Autism — what we know (and what we don’t know yet) | Wendy Chung

Autism — what we know (and what we don’t know yet) | Wendy Chung

“Why?” “Why?” is a question that parents ask me all the time. “Why did my child develop autism?” As a pediatrician, as a geneticist, as a researcher, we try and address that question. But autism is not a single condition. It’s actually a spectrum of disorders, a spectrum that ranges, for instance, from Justin, a 13-year-old boy who’s not verbal, who can’t speak, who communicates by using an iPad to touch pictures to communicate his thoughts and his concerns, a little boy who, when he gets upset, will start rocking, and eventually, when he’s disturbed enough, will bang his head to the point that he can actually cut it open and require stitches. That same diagnosis of autism, though, also applies to Gabriel, another 13-year-old boy who has quite a different set of challenges. He’s actually quite remarkably gifted in mathematics. He can multiple three numbers by three numbers in his head with ease, yet when it comes to trying to have a conversation, he has great difficulty. He doesn’t make eye contact. He has difficulty starting a conversation, feels awkward, and when he gets nervous, he actually shuts down. Yet both of these boys have the same diagnosis of
autism spectrum disorder. One of the things that concerns us is whether or not there really is an epidemic of autism. These days, one in 88 children will be diagnosed with autism, and the question is, why does this graph look this way? Has that number been increasing dramatically over time? Or is it because we have now started labeling individuals with autism, simply giving them a diagnosis when they were still present there before yet simply didn’t have that label? And in fact, in the late 1980s, the early 1990s, legislation was passed that actually provided individuals with autism with resources, with access to educational materials that would help them. With that increased awareness, more parents, more pediatricians, more educators learned to recognize the features of autism. As a result of that, more individuals were diagnosed and got access to the resources they needed. In addition, we’ve changed our definition over time, so in fact we’ve widened the definition of autism, and that accounts for some of the increased prevalence that we see. The next question everyone wonders is, what caused autism? And a common misconception is that vaccines cause autism. But let me be very clear: Vaccines do not cause autism. (Applause) In fact, the original research study that suggested that was the case was completely fraudulent. It was actually retracted from the journal Lancet, in which it was published, and that author, a physician, had his medical license taken away from him. (Applause) The Institute of Medicine, The Centers for Disease Control, have repeatedly investigated this and there is no credible evidence that vaccines cause autism. Furthermore, one of the ingredients in vaccines, something called thimerosal, was thought to be what the cause of autism was. That was actually removed from vaccines in the year 1992, and you can see that it really did not have an effect in what happened with the prevalence of autism. So again, there is no evidence that this is the answer. So the question remains, what does cause autism? In fact, there’s probably not one single answer. Just as autism is a spectrum, there’s a spectrum of etiologies, a spectrum of causes. Based on epidemiological data, we know that one of the causes, or one of the associations, I should say, is advanced paternal age, that is, increasing age of the father at the time of conception. In addition, another vulnerable and critical period in terms of development is when the mother is pregnant. During that period, while
the fetal brain is developing, we know that exposure to certain agents can actually increase the risk of autism. In particular, there’s a medication, valproic acid, which mothers with epilepsy sometimes take, we know can increase that risk of autism. In addition, there can be some infectious agents that can also cause autism. And one of the things I’m going to spend a lot of time focusing on are the genes that can cause autism. I’m focusing on this not because genes are the only cause of autism, but it’s a cause of autism that we can readily define and be able to better understand the biology and understand better how the brain works so that we can come up with strategies to be able to intervene. One of the genetic factors that we don’t understand, however, is the difference that we see in terms of males and females. Males are affected four to one compared to females with autism, and we really don’t understand what that cause is. One of the ways that we can understand that genetics is a factor is by looking at something called the concordance rate. In other words, if one sibling has autism, what’s the probability that another sibling in that family will have autism? And we can look in particular at three types of siblings: identical twins, twins that actually share 100 percent of their genetic information and shared the same intrauterine environment, versus fraternal twins, twins that actually share 50 percent of their genetic information, versus regular siblings, brother-sister, sister-sister, also sharing 50 percent of their genetic information, yet not sharing the same intrauterine environment. And when you look at those concordance ratios, one of the striking things that you will see is that in identical twins, that concordance rate is 77 percent. Remarkably, though, it’s not 100 percent. It is not that genes account
for all of the risk for autism, but yet they account for a lot of that risk, because when you look at fraternal twins, that concordance rate is only 31 percent. On the other hand, there is a difference between those fraternal twins and the siblings, suggesting that there are common exposures for those fraternal twins that may not be shared as commonly with siblings alone. So this provides some of the data that autism is genetic. Well, how genetic is it? When we compare it to other conditions that we’re familiar with, things like cancer, heart disease, diabetes, in fact, genetics plays a much larger role in autism than it does in any of these other conditions. But with this, that doesn’t
