There is clear recognition that there are a number of medical conditions associated with what has been described as regressive autism.
These conditions may include: immune system dysregulation, significant gastrointestinal pathology, disturbances in digestive enzyme production, nutritional deficiencies, food allergy and hypersensitivities, disturbed amino acid and fatty acid metabolism abnormalities, mitochondrial dysfunction, toxicity problems resulting from detoxification pathway abnormalities, chronic infections of viral, bacterial or fungal origin, thyroid hypofunction, metabolic pathway disorders, etc. The complexity of neurological as well as medical concerns associated with regressive autism results in significant challenges faced by families and practitioners.
Autism and related conditions have been estimated to occur in as many as 1 in 166 individuals (Centers for Disease Control and Prevention) however more recent reports suggest that 1 in 80 children have been diagnosed with this disorder in some parts of the U.S.
Autism is four times more likely to affect boys than girls and is recognized to commonly present before three years of age. Of grave concern is the recognition that there is an epidemic of this complex and disabling condition. Nationally, the rates of children being diagnosed with autism having increased dramatically, leading to the recognition of the explosion of this epidemic in the past decade.
Some children are born with the condition and manifest with symptoms shortly following their birth. However the most prevalent form is recognized as regressive autism, when the child appears to be progressing normally with eye contact, socialization and ability to interact with those around them. However, following a toxic or other insult on the body’s immune and/or detoxification pathways these mechanisms may be disrupted followed by regression and manifestation of autistic symptomatology.
Autism has been referred to in terms of a spectrum disorder since it is characterized by varying degrees of impairment in communication skills, social interactions, and restricted, repetitive and stereotyped patterns of behavior.
This spectrum may present on a continuum, starting with the lesser severe symptoms on one side of the continuum as represented by attention deficit disorder (ADD) and attention deficit hyperactivity disorder (ADHD). However as the severity of symptoms increase then in the center of the continuum then there may be presentation of more prominent forms of the disorder inclusive of pervasive developmental disorder (PDD) and Aspergers syndrome. The most severe symptom presentation, seen on this spectrum, involves the most severe and incapacitating neurodevelopmental symptoms as is clearly seen in severe autism.
Dr Bernard Rimland, founder of the Autism Society of America (ASA) and the Autism Research Institute (ARI), is credited with championing the biomedical approach to autism. For over thirty-five years Dr. Rimland has been tracking promising treatment interventions for autism and bringing scientists and practitioners together to evaluate these treatment modalities. In 1977 Dr. Rimland and his colleagues at the University of California at Davis and San Francisco conducted a double blind, placebo-controlled clinical trial that showed the beneficial effect of high doses of vitamin B-6 (pyridoxine) and magnesium on autistic behavior. Their landmark paper, on the clinical effectiveness and safety of high doses of vitamin B-6, was published in the American Journal of Psychiatry in April 1978. The results of this study, in conjunction with 17 other published studies (dating from 1965 to 1994) supported the effectiveness of Vitamin B6 and Magnesium in one of the first biomedical interventions in treating autism. The outcome of this clincial trial motivated Dr. Rimland to investigate other biomedical treatment approaches to autism.
The causes and/or contributing factors for development of late-onset (regressive) autism are multifaceted and comprise an area of ongoing research and evaluation.
Current thinking is that late-onset autism is the result of environmental-gene interactions. The intensive search for a genetic cause of autism has not been established as researchers have failed to identify a specific gene or complex of genes that can account for the significant increase in the incidence of autism that is now recognized to have over the past decade include issues related to triggers, contributors or potentiators : (1.) genetic predisposition with the recognition of specific polymorphisms and specific metabolic defects, (2.) prenatal insult or postnatal infection has been considered a trigger for some autistics, (3.) immune system dysregulation, including IgA and IgG deficiency, autoimmune reactions, aberrant cytokine profile T cell abnormalities, chronic inflammation and autoimmunity, etc., has been described in the scientific literature, (4.) biochemical abnormalities in regards to amino acids, pheno-sulfertransferase problems, G-alpha protein defects affecting retinoid receptors in the brain which are crucial for sensory perception, language processing, vision, etc. have been established in some autistics, (5.) neurochemical/toxic insults resulting from exposures to chemicals agents including heavy metal/mercury toxicity (thimerosal preservative in vaccines, etc.) with dysfunction of detoxification pathways, (6.) dietary triggers including formation of opiate peptides from incompletely digested casein and gluten proteins, (7.) nutritional deficiencies of vitamins, minerals, amino acid and/or essential fatty acid abnormalities, etc, (8.) occurrence of marked gastrointestinal dysfunction/pathology characterized by intestinal permeability, dysbiosis (with overgrowth of pathogenic yeast, bacteria, parasites and viruses), malabsorption problems, food allergy/sensitivities, digestive enzyme deficiencies, inflammatory gastrointestinal conditions (autistic enterocolitis, gastritis, esophagitis, duodenitis, colitis, etc) as well as ileal lymphoid nodular hyperplasia, (9.) role of vaccination additives, including the MMR (Measles, Mumps and Rubella) triple vaccine, in triggering the onset of autism (10.) the possible role of metallothionine impairment which could lead to compromised immune, gastrointestinal and detoxification function in some autistics, (11.) detoxification impairments and abnormalities with disordered methylation defects, (12.) metabolic imbalance involving impaired antioxidant defense with alterations in glutathione leading to disruption of cell function and signaling. The current thinking is that a combination of factors are possible triggers and/or contributors in the etiology of regressive autism.
The complexity of causes of autism requires not one but rather a multi-faceted approach to this challenging disorder.
The most rewarding treatment programs involve a combination of intensive educational therapies implemented in conjunction with biomedical and nutritional interventions.
This multifaceted approach appears to provide the most compelling results as described by families of children with autism as well as practitioners treating those on the autism spectrum. There is an ever-growing list of biomedical interventions and treatment options that can have a profound influence on the function and behavior of many children with autism. Utilizing the Biomedical treatment model offers children on the autism spectrum hope for the future and a means of helping them medically, behaviorally and cognitively.
