SCHAFER AUTISM REPORT "Healing Autism:

To List an event in th Autism Calendar:

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February 3, 2003

THE MISUNDERSTOOD CHILD

I am the child that looks healthy and fine.

I was born with ten fingers and toes.

But something is different, somewhere in my mind.

And what it is, nobody knows.

I am the child that struggles in school,

Though they say that I'm perfectly smart.

They tell me I'm lazy - can learn if I try -

But I don't seem to know where to start.

I am the child that won't wear the clothes

Which hurt me or bother my feet.

I dread sudden noises, can't handle most smells,

And tastes - there are few foods I'll eat.

I am the child that can't catch the ball

And runs with an awkward gait.

I am the one chosen last on the team

And I cringe as I stand there and wait.

I am the child with whom no one will play -

The one that gets bullied and teased.

I try to fit in and I want to be liked,

But nothing I do seems to please.

I am the child that tantrums and freaks

Over things that seem petty and trite.

You'll never know how I panic inside,

When I'm lost in my anger and fright.

I am the child that fidgets and squirms

Though I'm told to sit still and be good

Do you think that I choose to be out of control?

Don't you know that I would if I could?

I am the child with the broken heart

Though I act like I don't really care.

Perhaps there's a reason God made me this way -

Some message he sent me to share.

For I am the child that needs to be loved

And accepted and valued too.

I am the child that is misunderstood,

I am different - but look just like you.

Kathy Winters/2003

[Thanks to Dennis Debbaudt and Rick Rollens.]

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ALSO IN TODAY'S REPORT

AWARENESS

* When a Child Can’t Relate: Asperger's in Parade Magazine

RESEARCH

* Common Pediatric Anesthesia Drugs: Brain Damage In Infant Rats

TREATMENT

* Sally Rogers on Autism Treatment the Denver Way

ADVOCACY

* Lobbyists Target Burton

PUBLIC HEALTH

* Notes on the Havocs of Autism – Part II: California

* Traces of Pollutants Found In Many People

* * *

AWARENESS

When a Child Can’t Relate: Asperger's in Parade Magazine

[By Sheryl Flatow in Sunday's Parade Magazine. Not available online. Thanks to Roxanne & Ed Przybysz.]

When Tyler Douglass was 18 months old, he was so articulate that people thought he might be gifted. But, as he grew, his mother saw a very different child. “He was a hard kid to live with,” says DeDe Douglass of Davis, Calif., a former special-ed teacher. “He had no social skills. He could talk and talk about whatever interested him, but he didn’t make conversation. He’d think nothing of walking out when someone was talking to him. He would say the most inappropriate, insensitive things to people. He had no friends. He preferred to be alone with his toys, especially mechanical toys.”

Tyler also was sensitive to light and sound, and he suffered from anxiety attacks and depression. He had no coordination and little physical strength. “No one could figure out why all this was happening,” says Douglass. “I kept hearing that he was severely emotionally disturbed or that maybe my husband and I needed a parenting-skills class.”

Then, when Tyler was 6, his parents brought him to the MIND (Medical Investigation of Neurodevelopmental Disorders) Institute, a research and treatment center at the University of California, Davis. There, he was diagnosed with Asperger’s Syndrome, a less severe form of autism, a condition in which children withdraw into their own worlds. Finally, Tyler’s parents could begin their search for proper treatment.

Asperger’s Syndrome is being diagnosed in greater numbers than ever before. But it is often misunderstood and misread, with the result that many children don’t get the help they need.

What Is Asperger’s Syndrome?

Hans Asperger, an Austrian pediatrician, firs described the disorder that would come to bear his name in 1944, just a year after the psychiatrist Leo Kanner, working in the U.S., identified autism. But it wasn’t until 1994 that the American Psychiatric Association recognized Asperger’s in its Diagnostic and Statistical Manual of Mental Disorders. Some experts still question whether Asperger’s is anything other than high-functioning autism. Others see clear distinctions between the two.