tell us what the genes are. It doesn’t even tell us in any one child, is it one gene or potentially a combination of genes? And so in fact, in some individuals with autism, it is genetic! That is, that it is one single, powerful, deterministic gene that causes the autism. However, in other individuals, it’s genetic, that is, that it’s actually a combination of genes in part with the developmental process that ultimately determines that risk for autism. We don’t know in any one person, necessarily, which of those two answers it is until we start digging deeper. So the question becomes, how can we start to identify what exactly those genes are. And let me pose something that might not be intuitive. In certain individuals, they can have autism for a reason that is genetic but yet not because of autism running in the family. And the reason is because in certain individuals, they can actually have genetic changes or mutations that are not passed down from the mother or from the father, but actually start brand new in them, mutations that are present in the egg or the sperm at the time of conception but have not been passed down generation through generation within the family. And we can actually use that strategy to now understand and to identify those genes causing autism in those individuals. So in fact, at the Simons Foundation, we took 2,600 individuals that had no family history of autism, and we took that child and their mother and father and used them to try and understand what were those genes causing autism in those cases? To do that, we actually had to comprehensively be able to look at all that genetic information and determine what those differences were between the mother, the father and the child. In doing so, I apologize, I’m going to use an outdated analogy of encyclopedias rather than Wikipedia, but I’m going to do so to try and help make the point that as we did this inventory, we needed to be able to look at massive amounts of information. Our genetic information is organized into a set of 46 volumes, and when we did that, we had to be able to account for each of those 46 volumes, because in some cases with autism, there’s actually a single volume that’s missing. We had to get more granular than that, though, and so we had to start opening those books, and in some cases, the genetic change was more subtle. It might have been a single
paragraph that was missing, or yet, even more subtle than that, a single letter, one out of three billion letters that was changed, that was altered, yet had profound effects in terms of how the brain functions and affects behavior. In doing this within these families, we were able to account for approximately 25 percent of the individuals and determine that there was a single powerful genetic factor that caused autism within those families. On the other hand, there’s 75 percent that we still haven’t figured out. As we did this, though, it was really quite humbling, because we realized that there was not simply one gene for autism. In fact, the current estimates are that there are 200 to 400 different genes that can cause autism. And that explains, in part, why we see such a broad spectrum in terms of its effects. Although there are that many genes, there is some method to the madness. It’s not simply random 200, 400 different genes, but in fact they fit together. They fit together in a pathway. They fit together in a network that’s starting to make sense now in terms of how the brain functions. We’re starting to have a bottom-up approach where we’re identifying those genes, those proteins, those molecules, understanding how they interact together to make that neuron work, understanding how those neurons interact together to make circuits work, and understand how those circuits work to now control behavior, and understand that both in individuals with autism as well as individuals who have normal cognition. But early diagnosis is a key for us. Being able to make that diagnosis of someone who’s susceptible at a time in a window where we have the ability to transform, to be able to impact that growing, developing brain is critical. And so folks like Ami Klin have developed methods to be able to take infants, small babies, and be able to use biomarkers, in this case eye contact and eye tracking, to identify an infant at risk. This particular infant, you can see, making very good eye contact with this woman as she’s singing “Itsy, Bitsy Spider,” in fact is not going to develop autism. This baby we know is going to be in the clear. On the other hand, this other baby is going to go on to develop autism. In this particular child, you can see, it’s not making good eye contact. Instead of the eyes focusing in and having that social connection, looking at the mouth, looking at the nose, looking off in another direction, but not again socially connecting, and being able to do this on a very large scale, screen infants, screen children for autism, through something very robust, very reliable, is going to be very helpful to us in terms of being able to intervene at an early stage when we can have the greatest impact. How are we going to intervene? It’s probably going to be a combination of factors. In part, in some individuals, we’re going to try and use medications. And so in fact, identifying the genes for autism is important for us to identify drug targets, to identify things that we might be able to impact and can be certain that that’s really what we need to do in autism. But that’s not going to be the only answer. Beyond just drugs, we’re going
to use educational strategies. Individuals with autism, some of them are wired a little bit differently. They learn in a different way. They absorb their surroundings in a different way, and we need to be able to educate them in a way that serves them best. Beyond that, there are a lot of individuals in this room who have great ideas in terms of new technologies we can use, everything from devices we can use to train the brain to be able to make it more efficient and to compensate for areas in which it has a little bit of trouble, to even things like Google Glass. You could imagine, for instance, Gabriel, with his social awkwardness, might be able to wear Google Glass with an earpiece in his ear, and have a coach be able to help him, be able to help think about conversations, conversation-starters, being able to even perhaps one day invite a girl out on a date. All of these new technologies just offer tremendous opportunities for us to be able to impact the individuals with autism, but yet we have a long way to go. As much as we know, there is so much more that we don’t know, and so I invite all of you to be able to help us think about how to do this better, to use as a community our collective wisdom to be able to make a difference, and in particular, for the individuals in families with autism, I invite you to join the interactive autism network, to be part of the solution to this, because it’s going to take really a lot of us to think about what’s important, what’s going to be a meaningful difference. As we think about something that’s potentially a solution, how well does it work? Is it something that’s really
going to make a difference in your lives, as an individual, as a family with autism? We’re going to need individuals of all ages, from the young to the old, and with all different shapes and sizes of the autism spectrum disorder to make sure that we can have an impact. So I invite all of you to join the mission and to help to be able to make the lives of individuals with autism so much better and so much richer. Thank you. (Applause)

