Can Autism be caused by MMR?

MMR Vaccine and Autism

Autism spectrum disorders (ASDs) are a group of related brain-based disorders that affect a child's behavior, social, and communication skills. Approximately 1 in 88 children are diagnosed with an ASD. ASDs are lifelong conditions with no known cure. However, children with ASD can progress developmentally and learn new skills. Some children may improve so much that they no longer meet the criteria for ASD, although milder symptoms may often persist.

Because the MMR vaccine is first given at age 12-15 months, and the first signs of autism often appear at 15-18 months of age, concerns have been raised about a possible link between the vaccine and the development of autism. Studies conducted in the US and Europe have found no association between the MMR vaccine and autism. Over the years, the Institute of Medicine and the AAP have organized several panels of independent scientists – all concluded that there is no association between MMR and autism.

How the Claim Started
Andrew Wakefield's study in The Lancet in 1998 began the concern about MMR and autism. Since the study was published, 10 of the 13 authors have retracted the findings. In 2010, The Lancet retracted the study, citing ethical misconduct on the part of Wakefield.

Autism Omnibus

Three rulings related to autism and vaccine injury compensation cases were issued on February 12, 2009, by the Special Masters of the US Court of Federal Claims. The rulings were part of the Omnibus Autism Proceeding, created by the National Vaccine Injury Compensation Program to handle the large volume of claims (over 4,900) that vaccines induce autism. In three separate rulings, each of the Special Masters ruled that the measles-mumps-rubella vaccine, whether administered alone or in conjunction with thimerosal-containing vaccines, was not a causal factor in the development of autism or autism spectrum disorders. 

Do Autism symptoms change over time? and Current treatments

Do symptoms of autism change over time?

For many children, symptoms improve with treatment and with age.  Children whose language skills regress early in life—before the age of 3—appear to have a higher than normal risk of developing epilepsy or seizure-like brain activity.  During adolescence, some children with an ASD may become depressed or experience behavioral problems, and their treatment may need some modification as they transition to adulthood.  People with an ASD usually continue to need services and supports as they get older, but many are able to work successfully and live independently or within a supportive environment.

How is autism treated?

There is no cure for ASDs.  Therapies and behavioral interventions are designed to remedy specific symptoms and can bring about substantial improvement.  The ideal treatment plan coordinates therapies and interventions that meet the specific needs of individual children.  Most health care professionals agree that the earlier the intervention, the better.

Educational/behavioral interventions:  Therapists use highly structured and intensive skill-oriented training sessions to help children develop social and language skills, such as Applied Behavioral Analysis.  Family counseling for the parents and siblings of children with an ASD often helps families cope with the particular challenges of living with a child with an ASD.

Medications:  Doctors may prescribe medications for treatment of specific autism-related symptoms, such as anxiety, depression, or obsessive-compulsive disorder.  Antipsychotic medications are used to treat severe behavioral problems.  Seizures can be treated with one or more anticonvulsant drugs.  Medication used to treat people with attention deficit disorder can be used effectively to help decrease impulsivity and hyperactivity.

Other therapies:  There are a number of controversial therapies or interventions available, but few, if any, are supported by scientific studies.  Parents should use caution before adopting any unproven treatments.  Although dietary interventions have been helpful in some children, parents should be careful that their child’s nutritional status is carefully followed.

Cause of Autism and Does Inheritance play a role?

What causes autism?

Scientists aren’t certain about what causes ASD, but it’s likely that both genetics and environment play a role.  Researchers have identified a number of genes associated with the disorder.  Studies of people with ASD have found irregularities in several regions of the brain.  Other studies suggest that people with ASD have abnormal levels of serotonin or other neurotransmitters in the brain.  These abnormalities suggest that ASD could result from the disruption of normal brain development early in fetal development caused by defects in genes that control brain growth and that regulate how brain cells communicate with each other, possibly due to the influence of environmental factors on gene function.  While these findings are intriguing, they are preliminary and require further study.  The theory that parental practices are responsible for ASD has long been disproved.

What role does inheritance play?

