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Autism: Searching for Causes


MEGHAN WALLACE: (Walks in, stares into the camera) Cheese! (Adults laugh)

FOUR-YEAR-OLD MEGHAN WALLACE IS TAKING PART IN THE LARGEST RESEARCH PROJECT IN THE U.S. ON THE CAUSES OF AUTISM. RESEARCHERS DON'T YET UNDERSTAND WHAT PRODUCES THIS DEVELOPMENTAL DISORDER.

AT KAISER'S SAN JOSÉ MEDICAL CENTER, PSYCHOLOGIST THOMAS CRAWFORD TESTS MEGHAN BY ENGAGING HER IN DIFFERENT WAYS. THE SYMPTOMS HE SEES CONFIRM THE AUTISM DIAGNOSIS HE MADE TWO YEARS AGO.


THOMAS CRAWFORD: Very rarely that she looked at me, unless I actively called her name.

Meghan! (He tries to get her to follow his gaze) Meghan, look at me. Look up here. Look!
When I tried to direct her attention to the bunny across the room, twice, two or three times, she couldn't follow my gaze. She didn't know that the eyes are important for knowing intention.


VANESSA: Right.
THOMAS CRAWFORD: // But when I made it a little more clear with a gesture - "look at that" // she was able to track to where it was.

Look. (He points to the bunny with his hand and she turns and looks)


Meghan: A bunny! (she runs to the bunny)


MEGHAN IS ONE OF 900 AUTISTIC CHILDREN NATIONWIDE WHO WILL HELP KAISER AND THE CENTERS FOR DISEASE CONTROL IN A STUDY CALLED "SEED". THE RESEARCH AIMS TO UNVEIL THE CAUSES OF AUTISM.


VANESSA WALLACE: We feel - my husband and I both feel - that if you don't know why it's happening, parents aren't going to be empowered to make the best decisions they can for their kid.
Sound up: Crawford: Get ‘em all!


AUTISM RANGES FROM SUBTLE TO SEVERE, BUT MOST AUTISTIC CHILDREN HAVE A VERY HARD TIME FOLLOWING SOCIAL CUES.


Sound up: THOMAS CRAWFORD: I don't know what Meghan wants.


THEY DISPLAY REPETITIVE BEHAVIORS AND HAVE DIFFICULTY COMMUNICATING AND INTERACTING. ALTHOUGH A FEW MEDICATIONS CAN SOMETIMES HELP, THE DISEASE'S SYMPTOMS ARE GENERALLY TREATED BY WORKING TO MODIFY BEHAVIOR AND IMPROVE INTERACTIONS WITH OTHERS.


Sound up: Please, may I dip it in.


Crawford: Yes you may.


IN THE 1990S, THE NUMBER OF DIAGNOSES OF THE CLASSIC FORM OF AUTISM IN CALIFORNIA INCREASED BY 300 PERCENT. AND THE NUMBERS CONTINUE TO CLIMB, PROMPTING OFFICIALS TO CALL IT A PUBLIC HEALTH CRISIS.


RON HUFF: Twenty years ago, it was very uncommon to see children in the regional center system with autism // Today, our regional center, for example, here in Sacramento, Alta California Regional Center, we're averaging about one diagnosis each day, 7 days a week.


NATIONWIDE, ONE IN EVERY 150 EIGHT-YEAR-OLD CHILDREN IS ON THE AUTISM SPECTRUM. THE SPECTRUM INCLUDES CLASSIC AUTISM AND TWO OTHER FORMS OF THE DISEASE -- ASPERGER'S AND P-D-D-N-O-S.
RESEARCHERS ARE VIGOROUSLY DEBATING WHAT THIS INCREASE MEANS. ARE MORE CHILDREN DEVELOPING THE ILLNESS? OR ARE OTHER FACTORS LIKE BETTER DIAGNOSIS AT PLAY? RON HUFF, WHO IS IN CHARGE OF DIAGNOSES AT SACRAMENTO'S REGIONAL CENTER, BELIEVES THAT AT LEAST PART OF THE INCREASE IS A TRUE INCREASE IN CASES, AND THAT IT'S NOT SIMPLY A CASE OF MORE ACCURATE DIAGNOSIS.

RON HUFF: Where are those older 20-, 30-year-olds that were missed 15 or 20 years ago that otherwise would have been diagnosed with autism? When we look into the community, we don't see those people.
SO WHAT IS MAKING TODAY'S KIDS SICK? WHILE KAISER WORKS ON ITS "SEED" STUDY, UC DAVIS IS FOCUSING ON AUTISTIC CHILDREN WHILE THEY'RE STILL IN THE WOMB, AS PART OF ITS OWN STUDY, CALLED "MARBLES."


TODAY, UC DAVIS RESEARCHERS ARE VISITING THE NEWBERRY FAMILY IN CITRUS HEIGHTS, NORTH OF SACRAMENTO.


