Autism Paradigm Shift: Environmental and Genetic Factors Cause Autism Disorders

The important testimony before the US Senate last week was of monumental importance in placing on the record of such a high public tribunal the evidence of credible experts confirming what has been known by many for so long: autism disorders are caused by the interaction of genetic AND environmental factors.  Autism is NOT entirely genetic in origin. Environmental factors, long neglected in research funding, are involved and future autism research MUST reflect that fact. The overwhelming funding  imbalance to date in favor of genetic focused autism research MUST be shifted toward exploration of environmental causes of autism disorders. The Autism Research Paradigm Shift must now pick up speed so that we can find causes of, treatments and cures for, autism spectrum disorders.

The near total dedication of funding towards genetic autism research was outed by Teresa Binstock over a decade ago and today genetics has contributed little if anything to understanding or addressing autism challenges. For several years it has been known that environmental factors are in fact involved in curing autism and in 2007 the University of Minnesota proposed an Autism Research Paradigm Shift:

"Autism research is poised for another paradigm shift, from an irreversible condition to a treatable disease. In the revolutionary paradigm, autism is not a rare disorder with a constant rate but frequent condition with a rising incidence. It is a combination of environmental influence and genetic vulnerabilities. It is both preventable and treatable, not by any one method but by a combination of behavioral and biomedical approaches. Autistic kids are not defective, they are sick but otherwise normal kids, and thus, recoverable.

Creating a premier center for effective treatment of autism is not as simple as adding a new wing on a hospital, purchasing the latest medical technology or creating another diagnostic center. 

What is needed is a revolutionary clinical effort premised on the paradigm that autism may well be a treatable and preventable disease.

 The University of Minnesota proposal may have been ahead of its time and the proposed paradigm shift has probably been set back by the intensive effort to discredit those who question vaccines.  Major media sources have dutifully swallowed the reported  pharma line that autism is purely genetic, which, if believed , would preclude further blame being placed on vaccines or vaccine ingredients as causes or triggers of autism disorders in some children. It will undoubtedly take time for the NYT, the Chicago Tribune, the Globe and Mail, CNN and CBC to catch up to the autism research and internet communities but it is now clear that the future of autism research must include a much greater focus on environmental causes of autism.   And of course, if they continue to dutifully follow pharmaceutical industry press releases these august media may never catch up or catch on to new developments in our understanding of autism disorders.

There is at least one hopeful sign though. The offficial Autism Speaks press release commenting on the US Senate hearings adopted a fairly bold tone in calling for more emphasis on environmental factors and autism:

"As this hearing reviews studies funded by the Environmental Protection Agency and the National Institute of Environmental Health Sciences on environmental factors associated with autism, including toxins and other factors that can influence brain development, Dr. Dawson reiterated that it is important to remember that, "Although genetic factors clearly contribute to the causes of autism, we also need to understand environmental factors and their interactions with genetic susceptibility."

The dramatic increase in autism prevalence over the last decade – increasing 600 percent in the last two decades – underscores the need for more research on environmental factors. "Our understanding of typical brain development combined with what we've learned from examining the brains of individuals with autism indicates that it is important to investigate the roles of the prenatal and early postnatal environment," explains Dr. Dawson. "To investigate environmental factors that may be active during this time, researchers are casting a wide net on potential environmental agents that can alter neurodevelopment, including exposure to infection, pesticides, and chemicals."

If Autism Speaks dares speak so boldly perhaps the Autism Research Paradigm Shift envisioned by the University of Minnesota  is fully under way and perhaps we can now look forward to understanding the environmental causes of, and finding treatments and cures for,  autism disorders.

Autism Epidemic: Genetic Autism Myth Finally Busted at the US Senate

It's gotta be genetic?  The myth that autism is 100% genetic, that environment plays no part in causing autism, that there is no true autism epidemic took a severe, even fatal beating, this week in the US Senate.

Teresa Binstock exposed the mindset that directed funding almost exclusively towards genetic based autism research over a decade ago. Years later,  and with little to show for the nearly cult like belief that autism is,  that autism must be, that autism just has to be,  100% genetic,  and public autism research funding dollars still flow almost exclusively toward genetic based autism research. This one way flow  of research funding has prevented us from greater understanding of  the environmental factors that might be causing or triggering autism in  children's prenatal and neonatal development.   This week, in the Children's Health Subcommittee of the US Senate Senate Committee of Environment and Public Works,  the "autism is 100% genetic myth" was busted. Despite few research dollars flowing toward environmentally based autism research it is environmental factors that are beginning to provide some understanding of autism and other neurodevelopmental disorders.

1.  Paul Anastas Ph.D.

  Assistant Administrator for Research and Development and Science Advisor U.S. Environmental Protection Agency (EPA)

Dr. Anastas gave a very careful and conservative review of existing environmental research with implications for autism and other developmental disorders.  By way of background he noted:

"children are especially susceptible to the effects of chemicals in the environment because they eat, drink and breathe in more for their body weight than adults. They absorb a greater proportion of many chemicals in the environment than adults do, and due to hand to mouth behaviors, young children tend to have higher exposures to contaminants in dust and soil, such as pollutants deposited from the surrounding air, dust from lead paint, tobacco smoke, cleaning products, pesticides and other chemicals.3, 4 Because of its extraordinary complexity, prenatal and early postnatal brain and nervous system development can be disrupted by environmental exposures at much lower levels than would affect adults.5,6,7,8,9 We are learning that there are critical windows of susceptibility both prenatally and in early childhood, during which the effects of exposures to environmental contaminants, depending on dose and timing, can be significantly more severe and can lead to permanent and irreversible disability.10,11,12 For these and many other reasons, EPA is especially concerned about potential effects of environmental chemicals on children’s health and neurodevelopment.

