Cobbers on the Brain

According to our article,” Environmental Factors in Autism”, their definition states Autism as neurodevelopmental disorders characterized by impairments in communication and social behavior, and by repetitive behaviors.
There are so many factors out in today’s society that are possibly the reason why we are seeing more and more autism cases today. Autism usually appears in the first three years of a child’s life by certain signs like no big smiles or other warm expressions by six months or like no words being spoken by 16 months.
In this blog, I want to talk about two factors that may be causing higher chances of having a child with autism—maternal diabetes and toxins.
First, let’s talk about maternal diabetes. According to our sources in our article, if a mother is pregnant and has diabetes, her child has a two-fold increases risk of obtaining Autism. Current research has proven links between obesity in the mother and her having higher chances of giving birth to a child with autism. However, other metabolic conditions like hypertension or diabetes really only showed trends for the risk of autism.
Secondly, toxins threaten developing fetuses which can cause birth defects. Two main agents are on scientists lists and they are called valproic acid and thalidomide. Valproic acid, when administered in utero, delays and lifelong deficits in motor performance, social behavior, and anxiety. For thalidomide, it regulates cytokine levels and macrophage inflammatory function. It was first used as an antiemetic in the 1950s but was found to cause birth defects shortly after. Finally, one study found that women who were early in pregnancy and were in close range to organochlorine pesticides which were sprayed on fields, had several more times likely of giving birth to a child with autism. These are all toxins that are shown to increase chances of birth defects and possibly cause autism but as of current research now, the concordance rate isn’t 100% and therefore, suggests genetics must play some role for a toxin to act as a trigger.
Science has shown that genetics play a role in autism spectrum disorders, but it also has revealed that genetics cannot fully account for all ASD cases, and thus that’s were many factors come into play like maternal diabetes and exposed toxins.
 

Autism Spectrum Disorder (ASD) is something I have grappled with trying to understand for much of my life. I think I grew up with the idea that autism was a consistent disorder between everyone with the diagnosis–that they all have severe issues functioning independently and learning in school. In high school, someone I had worked with in a theatre production shared that they had autism about 2 months after I had known him–I would have never thought this was the case.
This friend had a milder diagnosis of ASD called Asperger’s, and this is when I learned that Autism did not manifest the same in all people.
This realization became an extra challenge when I started researching the biochemical and environmental factors that cause the development of autism. In one paper by Andreas Grabrucker, titled “Environmental Factors in Autism,” he identified eight risk factors that impact neurological functioning leading to the development of autism.

1. Prenatal viral infection–Maternal infection, autoimmune disease, and/or allergy could change the immunity of the fetal brain and the fetal immune system
2. Zinc deficiency–Maternal or early development zinc deficiency might give an explanation of gene/environment interaction
3. Abnormal melatonin synthesis–Melatonin regulates the circadian rhythm, is an antioxidant, is involved in the immune response, and regulates synaptic plasticity
4. Maternal diabetes–Diabetes in the mother during pregnancy increases autism risk by 200%
5. Prenatal and perinatal stress–Prenatal stress activates the HPA axis resulting in abnormalities in postnatal immune function
6. Toxins–Certain pesticides may contribute to autism as well as psychiatric drugs taken by the mother during pregnancy
7. Parental age–Advanced maternal age might contribute through increased pregnancy complications and maternal autoimmunity
8. Postnatal risk factors–Gastrointestinal or immune system abnormalities, allergies, and exposure of children to drugs, infection, certain foods or heavy metals have been proposed a s risk factor for autism

There is a strong role of the placenta,  in regards to what passes from mother to fetus that may lead to development of autism. Here are some examples of substances that can pass through the placenta during pregnancy.

If all of these explanations weren’t complicated enough on their own, Grabucker describes many of these risk factors being related to each other, and an interconnected model of risk factors is proposed with zinc deficiency and immune system abnormalities placed in the center.
To eloquently provide a hypothesis that incorporates how all of these factors work together would be extremely helpful reducing rates of autism.
Here are some 2016 facts from the Centers for Disease Control and Prevention about current autism rates in the U.S.:

• 1 in 68 children have ASD
• Boys are 4.5 more likely to have ASD diagnosis than girls
• Until recently, rates have risen since the 1960s
• Rates have are unchanged from 2 years ago

As researchers continue to try to prevent the development of autism, it is important for our entire society to think about how to best care for individuals and families affected by autism.
Starting in the 1970s, federal guidelines supported the inclusion of children with special needs into mainstream schooling, mandating that these students be placed in the least restrictive environment for their education. Eileen Bailey, a health guide for Health Central, outlines the benefits and disadvantages of mainstreaming students with ASD.
Benefits:

• Prepares students for life outside of school–learning how to interact with different types of people
• Early inclusion may help increase IQ scores of ASD students
• Neurotypical students provide an example of appropriate social behavior for ASD students

Disadvantages:

• Teachers don’t have training or time to tend to needs of ASD students
• ASD students may require nontraditional classroom instruction
• May subject ASD students to be bullied

The juxtaposition of these benefits and disadvantages illustrates the ambiguity of mainstreaming ASD students in classrooms.
All in all, as I continue to seek answers in my study of autism, I seem to end up with additional questions and a more complex idea of it all. From the many interconnected risk factors for its development, to the uncertain societal solutions for supporting individuals with autism.

