If you bring your young child to a doctor’s office because he lacks social skills, doesn’t make good eye contact and talks very little or has unusual speech patterns, he will undoubtedly be diagnosed as “autistic.” You are also likely to be told nothing can be done. That is tragic because, these vague symptoms can be presentations of many conditions, some of which are treatable. These symptoms weren’t even the most important clinical features emphasized by Leo Kanner when he proposed this diagnosis in 1943, so why have they become the new norm?
Kanner’s diagnosis was based on examining eleven children, many of whom had a parent who was a psychiatrist, and therefore more likely than most parents to notice behavioral oddities. His patients included eight boys and three girls, a different ratio from the fairly consistent report of four boys for every girl seen now.
Only three were mute. Many of these children showed improvement in their speech and behavior over time… without any of the treatments offered today. If they had gastrointestinal issues they were relatively brief, and consisted primarily of intolerance to infant formulas and vomiting the first year. That is a very different clinical picture from the chronic issues with food and the gut seen today.
The current “epidemic of autism” is not primarily composed of children similar to those seen by Kanner. They are still relatively rare compared to the current ones, who are being diagnosed with today’s “autism”at a rate of one in fifty children. This is because “autism” is being diagnosed when children actually have neuro-immunological, and/or sensory-motor integration disorders. These also render children less socially engaged, but for entirely different reasons than the disinterest in people described by Kanner.
How social do you feel when you have the flu and a headache? How would you act if you had no depth perception and couldn’t predict the visual world around you, especially when it moves? Unfortunately, children diagnosed with autism are usually treated as though they all have the same disorder. This attitude not only keeps them from getting the right treatment, it lies at the heart of the current vaccine controversy: the most critical health issue today.
Face One: The “little professors,” autism as a genetic neurodevelopmental disorder
Kanner chose to call the children “autistic” because they were “very self-sufficient” and “happiest when left alone.” They had no tolerance for deviations of any kind in even the simplest mundane details of life. They demanded that phrases be repeated exactly the same way, and that actions always be performed in the same sequence.
All of those who spoke had perfect enunciation. One of their most striking features was their high intelligence, and fascination with trivia.
“Almost all of the parents reported, usually with much pride, that the children had learned at an early age to repeat an inordinate number of nursery rhymes, prayers, lists of animals, the roster of presidents, the alphabet forward and backward, even foreign language lullabies.”
Each of these children engaged in a speech pattern peculiar to autism, but absent in many of the children diagnosed as autistic today: the reversal of personal pronouns. They said “you” instead of “I” when referring to themselves. This is because people referred to them as “you” when speaking to them directly. Until this quirky cognitive error was recognized, it created confusion. One mother thought her child was tormenting her when he said, “You soiled your pants.” He was actually fessing up after he had an accident, and she found the evidence.
Many of Kanner’s children had high IQs, but were initially thought to be mentally retarded. They all came from very intelligent and accomplished parents, who often had obsessive personalities. Kanner also saw little display of affection among family members. He wrote:
“For the most part, the parents, grandparents, and collaterals are persons strongly preoccupied with the abstractions of a scientific, literary, or artistic nature, and limited in genuine interest in people. Even some of the happiest marriages are rather cold and informal affairs.”
This observation during an era of psychoanalysis led to the harmful concept that cold-hearted or “refrigerator” mothers caused their children’s autism. Fortunately, psychological explanations for autism have been abandoned. Instead, science has turned to genetics.
Some genetic cases of autism are probably the result of “assortative mating,” which is the technical term for people with similar genetics and traits being attracted to each other, such as two introverted engineers. When “like marries like,” it increases their chance of having a child who is a more extreme version of themselves.
One of the seminal papers leading to a genetic model for autism was based on research by my former colleagues, Susan Folstein and Sir Michael Rutter. They discovered that identical twins are more likely than fraternal twins to both have autism, if one of them does. That is a strong indicator for autism having a genetic component, but the twin study was published in 1977, before other causes started having an increasing impact.
We only have 19,000 genes in our genome, and over 1200 of them have been associated with autism. That alone should have us suspicious about the role of genetics as a primary factor in causing this increase. So should another study that looked at siblings with autism. Researchers were shocked that 70% did not have the same genetic mutation. Obviously, something else is going on, but initial impressions die hard.
Many of the 1200 genes being identified actually have to do with susceptibility to the other causes, and not the original autism cases. One brain area affected in autism is the six-layered cortex, which is associated with higher thought. The cortex consists of an orderly array of minicolumns, the brain’s basic micro-processing units.
The earliest autopsies of autistic people dying from unrelated causes revealed that they had more densely packed minicolumns. Initially scientists found minicolumns that were wider than those of typical brains. However, subsequent research found that they become narrower over time, but are still densely packed. Either way, they are less “discrete” from each other, which creates “cortical noise.”
Research shows that their minicolumns lack the interneurons normally found around their periphery. This is also responsible for their symptoms. Interneurons are inhibitory, and use GABA as their neurotransmitter. They provide the brakes to prevent runaway activity in the cortex. Seizures, migraines, and savant skills are features in many children with autism, and these could be the results of missing or dysfunctional interneurons.
This minicolumn pathology probably does not stem from problems in the production of brain cells, which occurs between gestational days 42 and 108. I suspect the developmental glitch occurs during the next phase: migration.
Our cortex is the outermost brain area closest to our skulls, but all of its neurons are created deep inside the brain. This means they must migrate long distances to get to their final destination. That makes them more susceptible than other brain cells to ending up in the wrong place.