It has been suggested that improvements in diagnosis may be contributing to the perceived increase in ASDs. However, one recent publication from researchers supported by EPA and the National Institute of Environmental Health Sciences (NIEHS) evaluated the rise in autism incidence in California from 1990 through 2006. They found that even when factors such as earlier diagnosis, changes in diagnostic criteria and inclusion of milder cases were taken into account, these did not fully explain the observed increase, and as a result the extent to which the continued rise represents a true increase in the occurrence of autism remains unclear.13 Additionally, through a recent evaluation of autistic disorder (AD) data from long-term (~ 10 years) studies , ORD scientists found significant and surprisingly uniform timing of increases in AD cumulative incidence (1988-1989) in Danish, California and worldwide data sets.14 It is not clear if the observed increase in AD is real, and if so, for what reason; or whether the apparent increase is due to improved diagnosis, increased observations, or other factors. However, these researchers concluded that it seems prudent to assume that at least some portion of the observed increase is real and results from environmental factors interacting with susceptible populations.14 Such exposures may be preventable; identification of candidate environmental factors should be a research priority.

The challenge is to determine what specific environmental factors may contribute to the onset or severity of autism and other neurodevelopmental disorders, so that exposure to these can be prevented."  

2. Linda Birnbaum, Ph.D., D.A.B.T., A.T.S. Director, National Institute of Environmental and Health Sciences and National Toxicology Program National Institutes of Health, United States Department of Health and Human Services

Dr. Birnbaum commented on the emerging emphasis on genetic and environmental interaction in understanding neurodevelopmental disorders:

"Scientists have made tremendous progress in understanding how the brain and nervous system grow and function. Research supported by NEIHS has clearly shown that it is not just genetics, but the complicated interplay of both genes and environment that determines the risk of many neurodevelopmental disorders. We now have new information on the role that early environmental exposures may play in the development of a broad spectrum of childhood and adult disorders, including autism, attention deficit hyperactivity disorder (ADHD), and learning disorders."
...

Development of the nervous system begins in the womb and extends through childhood. During these periods of rapid development, the brain is vulnerable to some environmental exposures that may have the potential to disrupt the chemical signals that organize development. Even small changes in the timing of critical development events can potentially have major consequences for brain structure and function. Thus even brief exposures at these vulnerable stages can have lasting effects on adult brain function. We refer to "windows of  susceptibility: to mean the life stage at which the brain is exposed, during which different agents can effect the brain in specific and deleterious ways. For example, the dose of lead that is neurotoxic to an infant is much less than the dose that would be neurotoxic for an adult, so infancy in this case is a "window of susceptibility",

Director Birnbaum commented specifically on the effect of environmental exposures on children's intelligence.  The "vast majority", to use the expression of CDC autism expert Dr. Yeargin-Allsopp,  of children with Autistic Disorder (which does not include Aspergers)  also have intellectual disabilities. I have photocopied Director Birnbaum's summary of the research on this important subject:

3, Issac N. Pessah Ph.D. Professor, Department of Molecular Biosciences, College of Veterinary Medicine, Director, UC Davis Children’s Center for Environmental Health and Disease Prevention University of California, Davis, Department of Molecular Biosciences

Dr. Pessah began his testimony before the subcommittee with a direct challenge to the view that diagnostic change is a full explanation for autism increases and that autism is 100% genetic:

"Although autism risk has strong heritability, no single locus alone appears to be sufficient to account for the full clinical phenotype. Results from many genomewide autism screens indicate that potential susceptibility genes are spread across the entire genome. Recently several very rare genetic mutations, single nucleotide polymorphisms (SNPs), de novo copy number variations, and epigenetic factors that influence DNA methylation were shown to contribute complexity in the transmission of autism risk. Yet genetics alone cannot account for the majority of autism cases currently being diagnosed. There is lack of full concordance between monozygotic twins, with some estimate ranging as low as 60%, and the prevalence of ASD among siblings has been reported as high as 14%. Interactions among multiple genes are likely to contribute to various types of autism, and heritable epigenetic factors and/or non-heritable environmental exposures are likely to significantly contribute to susceptibility and variable expression of autism and autism-related traits. It is therefore likely that constellations of epigenetic and environmental factors are contributing to the increasing prevalence of ASD, a rise that cannot be fully accounted for by changes in diagnostic criteria.

....

There is a critical need to identify environmental factors, including exposure to xenobiotic chemicals and changes in diet that contribute to autism risk and severity. The vast majority of public and private resources has, and continues, to support work on identifying genetic impairments associated with autism risk. From these studies we have learned that genetics alone cannot predict the majority of autism cases, the patterns of impairments, severity, nor can they predict success for current treatment modalities. Moreover, we have learned that many of the molecular and cellular systems that are associated with autism are the very same ones that are the target of environmental chemicals currently of concern to human health because of their widespread use.


..