Twin and family studies strongly suggest that some people have a genetic predisposition to autism.  Identical twin studies show that if one twin is affected, there is up to a 90 percent chance the other twin will be affected.  There are a number of studies in progress to determine the specific genetic factors associated with the development of ASD.  In families with one child with ASD, the risk of having a second child with the disorder is approximately 5 percent, or one in 20.  This is greater than the risk for the general population.  Researchers are looking for clues about which genes contribute to this increased susceptibility.  In some cases, parents and other relatives of a child with ASD show mild impairments in social and communicative skills or engage in repetitive behaviors.  Evidence also suggests that some emotional disorders, such as bipolar disorder, occur more frequently than average in the families of people with ASD.

The Evolution of Autism

History of Autism

Assuming that Autism is a neurological disorder and not caused by “bad” parenting or environmental toxins then it has, most likely, always existed among human beings; however, it was not scientifically described or empirically researched until the 20^th century.

Early 1900s

In the early 1900s autism was thought to be a form of childhood schizophrenia, feeble-mindedness, or childhood psychosis.

The term autism was first used by the Swiss psychiatrist Paul Eugen Bleuler between 1908 and 1912. He used it to describe schizophrenic patients who had withdrawn from social contact, appeared to be living in their own world, and were socially disconnected. The root of the word autism is derived from the Greek “autos” which means “self”. That root is combined with the Greek suffix “ismos,” meaning the act, state, or being of. Bleuler used the word “autism” to mean morbid self-admiration and withdrawal into self. It suggests a state of being absorbed by oneself, lost in oneself, removed from social interaction, and isolated from social interaction. While Bleuler described and documented characteristics of autism, his adult patients were diagnosed as having schizophrenia and children were diagnosed as having childhood schizophrenia.

1920s and 1930s

In 1926, Dr. Grunya Efimovna Sukhareva, a Russian psychiatrist described what would later become the core deficits of Asperger Syndrome in boys that she labeled as having schizoid personality disorder of childhood. In 1933, Dr. Howard Potter described children who would now be identified as autistic as having a childhood form of schizophrenia.

1930s and 1940s

The two main pioneers in autism research, Hans Asperger and Leo Kanner, began working separately in the 1930’s and 1940’s. In 1934 Hans Asperger of the Vienna University Hospital used the term autistic and in 1938 he adopted the term “autistic psychopaths” in discussions of child psychology. However, Leo Kanner of Johns Hopkins Hospital began using the term autism to describe behaviors that are now recognized as Autism Disorder or classical autism. Leo Kanner is the one who is usually credited for using the term autism as it is known today.

Kanner’s 1943 descriptions of autism were the result of his observations of eleven children who showed a marked lack of interest in other people, difficulties in social interactions, difficulty in adapting to changes in routines, good memory, sensitivity to stimuli (especially sound), and a highly unusual interest in the inanimate environment. These socially withdrawn children were described by Kanner as; lacking affective contact with others; being fascinated with objects; having a desire for sameness; and being non-communicative in regard to language before 30 months of age. Kanner emphasized the role of biology in the cause of autism. He felt that the lack of social connectedness so early in life must result from a biological inability to form affective relationships with others. However, Kanner also felt that parents displayed a lack of warmth and attachment to their autistic children. In his 1949 paper, he attributed autism to a “genuine lack of maternal warmth.”

In 1944, working separately from Kanner, Hans Asperger described a “milder” form of autism, known today as Asperger Syndrome. Asperger also studied a group of children who possessed many of the same behaviors as described in Kanner’s descriptions of autism. However, the children he studied demonstrated precocious vocabulary and speech development but poor social communication skills. These children appeared to have a desire to be a part of the social world, but lacked the necessary skills. He also mentioned that many of the children were clumsy and different from normal children in terms of fine motor skills.

1950s

During the 1950s, Bruno Bettelheim, a University of Chicago professor and child development specialist, furthered Kanner’s 1949 view that autism resulted from a lack of maternal warmth. Bettleheim’s view of autism being caused by emotionally cold and distant mothers became known as the Refrigerator Mother Theory of autism. The idea behind the theory was that children became autistic because mothers didn’t interact, play, or them; in a sense, they were “frigid.” He published articles throughout the 1950s and 1960s to popularize this position. Proponents of this view were searching for a place to lay blame for autism.

