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"Healing Autism: No Finer a Cause on the Planet" ________________________________________________________________

RESEARCH

* Media Alert: Are We Making Our Kids Sick? Kids & Chemicals - Special Rept.

* Possible Autoimmune Enteropathy Found In Autistic Children

* Looking Into Autism

* No-Symptom Sensitivity To Gluten May Result In Neurological Dysfunction

PUBLIC HEALTH

* MMR Doctor Advises Giving Parents The Choice Of Single Vaccines

EDUCATION

* U.S. May Train Teachers On How To Help the Autistic

* Special Ed Graduation Rates Rise

* DREDF Tracking IDEA Political Developments

Are We Making Our Children Sick? Kids And Chemicals, A Special Report Bill Moyers Tracks The Scientific Search For Answers About How Environmental Toxins Affect America's Children

[In March of last year, Moyers covered the subject of industrial pollution in a report titled "Trade Secrests." This report focuses on children. Thanks to Dave Swartz,.] Premieres Tonight, Friday, May 10 at 9:00 (ET) on PBS (check local listings)

It is a medical mystery marked "urgent." Across America growing numbers of children are suffering from asthma, childhood cancers like leukemia, as well as learning and behavioral disabilities. Scientists are searching for clues to the causes of these illnesses, and a growing body of research suggests that everyday environmental toxins-what kids eat, drink, and breathe-may put them at risk. Equipped with new technology and more sophisticated analysis, these scientists are asking compelling questions about the health risks to children growing up exposed to an ever-increasing number of untested chemicals in our environment.

Kids and Chemicals, a special edition of NOW with Bill Moyers to be broadcast on PBS, Friday, May 10 at 9 p.m. (ET), features medical investigators and health officials engaged in the latest research on links between childhood illness and environmental contamination. The program looks at families around the country who are coping with the consequences to their children of potentially toxic exposures.

"The disturbing increases in childhood illness in America cannot be ignored," says Bill Moyers. "How does the exposure affect children's health? The new research is studying how chemicals enter the human body, and posing questions that they could never ask before: Do chemicals affect children, babies and unborn fetuses more than adults? What factors increase toxicity, and how can we protect children from harm?" Kids and Chemicals' producers Gail Ablow and Greg Henry go to Fallon, Nevada, a small desert town that has had 15 recorded cases of childhood leukemia in just five years. A l armed, Dr. Mary Guinan, who was one of Nevada's top health officials, called in the Centers for Disease Control and Prevention to investigate the potential links between this childhood cancer and the environment. Could toxic substances in water, food, air, schools, homes or the ground in Fallon be responsible for this "cancer cluster"? If so, which chemicals? Without clear evidence of a specific cause, everything-from jet fuel emissions to pesticides to naturally occuring arsenic in the water-is suspect.

As Moyers and his team learn in Fallon, research on cancer clusters once focused mainly on gathering environmental samples because investigators simply didn't have tools sensitive enough to measure which toxins had been absorbed into people. Dr. Richard Jackson, the director of the National Center for Environmental Health at the Centers for Disease Control and Prevention, explains how his laboratories are using the latest instruments. His research scientists are using sophisticated blood and urine analysis to test for minute traces of toxins in the bodies of the sick children and their families in Fallon.

This work is part of a larger movement in children's environmental health unfolding nationwide. Dr. Phillip Landrigan of the Mount Sinai School of Medicine in New York City works with scientists around the country to understand how kids are affected by exposure to chemicals. "Of the 3000 high production volume chemicals in use in this country today, only 43% have been even minimally tested," he tells Moyers. "Only about 10% have been thoroughly tested to examine their potential effects on children's health and development."

Speaking with Landrigan, Moyers learns that children are potentially more vulnerable to chemicals than adults. "First of all they're more heavily exposed pound for pound," says Landrigan. "They eat more food, they drink more water, they breathe more air. Then, of course, kids < B R>play on the ground. They live low, they put their hands in their mouth and so they transfer more toxic chemicals into their body than we do."

