crosspost:FW: [Autism-Biomed-BayArea] Discover Magazine -- Autism: It's Not Just in the Head

[Guest guest]

Have you seen this?

Heidi

-------------- Forwarded Message: --------------

From: Lynne Arnold <lynne@...>

<bayareaprekasd >, <autisminterventionsocal >,

<Autism-Biomed-BayArea >, Central CA

<AutismInterventionCentralCA >, TACA

<lynne@...>, Lynne Arnold

<lynne@...>, Northern CA

<AutismInterventionNorthernCA >, CSB

<csb-autism-rx >

Subject: [Autism-Biomed-BayArea] Discover Magazine -- Autism: It's Not Just in

the Head

Date: Sun, 18 Mar 2007 20:48:09 +0000

Discover Magazine, April 2007

[buy it on the newsstand and give it to everybody. This is a very important

article for the autism community. Lynne]

Autism: It¹s Not Just in the Head

The devastating derangements of autism also show up in the gut and in the

immune system. That unexpected discovery is sparking new treatments that

target the body in addition to the brain

By Jill Neimark for Discover Magazine.

³There were days I considered shutting the garage door and letting the

car run until I was dead,² says Colorado mom , of the time nine

years ago when she learned that both her boys--not just her

firstborn--suffered from autism. n, her angular, dark-haired older

child, was diagnosed in 1996 at age 4. , her round-faced, hazel-eyed

younger son, was diagnosed in 1998 at age 2 1/2.

But and n¹s story does not have a tragic ending. After

interventions that included occupational and speech therapy, as well as

dietary change and nutritional supplements, both boys improved

significantly. Their tale of slow, steady recovery reflects the changing

landscape of autism today. The condition, traditionally seen as genetic and

originating in the brain, is starting to be viewed in a broader and very

different light, as a possible immune and neuroinflammatory disorder. As a

result, autism is beginning to look like a condition that can, in some and

perhaps many cases, be successfully treated.

That is astonishing news about a disorder that usually makes headlines

because it seems to be growing rapidly more widespread. In the United

States, the diagnosis of autism spectrum disorders has increased about

tenfold over the past two decades, and a 2003 report by the Centers for

Disease Control suggests that as many as one in every 166 children is now on

the autism spectrum, while another one in six suffers from a

neurodevelopmental delay. This explosion of cases has raised countless

questions: Is the increase real, is it the result of increased awareness and

expanding diagnostic categories, is it due to environmental changes, or all

of the above? There may be no single answer. But the public concern about

autism has caught the ear of federal lawmakers. The Combating Autism Act,

approved last December, authorized nearly $1 billion over the next four

years for autism-related research and intervention.

Meanwhile, on the sidelines of that confusing discussion, a disparate

Group--immunologists, naturopaths, neuroscientists, and toxicologists--is

turning up clues that are yielding novel strategies to help autistic

patients. New studies are examining contributing factors ranging from

vaccine reactions to atypical growth in the placenta, abnormal tissue in the

gut, inflamed tissue in the brain, food allergies, and disturbed brain wave

synchrony. Some clinicians are using genetic test results to recommend

unconventional nutritional therapies, and others employ drugs to fight

viruses and quell inflammation.

Above all, there is a new emphasis on the interaction between

vulnerable genes and environmental triggers, along with a growing sense that

low-dose, multiple toxic and infectious exposures may be a major

contributing factor to autism and its related disorders. A vivid analogy is

that genes load the gun, but environment pulls the trigger. ³Like cancer,

autism is a very complex disease,² says Craig Newschaffer; chairman of

Epidemiology and Biostatistics at the Drexel University School of Public

Health, ³and it¹s exciting to start asking questions about the interaction

between genes and environment. There¹s really a very rich array of potential

exposure variables.²

In one way, the field seems like a free-for-all, staggeringly

disordered because it is littered with so many possibilities. But one can

distill a few revolutionary insights. First, autism may not be rigidly

determined but instead may be related to common gene variants, called

polymorphisms, that may be derailed by environmental triggers. Second,

affected genes may disturb fundamental pathways in the body and lead to

chronic inflammation across the brain, immune system, and digestive system.

Third, inflammation is treatable.

³In spite of so many years of assumptions that a brain disorder like

this is not treatable, we¹re helping kids get better. So it can¹t just be

genetic, prenatal, hardwired, and hopeless,² says Harvard pediatric

neurologist Martha Herbert, author of a 14,OOO-word paper in the journal

Clinical Neuropsychiatry that reconceptualizes the universe of autism,

pulling the brain down from its privileged perch as an organ isolated from

the rest of the body. Herbert is well suited to this task, a synthetic

thinker who wrote her dissertation on the developmental psychologist Jean

Piaget and who then went to medical school late, in her early thirties.

³I no longer see autism as a disorder of the brain but as a disorder

that affects the brain,² Herbert says. ³It also affects the immune system

and the gut. One very striking piece of evidence many of us have noticed is

that when autistic children go in for certain diagnostic tests and are told

not to eat or drink anything ahead of time, parents often report their

child¹s symptoms improve-until they start eating again after the procedure.

