Professor Robyn Cosford: Letter in Response “Diagnosis: Autism”
Our Chair, Professor Robyn Cosford recently wrote a letter in response to The Australian regarding their recent article “Autism to cost budget $8.25bn: will the safety net break?”. It was not published. However, we believe that the points raised are important and should be shared.
1 May 2023
Letter in Response
Diagnosis: Autism
Dear Stephen,
Thank you for your in depth article on Autism and the burden it represent for individuals, their family, society at large and the NDIS system in particular.
The data is very clear that the incidence of autism has risen dramatically since the 1980s. The seminal paper of Eric Fombonne (1999) placed the incidence prior to1989 at 4/10,000 with a year by year increase to average 7.2/10,000 from 1989 to 1999. CDC data gives an incidence in the USA of 1/10,000 in 1970, jumping to 1/1,000 by 1995, with an almost exponential increase from 1/500 1999 to the latest figures of 1/54 in 2016. It is said to now be around 1/34.
It is certainly true that some of this increase is artifactual, as result of changing diagnostic criteria and hence increased awareness by medical practitioners, teachers and parents alike. Many are now diagnosed as being autistic or having autistic trait who historically would simply have been labelled ‘quirky’ or ‘eccentric’. However, any teacher who has been in the classroom setting for 30 years or more, or any general practitioner who has been treating families for more than 30 years, will be able to clearly say that the actual incidence in their classrooms or practices has increased dramatically over that time, so much so that many teachers spend much of their time now in behavioural management rather than teaching.
When I went through medical training in the early 1980s, to see a child with autism it was necessary to go to specialised autism schools: these days, every family have either have an autistic child themselves or in their extended family, or have friends with an autistic child: they are now commonly seen in society and the more severe cases are unmistakable.
Autism tends to run in families. Interestingly however, it is more a ‘horizontal inheritance’ where siblings or cousins will be affected, with only mild autistic trait, some other mental diagnosis or ‘eccentricity’ in parents and grandparents: it is apparently worsening as we come down through the generations from 1990s onwards.
There was a push in 2000s to identify the genetic basis for autism, and despite intense efforts, no specific autism genes were identified, but over 40 genes that appeared to predispose, now expanded to over 100. Further research has identified numerous SNPS or point changes in DNA, often related to oxidative function, nutrient metabolism and detoxification pathways, such that Autism Panels have been developed to look for those and guide intervention. However, having those SNPS alone does not necessarily result in autism.
It has been said that ‘the genes load the gun but the environment pulls the trigger’. The field of epigenetics, or the effect of environment on gene expression and hence body function , has exploded in the past 20 years. In many cases it seems that the effect of the environment (as in factors external to the genes) is in fact more important than the genes themselves.
Since 1980s, there have been many significant changes to environmental factors impacting on our bodies. The significant shift in diet, from whole, simple foods to highly processed convenient foods, with higher refined carbohydrate and sugar intake and numerous food additives has significantly increased to the burden of obesity, diabetes and cardiovascular disease for example, with numerous studies attesting to the positive effect in these disorders of changing to a Mediterranean-style diet high in vegetables, fruits, nuts, seeds, legumes and whole grains, but also in dementia. It should be no surprise then, that specific dietary change may have a positive effect in autism.
Another marked environmental change over that time frame has been the dramatic increase in the use of herbicides and pesticides in large scale agriculture. One such chemical is glyphosate, or Roundup, which has increased in use since 1974, with over 1.6 billion kg of glyphosate applied to crops in the USA, and with 15 fold increase to 2014 since the introduction of Roundup Ready genetically engineered roundup tolerant crops in 1996. ( Trends in glyphosate herbicide use in the United States and globally ). From the late 1970s to 2016, there was a 100-fold increase in the frequency and volume of application of glyphosate based herbicides (GBHs) worldwide, with further increases expected in the future.
This chemical is interesting as it has an effect on the shikimate pathway in plants and bacteria, blocking the production of aromatic amino acids which are essential to human health. It was originally patented as mineral chelator and so also binds and removes minerals such as calcium, magnesium, manganese, copper and zinc, resulting in nutrient deficient plants. A diet low in added herbicides and pesticides will reduce the load of this and other chemicals and improve mineral nutrition and may also have a positive impact in autism.
Another external factor particularly applicable to children is the continually increasing vaccination schedule, going from only the DTP and polio prior to 1980, to 15 injections for 13 diseases (more for indigenous children and children with underlying health conditions) in Australia for children under 5. Vaccines contain not only the agent to which the body is to respond to create antibodies, but also adjuvants to increase the response, for example aluminium, and preservatives like mercury in the form of thiomersol, now largely removed from vaccines and replaced by synthetic chemical preservatives.
Aluminium has long been known in the field of toxicology, to be a neurotoxin when exposed orally or via inhalation. However there is a scientific gap in the studies on the toxicity of aluminium salts as adjuvants in the vaccines. The aluminium salt adjuvants have been added on the basis of dose required for efficacy, with no studies into safety in the injected form, with no consideration to pharmacokinetics and the possibility of long term storage of these substances and hence long term effects. However recent human studies have demonstrated a correlation between aluminium adjuvants in vaccines and the development of ASD, and autopsies post-mortem of people with ASD but also Alzheimers Disease and Multiple Sclerosis have demonstrated extremely high levels of aluminium in the brain. That there are significant issues at least for some is clearly indicated in the studies focused on this.
Reviewing the association between aluminum adjuvants in the vaccines and autism spectrum disorder
Another major environmental change over this time has been the increasing introduction of technology and electromagnetic field pollution by non natural, non-natural, non-human microwaves, with the result that children are often introduced to playing on a mobile phone while very young spending more time inside on computers and related devices and less and less time outside playing.
While autism presents as a neurodevelopmental and behavioural disorder, and thus fell into the Diagnostic Services Manual (DSM) as a psychiatric disorder, it is in fact a neurological and metabolic disorder.
Children and adults with Autism Spectrum Disorder (ASD) suffer concomitant physical and metabolic dysfunctions at a much higher rate than neurotypical children and adults. Children with ASD have a higher incidence of concomitant Inflammatory Bowel Disease, Precocious Puberty and Mitochondrial Disease amongst many others, while adults with ASD have increased incidence of Parkinson’s Disease and Dementia.
There is increasing research into the Gut- Brain Axis & and Endocrine- Brain Axis: that the brain is not chopped off at the neck, but is involved when there is metabolic derangement and leaking of the gut wall and the blood-brain barrier, allowing toxins and other substances for example to enter the brain, activate the brain immune cells (microglia) and result in brain inflammation and dysfunction. The predisposition of those with ASD to gut issues appears to be intimately associated with the cognitive challenges we observe with ASD.
Given all of this, it should be of no surprise that interventions geared to understanding the underlying genetic points of weakness, the environmental load perhaps from food, chemicals, toxic minerals and electronic equipment and field effects, in the hands of trained functional medicine practitioners, typically result in at least some amelioration of symptoms, and in many documented cases, reversal of the autism diagnosis.
There is hope for intervention and change for this predominantly environmentally induced disorder.
Yours faithfully,
Dr Robyn Cosford (retired)
Professor, Nutritional and Environmental Medicine
Chair; Director, Children’s Health Defense Australia Chapter.