Traveling to Research Triangle Park, North Carolina, Moyers meets Dr. Linda Sheldon of the Environmental Protection Agency's National Exposure Research Lab. Sheldon demonstrates how her team of scientists is gathering evidence of exposure to everyday chemicals in nursery schools, homes and daycare centers.

In New York City, a groundbreaking study led by Dr. Frederica Perera at Columbia University's Mailman School of Public Health, follows more than 500 expectant mothers. These women are wearing air quality monitors in backpacks to trap the environmental toxins they breathe. As their children are born and as they grow, Dr. Perera and her team will look for links between the chemicals that the mothers were exposed to while their babies were developing in the womb and asthma, cancer risk, and learning disabilities.

Dr. Sandra Steingraber, a biologist at Cornell University, joins Dr. Landrigan in asserting that exposure during pregnancy doesn't, by itself, mean a child will get ill. What matters is the intensity of the exposure and when it occurs during fetal development. A chemical exposure occurring early in pregnancy might cause a miscarriage, argue the researchers. If it occurs later on, it might cause physical birth defects. Later still, it might damage brain cells. Scientists are trying to precisely identify these "windows of vulnerability." Says Dr. Steingraber: "Maybe certain problems that we understand . . . as attention deficit disorders, hyperactivity, the inability to pay attention, aggressive and violent behaviors, might have their origins during those windows of vulnerability during pregnancy and these questions are just being asked. Data is just beginning to come in." Dr. Perera's team at Columbia is also studying the way that chemicals can actually bind to human DNA in the womb and cause a mu t ation called an "adduct." Work by Dr. Perera has shown that the greater the number of adducts, the greater the risk for cancer. "And that's the missing link in all of this," says Dr. Steingraber. "That's the link we're beginning to fill in."

To place the current studies in a public health policy context, Moyers revisits the firestorm over lead research; recalling the revolutionary work of Dr. Herbert Needleman, who correlated low-level lead exposure to lower IQ's in children in 1979. Twelve years later, Needleman's work was attacked by the lead industry as it tried to protect its economic stake in lead products. Ultimately, the validity of Dr. Needleman's work was fully vindicated, and new public policy required unleaded gasoline and restrictions on lead paint. And many scientists believe that, as a result, children's IQ scores have risen, on average, three points. Yet, as Moyers points out, lead remains the number one environmental threat to children's health; many old houses and even many school buildings are still testing positive for lead today.

In Herculaneum, Missouri, lead contamination is a very current issue. The community is up in arms about the astonishingly high levels of lead to which their families have been exposed because the town's primary industry, the Doe Run lead smelter, failed to comply with EPA standards. "Doe Run played a really good game," Robyn Warden, a mother, tells Moyers. "They told people everything was under control and we were safe. And people weren't educated enough to know any different. It took people actually investigating lead to figure out that we were being lied to."

Dr. Steingraber knows the importance of informed parenting. Even in a seemingly pristine environment in rural New York, she knows there are possibilities of risk. "Just because there are no smoke stacks visible around us, just because you live a long way from the source of these chemicals, doesn't mean that natu r e won't bring them to you in some way," she says. A mother who breast feeds her infant son, Dr. Steingraber also realizes that she passes toxins directly to her baby every time she nurses. "No woman has uncontaminated breast milk on this planet," she states. Dr. Steingraber tries to reduce her children's exposure at home by using non-toxic products. "But we can't shop our way out of our current situation," she warns. "We still need to take action. It's time that our public policy takes action to get our kids out of harm's way."

There are unknown answers to many questions. Moyers reports on a proposed new project called "The National Children's Study," which will track 100,000 children from the womb to age 18 if it receives full funding from Congress. This long-term study may provide the definitive answers necessary for new regulations and laws protecting children from exposure to toxins. "Without conclusive science," Moyers says, "it is a constant fight to protect children's health."

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* * *

Possible Autoimmune Enteropathy Found In Autistic Children

A team of UK researchers has found evidence supporting an autoimmune basis for bowel abnormalities in children with autism. The investigators reported IgG binding to the epithelial cell surface, lymphocyte infiltration, and increased crypt cell proliferation in the small bowel of children with autism. "These features raise the possibility of autoimmunity in severe autism", concludes Julio Licinio (University of California, Los Angeles, CA, USA) in an accompanying editorial (Mol Psych 2002; 7: 329).