“In autism, children appear to be born without an interest in others,” says Ami Klin, Ph.D., an associate professor at the Yale Child Study Center in New Haven, Conn. “children with Asperger’s Syndrome seem to crave relationships but don’t know how to establish them. They simply don’t know how to interpret the cues that would be important for them to participate more meaningfully in social interactions. As a result, they tend to get Into a lot of behavioral difficulties. They have limited self-censorship, so they may say whatever comes into their minds.”

“They’re frequently referred to as “little professors,” notes Marjorie Solomon, a researcher at the MIND Institute. “Their use of language is more formal or stilted than you would expect from children, and they can go on and on about a particular interest -- like black holes or sharks -- about which they know a lot of facts.”

Researchers have not yet discovered what causes Asperger’s. “There are a lot of theories,” says Sally Ozonoff, a clinical psychologist at the Institute. “We know that these traits absolutely can run in families. But what runs in families isn’t just autism or Asperger’s. The same genes appear to have different effects: You see speech disorders, language disorders, learning disabilities, social difficulties and loner siblings or parents. And there might be an environmental influence as well.”

It is the lack of social skills that most sets children with Asperger’ s apart. That is certainly true of Andrew Crain, a very bright 13-year old also from Davis, who was diagnosed with Asperger’s in 2000. “Andrew sees how kids at school interact and he knows there are other forms of communication going on,” says Carissa Crain, who began looking for answers when her son was 8. “He knows he misses things, and it makes him very frustrated and angry. He says he’s not human, because he can’t handle human emotions. He’s had lots of behavioral problems in school, and we’ve had a hard time getting the school district to deal with Asperger’s rather than focus on his behavior.”

Exploding numbers

The number of cases of autism in the U. S. has been skyrocketing. Until the 1980s, it was thought to be between one in 5000 and one in 1000, based on numerous studies; today, experts believe the figure is closer to one in 500. That’s an increase of about 1000%. Some maintain that because specialists have become better at diagnosing autism, they are catching the borderline forms as well. One of the few studies on the incidence of Asperger’s puts the number of cases at one in 1200. It is found four times more often in boys.

Getting children the help they need

While there is no cure for Asperger’s, experts agree that the earlier a child is properly diagnosed and receives individualized assistance, the better the chance that he can lead a quality life. “Unless we intervene, the waste is too great,” says Ami Klin of Yale. Some children with Asperger’s also are treated with SSRIs, a type of antidepressant that helps control ritualized behavior.

Each specialist interviewed for this article agreed that it’s generally best for a child with Asperger’s to be “mainstreamed,” but with additional help. “These children have a social disability, and they need to practice their skills in a natural environment,” explains Klin. “but you can ’t just place them in regular schools and forget about them. The child needs to be provided with a continuum of services. For some t things, they need to work in small groups. For others, they need individual attention.”

Many children, however, are not getting the help they need. Andrew Crain, a voracious reader who can finish a 1000-page book in two days, was given no classroom assistance or accommodation by this school system and failed just about all of his classes last year. “If you don’t have the resources in place when your child is in elementary school, it’s virtually impossible to get the services you need later on,” says his mother.

On the other hand, Tyler Douglass, now 10, has an aide in his fourth-grade classroom, as he has had since first grade. He has had all kinds of therapy -- at the MIND Institute, in school and in private. He’s also on medication.

DeDe Douglass is a tireless advocate on her son’s behalf. “Tyler has come a long way in the last year and half,” she says. “He still has anxieties and phobias. His lack of empathy has been the toughest thing for me as a mother, but he is now developing some. After all the therapy, he’s a little happier, less depressed. He’s started a bird club, which has given him friends for the first time.

“You’ve got to start somewhere. I just want him to be able to do what is socially appropriate -- not just for other people, but for his own dignity.”