We know that autism prevalence continues to increase dramatically clearly implicating environmental factors in autism risk. We must identify which environmental exposures and combination of exposures are contributing to increased overall risk in the population and identify the most susceptible groups. Only by bringing together the concerted effort of multidisciplinary teams of scientists can we identify which of the >80,000 commercially important chemicals currently in production promote developmental neurotoxicity consistent with the immunological and neurological impairments identified in individuals with idiopathic autism. It is clear that there is a critical need to identify which chemicals in the environment that influence the same biological pathways known to be affected in autism. Limiting exposure to these chemicals is the only way to mitigate or prevent autism in susceptible individuals.  (Bold emphasis added - HLD)

4. Bruce P. Lanphear MD, MPH Senior Scientist, Child & Family Research Institute, Professor, Simon Fraser University, Vancouver, BC, Adjunct Professor, Cincinnati Children's Hospital Medical Center

Dr. Lanphear 's prepared statement was relatively brief and to the point; and  the body of the statement is reproduced below with my empahsis in bold:


Children’s environmental health -- the study and prevention of disease and disabilities in children from exposures to social, physical, biologic, and chemical agents -- has emerged as a new field of research, policy, and clinical practice (Landrigan et al. 1998). The growth of this field has been fueled by the emergence of new morbidities in children, research showing that the fetus and child are particularly vulnerable to environmental influences, and mounting evidence implicating environmental exposures as major risk factors for prevalent diseases and disabilities in children (Lanphear, 2005).

One in six American children have a developmental problem, from a subtle learning disability to overt behavioral disorders, such as attention deficit hyperactivity disorder (ADHD) or autism (Boyle et al. 1994; Hertz-Picciotto, 2009). These conditions can severely impair a child’s ability to succeed in school, elevate their risk for violent and criminal behaviors, and dramatically diminish their ability to contribute to society. The findings from some of the most thoroughly studied and widely dispersed environmental toxicants indicate that exposure to exceedingly low levels are risk factors for the “new morbidities” of childhood -- intellectual impairments, behavioral problems, asthma and preterm birth (Lanphear, 2005). Indeed, there is often no apparent threshold and, in some cases the effects appear to be greater at the lowest levels of exposure (England et al. 2001; Canfield et al. 2003; Lanphear et al. 2005; Yolton et al. 2005).

Exposures to established environmental toxicants -- such as lead, tobacco, PCBs and mercury -- have consistently been linked with higher rates of intellectual impairment or behavioral problems, such as conduct disorder and ADHD (Needleman et al. 1990; Schantz et al. 2003; Kahn et al. 2003; Wakschlag et al. 2002; Stewart et al. 2003; Needleman et al. 1979; Lanphear et al. 2005; Yolton et al. 2005). There is emerging evidence that a whole host of new environmental chemicals – such as Bisphenol A, PBDEs, pesticides, phthalates, and airborne pollutants – are associated with intellectual deficits or behavioral problems in children, but the evidence is not as conclusive (Rauh, 2006; Engel, 2010; Eskenazi, 2007; Braun, 2009; Perera 2009; Herbstman, 2010). Much of this research was done by the NIEHS/US EPA Children’s Environmental Health Research Centers working collaboratively with the Centers for Disease Control and Prevention.

Children’s developing brains are more vulnerable to certain toxicants and pollutants than adults. The central nervous systems of the fetus and young child, which are undergoing rapid changes, are particularly vulnerable to some toxicants. The fetus is a recipient of toxicants through placental transfer (Perera et al. 2003; Whyatt and Perera 1995; Bearer 2003). In some cases, such as mercury, the fetus is exposed to a larger dose than the mother (Ramirez et al. 2000). In other cases, such as organophosphate pesticides, the fetus may lack critical enzymes to metabolize environmental toxicants (Chen et al. 2003). Toddlers are often at greater risk for exposure to many environmental toxicants because they have a high degree of hand-to-mouth activity and they absorb some toxicants more efficiently (Bearer 1995).

Biomarkers are revolutionizing our ability to study the impact of environmental chemicals on neurodevelopmental disabilities (Perera, 1997; Lanphear and Bearer 2005; CDC 2003; Sexton et al. 2004). Historically, scientists and clinicians relied on indirect markers -- housing condition, poverty, questionnaires, and community-level monitoring of water and air -- to quantify the effect of environmental influences on children’s health (Sexton et al. 2004). Biomarkers are making it possible to directly measure the internal dose for many environmental chemicals and test causal associations of environmental exposures with disease and disability in children.


I wanted to share some of the results of the Cincinnati Children’s Environmental Health Center to highlight the impact of low-level toxicity on children. In a 2003 study, published in the New England Journal of Medicine, we estimated that an increase in blood levels from <1 μg/dL to 10 μg/dL was associated with a 7 IQ point decrease (Canfield, 2003). Because of the policy implications, we convened an international group of experts to conduct a pooled analysis of seven cohort studies. We estimated that an increase in blood levels from <1 μg/dL to 10 μg/dL was associated with a 6 IQ point decrement (Lanphear, 2005). These studies have been confirmed by over ten studies conducted around the world.


We also confirmed earlier reports implicating childhood lead exposure in the epigenesis of psychopathology in children. We estimated that one in five cases of ADHD in US children were due to childhood lead exposure (Froehlich, 2009). We also found joint effects of prenatal tobacco exposure and childhood lead exposure. Although each toxicant was associated with a 2.5-fold elevated risk for ADHD, children with higher exposures to both toxicants had a 8-fold elevated risk for ADHD (Froehlich, 2009).


Finally, we confirmed that childhood lead exposure is a risk factor for criminal arrests in young adults. We found that lead exposure is associated with conduct disorder, criminal arrest and impaired brain development using magnetic brain imaging (Braun, 2008; Cecil 2008; Wright, 2008; Brubaker 2009). These and other studies suggest that much of the criminal and violent behaviors in the US can be attributed to lead toxicity (Nevin, 2000; Reyes, 2007). Gould used these studies to conduct a cost-benefit analysis of lead toxicity. She estimated that for every dollar spent to reduce lead exposure, society would benefit by $17 to $220, a net annual benefit of $30 billion to $44 billion (Gould, 2009).


