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Understanding Autism

August 24, 2001 at 12:00 AM EST
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RAY SUAREZ: Now, understanding autism, a developmental disorder that afflicts about half a million people in this country. The cause is still a medical mystery, but some progress is being made. Elizabeth Brackett of WTTW-Chicago reports.

JEFF BOSCO: Zach, it’s okay.

ELIZABETH BRACKETT: The screams of their unhappy little boy let Tami and Jeff Bosco know that something was wrong with their child.

TAMI BOSCO: Zachary was a difficult baby from the beginning, but we just wrote it off that he was a stubborn, difficult child. The pediatrician, the doctor said, “you know, every once in a while, you just get a child like that.” We couldn’t take him anywhere. I mean, we basically just stayed home. He was fine in his home environment, but we couldn’t take him to restaurants. I would have to leave the Target or the grocery store, with things still in my cart because he would just go into a complete rage. And I could not… I couldn’t control him.

JEFF BOSCO: It was a full blown rage that could last for 20 to 30 minutes. And we did this for about six months to a year. We did this where he would have four or five rages a day. And that’s when we knew that something just was not right.

ELIZABETH BRACKETT: The Bosco family sought out Dr. Bennett Leventhal at the University of Chicago to help their son, Zachary. After three days of examinations, Dr. Leventhal gave them the diagnosis they had suspected and feared: Zachary had a form of autism.

JEFF BOSCO: It did feel like the bomb dropped on our house, because what was relayed to us was we’ve tested, after two and a half days of testing, his IQ is below 70. At that time, he wasn’t saying any words. We don’t know if he’ll ever speak. And then they give you an article that says, well, you know, 80 percent of these kids have to be put into an institution.

TEACHER: Water. Look, it’s getting wet.

ELIZABETH BRACKETT: Children in this after-school program outside of Chicago have all been diagnosed with a form of autism. Autism is a complex developmental disability that typically appears during the first three years of life. It affects normal brain development, making it harder for the autistic child to communicate with others and relate to the outside world. There are several types of autism. In the standard psychiatric handbook, they’re all grouped under the heading “pervasive developmental disorder.” There have been many theories as to what causes autism. One of the early theories, says Dr. Leventhal, was to blame the child’s mother.

DR. BENNETT LEVENTHAL: It was thought that children were, initially when they were first born and the first few weeks or months of life, tended to turn inward, and it was the mother’s job to coax the child to join the rest of the world. We now know that is completely untrue.

ELIZABETH BRACKETT: Are there any known causes of autism?

DR. BENNETT LEVENTHAL: Well, I think there is no doubt today that it is an abnormality in the way the brain develops, and there is strong evidence to suggest that at least the predominant cause is genetic, although there is clearly some evidence that other kinds of events can cause the same kind of brain damage.

ELIZABETH BRACKETT: When the answer is autism, what do parents do? Traditional psychiatry has offered very few answers. But scientists here at the Pfeiffer Institute in Naperville, Illinois, believe they have identified the cause of autism, or at least its major contributing factor.

WILLIAM WALSH: We may have found a cause of autism.

ELIZABETH BRACKETT: William Walsh, a chemist and senior scientist at the Pfeiffer Institute, bases his new and controversial finding on the study of 503 children who have been diagnosed as autistic by their own physicians.

WILLIAM WALSH: We found they all had the same severe problem. We found that every single autistic that we saw has a rather remarkable really nasty error of metal metabolism. It seems to be inborn and genetic, and… it’s an inability of a particular protein to function. A protein that’s supposed to be managing our metals– it’s called metallothionein– that protein is not doing its job. And so you get all these crazy levels of metals in their brain and in their blood, but it also is the very same system that has the job of keeping toxic metal from harming us.

ELIZABETH BRACKETT: Walsh presented the results of the analysis done in his labs at the American Psychiatric Association meeting in May. But it has not yet been published in a peer review journal. Walsh found the metal metabolism imbalance by analyzing samples of the children’s blood, urine and hair. He says to his surprise, he found problems with the protein metallothionein in all but four of the 503 autistic children, no matter what kind of autism they had been diagnosed with.

WILLIAM WALSH: You find that there is a chemical imbalance in the brain, then it can be changed. One can tinker with the chemistry and hopefully help the patient.

