SCHAFER AUTISM REPORT "Healing Autism:

No Finer a Cause on the Planet"

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Friday, November 22, 2002

ADVOCACY

* Burton Calls On Pres. Bush To Hold A White House Conference On Autism

COMMENTARY

* A Bipartisan Effort to Repeal Homeland Security Vax Indemnity?

RESEARCH

* Wakefield to Medicine: Examine the Child, Not to 'Fly the Sun'

* Effect of Pentavac & Measles-Mumps-Rubella (MMR) Vaccination On

The Intestine

* Why Women Can’t Read Maps

AWARENESS

* California's Autism Mystery Deepens: CNN

* Funding Cuts Hit Efforts To Put Handicapped In Workplace

PUBLIC HEALTH

* Parents Flock To Single Jabs Clinc

* Readers' Posts

ADVOCACY

Burton Calls On President Bush To Hold A White House Conference On Autism

[From Congressman Dan Burton's office.]

Congressman Dan Burton (R-IN), Chairman of the Committee on Government Reform, today wrote President Bush urging him to host a White House conference on autism and to begin a national effort to determine why autism has reached epidemic proportions in the United States.

A recent study funded by the State of California determined that the number of autistic children in California has tripled over the past 10 years, and that the increase could not be attributed to better diagnoses, a broadening of the definition of autism or more accurate testing.

Said Burton, "Fifteen years ago, one in every 10,000 children in America was autistic. Today, one in every 250 children is autistic. We have an epidemic on our hands. This explosive growth in autism has had devastating consequences for families and communities all across the country. Families of autistic children face great emotional and financial hardships as they seek care for their children. As a nation, we must develop solutions to help families and communities cope with these challenges."

One possible factor in the recent surge in autism cases cited in Burton's letter is the mercury preservative that was used for years in pediatric vaccines. Over the last ten years, additional vaccines were added to the routine vaccination schedule, increasing the cumulative amount of mercury to which young children were being exposed. Concluded Burton, "I believe we must try to determine what is causing this outbreak and how it can be stopped. President Bush is in a unique position to provide the leadership that this issue needs. He could bring together parents of autistic children and the best minds from the scientific community to chart a course of scientific research to uncover the underlying causes of this alarming epidemic."

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COMMENTARY

A Bipartisan Effort to Repeal Homeland Security Vaccine Indemnity? By Lenny Schafer [With some material from a report from The Citizens Voice.]

In addition to Rep. Dan Burton's efforts to remove the vaccine manufacturers indemnity from accountability and lawsuit caps, other members from both parties have promised post-facto action. Republican Senators Snowe, Collins from Maine and Chaffee from Rhode Island had wrangled commitments from Senate House leader Dick Armey to revisit the legislation during its funding phase in the new session next year.

Along with them, Republican Senator Arlen Specter from Pennsylvania voted in favor of the Homeland Security Act. Specter said he believed it was "vitally important" that the act be passed so "we move ahead to put all the so-called dots on the screen."

"Had all the dots been on the screen, I think 9/11 may have been prevented," Specter said.

Specter added that all provisions, including the provision about childhood vaccines, "require very extensive consideration and analysis."

"I am very distressed to see them added on the bill, with no hearings and no chance for consideration," Specter said, "This is really a case where it is a matter of take it or leave it on a bill which is undesirable in many aspects, but the importance of protecting America from terrorist attacks outweighs so many of these provisions which are highly undesirable."

Specter concluded that the bill was presented as "legislative blackmail, with the House having gone home, a take-it-or-leave-it proposition" which put him in a "very difficult position."

On the Democratic side, congressional leaders Sen. Daschle and Rep. Pelosi also vow to repeal these and other provisions of the Homeland Security Bill. To be sure, any reversal will not come easy, if at all. The last time some congressional Democrats were hopeful of fixing legislation after-the-fact was when President Clinton signed the Welfare Reform Act. It never happened.

