecdotal) evidences that at least some of the patients have responded favorably to various dietary regimes and supplementation (GFCF diet, bowel yeast eradication, Secretin treatments, antioxidants and tryptophan supplements, etc.), an inherited or acquired metabolic abnormality as a cause of autism remains a distinct possibility. One must however, be cautious in interpretation of mentioned gastrointestinal symptoms since similar symptoms can be a result of an overt sympathetic stimulation also suspected in children with autism (more about it in further text). |
| Could an infection be responsible for development of autism? Infection has long been suspected as a plausible cause of autism, and possibly a contributing factor in a number of other so-called "mental illnesses" (please refer to PANDAS PITAND section within this site). Some of the more recent studies have renewed our interest in this direction (Wakefield, Gupta). However, the 2003 British study has discredited some of the Wakefiled's theories, but not necessarily the basic premise of his theories. Swedo et al. (1996), and Allen (1997) have successfully defined the pathophysiological basis for the infection-mediated (autoimmune) mechanisms of certain mental illnesses in children (PANDAS and PITAND syndromes). Even though these syndromes remain highly controversial, it has been our professional experience that these syndromes indeed exist and that they can be treated successfully. |
Can immunizing your child (MMR) cause autism? Wakefield's study has created a lot of controversy and "soul searching" by the medical community. Several later studies (Britain, Denmark) have essentially discounted MMR as a major potential cause of Autism.
| Addendum: Ten of twelve authors of the original paper that has started the MMR controversy (Lancet 351[9103]:637-41, 1998) have recently issued a partial retraction (Lancet 363:747-50;820-24, 2004). The group of ten did not include the principal investigator, Dr. Wakefield. In their statement the group retracts "...the interpretation of the data suggesting a link between autism and the MMR." At the same time they reassert that "... the discovery of a possible link between bowel disease and autism is a serious scientific idea ... and one that deserves further investigation." |
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What is the true incidence of autism in the United States? Recent reports estimate the incidence of autism in the US at 1:150 (NIH 2007). Even if one corrects it for an increased awareness of this disorder within the medical community and better diagnostics, this still represents an alarming increase. Particularly concerning are the reports of autistic "clusters" in New Jersey and California, what lends further credence to theories of non-genetic cause of autism.
| Incidence of ASD in different populations: |
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California (1987-1994) 1:671
Brick Township, New Jersey (1998) 1:149
Northern Finland (5-7 year olds) 1:483
Yokohama, Japan 1:473
Fukushima-ken County, Japan 1:2016
Nordland County, Norway 1:1818
Slovenia (estimate): only ~20 cases in the population of 2.3 million (at least two have been diagnosed in children of immigrants!)
Croatia: 400+ cases in population of 4.25 million
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| The most recent estimates for the United States (lower 48 states) 1: 110 - 130 |
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| Mental retardation in autism? Just because we are unable to communicate adequately with these children does not necessary mean that they are retarded. Evidences (if one cares to search for them) speak quite differently. Children with autism are likely not retarded, they are simply isolated and insulated from the environment that they consider (and continuously experience) as unpleasant and hostile. |
| Autism and seizures. Seizures are present in almost 30% of patients with autism and can be (in the beginning) clinically inapparent and very resistant to treatment. Since seizures frequently appear later in the course of the disease, this might suggest that the tissue damage responsible for the symptoms of autism could be a continuing, progressive process (at least in its earlier stages). This progression increases the possibility of an outside factor ((infection, auto-immune reaction to an infection, toxins, etc.) being the cause. Ketogenic diet has been employed with some success in autistic patients with refractory (intractable) seizures, and IVIG has been used as the last resort in few of them. |
| What does and doesn't work in autism? |