Sound up: Researcher Meaghan Oliver: Hi Hayden, hi big boy!


THEY'VE BEEN FOLLOWING SIX-MONTH-OLD HAYDEN SINCE HE WAS IN UTERO. THEY'RE INTERESTED IN HAYDEN BECAUSE HIS FIVE-YEAR-OLD BROTHER JASON IS AUTISTIC.


Sound up: STEPHANIE: Hi Jason. Come sit right here.


STUDIES SHOW THAT 10 TO 15 PERCENT OF COUPLES WITH AN AUTISTIC CHILD WILL HAVE ANOTHER AUTISTIC CHILD. THIS UNFORTUNATE STATISTIC GIVES RESEARCHERS THE OPPORTUNITY TO STUDY THESE AUTISTIC CHILDREN AND THEIR MOTHERS FROM PREGNANCY ON. THE MARBLES STUDY HAS SO FAR ENROLLED 70 FAMILIES WITH AN AUTISTIC CHILD.


Sound up: Phlebotomist: Any significant events in his life?


IRVA HERTZ-PICCIOTTO: // The idea behind this study is that if there are early factors that influence autism, we would like to be able to study them as they happen and not be trying to get people to remember what happened when you were pregnant.


STEPHANIE NEWBERRY: I was excited about the research project // because I'd have more people watching Hayden than just his pediatrician and myself.


IN THIS SIMPLE TEST, IF HAYDEN DOESN'T RESPOND TO HIS NAME, IT COULD BE AN EARLY SIGN OF AUTISM.
JASON, HAYDEN'S DAD: Hayden! Hayden! Hey buddy. What's up? (Hayden turns his head towards his dad).


Sound up: Researcher (off camera): Good job!


THOUGH AUTISM RUNS IN FAMILIES, THERE ISN'T A UNIQUE "AUTISM GENE."


BUT HERTZ-PICCIOTTO AND HER COLLEAGUES HAVE IDENTIFIED ELEVEN GENES THAT ACT DIFFERENTLY IN AUTISTIC CHILDREN. THESE GENES ARE FOUND IN THE CHILDREN'S "NATURAL KILLER CELLS." THOUGH THEY SOUND LIKE VILLAINS, NATURAL KILLER CELLS ARE ACTUALLY SUPERHEROES OF OUR IMMUNE SYSTEM THAT ATTACH TO AND KILL CANCER CELLS AND VIRUSES. SO WHAT DOES THIS LINK BETWEEN AUTISM AND THE IMMUNE SYSTEM MEAN?


IRVA HERTZ-PICCIOTTO: We don't know exactly how it's relevant. Is a change in immune function somehow underlying what causes the brain pathology or is it the brain pathology that causes the changes in the immune system, or is it neither?


Sound up: (off camera) Is this the good arm?


AS RESEARCH PROGRESSES, SCIENTISTS EXPECT TO FIND THAT MANY DIFFERENT GENETIC FACTORS INTERACT WITH ENVIRONMENTAL FACTORS TO CAUSE AUTISM.


IRVA HERTZ-PICCIOTTO: // In one case it might be one gene and three environmental factors. In another case, it might be 5 genes, a child who really is genetically loaded in a sense, and a single environmental factor might tip the scale. And those environmental factors might operate at different points in time. So there may be something that happens near the time of conception. There may be things that happen in the first or the second trimester of pregnancy. There may be events around the time of birth or in the first few months or year of life.


MEAGHAN: We did this before. We did this in the second trimester of her pregnancy. And we're looking for pesticides, any sort of yucky stuff that mom, dad and kids would be bringing in.


LONG DOMINATED BY PSYCHOLOGICAL, AND LATER, GENETIC RESEARCH, THE AUTISM SCIENTIFIC COMMUNITY ONLY RECENTLY STARTED LOOKING AT ENVIRONMENTAL FACTORS.


BUT SOME PARENTS OF AUTISTIC CHILDREN HAVE LONG VOICED CONCERNS THAT THE ENVIRONMENT IS INVOLVED IN THEIR CHILDREN'S DISEASE. THEY BELIEVE THAT VACCINES ARE SOMEHOW CONNECTED TO AUTISM.


THIS BELIEF HAS BEEN BROUGHT ON, IN PART, BY THE FACT THAT 15 TO 40 PERCENT OF AUTISTIC CHILDREN START DEVELOPING IN A TYPICAL FASHION AND THEN REGRESS. THAT REGRESSION SOMETIMES COINCIDES WITH THE TIME PERIOD AROUND 18 MONTHS WHEN KIDS GET THEIR BOOSTER SHOTS. THIS IS WHAT FUELED JASON'S FATHERS' SUSPICIONS OF A LINK.


