What have we learned since Rain Man brought autism into the public spotlight?

In 1988 when the movie Rain Man was first released, many people had little familiarity with autism or understanding of what neurotypical individuals can experience on a day-to-day basis. Since then, we have indeed acquired a significant amount of information and more scientific research about the disorder, but what have we really learned as far as valid therapies and even potentially reducing its incidence?

Autism spectrum disorder (ASD), now diagnosed as a single disorder, is a complex neurodevelopmental disorder characterized by repetitive behaviors and restricted interests, social impairments, and serious communication difficulties with some being mute. The etiology of ASD remains to be understood, but it likely involves a complex interplay of genetics, environmental factors and the induction of autoimmune mediated pathology.
 
Two independent studies published in Pediatrics and JAMA Pediatrics estimate that one in 40 children has ASD. In only two years, this incidence rose 15% and is the highest prevalence since the CDC began tracking ASD in 2000. The WHO tells us that autism is a global problem with one in 160 children at present who has been diagnosed with ASD, compared to the 1980s when autism prevalence was reported as four in 10,000.
(https://pediatrics.aappublications.org/content/142/6/e20174161
https://jamanetwork.com/journals/jamapediatrics/article-abstract/27164020)

The Rising Tide of Autism

Across a mere ten-year period, from 1993 to 2003, statistics from the U.S. Department of Education revealed a 657 % increase in the nationwide rate of autism. Genetics cannot possibly account for such a rapid and tremendous rise in a disorder's prevalence over a matter of just a few years.

Genetics haven’t changed - it’s our environment and the level of toxicity on so many levels that’s been so dramatically altered for the worse. Almost every chronic disease has exponentially risen as well, which I have discussed in other blog and scientific articles on our website. But the health effects upon our children and ultimately their future is something every one of us should find truly concerning if not downright appalling.  

A recent analysis of the 2016 National Survey of Children's Health data published online in JAMA Pediatrics indicated that as many as one in six U.S. children between the ages of 6 and 17 has a treatable mental health disorder such as depression, anxiety problems or attention deficit/hyperactivity disorder (ADHD).   

Take a look at these shocking statistics from the Centers for Disease Control and Prevention (CDC):

9.4% of children aged 2-17 years (approximately 6.1 million) have received an ADHD diagnosis.2 Read more information on ADHD here.
7.4% of children aged 3-17 years (approximately 4.5 million) have a diagnosed behavior problem.3
7.1% of children aged 3-17 years (approximately 4.4 million) have diagnosed anxiety.3
3.2% of children aged 3-17 years (approximately 1.9 million) have diagnosed depression.


Why, why, why? What is going on with the decline in brain health?   

These are some factors at play in brain malfunction of kids and, for that matter, for all of us.   

1.  Diet of highly sugar diets with processed, GMO foods laced with pesticides. There is strong epidemiological data that correlates increased usage of glyphosate with an increase in autism rate.

2.  Alteration of the gut microbiome and subsequent loss of stability of the body’s ecosystem and immune function.  

3.   Acetaminophen:  research suggests that it can be a contributor to autism spectrum disorders and possibly ADHD.

4.   Genetics and epigenetics:  Genetics looks at single genes and their function, but genomics looks at the relationship between all of the genes, and epigenetics is looking at the expression of those genes. Most studies have focused on genes, and suggest that hundreds of gene variants may increase risk. So-called copy number variations, which include long stretches of duplicated or deleted DNA that can alter gene expression, appear especially common in autism.  It is of note, that it is the environment that is fueling epigenetic changes leading to disease. In a 2015 paper, the project linked epigenetic changes in the father’s sperm with risk of autism in the children.

5.   High levels of propionic acid produced by the altered gut microbiome can alter metabolic and immune pathways, gene expression, and synaptic plasticity. Propionic acid (PA) is used as a preservative in processed foods such as cheeses, baked goods, or additive for artificial fruit flavors.

6.   The CDR (Cell Danger Response) as put forward by Dr. Robert Naviaux: the CDR is an ancient metabolic response to threat, according to Dr. Naviaux who states that autism is therefore an “eco-genetic” syndrome that alters child development. In the short term, the CDR acts to protect. Once the “threat” is nullified, the CDR turns off and the cells take steps to reverse the effects of the CDR, resulting in healing. But chronic CDR has the ability to disrupt the function of every cell in the body. This will have a direct and ongoing impact on the gut and microbiome, mitochondrial function, neurotransmission and detoxification capacity.  The CDR can be turned on by infectious agents, toxins, chemicals and other environmental influences.

7.    Toxin exposure:  Exposures to environmental toxicants such as mercury, lead, arsenic, polychlorinated biphenyls (PCBs) and toluene are known causes of neurodevelopmental disorders.  It is of note that most of the 85,000 chemicals have never been tested. Evidence of increased risk appears significant with phthalates, BPA and heavy metals.  

8.    Mitochondrial dysfunction: Impaired mitochondrial function may influence processes highly dependent on energy, such as neurodevelopment, and contribute to autism.  

9.    Vaccines have been hotly debated as a potential cause or link to autism. Millions of parents across the globe have reported the onset of the onset of their children’s autism after a vaccine. Unfortunately, there is a good deal of information regarding the link to vaccines and autism due to selective censorship and removal by online social media sites and Internet search engines.

10.   Transgenerational toxicity refers to toxin exposure during pregnancy that can affect the risk of autism not just for the woman’s child, but also for her grandchildren or even a future generation. We are just beginning to scratch the surface of transgenerational effects. Recently three laboratory animal studies examined the effects of environmental exposures on several generations. The latest study, funded in part by the Autism Speaks, the nation’s largest autism advocacy organization, investigated the effects of exposure to bisphenol A (BPA), which is found in many plastics. The two additional papers examined exposure to other environmental chemicals, respectively a fungicide and a jet fuel chemical that has become widespread in our environment.

