Virtually every fortified cereal packet broadcasts
the message that vitamin A is vital for good eyesight.
But even the most gung-ho marketing manager would
pause before claiming that the vitamin can dramatically
improve the symptoms of autistic children by repairing
damage to their retina. However, this is precisely
the claim being made by an American paediatrician,
who has evidence that treating these children
with the right sort of vitamin A is not only highly
effective but provides valuable new insights into
some of the most puzzling symptoms of this disorder.
"Once you understand the way autistic children
'see' their world,"
says Dr Mary Megson, a professor of paediatrics
at the Medical College of
Virginia, "the fact that they don't look
you in the eye and can't bear for
things to be changed makes perfect sense."
She emphatically rejects the
widely accepted hypothesis that these children
have no theory of mind (ie,
no understanding that other people have their
own thoughts, plans, points of
view), and that they relate to other people as
just another type of thing.
Instead, she maintains that their seemingly alienated
perfectly rational. It is their way of surviving
in an extraordinary and
terrifying visual world, the result of damage
to a protein pathway that
affects the way that certain specialised cells
in their retinas work.
"Imagine that everything appeared to you
like a some paintings by Picasso,
flat and two-dimensional, with various features
superimposed," urges Dr
Megson, who has specialised in developmental disorders
for the last 15
years. "Or think of a Hockney collage, digitally
remastered with all the
depth cues taken out."
At a conference on nutritional psychiatry in London
earlier this year,
Dr Megson described how she has found that a proportion
of her patients have only a tiny visual window
on the world where things are reasonably clear
and appear in 3D. All around this they only see
colours and vague shapes. This makes it very hard
for them to follow movement, especially the subtleties
of facial expressions. Making sense of a new scene
is equally challenging - hence their desperate
insistence that everything should follow ritualised,
What concerns Dr Megson, like many other clinicians
in this field, is
the massive increase in the number of children
coming to her with this sort
of damage. "Since I've been practising, the
number of cases has gone up from one in 10,000
to one in 600, and it may be more," she says.
officially 1,522 cases in the state of Virginia,
but I've got 1,200 in my
practice, which just covers one district."
She is certain that vaccination is at least one
of the factors fuelling the rise. But although
she agrees with Andrew Wakefield's controversial
ideas about the effects of the MMR vaccine on
the gut, she is particularly concerned about the
vaccine for whooping cough and the "pertussis
toxin" it contains. The evidence that she
has seen has convinced her that certain children
have a genetic susceptibility that makes certain
proteins in their bodies vulnerable to damage
by the toxin, which can have wide-ranging effects.
Known as "G proteins", they are found
all over the body, but
especially in the brain and guts, and are involved
in boosting or dampening
down the signals coming in from our senses (such
as sight via the retina),
as well as controlling such vital pathways as
those for fats and glucose.
The scary visual world of the children provides
a close-up of how
far-reaching the damage can be.
The theory is that receptors in the brain that
control the "rod" cells
in the retina have been affected by the whooping-cough
vaccine. Rods are the cells that convey shading
and depth, and allow us to see in black and white
in the dark. They are more thickly clustered around
the edge of the retina.
"When these children look away from you,"
says Dr Megson, "they are turning their eyes
so that the light reflected from your face lands
on the outside of their retina, where the rods
still have some function."
Controversial as her theory is, what has made
her clinic in Richmond,
Virginia, such a magnet for desperate parents
is that it leads to a form of
treatment that seems to be having considerable
success. The key to getting
the G-protein pathways working again is a form
of natural vitamin A. "The
results can be dramatic," says Dr Megson.
"Within a few days, these children
regain eye contact. They may start looking at
their mother and speaking.
Watching it happen, you get a strong sense of
something being unblocked."
It is vital to use unsaturated "cis"
vitamin A, as found in cold-water
fish such as salmon or cod, as well as liver,
kidney and milk fat.
"These are foods that children often don't
get in modern diets," says Dr Megson. "Synthetic
vitamin A, the sort often found in supplements
and cereals, can actually make matters worse because
it has to be properly absorbed. This in turn needs
a healthy gut, but many of these children have
damage to the gut due to food allergies and overuse
of antibiotics." That is why treatment is
usually supported by removing certain foods from
the diet, most commonly wheat and milk, and giving
probiotics - beneficial gut bacteria.