Clinic Notes: Successful Treatment of Autism Depends on Parental Involvement

Many studies have shown that early diagnosis and intensive therapy is the key to the successful treatment of autism. Multiple therapies including Applied Behavior Analysis (ABA), speech therapy, occupational therapy, and medication are essential. Parents must not only find a way to pay for these services, but get their children to therapy, which is usually weekly. (Unfortunately, money, or the lack of it, determines what services, if any, a child with autism will receive.) Only a small percentage of parents can afford, or find qualified therapists who will see their child more than once a week. Autism is epidemic and money speaks. Lovaas recommends 40 hours of ABA a week, but who can afford that or find a therapist who will give a single child an entire workweek. So the majority of the therapy--ABA, speech, ot, etc falls to the parent. It's a burden--but one that pays off in the long run.

Clinic Notes: Let's Just Bury our Heads in the Ground and Autism Will Go Away

Well here's a cheap and quick way to cure autism--just say it is not a medical disorder or disability but a "socially created disability," whatever that is. Apparently, that's what President Obama's nominee Ari Ne'eman to a national disability council is saying. Mr. Ne'emans, who has very mild Asperger's, is against investing money in anti-cure autism research. Well, that's going to thrill parents who bring their children with autism to my clinic. I glad that Mr. Ne'emans has overcome his disorder and is in a position to be nominated, but I don't think he would be any parent of a child with autism first choice. I doubt that he has seen children with autism banging their heads or biting themselves. Or children with autism who have developmental delays in all areas including language. I don't know how this was socially created. Perhaps the next time a mother brings her child with autism to my clinic complaining that throwing feces is a problem at home and school I will just say, "That's just a socially created disability."

Clinic Notes: Darwin and Autism

Autism is considered to be a genetic disorder by many and numerous researchers are looking for the "autism gene." The concordance rate for autism (the probability for getting autism) is 60% for identical twins, but drops to between 4-8% for fraternal twins and non-twin siblings. In most cases, the number of individuals with a genetic disorder remains constant in within a population unless an individual with the disorder breeds. In the past ten years there has been an explosion in the number of children diagnosed with autism. If autism is a genetic disorder, then why the dramatic increase? Is it evolving in the population? That would not make sense. Natural selection couldn't be operating here and mutations are unlikely with such an explosion of cases. I wonder if epigenetic markers could be a factor. Epigenetic markers sit on genes and tell them to switch on and off. Stress, diet, etc can cause epigenetic marks can switch genes on and off and affect what is passed on the offspring. So if this idea is correct, and I admit this is a long shot, what happened to the parents of the children with autism that perhaps affected the wiring of their brains? Please email me with your hypotheses.

Clinic Notes: Autism and Diet Redux

Okay another study, this one by Dr. Timothy Buie of Harvard Medical School, says that digestive problems are not more common in kids with autism and special diets do not work. Furthermore, there is no evidence of a "leaky gut" as reported by Andrew Wakefield who first suggested the link between autism and the mercury preservative in measles vaccine. The scientific evidence is overwhelming, but the myth persists. Many children who come to my clinic are on a gluten free diet, but I've never seen any improvement and I have seen very few children with autism who have digestive problems other than being finicky eaters. The special diets cause no harm, other than in some cases, depriving the child of therapies like ABA, which require more effort

Clinic Notes: Does Acetaminophen Cause Autism?

Many parents of children with autism blame the vaccinations that their children were given between 2 and 3, more specifically the Thirmosal preservative (Mercury) used in the vaccine, as the cause of their children's autism. The scientific data do not support this but the argument goes on. Now a new culprit related to the vaccine has been suggested. Acetaminophen, which physicians suggests be given to reduce the fever that can occur following the injection instead of aspirin, which can cause Reye's Syndrome. Well, the change from aspirin to acetaminophen does correlate with the increase in autism, but children are given acetaminophen to reduce fever whenever they are sick and they, along with most children who receive acetaminophen following the vaccines do not get autism. Statistically, anything that has increased along with the increase in autism will correlate. The increase in the use of cell phones would correlate with the increase in autism. But cell phones don't cause autism. Or do they?

Clinic Notes: Help Wanted. Need People with Autism

The children with autism that I see in my clinic are very young, usually between 2 and 6. Most of the older children that I see in my clinic have been coming for years. They all progress at different rates and I wonder about their future. Where will they work, where will they live, will they marry and have children? Well, a report this week gives me a clue into the work future for some of them. Several companies such as Wrigley have hired people with autism as computer systems developers because they are able to focus for long periods of time on detailed tasks that others would get bored. A company in Denmark and another in Chicago hire and train people who have high functioning autism as consultants on data entry and code checking and send them out to work in various industries. So it looks like there will be jobs for the children that I see in my clinic if I can get them to the point that they can manage their sensory problems, follow directions, and communicate.

Clinic Notes: Social Skills and Autism

Autism is primarily a communication disorder. Children with autism may lack functional language or may have language that is functional, except in social situations. For children with autism who lack language then ABA and therapy with a Speech Language Pathologist is essential. But what about the high functioning children with autism or Asperger's.. How do they develop social skills? First of all, they need to be in a classroom where there are other children at their level or above, or they need to be mainstreamed. Of course, just putting them in a regular classroom without social skills training and attention to situations where the stimulation is too great could be a disaster. A child with autism may do find socially in a quiet classroom and have a meltdown in a noisy lunchroom. Second, social skills can be taught using social stories and practicing social skills in a controlled environment where the sensory stimulation can be controlled, as well as potential bullying. This is a lot to ask of a teacher so extra staff need to be trained to work with these higher functioning children. Go to: http://www.washingtonpost.com/wp-dyn/content/article/2009/12/02/AR2009120202884.html?hpid=moreheadlines for an interesting account of how one school is accomplishing this.