| Let's begin with a simple admission that there is nothing out there that really works in autism. "Cures" of different kinds have come and gone, but the objective outlook for these patients has changed very little in the past fifty years. It is likely that until the cause (or causes) of autism has been defined no cure will be found. There have been scores of "miracle cures" rising and dashing hopes of desperate parents, but in the end there is still no appropriate answer to the autistic "puzzle". Below is a concise review of more common remedies that have been touted as "cures" in autism with appropriate commentaries enclosed. It is important to point out that these comments have been carefully extrapolated from the available medical literature, but under no circumstances can be applied to every and each individual case. It is entirely possible and even likely that some of the treatments discussed (and negatively appraised) in further text have had a favorable outcome in at least some of the patients. What we wish to call your attention to, is that ever important equation in consideration of any new treatment for any medical problem: the cost of the treatment (monetary and other expenses, possible side effects of the treatment) versus possible benefit of the treatment (final outcome). The list below is by no means an all-inclusive list and many more treatments have been reported. However, for the information purposes we have enclosed the most touted, most controversial, and the newest therapies for autism. |
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| An essay written by a 16 year old patient of ours with Autism (the exact transcription) |
| What I hear is quiet, and relaxing. The warmth of the surroundings is welcoming. The farm is like a little peace of heaven. When I am on the farm I can be me. I can run fast, far, and free. I can climb like a monkey and fish like a man. No one has to know how different I am. On the farm you can be anything. |
| I sleep in bed with the moonlight shining in. It is golden and bright. It brings with it the protection of a worn, well tattered, well loved old, faded blanket. It shines like a light that is coming to carry me away. It hits the side of the red brick house with purpose and furasity. Moonlight is welcome to visit me anytime. The warmth it brings makes me feel protected and normal. The beams come visit me just like anyone else. I can pretend to be just another kid who sees the same moon, only with autistic eyes. |
| I love the water. Any kind, even the murky, dirty, grotesque slimy water of the creek. The creek exists on its own and accepts the fact that its beauty lies within it, unseen by the eye of men. I can associate with this. My inside is deep, dark and murky. I share secrets with the water. I feel accepted by the creek for the creature that I am. No judgement does take place between us. |
| Stillness and peacefulness surround me. Old, worn, well traveled brick streets that have seen a lot welcome me to the weekend getaway. They have seen much before me, and will see much after me. As I walk streets, I hold dear the knowledge that I am just a heavy weight traveling to and from. My destination and purpose matter not. I am just passing threw like socks on their way to the washing machine. Each sock is washed the same whether on the right foot or the left. |
| Wild and free, overgrown and untamed, the soft green field is alive. It does as it wishes, it does not meet expectations placed on it. I am nothing that the field is and it is everything that I want to be. I don't, I can't, I won't. I can only pretend to be the delightful and mindful Joey (not the real name!) |
| Yes, I am different. I struggle to be me, the average american teen. I am not, have not, and will never be, such a form filled, cutout mold filling teen. This is not to say that I do not want to fit in. I do, I just have to pretend. My isolated world is terrifying. When I am on the farm, I escape the reality of my world and blend into the big picture, invisible, and for a short while incognito. I can be whomever, Tom, Dick, or Harry. The farm offers without judgement a place to escape to a world I desperately want to belong to. |
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Wish to learn more about how these patients truly feel? Please read D. Williams' book
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| "NOBODY NOWHERE" |
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| Where do we go from here? |
| One of more promising recent developments has been the theoretical speculation that an endorphin-related abnormality in patients with autism could be responsible for the development of core symptoms in this disorder. Even though this theory does not necessarily address the cause of autism, it offers an exciting and applicable explanation of the basic pathophysiology of autism, and could be an imporant lead in further search for the cure of this disorder. In fact, a similar pathophysiological mechanism is applicable to some cases of refractory Anorexia nervosa as well. As for the cause or causes of autism, one will have to start with a comprehensive exploration of the extraordinary, ever present sympathetic sensitivity in these patients and attempt to define the possible reasons for it. An autistic child with widely dilated pupils, severe tactile, visual and auditory sensitivity is a classical picture of an inner terror. Adding to the horror is patient's apparent inability (and unwillingness) to express and relate his or hers personal turmoil outward, leaving them alone and misunderstood. |
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Copyright by WebPediatrics.com©2003 * Modified Friday, October 14, 2011
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