If symptoms can improve in such a short time frame simply by avoiding

exposure to foods, then we¹re looking at some kind of chemically driven

Œsoftware¹--perhaps immune system signals-that can change fast. This means

that at least some of autism probably comes from a kind of metabolic

encephalopathy-a system wide process that affects the brain, just like

cirrhosis of the liver affects the brain.²

In 1943 s Hopkins University psychiatrist Leo Kanner first

described autism as a now-famous collection of symptoms: poor social

engagement, limited verbal and nonverbal communication, and repetitive

behaviors. Back then, autism was considered rare; Kanner first reported on

just 11 patients, and s Hopkins still has records of about 150 patients

he examined in total. Even within this small group of patients, other, less

visible symptoms were evident. In his 1943 paper, ³Autistic Disturbances of

Affective Contact,² Kanner noted immune and digestive problems but did not

include them in the diagnosis. One reads with a shiver sentences lifted out

of various case histories: ³large and ragged tonsils. . . she was tube-fed

five times daily. . . he vomited all food from birth through the third

month. . . he suffered from repeated colds and otitis media. . . .²

Herbert believes that the clues linking the obvious behavioral

symptoms to more basic, but less obvious, biological dysfunction were missed

early on. ³What I believe is happening is that genes and environment

interact, either in a fetus or young child, changing cellular function

allover the body, which then affects tissue and metabolism in many

vulnerable organs. And it¹s the interaction of this collection of troubles

that leads to altered sensory processing and impaired coordination in the

brain. A brain with these kinds of problems produces the abnormal behaviors

that we call autism.²

Herbert¹s full-body perspective helps make sense of the contusion

surrounding the diagnosis of autism and helps justify the increasingly

common use of the plural ³autisms² to describe the wide variations in this

disorder. As Newschaffer points out, ³Children with Asperger¹s syndrome

certainly share a lot of the behaviors of those with more severe autism. But

is it the same disease, and is it caused by the same thing? A number of

significant features of autism are not part of the diagnostic schema right

now, but eventually, those features may end up distinguishing one causal

pathway from another. How is a child sleeping? Does he or she have

gastrointestinal symptoms? By looking at those things we may see risk-factor

associations pop out that we¹ve never seen before.²

Herbert likens autism to a hologram: ³Everything that fascinates me is

in it. It¹s got epidemiology, toxicology, philosophy of science,

biochemistry, genetics, systems theory, the collapse of the medical system,

and the failure of managed care. Each child that walks through my door is a

challenge to everything I ever knew, and each child forces me to think

outside the box and between categories.²

Each child¹s path to autism may be distinct, she says, but they may

share common inflammatory abnormalities. She has shown through morphometric

brain imaging that white matter--which carries impulses between neurons--is

larger in children with autism.

³It was the most absolutely outstanding piece of information in all

the brain data looked at,² Herbert recalls of the years 2001 and 2002, when

she was analyzing this brain imaging data. ³People were saying, don¹t look

at the white matter, look at the cerebral cortex, but I knew we had an

important finding.²

Could white matter become chronically inflamed? It may well be,

according to new research from Pardo, a neurologist at s Hopkins.

In a 2005 study in the ls of Neurology, he found inflammation in

immune-responsive brain cells of autistic patients. ³Patients with autism

report lots of immunological problems. We looked for the fingerprints of

those problems in the brain,² says Pardo. ³We had brain tissue from autistic

individuals as young as 5 and as old as 45 and we found neuroglial

inflammation in all of them. Neuroglia are a group of brain cells that are

iljPOl1ant in the brain¹s immune response. This inflammatory reaction

appears to happen both early and late in the course of the disorder. If it

happens early, it could dramatically influence brain development. We¹re

very excited about this research because one potential treatment approach,

then, is to downregulate the brain¹s immune response.² To study that

approach, Pardo is collaborating on a pilot study funded by the NIH to test

minocycline, an anti-inflammatory antibiotic drug, on autistic children.

³Minocycline is a very selective downregulator of microglial inflammation,²

he says. ³Neurologists already use it in multiple sclerosis and

Parkinson¹s.²

³What we¹ve got here is a far more comprehensive set of

characteristics for autism,² says Herbert, ³one that can include behavior,

cognition, sensorimotor, gut, immune, brain, and endocrine abnormalities.

These are ongoing problems, and they¹re not confined just to the brain. I

can¹t think of it as a coincidence anymore that so many autistic kids have a

history of food and airborne allergies, or 20 or 30 ear infections, or

eczema, or chronic diarrhea.²

All this marks a Copernican-scale shift in our approach to the

disorder. I myself was irresistibly drawn to the subject when viewing an

online video of a heavily affected 11-year-old who, after a series of

chelation treatments to remove mercury, announced to his mother, ³Mom, I¹m

back from the living dead.² The statement was heart-breaking in its simple

eloquence. Mercury chelation, in this particular child¹s case, was a near

panacea.

Beck, of Oviedo, Florida, tells a similar story. Her son

was diagnosed with autism in 2004 at about age 2. After 18 intensive months

of treatment that involved chelation--a treatment that draws heavy metals

out of the body--and dietary changes, among other therapies, Josh appears

neurotypical. ³We took him to Dr. Gavin, a specialist at Nemours

Children¹s Clinic, who administers the ADOS test, a diagnostic test to see

where on the spectrum a child falls,² she says. ³After the two-hour

evaluation, Gavin said he did not see the criteria for autism. In her words.

he was Œresponsive, curious, and active, able to engage in the test

without a problem, able to express himself clearly.¹²

But fascinating anecdotes aside, does hard evidence exist of specific

vulnerability genes or how they might impair the immune system, brain, and

gut--and most important, do we have any rational, reliable approached to

help

repair the damage?

The answer is a provisional yes.

³We¹re beginning to understand that genetics is really about

vulnerability,² says neuroscientist Pal Levin, director of the Vanderbilt

Kennedy Center for Research on Human Development. Levitt and his colleagues

recently discovered that a common variant of a gene called MET doubles the

risk of autism. The finding was widely regarded as a breakthrough because

MET modulates the nervous system, gut, and immune system-just the kind of

finding that matches up with the emerging new view of autism.

³Everyone was focusing on genes expressed in the brain,² says Levitt,

³but this gene is important for repair of the intestine and immune

function. And that¹s really intriguing because a subset of autistic

children have digestive and immune problems.² Equally interesting is that

the gene variant occurs in 47 percent of the population--in other words. it

is just one contributing factor, and it probably works in concert with

other vulnerability genes. And finally, in a twist that intrigues other

researchers, the activity of the gene is affected by what is known as

oxidative stress--the kind of damage one sees with excessive exposure to

toxins. ³As we identify other vulnerability genes like this,² says Levitt,

who hopes to engineer a mouse model of this gene variant for study, ³we may

be able to develop effective interventions for children.²

In other provocative research, Jill , director of the Autism

Metabolic Genomics Laboratory at the Arkansas Children¹s Hospital Research

Institute (and professor of pediatrics at the University of Arkansas for

Medical Sciences) has found that many children with autism do not make as

much of a compound called glutathione as neurotypical children do.

Glutathione is the cell¹s most abundant antioxidant, and it is crucial for

removing toxins. If cells lack sufficient antioxidants, they experience

oxidative stress, which is often found with chronic inflammation.

In her most recent study, published in the American Journal of Medical

Genetics in 2006, found that common gene variants that support the

glutathione pathway may be associated with autism risk. Intriguingly, this

pathway is linked metabolically to the methylation pathway. Methylation is a

fundamental biochemical process that helps regulate which genes are

expressed; abnormal methylation can cause disease. Because the pathway

provides the precursors to glutathione, impairments in methylation can also

called oxidative stress. ³It¹s very provocative,² says. ³It suggests

that some autistic behaviors are a neurologic manifestation of a

genetically based systemic, metabolic derangement.² Some of the

abnormalities saw in this study have already been associated with

gastrointestinal and immunologic dysfunction.