Additionally, most cortical neurons migrate radially, in a vertical direction from their point of origin, using scaffolding created by local glial cells as their guide. Interneurons, on the other hand, rely upon an entirely different method of migration. They arrive at their places in minicolumns by moving tangentially, using chemical markers as signaling pathways to find their way. Obviously, there are many possible ways for things to go wrong with this migration.
The type of neurodevelopmental scenario just outlined is what many scientists think of as autism, which is why they insist vaccines can’t be causing it. They are right. However, I believe this represents only a minority of the cases of “autism” being diagnosed today.
Face Two: “Lost in space,” autism as a sensory processing disorder
One consequence of having more densely packed minicolumns and reduced interneurons is disruption in sensory processing. As a result, many of the children have great difficulty navigating in space. Some don’t know where their bodies begin and end, and appear clumsy, or rock to orient themselves. This can be a result of problems within their somatosensory and/or parietal cortex, but other brain areas might be involved as well.
However, not all of the problems we attribute to the brain arise in the brain. When a child has problems with a sensory organ, such as their eyes, leaving this uncorrected can alter their brain’s sensory cortex during critical stages of sensory development.
As humans are spending far more time looking at things that are close to us, rather than the horizon, it is having evolutionary consequences. Generations of reading, and living indoors, is changing our vision and making us more near-sighted, but that isn’t all.
At least one of Kanner’s children had sensory processing issues, describing his world as “flat.” This can be caused by the eyes not working together properly to see depth. Strabismus is the technical term for eyes that don’t track well. As many as 70% of children diagnosed as autistic have it, but many go undetected.
These children often touch things to locate their position in space. They may have double vision, and won’t look directly at you because it takes too much effort. Without binocular vision to determine depth when something is moving towards them, these children also withdraw socially. Perhaps this is why some autistic children prefer looking at pictures of people who can’t move over looking at people in real life. Visual therapy and/or corrective prismatic lenses can often make a huge difference.
Face Three: The “canary generation,” autism as an inflammatory reaction to an increasingly toxic and nutritionally depleted world
Most of Kanner’s children improved over time, learning how to use pronouns and behave appropriately in public. However, not all of the patients in his original case series were purely neuro-developmental. Two of the eleven, Elaine and Richard, might have developed symptoms primarily as the result of brain inflammation. I believe this is a confounding variable, and it lead to the incorrect idea that autism could appear more than a year after birth, even when a child had been developing normally up to that point.
Elaine stood up at seven months and walked at less than a year. She could say four words at the end of her first year. She then had an illness with a high fever at 13 months, and “her increasing
difficulties were interpreted as possible post-encephalitic behavior disorder,” the technical term for a disorder caused by brain inflammation.
Richard was vaccinated for smallpox at 12 months, after which he had a fever and diarrhea for close to a week. When assessed at age three years and three months, his mother noted, “I can’t be sure just when he stopped the imitation of word sounds. It seems that he has gone backward mentally gradually for the last two years.”
This timing coincides with the smallpox vaccine, which was not widely used at that time and was considered to be a miracle. Subsequent research showed that infants under the age of twelve months are particularly susceptible to adverse events with this particular vaccine. He might be the first vaccine injured child to have been mislabeled as autistic.
By far, the greatest increase in the autism syndrome appears to be from brain Inflammation, or encephalitis, which can arise from exposure to environmental chemicals, disruption in the gut biome,
infections, and iatrogenic (physician-induced) sources. Children who are nutritionally deficient are the most susceptible, but there are also genetic factors. Brain inflammation, or microglial activation, has been discussed in my previous blogs that you can read here and here.
Research at Johns Hopkins by Drs Vargas and Pardo, looking at spinal fluid for inflammatory markers and brain imaging, suggests this might be a sizable portion of the current group of children being diagnosed as autistic. Their results have been repeated in Japan. The scientists concluded:
“…the present PET measurements revealed marked activation of microglia in multiple brain regions of young adults with ASD (autism spectrum disorder). The results strongly support the contention that immune abnormalities contribute to the etiology of ASD.”
Most scientific research on autism proceeds as though all autism is the same. As a result, children are not getting their fundamental medical and educational needs met, and the controversy and confusion over the real causes of the exponential increase in the diagnosis of autism continues.
It has become so common for children to develop a high fever after vaccination that parental concerns are frequently dismissed when they call to report it to their doctors. Some of these children stop developing normally, and are subsequently diagnosed with autism. Their parents are certain that vaccines were responsible, but they are usually told this is impossible.
Whether vaccines could be doing more harm than good is one of the most controversial, and critical, questions today that demands resolution. Many nurses and doctors believe vaccines are safe, but others are very conflicted. A neonatal nurse whose Jewish ancestors escaped the holocaust poignantly expresses the ethical dilemma; She prays daily she won’t “go to Hell” for being required to vaccinate newborns.
Mothers whose friends have children with vaccine injuries are afraid to vaccinate their children. If they don’t, they and their children will likely become pariahs in their community. Many doctors and parents are afraid of the consequences of losing herd immunity because of those who choose not to vaccinate their children. The issue has become heated on both sides, but the debate is largely outside both science and the mainstream media.
This repeated denial of the mother’s version of events is creating a major distrust of the medical profession. The confusion is interfering with appropriate care. Some are in denial regarding the risks involved with vaccinations because of cognitive dissonance (the inability to reconcile two sets of information). Others have financial conflicts of interest, but even scientists and doctors without pharmaceutical ties insist that vaccines can’t be causing
autism; they are thinking of the original cases, which were predominantly genetic/neurodevelopmental.
Ironically, vaccination could have been muddying the clinical picture of autism from the very beginning. It is time to get clarity. We need to determine on a case-by-case basis which face of autism a child is presenting. We also need to step back and take a critical look at the role of vaccines in our children’s current health crisis and modify our protocols accordingly.