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RESEARCH

Common Pediatric Anesthesia Drugs Cause Brain Damage In Infant Rats Also causes learning and memory problems

A team of researchers from the University of Virginia Health System and Washington University School of Medicine in St. Louis has found that drugs commonly used to anesthetize children can cause brain damage and long-term learning and memory disturbances in infant rats. The researchers report their findings in the Feb. 1 issue of the Journal of Neuroscience. "We frequently perform surgical procedures on children, including premature infants, and those procedures have become increasingly more complex and take longer to perform," says the study's lead author Vesna Jevtovic-Todorovic, M.D., associate professor of anesthesiology at the University of Virginia Health System. "That means many pediatric patients are being exposed to anesthetic drugs more frequently and for longer periods of time. Our results would suggest that might be problematic."

Previously, Jevtovic-Todorovic was at Washington University School of Medicine in St. Louis, where the rest of the research team is located. The investigators anesthetized 7-day-old rats with a combination of three drugs -- midazolam, nitrous oxide and isoflurane -- commonly used in pediatric surgery.

As the animals recovered from the anesthesia, the researchers divided them into three groups: One group was sacrificed the next day and their brains examined, a second group grew to be about a month old and a third group grew into adulthood. The latter two groups were tested for effects of anesthesia on learning and memory. Members of the research team also recorded electrical activity in the hippocampus, a brain structure known to be important in learning and memory.

"These infant rats were anesthetized during the brain growth spurt period called synaptogenesis, which lasts for the first few weeks of life in rats, but in humans it extends from the third trimester of pregnancy until about age 3," says senior investigator John W. Olney, M.D., the John P. Feighner Professor of Neuropsychopharmacology at Washington University School of Medicine in St. Louis. "During this period, nerve cells in the brain make connections with one another and form large networks. But if something interferes with that process, the cells are programmed to kill themselves."

In this study, the team found moderately severe cell death had occurred in several brain regions in every brain examined. This included brain regions involved in learning and memory such as hippocampus.

In addition, the rats exposed to anesthesia in infancy had significant learning and memory deficits, both at 1 month of age and in adulthood. Rats were tested in several kinds of mazes that behavioral scientists commonly use to evaluate learning and memory. In all of these tests, rats that had been anesthetized in infancy were significantly worse than those that had not been given the standard anesthesia drug combination.

The researchers also examined brain slices from the hippocampus of month-old rats. They ran electrical currents through those slices to induce a process known as long-term potentiation (LTP), which is thought to occur during learning and memory formation. Brain slices from rats who had been anesthetized with the three drug "cocktail" had far less LTP activity than normal.

"In each part of this study, we found essentially what we expected," Jevtovic-Todorovic says. "Once we had confirmed cell death, we would have expected behavioral deficits, and we found those as the rats grew into adulthood. In the electrophysiological experiments, we also found evidence of disturbances in the neural circuits of the hippocampus, the brain region which, through those circuits, plays an important role in learning and memory."

The team also found that the rats appeared to behave normally in most other ways, and there were no outward signs of brain damage.

"That's important because if similar brain damage had occurred in a human infant, it appears there would not be any overt signs that would alert you to it," Olney says.

This study fits together with a line of research that has repeatedly identified a relationship between certain classes of drugs that inhibit nerve cell activity and damage to the developing brain. Anesthetic drugs work in one of two ways, both of which inhibit nerve cell activity: Either they inhibit excitatory neurotransmission in the brain or they enhance inhibitory neurotransmission.

The excitatory system that stimulates nerve cells is what scientists call the NMDA glutamate transmitter system. In 1998, Jevtovic-Todorovic discovered that the drug nitrous oxide, or laughing gas, work by inhibiting the NMDA glutamate system. Another anesthetic drug known as Ketamine, also works by inhibiting the NMDA glutamate system.

Other anesthetic drugs work by enhancing the inhibitory activity of GABA (Gamma Amino Butyric Acid). GABA is the primary inhibitory transmitter in the brain.

In related research, Olney and colleagues in Germany demonstrated that when the developing brain is exposed to drugs that block NMDA glutamate activity, nerve cells in the brain commit suicide. They also found that drugs that enhance GABA activity can cause nerve cells in the developing brain to self-destruct.

