When working with a child (or adult), one must start with a reminder that like any person, any biological organism, these children have multiple variables that may affect their moods, their actions, their attitudes, their performance. Not understanding these are potentially normal children who are uncomfortable, do not feel good, is missing part of the immediate battle to do the right thing to help that child (or adult). It is a completely different tactic or response when a child is acting out because they do not feel well, are in pain, versus the oppositional behavior or attempts to resist learning of a child who is now brighter and in theory does feel much better, but just doesn’t want to cooperate. Just like any of us, these children become much more receptive to learning, much more productive, when their brains are functioning, not foggy or zoney, not constantly uncomfortable. I would politely challenge any reader of this book how they would have done in school (educationally or developmentally) if in a constant fog or zone, often in pain. In no other area is the crossover more graphic than thinking about the spaciness, zoneyness, brain-fog of a child with autism/PDD, a child with the new, now majority mixed or quiet ADHD, most adults now labeled ADHD, and an adolescent or adult with what has continued to be called facetiously chronic fatigue syndrome/CFIDS.
As noted, understanding this first through the eyes of adults and teenagers suffering from the early days of “complex neuroimmune, complex viral illness” has helped me as a pediatrician and as a person to understand these frequently nonverbal children. Older children and adults would often describe their headaches as “the brain felt like it was going in twenty thousand directions at one time.” They have a whole syndrome, fibromyalgia (essentially this disorder in adults with more physical then “mental” dysfunctions) describing multiple trigger points, tenderness, and areas of pain. As noted previously, most therapists and physicians dealing with these children do not think of this, do not have any more insight into the true nature of disorder, than the experts from the CDC who first coined the name “yuppie flu” to put down and label psychosomatic this disorder in previously high-functioning adults. I frequently wonder if we might have ended this disaster medically before it grew larger if we had approached those adults with an open mind, if we had understood something was physiologically wrong and had studied it, tried to figure out objectively what really was going on. The psychiatric implications first condemned the adults, and now so many children, to be misdiagnosed and misunderstood at a critical time for them and for our society. Without bringing about a true recognition, and the urgency for research and real answers, health, education, and welfare costs can only continue to spiral out of control until the system collapses!
Combine all the mistakes about this disorder, the failure to recognize both its sufferers’ cognitive potential and likewise the amount of pain, dysfunction, and discomfort they are in, and we are torturing these children and their families. Years ago, beginning to realize how completely distorted, broken, the “system” had become, I began to say quite cautiously to parents that “heaven forbid,” but they would be better off dealing with a child with cancer than with “autism.” A few years ago, I met a father who had a child who had autism and another who had cancer, and he was openly telling other parents it was easier to deal with the child with cancer than with the child with autism. It is my sincere hope that if the crisis comes back to the medical world, where it belongs in the first place, we would change this and approach it for the children and their families just like cancer, just like TB, just like other infectious diseases, in this case much more chronic.
Falsely believing in a mysterious developmental disorder, we have not approached these children and their problems with the urgency they deserve. This deserves the magnitude, and more, of any effort for polio, measles, cancer, and any other critical childhood illness. We must create a pediatric, medical, and social world that helps support these children and their families, and recognizes that as science is supporting, that if it is not predamaged, the brain has a tremendous potential for recovery and redevelopment. As noted above, if we understand we are not born with mature bodies or brains, but must use and develop them, then the understanding of how to help redevelop a child is already out there for all of you—we just need to recognize and deal with the real problem.
8
MISTAKES AND MISDIRECTIONS
Mercury
OVER THE YEARS MANY MISTAKES HAVE been made, and continue to be made, in trying to explain the mysterious causes for the outbreak of autism and other cognitive dysfunction in children and adults. For me, any idea not based on logic or science has never had a chance of providing answers. Yet, after first convincing adults why they now have CFS/CFIDS or adult ADHD due to heavy metals, toxins, multiple different environmental or other metabolic arguments, the same logic, the same therapies are being sold to these frantic parents and their sadly dysfunctional but ill children. Like what happened in adults, unless they address primary causes, the primary reasons for dysfunction, a lot of efforts may seem to help a child for a short time, but they are not going to continue to help or likely be even safe longer term, and this is supported by a mounting number of long-term failures. Accepting these limits and these problems are part of the mistake in thinking these disorders are somehow developmental and can’t be helped otherwise.
For instance, we are taught in medical school that lead and other heavy metals are not good for the brain. The key is, as pediatricians we were never taught that there was any connection between heavy metals and autism. To make up or imagine “undetectable” levels of heavy metals, particularly when those heavy metals cannot cause “autistic” symptoms, cannot and will never explain this growing epidemic of ill children.
With mercury poisoning, the characteristic motor findings are ataxia, dysarthria, and spasticity. In autism, the only common motor manifestations are repetitive behaviors (stereotypies) such as flapping, circling, or rocking. As part of this dysfunction, there has been a dramatic increase in children on the spectrum with fine and sometimes gross motor issues, children with levels of hypotonia. To me, none of this is compatible with old ideas of autism, and there is nothing in multiple peer-reviewed medical literature articles to support this type of motor changes arising from mercury or other heavy metals. If a child did present with ataxia and/or dysarthria, along with autistic behaviors, then a careful medical evaluation, looking for an alternative or additional factor, is justified.
