(March, 2011) Over the past decade, autism - a developmental disability affecting personal communication and interactions - has increased tenfold. Some experts suggest that recent broadening of diagnostic criteria for autism and greatly increased diagnoses at younger ages may help explain this rise in new cases.
“Everybody knows about autism now,” says Gary W. Goldstein, MD, professor of neurology and pediatrics at Johns Hopkins University, “and they didn’t 16 years ago.” But due to dramatic increases in this disorder—from 6.2 cases of autism per 10,000 births in 1990 to 42.5 in 2001—in one state alone, researchers increasingly suspect environmental factors.
“It’s time to start looking for the environmental culprits responsible for the remarkable increase in the rate of autism in California,” says Irva Hertz-Picciotto, PhD, MPH, who heads the division of environmental and occupational health at UC Davis. “Genetics don’t change in such short periods of time.”
“We have only 20,000 to 25,000 genes. But we have 100,000 environmental exposures,” says Dr. Goldstein. “If you have a PCB exposure in utero or early in life, it can affect your brain structure and how you process sound,” explains Martha R. Herbert, MD, PhD, a pediatric neurologist at Massachusetts General Hospital. “We should get a grip on all the different things that we are doing on our all-too-fragile planet that have been causing unnecessary harm to our children.”
Many studies link toxic exposure to lead, mercury, and pesticides to the growing incidence of this disorder, making it important to consume organic foods before conception and during pregnancy. Advanced parental age, low-birth weight, and exposure to mother’s epilepsy drugs in utero have also been associated with autism. Infections including Lyme disease also may be involved. Perhaps the most troubling potential cause is simultaneous administration of multiple vaccines (as in measles-mumps-rubella shots). Also aluminum and mercury preservatives in some vaccines can overwhelm the central nervous systems.
Recent research in Science suggests that environmental factors combine with genes that appear to underlie autism to interrupt normal brain development at an early age. Because numerous genetic mutations and vastly more environmental factors are involved, this is a strikingly individual condition. “Almost every kid with autism has [his] own particular cause” for this disorder, says Christopher Walsh, MD, chief of genetics at Children’s Hospital in Boston.
No two autistic children exhibit exactly the same symptoms, either. But a deficit in social relations or lack of desire to connect and share with others is universal to all. Initially, parents may think a child with autism is hard of hearing or mentally retarded because they’re so unresponsive. Speech development is usually delayed and tends to be characterized by repetitive, stereotyped, or unusual language use. Many children with autism are inflexible about routines and rituals, have restricted and intense patterns of interest, and are preoccupied with parts of objects. Unpredictable behaviors like incessant rocking or foot pounding are common; some children sit for long periods in silence.
“Autism spectrum disorders are defined behaviorally,” says Dr. Herbert. “There are no biological markers,” though “certainly the immune system and the gastrointestinal system feature prominently in many individuals.” It’s important to note that between 50 and about 70 percent of children with autism have some kind of gastrointestinal condition. In addition, “we have a lot of documentation of immune problems,” she adds, and “documentation of inflammation in the brain.”
It’s wise to avoid allergenic foods, as well as processed foods with artificial colors, chemicals, and preservatives. “There are many anecdotal reports of dramatic improvements in children with autism from parents who removed casein (milk protein) and gluten (the protein in wheat, barley, rye, and oats) from the [kids’] diet[s],” notes nutritionist Patrick Holford.
This can take time. The Autism Research Unit at Sunderland University recommends a gradual withdrawal of foods, waiting three weeks after the removal of dairy foods (casein) before removing wheat, oats, barely, and rye (gluten) from the diet. Initially children may go through ‘withdrawal’ and their symptoms may get worse. Keeping a food diary helps parents identify a child’s food sensitivities: citrus, chocolate, corn, eggs, nightshade plants (bell peppers, eggplant, tomatoes), and soy are common offenders.
Numerous studies report that supplemental nutrients (vitamins A, B complex, C, plus omega 3 fatty acids, magnesium, and zinc) appear useful in autism. Choline and coenzyme Q10 improve brain function and may also benefit children with autism. Some of these children lack certain amino acids, and if so, L-glutamine may be advised before bedtime. Work with a nutritionist to find the right diet for any child with autism.
Special education including occupational and speech therapy can help. Gradual and systematic behavioral interventions that mimic the ways kids normally learn have been shown to improve communication, engagement, and social interactions in autistic children. “The earlier in a child’s life [intervention] is started,” says Laura Schreibman, PhD, a psychologist who directs the Autism Research Program, at UC San Diego, “the more effective it is likely to be.”