Thursday, December 20, 2007

Why is Aspergers associated with Autism?

I was always going to do this post but until two days ago when my youngest son was diagnosed with high functioning autism, the words were going to be different and this was going to be a rant.

Since then, I've spent a while trying to figure out his condition. Now I can see the link.

The Usual Reaction
I've always considered Aspergers to be quite different from Autism - I was certainly different to most of the autistic people I'd met, many of whom couldn't function in society because of the nature of their condition.

I think that my reaction is pretty much the same as most of the population. Like other "popular" conditions, such as schizophrenia, autism has been spoilt by a mis-representation in the movies. Movies only show the very worst and most sensational cases and even then, they make a lot up.

Sure, I knew that at least some forms autism actually resulted in "smarter" people who had no social skills. That happened in Mercury Rising with Bruce Willis right? It might also have been in "a beautiful mind" but I never got to see the film so I can't be sure.

If you are after a complete and accurate description of autism, you should refer to the Wikipedia article since I intend to only cover a small area;


Some Brief Facts
Autism is a mental condition which you are born with. Despite spammer/scam artist claims to the contrary, it can never be cured although in time, the "sufferers" may learn to hide some of the worst symptoms.

There is a split in autism that, separates "High Functioning Autism" from Low Functioning Autism. The main characteristics that set high functioning autism apart are an IQ of 80 or above and the ability to speak, read, and write. People with mild HFA have minimal problems getting (and keeping) employment and many are employed in highly technical environments.

Autism is grouped with four other pervasive developmental disorders (PDD), all of which have problems of social interactions and communication, restricted interests and repetitive behavior. Of the other four, Asperger's is closest to Autism in symptoms (and probably cause). Unlike Autism, Asperger's has no substantial delay in language development.

So What does it all Mean?
Basically, this means that there could be NO other differences between a child with Aspergers and a Child with High Functioning Autism other than a language delay. The cut off point for the language delay is 4 years of age. If the child is not capable of carrying out an "independent" conversation by the age of four, then they will be considered autistic. Note that the emphasis is on conversation, not on knowing the words, being able to read or being able to write. In my Son's case, you can ask him about preschool and he'll tell you a whole heap of facts and one-liners about what happened. It's generally a one way conversation.

This sounds a bit pedantic, and I guess the diagnosis is, but that's currently how it's done.

So, will this improve? It is difficult to say however in HFA, it is very likely that conversational skills will improve with practice, age and use. Eye contact could always be a problem, but there are other ways around that. The ability to hold conversations however will not necessarily "upgrade" a diagnosis to Aspergers, though I'm a little skeptical myself about that one.

The Spectrum
It is important to realize that there is a whole spectrum for autism, not just a few labels and that this means that there is almost infinite variation. The diagram below is very simple and does not cover much at all but it may give you some idea. In reality, the diagnosis would look much more like a star with various branches indicating IQ, communication ability, empathy, motor control etc. Each type of autism would have various characteristics and would define a certain shape on the star. The lines between one shape and another would be very blurred.

<--- Normal ------ Aspergers ----- HFA -------------------- LFA ---->

One Last Point
Whenever anyone is told about an autism diagnosis, their first reaction is usually something along the lines of " that can't be it because he shows empathy or has emotions". I'm going to quote from Wikipedia since I can't think of a better way to end this point.

They do not lack empathy (although they may have difficulty expressing it), and can thus enjoy films and stories with emotional content. Some may gain the bulk of their insight into why people behave the way they do through watching movies that provide a forceful and musically-cued "capsule lesson" in human emotions (e.g. melodramas).

15 comments:

Anonymous said...

Hi,

So, you have AS, your wife is NT, yet you have two children with HFA (or one with HFA and one with AS)?

As I understood the chances of passing such a gene were infinitesimal (I read a few citations, one had the chances of an Aspie parent and an NT parent producing a child on the spectrum at 1 in 500, another was 1 in 1200), but it seems that for you it is surprisingly dominant.

What I'm asking is, what are the actual chances of an AS/NT couple of producing a NT child? It has been confusing me for a while.

Thanks and best of luck,
T

Gavin Bollard said...

I have one child with HFA and one with AS?

The odds of passing the Asperger's gene on are obviously much higher than older research suggests.

I've talked to quite a number of aspie couples and almost all of them so far have at least one aspie child.

In theory the Asperger's condition should be more prominent in males, and my experience confirms it (for me). There do seem to be a lot more males than females with the condition. I am however astounded by the high number of females - still lower than males but much higher than expected.

Modern genetics is a very young science. It's only been quite recently that they've realized that DNA isn't anywhere near as complex as originally thought. Less elements in DNA obviously means greater chances of passing on genetic differences.

I don't claim to be a scientist or doctor and can't answer your question with any real authority but based on what I've seen, the Aspie gene has a very good chance of being passed on.

