Health experts tackle escalating incidents of developmental disorders

Unraveling autism
Health experts tackle escalating incidents of developmental disorders

By Nancy Devine
November 20, 2000
Photo: M.I.N.D. Institute, UC Davis

Developmental pediatrician Robin Hansen, MD, works with a young patient at the M.I.N.D. Institute at UC Davis. Scientists are trying to pinpoint a cause and relieve symptoms for autistic children who have become isolated and unable to respond to others.


	You've read the article. Now tell us what you think. Related sites Autism Society of America Yale Child Study Center Center for the Study of Autism Understanding Autism: A Guide for Nurses Autisminfo.com Autism Resources The mercury-autism connection After giving birth to her son, Lyn Redwood, MSN,FNP, of Tyrone, Ga., and her physician-husband tracked his development up to 15 months. After a series of vaccines, the boy started to regress, so Redwood had him tested. The diagnosis: severe developmental delay. Redwood began to investigate the vaccines that preceded the diagnosis and found that all contained thimerosal, a preservative containing 49.6 percent ethylmercury by weight. By examining her son’s records, she found that he had received 237.5 micrograms of ethylmercury in the first 18 months of life. "I sent a piece of my son’s baby hair for mercury testing and it came back with a report stating it contained 4.8 parts of mercury per million," Redwood said. "That’s five times the allowable level for mercury. Research studies of children in the Faroe Islands whose mothers were eating mercury-contaminated seafood during pregnancy reported blood levels of 15 to 30 micrograms at birth, resulting in developmental delay. So I started looking at all the diagnostic markers for autism and found all those diagnostic markers to mercury. Looking back at it now, my son’s symptoms for mercury poisoning were classic. My husband’s a physician and he didn’t see it, and I’m a nurse practitioner, but I had never seen a child with mercury poisoning." Thimerosal – scientifically associated with a number of neurological disorders including autism, attention deficit disorder, speech delays and tics – was originally determined to be dangerous and was recommended to be withdrawn from nonprescription products by FDA experts in 1982, Redwood said. Some manufacturers dropped it; others didn’t. In 1998, thimerosal was banned for use in over-the-counter products by the FDA, yet it continues to be used in some pediatric vaccines. Redwood and the Coalition for Safe Minds filed a petition Oct. 24 in Washington’s federal district court to obtain an immediate recall of all pediatric vaccines containing thimerosal or other toxic mercury compounds. She has written several research papers on mercury toxicity, and the Washington Post published a column by Marguerite Kelly on Nov. 1 that discussed the need for mercury-free vaccines. ~ Nancy Devine

Imagine living in a world where fluorescent lights scream like chainsaws, sunlight pierces like a laser and visual images shatter into fragments. More than half a million Americans live in some variation of that red-alert, anxiety-filled world – those individuals diagnosed with autism or some form of pervasive developmental disorder (PDD) that usually appears during the first three years of life.

Autism is a complex developmental disability that affects normal brain development, according to the Autism Society of America. Several related disorders are grouped together under PDD, all characterized by severe and pervasive impairment in social interaction and communication skills.

The disability, which may be mild or severe, is four times more prevalent in boys, and about 75 percent of affected individuals test in the range of mental retardation. Those who test above normal I.Q. are called "high functioning" and may hold jobs.

No cause, no cure
The prevalence rate for autism, estimated by the CDC to affect one in 500 individuals, has escalated at an alarming rate in certain regions, where increases of up to one in 150 individuals have been reported.

Health experts have responded with more studies and treatments for a disorder with no proven cause or cure, even as existing services for developmentally disabled patients are overwhelmed. Scientists and parents are pursuing every possible connection or treatment that could pinpoint a cause or relieve painful symptoms for children who have become profoundly isolated and unable to respond to others.

"We have several medical intervention studies, one of which is a double-blind placebo control study of children within the PDD spectrum taking risperidone, which is approved for adults for problems such as inattention, anxiety, obsessive-compulsive behavior or aggressive and self-injurious behavior," said Kathy Koenig, MSN, an associate research scientist at Yale Child Study Center in New Haven, Conn.

"We also have social skills intervention studies because early training can help these children, and one new study is on explicit explanations of eye contact skills, turn-taking in conversation and others. Any improvement is progress."

Autism is treated with speech/language therapy, physical therapy, sensory integration, occupational therapy, applied behavior analysis, medications and dietary interventions, but more research is needed to determine the most effective treatments for each disability. Early diagnosis and intervention are crucial.

Researching a reason
Many experts are looking for possible biomarkers in blood or genes that could indicate a child’s predisposition to autism, while others are examining levels of medications or chemicals that may be involved in triggering the disability to cause the increase in prevalence.

"Very often, autism develops after a series of vaccines, or maternal measles, or a series of antibiotics for infections – these things tend to precede the diagnosis," said Sharla Perel, MS, OT, who has worked with autistic children at P.S. 77 in Borough Park, N.Y., for 10 years. "There’s enough evidence for correlation that one has to look at these things."

One team developed the Defeat Autism Now protocol, a guide for parents and practitioners to reduce food allergies, mineral deficiencies, yeast overgrowth and medication toxicities that, when eliminated, have helped autistic individuals progress, according to Maureen McDonnell, RN, owner and director of Health Education Services in Pennington, N.J.

Another group has identified a preservative in some pediatric vaccines, thimerosal, as a trigger for autism. Thimerosal contains 49.6 percent mercury by weight and has been scientifically associated with a number of neurological disorders including autism, attention deficit disorder, speech delays and tics, said Lyn Redwood, MSN, FNP, president of the Coalition for Safe Minds in Tyrone, Ga.

"We feel strongly this epidemic has been the result of mercury exposure," Redwood said.

In 1998, parents and physicians launched the Medical Investigation of Neurodevelopmental Disorders Institute in Davis because they believed a possible link existed between environmental contributions and neurodevelopmental disorders. The institute received $34 million from the state of California in June to pursue 19 studies, which now are under way.

"Estimates from the NIH show that 17 percent to 29 percent of all American children have neurodevelopmental disorders," said David Amaral, Ph.D., professor at the UC Davis department of psychiatry.

"I’m a neuroscientist, not an immunologist, and it might be environmental exposure or some change in pediatric care policy, but we’re facing an incredible lack of knowledge.

"It’s a win-win to conduct the vaccine study in a neutral way. If investigations show a clear link between vaccines and autism, then we could prevent future cases," said Amaral, who is also the institute’s research director. "If, conversely, we can’t demonstrate a link, that would be reassuring to parents."

Meanwhile, autistic children can greatly benefit from applied behavior analysis at schools like the ABC School in Sacramento.

"We use a set of principles to reinforce specific behaviors," said Michelle Williams-Wenell, ABC school public relations and development specialist. "Our data shows that 40 percent of the kids who come here before the age of 4 years and 1 month have gone on to full-inclusion settings."