Monday, March 10, 2008

Features of Autism Spectrum Disorder

Of our two kids, one is on the autism spectrum. So I'm not surprised when I come home and see toys lined up as in the above picture, as people often write that such things are common. In retrospect, I also shouldn't be surprised that the same child that lined those toys up also had a lot of GI issues as a baby, likes to hide under tables at times, and is somewhat hyperactive. We have also had a lot of problems with toe walking, to the point of having to put leg casts on for several months. Even though not all of these things are listed in the DSM-IV, many children on the spectrum have these same issues, so it shouldn't be surprising that my child displays these features.

Except for the fact that the child I'm referencing above is my younger one, Sweet Pea, who is most definitely not autistic.

Sweet Pea is one of the most social kids in her class, and would never qualify for an autism diagnosis.

Recently, in the Poling case, the Division of Vaccine Injury Compensation decided

In sum, DVIC has concluded that the facts of this case meet the statutory criteria for demonstrating that the vaccinations CHILD received on July 19, 2000, significantly aggravated an underlying mitochondrial disorder, which predisposed her to deficits in cellular energy metabolism, and manifested as a regressive encephalopathy with features of autism spectrum disorder.

Many people say that this document says that the government admits that vaccines cause autism. Rather than focusing on what Hannah Poling primarily has (mitochondrial disease), many have focused on the phrase "features of autism spectrum disorder".

Having never met Hannah Poling, I'm not sure if she is on the autism spectrum. It is entirely possible that she is. If one out of 150 individuals are, then it makes sense that at least one out of every 150 individuals with mitochondrial disease is also autistic, independent of their mito disease (I know, there may be more, but I'm talking independent of their mito disease, not linked to it). But the court document doesn't say Hannah is autistic, just that she displays "features of autism spectrum disorder". And someone looking at certain aspects of Sweet Pea's behavior and condition might decide that she had "features of autism spectrum disorder" too, which I know is totally false.


Anonymous said...

My daughter has always lined things up. She enjoying cutting up lots of paper into little pieces too. She can spend hours doing either. When she was a toddler I never thought much about it.

Niksmom said...

Okay, this is totally not about the actual content of this post...but my first thought upon seeing the picture was, "How sweet, it's a little animal parade!"...which is probably closer to what Sweet Pea had in mind when she set them up?

My 18 yr old niece was a toe-walker when she was little and one doc tried to convince my sister that her daughter had some neurological impairment. Uh, nope. She outgrew it.

Jen P said...

Both of my kids are toe-walkers, and get am I. The Younger is clearly not on the spectrum but he also lines things up. I refer to him as Mr. OCD. Both have sensory processing disorder which makes sense since me and The Hub have "features" of that as well.

I could say that The Younger shows features of a lot of the things which make The Elder autistic, however, there were not the social and communicative red flags, as a matter of fact it was in observing The Younger that confirmed that The Elder has ASD.

leila said...

I'm terrified that this case will generate an anti-vaccine hysteria. But that doesn't mean we have to be in denial. There are a minority of cases where children lose skills and later on develop autism, after a high fever. If the fever was due to the vaccine or to some other illness the child got at that same time, it's very hard to prove at this point.

I saw Hannah Poling on Larry King Live, and she looked very much autistic. I don't think it matters if she fits the DSM criteria 100%, that child clearly has the sensory issues and the social and speech deficits that are at the core of autism. The government is considering her autism a byproduct of her mitochondrial disorder, but for the general public, and for the Poling family, it doesn't seem to matter much what came first, the egg or the chicken. What matters is that the child acted neurotypical one day, and after apparently reacting to the vaccine, she lost the skills she had before, and the government is not contesting this fact.

In a perfect world we would be able to find out what makes some individuals prone to regression, and screen for that genetic difference before vaccination so parents and doctors would know when to worry or not. In the meantime, parents ARE worried, especially after the Poling case made the headlines.

Club 166 said...

Buddy Boy goes thru reams of paper. This week he constructed what he termed a "paper factory" with two buildings made of blocks connected by a long string of blocks that wound around the world. One of the buildings was filled with torn up confetti sized bits of paper.

Yea, that was probably more where Sweet Pea was headed with that. When she plays alone in her room, she makes different voices for the different animals (or dolls if she is playing with them). It's kind of funny.