Over the past century, increasing evidence has emerged linking chronic, low-level exposure to environmental influences and industrial pollutants with many of the most prevalent and disabling learning and behavioral problems in children. But questions remain. It is critical, for example, to examine the interactions of multiple environmental toxins or pollutants and to identify how genetic susceptibility or other markers of susceptibility elevate the risk for disease or disability. It is critical to discern whether the new chemicals are risk factors for autism and other emerging behavioral problems in children. Funding that is directed to children’s environmental health research – the Children’s Environmental Health Centers, the National Children’s Study and other research awards -- offers us the opportunity to resolve many of the unanswered questions and prevent some of the most serious problems that impact children’s learning abilities and behavioral problems, but much more needs to be done.

A parent Mary Moen also testified before the committee giving evidence familiar to many of us of the challenges  of raising a child with an autism disorder and an 48 year old family member, suspected of being autistic, who has lived dependent on the care of her aging parents.

The evidence of the experts who testified before the Children's Health Subcommittee of the US Senate Committee on Environment and Public Works have clearly busted the myth that autism, and other neurodevelopmental disorders are 100% genetic. They have presented studies of the known toxic substances including mercury, lead and various pollutants which we inhale, consume or are exposed to and the much harsher impact these substances have on prenatal and neonatal neurological development.  

It will take time for this information to permeate the public consciousness. The "it's gotta be genetic" mindset is too deeply entrenched in the culture of public health authorities in Canada and the US to change quickly. There are vested corporate interests for whom a 100% genetic theory of autism absolves them of any possible responsibility for harm caused by their products. There are traditional media sources hungry for corporate advertising dollars who will read the latest script offered up by the pharmaceutical marketing/research departments who will dutifully report that autism is 100% genetic and damn those crazy parents of autistic children who just can't accept that "fact"  and take responsibility for what our genes have done to our children.  The "it's gotta be genetic" mindset is also helped by the Neurodiversity ideologues for whom autism is just a natural variation, not a disorder to begin with, and who abhor any discussion of environmental causes of autism because, heaven forbid, the existence of known environmental triggers of autism might confirm that their DSM autism diagnosis is what it claims to be when  it was  obtained by visits to a qualified physician ...  a neurologically based mental disorder.

This is one case though where the truth, as it did with the tobacco and lung cancer issues of decades past, will out. The overwhelming commitment of research dollars to genetic based autism research has yielded very, very few results and has failed to identify common genetic bases for autism. That failure, and the  environmental research cited before the US Senate, which resulted from relatively limited research funding,  both point to environmental factors as triggers and causes of autism disorders in interaction with genetic factors.

The truth will out but it is long past time to even out the funding , as Dr. Irva Hertz-Picciotto has called for,  and direct some of the genetic based autism research dollars toward more environmentally focused autism research. The autism is 100% genetic myth is dead.  It is time to fully embrace the environmental genetic interaction model  of autism and find out how to help our  autistic children and children not yet born.

IACC Head Says No Question Environment Is a Component of Autism

David Kirby's recent interview with Dr. Thomas Insel of the Interagency Autism Coordinating Committee is quite possibly the autism interview of the decade, one that will be referenced in future histories of autism.

Kirby interviewed Dr. Insel after the release of new CDC data showing yet another stunning increase in autism rates to 1 in 110. In Dr. Insel on Rising ASD Numbers: “No Question” About Environmental Factors  Kirby quotes a very candid Dr. Insel  about the role of environmental factors in causing autism:

"there is no question that there has got to be an environmental component here."

That statement is a huge development in in the history of autism research. It marks the official  end of the "it's gotta be genetic" mindset of autism research identified 10 years ago by Teresa Binstock.

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Autism Rising - Time To Deal With Reality

Autism is rising.

The CDC is expected to release information today confirming that autism now affects 1 in 100 up from estimates of 1 in 150 formed just 2 years ago,and previous estimates of 1 in 166, 1 in 250 and 1 in 500. By any measure the increase in autism diagnoses is astonishing. Those who deny that autism is really increasing will, yet again, trot out the 1993-4 diagnostic definition changes as the primary factor explaining the increase in diagnoses.

Think about it people the definition was changed 15 years ago. We can no longer rely on that change to explain the dramatic increases in autism diagnoses that occur every two years.

US institutions like the NIH, the NIMH, the CDC and the IACC must lead the way in encouraging research of the environmental causes which fully explain these startling increases. (As a Canadian involved with autism advocacy I know first hand the pathetic ineptitude of Canadian research institutions to be of any assistance. As an autism advocate my name was twice put forward as a candidate to attend the sham National Autism Conference but was rejected by our Canadian leadership who instead opted for feel good autism representatives to attend) Leading Canadian autism researches like Dr. Laurent Mottron hold to the view that autism can not be cured, that it is nonsense to talk about curing autism.

If autism research leadership comes it will come from the US. Let us hope that despite President Obama's appointment of an anti autism cure person who does not believe that autism is a disability to a disabilities council advocates can pressure US institutions into conducting the necessary environmental based autism research.

Let us dig our heads out of the sand before it is too late.

It is time to deal with the reality of autism rising.

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Autism and Human Exposure to Environmental Chemicals: Time to Put a Stake Through the Heart of the "It's Gotta Be Genetic" Model of Autism Research

"My own hunch is that the NIH and NIMH will not change from within; the senior practitioners of the "it's gotta be genetic" model have too much influence. Just as Semmelweiss and his data were suppressed, so too will the NIH/NIMH autism-research insiders continue to act against the the growing body of new data in autism; the NIH's pro-genetic old-timers will cling to their paradigm and its funding. As a result, change within the NIH and NIMH will have to be initiated from outside those tax-supported corporations."

