Autism Research Awakening: Environment Plays A Role In Causing Autism

“We have to look also at environmental factors, and from my point of view, the interaction between the genetic factors and the environmental factors ... It looks like some shared environmental factors play a role in autism, and the study really points toward factors that are early in life that affect the development of the child"

Joachim Hallmayer, MD,  associate professor of psychiatry at Stanford University in California

WebMD reports on a new study published in the Archives of General Psychiatry which  found that autism was surprisingly common in fraternal twins, despite the fact that they don’t share as many of the same genes as identical twins, suggesting that some common environmental factors might be playing as big a role in causing their autism disorders as genetics.  Dr. Hallmayer was one of the study researchers who were surprised with the result.  Is this an awakening in the autism research professions?

For some it probably is.  For others not so much.  Even this humble autism father/blogger reported an autism paradigm shift 4 years ago and I have followed it since then blogging on developments in the area of environmental causes of autism. But there are die-hards who will not be convinced, who will not change their minds no matter what. Academic careers and reputations as expert witnesses have been built promoting the view that autism is 100% genetic and that accordingly autism disorders are not actually increasing.  Reported increases of autism diagnoses are routinely dismissed as due entirely to diagnostic definition change and increased awareness.  Of course manufacturers of products from vaccines to children's toys have a vested interest in encouraging the "it's gotta be genetic" autism causation paradigm described over a decade ago by Teresa Binstock.  Many will never admit that autism could ever be caused by the interaction of environmental and genetic factors.  

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John Hopkins Study: Gene-Environment Interactions Influence Psychiatric Disorders

“Psychiatric diseases have genetic roots, but genes alone do not explain the entire disease ... When we study genes in conjunction with environmental challenges, we can better understand how diseases develop.” 

-  Mikhail V. Pletnikov, associate professor of psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine, Study: Gene-environment interactions influence psychiatric disorders, John Hopkins University Gazette

In a John Hopkins University study pregnant laboratory mice bred with a specific genetic variation known as mhDISC1 were given a drug to stimulate their immune systems at the end of the first trimester of  their pregnancies while other mice with the same genetic variation did not receive the drug. The genetic variation involved is believed to be associated with mental illnesses in humans. The mice receiving the drug produced behavioral abnormalities, elevated anxiety, depressionlike responses, an altered pattern of sociability and a weakened response to stress. These responses were not present in the mice who did not receive the drug which suggested that the conditions resulted from the gene-environment interaction not the genetic variation alone. The study reports  also indicate that the same genetic variation can give rise to different illnesses depending on interactions with environmental factors and can impact on the size of different brain parts incuding the amygdala and the hypothalamus areas found in the brains of humans with major depression and bipolar disorder.

The study results appear to be another significant example of  an emerging paradigm shift away from viewing psychiatric and mental disorders as purely genetically determined toward an understanding of such disorders, including autism disorders, as arising from gene-environment interaction.  Future studies are likely to reflect this paradigm shift:

"Previous studies have suggested that the prenatal immune response to a microbe—be it a major illness or just transient flulike symptoms barely noticed by the pregnant woman—may be responsible for the increased incidence of adult psychopathology in humans. But this hypothesis, Pletnikov said, has been difficult to prove. Using this mouse model, he suggested, is a valuable way to study the relationship between gene-environment interactions and mental illness, and should be replicated to find more of these interactions to gain a better understanding of these relationships.

Future studies, he said, will try to sort out whether different timing or stimulating different parts of the immune system might lead to specific types of mental illness, and will explore the consequences of other environmental adverse events such as stress or drug abuse."

 
The John Hopkins University Gazette article by Stephanie Desmon of John Hopkins Medicine lists several supporters of the study including Autism Speaks.

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Autism Paradigm Shift: Environmental and Genetic Factors Cause Autism Disorders

The important testimony before the US Senate last week was of monumental importance in placing on the record of such a high public tribunal the evidence of credible experts confirming what has been known by many for so long: autism disorders are caused by the interaction of genetic AND environmental factors.  Autism is NOT entirely genetic in origin. Environmental factors, long neglected in research funding, are involved and future autism research MUST reflect that fact. The overwhelming funding  imbalance to date in favor of genetic focused autism research MUST be shifted toward exploration of environmental causes of autism disorders. The Autism Research Paradigm Shift must now pick up speed so that we can find causes of, treatments and cures for, autism spectrum disorders.