The best possible scenario for families with autism would be for both camps to come together to make a bipartisan push at the drastically needed changes to the legislation. For progress to happen, there has to be less, not more politicizing of the issues. There was never any bipartisan effort to fix the Welfare Reform Act, so it is not surprising it didn't go anywhere. Politicians don’t always act like hookers. Sometimes they can be statesmen, if the cause is right. Once again, its up to parents to take the lead and show them the way. We show them our non-partisan kids and what non-partisan autism has done to them. Tort reform should never come at the expense of disabled children and their extra need for equal protection under the law. We must put forth bipartisan solutions, and avoid the temptation to fall into partisan wallowing and recrimination. Let's work together to fix this epidemic so we can all go home.

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RESEARCH

Wakefield to Medicine: Examine the Child, Not to 'Fly the Sun'

[This letter has been submitted to the New England Journal of Medicine. Dr. Wakefield addresses the controversial new Danish study lead by Dr. Kreesten Madsen. The letter contains technical language.]

Dr Andrew J Wakefield MB.,BS FRCS FRCPath

Sir,

Population-based studies (1), in contrast with molecular and immunological studies (2-6), have not found an association between MMR vaccination and autism.

As pointed out by Madsen et al (NEJM 2002;347:1478-1482 (1)) and endorsed by others (7), epidemiological studies that have examined this relationship have been inadequate.

Have Madsen et al fared better? I have no doubt that other correspondents will deal with a principal limitation of their study, that is, the failure to disaggregate the relevant autism subset – one which they attempt to describe in the introduction to their paper - from the overall autism population.

This is equivalent to looking at the totality of hepatitis, irrespective of aetiology, in a study designed to examine a possible causal relationship with a single, specific exposure that may account for a minority hepatitis subtype only.

My purpose is to try and help clarify the hypothesis of my group, and to dissociate this from the many proxy hypotheses generously, if erroneously tested in our name.

Our studies have been concerned with examining the aetiology and pathogenesis of autism in a subset of children who became encephalopathic after a period of normal development and suffer an immune-mediated gastrointestinal pathology (2-4,8-14).

Within the relevant subset of children we have observed frequent atopy (especially food allergy), antibiotic use, ear infection, multiple concurren t vaccine exposure and a strong family history of atopic and autoimmune disease, as reported by others (15).

Consistent with these clinical observations, there appears to be, in many affected children, a TH2 mucosal and systemic immune bias; this is evident in lymphocyte cytokine profiles (14,16), eosinophil infiltration of the intestinal mucosa, and up-regulation of class II antigen within the intestinal lamina propria that is not seen on the adjacent epithelium (8-10).

Dysregulated mucosal immunity in affected children is accompanied by an excess of TNFa-positive lymphocytes, to an extent that distinguishes the autistic lesional mucosa from both inflammatory and non-inflammatory paediatric controls (14) that is consistent with the findings of others (17).

There is a profound expansion of CD19+ lymphocytes in the lamina propria, mirroring the associated hyperplastic lymphoid response that, at the macroscopic level, is particularly evident in the ileum and colon (13).

In controlled, systematic studies intestinal lymphoid hyperplasia of the degree seen in affected children is clearly not, as anecdotal impression would have it, a normal variant (9,18).

While the TH1-TH2 model is an oversimplification, its serves as a useful template for our working model.

Early on in the current debate, in a paper that sought to articulate the hypothetical relationship between MMR and regressive autism, we wrote, “At the level of the immune response, the newborn tends towards a TH2 response to pathogens and gradually shifts towards a TH1 response with age.

If this transition does not take place appropriately, the infant is likely to be at greater risk of mounting aberrant immune responses in later life, as seen in patients with allergies.

Given that, under normal circumstances the age of this transition will be different for different children, it seems inevitable that a ubiquitous viral exposure [MMR] of all 15-month-old children could induce an immune response that is consistent with the individual dynamics of this TH2-TH1 transition.” (19).

A precursor to an adverse reaction to MMR may be a congential or acquired aberrant TH2 immune programming.

This would increase the likelihood of an inadequate antiviral immune response in the face of a live viral vaccine and may facilitate viral persistence and immunopathology, as described for measles virus in affected children (2,4).

The key to defining the “child at risk”, therefore, is an examination of the co-factors that may interfere with the appropriate TH2-TH1 transition prior to, or concomitant with, MMR exposure.