The above findings prompted them to study alcohol, which is known to block NMDA glutamate activity and also to enhance GABA activity. They found that alcohol powerfully triggers nerve cell suicide in the developing brain, providing a likely explanation for the learning and memory disturbances associated with the human fetal alcohol syndrome. More recently, Olney and colleagues demonstrated that sodium channel blocking drugs used in pediatric medicine to manage epilepsy also cause nerve cell suicide in the infant rat brain.

"In all of these studies, we have found that drugs that enhance GABA inhibition or that inhibit glutamate excitation can trigger massive cell suicide in the developing brain," Olney says. "If you put nerve cells to sleep when they are supposed to be making connections, it interferes with their timing, and nerve cells are programmed to kill themselves if they don't make their connections on time."

Part of the reason cells are programmed to self-destruct is that there is redundancy built into the system. An infant is born with an excess number of nerve cells, and some cell death is normal in the developing brain. But Olney's team has found that when drugs interfere with the cell and put it to sleep when it is trying to make connections, the suicide rate rises to abnormally high proportions.

Previous studies by these researchers have helped explain how abuse of certain drugs, including alcohol, can damage the developing brain. But in the present study by Jevtovic-Todorovic and colleagues, the investigators found that drugs used commonly in pediatric anesthesia also can damage the developing brain.

According to Olney, this is a serious dilemma because anesthesia is required to do surgery, and surgery is the only option for some infants with life-threatening problems.

"But some pediatric surgery is elective," Olney says. "In light of these findings, I would recommend that if surgery really does not have to be performed early in life, it would be prudent to postpone it."

The investigators also suggest that some surgical procedures might not require general anesthesia, or in some cases the duration of general anesthesia could be reduced. They also say that the common practice of keeping newborns continuously sedated in pediatric intensive care units should carefully be evaluated in order to minimize potential damage from the sedating drugs.

* * *

TREATMENT

Sally Rogers on Autism Treatment the Denver Way

Excerpted Interview with Sally Rogers of the M.I.N.D. Institute.

The psychologist Sally Rogers is one of the world’s leading researchers when it comes to autism treatment. Since the beginning of the 1980’s, she and her team have been developing a successful treatment program for children with autism called The Denver Model. In some respects it overlaps with the traditional Lovaas UCLA Model but in others it has some significant new features. We met Sally Rogers for a talk about early and intensive behavioral treatment of autism – both as seen from a practical everyday perspective and from a research point of view.

Could you tell us, just briefly, about your background, your interests and your work at the M.I.N.D. Institute? Sure. I’m a developmental psychologist. I did my Ph.D. with specialization in mental retardation and developmental disabilities, so I have always done this kind of work, and I have always enjoyed this kind of work.

I have also always worked with young children, as well as adults, so I have always had this mixed background of very young children and people who were more mature. So even though I didn’t start off with a specific focus on autism, I had always had interest in autism, I had always worked with some children and adults with autism, and with lots of adults and children with mental retardation and other developmental delays.

So, then in 1981 I received a grant to start a preschool program for children with autism, and that’s when I got very specialized into autism.

So you both have a theoretical and a practical background.

Yes. I’ve been developing and using our approach since 1981. Our approach is called ‘the Denver model’, and we’ve been publishing on the Denver model and teaching it and trying to refine the method ever since then.

Publications We published four outcome papers in the 80’s (Rogers et al., 1986; Rogers et al., 1987; Rogers and Lewis, 1989; Rogers and DiLalla, 1991). They talked about the children’s progress in the group model. We currently have two studies going on the rest of the model – one on the 1:1 teaching routines and one on the integrated preschool model. We need to finish those studies, analyze the data, and write them up.

Other Research In addition to the clinical work, the treatment work, I have several funded studies. We’ve been looking at different aspects of autism, and I’m particularly interested early developmental processes and how autism takes on its form across the first five years. So we’ve been studying a very large group of two-year-olds in Denver with autism, Fragile X, Down syndrome, mental retardation and then one-year-olds with typical development. We’ve been following those children now for the past five years. We’re looking at a wide variety of measures.