Comments (48)

  1. Anyone who wants to know more about autism causes, please read J.B. Handley’s book on autism. He also gives some ideas on how to help reduce symptoms.

  2. Not even it’s amazing how they are attempting to sell something you can’t have information on unless you work for the cdc as a biologist I say let’s test everything in this and proof is in the results autism is on the rise as they attempt to kill all humans

  3. This is so backhanded to autistics. Stop speaking about autistics like they were some type of disease, and to assume someone is not autistics based solely off of eye contact is extremely ignorant. Autism isn’t developed over time, it’s how our brains are wired before we even come out of the womb

  4. i am an aspie and so is my parent

  5. I think I have autism. I appreciate this video because it points out that not all people operate the same way. "People with autism learn and behave differently". What I don't appreciate about this video is the implicit policing of autism. Although we are developing "solutions" for the "diagnosis" of autism, a concept of "deficiency", "abnormality", and "correction" starts to linger…just putting it out there

  6. How can I see if my son is on the autistic spectrum.. my doctor and quite a few other mothers have told me to get him checked.. please advise or help in any other way he’s 3 years old

  7. Vaccines indeed cause autism. Check the facts here

  8. Please…Dr. Sebi has been curing autism since the 80s. He just never got much media attention cause he's considered a "fake" doctor. But many people around the world have been cured by him from autism and literally every other disease known to man. Look him up.

  9. What year was this? It’s totally outdated!!! Worst video on Autism

  10. It's because of the vaccines! Ban all vaccines !! People must hear the truth !

  11. The bit about the eye tracking in babies is very interesting. My son who’s 3 developed ‘normally’ up until he was a year old, met all milestones, made eye contact and smiled and copied sounds. He then regressed leading to his diagnosis. He is coming on leaps and bounds thanks to early intervention but I wonder whether that eye tracker machine would have picked up on him as a small baby because he did make eye contact then 🤔

  12. Year 2019. It's scary how much of this is wrong and has been updated in the last 5 years. Her source numbers are accurate, her anti-vaccination information is accurate. But in the last year alone we have learned that Estrogen plays a significant part in Autism. And there is so much more to learn. The eye test for babies is at best only a indicator. Either infant could become autistic or not. Not everyone with autism has difficulty meeting someone in the eye. And the idea of drugging kids or adults scares the frack out of me.

    53, diagnosed this year. And the lack of services or help has left me nearly incapable of taking care of myself.
    Society has a lot to learn.

  13. Vaccines can and do cause Autism. Hasn't she learned about the use of Alluminum in vaccines which can cross the brain barrier and cause Autism in our young generations but also Alzheimer's in the elderly?


  15. This Broad is a Paid Shill…

  16. We need more access for testing for the spectrum because I have found very few options in this are. Schools fight you and don't want to offer services. My oldest wasn't diagnosed until high school and suffered through it with school..bullies etc. There has to be easier access..

  17. Activated Charcoal and intravenous detox by integrative medical doctors. Absorb and detox the metals and chemicals in the vaccines causing the autism. FYI: FDA approved chemical fee aka adjuvent free vaccines. So the chemicals don't need to be in the vaccines.