The near total dedication of funding towards genetic autism research was outed by Teresa Binstock over a decade ago and today genetics has contributed little if anything to understanding or addressing autism challenges. For several years it has been known that environmental factors are in fact involved in curing autism and in 2007 the University of Minnesota proposed an Autism Research Paradigm Shift:

"Autism research is poised for another paradigm shift, from an irreversible condition to a treatable disease. In the revolutionary paradigm, autism is not a rare disorder with a constant rate but frequent condition with a rising incidence. It is a combination of environmental influence and genetic vulnerabilities. It is both preventable and treatable, not by any one method but by a combination of behavioral and biomedical approaches. Autistic kids are not defective, they are sick but otherwise normal kids, and thus, recoverable.

Creating a premier center for effective treatment of autism is not as simple as adding a new wing on a hospital, purchasing the latest medical technology or creating another diagnostic center. 

What is needed is a revolutionary clinical effort premised on the paradigm that autism may well be a treatable and preventable disease.

 The University of Minnesota proposal may have been ahead of its time and the proposed paradigm shift has probably been set back by the intensive effort to discredit those who question vaccines.  Major media sources have dutifully swallowed the reported  pharma line that autism is purely genetic, which, if believed , would preclude further blame being placed on vaccines or vaccine ingredients as causes or triggers of autism disorders in some children. It will undoubtedly take time for the NYT, the Chicago Tribune, the Globe and Mail, CNN and CBC to catch up to the autism research and internet communities but it is now clear that the future of autism research must include a much greater focus on environmental causes of autism.   And of course, if they continue to dutifully follow pharmaceutical industry press releases these august media may never catch up or catch on to new developments in our understanding of autism disorders.

There is at least one hopeful sign though. The offficial Autism Speaks press release commenting on the US Senate hearings adopted a fairly bold tone in calling for more emphasis on environmental factors and autism:

"As this hearing reviews studies funded by the Environmental Protection Agency and the National Institute of Environmental Health Sciences on environmental factors associated with autism, including toxins and other factors that can influence brain development, Dr. Dawson reiterated that it is important to remember that, "Although genetic factors clearly contribute to the causes of autism, we also need to understand environmental factors and their interactions with genetic susceptibility."

The dramatic increase in autism prevalence over the last decade – increasing 600 percent in the last two decades – underscores the need for more research on environmental factors. "Our understanding of typical brain development combined with what we've learned from examining the brains of individuals with autism indicates that it is important to investigate the roles of the prenatal and early postnatal environment," explains Dr. Dawson. "To investigate environmental factors that may be active during this time, researchers are casting a wide net on potential environmental agents that can alter neurodevelopment, including exposure to infection, pesticides, and chemicals."

If Autism Speaks dares speak so boldly perhaps the Autism Research Paradigm Shift envisioned by the University of Minnesota  is fully under way and perhaps we can now look forward to understanding the environmental causes of, and finding treatments and cures for,  autism disorders.

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Autism Rising? Dr. James Coplan Says It Ain't So But Is He Right?

Dr. James Coplan,  a developmental pediatrician with four decades of experience with special needs children,  argues in Psychology Today that there is no increase in incidence of autism.  Dr. Coplan distinguishes between autism prevalence which he describes as rates of autism diagnosis and rates of autism incidence which he describes as rates of autism occurrence .  The essence of the Coplan autism epidemic denial has been heard before and is obviously partially correct. The  changes in diagnostic definitions of autism from the DSM-III to the DSM-IV have expanded dramatically the numbers of persons described as autistic. I agree with that observation and I don't know of anyone who disagrees with it.  The problem is that those diagnostic definition changes do not necessarily explain the entire, startling increase. 

Dr. Coplan does not really provide any credible argument or evidence to show that the entire startling, increase in autism diagnoses  results from the 1994 diagnostic changes.  Since my son was diagnosed 12 years ago (and his diagnosis is Autistic Disorder, assessed with profound developmental delays) the reported rates of autism, the autism prevalence as described by Dr. Coplan,  have literally skyrocketed. From 1 in 500 to 1 in 110 with the most recent increase from 1in 150 to 1 in 110 occurring over a two year period, long after the DSM-IV changes.  Dr. Coplan simply provides no compelling argument or evidence to support his rigid thinking that the increase is explained entirely by the diagnostic changes, increased awareness or the internet as some are now using to spice up the denial argument.

Another problem for Dr. Coplan is that he is not criticizing parents of autism children , celebrities, or doctors who do not follow medical "consensus"  with his argument. It is easy to mock, ridicule and belittle   a celebrity actress autism mom when defending the safety of vaccines (even though it is an irrational strategy which simply creates more suspicion of health authorities).  It is much more difficult to ridicule the CDC which compiles the autism prevalence rates. It is much more difficult to mock the IACC which has published information indicating that only about 40-50% of the increase can be explained by the 1994 diagnostic change and social ascertainment factors.