The good news is that oxidative stress in some autistic children may

be treatable with targeted nutritional intervention. and her

colleagues have tracked eight autistic children who were taking supplements

of key nutrients in the methylation pathway--folinic acid, trimethylglycine,

and methyl-B12--and found a significant increase in important markers of

methylation and glutathione synthesis. The next step is to see if the

symptoms improve as well.

and her colleagues just received a $2.4 million grant from the

NIH. Part of which will be the sorting out the relationship between

metabolism, genes, and behavior. ³What would be incredible is if we could

correlate individual differences in behavior with specific abnormal

metabolites,² says. They will then look at children between 18 to 24

months old, which is usually before autism is diagnosed. That could help

identify the causes of the disease, as well as permit earlier intervention.

³We also plan to look at mitochondrial dysfunction,² she says. ³Since

mitochondria are the energy powerhouses of the cell, they¹re also the place

where the most free radicals (which playa role in oxidative stress) are

produced. If the electron transport chain in the mitochondria is faulty and

you¹re not efficiently making ATP, you¹ll produce more free radicals and

deplete your glutathione. If this hypothesis turns out to be correct, we can

give nutrients like coenzyme Q10, magnesium, and acetyI-L-carnitine to help

stabilize the mitochondria. Now, this is just a hypothesis, but that¹s the

risk you take with science. You make your best guess and you carry out your

study and you see.²

³It¹s interesting to see metabolic abnormalities addressed this way,²

says Isaac Pessah, chairman of Molecular Biosciences and director of Center

for Disease Prevention at the University of California at . ³I think

glutathione balance in the kids is potentially very important in terms of

toxic environmental exposures.²

There is a growing sense, Pessah adds, that our heavily

industrialized, chemical-soaked environment--and the way it acts on

vulnerable genes in some individuals-may be a major culprit. In December

2006, Harvard researchers boldly announced in The Lancet that industrial

chemicals may be impairing the brain development of children around the

entire world. And at a November 2006 conference at the University of

California at ¹s M.I.N.D. Institute, Pessah gathered experts to discuss

the clinical implications of environmental toxicology in autism. Says

Herbert, ŒWe discussed the enormous number of chemicals in our environment

and how little we know about chronic, low-dose, multiple exposures and

their effect on diseases like autism. Maybe the many autism cases we are now

seeing are a new illness of the current generation.²

Several large-scale, federally funded epidemiological studies are

under way to pinpoint possible environmental triggers, as well as early

biomarkers of autism. ŒWe have to build a large enough study to be able to

look at both genes and environment together,² says Newschaffer, who is a

principal investigator on a study by the Centers for Disease Control that

will look at 2,700 children over the next five years.

In another ambitious study, called the Autism Birth Cohort, Columbia

University and the Norwegian Institute of Public Health will follow 100,000

pregnant women for 72 months, studying their health and genetics and testing

everything from blood to urine samples. The hope is to discover

environmental factors that contribute to autism risk, from diet or infection

to toxins like heavy metals, pesticides, and the countless synthetic

molecules in products today.

Other large, NIH- and EPA-funded studies are teasing out immune

abnormalities that may contribute to autism. In research on more than 700

families with an autistic as well as a neurotypical child, Pessah and his

colleagues have found in the autistic child a significant reduction in

immunoglobulins and an abnormal profile of cytokines, which are critical to

immune response. ³The immune system is involved in important aspects of

neurodevelopment,² says Pessah. ³We¹ve found the presence of immune

antibodies that we think may influence brain proteins. In the next five

years, as the study continues, we hope to reach about 1,600 families total.

We need that many to get real statistical power. We hope to find out what

type of skewed immune response the typical autistic child has and to isolate

toxic exposures, such as proximity to highways or toxic waste dumps.²

Herbert argues that ³we can address the disturbed pathways now, before

me gene hunters have definitive information. Genes, after all, don¹t

specify behaviors. They make regulatory factors that interact in highly

complex ways. And as far as the impact of chemicals on neurodevelopment,

only about 20 to 30 of the 85,000 chemicals made have been studied. We can,

at the very least, try to modulate autism by treating the tissue

inflammation.²

In other words, treat now, before the gavel of science strikes a final

judgment, which might be decades away. That¹s what and her husband,

, did for n and : They blended mainstream treatments like

speech and occupational therapy with the best biomedical approaches

available. I was told to take my boys home and love them,² recalls .

³The neurologist said don¹t waste your time on alternative treatments,

nothing about them is proven. My boys could have ended up institutionalized,

or my husband and I would have had to take care of them their whole adult

lives. When your child gets a diagnosis of autism, you lose the child you

were dreaming about, the one who will go to college, get married, become a

parent. That just wasn¹t an option.²

The boys first saw an alternative Colorado practitioner who had been

trained by group called Defeat Autism Now! (DAN!). DAN! was co-founded in

1995 by the psychologist Bernard Rimland, whose own son was autistic. DAN!

treatments focus on intestinal issues, detoxification, nutrition, and

neuroinflammation. Recommendations include dietary restriction, usually

eliminating gluten (present in wheat and other grains) and dairy.

³For weeks after stopped drinking milk, he had welts allover his

body,² recalls, ³as if he were going through a detoxification reaction.

At the same time, he had his first formed, regular bowel movement. His sleep

improved.²

Other DAN!-recommended treatments include detoxification to remove

heavy metals and other suspected pollutants, nutritional supplementation,

and sometimes off-label use of anti-inflammatories, antivirals, and allergy

medications. These so-called biomedical treatments range from relatively

inexpensive dietary changes costing a few hundred dollars a month to doses

of antifungal drugs that can cost several hundreds of dollars. Many DAN!

supplements play critical roles in the pathways studied by scientists like

Jill . DAN! practitioners are, of course, leaping into the deep end of

the pool before science has truly proved these treatments effective, but

there are many anecdotal cases of improvement.

Not surprisingly, there has been criticism of the biomedical

approach, especially when doctors promise too much or parents hope too

desperately for recovery. As notes, one mother killed herself after

seeking every possible treatment for her autistic daughter to no avail,

causing a furor among parents with autistic children.