11.   EMF:  Wireless radiation can open cell membrane calcium channels, allowing too much calcium to moves into cells. This contributes to inflammatory overload.  

12.    Stress:  Findings indicate that people with ASD may be at high risk for experiencing stressful and traumatic life events, the sequelae of which can negatively impact mental health through the development of comorbid psychopathology and/or worsening of the core symptoms of ASD. Also high levels of stress during pregnancy has been linked to autism spectrum disorder for researchers have observed a variant of a stress-sensitive genes  

13.     A dysregulated immune response results from multiple environmental factors including infectious triggers (e.g. candida, bacterial pathogens (strep, mycoplasma etc.), fungi, viruses, chemicals, toxins, allergens and more.

14.   Endocrine disruptors have come under scrutiny because they can interfere with hormonal pathways involved in brain development.

15.   Prenatal exposure to air pollution and living near areas where the air is polluted with Organophosphates and Pesticides: Studies from the United States, Israel, and Taiwan have reported positive associations between particulate matter (PM), nitric oxide (NO), and nitrogen dioxide (NO2) and air pollution exposure to an increased risk for ASD.  

“Be in Charge,” University of California – Davis (http://beincharge.ucdavis.edu/index.php), reported on a study of organophosphate pesticide exposure during pregnancy, it was found that women who lived within 1.5 kilometers (just less than a mile) of treated agricultural fields during their pregnancy had a 60 % higher risk of having a child diagnosed with autism. The pesticide chlorpyrifos was associated with heightened risk during the second and third trimester. Another recently discovered chemical affecting our health is atrazine. Atrazine is a popular herbicide used extensively on corn and sorghum in the Midwest. In fact, it’s the second most used pesticide in the U.S., with more 75 million pounds used each year. It’s also the most commonly detected pesticide in drinking water, showing up in 94 % of samples tested by the USDA, despite its influence on autism genes.
 
16.   Folic acid deficiency: The SAD (Standard American Diet) is extremely deficient in folic acid.  The best foods with folic acid include broccoli, chickpeas, asparagus, brown rice, and Brussel sprouts, many if not all of which are absent in our diets. A recently published paper cites evidence that folic acid supplements may indeed reduce autism risk associated with pesticide exposure. Another study reported results from a small clinical trial suggesting that folinic acid, a form of folic acid, can ease language and communication difficulties in people with autism with the theory being some children have antibodies against the folic acid receptor. Folic acid is vital for brain function for all. In elderly people deficiency of folic acid contributes to aging brain processes, increases the risk of Alzheimer's disease and vascular dementia.

17.    Vitamin D Deficiency: Some studies have shown maternal vitamin D deficiency may have specific associations with the risk of autism spectrum disorder (ASD) and intellectual disability (ID) in offspring.

18.   Parental Age: In a recent review of epidemiological studies of non-genetic autism factors, researchers reported advanced parental age and preterm birth as established risk factors.

Summing up: it’s clear that we CANNOT attribute the rise in autism to a matter of genetics. And by recognizing that so many environmental factors are contributing to the rise of disease in children, we can also better initiate treatment strategies to address these impacts on the neuro-immune pathways that affect the brain.  

With awareness comes change. The movie Rain Man definitely made a lasting and significant impact on how we think about autism and opened the door to more conversations and more understanding. And current programs such as the critically acclaimed Netflix series, Atypical, have certainly brought autism to the forefront as it broadens awareness of the disorder. But we know we still have more work to do to continue providing even more solutions for individuals with autism as well as their families. But isn’t that the beauty of being part of a collaborative and supportive community?!

In health and hope,
Dr. Suzanne Gazda

References
For your convenience we have listed below additional sources for and links to studies and data referenced in this article.
Please be sure to visit our Helpful Links section as well for several autism resources and community nonprofit organizations.

https://www.who.int/news-room/fact-sheets/detail/autism-spectrum-disorders

https://www.statista.com/chart/17578/autism-rate-in-the-united-states/

https://www.bmj.com/content/364/bmj.l962

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6471505/

https://www.nature.com/articles/s41598-019-45348-z

https://www.ncbi.nlm.nih.gov/pubmed/24113318

https://www.nih.gov/news-events/news-releases/nih-funded-study-suggests-acetaminophen-exposure-pregnancy-linked-higher-risk-adhd-autism

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5814017/

https://onlinelibrary.wiley.com/doi/abs/10.1002/aur.1629https://link.springer.com/article/10.1007/s10615-018-0649-6

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4737505/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3944636/

https://www.sciencedirect.com/science/article/pii/S0160412018315678?via%3Dihub

https://www.ncbi.nlm.nih.gov/pubmed/27984170

Elevated Urinary Glyphosate and Clostridia Metabolites With Altered Dopamine Metabolism in Triplets With Autistic Spectrum Disorder or Suspected Seizure Disorder: A Case Study. Shaw, W., Integrative Medicine. Vol 16, No 1. February, 2017

Frye R.E. et al. Moleclular Psychiatry, 23, 247-256 (2018) PubMed
https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2667432jamanetwork.com/journals/jamapsychiatry/fullarticle/2667432

Magnusson, C., Lundberg, M., Lee, B.K. et al. Maternal vitamin D deficiency and the risk of autism spectrum disorders: population-based study. BJPsych Open. 2016;2(2):170-172