Another huge problem for Dr. Coplan is that his argument ignores any possible environmental factors as causes or triggers of autism disorders.  If autism incidence, rather than diagnosis, has remained constant than that supports the decades  old thinking that autism was entirely genetic; that no environmental factors were involved. That paradigm was never much more than an assumption to begin with but it is  now giving way to a new paradigm; one that views autism disorders as resulting from the interaction of genetic and environmental factors.  

That autism paradigm shift is remarkable in its own right given the fact that autism research funding has been directed overwhelmingly toward genetic research at the expense of environmentally  focused research.  In other words if you look at the sky you will see the sky.  If you look at the ground you will see the ground.  If you do genetic research .... well you will find that in 3% of cases studies persons with autism had common genetic processes all of which were unique to the individuals involved.  YUP after decades of genetic research that's all we got.  With a shift toward more environmental autism research we are likely to find more environmental triggers of autism disorders ... and more information to explain the startling increases in autism incidence.

This humble autism dad in small town New Brunswick, Canada does not need a distinguished pediatrician like Dr. Coplan to convince me that the DSM-IV expanded the numbers of those diagnosed  with autism.  And I agree with him that the DSM-5 will continue that expansion. A great danger of that future expansion is that the obsession with genetics will once again be supported by the inability to distinguished autism prevalence and incidence because of a new DSM change.  The environmental aspect of autism disorders, the environmental triggers of autism disorders, which may essentially be synaptic disorders, will be neglected and the real increase in autism incidence denied and obscured again.

Dr. Coplan's decades of pediatric experience should be respected and valued but they should also be seen as potential obstacles to new thinking, new paradigms and new evidence from credible authorities, like the CDC and the IACC. Researchers like Dr. Irva Hertz-Picciotto,  who has said that we need more environmental focused research to help us understand what is happening, should be heeded and their opinions valued.  We have to move to a new paradigm and abandon the old assumptions that autism is entirely genetic, that autism is not actually increasing, if we are to understand what is causing these autism disorders that may be synaptic disorders.

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The Time is Now to Redress the Autism Research Imbalance

As with many complex disorders, causation is generally thought to involve some forms of genetic risk interacting with some forms of non-genetic environmental exposure. The balance of genetic risk and environmental exposure likely varies across the spectrum of ASD.  ..........  Researchers are working to better understand the interaction of genetic vulnerability with developmental experiences, such as a specific environmental exposure. While gene-environment interactions have been hypothesized to play a role in many medical disorders, these interactions have been difficult to prove or disprove beyond statistical tests showing that some genetic subgroups have a greater response to some environmental factor. ............ Progress in identifying environmental factors which increase autism risk has been made recently (Eskenazi et al., 2007; Palmer et al., 2006; Palmer, Blanchard, & Wood, 2009; Rauh et al., 2006; Roberts et al., 2007; Windham et al., 2006), although this area of research has received less scientific attention and far fewer research dollars than genetic risk factors. Environmental factors may be pertinent not only to brain development but also to chronic systemic features of at least some subgroups of ASD.

- The 2010 Interagency Autism Coordinating Committee Strategic Plan for Autism Spectrum Disorder Research - January 19, 2010, Question 3: What Caused This To Happen and Can It Be Prevented?

The 2010 IACC Strategic Plan  statement  that environmentally focused autism research has been under funded and largely ignored could properly be characterized as a long overdue confession by the autism research establishment.  Autism research has been  focused overwhelmingly on genetic causes of autism to the near exclusion of environmentally focused research. for well over a decade with potentially serious consequences for our current understanding of possible autism causes and treatments.   Given that imbalance it is perfectly understandable that few potential environmental causes of autism have been identified or confirmed through research.  If we don't open our eyes and look, if we don't do the research, then we will not find environmental causes of autism.

The overwhelming imbalance in favor of genetically based autism research was identified over a decade ago by  researcher Teresa Binstock in her 1999 description of the  "It's gotta be genetic" autism research paradigm.  Binstock  pointed to the culprit -  the old guard network that insisted that autism research be genetically focused in order to have any hope of receiving public funded research dollars:

My own hunch is that the NIH and NIMH will not change from within; the senior practitioners of the "it's gotta be genetic" model have too much influence. Just as Semmelweiss and his data were suppressed, so too will the NIH/NIMH autism-research insiders continue to act against the the growing body of new data in autism; the NIH's pro-genetic old-timers will cling to their paradigm and its funding. As a result, change within the NIH and NIMH will have to be initiated from outside those tax-supported corporations.