The Denver Model Could you briefly describe the elements of the Denver model? It’s a developmental approach which has two dual foci, one on intensive teaching and the other on developing the social-communicative skills that are so affected by autism. We believe that development in early autism is somewhat plastic, and that much of what seems to be the overall handicap in autism is kind of secondary to an initial, probably less pervasive impairment. The initial impaired process, the disruption of social communicative development creates a secondary set of processes, like the exaggerated interest in objects and repetitive patterns, and that if we begin very early to focus on the social communicative processes, we can prevent some of the cascading effects of autism.

So, intensive teaching and intensive focus on social communicative development and skill building are the main emphases of our treatment approach. We understand that social communicative development develops from emotional relatedness, and so, side by side with intensive teaching is this emphasis on affective connection, relationship building and understanding communication as involving an emotional exchange between people.

So these things are done side by side in the Denver model. They alternate back and forth, literally.

Setting

How is this the Denver model carried out in practice? In what settings? It can be done in many ways. We no longer have our center-based program, because we’d started to use more inclusive settings, and I found that just so much more viable. It’s such a richer environment for the children that we eventually moved away from our center based teaching. So, all of the children in the Denver model preschool program are in interventions in typical preschools. Generally it’s a combination of typical preschool group half a day, intensive teaching half a day.

Is it one-on-one or group based? Intensive teaching at home is one-on-one. In the inclusive classroom the child is a part of group activities, but his or her teaching is being carried out directly by an adult inside the group activity. But the support of the child is embedded in the group. The kids are learning, they’re being taught all the time, but they are inside the group. The teaching is coming from the main teacher or adult who is leading the activity. They’re not separate. They don’t have a shadow that they are aware of – there is somebody shadowing them. They are in a normal preschool with age-typical peers.

So it is one child with autism? Hopefully. That’s the right way to do it.

Is it common to have an inclusive setting in the USA? It depends on what part of the country you’re in. In the western part inclusive education is very common. Along the eastern sea border it’s not so common. There’s a history of special schools along the east coast.

Family in Focus So that’s kind of the underpinnings of the Denver

model: the dual approach, very family based. Families choose the objectives, they decide what’s important. We follow the family’s lead. The family’s part of the team, every meeting. So it’s very family-focused. And it’s very individualized. But we do have a curriculum. There’s a very specific teaching approach, we have a treatment fidelity measure so we can measure the quality of it.

Lovaas

What is your opinion about Ole Ivar Lovaas’ study and the replication sites?

+ Interview with references continues:

* * *

ADVOCACY

Lobbyists Target Burton

Rep. Tom Davis (R-Va.), chairman of the House Government Reform Committee, has ended a dispute over what to do with his predecessor, Rep. Dan Burton (R-Ind.), and has decided to give him a subcommittee chairmanship.

Davis told The Hill that he would do so despite criticism from some drug companies who believe Burton has a personal vendetta against them.

“Dan ought to have a subcommittee,” Davis said. “I have full confidence in Dan Burton. If anybody feels shafted, we’ll sit down with them.”

Under criticism from some GOP lawmakers, Davis has also rehired committee staffers whom he had fired.

He says the realignment of jurisdictions between Burton and Rep. Mark Souder (R-Ind.), who is giving up oversight of public health policy, is “completely amicable.” Davis expects to finish sorting out the subcommittee assignments within a few days, he says.

But lobbyists for the pharmaceutical companies that make vaccines for children do not want Burton, who has an autistic grandson, to be given a platform to pursue more investigations into claims that children’s vaccines can cause autism.

The lobbyists spoke on the condition of anonymity. John Cardarelli, Burton’s press secretary, did not return repeated calls requesting comment.

“[Burton] has set back immunization efforts in this country 10 years,” said a lobbyist for a drug company. “We’re now seeing parents scared to get kids immunized. Everybody has expressed their concern about Burton running these anti-vaccine hearings. The feedback we’ve got is that nobody in leadership is excited.”

