By Dorsey Griffith http://www.sacbee.com/news/news/old/local02_19991021.html
Bee Medical Writer
(Published Oct. 21, 1999)
They are boys and girls who flip-flop for hours like fish out of water, or twist and turn a piece of string between their fingers in endless, silent fascination, or take food from the refrigerator and flush it down the toilet.
As frustrated parents cry out for help with their autistic children, researchers and doctors remain baffled about what causes the disorder, which by many accounts has turned into an epidemic.
"Autism is getting a lot of attention because of what looks like an increase of reported cases," said Dr. Tom Anders, acting director of UC Davis' Medical Investigation of Neurodevelopmental Disorders Institute. "We don't have any idea why. There are theories but no good research."
Backed by $1 million in state funds, the new MIND Institute is launching a study to find some answers as part of a many-faceted approach to better understand and treat autism, a disorder discovered in early childhood that leaves children asocial and often noncommunicative.
But first, researchers have to ask questions -- hundreds of them -- of the parents of some 1,500 autistic children in California selected randomly through a statewide program for children with developmental disabilities.
Questions such as:
Does the child or anyone in the family have allergies?
What vaccinations has the child and the mother had and when?
Where has the family lived over the past several years?
Does the child have chronic diarrhea or constipation? Epilepsy? Insomnia?
Researchers will compare the answers they get with another set of data from the parents of children who have never been diagnosed with autism. Preliminary findings should be available 12 to 18 months from now.
Chuck Gardner, whose 7-year-old son, Chas, is autistic, said much of what is known about the disorder comes from parents of autistic children comparing notes. Chas, for example, has severe gastrointestinal problems and trouble sleeping, in addition to the more common symptoms of autism.
"Nobody knows anything about it, but anecdotally parents all say the same things about their kids," he said.
While such an epidemiological study cannot define the cause of autism, it should give scientists some good clues, said Dr. Robert Byrd, the MIND Institute study's principal investigator.
"Epidemiological studies showed us that smoking is associated with cancer and heart disease," he said. Once a connection is established, scientists can try to offer reasons for the association and find a cure.
A state study conducted last year showed the incidence of autism has increased 273 percent since 1987, with a 16.3 percent increase during 1998 alone. Whether the surge is due to more frequent diagnosis of the disease, an onslaught of patients from other parts of the country, or environmental factors is not known.
There is a growing suspicion among many parents and some scientists that one or more childhood vaccines may be the culprit.
Rick Rollens is among them. Rollens, who helped found the MIND Institute, said his son, Russell, was developing normally until he was 7 months old.
But after getting his third DPT (diphtheria, tetanus and pertussis) and his first HIB (Haemophilus influenzae type B) vaccines, Russell, now 9, became chronically ill, developed a high fever and started crying and screaming uncontrollably.
"He was never the same," said Rollens. "Then he was diagnosed with autism at a little over 2 years old."
So far, there is no definitive data linking autism to vaccines. Noting that many autistic children also have severe gastrointestinal problems, a British scientist has hypothesized that the measles-mumps-rubella vaccine causes a persistent intestinal infection that alters digestion, producing opiate-like peptides (amino acid compounds) that can affect the brain and a child's behavior if leaked into the bloodstream.
"Over a long period, if you continue to dose the brain with an opiate," said UC Davis neuroscientist David G. Amaral, "it could change the structure and function of the brain and lead to autism."
Autism rates rising in California
Autism is a permanent mental disorder with unknown causes, usually discovered before age 3. Some children diagnosed with the disorder, which afflicts boys more often than girls, seem to develop normally at first then lose the skills they previously acquired.
Symptoms of autism include:
Asocial behavior (not reaching out to parents for comfort when hurt or tired, no interest in playing with peers)
Rejection, of parental or sibling affection, sometimes violently
Unwillingness to make eye contact
Delayed or failure to use speech to communicate
Unusual responses to sounds, touch and other sensations
Absence of emotional reaction
Self-injury through headbanging or biting
Engaging in repetitive obsessive or bizarre behavior
lack of fear of realistic dangers
Source: Johns Hopkins Family Health Book
While studying this potential effect in children would be difficult, Amaral is using monkeys to learn more with funds from the MIND Institute. UC Davis veterinarians have told him that a number of rhesus monkeys at the primate center have persistent gastrointestinal problems. What he wants to learn is whether the problems are similar to those of some autistic children.
If he finds a similarity, he will give the monkeys opiate-like peptides with radioactive tags that could be traced into the brain.
If the peptides penetrate the brain, it would support the vaccine theory, Amaral said.
Amaral cautioned that childhood vaccines should not be avoided at this point. "If you don't immunize, the potential for catastrophe is enormous," he said.
Amaral is also studying a remote part of the brain known as the amygdala, which is involved in regulating social behavior. He hopes to determine if the brains of autistic people show changes in the amygdala. Such findings could help future work on prevention and treatment of autism.
The MIND Institute, which at this point operates out of research labs and clinics on campus and at the medical center, also has funded research looking for links between brain disorders and a child's immune system.
Dr. Robin Hansen, a UC Davis pediatric specialist, will look at blood samples from 150 newborns later diagnosed with autism, cerebral palsy and mental retardation. She will compare them to samples from 50 children without the disorders, looking for prenatal infections, blood clotting problems or other abnormalities that may be associated with the disorders.
The research is needed to sort out the theories and offer autistic children and their parents hope, she said.
"Parents are so overloaded with information that is really unsubstantiated. There are lots of ideas, but we don't have much good data on which to make good decisions," said Hansen.
Anders predicts that within two years the university's MIND Institute will be on the cutting edge of research into disorders of the brain.
"My view is that when you can understand the biological mechanisms underlying this
disorder, you will understand how the brain works," said Anders. "It is that
complicated an illness."