-Teresa Binstock, 1999, IGNAZ SEMMELWEISS and AUTISM: when prevailing paradigms resist change

The imbalance in favor of genetic over environmental focused autism research has resulted in a call for more balance from many sources and hopefully that call will result in more than lip service.  There have been signs of an autism research paradigm shift over the past few years from the purely genetic model of autism to one which looks at autism as the result of a genetic and environmental interaction but the pace of change has been far slower than first hoped as pointed out by the 2010 IACC Strategic Plan above , by Dr. Irva Hertz-Picciotto and by Dr. Jon Poling.

Too much time has been wasted on the irrational insistence that autism research must be genetically focused.  We have lost the knowledge that years of more balanced autism research, with greater attention to potential environmental factors, might have given us. We must find that balance as we move  forward or more knowledge, and possibly treatments and cures, will continue to be lost.

Environmentally focused autism research must receive more attention and funding. Even the IACC has recognized the imbalance in favor of genetic over environmentally focused research. 

It is now time to redress the imbalance. 

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Autism Rising in Chicago: Tribune Investigation Determines Autism Increase is Real

For the most part the article Autism treatments: Risky alternative therapies have little basis in science goes over old ground in attacking alternative autism therapies. At times it appears that the article is actually going to send current autism knowledge back to 1999 when Teresa Binstock outed the medical establishment for insisting that only genetic based autism research receive scarce funding dollars and that , by implication, environmental factors played no role in causing autism.

All of a sudden, almost out of the blue, the Tribune investigative report answers in the affirmative a question many have been asking by declaring that the startling rates of increase in autism over the past decade are real:

Chelation's popularity as a treatment for autism is driven by the unproven idea that the disorder is tied to accumulation of heavy metals in the body. Mercury, once common in vaccines as part of a preservative called thimerosal, is often pegged as the culprit. Yet the federal Institute of Medicine reported in 2004 that a review of dozens of studies had failed to show a link between vaccines, thimerosal and autism. Subsequent studies also found no connection. After thimerosal was removed from childhood vaccines except for some flu shots, autism diagnoses continued to rise.

Congratulations to the Chicago Tribune for its investigation confirming that autism is indeed rising; that the increases in autism are indeed real. Since genetics can not explain these startling increases it should be clear, based on the Chicago Tribune's conclusion, that the autism increase is real, that environmental factors have to be involved in causing autism disorders. Maybe the Tribune can now do an investigative piece explaining why health authorities have discouraged environmentally based autism research over the past decade and more.

Maybe if health authorities pushed research of some of those potential environmental causes or triggers they could find cures and parents would not be left on their own trying to help their autistic children without the benefit of help from, and usually under attack by, scientific and health authorities.

Maybe.

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Autism Is A Complex Disorder, A Single Causal Mechanism Is Unlikely

There are some who believe, as an article of faith, that autism is 100% genetic.

They cling to this belief even though the fact that one identical twin has an Autism Spectrum Disorder diagnosis does not necessarily mean that the other twin will also have an ASD. For many with the "it's gotta be genetic" mindset no explanation, no study, no evidence will budge them.

For everyone else in the world though Dr. Harvey Singer of Johns Hopkins Hospital in Baltimore who, with his colleagues, has studied the effects of mice that developed autistic like behaviors after being exposed before birth to antibodies from mothers of autistic children, has some wise words to share with us. Dr. Singer is quoted in a Reuters article Mother's antibodies may contribute to autism :

"Autism is a complex disorder and it would be naïve to assume there's a single mechanism that can cause it. It's most likely the cumulative effect of several factors, including genes, metabolism, and the environment. We believe we have identified one of those factors."

I am pleased any time I see such a sensible perspective offered about autism by someone with the knowledge and credibility to have his comments be given serious weight and consideration. Here in Canada our autism research community, and our CIHR, are dominated by a small Montreal based neuroscience elite that still leans heavily towards the outdated "it's gotta be genetic" view of autism that Teresa Binstock cautioned against a decade ago. There is an Autism Research Paradigm Shift taking place ... in the United States ... if not in Canada.

Once again, I must thank our American friends for offering informed, sensible information about the nature of autism disorders, their possible causes and interventions.