 

Teresa Binstock, 1999,  IGNAZ SEMMELWEISS and AUTISM: when prevailing paradigms resist change

"Right now, about 10 to 20 times more research dollars are spent on studies of the genetic causes of autism than on environmental ones.

We need to even out the funding."

 

Dr. Irva Hertz-Picciotto, 2009, UC Davis M.I.N.D. Institute Researcher

The CDC has issued its Fourth National Report on Human Exposure to Environmental Chemicals which is available for downloading along with an executive summary and a list of the 212 chemicals present in humans measured by the CDC:

The Fourth National Report on Human Exposure to Environmental Chemicals is the most comprehensive assessment to date of the exposure of the U.S. population to chemicals in our environment. CDC has measured 212 chemicals in people's blood or urine—75 of which have never before been measured in the U.S. population. The new chemicals include acrylamide, arsenic, environmental phenols, including bisphenol A and triclosan, and perchlorate.

The blood and urine samples were collected from participants in CDC's National Health and Nutrition Examination Survey (NHANES), which is an ongoing survey that samples the U.S. population every two years. Each two year sample consists of about 2,400 persons. The Fourth Report includes findings from national samples for 1999–2000, 2001–2002, and 2003–2004. The data are analyzed separately by age, sex and race/ethnicity groups.

I do not want to be accused of quackery or woo or some other such  insult used to  bully people into submission who disagree with the scientific and medical orthodoxy of the day.  Therefore  I am not saying that because the CDC has issued another report measuring the presence of hundreds of toxic  chemicals in human beings that it  means that autism, or any  other neurological or developmental disorder, is environmentally caused or triggered by these substances. The CDC site (FAQ section) makes it clear that:

The National Exposure Report does not provide health or toxicity information, state- or community-specific data, specific product or environmentally related information, or regulatory guidelines or recommendations.

I also fully acknowledge that I have only begun to read this report and that reading it and understanding the report will take this humble layperson some time. The report itself though is further confirmation of the presence of many toxic, dangerous substances in human bodies, including the bodies of young children and pregnant women.  My suspicions aside, I recognize that further research is necessary to indicate what role is played by these substances in causing or triggering autism and other disorders in our children.

There is no dispute that autism diagnoses have risen dramatically and that some of the increase is accounted for by diagnostic definition changes, increased awareness and other social factors.  But no one can credibly say that the toxic substances described in  the CDC's latest report on human exposure to environmental chemicals are NOT linked to the increases in neurological disorders in children, including autism.

Tomorrow, Friday, December 18, 2009 the CDC is expected to release a study confirming that 1 in 100 persons have autism spectrum disorders.   Given the increasing numbers of  persons with autism disorders and the presence of so many environmental chemicals, including mercury, lead and arsenic, in the bodies of our children, it is time to do the environmentally based research to determine what impact these chemicals are having on the development of our children.

Amongst other research on the effects of these chemicals, it is time to emphasize environmentally oriented autism research.

It is time to put a stake through the heart of the "it's gotta be genetic model"  of autism research.

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CanTitanium Dioxide Nanoparticles Trigger Autism?

Add Titanium Dioxide Nanoparticles to the growing list of possible environmental triggers or causes of autism spectrum disorders. The die hard proponents of the belief that the astounding increases in rates of autism diagnosis are entirely due to changes in diagnostic criteria, increased awareness and other social considerations will be disappointed to learn of yet another possible environmental trigger or cause of autism spectrum disorders.

As reported at UPI.com Tokyo University of Science researchers led by pharmaceutical sciences Professor Ken Takeda have found that Nanoparticles of titanium dioxide, used in air and water purification and self-cleaning surfaces, cause brain dysfunction in mice. The researchers' findings could implicate titanium dioxide nanoparticles as autism inducing triggers:

The researchers, led by pharmaceutical sciences Professor Ken Takeda, said genes affected by titanium dioxide nanoparticles are associated with childhood disorders such as autism, epilepsy and learning disabilities.

This particular study focused not just on titanium dioxide found in a number of commonly used products such as paint, sunscreen and food coloring but on the use of molecular sized nanoparticals of titanium dioxide which behave differently at that molecular level:

Nanotechnology deals with engineering at the molecular scale. Materials reduced to nanoparticles behave in ways dissimilar to those we're used to, altering their reactivity, surface area to volume and other properties, the researchers said.

It seems that, all too often, new technologies emerge, are widely distributed to a consuming public and are tested later for health and safety implications.

Make it, use it, test it later for possible harm.

Note: For more on Titanium Dioxide Nanoparticles and health implications see Inhalation Exposure Study of Titanium Dioxide Nanoparticles with a Primary Particle Size of 2 to 5 nm at Environmental Health Perspectives. The abstract of the 2007 article states as background:

Nanotechnology offers great promise in many industrial applications. However, little is known about the health effects of manufactured nanoparticles, the building blocks of nanomaterials.

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Autism Still Rising in Australia

According to the Australian Broadcasting Company News two new independent studies from Melbourne's La Trobe University indicate that autism is on the rise in Australia. Official Australian estimates of 1 in 160 are now being challenged by the two studies one of which reports an incidence of 1 in 119 persons affected by an autism spectrum disorder diagnosis. A second study from La Trobe using much smaller study group reports a 1 in 100 figure.