It was also during this decade and into the next that parents were counseled to institutionalize their children in order for them to receive appropriate treatment.

1960s

Beginning in the 1960s there was increased awareness within the professional community that the refrigerator mother theory did not adequately account for autism. The theory ignored the fact that siblings of autistic children were not autistic despite having the same mother, and scientific advancements began to suggest more biological causes.

In 1964, Bernard Rimland, a psychologist with an autistic son, stressed the biological causes of autism in his book “Infantile Autism: The Syndrome and its Implications for a Neural Theory of Behavior.” The publication of this book directly challenged the prevailing refrigerator mother theory of autism. In 1965, Rimland established the Autism Society of America, which was one of the first advocacy groups for parents of children with autism. He established the Autism Research Institute in 1967 to conduct research on treatment for autism.

In 1967 autism continued to be classified under schizophrenia in the International Statistical Classification of Diseases and Related Health Problems. This promoted the view that autism was a mental illness rather than a developmental disability.

1970s

There was a push during this decade to better define autism and, with scientific advancement, there was better understanding of autism as having a neurobiological basis.

1980s

The publication of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III) in 1980 finally set autism apart from schizophrenia as it was now categorized as a neurodevelopmental disorder. Autism research continued to increase during the 1980s along with recognition within the scientific community that autism resulted from neurological disturbances rather than pathological parenting.

It was during this decade that Asperger’s work was translated to English and published. The term, “Asperger’s Syndrome” was first used in 1981 by the British psychiatrist Lorna Wing. She also developed the Wing’s Triad of Impairments, which is Impairment in Imagination, Impairment in Social Communication, and Impairment in Social Relationships to describe autism.

1990s

In 1994 Asperger’s syndrome was officially added to the DSM-IV as a progressive developmental disorder. Two nonprofit groups, the National Alliance for Autism Research and Cure Autism Now, were founded to stimulate autism research and raise awareness about the disorder. Research starts to suggest that autism is a spectrum disorder. Near the end of the decade, as autism rates rose, it was speculated that autism was due to mercury in vaccines.

2000s

In 2000, vaccine makers removed thimerosal, a mercury-based preservative, from all routinely given childhood vaccines. Public fears were that exposure to the preservative were related to autism. The National Institute of Health estimated that autism affected 1 in 250 children in 2001. The Institute of Medicine found no credible evidence of a link between thimerosal or any other vaccine and autism in 2004.

The prevalence of autism increased significantly during this decade as a result of better detection, broader diagnostic criteria, and increased public awareness. In 2007 the Centers for Disease Control and Prevention reported that approximately 1 in 150 children were diagnosed with autism. Part of this increase is a result of better understanding of autism as a spectrum disorder.

2010s

A hundred years later, the term autism describes a neurodevelopmental condition that results in significant social cognitive and social communicative impairment. Current research is focused on identifying biologically distinct subtypes of autism. The belief is that once subtypes are understood advance can be made in regard to understanding cause and developing effective treatments. The ultimate goal of this line of research is to eventually find a cure and be able to prevent it.

Until that time, the prevalence of autism continues to increase. In 2012, the Centers for Disease Control and Prevention reported that approximately1 in 88 children are diagnosed with an autism spectrum disorder.

The upcoming publication of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) in May 2013 will remove Asperger Syndrome and PDD-NOS as separate from autism. Instead, diagnosis will be autism spectrum disorder in an attempt to more accurately reflect the continuum and severity of the types of symptoms and behaviors displayed.

It will be interesting to see how these diagnostic changes and research into the biological subtypes of autism impact the future evolution of this neurodevelopmental disorder.

Source:

http://ct-educationadvocates.com/information/autism/ the-evolution-of-autism/

Autism Treatment Network

Our Autism Treatment Network is a collaboration of medical centers dedicated to providing families with state of the art, multidisciplinary care. The ATN was established to provide a place for families to go for high quality, coordinated medical care for children and adolescents with autism and associated conditions.