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Autism Rising: Autism Rates Higher Near Toxic Dump Sites

The ideologically based belief that autism is entirely genetic has been taking a beating in the past few years as an Autism Research Paradigm Shift has been taking place which focuses more attention on the possible environmental factors involved in causing autism disorders. And the evidence of possible environmental causes or triggers of autism disorders continues to accumulate.

The UC Davis Mind Institute study is a recent highlight of this shift towards open examination of environmental triggers and factors contributing to the increasing diagnoses of autism disorders. The The Interagency Autism Coordinating Committee Strategic Plan for Autism Spectrum Disorder Research - January 26, 2009 essentially codified the Autism Research Paradigm Shift with numerous elements of its Strategic Plan emphasizing possible environmental contributors and causes of autism disorders.

Now Catherine DeSoto has published a correlational study, Ockman's Razor and Autism: The case for developmental neurotoxins contributing to a disease of neurodevelopment, at Neurotoxicology doi:10.1016/j.neuro.2009.03.003 which finds that:

"within the state with the highest rate of ASD, the rate is higher for schools near EPA Superfund sites, t (332) = 3.84, p = .0001. The reasons for the rise in diagnoses likely involve genetically predisposed individuals being exposed to various environmental triggers at higher rates than in past generations.

The study is the subject of a synopsis by Heather Patisaul, Ph.D. of North Carolina State University, at Environmental Health News. Ms Patisaul explains that the Superfund sites frequently contain such pollutants as chloroethelyenes, benzene and metals (lead, mercury, cadmium, chormium, arsenic). She reports that the study found autism rates signficantly higher near the toxic Superfund Sites:

Rates of the disorder were one and a half times higher in the districts within 10 miles of the toxic sites. That translates into 1 child in 92 in districts closer to the sites compared to 1 child in 132 in the districts farther away. Schools within a 20-mile radius of Superfund sites had similar autism trends as the schools with 10 miles of the sites.

Ms Patisaul cautions that correlational studies such as this might first identify possible causal relationships but will require further information to verify any such association. Hopefully the studies necessary to verify or refute possible connections and causes will be conducted without unecessary delay.

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National Children's Study Examining Environmental Genetic Interaction Will Boost Autism Research Paradigm Shift

Autism is only one of the conditions that will be examined as part of the National Children's Study being conducted by the U.S. Department of Health and Human Services (including the Eunice Kennedy Shriver National Institute of Child Health and Human Development and the National Institute of Environmental Health Sciences, of the National Institutes of Health and the Centers for Disease Control and Prevention), and the U.S. Environmental Protection Agency. But the massive study of the interaction of environmental genetic factors will undoubtedly push into motion the autism research paradigm shift called for over the past decade, a paradigm which breaks away from the simplistic "it's gotta be genetic" funding mandates that have restricted expansion of knowledge of environmental causes of autism and limited the ability to find treatments and cure for autism disorders.

Today it was announced that NCS centers at The University of North Carolina at Chapel Hill and the Mount Sinai School of Medicine in New York will begin recruiting volunteer Study participants this week. Over the course of the study the health of 100,000 children from diverse backgrounds and 105 locations across the US will be studied as they grow to adulthood.

Information gathered during the study will be analyzed periodically and released to the public. This will probably generate more research including research of the genetic-environmental factors and processes giving rise to autism disorders.

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Autism Research Folly

"the NIH and NIMH are impeding progress in research about causes, diagnostics, and treatment in autism and similar syndromes.

By clinging to an oversimplified and outmoded model of autism (ie, it's gotta be genetic), the stubborn persistence of several research administrators in the NIH and NIMH means that funding for autism and autism-spectrum syndromes remains funneled into the hands of a small group of researchers who pledge (via NIH-grant contracts) to conduct their research in accord with the model wherein "it's gotta be genetic" (1).

This funding pattern imposes a serious limitation on research that ought be occurring, given the growing amount of new data which indicate that *more than* genetic-aspects need be considered.

The relationship between (a) the offically approved though outmoded paradigm and (b) subsequent funding patterns is worth re-stating:

The persistence of the NIH and the NIMH in focusing almost entirely upon a genetic-theory of autism means that a goodly amount of data continues to be ignored, shunted from view, and unfunded -- even as the primary genetics-model researchers are blessed with abundant funding despite decades of non-success (1). For instance, the data from Wakefield, Warren, Singh, Shattock, Oleske et cetera are important, as are patterns amidst parental anecdotes -- eg, gastrointestinal atypicalities, vaccination effects, extraodrinarily recurrent otitis et cetera.