He added: “My gut feeling is that it does not matter what the name of the subcommittee is. It is a broad enough forum. I don’t see Dan Burton going away.”

Another lobbyist for a vaccine-manufacturing drug company said they were unhappy to see Burton further undermine the benefits of vaccines, but that the industry had no organized strategy to oppose him or ability to effect committee assignments.

Public health groups are concerned, too. “If he does not have a subcommittee chair, he’ll do something else,” said a lobbyist for an advocacy organization. “The bigger question is: When is enough enough? Some of us would say it’s been enough.”

While the leadership is not happy with the situation, it is staying silent. John Feehery, a spokesman for Speaker J. Dennis Hastert (R-Ill.), declined to comment on the matter.

For its part, the Pharmaceutical Research and Manufacturers of America (PhRMA), the lobbying group for the industry, denied it is opposed to Burton ’s chairmanship.

“In three weeks of legislative strategy meetings, I did not hear one person say one thing about Mr. Burton,” said Mike Tuffin, the group’s spokesman. “That’s an internal House matter. We’re not concerned at all who might chair the subcommittee.”

In the 2002 election cycle, drug companies raised $17,481,391 for the Republicans, according to Opensecrets.org. The United Seniors Assn., an advocacy group largely funded by PhRMA, ran a reported $12 million in political advertisements supporting GOP candidates.

The few companies that make vaccines, which are expensive to produce and heavily regulated by the Federal Drug Administration, are concerned mainly because Burton’s tactics could subject them to lawsuits over products that generate only 5 percent of their revenues, experts in the industry said.

But Davis, who was chosen over more-senior lawmakers to lead the panel several weeks ago, has the power to rein in Burton: To prevent so-called fishing expeditions, all subpoenas will have to be approved by the full panel’s chairman.

Burton, as committee chairman, held extensive hearings into allegations that children’s vaccines have caused an alarming rise in autism, and vaccine safety generally. He has a strong following among a small, but politically potent, group of parents with autistic children.

Since April 2001, Burton has held five hearings on the subject, according to the committee’s website. He has written letters asking President Bush to host a White House conference on autism and to others advocating increases in research funding.

“It’s been pretty clear that there is some connection between vaccinations and autism,” said Craig Snyder, a lobbyist with IKON Public Affairs. “I’m sure he would continue to explore this.”

Meanwhile, Souder, who currently chairs the Subcommittee on Criminal Justice, Drug Policy, and Human Resources, said he was more than willing to relinquish oversight of public health policy.

“It’s more a practical matter,” said Souder, adding that his panel had oversight of too many issues. “My primary goal is to keep oversight of narcotics policy, faith-based initiatives, social issues and, hopefully, national parks.”

* * *

PUBLIC HEALTH

Notes on the Havocs of Autism – Part II: California

MMR and Acquired Autism

(Autistic Enterocolitis)

- A Briefing Note

By David Thrower

February 2003

The most important single point to note is

that all the studies that "disprove" an MMR/autism link

are only epidemiological, statistical-type studies, which

do not examine actual children, whereas those studies that

point towards a link are based upon the detailed clinical

examination of the children affected. And these latter

studies also, interestingly, bear out the accounts of the parents.

-David Thrower

California

California has probably the most useful and detailed autism data in the world, going back to 1970. Trends monitored there have a potential worldwide significance.

The rise in autism was first highlighted by a report Changes in the Population of Persons With Autism and Pervasive Developmental Disorders in California’s Developmental Services System, 1987 through 1998 - A Report to the Legislature, tabled on March 1st 1998 by the Department of Developmental Services, Sacramento, California Health and Human Services Agency.

Department of Developmental Services data, released at the start of 2002, shows that a record number of professionally-diagnosed DSM-IV criteria autism cases, 2,725 cases, entered the State system during 2001.

This year-2001 number represents a 20% increase over the year 2000, itself a record.

In 2001, there were more cases of level-one autism in California than in 1994, 1995 and 1996 combined.

Historically, autism made up 3% of childhood disability in the State Developmental Services system. It now comprises 35% of the total.

