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Autism: New Insights But Cure Still an Elusive Goal

Diet and nutrition among areas of research

THURSDAY, April 28, 2005 (HealthDay News) -- Autism is a confusing and frustrating developmental disorder, one that is hard to diagnose, hard to treat and impossible to cure.

"It was poorly recognized by medical professionals, particularly in the early days," said Andy Shih, chief science officer of the National Alliance for Autism Research in Princeton, N.J. "Autism was once called youth schizophrenia, and there's been a lot of conflict over whether or not autism is an independent disorder."

These days, scientists are making promising gains in the search for the triggers and causes of autism, with the ultimate goal of finding ways to treat children with the disorder. And with April designated National Autism Awareness Month, doctors and researchers are taking stock of what they've learned about autism -- and how much more they need to know.

Autism, also called autistic disorder, usually is diagnosed in children younger than 3, according to the U.S. Department of Health and Human Services. The disorder prevents children from interacting normally with other people and affects almost every aspect of their social and psychological development.

Autism has a wide range of symptoms, and varies even among children suffering from similar characteristics. But according to the federal Autism Information Center, children with autism:

  • Have difficulty communicating with others. They may not interact with others the way most people do, or they might not be interested in other people at all. Some children with autism may not seem to notice when other people are trying to talk to them. Others might be very interested in people, but not know how to talk, play or relate to them.
  • May become upset by a small change in their environment or daily routine. For instance, if a child is used to washing his or her face before dressing for bed, he or she might become very upset if asked to change the order and dress first and then wash.
  • Exhibit repetitious behaviors, such as rocking back and forth, head banging or touching or twirling objects.
  • Have a limited range of interests and activities.

Symptoms of autism can be seen in early infancy, but the disorder also can appear after months of normal development. In most cases, there's no obvious cause to explain what triggered the disorder.

Studies estimate that as many as 12 in every 10,000 American children have autism or a related condition, according to the Department of Health and Human Services. Autism is three times more common in boys than in girls.

To help guide scientists and funding, the National Institutes of Health designed an autism research matrix in November 2003 that comprehensively covers everything that still needs to be learned about the disorder before effective treatments can be discovered, Shih said.

The matrix includes a multi-pronged strategy. For example, Dr. Woody McGinnis, a primary-care physician from Ashland, Ore., who specializes in behavioral disorders, is coordinating a multiple-center NIH study on ways to treat autism through diet and nutrition.

McGinnis' research focuses on the role of oxidative stress in autism.

"Oxidation is basically burning," McGinnis said. "Chemically, it involves the loss of electrons. A burning match is a clear case of oxidation." Other examples include an apple slice turning brown or vegetable oils that go rancid, he said.

McGinnis' studies have found that autistic children exhibit high levels of cellular oxidation, which exacerbates the disorder's symptoms.

To treat this, McGinnis is exploring the intravenous use of important antioxidants such as zinc, magnesium and various vitamins. He said his research has shown some success. "Some of these kids talk only on the days they get these IV treatments," McGinnis said.

Another line of research is offered by the High Risk Baby Siblings Autism Research Project, a National Institute of Child Health and Human Development program that focuses on early diagnosis of autism spectrum disorders, Shih said.

In this study, researchers at eight academic medical centers are closely following the development of children whose older siblings already have been diagnosed with autism, Shih said.

"Hopefully, by tracking their development they can find behavioral and environmental cues that will help diagnose future cases," Shih said.

Researchers also have found that children with autism tend to have a higher rate of head growth in the early months of their development, Shih said. "It could be an early indicator," he said.

All these studies and findings will contribute to the larger goal of the Autism Phenome Project, an NIH effort that is a "comprehensive effort to describe all the behavioral aspects and biological aspects of kids with autism," Shih said.

McGinnis believes the project ultimately will find that there's no one factor that causes autism.

"I believe the causes of autism are multiple," McGinnis said. "Autism is resulting from one or more environmental factors imposing upon one or more genetic predispositions."

In the meantime, experts stress the importance of early diagnosis of autism in helping treat children with the disorder.

The U.S. Centers for Disease Control and Prevention recently began a campaign called "Learn the Signs. Act Early." It is aimed at increasing parents' knowledge of a child's overall development, especially important milestones in how a child learns, plays, speaks and acts.

McGinnis said parents who think something's wrong with their child's development should doggedly pursue their concerns, even if the first doctor they consult dismisses their worries.

"Parents usually know best when there's something going wrong in the child's development," he said. "That's just a clinical truism."

More information

To learn more, visit the U.S. Centers for Disease Control and Prevention's Autism Information Center.

SOURCES: Andy Shih, chief science officer, the National Alliance for Autism Research, Princeton, N.J.; Woody McGinnis, M.D., Ashland, Ore.; U.S. Department of Health and Human Services; U.S. Centers for Disease Control and Prevention
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