  18. Minimal drugs nutrition is the best choice first.
    I’m sure there are many things that cause autism BUT to say vaccines are not in the mix? I say propaganda bullshit. Period.

  19. "risk" of autism??? I feel like some of my autistic traits are the best parts about me! I would definitely that that "risk" again.

  20. Autism is caused by neuroinflammation during brain development (in utero or up to about age 3-4, but occasionally up to age 10-12). Infections and toxic exposures cause this inflammation and can cause autism. Neuroinflammation also causes other mental illnesses and neuro disorders. This is settled science and is consensus opinion in the field.

    This lecturer is ignorant of the science. Only MMR and thimerosal have been much studied in humans as causes of autism. No other vaccines or vaccine ingredients have been studied. And the MMR-autism studies suck. They are observational (not randomized), and therefore suffer from selection bias (healthy user bias, specifically).

    The twin studies she mentioned are fatally flawed because they erroneously assume that gene-environment interactions do not exist. GXE interactions dramatically inflate the heritability estimate and they occur in autism (and other neuropsychiatric disorders). All the twin studies are severely affected by this error and therefore they are all worthless and wrong.

    Vaccines cause autism because they can stimulate chronic neuroinflammation. Aluminum-containing vaccines are the most dangerous because the aluminum travels into the brain and stays there.

    There is overwhelming credible evidence that vaccines cause autism.

  21. Please don't cry at the end or I'll do it as well

  22. so disappointed in TED for putting this woman as a lecturer

  23. Lol says a Chinese – The Rothschilds from The East.

  24. You are watching a Government is God /Big Pharma Ad here., so here:
    Autism Conference and Vaccines: Raise Your Hand!

  25. Its way more then they think period, just some dont have the support and people who know the signs at all never mind the ones that can mask everything and are not realizing what they are fighting in the mind. Major part is genetic and the environment you live in can bring it about cause most the time its a sever thing that happens that manifests it. Also you can eventually get it through lack of trying during a life time. This mental health topic is the base to every other problem we face in the brain, and its not true about the rate of women to men ratio with autism it just manifest itself differently because of the need to reproduce on the woman side so eventually women will allow things because its easier then finding the mate they really desire.

  26. Wake up people she lies what was the one thing they all did the child had a injection

  27. 02:54 is a lie!

  28. She lost me at vaccines don't cause autism. The correct fact is most vaccines on the market do, due to the fact that there are heavy metals including but certainly not limited to Mercury in most of them. I am asking myself and I can tell you first-hand that there are plenty of autistics out there whose autism has been caused by vaccines. You don't have to be f**** doctor a rocket scientist to understand that. I have dealt with the system my entire f**** life I was one of those aspies that grew up in the 90s right smack-dab in the middle of the f**** vaccine craze start and diagnose craze start you know that crazed where the pharmaceutical companies getting f*** in bed with the medical industry and label every single thing as a disorder so they can peddle their drugs on people. I love how she wrote that line to induce Applause. I have been drugged labeled bullied Etc and all by the system specifically drugs and vaccines. Anyone who says vaccines cannot cause autism is either working for the system or are just uneducated. Sincerely an aspie.

  29. Vaccines cause Autism. Until it happens to your children, you don't know who to believe about how dangerous vaccines really are.
    The truth will out and science is on the side of those who demand safety and freedom of choice.
    Safety IS Natural Herd Immunity.

  30. My dear lady, vaccines DO cause autism. She is probably well paid by some Pharma company. Just watch movie Vaxxed. That's only tip of the iceberg. There is tuns of info about vaccines and their dangers. Just find it. I personally know many parents whose kids developed autism very shortly after being vaccinated. Healthy kids just don't "get" autism. It is triggered by "something" in environment, mostly vaccines……Do your research, people.

  31. Funny how autism becomes prevalent the same year most of our cell phone towers first appeared. Maybe our population being in a constant low level radiation field could be part of the increase of development problems and miscarriages. But hey maybe I'm insane to think that but these cell towers are killing us, take notice that in very poor countries where there are no towers they have a much lower population in the spectrum.

  32. The studies which "prove" autism is not caused by vaccines are BOGUS. Please inform yourself by reading The Autism Vaccine, and also How to End the Autism Epidemic. They both PROVE that the studies were FALSE and also that ALUMINUM, not mercury is the cause. The CDC is a revolving door with Big Pharma.
    Yes, there is a genetic component, but the gene must be triggered by an environmental trigger.


