Austims - Causes and Treatments

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Yes, I made it a project to try to understand the biological causes of ASD. Now you get to hear about it.

I saw an article in the New York times today about kids growing out of Autism. It attributed improvement to a series of behaviors therapies. At the same time, other studies seems to imply that this is correlation not causation. Ten percent of kids diagnosed with Austism ?recover? regardless of treatment. I am not a doctor or medical researcher but I thought I'd post the impressions I've been getting about causes and treatments of autism from reading some of the medical literature. Please note, that is probably just as likely to be snake oil as most of the behavior programs are.

The basic mechanism of autism seems to be an attempt by the brain to achieve enhanced stimulation. The locus coeruleus, the area of the brain that regulates the level of noradrenaline in the brain, goes into overdrive. Noradrenaline governs the fight or flight response. Basically, this triggers a low level fight or flight response. Autistic sensitivity to light and sound is similar to the hypersensitivity found in an individual undergoing a danger response. This would also help explain why ADHD (brain needs stimulation, also theorized to be related to the LC) and anxiety disorders are, often, found in individuals with ASD. The locus coeruleus is also engaged when the fever response. Autism symptoms can improve when a person has a fever as the locus coeruleus seems to fall back into a default or ?normal? state.(1)

In a neurotypical individual the amygdala plays an important role in social interactions. It also processes fear and aggression. An ASD individual does not utilize the amygdala when engaging in social interactions. My take on this is that as the locus coeruleus is stuck in fight or flight mode the amygdala is incapable of passing useful social information to the rest of the brain. Basically, it has become stuck outputting the equivalent of ?danger will Robinson? every time it sees a person so the brain wires around it.(2)

Subsequent neurological studies have suggested that those with ASD undergo a complex rewiring of front regions of the brain. Think of it as hardware and software. With the amygdala (the hardware) out of the equation the brain rewires to handle the task in software. The delayed responses to social stimuli seen in ASD individuals represent a form of emulator lag. The frontal lobe is, basically, acting to process social information as the areas of the brain that have been hardwired for the task are non-functional.

Notably the Baron-Cohen, Ring, study found ASD individuals using the Superior Temporal Gyrus instead of the amygdala to process social interaction. (This is not in the frontal lobe). This area of the brain has been associated with the ability to develop a sense of language. The use of the STG to process social interaction may result in the noted difficulties of some autistic individuals in developing verbal skills. More studies need to be conducted to see if the involvement of the STG changes between LFA and HFA/Aspergers.

If right this theory would suggest four, at least, four causes for ASD.

1) Evolutionary ASD. This refers to ASD caused by some evolutionary purpose. This would apply to Aspergers and other forms of mild ASD. One possible explanation is that increased brain stimulation caused by an overacted LC results in an increase in intelligence. Another, potential, explanation is that the difficulties ASD individuals have socializing might result in a lessening of susceptibility to ?group think,? the process where one group will adopt an untrue premise and use social pressure to bring others into conformity. It is possible that, within the context of a hunter gather band, a group can literally group think itself to death, adopting an untrue belief about a survival related fact that proves fatal to all members. Individuals with evolutionary ASD might act as a form of biological circuit breaker, allowing alternative viewpoints to enter into the group.

2) Cognitively related ASD. Most likely this is caused by neurons undergoing a danger response as a result of excess APT.(3) In this, proposed, model the responsiveness of neurons declines. The brain then supercharges the locus coeruleus in an attempt to turn up the proverbial volume. This hypothesis would imply that ASD is not a defect but the brains attempt to utilize an evolutionary mechanism to deal with unresponsive neurons. Austism isn't something going wrong, it is something going right in the face of other difficulties. Additional research in this area may prove quite interesting.

3) Endocrine Related ASD. Persons with Auspergers are noted for having low cortisol levels in the morning. Cortisol is a stress hormone (though I gather from talking to Addisons sufferers that it is used to deal with, not cause, stress). In those with evolutionary ASD, low cortisol-at least based on my uneducated hypothesis-is part of the process through with the LC goes into permanent danger mode. Endocrine related ASD posits a cortisol in which cortisol levels are normal but the body responds as if it was lacking cortisol.

Endocrine related ASD posits a molecular defect in either cortisol synthesis or metabolism. At present, endocrinology is largely limited to the gross present or lack of hormones. Relatively little research has taken place on defects in the molecular composition of cortisol, or in the process in which its metabolized. Rare conditions with gross physical manifestations, such as Primary Generalized Glucocorticoid Resistance, are known to exist.

Endocrine related ASD could explain the roughly 10% of ASD affected persons who ?grow out of? the condition. As the body ages, more cortisol is produced (a given amount of blood from an older individual will have more cortisol than the same amount from a younger individual). Under this hypothesis, it might be possible that a certain amount or percentage of cells produce defective cortisol. As a person ages, and the amount of cortisol increases, the effects of the defective cortisol lessen.

4) Induced Evolutionary ASD: Prenatal maternal stress has been associated with development of ADHD and Autism in children.(4) If ASD confers some evolutionary advantage in certain circumstances, a biological mechanism might exist to increase the number of children born with ASD when those circumstances exist.