The usual "we don't know if the increase is real, or is the result of better diagnosis" stuff is quoted in the ABC News article. Maybe we should just assume that the increasing rates of autism in Australia, and elsewhere in the world, are due entirely to better diagnosis and increased awarness. Like the famous three monkeys we could cover our eyes and ears and ignore the autism epidemic.

Perhaps like Dorothy from the other Oz we can just click our heels three times and wish that autism were not actually rising, that there were no environmental factors causing increases in autism. Or maybe we could do the research necessary to determine what environmental factors are causing the autism increases.

We really don't need any wizards telling us it is all in our heads.

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New Autism Studies Begin to Fill Out the Genetic Part of the Autism Equation

WebMD reports that three studies published online claim to have identified gene variants involved in about 15% of autism diagnoses. The research subjects were mostly children with autistic disorder diagnoses. Hakon Hakonarson, MD, PhD, director of genomics research at The Children's Hospital of Philadelphia and the lead author of two of three studies states that:

"the newly identified gene variants found to boost autism risk are involved in facilitating communication between brain cells -- making more credible the suggestions from other autism experts that autism or ASDs are due to abnormal connections between brain cells early in development."

Dr. Hakonarson also points out that having the genetic variant does not automatically mean that autism will result. Other genetic and environmental factors are also involved.

Dr. Thomas Insel of the NIH was interviewed by WebMD about the studies and also places the new genetic studies results in a genetic and environmental context:

"If you think about autism as a jigsaw puzzle with 500 pieces, each of these findings is an 'edge' piece. But many edge pieces are needed to make progress.

It would be a mistake for people to read this and think this is only about genetics. Almost everybody agrees that autism is a collection of different disorders. Some of them may be heavily genetic. But I think most experts would say the bulk of autism is the result of both genetic and environmental effects that are interacting in some way that we have yet to fully describe.

This begins to fill out the genetic part of the equation."

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President Obama Requests Autism Research Dollars, Let's Hope Some Is for Environmental Autism Research

President Barack Obama has requested $211 million as part of the Department of Health and Human Services budget for autism research and services. Let's hope a substantial portion of the research is directed towards environmental research, including possible vaccine causes, and for treatments. The "it's gotta be genetic model" of autism research funding identified by Teresa Binstock in 1999 has ignored the environmental component of autism causation referenced on several occasions by Simon Baron Cohen. The notion that this complex condition is entirely genetic was never evidence based.

Hopefully President Obama will not let the IACC continue its shenanigans. Hopefully he will ensure that funding is set aside out for vaccine autism research as recommended by Dr. duane Alexander, Dr Bernadine Healy and Dr Julie Gerberding amongst others AND FOR ALL OTHER appropriate environmental autism research.

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National Children's Study Examining Environmental Genetic Interaction Will Boost Autism Research Paradigm Shift

Autism is only one of the conditions that will be examined as part of the National Children's Study being conducted by the U.S. Department of Health and Human Services (including the Eunice Kennedy Shriver National Institute of Child Health and Human Development and the National Institute of Environmental Health Sciences, of the National Institutes of Health and the Centers for Disease Control and Prevention), and the U.S. Environmental Protection Agency. But the massive study of the interaction of environmental genetic factors will undoubtedly push into motion the autism research paradigm shift called for over the past decade, a paradigm which breaks away from the simplistic "it's gotta be genetic" funding mandates that have restricted expansion of knowledge of environmental causes of autism and limited the ability to find treatments and cure for autism disorders.

Today it was announced that NCS centers at The University of North Carolina at Chapel Hill and the Mount Sinai School of Medicine in New York will begin recruiting volunteer Study participants this week. Over the course of the study the health of 100,000 children from diverse backgrounds and 105 locations across the US will be studied as they grow to adulthood.

Information gathered during the study will be analyzed periodically and released to the public. This will probably generate more research including research of the genetic-environmental factors and processes giving rise to autism disorders.

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Autism Research Folly

"the NIH and NIMH are impeding progress in research about causes, diagnostics, and treatment in autism and similar syndromes.

By clinging to an oversimplified and outmoded model of autism (ie, it's gotta be genetic), the stubborn persistence of several research administrators in the NIH and NIMH means that funding for autism and autism-spectrum syndromes remains funneled into the hands of a small group of researchers who pledge (via NIH-grant contracts) to conduct their research in accord with the model wherein "it's gotta be genetic" (1).

This funding pattern imposes a serious limitation on research that ought be occurring, given the growing amount of new data which indicate that *more than* genetic-aspects need be considered.

The relationship between (a) the offically approved though outmoded paradigm and (b) subsequent funding patterns is worth re-stating:

The persistence of the NIH and the NIMH in focusing almost entirely upon a genetic-theory of autism means that a goodly amount of data continues to be ignored, shunted from view, and unfunded -- even as the primary genetics-model researchers are blessed with abundant funding despite decades of non-success (1). For instance, the data from Wakefield, Warren, Singh, Shattock, Oleske et cetera are important, as are patterns amidst parental anecdotes -- eg, gastrointestinal atypicalities, vaccination effects, extraodrinarily recurrent otitis et cetera.

However, as recent years have shown, despite the many new data and anecotes, the NIH and NIMH are resistant to change. The new data remain virtually ignored, the parents' anecdotes treated as if mere hearsay. Not surprisingly, in the face of this bureaucratic intransigence, the goal of changing and improving the NIH and NIMH in regard to autism funding will require increased effort."

