Autism - As the Incidence Rises - Possible Answers and Solutions Emerge

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(May 15, 2003) - Autism is defined as "a neurodevelopmental disorder characterized by impairments in social relating, language, and by the presence of repetitive and stereotyped behaviors." It is not to be confused with mental retardation, since people with autism can have high IQs. Writing recently in Alternative Medicine Review, Parris Kidd, PhD notes, "Adult individuals with autism have life outcomes that range from complete dependence to (rarely) successful employment."

Even more alarming is a description of autism by Walter Spitzer, MD, a leading Canadian epidemiologist: in its most severe cases, he said, an autistic person is "a dead soul in a live body."

In recent years, the incidence of autism has been increasing worldwide. Exact figures are imprecise but the the National Institutes of Health estimates that some 400,000 Americans are diagnosed with autism. (The condition is about four times more prevalent in males.) However, a 1999 report by the California Department of Developmental Services (DDS) puts the number much higher - up to 1.5 million. This month, a new report suggests that the rise in autism's incidence is reaching alarming proportions.

Cliff Allenby is the Director of the California DDS. The agency provides services and supports to children and adults with developmental disabilities. On May 13, Allenby issued a "message from the director" which made national headlines. He noted that a new study finds that autism has doubled in California in the past three to four years. "Autism," Allenby writes, "is the fastest growing disability served by the California Department of Developmental Services, affecting more than 21,000 persons in California and representing a nearly 100 percent increase in caseload since 1999." The new report is the continuation of a study published by DDS in 1999, which reported a 237 percent growth in thenumber of autism cases between 1987 and 1998. In light of the new figures, autism in California has increased 634 percent between 1988 and December 2002.

According to the Associated Press, "The disorder is now more prevalent in California than childhood cancer, diabetes and Down syndrome."

The Autism-Immunization Link

Not surprisingly, the question of why the incidence of autism is increasing is controversial. Some observers, like the National Vaccine Information Center, suggest that there is an association between autism and certain immunizations, particularly the near-universal MMR (measles-mumps-rubella). Evidence has been published in the scientific literature reinforcing that viewpoint, including a much-debated article in The Lancet in 1998.

Some observers have seen a parallel between the sharp rise in autism and the increasing number of vaccinations given to children before the age of two, typically 30 or more different vaccinations. In addition, during the years that autism rates were starting to show a precipitous rise, many vaccines included the preservative thimerosal, which contains the highly toxic form of mercury, ethylmercury.

In April 2001, the Committee on Government Reform of the US House of Representatives held two days of especially probing hearings on autism including on the issue of a possible association with immunizations. Rep. Dan Burton (R-IN), the chairman of the Government Reform Committee until January 2003, has a personal interest in autism - his grandson was diagnosed with it. Between 2000 and 2002, Burton chaired five committee hearings on the subject (see links below), reflecting his usual hard hitting approach including an openness to unconventional ideas and therapies. At a 2002 hearing, Burton said in his opening statement, "My only grandson became autistic right before my eyes - shortly after receiving his federally recommended and state-mandated vaccines. Without a full explanation of what was in the shots being given, my talkative, playful, outgoing healthy grandson Christian was subjected to very high levels of mercury through his vaccines. He also received the MMR vaccine. Within a few days he was showing signs of autism."

The possible association of autism and vaccinations remains unpopular: According to one article, "Dr. Walter Spitzer, the Canadian physician who could be considered the 'dean' of epidemiology, has come in for harsh criticism for saying there might be a link between measles-mumps-rubella (MMR) vaccine and autism." Later, Spitzer wrote an article for The Daily Mail (UK) about the "scandal" of the autism-vaccination debate: "The most important thing I have learned in the past 18 months is that autism is a terminal illness. Autistic children are never cured or, at least, so rarely as for it to be a medical curiosity. If the side-effect of MMR was death, the concern would be much, much larger, but a deferred death - and in the most severe cases that is what autism is, a dead soul in a live body - just does not generate the concern that it should."

Acceptance of the vaccine-autism hypothesis appears to be gaining momentum. On the first weekend of May, a three-day meeting at Loyola University in Chicago, convened by Autism One, brought together researchers, clinicians, activists, and Rep. Burton, who now chairs the Government Reform Subcommittee on Human Rights and Wellness. According to a UPI news article about the conference, attendees "said growing evidence indicates that vaccines are linked to increasing rates of brain problems and that government health agencies have done little to recognize it." At the conference, Burton said, "I hope somebody will ask the question, 'Is there collusion between the pharmaceutical companies and our health agencies?' The appearance in many cases is that there is."

