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HOUSE CALL WITH DR. SANJAY GUPTA

Autism Still Largely a Mystery for Those Affected; Debt and Divorce Can Follow Autism Diagnosis; Getting Through To Girls About Fitness Critical

Aired August 12, 2006 - 08:30   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.


DR. SANJAY GUPTA, CNN SENIOR MEDICAL CORRESPONDENT: Good morning and welcome to HOUSE CALL. I'm Dr. Sanjay Gupta.
Well, we've spent the last month talking with experts, parents, and children with autism. This morning, we're going to bring everything that we found out to you.

You hear headlines often about autism, but the question is what do they really mean? For example, just recently scientists reported different genes may cause autism in boys versus girls. In a very small study, researchers believe autism may be diagnosed as early as birth by abnormalities in the placenta.

Headlines -- they often offer so much hope. And yet for the millions of parents, children, and adults affected by autism, this disorder is still a big mystery. So helping us sort out fact and fiction is Dr. Anshu Batra. She's a pediatrician who specialized in autism at the Cedar-Sinai Medical Center in Los Angeles. I'll also add that she lives first hand as a parent of children with this disorder as well.

First of all, doctor, thank you very much for joining us.

DR. ANSHU BATRA, CEDAR-SINAI MEDICAL CTR.: Thank you very much for having me, Sanjay.

GUPTA: Sure. Doctor, if you can start off by just giving us a clear definition. What is autism?

BATRA: Well, autism is defined as a neurodevelopmental disorder that's characterized by deficits in three core areas of a child's development. A qualitative impairment in language, a qualitative impairment in social interaction, and some stereotyped repetitive behaviors.

GUPTA: OK. So and we're going to delve more into that specifically.

BATRA: Absolutely.

GUPTA: But some statistics that are interesting to me -- as many as one in 166 children are diagnosed with autism. That's a high number. And yet, doctors still don't know the cause.

(BEGIN VIDEOTAPE) GUPTA (voice-over): It is a true medical mystery. The secrets of an autistic brain.

WENDY STONE, VANDERBILT KENNEDY CTR.: There is no identified single cause of autism that is universal for all children. Well -- and there may never be.

GUPTA: As with many mysteries of the mind, doctors point to genetics and environment as culprits. But as the mystery starts to unfold, we learned that it could be more complicated than that.

The newest research shows that there is something that a child is born with that allows outside factors to wreak havoc on their little brains. More simply, these children are not necessarily born with autism, but they are born with the potential to develop it.

And what exactly are those outside factors? Not sure.

STONE: Before we're born, it's the mother's womb and placenta. After we're born, it's what we eat, it's what we breathe, it's what we drink. And there are so many different things out there. And that it's hard to pinpoint exactly what it is.

GUPTA: Still, any parents of an autistic child will have theories. When Zack's Couch's parents learned he had autism, his mother began to change his diet, worried he was eating something that was causing him to get worse.

Some families believe that a preservative in some childhood vaccines called Thimerasol is causing autism in their children. The CDC says no scientific link.

DR. ROBERT DAVIS, CDC: Now that we have the data coming in, there is no data to suggest that the Thimerasol or the mercury in vaccines is linked to autism.

GUPTA: And what about the genetic link? Well, doctors at Vanderbilt are studying siblings of autistic children.

STONE: They are at elevated risk for developing autism. Even from birth, we can start following these children. And we can identify the very earliest signs.

GUPTA: Catching those early signs may help doctors get one step closer to solving the mystery.

So what exactly is happening in an autistic brain? At the University of Pittsburgh, doctors are seeing what's happening inside the autistic brain. The picture here shows a normal brain on the left, an autistic brain on the right with dramatically fewer connections lighting up.

No, we still don't know what exactly causes it or even how to explain the rising rates across the United States. But every day, we're getting closer to solving the mystery of autism.

(END VIDEOTAPE)

GUPTA: The lack of a cause or cure for these disorders can be frustrating to everyone involved. And Dr. Anshu Batra is our guest.

Lots of questions that you probably get all the time. We want to give you some questions for our inbox now as well, doctor. It's been flooded with lots of questions on this topic.

Marie from Pennsylvania wants to know this. "How is autism detected and diagnosed?" And how do you specifically know if a child is autistic versus just being too slow to develop?