The Autism Speaks Autism Treatment Network serves as base for the Autism Intervention Research Network on Physical Health (AIR-P). The AIR-P includes a network of dedicated doctors, nurses, and specialized health care professionals who understand autism spectrum disorders. The network model of care promotes treating the whole child over time through a family-centered, comprehensive, and multidisciplinary approach.

We are dedicated to finding better ways to manage the health of children and adolescents with autism. The ATN/AIR-P is devoted to improving the quality and availability of medical care for children and adolescents with ASD. Working together to develop uniform approaches for diagnosing and treating ASD and associated conditions.

The ATN/AIR-P conducts clinical research projects on the medical conditions that often accompany ASD. This research is aimed at having an impact on the health of children with autism by answering questions that have long concerned clinicians and families.

The ATN/AIR-P provides the latest information about effective care of the whole person with autism. The network’s expert clinicians and researchers work together along with families to develop and disseminate tool kits filled with resources and tips for families and professionals to use in the everyday care, treatment and support of individuals with autism.

Sources:

http://www.autismspeaks.org/science/resources-programs/autism-treatment-network 

http://www.autisminterventionresearch.net/site/pp.aspx?c=7oJGLPPsFiJYG&b=8238437 

Is Autism Really on the Rise?

The following article is very interesting. Everyone keeps talking about the constantly rising rate of autism. I have never thought about it from the stand point of this article; are the amount of cases of autism really rising or are things just changing and unnecessary diagnosis's being made?

By Salynn Boyles

WebMD Health News

Dec. 31, 2002 -- New research from the Centers for Disease Control and Prevention suggests that autism rates are at least 10 times higher than three previous studies in the U.S. have suggested. But experts say it is not yet clear if the increase is real or reflects changes in reporting and diagnostic practices.

CDC investigators have tracked autism cases in the metropolitan Atlanta area since 1996, finding that 34 children per 10,000 either have autism or disorders linked to it. That is far higher than the average estimate of roughly three autism cases per 10,000 children in studies conducted in the U.S. before 1990. But it is in line with another recently reported CDC investigation from New Jersey and studies from the United Kingdom and Canada.

The Atlanta surveillance is the first ongoing investigation of autism within a population in the United States, but the CDC has recently begun to track autism cases at a dozen other sites around the country. CDC epidemiologist Marshalyn Yeargin-Allsopp, MD, who led the Atlanta investigation, tells WebMD that the new surveillance network will provide a much better picture of the true incidence of autism within the U.S.

"Despite all of the talk of an epidemic of autism, there is really no way to know if there is a real increase in cases because so many things have changed within the last 10 years or so," she tells WebMD.

The definition of autism has been expanded to include a wider spectrum of disorders, including Asperger syndrome and pervasive developmental disorder. In addition, an increase in services for autistic children has prompted more aggressive diagnosis, as has increased media attention and parental awareness.

The CDC report, published in the Jan. 1, 2003, issue of The Journal of the American Medical Association, examines autism prevalence among children aged 3 to 10 in metropolitan Atlanta. In the 1996 investigation, 987 children with autism or related disorders were identified, resulting in 3.4 cases per 1,000 children. Four times more boys than girls had the developmental disorder, but no difference in the rates of autism was seen between black and white children.

Autism researcher Eric Fombonne, MD, tells WebMD that the new CDC figures probably still underestimate the true incidence of autism. A study he conducted in Canada and several other recent investigations suggest the prevalence rate may be closer to 60 cases per 10,000 children -- almost double the CDC's Atlanta findings. In an editorial accompanying the CDC study, he writes that underestimated cases may be partly to blame on the fact that children with milder autism may have been missed.

Fombonne notes that there is, so far, little clinical evidence to back up claims that environmental influences play a role in the development of autism. He writes that claims of an association with measles-mumps-rubella vaccine have not been supported by recent studies, and there is also little evidence for causal association with other exposures, such as mercury-containing vaccines.