Some children just do not get better, no matter what the

intervention. Mumper is CEO of a group called Advocates for

Children and former director of pediatric education at the Lynchburg Family

Practice Program affiliated with the University of Virginia. Of the 2,000

children in her practice, about 400 have autism spectrum disorders. She

describes one boy whom ³I have not helped despite my best efforts. He is 17

and still nonverbal and has horrible, erosive esophagitis in spite of the

fact that he works very closely with a gastroenterologist. He has to sleep

standing up and leaning over his dresser because of the pain, and he has

very idiosyncratic reactions to medications. And even though he is

nonverbal, he can type anything to me. He¹s alpha-smart. The horror is that

he¹s trapped in a body that doesn¹t work.²

³I hate the term Œfull recovery,¹² adds, ³because of this false

hope. Some children do lose the diagnosis, but that¹s rare. I don¹t think

that should be out there as a goal. We need to accept (the kids) and love

them for who they are--because they are lovable. They¹re quirky.²

¹s boys benefited from their DAN! doctor, she says, but it was in

2003, when she switched to a highly unconventional molecular biologist and

naturopath based in Maine, Amy Yasko, that she began to see more striking

changes. Yasko blends the new findings on methylation with a scientist¹s

background in the finer steps of fundamental detoxification pathways in the

body. However, she largely favors herbs, dietary change, and nutritional

supplements over prescription medications. She monitors biomarkers of

detoxification in the urine as often as every week or two and tweaks

supplements accordingly. Her program is intensive and steeped in molecular

biology; her twice-yearly conferences are extremely dense, scientific, and

intended to help parents become at least semiproficient in the biology and

chemistry themselves. It is a far cry from the old doctor-patient model--

Yasko works primarily on the internet now -- with phone consultations, to

interpret test results. She decided to do this when her waiting list for

individuals stretched to five years, and, she says, she felt she was not

helping enough children. e-mailed me about 40 charts of metal ³dumps²

for both of her boys--urinalyses Yasko had ordered and charted on a graph to

show the excretion of everything from arsenic to aluminum, mercury, and lead

over time. ³All these little things started clicking after we started with

her,² says .

³I call this approach biomolecular nutrigenomics, after Bruce Ames, a

professor of biochemistry and molecular biology at the University of

California at Berkeley,² says Yasko. ³He said that someday it would become

routine to screen individuals for polymorphisms and that nutritional

interventions to improve health were likely be a major benefit of the

genomics area.² Yasko tests for common polymorphisms in the methylation

pathway, even though these findings are still preliminary. This has made

her controversial among her peers. Yet several doctors and scientists with

autistic children admitted privately to using Yasko¹s services while being

unwilling to go on the record to support her.

Yasko, who says she moved her husband and three daughters from

Connecticut to a rural area of Maine to ³hear the snowflakes fall on the

snow and get to that quiet place inside where I can think,² seems immune to

the controversy. ³I was in a research environment for a long time, where

you had to publish. Then I was in biotech for a long time, where you had to

keep everything quiet. When I began to focus on autistic children, I made a

decision that instead of publishing in peer review journals, I was going to

go directly to the moms and help them. I knew in making that decision I was

going to get flak. That¹s OK. It was like I was on those cliffs you see in

the movies, and you¹re going to jump. You don¹t know if there¹s water below,

or enough momentum to get to the other side, but you just jump.²

Today ¹s boys participate in individualized programs at school

and are being monitored in two national studies of families with more than

one autistic child-one at the Duke Center for Human Genetics, another at

the University of Washington. has, in addition, been tested three times

at the University of Colorado Health Sciences Center¹s toddler development

program. Both are still on the autism spectrum--but the incessant tantrums,

digestive problems, and infections have vanished. n no longer chews on

his shirt, flaps his arms, and grinds his teeth. In fact, he made honor roll

in his classes last year. Swift, the boys¹ schoolteacher since the

autumn of 1996, describes them as ³sociable and on the whole very happy,

with a great sense of humor. is probably the most changed of any

autistic child I¹ve ever worked with.²

, who stopped speaking entirely at age 2, is now a font of

creative language. I know this because and the boys spent a weekend at

my house. At lunch, poured a Vesuvius of ketchup onto his plate and

began transforming his french fries into boats that sailed across the

ketchup before they were disposed of in his mouth; he then began to

entertain us by pretending he was an announcer at a regatta, where he, of

course, was winning the race. What had once been autism had erupted into a

geyser of quirky creativity.

The boys¹ blossoming, according to their mom, is one not easily

measured on tests. ³It¹s the length of their sentences, their empathy and

sense of humor. Last night we went by a house that was all lit up for the

holidays and joked, ŒDoes that guy want to be seen from space?¹ When we

used to take to the dentist, he would scream bloody murder and we¹d

try to papoose him-put him on a board and wrap him in sheets, but even that

didn¹t work. so they put him to sleep just to clean his teeth. Last year we

went to the dentist. and he heard a little boy crying, walked over to him,

rubbed his back, told him it wouldn¹t hurt, and not to worry. My heart was

melting.²

Can we cajole a mysteriously shuttered brain and body back toward

normal? And if so, will autism give us new insight into other disorders?

Martha Herbert thinks so: ³A lot of these metabolic pathways are pretty

fundamental to life. If we can crack the puzzle of autism and be clear

about how we did it, that may have huge implications for other chronic

environmentally triggered systemic illnesses. Autism could be a much-needed

wake-up call to us all.²

[Guest guest]

Thank you *so much* for posting this! I've been hearing about this

article for days and haven't been able to go to the store to get the

magazine. I've been dying to read this!

Cheryl

On Mar 18, 2007, at 2:27 PM, theshabbysheep@... wrote:

> Have you seen this?

>

> Heidi

>

> -------------- Forwarded Message: --------------

> From: Lynne Arnold <lynne@...>

> <bayareaprekasd >,

> <autisminterventionsocal >, <Autism-Biomed-

> BayArea >, Central CA

> <AutismInterventionCentralCA >, TACA

> <lynne@...>, Lynne Arnold

> <lynne@...>, Northern CA

> <AutismInterventionNorthernCA >, CSB <csb-autism-

> rx >

> Subject: [Autism-Biomed-BayArea] Discover Magazine -- Autism: It's

> Not Just in the Head

> Date: Sun, 18 Mar 2007 20:48:09 +0000

> Discover Magazine, April 2007

> [buy it on the newsstand and give it to everybody. This is a very

> important

> article for the autism community. Lynne]

>

> Autism: It¹s Not Just in the Head

>

> The devastating derangements of autism also show up in the gut and

> in the

> immune system. That unexpected discovery is sparking new treatments

> that

> target the body in addition to the brain

>

> By Jill Neimark for Discover Magazine.