  34. If vaccines do not cause autism, why do the vaccine makers warn that SIDS and autism are potential side effects ON THE VACCINE INSERTS?

  35. If autism has a multi-factor etiology, like schizophrenia, then maybe vaccination is one factor? There has not been enough research to rule this possibility out.

  36. I would recommend that she refer to a person as currently non verbal as opposed to non verbal. Over the years, I have worked with students who have learned to speak. Also, it's been my experience that if one sees a person as currently non verbal, they will approach them in a much more open way.

  37. I don't think it's genetics, because we would have been had way more cases look at the rise of autism it's the GMO foods

  38. She had me until she started talking about eye contact. I'm terrible at eye contact, but I don't have autism. Then again I suppose she's not saying that eye contact is the only determining factor.

  39. So why wan't the much stronger association between circumcision and autism not even mentioned? The general consensus among autism researchers is that it is caused by a genetic disposition being triggered by an environmental factor and to date one of the most plausable examples of a trigger is trauma caused by infant circumcision. This also goes some way to explaining the disparity between the sexes and the very high incidence in USA. Unfortunately the bulk of research into autism is financed by US money and cultural bias leads to a lack of funding and therefore interest in further research, into the association with circumcision.

  40. More generalizations and dismissals. Decades of formal research, billions of dollars and STILL nothing at the clinical level to prevent or effectively treat my son's ASD directly. Not even an explanation of why my son has the challenges he has specifically. DO SOMETHING.

  41. So you’re saying a genetic epidemic???? You sound ridiculous.

  42. This is a load of bullshit….I can't believe what I'm hearing…..Glyhosate is in all vaccination's.

  43. My son was diagnosed with Asperger Autism at 17yrs of age ( he is now 29) and when he was nearly 18 had an admission to hospital with the cause "psychosis", whereby over the next ten years he was given anti-psychotic drugs for his mental health and subsequent hospital admissions each year…… in the early years of his diagnosis I was not educated by the doctors of how to cope with things other than medication! I have since learnt in the last few years that just medication alone is not the cure for the mental illness as the medication just seem to make his condition worse by many side affects including things like paranoia, hallucinations, depression etc…….. This past ten years have been really traumatic for both of us and have survived some events including him trying to hurt himself very badly (twice), I won't go into the details . I have made it my journey to empower myself to not just take the Psychiatrists treatment as the way to just manage the symptoms, I believe through the research that I have found with people like Dr Amen that we need to look at the bigger picture "the brain", this lead me to go back and question everything in my son's life journey. Did the fact that my son was born premature at 32 weeks have a cause that the brain was not completely formed or did a fall when he was about 3yrs of age where he hit the front of his head – cause his autism ? At no time did any of the doctors in his diagnosis take this into account and examine/scan the brain first before prescribing my son with anti-psychotic medication – this brings me to the point in his life now, I am researching as much as I can to find the information I need to treat the underlying issues which could be dormant infections, stress and trauma that keeps the depressive moods active. The exciting part of my research shows me that our brain can be healed to repair damage caused by factors that are not on the surface by just talking therapy, I believe that a Neuro Psychiatry Assessment by way of a SPECT brain scan may help me with the uncertainties that I feel the doctors are failing to take into account when treating my son, so this journey is still ongoing but I have found some excellent professional doctors online like: Dr John Bergman, Dr Daniel Amen, and Joe Dispenza after viewing many of their TedX talks and videos I believe that there is HOPE that I can find a better way for my son to live a happy and mentally healthy life…. I am located in Melbourne Australia and am always looking for people who may be able to give me strategies with proven results, so if there is anyone reading my story I would be so grateful for your input, thank you.

  44. Vitamin D, Omega 3 Fatty Acids a Blue Berries and other brain foods plus foods which health the gut.

  45. Can you explain me why my son changed in one week time from a very social engaging boy with normal behavior to a boy that hardly makes contact with his environment and shows repetative behavior after the MMR vaccination Miss Wendy Chung?

    Is this just coincidence or are you told by the pharmaceutical companies to mislead the world? Miss Wendy Chung did you know that the medical studies are supported by the pharmaceutical companies?

  46. In traditional Australian Aboriginal culture, it is offensive to look people in the eye. Does that make their culture autistic? 😡 Stupid psychologists. 😝

  47. Why are they clapping,are they morons?

  48. my son is 6 and has autism, but he is the sweetest ❣️

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