A fascinating conference run by the Autism Support Group in Salisbury.

Dr John Richer from the John Radcliffe Hospital in Oxford started the day with a lucid explanation of Autistic Spectrum Disorders.
He suggested that there are no rigid barriers which divide the mildly eccentric child from the fully autistic - they are merely at different points on the spectrum. The aim of treatment is therefore not to 'cure' but to move them up the spectrum. Studying the way ASD children behave helps to explain why they behave that way and make it easier to help them.

Fear
ASD children are very fearful of a world they do not understand so they try to avoid anything unknown and all social contact. 'Avoidance behaviours' include:
• Turning, moving or looking away
• Hanging the head down
• Covering ears or eyes
• Pulling in the chin and hunching
• The 'fear, or appeasement, grin' - the corners of the mouth remain straight instead of turning up as in a smile

'Motivational Conflict'
They both do and don't want to make contact so they 'dither', change their minds and sometimes both approach and reject at the same time. When trying to make contact they are still fearful so can be very nervous, over-intense or aggressive.

Security
They will use repetitive rocking, rolling, fumbling, dangling or tapping as relaxing ways to secure and calm themselves.

Conversation - Intersubjectivity
Humans take turns in conversation to share information. A baby acts and then looks for a response. It gets it and and then responds in turn. But ASD children do not understand this exchange so, because they are uncertain how to reply, they avoid doing so. But this means that they fail to learn how to socialise or exchange information. They are unable to understand what is going on in another person’s mind so appear egocentric or unwilling to listen. In fact they are unable to both speak and listen at the same time (they operate like a walkie talkie on which you can only speak or listen, not both together). So, from a very young age, they fail to engage socially.

Stress
Unstressed ASD children may behave almost 'normally' but under stress they will become egocentric, aggressive/defensive, lose their perspective of the other person, be hurtful or offensive although it is not their intention to be so.
It helps to develop a script or pattern of behaviour for them to use in stressful situations. This can be learnt and rehearsed when not under stress to be brought out when needed.

Transition Period
All children develop in spurts and are more sensitive at different ages. They will be more vulnerable to their environment and to stress at these times.

Indicators of ASD
• Genetic predisposition
• Immune system problems
• Attention problems
• Low frustration tolerance
• Sensory hyper-sensitivity
• Motor oddities
• Temperamental disposition - Introvert, need 'solo' time; non-intuitive- 'thinking' rather than 'feeling'; orderly - like predictability
• Subjected to stress at sensitive developmental periods
• Suffers from multiplicity of food intoler- ances/nutritional deficiencies

Treatment
• Intervene as early as possible
• Deal with any physical problems first. Use a ‘hunter/gatherer’ diet to pinpoint intolerances, asses nutritional status, address digestive problems.
• Provide security. ASD children may need to sleep with their parents and be frequently held to provide security.

Further information to be found in:
Autism and the Search for Coherence by Dr John Richer and Sheila Coates published by Jessica Kingsley.

Paul Shattock of the Autism Research Unit in Sunderland looked at the massive increase in the incidence of ASD throughout the Western world.

He acknowledged that there was, obviously, a genetic component to autism but pointed out that 85% of research funding goes into genetic research and only 15% into possible environmental triggers - e.g:
• The failure to expose small children to disease before vaccination
• Pesticides and plasticiser residues
• Heavy processing of foods
• Antibiotic overuse
• Heavy metal toxicity, toxic fumes, dioxins, pcbs, drug residues in water etc.

He sees relevant genetic factors as:
• Failure in the sulphation process. This means they are unable to detoxify their own systems and to excrete natural debris such as defunct neurotransmitters.
• Creation of harmful peptides which can permanently damage nerve endings in the central nervous system

The analysis of the urine profiles of the children whose parents blame the MMR vaccine for their regression into autism does show a quite different pattern to that of other ASD children.
However he also suggested a possible connection with organophosphates which are known to block brain chemical pathways and whose use coincides with the rise in ASD. Normally we sulphate OPs out of our systems but ASD children are poor at sulphation.

He then looked briefly a the protocol they have developed which includes a casein free, followed by a gluten free diet, the assessment of other food intolerances, a programme of supplementation to
include vitamins, minerals, enzymes, fatty acids, glutamine to repair the gut, re-sulphation with Epsom salts baths, filtered water and a diet of organic food.

For a detailed description of the protocol and of Paul Shattock's work check out: http://osiris.sunderland.ac.uk/autism

Dr Andrew Wakefield described how he, as a gastro-enterologist specialising in Crohn's disease, became involved with the MMR vaccine. He was asked to see a group of children who had regressed into autism after vaccination and who all shared severe gastro-enterological symptoms and a tendency to infections.

On investigation these children showed no signs of genetic immuno-deficiently but all had severe inflammation and ulceration through out the intestine although this was neither Crohn’s Disease nor Ulcerative Colitis. (Indeed some of their ‘autistic’ rocking etc behaviours may just have been a way of trying to relieve gastric pain.) However, such inflammation could result from a viral infection. It could also cause oxidative stress which would cause significant biochemical changes.

The measles virus in developing countries is known to cause inflammation in the gastro intestinal tract. The measles protein was found in 82% of 91 autistic children but only 7% of 70 normal children. 50 of 51 affected children had had the vaccine; only one out of the 51 harboured the ‘wild’ rather than ‘vaccine’ type measles virus.

Inflammation of the bowels in a blind trial of these children showed that 57% of children who had been vaccinated twice had acute inflammation, but only 13.5% of those who had been vaccinated once. The mercury in the vaccine appeared to be a separate issue, only affecting those children whose immune systems were unable to tolerate it.

Dr Wakefield suggested that there could be many similarities with the AIDS virus which causes similar sulphur and glutathione deficiencies. He also suggested that there was a possible interaction between the mumps/rubella and the measles viruses in the vaccine which could alter the immune response to the latter.
The work that has gone on in the UK and the US and in a recent trial in Norway suggests that gastrointestinal treatment with diet and nutritional supplementation can be extremely effective.

You can find details of the research work on Dr Wakefield's website at www.visceral.org.uk

Click here for more general articles on autism

First Published in 2004

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