However, as recent years have shown, despite the many new data and anecotes, the NIH and NIMH are resistant to change. The new data remain virtually ignored, the parents' anecdotes treated as if mere hearsay. Not surprisingly, in the face of this bureaucratic intransigence, the goal of changing and improving the NIH and NIMH in regard to autism funding will require increased effort."

Teresa Binstock, Researcher in Developmental and Behavioral Neuroanatomy, in IGNAZ SEMMELWEISS and AUTISM: when prevailing paradigms resist change, 1999

The Binstock article, referenced above, was a review of Jeanne Achterberg's book Woman as Healer and the sad story of Ignaz Semmelweiss who challenged medical orthodoxy of his time (1818-1865) by gathering data and arguing that peuperal (childbed) fever was caused by the unclean hands of those who delivered, or assisted, delivery of children. Hospital wards staffed by midwives had a 3% mortality rate due to fever while those staffed by medical students who often came straight from autopsy rooms to the maternity rooms, and either did not wash their hands, or wiped them on already bloody, dirty clothes, had a 10% rate.

The medical establishment of the time did not believe Semmelweiss and he was professionally punished by lowering his academic standing and restricting his hospital privileges. Ultimately he became depressed and committed to an asylum where he died of blood poisoning. Binstock noted similarities between the treatment afforded Semmelweis, his conclusions, and his data and what has happened today to the anecdotal evidence of parents and researchers who followed up on that anecdotal evidence.

Teresa Binstock's contention that research of a possible vaccine-autism conection has been discouraged by public authorities is in fact confirmed in the Institute of Medicine (IOM) Immunization Safety Review: Vaccines and Autism (2004) . In that document the public health authorities expressly discouraged research of vaccine-autism connections as shown at p. 152:

Biological Mechanisms Conclusions

In the absence of experimental or human evidence that vaccination (either the MMR vaccine or the preservative thimerosal) affects metabolic, developmental, immune, or other physiological or molecular mechanisms that are causally related to the development of autism, the committee concludes that the hypotheses generated to date are theoretical only.

SIGNIFICANCE ASSESSMENT

The committee concludes that because autism can be such a devastating disease, any speculation that links vaccines and autism means that this is a significant issue.

PUBLIC HEALTH RESPONSE RECOMMENDATIONS

The committee recommends a public health response that fully supports an array of vaccine safety activities. In addition the committee recommends that available funding for autism research be channeled to the most promising areas.

Policy Review

At this time, the committee does not recommend a policy review of the licensure of MMR vaccine or of the current schedule and recommendations for the administration of the MMR vaccine.

At this time, the committee does not recommend a policy review of the current schedule and recommendations for the administration of routine childhood vaccines based on hypotheses regarding thimerosal and autism.

Given the lack of direct evidence for a biological mechanism and the fact that all well-designed epidemiological studies provide evidence of no association between thimerosal and autism, the committee recommends that cost-benefit assessments regarding the use of thimerosal-containing versus thimerosal-free vaccines and other biological or pharmaceutical products, whether in the United States or other countries, should not include autism as a potential risk.

Apart from the express discouragement of funding of research of a possible vaccine autism connection it is interesting to note the first paragraph of the above quote. The highlighted portion states "In the absence of experimental or human evidence " that vaccines are causally related to autism any such hypothesis can be theoretical only. Having noted an absence of evidence the IOM then discouraged any research that might have produced such evidence. It is also becoming less certain that the epidemiological studies were as well designed as the IOM contended given the continued presence of thimerosal in vaccines, including some vaccines given to pregnant women.

In the last year the Poling case upset the IOM 2004 strategy. Government had to acknowledge that, at least in some subsets of children vaccines could trigger "autism like symptoms" :

if you're predisposed with the mitochondrial disorder, it can certainly set off some damage. Some of the symptoms can be symptoms that have characteristics of autism.

Dr. Julie Gerberding, Director, CDC, CNN Interview with Dr. Sanjay Gupta, March 29, 2008

As many have noted there is no intelligent distinction between autism and autism like symptoms. Autism is currently diagnosed by symptomatic behavior. In addition to Dr. Gerberding's reluctant acknowledgement of a vaccine-autism connection, Dr. Bernardine Healy, former director of the American Red Cross and the NIH, exposed limits of the epidemiological studes and expressed the need for further research of possible vaccine-autism connections in April 2008.

It is sheer folly to discourage research into possible environmental triggers or causes of autism. Not doing the research means that we might have missed out on possible treatments or preventative measures for autism. Teresa Binstock pointed out the folly of such a course of action in her 1999 comment. Now Irva Hertz-Picciotto, an author of the recent California study, has called for increased funding of research of possible environmental causes of autism.