Teresa Binstock, Researcher in Developmental and Behavioral Neuroanatomy, in IGNAZ SEMMELWEISS and AUTISM: when prevailing paradigms resist change, 1999

The Binstock article, referenced above, was a review of Jeanne Achterberg's book Woman as Healer and the sad story of Ignaz Semmelweiss who challenged medical orthodoxy of his time (1818-1865) by gathering data and arguing that peuperal (childbed) fever was caused by the unclean hands of those who delivered, or assisted, delivery of children. Hospital wards staffed by midwives had a 3% mortality rate due to fever while those staffed by medical students who often came straight from autopsy rooms to the maternity rooms, and either did not wash their hands, or wiped them on already bloody, dirty clothes, had a 10% rate.

The medical establishment of the time did not believe Semmelweiss and he was professionally punished by lowering his academic standing and restricting his hospital privileges. Ultimately he became depressed and committed to an asylum where he died of blood poisoning. Binstock noted similarities between the treatment afforded Semmelweis, his conclusions, and his data and what has happened today to the anecdotal evidence of parents and researchers who followed up on that anecdotal evidence.

Teresa Binstock's contention that research of a possible vaccine-autism conection has been discouraged by public authorities is in fact confirmed in the Institute of Medicine (IOM) Immunization Safety Review: Vaccines and Autism (2004) . In that document the public health authorities expressly discouraged research of vaccine-autism connections as shown at p. 152:

Biological Mechanisms Conclusions

In the absence of experimental or human evidence that vaccination (either the MMR vaccine or the preservative thimerosal) affects metabolic, developmental, immune, or other physiological or molecular mechanisms that are causally related to the development of autism, the committee concludes that the hypotheses generated to date are theoretical only.

SIGNIFICANCE ASSESSMENT

The committee concludes that because autism can be such a devastating disease, any speculation that links vaccines and autism means that this is a significant issue.

PUBLIC HEALTH RESPONSE RECOMMENDATIONS

The committee recommends a public health response that fully supports an array of vaccine safety activities. In addition the committee recommends that available funding for autism research be channeled to the most promising areas.

Policy Review

At this time, the committee does not recommend a policy review of the licensure of MMR vaccine or of the current schedule and recommendations for the administration of the MMR vaccine.

At this time, the committee does not recommend a policy review of the current schedule and recommendations for the administration of routine childhood vaccines based on hypotheses regarding thimerosal and autism.

Given the lack of direct evidence for a biological mechanism and the fact that all well-designed epidemiological studies provide evidence of no association between thimerosal and autism, the committee recommends that cost-benefit assessments regarding the use of thimerosal-containing versus thimerosal-free vaccines and other biological or pharmaceutical products, whether in the United States or other countries, should not include autism as a potential risk.

Apart from the express discouragement of funding of research of a possible vaccine autism connection it is interesting to note the first paragraph of the above quote. The highlighted portion states "In the absence of experimental or human evidence " that vaccines are causally related to autism any such hypothesis can be theoretical only. Having noted an absence of evidence the IOM then discouraged any research that might have produced such evidence. It is also becoming less certain that the epidemiological studies were as well designed as the IOM contended given the continued presence of thimerosal in vaccines, including some vaccines given to pregnant women.

In the last year the Poling case upset the IOM 2004 strategy. Government had to acknowledge that, at least in some subsets of children vaccines could trigger "autism like symptoms" :

if you're predisposed with the mitochondrial disorder, it can certainly set off some damage. Some of the symptoms can be symptoms that have characteristics of autism.

Dr. Julie Gerberding, Director, CDC, CNN Interview with Dr. Sanjay Gupta, March 29, 2008

As many have noted there is no intelligent distinction between autism and autism like symptoms. Autism is currently diagnosed by symptomatic behavior. In addition to Dr. Gerberding's reluctant acknowledgement of a vaccine-autism connection, Dr. Bernardine Healy, former director of the American Red Cross and the NIH, exposed limits of the epidemiological studes and expressed the need for further research of possible vaccine-autism connections in April 2008.

It is sheer folly to discourage research into possible environmental triggers or causes of autism. Not doing the research means that we might have missed out on possible treatments or preventative measures for autism. Teresa Binstock pointed out the folly of such a course of action in her 1999 comment. Now Irva Hertz-Picciotto, an author of the recent California study, has called for increased funding of research of possible environmental causes of autism.

It is time to move away from the "it's gotta be genetics" paradigm of autism research that Binstock described in 1999. It is time to move ahead with the autism research paradigm shift that the University of Minnesota called for in 2007, a paradigm based on the premise that autism is caused by a combination of environmental influence and genetic vulnerabilities.

It is time to end the "its gotta be genetics" autism research folly.

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"MARBLES" - Rare Study Examines Environmental Factors In Autism Disorders

MARBLES, Markers of Autism Risk in Babies - Learning Early Signs, is a rarity. The study being conducted by UC Davis researcher Irva Hertz-Picciotto is looking at possible environmental triggers for autism.

The Autism Knowledge Revolution advances almost daily with announcements of genetic studies and breakthroughs in understanding genetic causes or bases for autism spectrum disorders. But there seem to be fewer studies focusing on possible environmental factors.

The News10/KXTV report quotes Ms. Hertz-Picciotto:

"Autism is very clearly not a single cause type of condition. It's got to be multiple factors," said Hertz-Picciotto, who hopes her study will reveal environmental factors that combined with genetics can trigger autism.

"We expect to find a number of different exposures that affect neurodevelopment and may be related to autism mildly, small increments of risk, for each exposure, but there may be multiple exposures," said Hertz-Picciotto.

To date the study involves 100 women and 59 babies who are being followed for a three year period. Blood samples will be withdrawn at regular periods.

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Flat Out Good Autism News

The word autism has almost become a synonym for controversy.