One such factor may be mercury, for which the immuno-toxicity (putting aside for now the associated neurotoxicity) of organic and inorganic derivatives is qualitatively similar.

Is a synergistic adverse interaction between mercury and a live viral vaccine biologically plausible? The immunosuppressive and immunomodulatory effects associated with mercury exposure are accompanied by increased susceptibility to challenge with infectious agents.

One of the best-characterised examples of T-helper cell phenotypic polarity in response to infection is the murine model of Leishmania major.

Murine susceptibility to L. major infection is dependent upon induction of a genetically restricted TH2 response.

Resistant animals, that exhibit a genetically restricted TH1 response to L.major, are rendered susceptible by prior exposure to mercury (20).

In previously resistant animals, sub-toxic doses of mercuric chloride induced an autoimmune syndrome characterised by the expansion of TH2 cells, IL-4 production by splenocytes and IgG1 and IgE production.

This was accompanied by a non-healing phenotype with increased footpad swelling and parasite burden.

Methyl mercury enhanced the immune damage and chronicity of coxsackie B3 myocarditis in mice, compared with mice infected without prior mercury exposure (21).

Similarly, mercuric chloride exposure significantly impaired macrophage-mediated resistance to generalised infection with herpes simplex type-2 in a murine model (22).

Mercury is only one of several exposures to infants that may potentially influence the immune response to live viral vaccines.

In testing the correct hypothesis at the population level, these factors will need to be taken into account and appropriate adjustments made.

It may be, for example, that the rapidly changing pattern of infant mercury exposure - as thimerosal in bacterial and subunit vaccines - will with the necessary adjustments, reduce statistical power to the extent that such studies fail to offer any convincing evidence either way.

It is my personal opinion that the answer will be found in the detailed analysis of each individual child - from clinical history to molecular idiosyncrasy.

The foundations of our hypothesis have not shifted.

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Effect of Pentavac & Measles-Mumps-Rubella (MMR) Vaccination On The Intestine

ds=12427783&dopt=Abstract <- - address ends here.

Gut. 2002 Dec;51(6):816-817.

B Thjodleifsson1, K Davídsdóttir2, U Agnarsson3, G Sigthórsson4, M Kjeld1 and I Bjarnason4 1 Department of Medicine, University Hospital, Hringbraut, Reykjavík, Iceland 2 Center for Children Health Services, Reykjavík, Iceland 3 Center for Children Health Services, Reykjavík, and Sudurnes Health Institute, Keflavik, Iceland 4 Department of Medicine, GKT Medical School, London, UK Correspondence to: Professor I Bjarnason, Department of Medicine, Guy’s, King’s, St Thomas’ Medical School, Denmark Hill Campus, Bessemer Road, London SE5 9PJ, UK; ingvar.bjarnason@kcl.ac.uk

Background: The safety of infant vaccination has been questioned in recent years. In particular it has been suggested that the measles, mumps, and rubella (MMR) vaccination leads to brain damage manifesting as autism consequent to the development of an "enterocolitis" in the immediate post-vaccination period.

Aim: To assess if MMR vaccination is associated with subclinical intestinal inflammation, which is central to the autistic "enterocolitis" theory.

Methods: We studied 109/58 infants, before and two and four weeks after immunisation with Pentavac and MMR vaccines, for the presence of intestinal inflammation (faecal calprotectin).

Results: Neither vaccination was associated with any significant increase in faecal calprotectin concentrations.

Conclusions: The failure of the MMR vaccination to cause an intestinal inflammatory response provides evidence against the proposed gut-brain interaction that is central to the autistic "enterocolitis" hypothesis.

PMID: 12427783 [PubMed - as supplied by publisher]

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Why Women Can’t Read Maps

The high incidence of male autism reveals basic mental differences between the sexes, says author Rod Liddle

-11-23&id=2520 <- - address ends here.

Almost everything we find out about autism is disturbing. Our worry increases exponentially with every new nugget of information, just as the numbers of those children diagnosed as suffering from one or another autistic disorder seem to increase exponentially year on year.

