SCHAFER AUTISM REPORT "Healing Autism:

No Finer a Cause on the Planet" ________________________________________________________________

Thursday, February 05, 2004 Vol. 8 No. 25

THE AUTISM CALENDAR: NOW WITH OVER 300 EVENTS LISTED

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PUBLIC HEALTH

* New Research Suggests Vaccine Ingredient & Autism, ADHD Link

* DTP Vaccines: Alum Deemed To Be Safe

* Demand For Single Jabs At Record Level; Sharp Rise In Measles

Cases As UK Parents Turn Their Backs On MMR Vaccine

* Gulf War Syndrome: The Legal Case Collapses

FORENSIC

* Amendment to Immigration Bill 'Could Bar People With Autism From

Entering Ireland'

LETTERS

* ABA/Lovaas Polyad

PUBLIC HEALTH

New Research Suggests Link Between Vaccine Ingredients and Autism, ADHD

Newswise — According to new research from Northeastern University pharmacy professor Richard Deth and colleagues from the University of Nebraska, Tufts, and Johns Hopkins University, there is an apparent link between exposure to certain neurodevelopmental toxins and an increased possibility of developing neurological disorders including autism and attention-deficit hyperactivity disorder. The research – the first to offer an explanation for possible causes of two increasingly common childhood neurological disorders – is published today in the April 2004 issue of the journal Molecular Psychiatry.

Though some speculation exists regarding this link, Deth and his colleagues found that exposure to toxins, such as ethanol and heavy metals (including lead, aluminum and the ethylmercury-containing preservative

thimerosal) potently interrupt growth factor signaling, causing adverse effects on methylation reactions (i.e. the transfer of carbon atoms). Methylation, in turn, plays a significant role in regulating normal DNA function and gene expression, and is critical to proper neurological development in infants and children. Scientists and practitioners have identified an increase in diagnoses of autism and ADHD in particular, though the reasons why are largely unknown.

In their work, the scientists found that insulin-like growth factor-1

(IGF-1) and the neurotransmitter dopamine both stimulated folate-dependent methylation pathways in neuronal cells. At the same time they noted that compounds like thimerosal, ethanol and metals (like lead and mercury) effectively inhibited these same biochemical pathways at concentrations that are typically found following vaccination or other sources of exposure. By better understanding what happens when infants and children are exposed to these materials, the work of Deth and his colleagues helps to explain how environmental contact with metals and administration of certain vaccines may lead to serious disorders that manifest themselves during childhood, including autism and ADHD.

"Scientists certainly acknowledge that exposure to neurotoxins like ethanol and heavy metals can cause developmental disorders, but until now, the precise mechanisms underlying their toxicity have not been known," said Deth. "The recent increase in the incidence of autism led us to speculate that environmental exposures, including vaccine additives might contribute to the triggering of this disorder."

Thimerosal, which was largely phased out in the U.S. and in Europe starting in 2000,was often used for its preservative abilities in multi-dose units of vaccines for diseases like hepatitis, whooping cough, tetanus and diptheria.

Today, most vaccines carry only trace amounts of it, according to the CDC.

But in larger, multi-dose vials of these vaccines, often shipped to and used in third world countries, thimerosal is still very common. Multi-dose flu vaccines still contain thimerosal.

Additionally, the scientists recently obtained more insight into the mechanism by which thimerosal interferes with folate-dependent methylation.

It acts by inhibiting the biosynthesis of the active form of vitamin B12 (methylcobalamin), which is of particular interest because doctors treating autistic kids are having good success with the administration of methycobalamin.

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* * *

DTP Vaccines: Alum Deemed To Be Safe

A new study has concluded that DTP vaccines containing aluminum are safe.

Datamonitor - Safety fears have plagued the vaccine industry in recent years, with concerns related to individual product types and vaccine ingredients, including the adjuvant alum. A recent review, published in Lancet Infectious Diseases, has concluded that vaccines containing alum are not associated with increased adverse events. This study should help to alleviate patient concerns and maintain uptake.