BATRA: I wish to God -- right now we don't have any clear cut x- ray or blood test that can really detect autism. It really is based on -- it's a behavioral diagnosis. It's based on clinical observation and clinical judgment.

GUPTA: So it can be so hard. It's interesting. You know, people...

BATRA: It's very hard.

GUPTA: People talk sometimes, as you know Dr. Batra, about you know, the child may not be speaking by a certain age, may not be pointing...

BATRA: Exactly.

GUPTA: ...or interacting, things like that. But those are vague admittedly.

And you know, doctor, you have three sons yourself. Two of them diagnosed with autism. I'm sure it was hard for you as well to actually learn that, you know, your first child that had autism actually had that. Let me ask you something as a parent. Does the label of autism actually help or harm the kids?

BATRA: You know, I'll be honest, as a parent, the label of autism is devastating. The label of autism, it gives you this -- it's almost like a death wish when you're delivered that diagnosis.

Having said that, though, and as a professional in the field, and very realistic with bureaucracy, the label at some point does help acquire services -- very much needed services for these individuals.

GUPTA: Let's get on to some of these causes, though, because we talk a lot about this. You know, actually coming in from Warren in Texas who writes this. "I have a one-year-old son. There is some speculation that the one-year-old booster shot may contribute to having autism. My wife and I are thinking about skipping the booster shot due to this worry. Please lend me your thoughts."

And doctor, I know you know all the scientific studies out there, but is this a real concern for parents?

BATRA: Oh, this is probably the number one question I get as a practicing physician. And as you mentioned in the preview that there's no clear scientific evidence to support the link between the immunizations and the development of autistic behaviors.

I make it very clear to families that do not - you know, do not skip vaccinations for your child.

GUPTA: Right.

BATRA: The actual -- the vaccinations actually help the child stay healthy from very, very -- you know, from viruses that can cause significant infant morbidity and mortality. And so it's very important to continue to immunize your child.

GUPTA: OK.

BATRA: But...

GUPTA: You recommend it. I mean...

BATRA: I completely recommend it.

GUPTA: And...

BATRA: I completely recommend it.

GUPTA: And let me just say to Warren as well, if you're watching Warren, you know, my daughter just turned one. And we got the booster shot as well. And you know, it's -- but it wasn't an easy decision. I mean, we obviously wanted to do it, but we understand the concern. But I think most doctors in the country are recommending it.

BATRA: Absolutely.

GUPTA: We are answering all your questions on autism.

Just ahead, the challenges that parents face.

UNIDENTIFIED FEMALE: The toll can be staggering.

(BEGIN VIDEO CLIP)

UNIDENTIFIED FEMALE: It's very difficult not to blame each other, not to resent things.

(END VIDEO CLIP)

UNIDENTIFIED FEMALE: The emotional and financial challenges of raising a child with autism.

And later...

(BEGIN VIDEO CLIP)

UNIDENTIFIED FEMALE: Those kinds of messages can be very, very strong for a teenaged daughter, who's growing up and looking at her mother. (END VIDEO CLIP)

UNIDENTIFIED FEMALE: The damaging messages parents may be sending their teens and how to correct them, coming up on HOUSE CALL.

(COMMERCIAL BREAK)

GUPTA: You know, it's hard enough to hear your child has been diagnosed with autism. One couple told us it felt like the family got hit by a truck.

But after the diagnosis comes the therapy, the specialists. All too often, there's something else. Debt and divorce.

(BEGIN VIDEOTAPE)

GUPTA (voice-over): Getting a haircut can be traumatic for four- year-old Sebastian Gomez. You see, Sebastian's autistic. And until recently, simply being touched could trigger a tantrum.

CHRISTINE FRY, PRINCETON CHILD DEV. INSTITUTE: It's really a milestone to come from a child who would throw himself on the floor for a haircut.

GUPTA: Contrast Sebastian now to him singing the same song a year ago.

(CRYING)

GUPTA: The exhaustion and frustration of a child you can't comfort or control is a pain families express in this video from autism speaks.

UNIDENTIFIED FEMALE: Everything I do is about autism.

UNIDENTIFIED FEMALE: I really have to give up my entire life.

UNIDENTIFIED FEMALE: Your life slowly is beginning to disintegrate. And you can't do anything to sort of keep it together.

GUPTA: For Maria and Alfredo Gomez living in a new house in Miami, Sebastian's autism diagnosis at 16 months led to another struggle. Debt. They were shelling out thousands of dollars for private therapists with no insurance coverage.

