There's one startling fact about autism that marks it out from all the other chronic diseases of modern times-the explosion of cases over the past 30 years. Back in 1985, just six children out of every 10,000 were diagnosed with autism; today, one in every 88 children has the condition, and some reckon it affects one in 50 children.
Specialists believe this is a reflection of our increased awareness and better understanding of the problem, but this doesn't fully explain the exponential increase in numbers. Along the way, genetics, antibiotics, processed foods, gluten and dairy, heavy metals and, more controversially, the measles-mumps-rubella (MMR) vaccine have all been fingered as likely culprits.
The UK's National Autistic Society says that all possible causes are still being investigated, except for the MMR one, of course, which they say has been proven beyond any doubt to not be a trigger. But a thought-provoking book-The Great Medical Controversy of Our Time-by researcher Graham Ewing argues that vaccines must be in some way implicated (see box: MMR redux, page 60).
The latest research is also narrowing the field. Although autism is described as a 'neurodevelopmental disorder', it's becoming increasingly likely that it's a condition that starts in the gut-something the discredited gastroenterologist Andrew Wakefield noted when he first began to draw an association between the problem and the MMR jab.
And with this insight has come a slew of new therapies and approaches, including special diets and supplements that are having some success. One 'mind-over-matter' healing therapy, NeuroModulation Technique (NMT), had an amazing effect on 18 children who were treated in a controlled study.
What is it?
Autism is a general term used to describe a wide range of social, emotional, verbal and learning problems that may be better delineated as 'autism spectrum disorders' (ASD). Many autistic people have one or more symptoms of varying levels of severity and, while it's often defined as a childhood disorder, it affects people throughout their lives.
Symptoms may become apparent within a few months of birth-new research says one tell-tale sign is an infant's inability to look into its parents' eyes-and they are certainly evident before the child reaches three years of age. Around a quarter of cases are known as 'regressive', which means the child is developing normally, but then suddenly regresses, usually in the ability to talk, walk and/or socially interact. It's these cases that have been associated with the MMR vaccine, as parents have seen their child decline within days of being vaccinated.
According to the prevailing theory, autism is caused by a combination of genetic factors. Studies of monozygotic twins (identical twins from the same egg) seem to support the theory: if one twin has autism, the other will also have it in up to 91 per cent of cases.
A few cases have also been linked to genetic disorders such as chromosomal abnormalities, including fragile X syndrome.
But when the research moves away from twins, the evidence for a genetic cause becomes much weaker. Only around 2 per cent of autistic children have parents with the condition, and this rises only slightly to 6 per cent for all 'pervasive developmental disorders', which includes Asperger's syndrome and Rett syndrome.1
It's in the gut
New research is narrowing the focus to the gut. Many autistic children have a host of gastrointestinal (GI) problems that carry on into adulthood, and some of the worst symptoms seem to improve if the diet is changed, often to exclude gluten.
Armed with these clues, researchers from Arizona State University analyzed the gut flora of 20 autistic children and a similar number of healthy children. They discovered that autistic children had significantly fewer types of gut bacteria-especially those from three crucial genera known to protect against a range of diseases.2
The finding suggests that an overuse of antibiotics and the typical Western diet of processed foods could be significant factors in autism.
This possibility is supported by another study, which found that autistic children had raised levels of antibodies-an allergic response-to wheat and gluten. Researchers from Columbia University in New York made the discovery from blood samples from 140 children, including 37 who were autistic. Although such raised antibody levels suggest intolerance to gluten, none of the children had coeliac disease, where gluten triggers violent and highly allergic-type reactions.3
None of this comes as a surprise to researchers at the Autism Research Unit at the University of Sunderland-now working as ESPA Research-who, for more than 15 years, have been championing the idea that autism is a metabolic disorder that starts in the gut, often due to an inability to properly break down peptides from gluten and dairy.
