Autism 101 from a medical perspective

Doctors John Green, M.D. and Alejandro Contreras, M.D., N.D. talk with Kathy Henley, Bette Moksnes-Koski and Doug Koski about Autism. 1 hr.

Partial Transcript :

Kathy Henley – Today we have Dr John Green and Dr Alejandro Contreras, and Bette Koski and Doug Koski here to discuss Autism. So, to begin I’d like each of us to introduce ourselves and have an opening statement. Bette …

Bette Koski – Yes, my name is Bette Koski and I am the parent of young son with Autism

Doug Koski – I’m, I’m Doug Koski and I am father of the same child

Kathy Henley – And I also have an adult son with Autism, and Dr. Green…

Dr. Green – Today we’ll talk about, ah, we call it Autism 101 we’ll try to focus on basic concepts and questions that we all have and, are interested in learning more about. So, let’s go ahead.

Kathy Henley – Dr. Contreras

Dr. Contreras – Well, eh, yes, we want to make this simple so people can hear about basic aspects of Autism, and that’s what we are getting together with parents that know about Autism and we can make this very informative and beneficial for people that are facing this problem.

Kathy Henley – Let’s have our first question, Bette?

Bette Koski – What is Autism?

Dr. Green – Autism is a, a, disorder in children who are, ah it also affects adults but starts in childhood, with symptoms of need for sameness, ah, often stereotypic strange behaviors, difficulty with communication and socialization, difficulty with ah, understanding subtlety, ah, kind of rigidity in behavior and, and in affect. These many times sensory issues, sensitivity to sound, light, ah, I think vibrations sometimes, odors, things that we don’t necessarily notice. Ah, Autistic children, children diagnosed with Autism often have some, but not all of, these features. So, that’s a general view of what Autism is.

Dr. Contreras – This is complicated you know to answer that question because a parent will say, you know, how do I know that I, my child has beginning of Autism? And, you know, delays is something we see especially communication. Communication delays in speech and they don’t get the signs of communication, you know like saying, bye (waving), they don’t, they don’t do it in the time that supposed to do those signs. So it’s a syndrome, I wouldn’t say that it’s an illness, it’s a syndrome of many factors that we will mention, eh, about that.

Dr. Green – I think that’s an important point, ah, the syndrome idea that it’s not a disease process that we have figured out and can predict and identify all the causes or all the effective treatments. But being a syndrome, I think of it as a diagnostic box, that, if a child has enough disturbing symptoms, we put them in the box. I don’t like the box but it gives something to work with, it gives parents access to more information from other parents about what is this problem that my child has, it gives access to services, and as I say it gives an internet address to look up more information and find out what other people are doing. And I think also as a syndrome there’s a wide range of severity, so that we have, we we talk about the spectrum of Autism, children with minor, barely Autistic features, ah, like delayed language or don’t quite get it socially, um, to children who are really severely affected. And, I personally think of it as manifestations of injuries, and manifestations of coping mechanisms, trying to overcome stress, pain, frustration, confusion, fear, that lead to funny behaviors; repetitive behaviors, stimming behaviors, ah, isolation, posturing, ah, self injury, biting, hitting, hand slapping, even aggression towards others. Very, I think, most of the time the behaviors that children have are meaningful behaviors, not psychotic behaviors, but almost like asking for help or communicating something that, something which is not clear from just watching the behavior.

Kathy Henley – Thank you. Doug?

Doug Koski – Yeah, okay, yeah, ah, touched on it lightly, but is there a cause, what is the cause of Autism?

Dr. Green – Well, there’s a lot of speculation. Um, I, I talk about the new autism. As I see it we have a new condition that’s really about a generation old. Um, first identified in the 40’s, very rare, generally severe, often from birth. Um, that was the original description of Autism, Kanner Autism. And what we see now, particularly the last about 20 years, is a very great increase in the frequency of Autism, the incidence of Autism, and different, different levels of severity, many of the children, many of the children have ah, regression. We see many children who started out with no sign of anything wrong, meeting milestones, and beginning to speak, communicate, emotional connection, ah, no signs of Autism. And then at between 12 and 24 months, a loss of contact, loss of language, loss of skills, often diarrhea, or abdominal issues. So, um, there’s a new illness that we’ve been visited with that we’re calling regress, regressive Autism and which is accelerated has escalated dramatically really more than 10 fold in the last 20 years. Causes. Speculation on causes range from the mercury in vaccines, and the mercury background from dental fillings and fish, and I think Mt. St. Helens perhaps, in our area, um, other heavy metals, lead, antimony, and, and in ah children’s clothing and as a flame retardant. The measles MMR combination which is a potent triple live vaccine, ah, that’s temporally very often associated with the regression. Many children within weeks or month or two of the MMR shot show this kind of regression I was describing. I think here are other factors that we haven’t yet identified. Um, in looking at the children who respond to a specific kind of treatment, ah, the benefit of the treatment suggests that’s getting towards the cause at least. Whether we’ve got to the core issue or not, I feel that we have as many questions yet as answers. But, many good questions with partial answers.

