The Autism Puzzle
Seeking the missing pieces

Gut Reaction
Gastroenterologist Andrew Wakefield, MB,BS., FRCS., FRCPath, is a medical expert with a research specialty in autism and its potential causes. Yet his interest wasn't always autism. Back in 1981 at the dawn of his medical career, Wakefield's passion was ... bowels. Specifically, bowel surgery and the study of chronic GI conditions, like Crohn's. Wakefield's shift to childhood development disorders began in 1995 when the parents of an autistic child asked for his help.

"They said their child had terrible GI problems and no one was taking them seriously," he says. "At the time, I knew nothing of autism." As he examined the child and began looking into the multiple digestive issues frequently associated with autism, he discovered that ?the story from these parents and others like them was so consistent and coherent, it merited investigation."

Brain Connection
Wakefield and colleagues examined several groups of autistic children and found many had an inflammatory bowel disease. "It wasn't Crohn's, ulcerative colitis or celiac disease. There was certain overlap with all these diseases but it seemed to be, on the face of it, a novel pathology associated with swelling of the lymph glands and a mild to moderate inflammation," he says. Symptoms included diarrhea, pain, constipation, abdominal distension, malabsorption and growth retardation. Several published studies later, Wakefield labeled the disease "autistic enterocolitis" and suggested it might be linked with the neurologic injury in children with autistic-sprectrum disorders. "It is possible that a primary inflammation of the intestine can lead to secondary problems in behavior, mood and other aspects of neurological function," Wakefield says.

Cause and Effect
As he investigated what might prompt the bowel inflammation associated with childhood development disorders, Wakefield's research suggested potential environmental causes and implicated - very controversially - the combined measles, mumps, rubella (MMR) vaccine. Based upon his review of the safety literature, he now recommends that parents consider having their children vaccinated singly, with a year in between shots.

"Parents should have a choice and that choice should include the ability to give vaccines singly," he says.
He strongly encourages parents to become fully informed on the subject. "The age of enlightenment is now. Parents should know the benefits and risks of vaccinations. They should not take the advice of their pediatrician without fully scrutinizing it," he says. Treatment Plan Wakefield is furthering research in this area as executive director of Thoughtful House, a nonprofit organization established in Austin, Texas, for children with developmental disorders. Founded in 2005, Thoughtful House combines medical care (thorough physical exams, including gastrointestinal and immune system assessments), behavior analysis and laboratory research in a one-stop medical shop for autism-spectrum treatment. Service also includes in-depth nutritional counseling, which addresses food allergies and intolerances and educates parents on the nuances of the gluten- and casein-free diet.

Bottom Line
"We're seeing an explosion of knowledge which confirms that these bowel symptoms reflect disease. What's emerging is that the disease is treatable and may lead to considerable improvement in the child's well-being," Wakefield says."Parents should know that the symptoms of autism and the associated intestinal problems are treatable....It's a great privilege to be part of this process and to help these children."