Two out of three persons with autism in California’s child-developmental system are now young children between the ages of 3 and 13. Eight out of ten persons with autism have been born since 1980 (1980 was the year that California mandated the full complement of childhood vaccines as a condition of school entry. MMR was also introduced in California 1979-80).

California now has 16,802 persons with level-one autism in its Developmental Services system.

The total intake for the three years 1999-2001 was 6,596. This compares with a total intake for the twenty-five years 1970-1995 of 6,527 cases.

This does not include children with persistent developmental disorder, non-specific (NOS) developmental delays, Asperger’s or and other autistic spectrum disorder - it is therefore the tightest definition of the severe-case numbers.

Statistics on autism in the individual regional centres in California, run by the state Department of Developmental Services, also show a sharp rise in the period 1998-2002:

(regional centre) At 1-7-98 At 1-3-02 Increase %

Alta 400 683 71%

Central Valley 150 361 141%

East Bay 606 1,087 79%

E. Los Angeles 443 976 120%

Far Northern 125 217 74%

Golden Gate 371 499 35%

Harbor 639 1,113 74%

Inland 568 1,195 110%

Kern 141 262 86%

Lanterman 418 842 101%

North Bay 215 350 63%

N. Los Angeles 742 1,746 135%

Orange 670 1,621 142%

Redwood Coast 76 103 36%

San Andreas 360 666 85%

San Diego 609 1,186 95%

San Gab/Pomona 581 937 61%

S. Central LA 549 874 59%

Tri-Counties 352 725 106%

Valley Mountain 153 373 144%

Westside 613 986 61%

(Statewide Total) 8,781 16,802 91%

Since this data was released, further rises have been recorded:

The quarterly data reported from the California Department of Developmental Services for the period April-July 2002 added a further 846 new children with level-one DSM-IV autism to the Department’s caseload. These 846 cases represented a new record high in the 31-year history of the system.

The increase was 18% higher than for the comparable quarter in the previous year. Autism now constitutes 40% of all developmental-disability intake for the California system.

On average, nine new cases are being added to the system, every day, seven days a week.

To set the 2002 figures in context, over the 28 years from 1971, to 1999, California produced 10,206 cases. In the subsequent three and a half years, 1999 to mid-2002, a further 8,554 new cases were added.

[Editor's note: Here is the most recent update of the California autism numbers:

New statistics from California reveal that the number of individuals diagnosed with severe autism and who are receiving services in that state jumped another 21 percent in 2002. The new figures from the California Department of Developmental Services come on the heels of another department report two years earlier that autism had increased 273 percent in the previous decade.

According to the new data, an alarming 20,377 individuals with a diagnosis of autism were receiving services from the department as of the fourth quarter of 2002, compared with 16,802 individuals as of the fourth quarter of 2001. The 21 percent one-year increase represents an all-time record number of new cases in the system’s 33-year history. The majority – 84 percent – of the new cases were children under the age of 18.

According to the Department, as of the end of 1994, there were 5,108 cases of autism in the entire system, compared with 20,377 at the end of 2002. In the 1970s, California consistently added 100 to 200 new cases a year. In the mid-1990s, an average of two individuals a day entered the California system. Today, the state is seeing an average of not 9, but 10 new cases a day.]

Comment: the above suggests a major rise in autism incidence in California.

The MIND Study, California

Following mounting concern at the apparent steep increase in autism in California, an urgent study was launched by the MIND Institute. Its findings were released on 17th October 2002, and appear to finally confirm (but see other contradicting studies in the following section) that autism has risen steeply.

The study was led by Dr. Robert Byrd, whose team had previously enrolled 684 Californian children who were receiving services from one of the Department of Developmental Services regional centers. Byrd’s team systematically gathered information for children in two age groups, 7-9 year olds, and 17-19 year olds. These were drawn from families of 375 children with a diagnosis of full-syndrome autism, and families of 309 children with a diagnosis of mental retardation without full-syndrome autism.