>

> ³There were days I considered shutting the garage door and letting the

> car run until I was dead,² says Colorado mom , of the

> time nine

> years ago when she learned that both her boys--not just her

> firstborn--suffered from autism. n, her angular, dark-haired

> older

> child, was diagnosed in 1996 at age 4. , her round-faced, hazel-

> eyed

> younger son, was diagnosed in 1998 at age 2 1/2.

>

> But and n¹s story does not have a tragic ending. After

> interventions that included occupational and speech therapy, as

> well as

> dietary change and nutritional supplements, both boys improved

> significantly. Their tale of slow, steady recovery reflects the

> changing

> landscape of autism today. The condition, traditionally seen as

> genetic and

> originating in the brain, is starting to be viewed in a broader and

> very

> different light, as a possible immune and neuroinflammatory

> disorder. As a

> result, autism is beginning to look like a condition that can, in

> some and

> perhaps many cases, be successfully treated.

>

> That is astonishing news about a disorder that usually makes headlines

> because it seems to be growing rapidly more widespread. In the United

> States, the diagnosis of autism spectrum disorders has increased about

> tenfold over the past two decades, and a 2003 report by the Centers

> for

> Disease Control suggests that as many as one in every 166 children

> is now on

> the autism spectrum, while another one in six suffers from a

> neurodevelopmental delay. This explosion of cases has raised countless

> questions: Is the increase real, is it the result of increased

> awareness and

> expanding diagnostic categories, is it due to environmental

> changes, or all

> of the above? There may be no single answer. But the public concern

> about

> autism has caught the ear of federal lawmakers. The Combating

> Autism Act,

> approved last December, authorized nearly $1 billion over the next

> four

> years for autism-related research and intervention.

>

> Meanwhile, on the sidelines of that confusing discussion, a disparate

> Group--immunologists, naturopaths, neuroscientists, and

> toxicologists--is

> turning up clues that are yielding novel strategies to help autistic

> patients. New studies are examining contributing factors ranging from

> vaccine reactions to atypical growth in the placenta, abnormal

> tissue in the

> gut, inflamed tissue in the brain, food allergies, and disturbed

> brain wave

> synchrony. Some clinicians are using genetic test results to recommend

> unconventional nutritional therapies, and others employ drugs to fight

> viruses and quell inflammation.

>

> Above all, there is a new emphasis on the interaction between

> vulnerable genes and environmental triggers, along with a growing

> sense that

> low-dose, multiple toxic and infectious exposures may be a major

> contributing factor to autism and its related disorders. A vivid

> analogy is

> that genes load the gun, but environment pulls the trigger. ³Like

> cancer,

> autism is a very complex disease,² says Craig Newschaffer; chairman of

> Epidemiology and Biostatistics at the Drexel University School of

> Public

> Health, ³and it¹s exciting to start asking questions about the

> interaction

> between genes and environment. There¹s really a very rich array of

> potential

> exposure variables.²

>

> In one way, the field seems like a free-for-all, staggeringly

> disordered because it is littered with so many possibilities. But

> one can

> distill a few revolutionary insights. First, autism may not be rigidly

> determined but instead may be related to common gene variants, called

> polymorphisms, that may be derailed by environmental triggers. Second,

> affected genes may disturb fundamental pathways in the body and

> lead to

> chronic inflammation across the brain, immune system, and digestive

> system.

> Third, inflammation is treatable.

>

> ³In spite of so many years of assumptions that a brain disorder like

> this is not treatable, we¹re helping kids get better. So it can¹t

> just be

> genetic, prenatal, hardwired, and hopeless,² says Harvard pediatric

> neurologist Martha Herbert, author of a 14,OOO-word paper in the

> journal

> Clinical Neuropsychiatry that reconceptualizes the universe of autism,

> pulling the brain down from its privileged perch as an organ

> isolated from

> the rest of the body. Herbert is well suited to this task, a synthetic

> thinker who wrote her dissertation on the developmental

> psychologist Jean

> Piaget and who then went to medical school late, in her early

> thirties.

>

> ³I no longer see autism as a disorder of the brain but as a disorder

> that affects the brain,² Herbert says. ³It also affects the immune

> system

> and the gut. One very striking piece of evidence many of us have

> noticed is

> that when autistic children go in for certain diagnostic tests and

> are told

> not to eat or drink anything ahead of time, parents often report their

> child¹s symptoms improve-until they start eating again after the

> procedure.

> If symptoms can improve in such a short time frame simply by avoiding

> exposure to foods, then we¹re looking at some kind of chemically

> driven

> Œsoftware¹--perhaps immune system signals-that can change fast.

> This means

> that at least some of autism probably comes from a kind of metabolic

> encephalopathy-a system wide process that affects the brain, just like

> cirrhosis of the liver affects the brain.²

>

> In 1943 s Hopkins University psychiatrist Leo Kanner first

> described autism as a now-famous collection of symptoms: poor social

> engagement, limited verbal and nonverbal communication, and repetitive

> behaviors. Back then, autism was considered rare; Kanner first

> reported on

> just 11 patients, and s Hopkins still has records of about 150

> patients

> he examined in total. Even within this small group of patients,

> other, less

> visible symptoms were evident. In his 1943 paper, ³Autistic

> Disturbances of

> Affective Contact,² Kanner noted immune and digestive problems but

> did not

> include them in the diagnosis. One reads with a shiver sentences

> lifted out

> of various case histories: ³large and ragged tonsils. . . she was

> tube-fed

> five times daily. . . he vomited all food from birth through the third

> month. . . he suffered from repeated colds and otitis media. . . .²

>

> Herbert believes that the clues linking the obvious behavioral

> symptoms to more basic, but less obvious, biological dysfunction

> were missed

> early on. ³What I believe is happening is that genes and environment

> interact, either in a fetus or young child, changing cellular function

> allover the body, which then affects tissue and metabolism in many

> vulnerable organs. And it¹s the interaction of this collection of

> troubles

> that leads to altered sensory processing and impaired coordination

> in the

> brain. A brain with these kinds of problems produces the abnormal

> behaviors

> that we call autism.²

>

> Herbert¹s full-body perspective helps make sense of the contusion

> surrounding the diagnosis of autism and helps justify the increasingly

> common use of the plural ³autisms² to describe the wide variations

> in this

> disorder. As Newschaffer points out, ³Children with Asperger¹s

> syndrome

> certainly share a lot of the behaviors of those with more severe

> autism. But

> is it the same disease, and is it caused by the same thing? A

> number of

> significant features of autism are not part of the diagnostic

> schema right

> now, but eventually, those features may end up distinguishing one

> causal

> pathway from another. How is a child sleeping? Does he or she have

> gastrointestinal symptoms? By looking at those things we may see

> risk-factor

> associations pop out that we¹ve never seen before.²

>

> Herbert likens autism to a hologram: ³Everything that fascinates me is

> in it. It¹s got epidemiology, toxicology, philosophy of science,

> biochemistry, genetics, systems theory, the collapse of the medical

> system,

> and the failure of managed care. Each child that walks through my

> door is a

> challenge to everything I ever knew, and each child forces me to think

> outside the box and between categories.²

>

> Each child¹s path to autism may be distinct, she says, but they may

> share common inflammatory abnormalities. She has shown through

> morphometric

> brain imaging that white matter--which carries impulses between

> neurons--is

> larger in children with autism.

