Are Environmental Agents Behind The Autism Epidemic?

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Are Environmental Agents Behind The Autism Epidemic?
November 17, 2002
Martha R. Herbert

A recent study from the University of California at Davis has validated reports of an unprecedented and baffling nationwide epidemic of autism, at the same time it challenges current scientific thinking about how diseases are caused.

Once blamed on emotionally distant mothers, more recent theories of autism invoke mainly genetic causation. But if we are facing an epidemic, the new research implicates environmental agents.

Autism, once thought to be rare, is as heartbreaking as it is now widespread. Parents often describe normally developing infants who inexplicably begin to deteriorate in the second year of life. Language is impaired; many cannot even speak. Social interaction is limited. The children make little or no eye contact and do not engage with playmates. Severe behavior issues arise. Cognitive abilities may decline. Seizures, clumsiness, gastrointestinal problems, immune imbalances, metabolic abnormalities and other conditions are often present. These children require increased medical care, specialized education and constant - usually lifelong - supervision. Families are stressed, schools can't cope and doctors have very little to offer.

The M.I.N.D. Institute at UC-Davis reviewed data from the California Department of Developmental Services, which showed nearly a statewide tripling of the most severe autism in little more than a decade, from 1987 to 1998. It ruled out other possible causes for the reported increases, such as better diagnosis or immigration into the state.

Beyond California, figures from the U.S. Department of Education show a nationwide average increase of 544 percent in autistic students from 1992-93 to 2000-01. Studies in Atlanta and New Jersey, by the Centers for Disease Control, turned up autism among 1 in 250 to 300 children. And these numbers reflect only the most severe cases: Including milder forms raised the rate in New Jersey to 1 in 150 children. Prior to 1980, studies showed autism rates of 1 in 2,000.

It is time to rethink the emphasis on genetics in autism research. As M.I.N.D. Institute study leader Dr. Robert Byrd said, "Genes don't cause epidemics." Autism research dollars have flowed to support genetic studies designed to find aberrant genes, but the only effective treatments have been expensive behavior-based interventions.

The new study strongly suggests that something else must be involved, because the human genome simply doesn't change this fast. So we must look where such rapid change does occur - in the environment.

If we are having an epidemic, then environmental influences, which could include chemicals, metals, vaccines and viruses, must be overwhelming more children than ever before. Since genes that affect the brain also affect the body, environmental triggers of autism would affect both. And in fact this "behavioral" disorder is often accompanied by gastrointestinal or immune diseases or other illness.

The cost of autism lies not only in human suffering. In California alone, nine new children are diagnosed with autism every day. Conservative estimates of $2 million for each autistic child's lifetime care do not include lost wages of the child or family members. Meanwhile, the National Institutes of Health spends $56 million per year on autism research - much better than the $5 million budgeted just five years ago but not sufficient for such an epidemic.

We must focus attention - and research dollars - on our environment and not just our genes. If we do not, we face more rising epidemics of unexplained diseases.

Martha R. Herbert is a pediatric neurologist at Massachusetts General Hospital and Harvard Medical School, and a board member of the Council for Responsible Genetics. This article was distributed by the National Environmental Trust, an op-ed service in Washington.

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Are Environmental Agents Behind The Autism Epidemic?