There are the middle-class parents who, terrified, keep their children away from those frightening MMR injections, believing, with ferocious conviction, that the government is deliberately inflicting autism on the under-five population either for reasons of economy, or out of stupidity, or through some undisclosed malevolent intent.

There are plenty of wacko conspiracy theories, evolved from the minds of paranoiacs and other assorted madmen, about the state and autism; cruise the Internet and see for yourself.

But even discounting these, the picture is pretty grim. Look at the figures for diagnosed cases of autism (and the milder Asperger’s Syndrome) and you’ll see that they have risen from four cases per 10,000 children only a few years ago to one in 200 in some areas. (Or one in 150 if you live in Silicon Valley, California, where autism is referred to, with a certain cruel accuracy, as Geek Syndrome.) Much of this rise is down to an increased likelihood of diagnosis these days — autism, like asthma, has a sort of horrible fashionableness about it.

But it’s probably not the sole reason for the astonishing jump in the number of children afflicted. And nobody is very sure what, actually, is responsible.

So, all of that is certainly worrying. And then there’s the stuff the researchers are coming up with in order to understand the condition better — and this, in a way, is going to give us a lot more to think, and worry, about.

Autism, in its many guises, is an overwhelmingly male affliction, characterised by an abnormality in social development and communication skills and, usually, an obsessional interest in all sorts of weird, mechanistic stuff, from an early age (usually between three and five years). The current thesis among those studying autism holds that the condition is simply an extreme example of male behaviour.

Simon Baron-Cohen, at the Autism Research Centre at Cambridge University, has put forward the ‘Extreme Male Brain’ theory of autism; simply that those abilities typical of the ‘average’ male brain — an ability to systematise, a facility for mechanistic analysis such as mathematics, computer programming and engineering — become, in their extreme form, part of what is now called a spectrum of autism. At the other end of the scale, the extreme female brain would be characterised by an extraordinary ability to empathise but a greatly impaired ability to, as he puts it, systematise. By ‘systematise’ he means an ability to read maps, do mathematical calculations, understand technical systems and so on; all those things which, colloquially, over the years, men have accused women of being hilariously useless at. The trouble is, men may now have the beginnings of scientific proof for what was previously seen as chauvinistic prejudice.

Baron-Cohen’s latest work, published in the magazine Trends in Cognitive Science and to be developed in a book early next year, is quite clear about the division between the average female brain and the average male brain. ‘Systematising and empathising are two key dimensions in defining the male and female brain ...not all men have the male type brain and not all women have the female type brain ...the central claim ...is only that more males than females have the male type brain.’

Whatever these careful caveats, the implication is pretty

straightforward: the average male is biologically suited — the crucial phrase — to certain kinds of occupation; the average female is suited to other, very different, kinds of work.

Now this runs counter to those attempts at social engineering, de rigueur for the past 30-odd years, which insist — with mounting hysteria and, more often than not, government-approved targets — that there be an even distribution between men and women across the multifarious professions and trades.

Obviously, Baron-Cohen’s argument does not run counter to the notion of equal opportunity — we are talking only about ‘average’ female and male brain types, and not about individuals. But for those people who howl in complaint when it is found that, for example, the engineering profession is overwhelmingly male, the answer is pretty clear: the reason for this may be a natural disinclination and, even more than this, a biologically determined lack of ability among women as much as a ‘sexist’ recruitment process.

(Engineering, actually, is a good case in point. Asperger’s Syndrome is sometimes called ‘the engineer’s disorder’; the child suffering from Asperger’s is almost always obsessed by the design and mechanism of some kind of machine or other. It is virtually a precondition of the affliction.)

In fact, the idea of a natural division of sexes within the labour force seems to be borne out already, and for anyone looking in at our society from the outside it is a case of the glaringly obvious.

It is in those professions where equality of opportunity between males and females is most advanced that one sees the greatest diffusion between men and women towards certain types of job. In the medical profession, for example, there are very few female surgeons and very few male speech therapists. One job requires many of those attributes associated with the male brain type, the other demands those attributes one associates with the female brain type. And so, naturally, men gravitate towards surgery and women towards speech therapy.