>

> ³It was the most absolutely outstanding piece of information in all

> the brain data looked at,² Herbert recalls of the years 2001 and

> 2002, when

> she was analyzing this brain imaging data. ³People were saying,

> don¹t look

> at the white matter, look at the cerebral cortex, but I knew we had an

> important finding.²

>

> Could white matter become chronically inflamed? It may well be,

> according to new research from Pardo, a neurologist at s

> Hopkins.

> In a 2005 study in the ls of Neurology, he found inflammation in

> immune-responsive brain cells of autistic patients. ³Patients with

> autism

> report lots of immunological problems. We looked for the

> fingerprints of

> those problems in the brain,² says Pardo. ³We had brain tissue from

> autistic

> individuals as young as 5 and as old as 45 and we found neuroglial

> inflammation in all of them. Neuroglia are a group of brain cells

> that are

> iljPOl1ant in the brain¹s immune response. This inflammatory reaction

> appears to happen both early and late in the course of the

> disorder. If it

> happens early, it could dramatically influence brain development.

> We¹re

> very excited about this research because one potential treatment

> approach,

> then, is to downregulate the brain¹s immune response.² To study that

> approach, Pardo is collaborating on a pilot study funded by the NIH

> to test

> minocycline, an anti-inflammatory antibiotic drug, on autistic

> children.

> ³Minocycline is a very selective downregulator of microglial

> inflammation,²

> he says. ³Neurologists already use it in multiple sclerosis and

> Parkinson¹s.²

>

> ³What we¹ve got here is a far more comprehensive set of

> characteristics for autism,² says Herbert, ³one that can include

> behavior,

> cognition, sensorimotor, gut, immune, brain, and endocrine

> abnormalities.

> These are ongoing problems, and they¹re not confined just to the

> brain. I

> can¹t think of it as a coincidence anymore that so many autistic

> kids have a

> history of food and airborne allergies, or 20 or 30 ear infections, or

> eczema, or chronic diarrhea.²

>

> All this marks a Copernican-scale shift in our approach to the

> disorder. I myself was irresistibly drawn to the subject when

> viewing an

> online video of a heavily affected 11-year-old who, after a series of

> chelation treatments to remove mercury, announced to his mother,

> ³Mom, I¹m

> back from the living dead.² The statement was heart-breaking in its

> simple

> eloquence. Mercury chelation, in this particular child¹s case, was

> a near

> panacea.

>

> Beck, of Oviedo, Florida, tells a similar story. Her son

> was diagnosed with autism in 2004 at about age 2. After 18

> intensive months

> of treatment that involved chelation--a treatment that draws heavy

> metals

> out of the body--and dietary changes, among other therapies, Josh

> appears

> neurotypical. ³We took him to Dr. Gavin, a specialist at

> Nemours

> Children¹s Clinic, who administers the ADOS test, a diagnostic test

> to see

> where on the spectrum a child falls,² she says. ³After the two-hour

> evaluation, Gavin said he did not see the criteria for autism. In

> her words.

> he was Œresponsive, curious, and active, able to engage in the test

> without a problem, able to express himself clearly.¹²

>

> But fascinating anecdotes aside, does hard evidence exist of specific

> vulnerability genes or how they might impair the immune system,

> brain, and

> gut--and most important, do we have any rational, reliable

> approached to

> help

> repair the damage?

>

> The answer is a provisional yes.

>

> ³We¹re beginning to understand that genetics is really about

> vulnerability,² says neuroscientist Pal Levin, director of the

> Vanderbilt

> Kennedy Center for Research on Human Development. Levitt and his

> colleagues

> recently discovered that a common variant of a gene called MET

> doubles the

> risk of autism. The finding was widely regarded as a breakthrough

> because

> MET modulates the nervous system, gut, and immune system-just the

> kind of

> finding that matches up with the emerging new view of autism.

>

> ³Everyone was focusing on genes expressed in the brain,² says Levitt,

> ³but this gene is important for repair of the intestine and immune

> function. And that¹s really intriguing because a subset of autistic

> children have digestive and immune problems.² Equally interesting

> is that

> the gene variant occurs in 47 percent of the population--in other

> words. it

> is just one contributing factor, and it probably works in concert with

> other vulnerability genes. And finally, in a twist that intrigues

> other

> researchers, the activity of the gene is affected by what is known as

> oxidative stress--the kind of damage one sees with excessive

> exposure to

> toxins. ³As we identify other vulnerability genes like this,² says

> Levitt,

> who hopes to engineer a mouse model of this gene variant for study,

> ³we may

> be able to develop effective interventions for children.²

>

> In other provocative research, Jill , director of the Autism

> Metabolic Genomics Laboratory at the Arkansas Children¹s Hospital

> Research

> Institute (and professor of pediatrics at the University of

> Arkansas for

> Medical Sciences) has found that many children with autism do not

> make as

> much of a compound called glutathione as neurotypical children do.

> Glutathione is the cell¹s most abundant antioxidant, and it is

> crucial for

> removing toxins. If cells lack sufficient antioxidants, they

> experience

> oxidative stress, which is often found with chronic inflammation.

>

> In her most recent study, published in the American Journal of Medical

> Genetics in 2006, found that common gene variants that

> support the

> glutathione pathway may be associated with autism risk.

> Intriguingly, this

> pathway is linked metabolically to the methylation pathway.

> Methylation is a

> fundamental biochemical process that helps regulate which genes are

> expressed; abnormal methylation can cause disease. Because the pathway

> provides the precursors to glutathione, impairments in methylation

> can also

> called oxidative stress. ³It¹s very provocative,² says. ³It

> suggests

> that some autistic behaviors are a neurologic manifestation of a

> genetically based systemic, metabolic derangement.² Some of the

> abnormalities saw in this study have already been associated

> with

> gastrointestinal and immunologic dysfunction.