In recent years there have been a number of events that have led to increasing concern over the safety of infant vaccination programs. Suggested links between the MMR (measles, mumps and rubella) and autism and the hepatitis B vaccination and multiple sclerosis are just two of the issues causing such fears. Preservatives, such as thimerosal, have long been scrutinized, particularly in the US, and their safety remains an issue.

However, much progress has been made in removing or reducing thimerosal in vaccines. The FDA has licensed new pediatric formulations of hepatitis B and diphtheria, tetanus and acellular pertussis (DTaP) vaccines. These include Recombivax-HB (Merck [MRK], thimerosal free) in August 1999, Engerix-B (GlaxoSmithKline [GSK.L], trace thimerosal) in March 2000 and DTaP vaccine Tripedia (Aventis-Pasteur [AVE.L], trace thimerosal) in March 2001.

Aluminum has been added to protein based vaccines for more than 60 years and is the most successful vaccine adjuvant to date. However, adverse events reported following the use of alum-containing vaccines have led to fears regarding its safety.

A recent study, published in Lancet Infectious Diseases, reviewed evidence of such adverse events, following the use of vaccines against diphtheria, tetanus and pertussis (DTP). The study focused on 35 reports, including three randomized trials, four semi-randomized trials and one cohort study. It looked at the incidence of erythema, induration, local reactions, collapse and convulsion and also the occurrence of crying and screaming. The review concluded that in both young and older children, alum-containing vaccines led to no serious and long-lasting adverse events.

Aluminum adjuvants are essential to the efficacy of many marketed vaccines, as well developmental compounds. Demonstrating the safety of alum is critical to securing patient confidence in such medications and driving and maintaining uptake. As DTP products currently form the mainstay of vaccine players' revenue, highlighting the safety of this adjuvant will prove even more important. This recent study should go some way towards alleviating concerns.

* * *

Demand For Single Jabs At Record Level; Sharp Rise In Measles Cases As UK Parents Turn Their Backs On MMR Vaccine

Fears over the safety of the MMR vaccine have boosted demand for single jabs to record levels, official figures reveal.

The number of parents seeking an alternative to the triple vaccine has meant a huge rise in single measles jabs imported into Britain.

Last year 103,000 doses were brought in, compared with just under 85,000 in 2002 and only 11,800 in 2001. That is a rise of 1,000 per cent in three years.

The soaring demand emerged as public health officials admitted that measles cases also rose steeply last year.

Health experts reported a 43 per cent rise as record numbers of parents turned their backs on the MMR jab, amid fears of a link to bowel disease and autism.

There were 442 measles cases in 2003, compared with 308 in 2002. The latest Health Department figures show uptake of MMR among two-year-olds is still shockingly low. Between July and September last year it climbed by just under one per cent, to 79.8 per cent. But in London over the same period, it fell by 0.1 per cent to a new low of 67.4 per cent.

Last year, health chiefs revealed that around one in every six children in Scotland was not being immunised with the MMR jab.

Uptake dropped to 85.8 per cent of two-year- olds the lowest for eight years.

Doctors warned that once the 'herd immunity' of children drops below 90 per cent, disease can flourish.

Health Protection Agency officials said yesterday that measles outbreaks could have been much worse without the number of single jabs.

The extraordinary admission coincides with an HPA attempt to determine the number of children who have received the single vaccine. It is thought so many families are choosing that route that medical authorities are being forced to take account of the protective role single vaccinations have played in keeping measles at bay.

Private clinics say they are inoculating thousands of youngsters against the disease which can cause deafness, blindness and can even prove fatal.

Private clinic Direct Health, which has seven centres south of the Border, gives single jabs to at least 20,000 children a year and Healthchoice UK says it vaccinates some 10,000 a year.

The Department of Health refuses to provide the jabs on the NHS, saying the time lag between doses unnecessarily exposes children to disease.