JASON NEWBERRY: // After he got his last round of shots, I really noticed that he just regressed; within a week or two after that he had just completely changed. // He wasn't playing with the dog, he wasn't doing anything. // He didn't even know how to be potty trained any more. So we had to put diapers back on him at about 2 years old.


ANOTHER SOURCE OF PARENTS' SUSPICIONS STEMS FROM A SMALL 1998 BRITISH STUDY THAT SUGGESTED LINKS BETWEEN THE MEASLES-MUMPS-RUBELLA VACCINE AND AUTISM. HOWEVER, MOST OF THE RESEARCHERS HAVE SINCE RETRACTED THE PAPER, ADMITTING IT DID NOT PRODUCE SUFFICIENT EVIDENCE OF A CONNECTION.


PARENTS ALSO SUSPECTED THIMEROSAL, A MERCURY DERIVATIVE USED AS A PRESERVATIVE IN SOME PEDIATRIC VACCINES. IT WAS ELIMINATED FROM ALL BUT THE FLU VACCINE IN 2001. BUT THE RATES OF AUTISM HAVE CONTINUED TO CLIMB.


CONCERNED ABOUT GUARANTEEING THAT INFECTIOUS DISEASES DON'T REEMERGE, PUBLIC HEALTH OFFICIALS HAVE INSISTED THAT RESEARCH DOESN'T BEAR OUT AN AUTISM-VACCINE CONNECTION.
BUT BASED ON ITS FINDING THAT THE IMMUNE SYSTEMS OF AUTISTIC CHILDREN ARE DIFFERENT THAN THOSE OF TYPICALLY DEVELOPING CHILDREN, UC DAVIS' MIND INSTITUTE HAS TAKEN A MORE NUANCED APPROACH TO THE ISSUE. THE MIND INSTITUTE SUGGESTS THAT A SMALL NUMBER OF CHILDREN MAY RESPOND TO VACCINES IN AN ATYPICAL WAY.


IRVA HERTZ-PICCIOTTO: // By and large, vaccines are safe and they're effective. // At the same time, // the number of vaccines that we give in a very short period of time may be too much for some children. And maybe it's because those children had other things that happened to them prenatally, I don't know, or maybe it's a genetic predisposition, or maybe there's just some subset of the population within the norm that are at one end of sensitivity where you know, 15 vaccines in a short period of time is not right, is not what they can handle.


IT'S NOW COMMON FOR PARENTS AND PEDIATRICIANS TO SPREAD VACCINES OUT OVER TIME.
STEPHANIE NEWBERRY: For Hayden, as far as immunizations go we have done an extended plan. He will have his immunizations up until he's four, instead of two. // I feel it's important to immunize him. I wouldn't not immunize him.


BOTH THE KAISER AND THE UC DAVIS STUDIES WILL LOOK AT THE VACCINATION HISTORIES OF CHILDREN AND MOTHERS. AND THEY WILL ALSO LOOK AT A WHOLE HOST OF OTHER LIFESTYLE AND ENVIRONMENTAL FACTORS.


Meaghan: When was the last time that anyone sprayed pesticide inside?


Stephanie: // Probably about 6 months ago in the playroom and the bathroom.


IRVA HERTZ-PICCIOTTO: All the mothers ask, // should I stop doing this, should I stop (LAUGHS) doing that? // So we have to tell them, you know, probably you want to avoid as much as you can some of the unnecessary chemicals.


RESEARCH HAS ALREADY REVEALED SOME LINKS. IN 2008, HERTZ-PICCIOTTO AND HER COLLEAGUES FOUND THAT MOTHERS OF AUTISTIC CHILDREN WERE TWICE AS LIKELY TO REPORT THEY HAD USED HOUSEHOLD INSECTICIDES AND PET SHAMPOOS FOR FLEAS OR TICKS.


IRVA HERTZ-PICCIOTTO: // We can't say at this point we've established some causal link because that's not what we've done. We've just shown some evidence of an association.
WHILE THE NEWBERRYS HOPE TO CONTRIBUTE TO THE UNDERSTANDING OF WHY CHILDREN BECOME AUTISTIC, WHEN IT COMES TO THEIR OWN SON, THEIR FOCUS IS ON THE FUTURE.

AFTER JASON'S FIRST YEAR IN THE LOCAL SCHOOL'S AUTISM PROGRAM, HIS PARENTS ARE NOTICING IMPROVEMENTS, AND THEY'RE WORKING TO REINFORCE HIS NEW SOCIAL SKILLS.
Stephanie: One of the goals for this year is to get him to answer who, why, when, where, instead of mimicking.


Stephanie: What's that?

Jason: Ooh-ah-ah, ooh-ah-ah.

Stephanie: What's his name?

Jason: He's a monkey. Ooh-ah-ah, ooh-ah-ah.

END

QUEST is a a KQED multimedia series exploring Northern California science, environment and nature.