>

> The good news is that oxidative stress in some autistic children may

> be treatable with targeted nutritional intervention. and her

> colleagues have tracked eight autistic children who were taking

> supplements

> of key nutrients in the methylation pathway--folinic acid,

> trimethylglycine,

> and methyl-B12--and found a significant increase in important

> markers of

> methylation and glutathione synthesis. The next step is to see if the

> symptoms improve as well.

>

> and her colleagues just received a $2.4 million grant from the

> NIH. Part of which will be the sorting out the relationship between

> metabolism, genes, and behavior. ³What would be incredible is if we

> could

> correlate individual differences in behavior with specific abnormal

> metabolites,² says. They will then look at children between

> 18 to 24

> months old, which is usually before autism is diagnosed. That could

> help

> identify the causes of the disease, as well as permit earlier

> intervention.

>

> ³We also plan to look at mitochondrial dysfunction,² she says. ³Since

> mitochondria are the energy powerhouses of the cell, they¹re also

> the place

> where the most free radicals (which playa role in oxidative stress)

> are

> produced. If the electron transport chain in the mitochondria is

> faulty and

> you¹re not efficiently making ATP, you¹ll produce more free

> radicals and

> deplete your glutathione. If this hypothesis turns out to be

> correct, we can

> give nutrients like coenzyme Q10, magnesium, and acetyI-L-carnitine

> to help

> stabilize the mitochondria. Now, this is just a hypothesis, but

> that¹s the

> risk you take with science. You make your best guess and you carry

> out your

> study and you see.²

>

> ³It¹s interesting to see metabolic abnormalities addressed this way,²

> says Isaac Pessah, chairman of Molecular Biosciences and director

> of Center

> for Disease Prevention at the University of California at . ³I

> think

> glutathione balance in the kids is potentially very important in

> terms of

> toxic environmental exposures.²

>

> There is a growing sense, Pessah adds, that our heavily

> industrialized, chemical-soaked environment--and the way it acts on

> vulnerable genes in some individuals-may be a major culprit. In

> December

> 2006, Harvard researchers boldly announced in The Lancet that

> industrial

> chemicals may be impairing the brain development of children around

> the

> entire world. And at a November 2006 conference at the University of

> California at ¹s M.I.N.D. Institute, Pessah gathered experts

> to discuss

> the clinical implications of environmental toxicology in autism. Says

> Herbert, ŒWe discussed the enormous number of chemicals in our

> environment

> and how little we know about chronic, low-dose, multiple exposures and

> their effect on diseases like autism. Maybe the many autism cases

> we are now

> seeing are a new illness of the current generation.²

>

> Several large-scale, federally funded epidemiological studies are

> under way to pinpoint possible environmental triggers, as well as

> early

> biomarkers of autism. ŒWe have to build a large enough study to be

> able to

> look at both genes and environment together,² says Newschaffer, who

> is a

> principal investigator on a study by the Centers for Disease

> Control that

> will look at 2,700 children over the next five years.

>

> In another ambitious study, called the Autism Birth Cohort, Columbia

> University and the Norwegian Institute of Public Health will follow

> 100,000

> pregnant women for 72 months, studying their health and genetics

> and testing

> everything from blood to urine samples. The hope is to discover

> environmental factors that contribute to autism risk, from diet or

> infection

> to toxins like heavy metals, pesticides, and the countless synthetic

> molecules in products today.

>

> Other large, NIH- and EPA-funded studies are teasing out immune

> abnormalities that may contribute to autism. In research on more

> than 700

> families with an autistic as well as a neurotypical child, Pessah

> and his

> colleagues have found in the autistic child a significant reduction in

> immunoglobulins and an abnormal profile of cytokines, which are

> critical to

> immune response. ³The immune system is involved in important

> aspects of

> neurodevelopment,² says Pessah. ³We¹ve found the presence of immune

> antibodies that we think may influence brain proteins. In the next

> five

> years, as the study continues, we hope to reach about 1,600

> families total.

> We need that many to get real statistical power. We hope to find

> out what

> type of skewed immune response the typical autistic child has and

> to isolate

> toxic exposures, such as proximity to highways or toxic waste dumps.²

>

> Herbert argues that ³we can address the disturbed pathways now, before

> me gene hunters have definitive information. Genes, after all, don¹t

> specify behaviors. They make regulatory factors that interact in

> highly

> complex ways. And as far as the impact of chemicals on

> neurodevelopment,

> only about 20 to 30 of the 85,000 chemicals made have been studied.

> We can,

> at the very least, try to modulate autism by treating the tissue

> inflammation.²

>

> In other words, treat now, before the gavel of science strikes a final

> judgment, which might be decades away. That¹s what and her

> husband,

> , did for n and : They blended mainstream

> treatments like

> speech and occupational therapy with the best biomedical approaches

> available. I was told to take my boys home and love them,² recalls

> .

> ³The neurologist said don¹t waste your time on alternative treatments,

> nothing about them is proven. My boys could have ended up

> institutionalized,

> or my husband and I would have had to take care of them their whole

> adult

> lives. When your child gets a diagnosis of autism, you lose the

> child you

> were dreaming about, the one who will go to college, get married,

> become a

> parent. That just wasn¹t an option.²

>

> The boys first saw an alternative Colorado practitioner who had been

> trained by group called Defeat Autism Now! (DAN!). DAN! was co-

> founded in

> 1995 by the psychologist Bernard Rimland, whose own son was

> autistic. DAN!

> treatments focus on intestinal issues, detoxification, nutrition, and

> neuroinflammation. Recommendations include dietary restriction,

> usually

> eliminating gluten (present in wheat and other grains) and dairy.

>

> ³For weeks after stopped drinking milk, he had welts allover his

> body,² recalls, ³as if he were going through a detoxification

> reaction.

> At the same time, he had his first formed, regular bowel movement.

> His sleep

> improved.²

>

> Other DAN!-recommended treatments include detoxification to remove

> heavy metals and other suspected pollutants, nutritional

> supplementation,

> and sometimes off-label use of anti-inflammatories, antivirals, and

> allergy

> medications. These so-called biomedical treatments range from

> relatively

> inexpensive dietary changes costing a few hundred dollars a month

> to doses

> of antifungal drugs that can cost several hundreds of dollars. Many

> DAN!