@Jen P,
I find it a bit ironic that Sweet Pea has some of the things (like toe walking and GI issues) that Buddy Boy has never had an issue with. Yet he is clearly autistic, while she is not. I guess that's why some of those "associated features" aren't listed in the DSM-IV.

I share your concern regarding vaccination rates. There are pediatricians all over this country cringing right now after this, trying to figure out how to convince their patients' parents to get them vaccinated.

As I've stated in other posts, if the Polings wouldn't have attached themselves to the anti-science, anti-vaccination crowd, and tried to generalize this to "vaccines cause autism", then I wouldn't be so upset. There are a small number of adverse vaccine reactions, which the fund is set up to reimburse for. The rules are loose enough that they don't require a scientific level of proof. Yet Kirby, Olmstead, and the rest take this case and twist it, like it does prove scientifically that they were right.

And the Polings, both of whom are educated enough to know better (especially the father) went along for the ride with the "vaccines cause autism" ride, which will now take years to undo.


Emily, as some know me said...

Hi, Joe and everyone--

TH ALWAYS lined up everything. His big collection item was (and is) acorns, so he'd especially line those up. But he'd do it with anything.

We also go through reams and reams of paper. TH produces about 50 pictures a day, highly detailed, Boschian productions with little, stereotyped figures by the hundreds. That, or plants.

I also looked at that and thought, Oh, those little animals are waiting for the bus. Now, if that were in a swirly design, I'd think TH had done it.

Our youngest, who is strongly likely to be on the spectrum (he's 18 months old, shows far more obvious "signs"), does not line up toys. He does, however, like to sit for an hour at a time with a baby wipe. He loves a good baby wipe.

I agree about the Polings. It's simply a shame.

daedalus2u said...

Neuropathy is not a characteristic symptom of autism. The vast majority of people with autism and the broader ASDs don't have the slightest bit of neuropathy.

It is very much a shame that this is wrongly being touted as the new paradigm of autism caused by vaccines when the case (if it is autism at all) is so atypical.

The father should know better.

S.L. said...

I agree 100% with what you are saying. In fact, I have a similar post waiting to be edited & published (before this whole case broke) about the issues my eldest had, in comparison to my youngest. What I'm seeing a lot of is that an action that a NT child may do, no one would ever blog on or whine about BUT if an autistic child is doing it, it must be worth complaining about. I see the double-standard a lot.

So many people have skimmed over (and missed the facts) of this case, seeing in it only what they want. I fear it will snowball further into a sort-of urban legend, and still years from now be known as the case "that proved vaccines cause autism." Quite a ripple effect can come from that.

Great piece. Love the picture!

kristina said...

Latest around here is that Charlie piles up his favorite things---backpack with photos and pens, blanket, shoes, Jim's coats, CD case---in front of the bathroom door before he showers. All of that is then transported beside his bed before sleeping.

Daisy said...

My daughter lined things up and sorted them when she was young. Now she sets things up to take pictures -- or I should say Make Pictures. She's a journalism major and photographer, and her brother is the one on the spectrum.

Ettina said...

"And someone looking at certain aspects of Sweet Pea's behavior and condition might decide that she had "features of autism spectrum disorder" too, which I know is totally false."

Actually, she does. That's exactly what 'features of autism' means. They are not autistic, but they have autistic traits.
Like my younger brother, 10 years old. Like Sweet Pea, he's very social and certainly not autistic (although sociable doesn't automatically mean non-autistic). But he makes stims (makes noises or sucks on things - he says he feels a need to do something with his mouth), he seems to have intense interests (though fairly typical, such as bionicle or pokemon) and he has learning differences (verbally gifted with poor executive functions).

Ettina said...

Another comment - for the sake of kids like Hannah Poling, you *should* vaccinate. Had she gotten one of those illnesses instead of the vaccination, she probably would've died.
I also read that kids with mitochondrial disorder are generally advised to be vaccinated. There are preventative measures that can reduce the risk of a serious complication. For example, many kids feel a bit sick after a vaccine and have less appetite than usual. Fasting, even for short periods, can wreak havoc on the metabolism of a person with a mitochondrial disorder. The best way to deal with that is simply to insist the child eat regularly, even if they aren't hungry. Most kids can go a few days with little or no food with no lasting effect, so a parent of a kid with an undiagnosed mitochondrial problem (as Hannah Poling's apparently was before her vaccination) would not realize it's so important that their child eat.