Autism Update


 
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Alison Palmer, BSN

Autism continues to be a hot topic area for new research.  This article will bring you up to date on the latest speculations and conclusions so that when the parents of your autistic patients bring you questions about the latest media hype you can help them understand the benefits and consequences of what they are hearing.

One area of neurological research focuses on the role of the cerebellum in autistic tendencies.  The cerebellum, located near the brainstem, is primarily responsible for motor movement, but it is also partially involved in speech, learning, emotions, and attention.  In some cases, this area of the brain is smaller in autistic individuals.  Some researchers also identify a basic functional deficit in communication between certain cortical areas within the brain.  Still others disagree, instead noting irregular levels of serotonin which helps regulate arousal and mood.

The corpus callosum has also been identified by some as underdeveloped.   However, an impairment of this area can be considered its own diagnosis, rather than falling under the ASD (autism spectrum disorders) umbrella.  Symptoms of an underdeveloped corpus callosum can include reduced motor coordination and muscle tone, delays in developmental milestones including speech and language, and social difficulties including impaired facial expression processing.

All of these neurological differences can occur within the genetic makeup or from influences during fetal development, during the birth process, from infection, or exposure to a combination of toxins.

Overall, the most common shift in trends moves away from identifying autism as simply a brain or neurological disorder.  To this date, over 10 different genes have been identified as playing a part in autism.  Researchers are becoming more aware that it is a whole-body, or neurobiological, response triggered by a combination of factors, including genetics, and environmental influences such as toxins and stressors.  Clear and definitive research efforts are complicated by these complicated pathways.  It's not just one gene or one toxin, but a combination of factors working together that create autistic patterns.  It is often difficult to say whether or not the medical problems consistently associated with autism (digestive disturbances, sleep disturbances, sensory problems, motor skill delays, seizures, etc) are resulting symptoms of the problem or core factors in creating the complex disease process of autism. However, while not offering an overall cure for autism these whole-body theories do provide a hope that there are actually things that parents and healthcare providers can do to help prevent or reduce the affects of ASD.

In the search for answers many studies are focusing on "everyday toxins".  These substances can be found in products we use every day: cosmetics, clothing, furniture, electronics, and food, to name a few.  The tricky part is that how these substances sneak into our body, to what extend they are safe, or dangerous, and the combinations that cause the most problems are still greatly unknown.

Finger pointing concerning toxins often identifies mercury as a cause of autism.  This is the source of complaints against childhood vaccines; many contain a form of mercury as an additive.  In particular, researchers feel that they have identified a genetic flaw- the lack of glutathione- that keeps autistic children from being able to rid their body of heavy metal toxins such as mercury.  This genetic connection resulted in the recent court ruling in favor, Hanna:  she developed autistic tendencies after routine childhood immunizations containing the derivative of mercury were administered to her.

Glutathione tends to be at lower levels in boys, the group most affected by ASD and also contributes to digestive health which is commonly an issue for the autistic patient. Glutathione can be brought back to near normal levels by using supplements of folinic acid, B6 with magnesium, and methyl B12.  Perhaps this genetic connection accounts for the dramatic success of these supplements in some cases.

While supplements are usually given to compensate for a lacking substance, the flip side of this are the popular elimination diets which focus on trying to find trigger, or irritating, substances and avoid exposure to them.  The most common diets remove wheat and gluten, dairy, dyes and additives.

Autism is a complex puzzle.  Researchers continue to gather pieces and try to fit them into the meaning of the whole disease process, but there is still much to be learned and put into perspective.  Because of the vast range of possibilities and causes, it can be difficult to direct treatments for autism.  Recent research can help families make more informed decisions, but many will still need to be open to "try and see" methods to find the best combinations of help.

References:

Boger-Megiddo, I., Shaw, D.W., Friedman, S.D., Sparks, B.F., Artru, A.A., Giedd, J.N., Dawson, G., and Dager, S.R. Corpus Callosum Morphometrics in Young Children with Autism Spectrum Disorder. Journal of Autism Developmental Disorders.

Volume 36(6):733-9, 2006.

Burgess, N. K., Sweeten, T. L., McMahon, W. M., and Fujinami, R. S. Hyperserotoninemia and Altered Immunity in Autism. Journal of Autism and Developmental Disorders. Volume 36(5):697-704, 2006.

Edelson, S. M. The Cerebellum and Autism Written. Autism Research Institute. 2007.

Herbert, M. R. Time to Get a Grip.  Autism Advocate.  Fifth edition, 2006.

Houlihan, J. Court Case Highlights Children's Vulnerability to Exposures Linked to Autism. Environmental Working Group. March 6, 2008.

Just, M. A., Cherkassky, V. L., Keller, T. A., Kana, R. K., and Minshew, N. J. Functional and Anatomical Cortical Underconnectivity in Autism: Evidence from an FMRI Study of an Executive Function Task and Corpus Callosum Morphometry. Cerebral Cortex. Volume 17: 951-961, 2007.

Miller, B. Gene Flaw May Link Autism, Vaccine Additive. Southeast Missourian. December 13, 2004.

Olmsted, D. The Age of Autism: Mercury in the Air. United Press International. March 15, 2005.

 

Copyright 2008- American Society of Registered Nurses (ASRN.ORG)-All Rights Reserved



 
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