A cautious message of hope for parents of autistic kids

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A cautious message of hope for parents of autistic kids

July 29, 2006

Seebach

http://www.rockymountainnews.com/drmn/opinion_columnists/article/0,2777,DRMN_239\

72_4878887,00.html

pictureAfter I wrote a column about autism spectrum disorders in May, many

people wrote to share their own and their families' tales of hope and

despair.

Among those who wrote with a cautious message of hope was Gut-

stein, a clinical psychologist who has taught at Baylor College of

Medicine and the University of Texas Medical School. Over the past several

years he has been pioneering an approach to autism and related conditions

that focuses on showing parents how to rebuild, or at least strengthen,

the emotional connections with their children that have been stretched

beyond breaking. He calls it " relationship development intervention " (his

Web site is rdiconnect.com).

Gutstein and members of his staff are in Denver this weekend for a

workshop, so we met over coffee Friday to talk about what he does.

The research literature on autism (he's paraphrasing a large body of

research, you understand, and I'm paraphrasing him) indicates that people

with autism spectrum disorders have difficulty dealing with the vast

unpredictability of everyday life, coping with novel or ambiguous

situations, coming up with multiple hypotheses and then choosing one. That

can happen for many reasons, certainly not excluding medical ones, but it

often plays out in the same way. A child who can't cope may become

fearful, unwilling even to interact with his or her parents because it

might lead to something threatening. The child's withdrawal in turn

deprives the parents of the feedback that would help them provide their

child just the right balance between reliable and comforting support on

the one hand and challenge and stimulation on the other.

In contrast, though, the behavioral therapies in wide use tend to teach

children static skills, make them less flexible, less capable of

functioning in a dynamic environment, and ultimately less able to function

as independent adults. Not all can do that; many have other impairments as

well. But that's no reason for giving up on all of them. It's a myth,

Gutstein says, that most autistics are mentally retarded.

His approach relies on identifying the small steps that children take as

they develop and showing parents how to model and reinforce them in

controlled settings and then in everyday life in ways that help children

gain confidence in their own abilities.

These steps might seem elementary - learning to look to a trusted person

for social reinforcement in a new or scary situation, say - but if your

child has never taken them, they loom as high as the blocks of the

pyramids.

I'm in no position to endorse an entire program, and besides it's in its

early days yet. Gutstein began working with a few families about 10 years

ago. His organization certified its first RDI consultants in 2001. There

are some 90 certified consultants now, with about 250 in training. To

grow, he'll need more people trained to do certification.

But the early results have been promising, and he knows what needs to be

done to demonstrate effectiveness. One small research study has been

accepted for publication, and another is under review. In the meantime, he

has published individual case studies, for example in My Baby Can Dance,

which is not the same thing as statistical data, but worth a look for

families trying to decide on a course of treatment.

A couple of additional items are worth passing along. One reader cited

studies by S. Jill and others on the possible role of glutathione

metabolism, which could affect children's ability to clear heavy metals,

including mercury from vaccines, from their bodies. The reader did not

cite specific articles, but one titled " Thimerosal neurotoxicity is

associated with glutathione depletion: protection with glutathione

precursors " appeared in the peer-reviewed journal NeuroToxicity in 2005.

While vaccines containing Thimerosal, a preservative containing mercury,

are obviously not the only factor in autism, and may not even be a

significant one, it is certainly possible that dosages safe for almost all

children might be dangerous for a small fraction of the population.

Another reader sent a link to an article in the Spring 2006 issue of the

Journal of American Physicians and Surgeons

(www.jpands.org/vol11no1/geier.pdf). The article, by Geier and Mark

Geier, " Early Downward Trends in Neurodevelopmental Disorders Following

Removal of Thimerosal-Containing Vaccines, " shows a reversal in the trend

lines for new diagnoses roughly coinciding with the date at which

Thimerosal began to disappear from pediatric vaccines, though it remains

in some others, including flu vaccines.

The authors cite the NeuroToxicity study, as well as another by A.S.

Holmes and others from the International Journal of Toxicology in 2003

that " examined first baby haircuts and determined that autistics had

significantly higher body burdens of mercury in comparison to nonautistic

matched controls, by demonstrating that the mercury level in hair, and

thus the ability to excrete mercury, was inversely proportional to the

severity of autism and overall much lower in the autistic group. "

Just thought you'd like to know.

Seebach is an editorial writer for the News. She can be reached by

telephone at or by e-mail at

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