Induced Evolutionary ASD would explain both the shut-in phenomena in Japan as well as the American Autism ?epidemic.? Both of these events have taken place in societies exhibiting long term social and economic difficulties. It is theoretically possible that economic stress responses mirror environmental stress responses within early human groups. This may correspond to a situation where, for much of human existence, ASD offers some form of biological benefit.

I might, and probably am, wrong on some or most of this. With the amount of neurological involvement in ASD have very real doubts that most forms of behavioral therapy will work. The research suggests that ASD is so hardwired into the brain that I have to wonder if a ?recovery? is not simply moving from LFA to HFA/Aspergers as a result of a lessening of some other condition.

Oh and if any researchers ever read this: what the h*ll is Guanfacine (Intuniv) doing?

(1) For involvement of the locus coeruleus with austism see: Mehler and Paupur, Autism, ?fever, epigenetics and the locus coeruleus? (deleted, not enough posts).

(2) For involvement of the amygdala see: See Baron-Cohen S, Ring H, Williams S, et al. Social intelligence in the normal and autistic brain: an fMRI study. The European Journal Of Neuroscience [serial online]. June 1999;11(6):1891-1898. Available from: MEDLINE Complete, Ipswich, MA. Accessed July 31, 2014.

(3) Naviaux, J C, et al. "Reversal of autism-like behaviors and metabolism in adult mice with single-dose antipurinergic therapy." Translational psychiatry 4.6 (2014):e400.

(4) Ronald, Angelica, Craig ERonald, and Whitehouse. "Prenatal Maternal Stress Associated with ADHD and Autistic Traits in early Childhood." Frontiers in Psychology 1(2011)

There is no cure for AS or autism. A cure for AS is morally equal to a cure for being gay, catholic, black or a woman. Thank goodness no "cure" exists for these states.

I don't think "cure" is the appropriate term for those that grow out of it. Yes I mean sure they improve, yet thats all they can do. They're still Autistic... its just that they improved based on the therapies that were provided to them.

Thank you for leading with sensory issues. I think there is also the aspect that for me to concentrate I need to feel safe to really get into it, including feeling safe both physically and socially, including not being distracted for a good long while.

As an adult, whether or not I would seek a quote-unquote "cure" is and must remain my personal decision. It is equivalent ethically to the decision whether to go cyborg.

Parents will seek "cure" for their children, whether we like it or not, straight up they will. So, I think we will be most effective trying to at least pitch them on positive ways to do this.

For example, I have read that learning sign language actually has positive transfer to speaking. That if a child is slow in learning to speak, learning sign language will help them with verbal speech if and when it comes. Well, let's publicize this and let parents know this. As well as do additional research to back this up and get some more specifics regarding the how.

Even in at least one medical article, I have heard stimming put forward as a quote symptom of autism spectrum. And maybe it is both a symptom and a positive thing. Stimming can help deal with sensory issues, can help maintain concentration, and can also let me really get into an activity and enjoy life. Basketball players stim, baseball players stim, poker players stim. Someone fiddling with a pen as they talk on the phone is engaging in stimming behavior. Now, stimming on the part of a child is sometimes acutely embarrassing to the parent. Okay, alright. Let's talk about teaching and modeling more low-key ways to stim, as well as teaching a public-private distinction which I think many kids can understand. Some people here at WP have said stimming itself can be distraction. That is not generally my experience, but I'm very open to this being another worthwhile topic we can discuss.


PS I love the political statement: We are all middle-functioning! I think this is a very good response to the fact that schools and social service agencies seem to "need" to classify human beings as either low- or high-functioning, their need, not ours.

Last edited by AardvarkGoodSwimmer on 01 Aug 2014, 5:05 pm, edited 1 time in total.

I was frankly autistic before the age of 5. After I started to speak, I wasn't "frankly" autistic any more. I was not even "autistic" under the old, Kanner definition. My clinical presentation was Aspergian.

I feel like I "recovered," in the sense that I acquired basic "theory of mind" after I started speaking. My speech inspired people to attempt to socialize with me; correspondingly, owing to my newfound skills, I began to respond by socializing with people, no matter how awkwardly. People don't usually care too much how one socializes until one reaches school age.

To me, some socialization ability came about "naturally." However, the acquisition of other facets of socialization (e.g., how to produce and respond to "small talk,)" was akin to the acquisition of skill in the playing of a musical instrument. I "practiced" constantly until I got it somewhat right. I actually spoke in "conversations" out loud, before I went into a place like a supermarket.

Any attempt to summarise causation would have to include and look closely at the role of neurotransmitters and genetic/epigenetic influences on them. That's actually a big ask. I've been studying it for two years and still feel that I've barely scratched the surface sometimes.

Neurotransmitters are "the software" of the brain. The communicators and link-makers. I think that is the starting point, however valid or not the interesting studies you cited are.

On a journey, where you start from greatly influences where you end up

Thanks for posting your summary though, all these things are very interesting and I will look at some of them in depth.

Wow, I do this.

And my mother, who I'm almost sure is on the Spectrum, does this, too.

I don't believe someone can be "cured" of autism / Asperger's. The word "cure" seems to imply "make-it-like-it-never-happened"----and / or to return the body or brain to its original state of "normal", or un-ill-ness. I believe, however, that one can "recover". I read an abstract in a book, that works for ME: If you get hit by a bus, you can recover from your injuries----but, you can NEVER take away the fact that you got hit by a bus!

Autism therapy: Social behavior restored via brain stimulation