Parents are routinely mocked and demonized for seeking to cure or treat their own children. ABA, well documented as an effective intervention for autism by decades of study and numerous credible professional reviews is labeled as "unproven" by anti-ABA advocates. Terms such as low functioning/high functioning used in the professional literature are disparaged. Mentioning possible environmental contributors to autism rates is dismissed by some even though studies show that autism can sometimes occur in one but not both identical twins. Even referencing autistic disorders as .... disorders... generates controversy.

But surely there is one point on which we can all agree; that everyone wishes for the safety and well being of all autistic persons. And surely we can all be thankful when news reports tell us that that two autistic persons are now safe and sound after wandering away from their homes in Utah and Boston.

The Deseret News reports that a 22-year-old severely autistic woman, described as having the mental capacity of a 5 year old, who wandered away from home in Provo Utah Sunday night was found safe Tuesday morning in Salt Lake City. In Boston, earlier this week, the Herald reported that a 3-year-old autistic child was rescued from danger by police after drivers saw him riding his tricycle amid speeding traffic on a busy thoroughfare.

As a parent who has experienced the fear and guilt of realizing that my autistic son had wandered away from the safety of home while I was distracted those feelings are revived every time I learn of another autistic person who has wandered away or is missing. The feeling of relief I experienced when, after calling 911, I learned my son was safe at a nearby convenience store where I quickly retrieved him, also resurfaces when the stories have good endings as they did this week in Utah and Boston.

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Environmental Causes of Autism and the Existence of an Autism Epidemic

If you can believe some professors of cultural anthropology and classical literature there are no environmental causes of autism and there is no autism epidemic. ALL of the dramatic increases in the numbers of autistic children and adults are due ENTIRELY to the definition changes in the DSM and to diagnostic substitution. Bringing their powers of personal opinion, societal observation and literary analysis to bare on the subject they have concluded that there is no autism epidemic.

We can all rest easy now that the rumor of an autism epidemic has been thoroughly discredited by these uh .... giants of science. No need at all for parents to worry about mercury, lead, pesticides and other harmless substances to which we as DNA bearing parents or our children themselves might be exposed. We can all rest assured that autism is purely genetic. Any and all increases in cases of autism must be due entirely to definition change, diagnostic substitution, increased awareness etc. According to the true believers autism has only genetic causes and there is nothing we can do to treat or cure our autistic children. Que Será Será.

Of course there are heretics out there, unbelievers who have not yet seen the light, people who actually give credence to theories about global warming. People who are concerned generally about the increasingly toxic bath into which each new generation is born. I must confess to being one of those heretics. While the genetic bases of autism are becoming known with increasing specificity the role of possible environmental cause or triggers of autism has not been eliminated. Far from it.

Studies of twins have established that it is not 100 per cent genetic, since even among identical twins, when one has autism, the likelihood of both twins having autism is only about 60 per cent. This means there must also be an environmental component, but what it is remains unknown.

Simon Baron-Cohen, Freedom of Expression, TimesOnLine, December 14, 2007

A recent article in Pediatrics, Official Journal of the American Academy of
Pediatrics, by authors Bruce M. Altevogt, PhD, Sarah L. Hanson, BA and Alan I. Leshner, PhD also addresses the mix of genetic, biological and environmental stressors. All three authors are members of the Forum on Neuroscience & Nervous System Disorders, Institute of Medicine, Washington, DC. Dr. Leshner is also associated with the American Association for the Advancement of Science, Washington, DC. In the abstract for Autism and the Environment: Challenges and Opportunities for Research, PEDIATRICS Vol. 121 No. 6 June 2008, pp. 1225-1229 (doi:10.1542/peds.2007-3000) , it was stated that:

Autism spectrum disorder is a complex developmental disorder that dramatically affects the lives of patients and their families and the broader community. The causes of autism are unknown; however, evidence increasingly suggests that a complex interplay among environmental stressors, genetic mutations, and other biological factors likely plays a significant role in the development and/or progression of autism spectrum disorder. [bold highlighting added - HLD]

In Environmental Factors and Limbic Vulnerability in Childhood Autism American Journal of Biochemistry and Biotechnology 4 (2): 183-197, 2008 Dr.Richard Lathe of Pieta Research, Edinbugh, expressly argues against diagnostic substitution as a complete explanation for the current prevalance of autism spectrum disorders and stresses the likelihood of substantial environmental contributions:

The rise in prevalence of autism spectrum disorders (ASD) is suggestive of a
new etiology. Diagnostic substitution alone is unlikely to account for the increase, while genetic association with detoxification gene alleles points to an environmental contribution. Subtle structural anomalies in the ASD brain are widespread but limbic damage seems important for the development of behaviors diagnostic of ASD. The limbic brain is especially susceptible to environmental challenge: internal sensing, physiological feedback and neuroinflammatory processes may underlie this sensitivity to insult. Primary damage leading to ASD in later life is likely to take place in utero and/or in the immediate postnatal period. Despite evidence of heavy metal involvement, a causal connection may not yet be concluded because subjects exposed to metals tend to be exposed to other environmental agents. Because maternal minerals and lipids are supplied to the unborn child, historic toxic exposure of the mother may be pivotal. A two-hit combination of genetic susceptibility and environmental challenge is argued to underlie the rise in ASD.

Personally, I believe that we are in the midst of an Autism Knowledge Revolution in which science, not the ancient Greeks, or superficial and irrelevant cultural comparisons, will determine with increasing certainty the causes of autism, be they genetic, environmental or some combination of factors. As that knowledge increases debates about whether we are living in an autism epidemic should also be decided with greater certainty.

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