While a characteristic sensory finding of mercury poisoning is a highly specific bilateral constriction of visual fields, not only has this not been reported in children on the spectrum, but the sensory defensiveness of autism is more likely related to altered sensory processing within the brain itself, rather than a peripheral nerve involvement more typically seen with metal poisoning.
Other signs that may appear in children with chronic mercury toxicity, such as hypertension, skin eruption, and thrombocytopenia, are seldom seen in autism. When mercury poisoning occurs in prenatal life or early infancy, head size tends to be small, and microcephaly is common. Microcephaly is not common with ASD, and there are literature publications supporting general macrocephaly (larger brains) or enlargement of particular parts of the brain in children with autism. It’s worth noting that in typical exposures to neurotoxins, the tendency becomes, again, decreased head size. In spite of the obvious differences noted above, in spite of the fact that after more than fifteen years of study, in spite of the fact no paper published in the peer-reviewed literature has supported or reported an abnormal body burden of mercury, or an excess of mercury in hair, urine, or blood, how many parents are asked to do chelation for their children to clear their body of toxic (often not measurable) toxins/metals? Parents are not told that these children do not have signs of true mercury or metal toxicity and that they fail to have detectable levels by any standardized, accepted lab testing technique. Nor are parents told the fact that in multiple pediatric studies, in multiple pediatric lectures, we are taught to be concerned about th
e potential for harm from chelation itself. (Note: Supported strongly by recent FDA reports on the dangers of chelator agents). With recent finding that DMSA (a common chleating agent) is toxic to mouse and rat brains, no prescription medication I would prescribe for a child now or in the future will ever have that level of toxicity. When I graduated from medical school, you were taught that you would chelate a child with a lead level of 15 to 20. Now, current teaching is to think of chelation at 60 or 70, and to chelate above 70 or 80. Why did this recommendation change? Not because lead is good or less toxic, but because in controlled studies, something yet to be done by any group advocating chelation for children with autism, it was found by the American Academy of Pediatrics that in cases of lead poisoning, except at higher levels, children who were chelated often did worse than children who were not. When one understands how metabolically off these children are (secondary to the immune system, low NK cells, abnormal mitochondrial function—not built-in defects), one can understand the number of anecdotal reports of children seeming to be helped by chelation. By now the lack of long-term gains or changes should make many more parents suspicious, and the complete failure of any published report to support chelation confirms that the likelihood of long-term harm, probably highly exceeds any real chance of gain or success. Consider that with the known toxicity of DMSA (and likely other chelating agents) and the negative potentials of chelation itself, when applied to a presumable autistic child, how many children have been hurt without it being documented or verifiable? This should be terrifying to readers of this book and many other organizations or societies dedicated to protecting children and helping parents. When did we enter a society where frantic, desperate parents are allowed to be led down false and potentially harmful paths for treating their children, while the real medical world, the pediatric world I trained with and grew up respecting, stands by letting it happen, partly innocently, and by now at least partly inexcusably.
Sadly, talking about misleading information, while parents were presented with multiple arguments how barely detectable mercury had somehow done this to their children, in real life, in the real world there were studies looking at contamininated seafood in Japan and Iraq (and reports from health departments in multiple countries in the world, particularly those that consumed a lot of fish) showing the effects of mercury toxicity, and none showed an association with autism or autistic symptoms. In fact, on autopsy reports, there were significant decrease of neurons, increase of glial cells, macrophages, a short frontal lobe, and lack of definition of the cortical layers. Not only are none of these findings characteristic of children with autism, but, in fact, a finding of atrophy of the cerebellar granule cell layer with relative sparing of Purkinje cells is in direct contradiction to new and old reports on brains of children with autism, showing loss of Purkinje cells, not sparing of those cells. It’s time to stop chasing impossible stories and ideas and bring together a hard focus, a call for true science, logic now, or as many have now seen, this will continue on the path it is, benefiting some, but destroying many.
Multiple studies in credible, peer-reviewed journals followed victims of high-dose acute or chronic mercury poisoning resulting from contaminated foods in Iraq, Pakistan, Guatemala, and Ghana. Again, none has reported manifestations suggestive of autism in survivors. In contrast, many of these survivors had clinical signs such as persisting ataxia and dysarthria that are seldom seen in autism. In autopsies of people with autism one finds no reports of significant cerebral cortical neuronal loss or calcarine atrophy. Frequently, autistic forebrains unusually show small, closely packed neurons and increased cell-packing density. Portions of the limbic system are consistent with curtailment ofdevelopment of this circuitry. (Note: Curtailment of development is consistent with a neuroimmune shutdown of blood flow and function, not being born mysteriously defective to begin with.) As noted, another consistent finding in the neuropathology of autism is reduction in Purkinje cells in the cerebellum, primarily in the posterior inferior hemispheres.