The study findings were that:

* The unprecedented increase in autism in California is real and cannot be explained away by artificial factors such as misclassification and criteria changes. Autism is on the rise in California and the study team does not know why

* The observed increase cannot be explained by a loosening in the criteria

* Some children reported with mental retardation and not autism did meet criteria for autism, but this misclassification does not appear to have changed over time

* Because more than 90% of the children in the survey are native to California, major migration of children into California does not contribute significantly to the increase in autism

* A diagnosis of mental retardation associated with autism had declined significantly between the two age groups studied.

* The percentage of parent-reported regression (loss of milestones) does not differ between the two age groups studied

* Gastrointestinal symptoms, including constipation and vomiting, in the first fifteen months are more commonly reported by parents in the younger group

Comment: the above study appears to offer firm evidence of a major rise in prevalence.

NEXT: Autism in the US

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* * *

Traces of Pollutants Found In Many People

A study released last week confirms what many scientists have long suspected -- that ordinary people carry in their bodies dozens of environmental pollutants, including a wide variety of industrial compounds, metals and pesticides.

While most of the substances were found in minute amounts, the study raises questions about what the cumulative effects may be of a mixture of substances known to individually have toxic effects at higher doses.

The study tested the blood and urine of nine people for 210 pollutants and found traces of 167 of those pollutants in one or more of the participants. The average number of pollutants found in the nine people was 91. None of those tested work with chemicals on the job.

The study was conducted by the Environmental Working Group, an environmental advocacy group in Washington; Mount Sinai School of Medicine in New York City, and Commonweal, a health and environmental research institute in Bolinas, Calif.

Since World War II, the petrochemical industry has introduced more than 75,000 new chemicals, although only about 12,000 are produced in high volume.

"We've never been confronted with this chemical mixture in our bodies in all of evolutionary history until now," said Richard Wiles of the Environmental Working Group. "But we know from animal studies that they can be harmful and we know that the effects that they are likely to cause are increasing in the population."

Those effects include increases since the 1970s in autism, attention-deficit disorder, early puberty, birth defects in male reproductive organs, and certain cancers, including childhood leukemia and breast, testicular, prostate, thyroid and childhood brain cancer, Wiles said.

Jay Vroom, president of CropLife America, a trade association for the pesticide industry, said the study's sponsors are trying to scare the American public.

There needs to be more research, but "there is no reason to panic," Vroom said. "Almost all the products associated with these residues have benefits to society."

A statement by the American Chemistry Council, a trade association for the chemical industry, said: "For the vast majority of environmental chemicals, there is no reliable evidence to suggest that trace amounts in human tissue present a risk to human health."

In the study, the number of pollutants found ranged from a low of 77 in Monique Harden, a 34-year-old attorney from New Orleans, to a high of 106 in David Balz, a 48-year-old research associate with Commonweal who has traveled widely and spends a lot of time in the outdoors.

Among the substances found in the participants were: Phthalates, which are plasticizers used in a wide range of cosmetics, shampoos and other personal care products. They are suspected of causing birth defects in male reproductive organs. Some phthalates were recently banned in Europe.

Four metals -- lead, mercury, arsenic and cadmium -- that can cause lowered intelligence, developmental delays, behavioral disorders and cancer. Sources of exposure include lead paint, canned tuna, arsenic-treated lumber, contaminated drinking water, pigments and bakeware.

Organophosphate metabolites, which are breakdown products of commonly used insecticides. Some organophosphates, which are toxic to the nervous system, have been banned for indoor uses, although agricultural use is still permitted.

Volatile and semi-volatile organic chemicals, including industrial solvents and gasoline ingredients like xylene and ethyl benzene. Most are toxic to the nervous system and some are carcinogens.

Furans, which are byproducts of plastics production, industrial bleaching and incineration. They persist for decades in the environment and can be dangerous to the developing nervous and hormonal systems of fetuses and young children.

"This is just a little sliver of the picture," Wiles said. "We know we could now test for 200 more chemicals than we tested for and we would probably find at least 100 of those in everybody."

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