Anonymous said...

Hi,

Thanks for your response. It certainly does seem that the chances of passing on the father's AS gene are upwards of 90%.

Regards,
T

Foresam said...

You need to start learning what's happened in the last few years. We've been curing autism since 2000. We've known it is NOT a genetic condition since 1999 when it was learned that all autism is caused by mercury. Nobody is born with autism unless they were poisoned by mercury in the womb.

Gavin Bollard said...

Since I've seen Aspergers at least follow down several generations transmitted by males, I find it a little hard to believe that all the females had Mercury in their womb - unless the males put it there.

I'm happy to let this comment stand however until I find evidence to the contrary.

Foresam said...

Gavin,
Testosterone makes mercury more potent while estrogen lessens the effect. Those with the APO-E4 protein can not rid themselves of mercury. That is the genetic component.

The fact that most autistic kids show some improvement with chelation confirms that removing the metals helps improve the autism. That means the metals are responsible for the condition. While mercury does kill brain cells, it also prevents methylation so that B-12 can not be converted to methyl B-12. Without methyl B-12, it is impossible for anyone to pay attention to anything. That is a perfect description of severe autism.

Gavin Bollard said...

From what I can tell, the Mercury train of thought comes from the flawed research of Dr Andrew Wakefield.

Here's an article which says about Mercury in the MMR Vaccine in the US;

"Crucially, it has never been an element of the MMR vaccine here"

It also mentions that Dr Wakefield is effectively outcast in both the US and the UK and has been condemned by a number of Government officials, including Tony Blair.

I told the truth all along, says doctor at heart of autism row

Another article for the interested;

Why investigating Wakefield matters.

The Wikipedia page on Andrew Wakefield is also worth a read because it covers his, and his colleagues retraction statements.

Gavin Bollard said...

Oh, and while on the subject of Chelation...

"Chelation therapy describes the use of chelating agents to detoxify poisonous metal agents such as mercury, arsenic, and lead by converting them to a chemically inert form that can be excreted without further interaction with the body. Chelation is also used as an unscientific treatment for autism or other conditions. There are no published peer review publications regarding the efficacy of chelation agents for the treatment of autism.

From the Wikipedia entry for Chelation

Foresam said...

Gavin
Wakefield had nothing to do with confirming the theory that mercury caused the autism epidemic. I know there was never thimerosal in the MMR. Thimerosal as the cause and the MMR vaccines as the cause are two different issues.

Trusting any information from Wikipedia is a mistake since any idiot can go in and edit this site. The fact that the word "unscientific" appears along with a complaint about no peer review should tell you this entry was edited by a nitwit. People who have cured their children with chelation would not call chelation unscientific. That would only be done by a nitwit who has something to lose by anyone showing that mercury is the cause.

There are trillions of dollars at stake here for the drug companies. That is the reason they have come up with some very good lies and misinformation. That's also why quackbusters, an arm of Pharma, is involved with Neurodiversity to pervert the disabled youth like Alex Plank into celebrating the brain damage that their products caused.

This is a good propaganda campaign, Gavin, to convince people that autism and Asperger's are simply "different wiring" and not actually mercury induced brain damage. Those of us who have seen improvement with chelation know the truth. We aren't about to fall for this propaganda.

eScential said...

Any simple answer to a complex problem is unlikely to be the answer.

Autism has many 'causes' or interactions that cause the appearance called autism. Already genes are being found that apply to only a limited number of persons. Some could be related to diet or as Dr. Laura says, nothing to do with diet, all improvement due to the added attention. Some could be subacutepanencephalitis or another infection.

Most are gene related with a combination of interactions. Since B12 has helped my mental function, I want to try MB12. I get called names for this rather than finding a path to try something innocuous, unlike chelation. If it worked for me, that would not mean it will work for my autistic son or cousin or aunt or neighbor or you. There are families with 4 or more children on the spectrum and twins where one is fully nonautistic. Mercury and any other simple answer cannot be THE answer.

Aranittara said...

We are not damaged and we don't need to or in many cases want to be cured
If you can't understand that I couldn't care less who are you to try to eliminate us to try to normalize us

Anonymous Ghost Writer said...

For the benefit of those who may be reading this blog and Foresam, how about a bit of Science from someone in the field.

APO-E4 is an Apolipoprotein, or protein that binds to lipids (fats and various oils) and is used in the metabolism of these fats in the liver, not the brain. While mercury [element] does absorb into that fatty tissue of the body easily, including the brain’s myelin, APO-E4 cannot and does not directly bind and transport mercury from the body. The most interaction that is possible is for APO-E4 is to facilitate the metabolism of Triglycerides in the blood stream which may be contaminated with Mercury.