Dr. Contreras – Well, in, yeah, there is a genetic predisposition in children. The question is really important because the contributing factors that Dr. Green is mentioning is something that we’re finding very serious in children. And, there is not a common agreement, there is not just one cause, it is multifactorial. So we see that there are chemical factors that is all over, you know, chemical, pollution, things that additives, dyes, there is some reason that is why we are researching. These children have this tendency to retain those chemicals more than other children. You question why is this child getting more toxic, and this one, not so much. So these children definitely have toxic problems, but also we know that there is a link with gastrointestinal problems. Gastrointestinal problems is another factor that we can see that many children have gastrointestinal problems and that’s something we can talk more about, definitely, but there are, there are several factors in the gestation, or the etiology of Autism that all researchers are looking for.

Dr. Green – I think your point about impairments in detoxification as perhaps a genetic predisposition it appears to be at least somewhat so. Um, is important. Why does one child have all the exposures, even in a family and do okay, or have maybe some minor, maybe a little dyslexic issues or ADD, but nothing really ah great problems and another in the family have frank, full blown autism, there has to be some genetic difference in that way and when you look into the genetics, we do find the detox pathway has some minor errors that don’t affect much, life, longevity, ah, they’re not lethal mutations, but small changes more commonly in the children, not, but nothing like 100%, about 25% is as high as we’ve found in any of the children with Autism. Still, when you look at those it explains, at least partially, the difficulty dealing with toxic load, dealing wit heavy metals, dealing with pesticides, dealing with indoor air pollutants, and volatiles, and gasoline, benzene, all the things that we all, we all are carrying a toxic load. But there’s something different about the way that children with Autism respond to those kinds of toxins, and also often to germs, that their, their immune capacity to defend themselves against opportunistic yeasts, against bacterial infections that we see a lot more antibiotic history in Autistic children in general than in neurotypical children. Ah, their, their immune defenses, again that’s part of the detox system is detoxifying infections, they don’t work, often don’t work as well as in other children. Ah, we also find more commonly autoimmune kinds of features in Autistic children, as if their immune system is, it’s there it’s operational but it’s making some mistakes in identity and in protecting itself rather attacking some of its own tissues. We’re not to the point at this stage to be able say that it’s causing disease but it’s a very troubling finding. And in the families of autistic children it’s more common to find rheumatoid arthritis, or allergies or other, other kinds of immune disorders. And again it’s not, there’s not a heavy load of that but there’s an indication of that, that kind of problem. And, ah, to go on with the same concept most, quite recently, studies of the brains on autistic children, who have died of other causes have shown that there’s an immune response, an inflammatory response in areas in the brain that are not working well. But it appears that those, that activation of the immune systems in those areas of the brain is caused by something, may well be caused by something outside of the brain. Ah, as our dear friend Martha Herbert has said, “is autism a disorder of the brain or Autism a disorder that affects the brain?” And, much evidence is, ah, is available to suggest that, ah, as she would put it, the brain is downstream of the body and the gastrointestinal issues, toxic issues ah, are spilling over to the nervous system which is extremely sensitive, doesn’t have a lot of defenses and manifest some of the difficulties that we see.

Dr. Contreras – I want to emphasize about the, the, the gastrointestinal issues, because you know the inflammation is something that, ah, is really an issue in all, in many of the Autistic children. And inflammation in the gastrointestinal system. Now we question, you know, what, what is causing that inflammation and we see that these, these children have an early history of abuse of antibiotics. Many of them, not all. But ah, that’s a factor that for most of the parents you know you think about that why my child has gastrointestinal problems, and what is causing, what is, pro, eh, affecting the brain and it has to do when there is inflammation there is not good absorption, there is malabsorption and the malabsorption causes deficiencies. So we see that many of these children, eh have deficiencies. Deficiencies in different nutrients because they don’t absorb it well. And why they don’t absorb it well just because there is an inflammation in the intestinal, in the gastrointestinal tube. So, and also we can see that there are many disbiotic problems. What I mean by that is that there is overgrowth of the flora and the yeast and it can be very serious in children. And we really, look into that and for most of the parents is important to be aware that something is, is affecting this gastrointestinal system. Because most of the time we look at the Autism like something in the brain something just in the brain but many children have this yeast, bacteria, parasite that are affecting the entrance of all the nutrients. So deficiencies is a big thing, like allergies is another thing. So if, if the intestinal wall is affected also there is a lot of intolerance to food, foods, and food is a big issue in them because they behave, eh, some of them they behave like celiac people, which is intolerance to glutein and also others to casein which are really important aspects for to test in children. And the interesting thing is that when you change certain diet in the children you see changes in them. When you supply some nutrients in them also produces changes in them. And, and, so there is that link that I, I was saying between brain functioning and gastrointestinal function, this, just this interesting parallel that we need to be aware of that, and, and so.
(Note : the remainder of this video has not yet been transcribed)