MMR gives immediate coverage against measles, mumps and rubella.

Dr Natasha Crowcroft, consultant epidemiologist with the HPA, said: 'We have had problems with measles outbreaks, but last year we tended to see cases spread out more around the country.

'We thought things were really going to get bad in London but it did seem to settle down.' She said the number of parents turning to single jabs was 'bound to be' part of the reason that measles failed to take hold in the capital.

Dr Crowcroft added: 'In broad terms, we know lots of children, especially in London, have had single vaccines. That may have damped down measles.' But she added: 'I can' t support single jabs, I don't think it is the right way to go.' A Department of Health spokesman said: 'There is no credible, scientific evidence showing an association between MMR and autism.'

* * *

Gulf War Syndrome: The Legal Case Collapses

An eight-year, multimillion pound legal battle by more than 2,000 veterans for compensation for Gulf war syndrome has collapsed because there is not enough scientific evidence to prove their case in court.

The Legal Services Commission (LSC), which is estimated to have spent around £4m on the case, is expected to withdraw legal aid this month after being told by the veterans' lawyers that the action has no real chance of success. Taking the case to trial in the high court could cost a further £4m in legal aid.

The legal team - headed by Stephen Irwin QC, the chairman of the bar, and Patrick Allen, senior partner of solicitors Hodge Jones & Allen - last night called on the government to set up a public review of the issues surrounding Gulf war illness and to make ex gratia payments to veterans.

To succeed in their claim against the Ministry of Defence, the veterans would have to produce scientific evidence not only that their illness was caused by their service in the 1991 Gulf war, but also that the MoD had been negligent. The burden of proof would be on them as claimants to prove their case.

But a trawl by scientists through 10 years of research worldwide, overseen by the veterans' lawyers and funded by the LSC, has found no evidence which establishes any specific cause for the range of health problems they suffer.

There is also little or no evidence of negligence on the part of the MoD, according to the legal opinion by Mr Irwin and the junior counsel Christopher Hough, which has gone to the LSC.

The collapse of the case comes only months after litigation by parents who blame the MMR vaccine for their children's autism suffered a similar fate, also for lack of scientific evidence to back up their claims.

Many of the 55,000 British troops who served in the Gulf have experienced a range of symptoms including muscle weakness, neurological symptoms, headaches, depression, fatigue, short-term memory loss and difficulty in concentrating, joint and muscle pain, sleep disturbances, skin rashes, and shortness of breath. Gulf war veterans, including British, American, Australian and Danish troops, have about twice the expected rate of ill health.

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FORENSIC

Amendment to Immigration Bill 'Could Bar People With Autism From Entering Ireland'

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Dublin, Ireland: Irish opposition parties claim that the government's proposed amendment to a controversial section of the immigration Bill could prevent people with Down's syndrome or autism from entering Ireland.

Amendments to the Bill, which is due to pass all stages in the Dáil

(Parliament) on February 4, define those to be refused entry as suffering from "profound mental disturbance" showing signs of psychotic disturbance.

The new law was made necessary by a High Court decision which struck down the existing Ministerial Orders controlling immigration, because they were not brought in through primary legislation.

The first draft produced by Michael McDowell, the Irish Minister for Justice, Equality and Law Reform, allowed immigration officers to refuse entry to people suffering from a disability, but this was amended in the Seanad to a definition of mental disorder contained in the Mental Health Act.

However, an Independent Senator, Joe O'Toole, claimed that this could include people with Down's syndrome or autism.

The latest proposed amendment, due to be debated in the Dáil on February 4, defines the reasons for exclusion even more narrowly. It also allows immigration officers to refuse entry to people suffering from tuberculosis, syphilis, drug addiction and other infectious or contagious parasitic diseases which are being prevented from spreading from abroad.

[What next: Snakes? -LS].