MARIA GOMEZ, MOTHER OF AUTISTIC CHILD: I could give you a list of horrible things that could happen to us, which would be covered by insurance, that would cover his occupational therapy. It would cover his speech therapy. If it's a developmental issue, it's not covered.

GUPTA: Only eight states mandate health insurance coverage for autism. And with therapies costing around $70,000 a year, autism can break the bank. Another complication, educational resources vary greatly from state to state.

DR. FRED VOLKMAR, YALE CHILD STUDY CENTER: It is a bit of a roll of the dice in terms of where you're at and what happens to be available.

GUPTA: Like many families with autistic children, the Gomezes were forced to move to get better care. They enrolled Sebastian at the Princeton Child Development Institute at New Jersey, where tuition is paid for by the state. Still with Alfreddo commuting from Miami, the distance tests the couples resolve and their marriage.

The reality, advocacy groups say the divorce rate in autism families is 80 percent.

M. GOMEZ: It's very difficult not to blame each other, not to resent things, the move, the changing our lives, the living in different states. It's a huge gamble. I will never forget the first time Sebastian just got up and gave me a kiss. I froze because never did I expect such a thing ever to happen.

GUPTA: Small miracles -- what the sacrifice and struggle of raising an autistic child is all about.

(END VIDEOTAPE)

GUPTA: And I'll tell you there are efforts to lessen that struggle we've been talking so much about. The U.S. House of Representatives is supposed to take up the Combating Autism Act this fall.

Now this act, if passed, would increase resources in every state for diagnosing and treating autism. And that could be very good news for lots of people.

We are talking with Dr. Anshu Batra. She's a pediatrician who specializes in autism at Cedar-Sinai Medical Center in Los Angeles.

Doctor, lots of parents, lots of grandparents have so many questions on this topic. I want to start with another one from Philip in Georgia who writes this, "My son is 4 and has autism. My wife had done research on autism, and found a process called chelation. Have you heard of this, and is it a good and safe process?"

Dr. Batra, obviously it's a controversial treatment. Quickly, what is it? And if you could answer Philip, is it safe?

BATRA: Chelation therapy is basically a detoxification process that -- again the philosophy is that heavy metals might have caused inflammation in the brain and caused damage of the child. And that's why you detoxify or try to remove the heavy metals from the individual.

Now, it's -- I'll have to tell you there's no proven scientific evidence to support its use in children with autism.

GUPTA: One thing we hear so often from the parents we talk to was the confusion over the myriad of treatments. You just sort of alluded to that from the lack of therapists with training. And that comes up so clearly in this question that we had from Connie in Texas. "I hear about so many treatment options to assist children with autism. How do I, as a responsible parent, separate the outrageous experiments from the true science-based trials that could help my child?"

Again, Dr. Batra, I think it's worth pointing out that you have two children living with this disorder. How do you separate? I mean, you must get all these different, you know, therapies that are potentially recommended. How do you know what's safe and effective and what's not?

BATRA: I'll tell you -- this is really hard. As a parent, you're willing to look under every rock to find a cure to help your child. But as a physician, you need to know the science behind the intervention and whether it's something that can be proven to be effective.

So I think in this case, it's very important for this family to have -- to go to someone who is knowledgeable, who can help them understand the therapeutic intervention, and discuss the pros and the cons, and see if - and make sure that it is not something that's detrimental for the child.

GUPTA: Dr. Anshu Batra talking about autism. When we come back, what happens to all those children when they grow up.

UNIDENTIFIED FEMALE: Growing up with autism from teens to adulthood, the special challenges and ways to overcome them.

First, this week's medical headline in "The Pulse."

(BEGIN VIDEOTAPE)

JUDY FORTIN, CNN CORRESPONDENT (voice-over): A Mayo Clinic study finds people who suffer from allergies like hayfever were three time mores likely than non-sufferers to develop Parkinson's Disease. While researchers believe inflammation is the link between the conditions, they say there is no proof allergies cause Parkinson's.

Lonely socially isolated children may grow up to be unhealthy adults. Doctors say lack of social support may increase the risk of coronary artery disease as people age.

Gun owning parents may need a reminder about safe storage, especially if they have a teenager. When surveying households with teens, researchers found 42 percent had an unlocked firearm in the home. That compared with 29 percent of parents with a child 12 or younger. The study concludes parents may believe adolescents are old enough to use good judgment around guns.