The essential difference between the two sexes has been noticed in babies as early as one day old — i.e., too soon for their lives to have been blighted by our ghastly and injurious attempts at gender-stereotyping. Day-old girls will become responsive to human faces shown on a television screen; boys go for things such as guns and trains and other inanimate, mechanical objects.

So, quite apart from helping us understand the nature of autism, this may also have a profound impact on social policy. Should we still insist that women constitute half of the workforce of computer programmers, engineers, maths and physics teachers and, conversely, men take up jobs in speech therapy and pre-school teaching?

Other researchers, though, have taken the theory even further. Chris Badcock’s paper ‘Mentalism and Mechanism’ suggests that there are two distinct types of cognition — male and female. They are, he argues, essentially ‘non-commensurate’ and incompatible. This should give the liberal social scientists a bit of fun. They will have to face the idea that we are different, men and women, and that legislation designed to negate those differences will be worse than useless.

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AWARENESS

California's Autism Mystery Deepens: CNN

Russell Rollens was a picture-perfect baby. Then at 15 months -- just like every other baby -- he got his measles, mumps and rubella vaccination, or MMR.

"He had a physical reaction to those vaccines, including a high-pitched scream and days of high pitched crying and listlessness," said Russell's father, Rick Rollens.

Ten years later, those problems continue. Russell is now autistic.

How does one describe what it's like parenting an autistic child? "It's a living hell," said Rollens. "For my son who suffers from the disorder, for our family members and everyone who knows and loves Russel. It's a constant struggle."

And it's a struggle that most autistic kids also go through in the classroom, like the one at ABC School for Autistic Children in Sacramento where classes are full.

And the number of students is growing. "We probably have 50 more kids just this year," said Brenda Terzich, co-founder and CEO of the ABC School.

And parents are asking questions. No one knows what causes the brain development disorder but Rollens, a lobbyist for autism and former secretary of the California Senate, thinks the MMR vaccine is connected.

"Thirty-three percent of children in families with autism believe vaccinations played a part in the development of their child's autism," he said.

But a recent study from the Danish Epidemiology Science Center following more than 500,000 children found no link between the two.

Dr. Robert Byrd, epidemiologist and pediatrician at University of California, Davis, doesn't believe the measles vaccine is a problem. But he said concern about what's in some vaccines is justified.

Byrd applauds the removal last year of a small amount of mercury preservative used since the early 1990s in a different vaccine -- the one for Hepatitis B. Mercury is found in several vaccines and some people suspect it may cause autism.

"To have any potentially harmful toxin packaged into something that's supposed to be good is not a good package," Byrd said.

Byrd wrote a recent study for the M.I.N.D. Institute at UC Davis that ruled out better testing and population increases as possible causes for California's dramatic increase in autism cases.

The rate in the state increased 273 percent between 1987 and 1998, according to a 1999 report by the California Department of Developmental Services.

Byrd believes what's happening here is probably happening nationwide. But California has the only system for registering autistic children.

There is no biological test for the disorder. Some researchers believe there could be a complex connection between genetics and the environment. For example, genetics may predispose a child to autism, but certain environmental factors need to be present for a child to develop the disorder.

Rollens feels certain vaccines are to blame. But he thinks other factors come into play as well. "I don't think anybody in any area of research believes there's one single cause," he said.

As for Russel, "We worry every day and night about his future. ... Who's going to take care of him when we're gone?"

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Funding Cuts Hit Efforts To Put Handicapped In Workplace

Patrick Hand of Alton won a gold medal for swimming this summer in the Special Olympics.

He's also had a lot of experience with state and local governments' funding cuts to social programs for the handicapped.

Hand, 33, has autism, a brain disorder that limits social and verbal skills.

Autism affects about 1.5 million Americans, according to the Autism Society of America.

Hand lives with his parents and finds part-time work through social agencies. The job must be located on a bus line because Hand's autism prevents his driving.

"The only way I can get to work is ride the shuttle bus," he said.

Hand said he has lost two library jobs that he loved because of government budget cuts to social programs.

The last library job was more than two years ago, when he worked for two months at the Wood River Public Library. He had to leave because of reduced funding.