It is time to move away from the "it's gotta be genetics" paradigm of autism research that Binstock described in 1999. It is time to move ahead with the autism research paradigm shift that the University of Minnesota called for in 2007, a paradigm based on the premise that autism is caused by a combination of environmental influence and genetic vulnerabilities.

It is time to end the "its gotta be genetics" autism research folly.

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Autism Rising - UC Davis Mind Institute Study Points To Environmental Factors

Although Classics Professor Kristina Chew, ASAN co-founder Dora Raymaker, and the once progressive Change.org have decreed that autism is most likely entirely genetic, with no environmental contributing factors, recent research says otherwise. The UC Davis MIND Institute has published a news release of a study indicating that the dramatic rise in California autism cases probably arises from environmental factors. The news release also calls for an autism research paradigm shift from simplistic focus on genetic causes of autism to an examination of both genetic and environmental factors. ... with the funding necessary to fully implement the shift. In fact UC Davis Mind Institute has already been a leader in this autism research paradigm shift with its CHARGE program, a major epidemiological study investigating environmental factors and gene-environment interactions in autism disorders.

January 7, 2009 (SACRAMENTO, Calif.) — A study by researchers at the UC Davis M.I.N.D. Institute has found that the seven- to eight-fold increase in the number children born in California with autism since 1990 cannot be explained by either changes in how the condition is diagnosed or counted — and the trend shows no sign of abating.

Published in the January 2009 issue of the journal Epidemiology, results from the study also suggest that research should shift from genetics to the host of chemicals and infectious microbes in the environment that are likely at the root of changes in the neurodevelopment of California’s children.

“It’s time to start looking for the environmental culprits responsible for the remarkable increase in the rate of autism in California,” said UC Davis M.I.N.D. Institute researcher Irva Hertz-Picciotto, a professor of environmental and occupational health and epidemiology and an internationally respected autism researcher. .... Hertz-Picciotto said that the study is a clarion call to researchers and policy makers who have focused attention and money on understanding the genetic components of autism. She said that the rise in cases of autism in California cannot be attributed to the state’s increasingly diverse population because the disorder affects ethnic groups at fairly similar rates.

...

“Right now, about 10 to 20 times more research dollars are spent on studies of the genetic causes of autism than on environmental ones. We need to even out the funding,” Hertz-Picciotto said.

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Autism Rising in Marin County

From coast to coast, across North America, autism is rising. In the United States, from South Carolina facing the Atlantic Ocean to Marin County, California, facing the Pacific, autism is rising and schools are struggling to meet the challenge of educating autistic children.

In Tsunami' of autism cases crippling to Marin parents, schools Rob Porter of marinij.com (Marin Independent Journal) reports on the struggles of parents and schools in Marin County, California, trying to provide an education to autistic school children whose numbers in Marin County have doubled from 76 in 2001 to 152 in 2008. The article is balanced quoting sources who explain the dramatic increases in autism diagnoses on the basis of the 1994 DSM changes which lumped Aspgergers Disorder together with Autistic Disorder but also quotes Robert Herndon, executive director of the Medical Investigation of Neurodevelopmental Disorders (MIND) Institute at the University of California at Davis who doesn't buy the belief that the DSM changes are a complete answer and points out that we really don't know at thist time what is behind the increases:

"The reason it's such a controversial question is that if we say autism is primarily a genetic disease, then we shouldn't be getting more of it. Genes don't just change - something in the environment has to interact with them. Some people don't want to think there is anything bad in the environment, while some want to say the environment is terribly toxic and that explains it. The truth is that we really don't know about any of them. There is no smoking gun. "

The truth is also that research into possible environmental causes of autism has been discouraged until fairly recently. That has been changing though and in 2007 the University of Minnesota aptly described a new paradigm for autism research, an autism research paradigm shift based on the possible interaction of genetic and environmental factors:

Autism research is poised for another paradigm shift, from an irreversible condition to a treatable disease. In the revolutionary paradigm, autism is not a rare disorder with a constant rate but frequent condition with a rising incidence. It is a combination of environmental influence and genetic vulnerabilities. It is both preventable and treatable, not by any one method but by a combination of behavioral and biomedical approaches. Autistic kids are not defective, they are sick but otherwise normal kids, and thus, recoverable.

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Study Suggests Post-Natal, Environmental Causes of Autism

"Our results suggest that FKPB12 regulates neuron signaling that curbs the manifestation of traits observed in several neurological disorders including autism, obsessive-compulsive disorder and schizophrenia.These disorders are widely believed to be "determined in utero by genetic hormonal and environmental factors. Because our study indicates that postnatal release of mTOR activity can result in certain perseverative behaviors, it challenges the idea that some aspects of these conditions are developmentally predetermined."