"Although claims about an epidemic of autism and about its putative causes have the most weak empirical support, the subsequent controversy has put autism on the public agenda," he writes. "In recent years, children with autism, their families, and professionals involved in their care and in research have seen welcome and legitimate increases in public funding. Yet, ironically, what has triggered substantial social policy changes in autism appears to have little connection with the state of the science."

Asperger's-no longer a form of Autism

Asperger's syndrome is to be dropped from the psychiatrists' Diagnostic and Statistical Manual (DSM) of Mental Disorders, the American publication that is one of the most influential references for the profession around the world.

The term "Asperger's disorder" will not appear in the DSM-5, the latest revision of the manual, and instead its symptoms will come under the newly added "autism spectrum disorder", which is already used widely. That umbrella diagnosis will include children with severe autism, who often do not talk or interact, as well as those with milder forms.

The British hacker Gary McKinnon is diagnosed with Asperger's and it contributed to a government decision not to extradite him from Britain to the US on cybercrime charges.

The DSM is used in a number of countries to varying degrees. Psychiatrists in some countries including Britain use the International Classification of Diseases (ICD) published by the World Health Organisation or a combination of both handbooks.

In other changes to the DSM, abnormally bad and frequent temper tantrums will be diagnosed as DMDD, meaning disruptive mood dysregulation disorder. Supporters say it will address concerns about too many children being misdiagnosed with bipolar disorder and treated with powerful psychiatric drugs.

The revisions come in the first major rewrite in nearly 20 years of the diagnostic guide used by psychiatrists in the US and other countries. The changes were approved on Saturday.

Full details of all the revisions will come in May 2013 when the American Psychiatric Association's new diagnostic manual is published. The changes will affect the diagnosis and treatment of millions of children and adults worldwide, as well as medical insurance and special education services.

The aim was not to expand the number of people diagnosed with mental illness but to ensure those affected were more accurately diagnosed so they could get the most appropriate treatment, said Dr David Kupfer, the University of Pittsburgh psychiatry professor who chaired the revision committee.

One of the most hotly argued changes was how to define the various ranges of autism. Some on the panel opposed the idea of dropping the specific diagnosis for Asperger's. People with that disorder often have high intelligence and vast knowledge on narrow subjects but lack social skills. Some Asperger's families opposed any change, fearing their children will lose a diagnosis and no longer be eligible for special services, but experts have said this will not be the case.

People with dyslexia also were closely watching for the update. Many with the reading disorder did not want their diagnosis dropped, and it will not be. Instead, the new manual will have a broader learning disorder category to cover several conditions including dyslexia, which causes difficulty understanding letters and recognising written words.

The shorthand name for the new edition, the organisation's fifth revision of the Diagnostic and Statistical Manual, is DSM-5. Group leaders say specifics will not be disclosed until the manual is published but they confirmed some changes. A 2000 edition of the manual made minor changes but the last major edition was published in 1994.

Source: http://www.theguardian.com/society/2012/dec/02/aspergers-syndrome-dropped-psychiatric-dsm 

What is Autism?

I have come to find that many people have heard of Autism but may not necessarily know what it really is. According to autismspeaks.org Autism is explained as followed:

Autism spectrum disorder (ASD) and autism are both general terms for a group of complex disorders of brain development. These disorders are characterized, in varying degrees, by difficulties in social interaction, verbal and nonverbal communication and repetitive behaviors. With the May 2013 publication of the DSM-5 diagnostic manual, all autism disorders were merged into one umbrella diagnosis of ASD. Previously, they were recognized as distinct subtypes, including autistic disorder, childhood disintegrative disorder, pervasive developmental disorder-not otherwise specified (PDD-NOS) and Asperger syndrome. 

ASD can be associated with intellectual disability, difficulties in motor coordination and attention and physical health issues such as sleep and gastrointestinal disturbances. Some persons with ASD excel in visual skills, music, math and art. Autism appears to have its roots in very early brain development. However, the most obvious signs of autism and symptoms of autism tend to emerge between 2 and 3 years of age. 

Autism Speaks continues to fund research on effective methods for earlier diagnosis, as early intervention with proven behavioral therapies can improve outcomes. Increasing autism awareness is a key aspect of this work and one in which our families and volunteers play an invaluable role.