* * *

LETTERS

ABA/Lovaas Polyad

In their letters concerning the efficacy of ABA, David Kiasi of Maryland and David Eland of Kansas rightly point out that (in Mr. Eland's

words) "few home ABA programs achieve the 47% recovery/success rate that Lovaas achieved" in a clinical setting and home programs in all likelihood have "a recovery rate less than half of 47%." These are valid observations, which parents should know before they embark on setting up ABA programs.

What I have not heard, however, is any comment on how intensive ABA therapy can benefit the children who never reach the point of being indistinguishable from their non-autistic peers. (Based upon what I've read, being "indistinguishable from one's peers" is the definition of "success" to some.) In other words, I have heard no one defend the achievements of the other 53% -- or 77%, or 80%, or whatever -- of children who are still distinguishably autistic when their ABA programs have ended. Since those children are not counted in the "recovery/success" column, one might conclude that their ABA programs have been failures.

Let me propose an alternative definition of success.

I believe that most children who receive ABA therapy benefit from it. How could they not? It's just common sense to me that intensive, structured, one-on-one training, adjusting goals as skills are mastered, and intelligently utilizing rewards, is bound to bring about substantial positive behavioral and academic results.

So the question I pose is whether or not those positive results equate to success, even if some percentage of the children who receive ABA still meet the diagnostic criteria for autism when their programs have concluded. I think they do.

If the gains made in ABA are reduced stimming, better focus, better eye contact, improved language abilities, improved living skills, and improved academic skills, even though he or she may still be very "distinguishable," that to me is success. And if (taking a longer view) ABA helps raise the child up to a level of functioning that enables him or her to stay out of an institution, live independently, hold a job, and form meaningful social relationships, even if the child doesn't end up being indistinguishable from his or her non-autistic peers, that would, in my view, justify the process.

- Neal Robb, Los Angeles

There is no doubt that Dr. Lovaas pioneered ABA and his study opened the way for many children to receive and benefit from proper ABA treatment. However, the 47% cited does not include the children who were not allowed to participate in the study because they did not meet the initial criteria of age and IQ scores.

Research is indispensable in this field, but an endless search for the reliable "cookbook" ignores those children who may not fit the mold but still be able to benefit, even to the point of recovery, from properly applied ABA methods. Lovaas cites the use of trained lead tutors to implement a program written to fit all children. If a child does not succeed with the program, they are dropped. We feel it is imperative that any ABA program be individually designed from the beginning and modified intelligently and in line with the best current practice and theories of ABA to fit the child. This modification should be done by a board certified behavior analyst who meets the standard for autism set forth by the Cambridge Center for Behavioral Studies, not a lead aide trained only in implementing one program that is supposed to fit all children. We have successfully treated many children this way, and those who have attained the level of independent functioning at age and grade level are all still independent as of last report. Several more are expected to achieve that status this year as well. Several of them did not meet the Lovaas entrance criteria. (Most were not testable for IQ at all an entry.) I cannot compare a percentage directly because we have so few children with testable IQs at entry - but I would like to see Lovaas's numbers with no limits on entrance criteria (perhaps taking children up to age 5 - we have children who have achieved independence with entrance ages that high) and no ELM measures to automatically drop children who do not achieve certain skills by certain points in their programs.

I ran into the entrance criteria problem as a parent in 1987. My daughter was too old and too retarded to even be considered for Lovaas. She is now a freshman at the College of Chemistry in Berkeley. She has had no special education since first grade. Needless to say, her ABA program was individualized to fit her, and there were no other options at that time.

Lovaas does not hold the only answer to recovery. A parent who chooses another quality ABA program such as one that uses Skinnerian principles of language functioning (as cited by Dr. Carbone) and intelligently applied individualized programming by board certified behavior analyst is not dooming their child to a lesser chance of recovery than a parent who chooses Lovaas. Quality ABA is not just the "Lovaas, one program fits all" children. Quality ABA is the program that works best for your child.

- Audrey Gifford, BCBA Bridges Behavioral Language Systems

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