ELIZABETH BRACKETT: Walsh has been studying disorders of metal metabolism for the past 25 years. (Beethoven’s Fifth Symphony playing) He garnered national attention last year after determining that Ludwig Van Beethoven had died from lead poisoning.

WILLIAM WALSH: This is Beethoven’s hair.

ELIZABETH BRACKETT: He did it by analyzing 170-year-old strands of the famous composer’s hair. Walsh began trying to understand what elements in the autistic child’s body or brain chemistry had gone awry. This research led to what he saw as a remarkably high correlation between autism and metal metabolism imbalance as a result of the disordered metallothionein proteins. But Dr. Leventhal remained skeptical.

DR. BENNETT LEVENTHAL: There is a tricky problem here. One is in order to do the kind of studies that are likely to tell us the causes of disorders like autism, ADHD and others, you have to very, very precisely define the characteristics that make up your diagnosis. So I don’t know in this particular study what his diagnostic criteria are. Just to say they have autism isn’t sufficient. There’s second this always of concern to us, and that is measuring things in the blood is not necessarily measuring anything related to what’s going on in the brain. So we always have to be very careful about generalizing from blood measurements to brain functioning.

ELIZABETH BRACKETT: Dr. Robert DeVito is the senior consulting scientist at the Pfeiffer Center. He is the former director of the Illinois Department of Mental Health. He is urging the medical community to test Walsh’s theory. Dr. Walsh says he has found the cause of autism. Is that too bold a statement?

DR. ROBERT DeVITO: Well, that’s a bold statement and I think he’s entitled to say that. I wouldn’t go that far, but I would say that he has come up with something that is tremendously important, and I think it should be given a very adequate trial within the scientific community, because I think a lot of good can come from this. But you want to make sure that you’re right because it affects a lot of people, and it affects people in such profound ways that it needs… It needs a real good review.

ELIZABETH BRACKETT: After believing that he had identified metal metabolism problems as a cause of autism, Walsh devised treatment that seeks to balance the autistic child’s body chemistry.

WILLIAM WALSH: We give them nutrients that stimulate the production of that protein. We’re trying to get the metallothionein protein that’s disordered working again. And if that happens, then the toxics that they’ve accumulated will naturally leave. They will be protected in the future from the environment with the toxics because it will be working, and their brain levels of copper and zinc and these other important meta will normalize.

DR. BENNETT LEVENTHAL: There is no evidence to suggest that there is any dietary intervention that makes a significant difference in any behavior disorder — not just autism. And so one has to be very, very careful until one can look at the study and say, was it appropriately done methodologically and published?

ELIZABETH BRACKETT: Devastated after the autism diagnosis for Zachary, the Bosco family came to the Pfeiffer Clinic for help. The Boscos began working with Walsh to balance their son’s body chemistry. The nutrient supplements cost them between $40 and $140 each month. A portion of the clinic visits are covered by the Boscos’ medical insurance, but the supplements are not. They say they saw the difference almost immediately, and that when Zachary is not taking the supplements, he regresses.

TAMI BOSCO: And once we started on the vitamin and supplements, he was a changed child. A good way to put it is he was in our world now instead of Zach’s world. His eye contact was better, his behavior was a lot better. He said “mommy” and “daddy” for the first time.

ELIZABETH BRACKETT: But Dr. Leventhal remains unconvinced that supplements can be credited with improving the behavior of autistic children.

DR. BENNETT LEVENTHAL: All children with autism, as best we can tell, get better over time, almost in spite of what we do to them. The question really is: Can we do things that enhance the amount of getting better? And I think there is plenty of evidence that suggest that speech and language therapy and good educational programming really makes a big difference in the ultimate outcome.

JEFF BOSCO: Most psychiatrists would probably say due to the schooling, due to the speech therapy and the OT therapy you’re giving him, that’s why he’s better. And I don’t deny that that’s helping. That is only one piece of this puzzle. There is another piece to the puzzle, that biochemically these kids need to be treated and treated with something that balances their body.

ELIZABETH BRACKETT: Walsh and his patients continue to like the results they see from the effort to balance the autistic child’s metal metabolism. Walsh hopes to publish his results in a peer reviewed medical journal in the next six months.