Back in my home town in Montana I have had the pleasure of working as an aid alongside some of the staff in my old school’s special education department. Over the past three year’s I have helped as an aid with these children after I had gotten done with classes for the semester and the majority of these children I worked with had autism. I had never worked with special needs kids before, so at the beginning of this experience I was definitely nervous.
I have been doing this because I enjoy the challenge of working with these children. I feel as if I am truly a part of helping people’s education as I work with and have watched these children progress over the past few years.
Now, the way you have to work with these children really varies from child to child, and as such every child needs to be cared for differently. Most of these children are very set in their ways and behaviors though. They have strict schedules that they all follow and any deviation from that schedule usually results in increased difficult behaviors.
It can be very strange for the outside observer watching in. For example, one of the children the first year I aided had a lot of peculiar qualities. The first time I saw him walk around and meow like a cat I asked one of the special ed. teachers if I should intervene. They told me right away that while I might feel like kids should have to act a certain way, sometimes intervening with these children just wouldn’t work. This is just their normal behavior and sometimes it needed to be accepted. The children in the classroom I were in were generally cased as the more moderate to severe children on the spectrum, and the high functioning ones that can follow normal rules are normally integrated into the regular classrooms.
Obviously this outward behavior was not always tolerate, and sometimes if he refused to transition to the next activity planned for him we would have to take away one of his “fun” activities for the day, which was never very fun because he didn’t always agree with doing that. Some of the children sometimes even had “meltdown” experiences with inconsolable crying and tantruming. The major problem with these were that we weren’t always sure what caused them and it made it hard to prevent the situations from happening again in the future.
There were a many other difficulties I experienced with working with these children. Many of the children I worked with had underdeveloped language skills that is a common problem among autistic children, preferred to be alone instead of interacting with the other children and had other difficulties in expressing needs and emotions. This made it particularly harder to interpret the individual needs of these children, but all the more rewarding when the hard work you put into these individuals in reflected in better behaviors.
Overall my experiences as a special education aid have been very beneficial for my own growth as a person. I have learned to work with kids, and especially special needs kids, at a much more helpful level than I ever thought I would be able to. If you ever find yourself in the situation where you can work with children’s in the special need’s department, I suggest you try it even if you think you might not enjoy it, it is truly a rewarding experience.

By way of definition, Autism is a neurodevelopmental disorder characterized by impairments in communication and social behavior, and by repetitive behaviors. Recent research has shone a light on the fact that while genetic factors are largely responsible for the occurrence of autism, specific environmental factors might act as risk factors triggering the development of autism in some instances. Thus, the confluence of environmental triggers and autism related genes is currently an area of keen research interest. As highlighted by Ashwood et. al. in a 2006 paper, for successful development of the central nervous system  to occur, a functional or normal balance of the immune response is paramount. Ergo, the brains of Autistic patients are characterized by structural and signaling synaptic deficiencies as well as a dysregulation of neuronal survival and growth factors named neurotrophins, all of which seem to be tied to a common thread of Zn 2+ and Immune system abnormalities, among other pertinent but less significant environmental factors.
A few of the environmental factors that trigger the mutation or expression of mutant autism related genes, affect Zn 2+ homeostasis, and proper immune system function include maternal diabetes, heavy metal poisoning, prenatal stress, parental age, malnutrition, psychiatric drugs, toxins, and melatonin deficiency. Regarding immune system abnormalities, a cytokine imbalance is characteristic in the CSF of autistic individuals, and could be the starting point of the inflammatory state, leading to the disruption of trophic factors and increased apoptotic signaling in the cytoarchitecture in the CNS. Consequently, neurodevelopmental arrest or slowed down growth occurs. In the case of the cytokine IL-6, an associated increased expression of proteins called metallothioneins (MTs) that cause Zinc sequestration has been noted. Its worth noting that Zinc is a necessary co-factor for the proper activity of a vast amount of enzymes and proteins. Furthermore, both Zn 2+ deficiency and IL-6 have been shown to cause a reduction in the activity of Insulin-like Growth Factor 1 (IGF-1), a substrate for the IGF-1 receptor that is a component of the PI3K-Akt and Erk- pathways. The former modulates neuronal growth as well as dendritic and axonal maturation and the latter, the expression of neurotrophins imperative for proper neurodevelopment.
While deciphering all the interconnections involved in the physiological state of autism might seem like trying to pick needles out of a haystack, the best that you the reader can do is to avoid the environmental stressors that trigger the expression of autism related genes. For instance, plan on having your children at a younger age to avoid autoimmunity issues, ensure that you are not over or malnourished, ladies avoid taking psychotic medications when pregnant and manage your Zn 2+ and blood sugar levels when pregnant. Special mention to researches working to elucidate the pathophysiology of autism and highlight possible treatment targets, I implore you the reader to support research efforts in this regard.