Simon Murch (Royal Free and University College Medical School, London,

UK) and colleagues studied intestinal samples from 25 autistic children with small intestine lesions using various immunochemical techniques. For comparison, they also used samples obtained from 18 normal controls, 11 children with coeliac disease, and five children with cerebral palsy.

Routine staining showed only minor differences between autistic children and controls, but immunochemistry highlighted striking abnormalities in the group with autism. The density of CD8 intraepithelial lymphocytes was significantly greater in autistic children than in normal controls or children with cerebral palsy, but was was not as high as in children with coeliac disease. Autistic children also showed a higher density of excess T cell infiltration within the lamina propria than any other group. However, the most striking finding was the deposition of IgG1 and IgG4 on the basolateral enterocyte membrane and the subepithelial basement membrane in 23 of 25 autistic children, but in none of the other groups. In some, deposition was patchy and incomplete; in others it was striking and extensive (Mol Psych 2002; 7: 375-82).

"Intestinal inflammation genuinely does occur in at least a proportion of autistic children", concludes Murch. However, he says that the big question is whether such unexpected gut involvement either causes or exacerbates the cognitive abnormalities that typify autism. "If the answer is yes, this may point towards the logical use of immune-based therapy in future children at the time of first regression", he says.

An important next step towards understanding the significance of intestinal abnormalities to autism will be to find out whether localisation of IgG represents specific binding to an individual epithelial antigen, and if so the identification of this antigen. Other questions still to be answered relate to lymphocytic infiltration, which is apparently panenteric.

"Follow-up research has indicated that these autistic children show enhanced spontaneous tumour necrosis factor production by duodenal and colonic lymphocytes and evidence of focal lymphocytic gastritis", reports Murch. In the meantime, he doubts that the histological findings can be used to aid diagnosis of autism. "The straightforward histology is too subtle for routine diagnosis, but the same was true for H pylori infection for many years; maybe we'll get better at pattern recognition", he says.

* * *

Looking Into Autism

Milne E et al. (2002). High motion-coherence thresholds in children with autism. J Child Psychol Psychiatry, 43:255-263.

When one thinks of autism, it is probably the communicative and social impairments that come to mind first – behaviors such as social avoidance, lack of eye contact, or speech impairments. Indeed, it is these symptoms that are used in the diagnosis of autism, and most research on this developmental disorder has focused on the manifestation and treatment of these overt behaviors.

Elizabeth Milne and her colleagues, however, have new evidence that might help us to understand the lower-level mechanisms behind autism. Children with autism were compared with age-matched control children on a motion-coherence task.

Thresholds for motion detection were measured by presenting an array of moving dots on a computer screen; in each array, some of the dots move coherently (that is, in a common direction) and others move randomly. Importantly, each individual dot has a lifetime of only four frames, so to detect coherent motion, the child must be able to extract some global information from the display.

Tracking an individual dot provides insufficient evidence to detect the coherent motion direction. The task thus provides a measure of sensitivity to global information in the stimulus.

The results revealed that children with autism showed a significantly higher threshold (lower sensitivity) for motion coherence than did controls. The authors suggest that these results represent impairment of the magnocellular visual pathway, which projects via the dorsal stream to the parietal regions of the brain.

Several parietal lobe structures are known to be abnormal in people with autism, and this could result from the dearth of information coming from the low-frequency, magnocellular pathway early in development.

Although it is presently more speculation than fact, such a model could provide an exceedingly parsimonious account of early perceptual and later behavioral aspects associated with autism.

These findings are also consistent with the ‘weak central coherence’ hypothesis put forward to explain other biases for preferential processing of local features in autism. Milne et al. take an important first step in looking at perceptual deficits, which now should be followed by further perceptual investigation and functional imaging.

* * *

MMR Doctor Advises Giving Parents The Choice Of Single Vaccines

A researcher who chaired the committee that introduced the combined measles, mumps and rubella (MMR) vaccination programme into the United Kingdom has said that offering the choice of single vaccines could end the stalemate whereby some parents are refusing to have their children vaccinated.