Before Wood River, Hand worked for two years at Lewis & Clark Community College in Godfrey. Budget cuts also ended that job.

"It was a pretty good job," Hand said.

The library jobs were arranged through the Alpha transitional program for disabled people who are nearing their goal of entering the community as regular workers.

For now, Hand is a cashier in the cafeteria of the Madison County Administration Building.

After two years of unemployment, he got the three-day a week cafeteria job in July through another employment program that is separate from Alpha.

But his hours recently were reduced from 22 1/2 a week to 21, again because of state budget cuts to the program he's in now.

Hand said he doesn't think he'll entirely lose his current job, where cafeteria manager Tammy Darr said he's excellent at figuring food costs, using the cash register and making change.

Since Hand depends on his job mostly for personal items and a savings account, he said the reduced work hours won't change his life much.

He's taking classes at Lewis & Clark Community College to help improve his social skills.

"I need to get out more," he said.

Some of the other five disabled workers in the cafeteria have had larger cutbacks, Darr said. The others' work time now ranges from 4 1/2 to 18 hours a week, she said.

Hand said he'd like another library job and to eventually live on his own.

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PUBLIC HEALTH

Parents Flock To Single Jabs Clinc

£195 for three vaccines

eid=89488

Scotland's first private clinic offering parents an alternative to the controversial MMR jab opens this week.

At least 30 babies will get their single measles vaccine during a day-long clinic in Glasgow on Sunday.

Parents are willing to pay more than £65 for each vaccine to protect their child against measles, mumps and rubella.

A medical team from London-based Choice Healthcare Services will return to Glasgow every three months to give the kids their follow- up jabs.

The firm, who only started advertising their visit to the Regency Medical Clinic in Glasgow's Clairmont Gardens a few days ago, have received a flood of requests.

Parents have been seeking an alternative to the MMR injection since studies suggested the vaccine could be linked to autism and bowel disease.

A Choice spokeswoman said: "The response has been amazing and we may need to set up more clinics in the city and throughout Scotland. Parents should be entitled to choose the best method for their children and that's not available here.

"The course starts with measles, three months later we recommend the rubella and then, after another three months, the child should come back for the mumps vaccination.

"The charge is about £65 but it could be a bit more because we are having to travel to Glasgow."

Another London-based company is also cashing in on parents concerns over the MMR.

Direct Remedie plans to hold regular clinics in Glasgow every few weeks, starting next month. And dozens of parents have already signed up.

Only one medical practice in Scotland, GP Plus in Edinburgh, currently offers single vaccines but there is a 10-week wait.

In August, the Government commissioned a £300,000 study into possible links between the MMR vaccine and autism.

It followed widespread criticism of Tony Blair's refusal to say if his youngest son, Leo, had received the triple vaccine.

At one stage, less than 87 per cent of Scottish parents were having their children inoculated - well below 95 per cent needed to prevent another epidemic.

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Readers' Posts

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Has anyone had any success in getting their medical insurance to cover speech therapy (long term)? I am in the process of switching insurances and cannot get a straight answer from customer service. pgaultney@hotmail.com

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Looking for examples of nutrition related goals for the IEP. How do we teach our children about nutrition when it doesn't follow traditional nutrition standards. What accommodations are written into the IEP? What specific goals and objectives? lloht@yahoo.com

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I read a piece in SAR today about SI, "A Look at Sensory Integration: Promise, Possibility, and the Art of Placebo" In it was the following: "If someone believes that a therapy works and invests personal energy into making a therapy work, then to some degree it will work" What I would like to know is how does this explain the gains my non-verbal autistic son made from SI when it was the only therapy he was getting at the time, and we were not using any biomedical interventions? How does one achieve the placebo effect belief in therapy when one is a 4 yo nonverbal autistic boy? Charles Whiting Wheeling, WV

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Re: the article in the Seattle Times about "Will". My 7 year old son is autistic. We had a problem with the ice cream truck, every child's dream. The music they played would send my child running around the house screaming at the top of his lungs until it went away. We called the owner's , and they agreed to turn the music off while they were on our street. He still watched it when it drove by to make sure there wasn't any music. Some people will help you if they know how. Jeannie Purvis

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