Autism Spectrum Disorder has been rising in the United States (an increase of 40% since 2000 according to the CDC) since Dr. Kanner discovered it in 1943. This is rise doesn’t have a certain contribution however due to its ever changing standards that qualify someone in the spectrum.
In majority, Autism is mainly caused by genetic factors that can predestine a child to impaired social and communication behaviors but maybe even heightened intelligence. However, in a paper published in 2013 that looked at environmental factors associated with Autism, stress seemed to stick out like a sore thumb.
How can stress cause a neurological disorder? The paper talks a lot about how prenatal stress can influence the development of the baby and even cause changes that previously would not have been a factor. They still think that genetics is the leading cause but that stress may play a role in increasing the risk.
An important system in the body is the HPA axis or hypothalamic-pituitary-adrenal axis that is responsible for the neuroendocrine adaptation component of the stress response. The stressor signals to the hypothalamus to start a cascade of hormones to be processed until a certain blood concentration of cortisol this protection is seemingly achieved and the cortisol exerts negative feedback to the hypothalamus.
One study looked at autistic children versus typical children cortisol circadian rhythm. They found that both groups showed expected circadian variation with higher cortisol concentration in morning than in the evening samples. The children with autism, but not typical children, showed a more variable circadian rhythm as well as statistically significant elevations in cortisol following exposure to a novel, nonsocial stimulus.
The HPA axis can also modulate the immune system in response to a stressor, with high levels of cortisol resulting in a suppression of immune and inflammatory reactions. This helps to protect the organism from a lethal over activation of the immune system, and minimizes tissue damage from inflammation.
With repeated exposure to stressors the HPA axis can become sensitized and no longer function correctly under stressed conditions causing dys-regulation of the immune system at a critical time in development.
Stress is a mainstay in our society nowadays, with economics being its pusher. Taking time to relax while pregnant should be kept in mind, since many implications of stress are now being realized.

Amyotrophic Lateral Sclerosis (ALS), also known as Lou Gehrig’s disease is a neurodegenerative brain disease. It has multiple causes, such as various mutations, and concussions and head trauma may also play a role. In over 90% of cases of ALS the cause is unknown. Only about 5-10% of cases of ALS are inherited from a person’s parents.
There is no cure for ALS. The average life expectancy for somebody with ALS is about 2-5 years. There is one medication, Riluzole that can extend some people’s lives for about 2-3 months. There are some forms of ALS that take significantly longer, but most people diagnosed with ALS sadly do not have long to live.
ALS usually starts with subtle muscle weakness. It can also start with shaking, tripping, or speech problems. However, in most cases it starts with muscle weakness in the arms and legs. Over time the muscle weakness worsens, leading to difficulty swallowing, walking, and even breathing. As ALS progresses patients must use wheelchairs, be unable to speak, and eventually need assistance breathing. Most people with ALS die because of respiratory failure.
ALS is difficult to diagnose. The symptoms of many other diseases can easily be mistaken for ALS. Patients undergoing the process of diagnosis usually get two or three opinions as well as a variety of tests to determine it is in fact ALS and not another disorder.
Most treatments for ALS are focused on improving a patient’s immediate quality of life. Treatments include: physical therapy, speech therapy, nutritional support, and eventually end of life care, sometimes including mechanical respiration.
There are a lot of ethical issues with treating ALS. Since patients do not lose brain function, physician assisted suicide is often brought up. There is also the cost of treatment. Riluzole, the only FDA approved medication for ALS is over $1000 a month. ALS is already a horrible disease. The financial and emotional burdens that falls on family members only make everything worse.
ALS is a tragic disease. It is important that people know about it so that people with ALS can access the support and care that they need. Some awareness efforts, most notably the ice bucket challenge, have been successful. Still, there is work to do to do to research and treat ALS.