In Chicago, Burton released a report by his subcommittee's staff, "Mercury in Medicine - Taking Unnecessary Risks," the results of "a three years investigation initiated by the Committee on Government Reform." A Microsoft Word formatted version of the report's summary, findings, and recommendations can be downloaded from Burton's Web site.

CAM and Autism

In 2002, Parris Kidd, PhD surveyed the field and wrote two lengthy articles on autism published in the peer-reviewed, Medline-indexed journal Alternative Medicine Review (vol. 7 no. 4, and vol. 7 no. 6). In "Autism, an extreme challenge to integrative medicine. Part 2: medical management," the second article, which focuses on treatments, Kidd writes "Conventional medicine has largely failed autistic individuals and their families."

Complementary alternative medicine (CAM), however, has been reported to help people with autism. Kidd reviews many of the CAM approaches that have shown some success. One of the pioneers of such therapies is DAN! - Defeat Autism Now! - a collaborative network founded in 1995 by Bernard Rimland, PhD, founder and director of the Autism Research Institute, and 29 other scientists, parents, and physicians. According to Kidd, "DAN! supports the current research consensus that autism is primarily organic in origin, while understanding that many of its features respond to psychological interventions.

"Among practitioners familiar with autism," Kidd writes, "there is strong consensus that modifying the diet and the gastrointestinal system sets the stage for the success of other treatments, and therefore should come first. Parents have found that, by closely regulating their child's diet, they can observe improvement, and that when dietary constraints are relaxed, the child often worsens. The recognition in recent years of a gut-immune-system-brain axis of pathology further supports this priority."

Kidd identifies food additives, colorings, sweeteners, and preservatives; casein and gluten foods; and many other foods as associated with autism or a worsening of its symptoms, including eggs, tomatoes, eggplant, avocados, red peppers, soy, and corn.

In the "Nutrients Most Likely to Benefit Autism" category, Kidd identifies multiple vitamin-mineral supplements; vitamin B6 and magnesium ("Taken together, the studies seem to establish that vitamin B6 can benefit as much as half of children and adults with autism, and that its efficacy and safety are improved when combined with magnesium"); dimethylglycine, folic acid, calcium, vitamin B3, vitamin C, zinc, essential fatty acids, vitamin A, taurine, and glutamine.

Kidd reports that practitioners of integrative and complementary alternative medicine suggest that correcting any gastrointestinal abnornmalities and eliminating heavy metal toxicity are also advisable.

Postscript: Federal Attention Requested

Rep. Burton cited the new California study on rising rates of autism in a letter to President Bush on May 15. In the letter (a Microsoft Word-formatted version can be viewed here), Burton, writing as the chairman of the Subcommittee on Human Rights and Wellness, recommends that Bush convene a White House Conference on autism "to confront the National problem of autism." Burton writes, "Autism is a devastating disease that has already reached epidemic proportions in this country, and the problem continues to grow. A White House Conference on autism could galvanize a National effort to find the underlying cause or causes of autism, and ultimately lead towards a cure for this terrible disease, as well as efforts to develop new services to help parents of autistic children meet the many challenges they face on a day-to-day basis."

Commenting on Burton's letter, Sherri Tenpenny, DO points to the costs of caring for the growing numbers of autistic children. "Take these numbers" she notes (referring to 20,000 autistic children in California alone and perhaps ten times that number nationwide), "the cost of care - approximately $2-2.5 million/child - and know that these kids are mostly on Medicaid and some are on Medicare, and that becomes a federal cost. That may get the attention of Bush and also Congress.

"What are we going to do with these kids when they are teenagers and the parents can no longer care for/control them at home? Most are strong, big, and violent, even as little kids. Where will they be housed? Who will pay for that? Worst yet, the largest number of these kids will be reaching puberty in about fifteen years, the peak of when the Baby Boomers will be getting chronic illnesses such as Alzeheimers. . .

"This [issue] needs to be hugely looked at by everyone. And also that there are treatments for these kids that work, and are not being covered by insurance. It is a complex problem that needs public attention."

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