According to their theory, autism is caused by the action of peptides beyond the brain and central nervous system (CNS). These errant peptides interfere with the peptides found naturally in the CNS that regulate our behavioural responses, emotions and cognitive abilities. Ultimately, these processes become so disrupted that the symptoms associated with autism start to manifest.
But how do those peptides get out of the gut in the first place? The ESPA researchers have found that an autistic child typically has a permeable gut that allows peptides to escape into the bloodstream. Anything-from nutritional and mineral deficiencies to toxins in the environment, including pesticides and even the MMR vaccine-can damage the gut wall, making it permeable, or leaky, they say.
Conversely, removing gluten and dairy from the diet should improve symptoms of autism-and this seems to be so. One study by the ESPA team found that 72 autistic children were helped by such a restricted diet,4 and a similar study, carried out two years later, was even more emphatic. In the latter study,5 researchers at Penn State University tracked the symptoms of 387 autistic children before and after a gluten-free and casein (dairy)-free diet. Most of the parents reported major improvements in their child's social behaviour, language skills, eye contact and attention span when following the diet.5
While many ASD children have gut problems, some also have high levels of toxic metals in their system, as suggested by the ESPA researchers. In fact, autistic children have been found to have higher levels of several toxic metals in their blood and urine compared with non-ASD children. The most common metals found were lead, thallium, tin and tungsten, all of which can impair normal brain functioning and development, and adversely affect other organs too. Researchers from Arizona State University, who made the discovery after analyzing blood and urine samples from 55 autistic children and comparing them with samples from 44 non-autistic children, say early exposure to toxic metals could be a factor in autism, and that symptoms might be improved by removing the metals through, say, chelation therapy.6
Antibiotics could also be playing a part. Women with bacterial infections while pregnant-and so routinely treated with antibiotics-are three times more likely to give birth to an autistic child, especially if the infection was diagnosed during the second trimester of pregnancy. Other infections more usually associated with pregnancy didn't result in autism, say researchers from the Kaiser Permanente Division of Research, who tracked 407 autistic children and compared them to 2,075 matching children as controls.7
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The rise of autism
There's been an explosion of autism cases over the last 30 years. Back in 1985, just six children out of every 10,000 were diagnosed with autism. Today, it's thought that autism may affect one in 50 children.
It's a brave person who continues to push the idea that the MMR vaccine has a part to play in the development of autism. The last one who tried was gastroenterologist Andrew Wakefield, who ended up reviled, discredited and stripped of his licence to practise medicine.
So step forward Graham Ewing, a medical researcher and chief executive of Montague Healthcare, which promotes the use of a new diagnostic technology, Virtual Scanning. Graham has written a substantial report-published in paperback as The Great Medical Controversy of Our Time: Why Vaccines MUST be Implicated in the Occurrence of Regressive Autism-concluding that the evidence for such a link is overwhelming.
He argues that the numerous vaccines given to a child before one year of age-in the US, the number is 26 and, in the UK, 19-are affecting the mechanisms that regulate the body's basic functions, including both physiological and nervous systems, and eventually results in symptoms typical of regressive autism, the type that suddenly arises in a child who was developing normally.
A young child's system is unable to deal with the heavy metals used in vaccines and so they accumulate and become neurotoxic. Regressive autism is the "inevitable consequence" for many children, he argues.
Other researchers have drawn similar parallels between heavy metals and autism, but Graham zones in on vaccines for several reasons:
o The increase in numbers of vaccines almost exactly tracks the rise in cases of autism, going as far back as the late 1960s onwards.
o Typical symptoms of regressive autism are almost identical to those of mercury poisoning, and thimerosal, a compound that contains mercury, has been used for years as a preservative
o Regressive autism is often seen at around age two, which coincides with the tailing off of the vaccine programme.
o Cases of regressive autism are rare in unvaccinated children.
The Great Medical Controversy of Our Timeis available from Montague Healthcare, Mulberry House, 6 Vine Farm Close, Cotgrave, Nottingham NG12 3TU, UK. To buy a copy, send a cheque for lb19.95, which includes P&P.