> supplements play critical roles in the pathways studied by

> scientists like

> Jill . DAN! practitioners are, of course, leaping into the

> deep end of

> the pool before science has truly proved these treatments

> effective, but

> there are many anecdotal cases of improvement.

>

> Not surprisingly, there has been criticism of the biomedical

> approach, especially when doctors promise too much or parents hope too

> desperately for recovery. As notes, one mother killed herself

> after

> seeking every possible treatment for her autistic daughter to no

> avail,

> causing a furor among parents with autistic children.

>

> Some children just do not get better, no matter what the

> intervention. Mumper is CEO of a group called Advocates for

> Children and former director of pediatric education at the

> Lynchburg Family

> Practice Program affiliated with the University of Virginia. Of the

> 2,000

> children in her practice, about 400 have autism spectrum disorders.

> She

> describes one boy whom ³I have not helped despite my best efforts.

> He is 17

> and still nonverbal and has horrible, erosive esophagitis in spite

> of the

> fact that he works very closely with a gastroenterologist. He has

> to sleep

> standing up and leaning over his dresser because of the pain, and

> he has

> very idiosyncratic reactions to medications. And even though he is

> nonverbal, he can type anything to me. He¹s alpha-smart. The horror

> is that

> he¹s trapped in a body that doesn¹t work.²

>

> ³I hate the term Œfull recovery,¹² adds, ³because of this false

> hope. Some children do lose the diagnosis, but that¹s rare. I don¹t

> think

> that should be out there as a goal. We need to accept (the kids)

> and love

> them for who they are--because they are lovable. They¹re quirky.²

>

> ¹s boys benefited from their DAN! doctor, she says, but it was in

> 2003, when she switched to a highly unconventional molecular

> biologist and

> naturopath based in Maine, Amy Yasko, that she began to see more

> striking

> changes. Yasko blends the new findings on methylation with a

> scientist¹s

> background in the finer steps of fundamental detoxification

> pathways in the

> body. However, she largely favors herbs, dietary change, and

> nutritional

> supplements over prescription medications. She monitors biomarkers of

> detoxification in the urine as often as every week or two and tweaks

> supplements accordingly. Her program is intensive and steeped in

> molecular

> biology; her twice-yearly conferences are extremely dense,

> scientific, and

> intended to help parents become at least semiproficient in the

> biology and

> chemistry themselves. It is a far cry from the old doctor-patient

> model--

> Yasko works primarily on the internet now -- with phone

> consultations, to

> interpret test results. She decided to do this when her waiting

> list for

> individuals stretched to five years, and, she says, she felt she

> was not

> helping enough children. e-mailed me about 40 charts of metal

> ³dumps²

> for both of her boys--urinalyses Yasko had ordered and charted on a

> graph to

> show the excretion of everything from arsenic to aluminum, mercury,

> and lead

> over time. ³All these little things started clicking after we

> started with

> her,² says .

>

> ³I call this approach biomolecular nutrigenomics, after Bruce Ames, a

> professor of biochemistry and molecular biology at the University of

> California at Berkeley,² says Yasko. ³He said that someday it would

> become

> routine to screen individuals for polymorphisms and that nutritional

> interventions to improve health were likely be a major benefit of the

> genomics area.² Yasko tests for common polymorphisms in the

> methylation

> pathway, even though these findings are still preliminary. This has

> made

> her controversial among her peers. Yet several doctors and

> scientists with

> autistic children admitted privately to using Yasko¹s services

> while being

> unwilling to go on the record to support her.

>

> Yasko, who says she moved her husband and three daughters from

> Connecticut to a rural area of Maine to ³hear the snowflakes fall

> on the

> snow and get to that quiet place inside where I can think,² seems

> immune to

> the controversy. ³I was in a research environment for a long time,

> where

> you had to publish. Then I was in biotech for a long time, where

> you had to

> keep everything quiet. When I began to focus on autistic children,

> I made a

> decision that instead of publishing in peer review journals, I was

> going to

> go directly to the moms and help them. I knew in making that

> decision I was

> going to get flak. That¹s OK. It was like I was on those cliffs you

> see in

> the movies, and you¹re going to jump. You don¹t know if there¹s

> water below,

> or enough momentum to get to the other side, but you just jump.²

>

> Today ¹s boys participate in individualized programs at school

> and are being monitored in two national studies of families with

> more than

> one autistic child-one at the Duke Center for Human Genetics,

> another at

> the University of Washington. has, in addition, been tested

> three times

> at the University of Colorado Health Sciences Center¹s toddler

> development

> program. Both are still on the autism spectrum--but the incessant

> tantrums,

> digestive problems, and infections have vanished. n no longer

> chews on

> his shirt, flaps his arms, and grinds his teeth. In fact, he made

> honor roll

> in his classes last year. Swift, the boys¹ schoolteacher

> since the

> autumn of 1996, describes them as ³sociable and on the whole very

> happy,

> with a great sense of humor. is probably the most changed of any

> autistic child I¹ve ever worked with.²

>

> , who stopped speaking entirely at age 2, is now a font of

> creative language. I know this because and the boys spent a

> weekend at

> my house. At lunch, poured a Vesuvius of ketchup onto his

> plate and

> began transforming his french fries into boats that sailed across the

> ketchup before they were disposed of in his mouth; he then began to

> entertain us by pretending he was an announcer at a regatta, where

> he, of

> course, was winning the race. What had once been autism had erupted

> into a

> geyser of quirky creativity.

>

> The boys¹ blossoming, according to their mom, is one not easily

> measured on tests. ³It¹s the length of their sentences, their

> empathy and

> sense of humor. Last night we went by a house that was all lit up

> for the

> holidays and joked, ŒDoes that guy want to be seen from space?

> ¹ When we

> used to take to the dentist, he would scream bloody murder and

> we¹d

> try to papoose him-put him on a board and wrap him in sheets, but

> even that

> didn¹t work. so they put him to sleep just to clean his teeth. Last

> year we

> went to the dentist. and he heard a little boy crying, walked over

> to him,

> rubbed his back, told him it wouldn¹t hurt, and not to worry. My

> heart was

> melting.²

>

> Can we cajole a mysteriously shuttered brain and body back toward

> normal? And if so, will autism give us new insight into other

> disorders?

> Martha Herbert thinks so: ³A lot of these metabolic pathways are

> pretty

> fundamental to life. If we can crack the puzzle of autism and be clear

> about how we did it, that may have huge implications for other chronic

> environmentally triggered systemic illnesses. Autism could be a

> much-needed

> wake-up call to us all.²

>

>

>

>

>