- AFP, NYU neuroscientist Dr. Eric Klann

Autism clearly has a strong genetic component. Some believe it is entirely genetic with no environmental causes or factors. Those who subscribe to the "entirely genetic" belief find it easy to believe that the astonishing rise in the numbers of autism disorder diagnoses is due entirely to diagnostic definition changes, enhanced public awareness and other social factors. If they are wrong in their beliefs, and if scientific researchers and health authorities refuse to investigate potential environmental causes or triggers of autism then possible treatments, cures or enhancements of the lives of autistic people will be sacrificed on the alter of such unwarranted certainty.

From the erroneous and harmful "Refrigerator Mother" beliefs of Bettelheim to the belief that autism arises solely from genetic factors our popular understanding of, and ability to treat and cure, autism disorders have been restricted by simplistic, single factor explanations of the complex group of pervasive developmental, or autism spectrum, disorders. Recently though there has begun an autism research paradigm shift based on the view that:

"autism is not a rare disorder with a constant rate but frequent condition with a rising incidence. It is a combination of environmental influence and genetic vulnerabilities. It is both preventable and treatable, not by any one method but by a combination of behavioral and biomedical approaches. Autistic kids are not defective, they are sick but otherwise normal kids, and thus, recoverable."

A significant example of the autism research paradigm shift can be seen in the recent study authored by researchers at New York University's Center for Neural Science and the Baylor College of Medicine and published in Neuron,Volume 60, Issue 5, 832-845, 10 December 2008. The researchers studied the effects on mice of removal of the FK506-binding protein 12 (FKBP12) which regulates an enzyme (mTOR) involved in learning and memorization. mTOR affects the the ability to change behavior and regulates connections between neurons thereby playing a key role in learning and memorization.

As stated on AFP News, removal of FKBP12 from the brains of mice late in development reduced the mice's capacity to analyze, respond and adapt to new situations. In one example the FKBP12 removed mice, once they learned a path through a maze, had difficulty learning how to travel through a different version of the maze. The AFP article describes this phenomenon as "enhanced perseveration, or pathological repetition, ... often observed in individuals suffering from autism or other neurological disorders".

The Autism Research Paradigm Shift is a central component of the Autism Knowledge Revolution now taking place. Hopefully, that revolution in learning and understanding autism disorders will not be derailed or slowed by the world's current economic crisis ... or by ideologies, agendas and simplistic views of autism disorders.

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The CDC and the Autism Research Paradigm Shift

David Kirby has published, at the Age of Autism, a letter from an official in the Office of CDC Director Dr. Julie Gerberding in which it is stated that:

While it is important to understand if autism is affecting any group of children disproportionately, it is also important to keep in mind that there are likely multiple causes of the autism spectrum of disorders. Most scientists agree that today's research will show that a person's genetic profile may make them more or less susceptible to ASDs as a result of any number of factors such as infections, the physical environment, chemical exposures, or psychosocial components.

It is not clear from Mr. Kirby's article who the official in the office of Dr. Gerberding was that sent the email or whether that official's view represents the official view of the CDC. But it seems consistent with the autism research paradigm shift proposed by the University of Minnesota:

Autism research is poised for another paradigm shift, from an irreversible condition to a treatable disease. In the revolutionary paradigm, autism is not a rare disorder with a constant rate but frequent condition with a rising incidence. It is a combination of environmental influence and genetic vulnerabilities. It is both preventable and treatable, not by any one method but by a combination of behavioral and biomedical approaches. Autistic kids are not defective, they are sick but otherwise normal kids, and thus, recoverable.

Creating a premier center for effective treatment of autism is not as simple as adding a new wing on a hospital, purchasing the latest medical technology or creating another diagnostic center.

What is needed is a revolutionary clinical effort premised on the paradigm that autism may well be a treatable and preventable disease.

The Autism Knowledge Revolution has been marked by dramatic advances in our understanding of the structural and genetic bases of autism. The autism research paradigm shift, a shift toward investigation of the interaction of genetic susceptibility and environmental triggers may well speed the pace of that knowledge revolution.

Reactionary bloggers at the Autism Hub and Neurodiversity ideological movements will not be happy with the autism research paradigm shift but the maturing of scientific inquiry into autism, the movement past official defensiveness, may someday result in more effective treatment and cures. And those are autism realities that will be happily embraced by most parents of autistic children.

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