04/27/08 — Doctor says finger-pointing isn't an answer to the 'whys' of autism

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Doctor says finger-pointing isn't an answer to the 'whys' of autism

By Phyllis Moore
Published in News on April 27, 2008 2:00 AM

With diagnosed cases of autism on the rise, physicians have to consider all possibilities when it comes to the most effective treatments.

Dr. Dave Tayloe of Goldsboro Pediatrics has found himself thrust into the heated battle since becoming president-elect of the American Academy of Pediatrics, moving into the top seat in October. In recent months, he has been traveling the country to discuss the issue in such arenas as the "Today Show" and "Larry King Live."

The biggest challenge comes from parents and advocacy groups, armed with their own research and seeking answers.

"It's often difficult because parents desperately want their children to be normal," Tayloe said.

Currently, 1 in 150 children are diagnosed with autism spectrum disorder, defined as a group of related brain-based disorders that affect a child's behavior, social and communication skills.

"They have expanded the spectrum. Seventy-five percent of our newly diagnosed cases are of the mild variety," Tayloe noted.

"You're looking at a child who has a delay in the development of speech and language and difficulty focusing their attention on another person. So this combination of developmental delay and the appearance that the child is in another world is where most of these children are discovered, somewhere around the age of 2 or 3 years."

One of the biggest misperceptions, the physician said, centers around the belief that vaccines cause autism. Studies being done in other countries, however, are not showing a linkage between the two, he added.

"It was attractive to some folks to see this increase in vaccines. Over the last 20 or 30 years, it has occurred at a time when we were diagnosing more kids with autism," he said.

Concerns have also been raised over the number of vaccinations given during one visit, which many feel may overwhelm the immune system.

Tayloe said it can be frustrating to have parents fail to come in for regular visits with a child, especially between the ages of 12 months and four years, putting them behind on shots needed.

"I space them out -- 12 months, 15 months, 18 months -- the shot acts as a carrot to get the parents to come in," he said. During each of those benchmark visits, he notes, he is also able to assess the child's development in language and other areas.

"It's not a real simple issue. If these people want to rework the vaccine program based on their hypothesis, we have got to oppose that. We think the public health is more important than a special interest group."

Efforts are, however, being made to work with autism advocacy groups and give answers that will satisfy critics.

"The people are upset with the Federal government because they don't think there's been enough vaccine safety research, and we're not afraid of the truth. We're willing to go there and run with it," Tayloe said.

Other connections have been drawn between autism and the environment. Specifically, lead and mercury issues as well as aluminum and pesticides. Those are not easy to study or draw conclusions from, Tayloe said.

He is more optimistic about efforts being done through the National Children's Study, which encompasses a 21-year span. Neighboring Duplin County is involved with that, he said.

Results could provide data and answers to a lot of the questions about autism, Tayloe said. The only thing is, it's going to take some time.

Medical groups are not opposed to holistic approaches or alternative therapies being touted as beneficial, Tayloe said. Whether it's a healthier diet or vitamins, as long as they've been deemed safe, there should be no problem.

But, the main thing, he says, is trying to get everyone on the same page, viewing science through a similar lens.

"We probably are the group in medicine that works with parents the most," he said. "It's very painful for us to find ourselves on the other side of parent groups."

Autism has become a complicated issue with a lot of different facets, Tayloe said -- therapy, causes, research, just to name a few. Most, though, can agree that it is a genetic condition.

"It's not an accident -- I have a family in Dudley with three autistic boys, another family here with two autistic boys," he said "There's a lot of different ways to get autism."

Ideally, he would advise parents to keep an open mind, do their homework and aspire to get the best medical assistance possible.

"Our job as physicians is making sure we consider all possibilities, particularly on a condition as baffling as autism," he said. "I think we have all got to work together, share ideas and come together on what is the best medical evidence for dealing with this."