Thimerosal the antibacterial component in vaccines that contains Mercury is used in microgram quantities (one/one millionth of a gram). While Thimerosal is linked the neurological disorders and mutagenic/tetragenic conditions the safe exposure limits are place well within the milligram range a thousand times greater than the concentrations found in most vaccines. In fact a shattered fluoro light will give a much greater exposure than the average vaccine to Mercury. The CDC has stated that "Since 2001, with the exception of some influenza (flu) vaccines, Thimerosal is not used as a preservative in routinely recommended childhood vaccines." Rarely do manufacturers change formulations between countries as it often costs more to have two separate manufacturing line operating at once, even between countries. I wish to point out that even thought mercury was removed from vaccines Autism is still diagnosed across the world.

Chelation, the binding of heavy metals to a biologically inert substance that can then be excreted from the body has enjoyed wide spread medical acceptance only in treatment of heavy metal poisoning. Heavy metals poisoning is defined by a metal that by its presence poses a threat to life, i.e. lead poisoning from using old artists white (Lead Oxide). Studies on the therapeutic use of chelating have advised caution when used for treatment of non-life threatening cases as many of the 'medicines' (and I use that word lightly) used can pose a risk of cancer if improperly used.

Finally, I find it offensive to be told that I am the way I am because of 'Mercury induced brain damage'! I do not wish for a cure nor do I want to be told that I am damaged or defective. I would be raked over hot coals if I were to say that someone confined to a wheelchair is defective yet I am told this everyday by popular opinion. I demand only the rights that I have been given under the Universal Declaration of Human Rights and various laws, to be treaded with respect as accorded to all people nor matter their race, creed or ability.

And for those that may wish to check some facts about the Vaccine-Autism link please see below.

http://www.journals.uchicago.edu/doi/full/10.1086/596476?cookieSet=1

http://www.cdc.gov/Features/AutismDecision/

http://www.cdc.gov/vaccinesafety/

(I would like to see the likes of Foresam argue with the CDC on this one, I'm sure though he would give it a try!)

Balach said...

Wow, so my druggie father had enough presence of mind to put Mercury in my mom's womb... twice?!? Wow. How amazing. And why do I say it like that? Because my girlfriend has three children. Two of them exhibit many Aspie traits. One of them has never been vaccinated. At all. She's 7.
Try again Foresam.
Oh, and thanks Mr. Doctor/Scientist man. I had no idea what I was reading till I got to your post.

eaucoin said...

I think the science here is still too new. Doesn't it make logical sense that a condition with a genetic predisposition will be more concentrated in afflicted families than in the general population. So the idea that an Aspie breeding with an NT has a 1 in 500 chance of producing a child with ASD (when experts like Tony Atwood are citing the ASD rate as maybe 1 in 150 in the whole population) seems like bad math. In my family, one of the co-morbids is epilepsy. Of the 50 grandchildren of my epileptic (and I believe Aspie) father, the full-blown autist and both of the Aspies are also afflicted with epilepsy. My husband pointed out to me once that the only factor in our extended family that is common to all of those with ASD symptoms is that they also resemble my father in appearance more than their unaffected cousins. I realize that this is anecdotal evidence only, but I can hardly wait until the body of evidence comes together in a meaningful way for the sake of my future grandchildren and great grandchildren. I'm sure hindsight will show us that we missed some fairly obvious information.

Andreas said...

I have a question for you, Gavin. How familiar with NLD/NVLD are you? (Nonverbal Learning Disorder)

I think the HFA and AS difference is a good one, only because from a research point of view, language delays are potentially very significant, biologically. Treatment (current) and every day Actual life, it makes little difference.

Although, this comparison of AS to NLD was quite interesting.

(Klin, Volkmar, Sparrow, Cicchetti, & Rourke, 1995)
The neuropsychological records of each subject were reviewed and rated according to 22 items—7 assets and 15 deficits considered to be the defining criteria of NLD.

An overwhelming concordance between AS and NLD was obtained (n = 18), whereas there was virtually no overlap between HFA and NLD (n = 1). Furthermore, 11 of the 22 NLD items were found to discriminate between AS and HFA, of which 9 appeared to be independent of diagnostic criteria.


Still, I have seen some studies where across all 3, there were few differences. I would like to scrutinize more! I believe there are 2 relatively distinct categories there, not 3. (all preliminary, of course).
--
As for the cure, I highly disagree. Adapting and compensating for symptoms is most likely. With the genetic prevalence, mercury seems highly unlikely, especially considering the amount in the oceans, and our compact light bulbs are loaded with them. While having hope is good, there is the risk of unrealistic and unrealized expectations, which would could be quite damaging. I understand Why you feel that way, for who would sit idly by and watch their child suffer? I ask that you be weary and remember that your child will try and live up to your expectations, if you consider that possibility, even if only a little, it could help you see things through your child's eyes.

Gavin, I commend you with posting those arguments, AND even addressing them. I'm sure that I was as offended as you were. That was very reasonable/responsible of you : )