Mind over matter
People of a logical, dogmatic or sceptical disposition, please look away now-but intention, or the power of thought, has been reversing autism. And it gets even more strange: the child being treated doesn't have to be in the same room-or even the same country-as the therapist, and the therapist can test the child's functioning by muscle-testing his own arm.
But here's the strangest part of all: this unlikely therapy has achieved dramatic improvements in 18 autistic children.
The therapy-NeuroModulation Technique (NMT), also known as the Feinberg Method-has been used on thousands of people suffering from conditions ranging from arthritis to Crohn's disease, irritable bowel syndrome (IBS) and other inflammatory disorders.
Clinical psychologist Robert Weiner, based in Dallas, Texas, had heard great things about NMT from other psychologists and wanted to try it out on autistic children. "I liken our autonomic system to that of a computer. Illness happens when there is a processing error, and this can be caused by any number of things such as trauma, toxins, an allergy or poison. NMT is just a way to send out the correct instructions so the system readjusts and performs healthily again," he explains.
With a small research grant, Dr Weiner launched a small study of NMT, which involved a group of 18 autistic children from across the US.1 Nine of the children received two sessions of NMT a week for six weeks, while the other children waited during those six weeks before beginning their own treatment.
Both groups showed significant improvements after the NMT treatment in comparison to measurements taken before starting the sessions, which amounted to just nine hours of therapy. That equates to two to three days of applied behavioural therapy, the favoured non-drug approach for autism.
Wendy, whose two sons participated in Dr Weiner's study, was astonished by the difference the therapy made, even though her husband thought the whole thing was "a scam" before they started.
"My older son, who was seven when he had NMT, had a difficult time keeping a calm body for any length of time. Now he can sit through a 40-minute 'circle time' at school with hardly any reminders from the teacher. He's doing better sitting properly at the dinner table and also in the shopping cart at the market," she says.
The younger son, who was five when he had NMT, displays so few symptoms of autism that sometimes his teachers have to be reminded that he has the condition.
Explore, 2014; 10: 13-23
What else may help?
Medicine has little to offer autistic children and their parents. Drugs may be prescribed, such as methylphenidate for hyperactivity and risperidone to control behavioural issues, although 'talking therapies' are also favoured as they provide coping skills for parents as well as the children. These include the Autism Preschool Programme, Child's Talk and More than Words.
Here are some other alternatives.
Vitamin D therapy.The hormones in the brain that affect behaviour-serotonin, oxytocin and vasopressin-are often abnormally low in the autistic child. New research has discovered that vitamin D acts as a trigger to convert other enzymes into serotonin. However, our natural stores of vitamin D are often below ideal levels for maintaining health, especially for those living in the northern hemisphere. To counteract this, researchers at the Children's Hospital Oakland Research Institute recommend that autistic children supplement with vitamin D, tryptophan and omega-3 fatty acids to restore levels.1
Diet.A gluten- and dairy-free diet has reversed some of the worst symptoms of autism (see main story). Intolerance to these foods may indicate other sensitivities too, so aim to remove as many chemicals as you can from the home environment; this includes perfumes, toiletries and chemical cleaning products.
Supplements.In addition to vitamin D, essential fatty acids (EFAs) play an important part in healthy brain functioning. The EFAs that cannot be produced by the body and so must be obtained from the diet are linoleic acid (omega-6) and alpha-linolenic acid (omega-3).
Enrichment therapy.This relatively new therapy encourages engaging with objects around the home through the senses, including the sense of smell and listening to classical music in the evening. In one study of 28 autistic boys, nearly half of those who did the therapy showed a "significant improvement" in their behaviour after six months, while the majority reported improvement in cognitive ability too.2
Chelation therapy.This is based on the theory that autism may be caused by heavy metals, so ridding the body of them should improve autistic symptoms. In one study, 221 autistic children and 18 non-autistic controls were given the oral chelating agent DMSA for three days. By that time, the autistic children were discharging mercury at levels five times those of the healthy controls.3
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