Involvement of granule cells has rarely been reported, while in contrast, mercury-exposed brains have shown significant and consistent damage to the cerebellar granule cell layer with relative preservation of Purkinje cells as previously noted.
Finally, but also ignored by all those who so strongly advocated mercury (or heavy metals) as a cause of autism, in our history, during the first half of the twentieth century, mercury was a common constituent of medications. Use of those mercury-containing compounds was associated with illness in young children, typically those between eight months and two years old, reflecting typical symptoms of photophobia, anorexia, skin eruption, and bright pink color of hands and feet. This was called “pink disease” or acrodynia. Survivors were not described to have behavioral disorders suggestive of autism.
Issues of mercury poisoning go back many years in Japan, including epidemics of methyl mercury poisoning back in the 1950s in Manamata and the 1960s in Niigata. Heavy prenatal exposure resulted in low birth weight, microcephaly, profound developmental delay, cerebral palsy, deafness, blindness, and seizures. Affected adults experienced impairments of speech, constriction of visual fields, ataxia, sensory disturbance, and tremor. Was autism recognized with higher frequency in Japanese children in the period of these toxic outbreaks? Japanese reports in the English language do not indicate that Japanese clinicians thought so!
In summary: While mercury poisoning and autism both affect the central nervous system, specific sites of involvement in brain and the brain cell types affected are different in the two disorders as evidenced clinically and by neuropathology. Overall the clinical picture of mercurism throughout history doesn’t mimic that of autism.
It’s again worth noting that most of the ideas claiming mercury or heavy metals in children with autism were also similarly proposed first to explain adults with the strange disorder of CFS/CFIDS. In these “proposed” disease models (MS, CFS/CFIDS, fibromyalgia) exposures such as maternal Hg exposures (e.g., from vaccinations, thimerosal-containing RhoGam injections during pregnancy, or dental fillings) have been ruled out repeatedly in the literature as having no connection to causation or reason.
Vaccines
Very sadly, also contributing to lack of focus on the real medical crisis is the failure to bring to the forefront the real medical world and the pharmaceutical industry (yes, your children need them as allies). In addition to blaming metals, the linkage of thimerosal to vaccines became a great case for physicians and clinicians who have long been opposed to vaccines, to now have a large audience of desperate parents willing to listen and unfortunately believe.
When one looks at the concept of combined stresses on the immune system, particularly stresses of possibly multiple vaccines in a sick, not fully healthy child, the chance that vaccines may be one of the combination of stresses leading to that autoimmune point is very real. The temporal relationship may at times let them seem to be possible “triggers,” but they are not the cause of this disorder/epidemic. The misdirection of parent anger and frustration at this point has only served to slow up real progress for these children.
Since I trained as a pediatrician with a good background in immunology and infectious disease, I was more than aware of childhood illnesses like measles, mumps, chicken pox, polio, and more. The fact is that the real diseases, the natural diseases, both mild and severe, were not associated ever (except fetal exposure to maternal rubella) with causation or cases of autism. This is supported by the fact that during decades where there were childhood epidemics of these disorders, the rate of something called autism was so rare (1–2/10,000) that as late as the 1970s, I and other pediatricians were still being told that if we saw one “autistic” child in the lifetime of our pediatric practice, it would be one too many. Needless to say, with many practices having six to twelve such patients now, that rule is long gone. To want to focus on and blame vaccines for the change now has never been and will never be good scientific reasoning or logic. By now it should b
e criminal to mislead so many innocent families (and their children) who do not have a medical education or background to understand the many fallacies of the ideas being presented. During early days of basic science in the first year of medical school, we spent a significant amount of time learning how to dissect a medical (or other) article. As physicians we spend years of medical training to try to learn how to sort out logic from science fiction, possibilities from reality. Asking parents to do that when they have no medical background is reprehensible.
I want to to stress again, there is a wealth of data supporting the lack of causation. Understanding the role of vaccination as a potential “trigger” and helping to remove their potential role as immune stressors in any child is important. As a pediatrician, I have followed a policy of supporting necessary, important vaccinations for every child, including many high-risk families, without ever having a vaccination lead to any kind of a lasting problem. Consistent with my medical school training, my pediatric internship and residency experience, I have never given a vaccine in the nursery (the most dangerous time in a child’s early life), I do not give six or eight vaccines at one time (but if a child is fully well, that might be okay), and I never give a vaccine to a child who is ill. It has been my experience that if I explain to a mother her child is ill, and ask her to please bring him or her back when well, the mothers in my practice have been likely to do so (or we might have a strong discussion by their next exam). Because some parents won’t come back, because some might be unreliable, was it ever a good policy to give so many vaccines to so many ill children? These are issues that should be studied further, looked at, and understood in terms of immune stress, not just classical ideas looked at under the concept of “vaccine injuries.” The ideas of NIDS presented in this book are not defending or looking at the role of vaccines in regard to causing or creating “autism.” That will never be the case; it’s time to move on.
The Myth of Autism Page 14