Dr Eileen Rubery, senior research associate at the Judge Institute of Management, University of Cambridge, chaired the committee that introduced MMR vaccination to the United Kingdom in 1994, when she was under secretary for the protection of health with the Department of Health.

Writing recently in the British Association’s journal Science and Public Affairs (April 2002), she expressed concern that the government’s policy of insisting that children should have access only to the combined MMR vaccine was not helping to solve the current crisis in the programme.

Some parents refused to allow their children to have MMR vaccination, after reports that the combined vaccine might be associated with increased risk of several disorders, including autism.

The medical community argued that the research was flawed and showed no direct association between MMR and autism, and so urged that the triple vaccination should continue and that single vaccines should not be available on the NHS.

However, some parents were not reassured by this advice.

Latest figures show that 86% of 2 year olds have received the MMR vaccine, compared with 97% who received tetanus inoculation.

Dr Rubery said that offering parents the choice of single vaccines—at their own expense—could solve the problem, even though she considered there was no evidence of an association between MMR and autism and acknowledged that the single vaccines had not been tested in the same way as the combined vaccine.

"My guess is that once parents can choose, many will reflect more calmly on the options and understand the benefits of the triple vaccine," she said.

"Just telling people that MMR is safe is not working, so the Department of Health needs to look again at how to improve uptake of vaccination against measles, mumps, and rubella." She based her suggestion on her experience in advising the Food Standards Agency on how to deal with public concerns about possible links between BSE and sheep, advice that was based on widespread and open consultation.

"This is not rocket science—it is applying standard psychology of giving people a choice," she concluded.

* * *

No-Symptom Sensitivity To Gluten May Result In Neurological Dysfunction

You may have gluten sensitivity and not even know it, according to a study published in the April 23 issue of Neurology, the scientific journal of the American Academy of Neurology. Loss of coordination (ataxia) may result from gluten sensitivity. This disease is known as gluten ataxia. The study found that some patients might never experience the gastrointestinal symptoms that prompt them to seek treatment for the disorder.

“Gluten ataxia is a common neurological manifestation of gluten sensitivity,” according to M. Hadjivassiliou, M.D., of the Royal Hallamshire Hospital, Sheffield, UK. “It remains unclear why some patients with gluten sensitivity present solely with neurological dysfunction when others present with gastrointentestinal symptoms (gluten sensitive enteropathy) or an itchy skin rash (dermatitis herpetiformis).”

Although the cerebellum (the part of the brain responsible for

coordination) and in particular the Purkinje cells (output neurons of the

cerebellum) appear to be most susceptible to damage in patients with gluten ataxia, other areas of the brain are not spared. “We were interested to determine the mechanism by which Purkinje cells are damaged in gluten ataxia,” commented Hadjivassiliou. Study results show that patients with gluten ataxia have antibodies against Purkinje cells and also that antibodies against gluten (antigliadin antibodies) cross-react with Purkinje cells.

“These results strengthen our contention that eliminating these antibodies through strict adherence to a gluten-free diet may have important therapeutic implications for patients with gluten ataxia,” concluded Hadjivassiliou.

The study was supported by the Friedreich's Ataxia Group, UK, and the Telethon Foundation, Italy.

The American Academy of Neurology, an association of 18,000 neurologists and neuroscience professionals, is dedicated to improving patient care through education and research..

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* * *

U.S. May Train Teachers On How To Help the Autistic

Federal money will go specifically for training teachers to deal with autistic students if a bill sponsored by Reps. Christopher H. Smith, R-N.J., and Michael Doyle, D-Pa., becomes law.

The Teacher Education for Autistic Children, or TEACH, Act would appropriate $20 million over five years for training teachers and paraprofessionals, and provide a tax credit for educators who take training courses in teaching the autistic.

"We've made a number of gains in addressing the autistic issue over the past few years, but we need to go further," Smith said yesterday. "The TEACH act will help us reach our goal."

Smith and Doyle expected to introduce the bill in Congress today or Monday.

No federal money is specifically directed to training of teachers who deal with the autistic. The federal government budgets about $140 million annually for special-education teacher training.

Autism, first identified in the 1940s, is a developmental disorder that impairs a person's social interaction and language skills. Though it once was thought to be rare, recent studies -- one of which was conducted in Brick -- made use of state-of-the-art techniques for detecting the disorder and found that autism occurs in up to one in every 150 children. Even with less thorough detection methods, autism rates have been found to be increasing dramatically.

The cause is unknown, although the majority of researchers believe it is genetic. There is no known cure, although the disorder can be treated. But treatment requires trained professionals, and that, like continued research, requires money.

Smith, whose district includes parts of Ocean and Monmouth counties, was one of the catalysts for the Brick study and has been in the forefront in trying to get federal money for training and research in autism.

The TEACH bill would authorize $15 million in grants, administered by the federal Department of Education under its Special Education Personnel Preparation program, for training both special-education and regular classroom teachers and aides. Some $5 million more would be meted out by states under the federal Individuals with Disabilities Education Act.

A professional who takes a certified course in teaching the autistic would be eligible for an income tax credit up to $10,000. In addition, the bill calls for reports on the effectiveness of strategies from the grantees and the appointment of a task force to further study the ailment and how schools should deal with it. "It's a good bill," said David O. Weiss, director of student services in Lacey. "We've hardly scratched the surface regarding what we know and what we need to know about autism. More and more children are being diagnosed . . . and it is so critical to reach these students in the first years."

"It's a step in the right direction," said Bob Lanzieri, a Brick resident and co-founder of Parents of Autistic Children. "Some of us have been saying for several years that there have got to be better ways of teaching the autistic. This funding can help us get the better methods into the classrooms."

In related actions, Smith is seeking through appropriations legislation to increase federal autism research funding from $65 million to $100 million at the National Institute of Health, and from $9.2 million to $17.2 million at the Centers for Disease Control and Prevention.

* * *

Special Ed Graduation Rates Rise

More special education students than ever graduated with standard high school diplomas in 1999, the Education Department said Friday in its annual report to Congress.

Special education programs serve a variety of students whose disabilities can include mental retardation, blindness, hearing impairments, emotional disturbances, dyslexia, autism or other conditions.

Congress currently is preparing to rewrite regulations on special education. Most Democrats and a few Republicans have pushed for millions of dollars more in federal money for schools to serve disabled students and a congressional commitment to make yearly increases in special education. They say the government has met less than half of its commitment to give states 40 percent of the money they need to help students with a range of disabilities.

Republicans and the Bush administration have blocked the efforts, saying states and schools must fix the current system before Congress increases funding substantially.

In its report, the Education Department noted that:

--A record 57.4 percent of special education students graduated from high school with standard diplomas in 1998-99, up from 51.9 percent in 1993-94.

--Dropout rates for special education students fell to 28.9 percent in 1998-99, down from 34.5 percent in 1993-94.

"Progress continues to be made, but at a time when barely half of students with disabilities are graduating on time from high school, we still have a long way to go," said Education Secretary Rod Paige.

Bill East, executive director of the National Association of State Directors of Special Education, said the improvements weren't surprising, since states and school districts have been working hard on both issues.

"If the education community as a whole continues to focus on graduation rates and dropout rates, ... then we're going to continue to see better numbers," East said.

The report also noted that more students with disabilities are being educated in regular classes than ever before, with 47.4 percent of students in "inclusion" programs. By contrast, in the 1984-85 school year, one-fourth of special education students spent most of their school day in regular classrooms.

Black students continued to be overrepresented in special education

classes: in 1999-2000, they made up about 21 percent of special education students ages 6-21, while representing just over 17 percent of all students.

By contrast, white students represent about 63 percent of students but only 62 percent of special education students. Hispanic students also accounted for a smaller proportion of special education students, 14.5 percent, compared with their enrollment of more than 15 percent.

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DREDF Tracking IDEA Political Developments

[Thanks to Ben Dorman on the ASA-ChapterNetwork list.]

Under State and Federal Advocacy / IDEA.

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