Judy Fortin, CNN.

(END VIDEOTAPE)

(COMMERCIAL BREAK) GUPTA: For resources of information on autism, click on the Autism Society of America's Web site. That's at autism-society.org. Also click on the CNN.com/health. You're going to find an article there with links to all the stories we did on autism and more links to other resources as well.

So speaking of resources, the public school's responsibility ends when a person reaches age 22. So what then? What about those teen years, the turbulence of high school when you may be a little bit different? Navigating those waters with us is Dr. Anshu Batra. She's an expert on many levels as a parent of children diagnosed with autism, and is a pediatrician who specializes in autism as well at Cedar Sinai Medical Center in Los Angeles.

Doctor, what about teenagers? You know, we always think of young kids. What about teenagers with autism? Lots of hormones surging. Difficulty communicating and socializing on top of that. It's a difficult mix. What advice do you have for parents?

BATRA: At that point, I really feel that a good comprehensive team approach needs to be in place with good behavioral therapy, with a psychologist who can help the individual cope with the stressors of being a teenager. And then as a medical doctor can help also help ease that child into and through the puberty -- the hormone years.

GUPTA: So some of the same advice as with young children.

BATRA: Absolutely.

GUPTA: And I was also sort of remarkable to find out that we had an e-mail came in from someone who had an uncle who's 62-years old with autism as well. I mean, people do grow up. And they need this -- the same sort of help as they get older.

Going back to our inbox now, this question coming in from the Philippines. Freda asks this, "Can autism ever be cured?" And doctor, I mean, there's a big organization I know you're familiar with called Cure Autism Now. I mean, is cure a word we should even be using with autism?

BATRA: Well, you know, absolutely. I think that's what drives us parents every day to keep moving on is that we're looking for a cure. And there will be a cure some day.

But you know, right now, there isn't a "cure" for autism, but the key to moving towards a cure is early identification, early identification and early therapeutic intervention. That is the key to closing the gap and hopefully moving towards a cure.

GUPTA: Well, I hope that what you're saying helps a lot of parents and children out there more importantly. Really good advice. A lot of people paying attention to this. Dr. Anshu Batra, thank you so much for being with us this morning.

BATRA: Thank you for having me.

GUPTA: And when we come back, talking with your teen about weight. How to get it right.

UNIDENTIFIED FEMALE: Teens, parents, and body image.

(BEGIN VIDEO CLIP)

UNIDENTIFIED FEMALE: I thought I was too overweight. And I would barely be eating enough for like one meal.

(END VIDEO CLIP)

UNIDENTIFIED FEMALE: Coming up, how parents can talk with their teens about weight.

(COMMERCIAL BREAK)

GUPTA: We're back with HOUSE CALL. We've been talking to struggling parents this is morning. After going on my Fit Nation Tour earlier this year, one thing I learned was that parents are grappling with another issue as well. And that is talking with their teens.

And now more than ever getting through especially to girls is critical.

(BEGIN VIDEOTAPE)

GUPTA (voice-over): Kathy Kassun and 17-year old Molly Kassun have a tight mother-daughter relationship. They talk about everything from school, to shopping, to prom. And also more sensitive subjects like weight and dieting.

MOLLY KASSUN: Probably back in the sixth and seventh grade when I did have - go through my phase where I thought I was too overweight, and I would barely be eating enough for like one meal. And that would be my day. And I think that was my drastic time.

KATHY KASSUN: I think it's just all around them. Advertising. And they just want to have that perfect body, which is so thin. And you know, it's not healthy.

GUPTA: Turns out Molly is not alone. Many teenagers feel intense pressure from what they see in media and advertising and from their peers to be thin.

If you're a parent who has a teenager who's obese or struggling with weight issues, how do you approach the subject without hurting their self esteem?

Dianne Neumark-Sztainer, author of "I'm Like So Fat" has interviewed thousands of teenagers and offers up this insight.

DIANNE NEUMARK-SZTAINER, PROFESSOR, UNIVERSITY OF MINNESOTA: My advise to parents is to talk less and do more. We spend so much time talking about dieting and weight. Not very effective. And what we can do can make a bigger difference.

GUPTA: She says parents should listen to how they talk about weight. Their words are powerful and they should be positive.

NEUMARK-SZTAINER: When they get dressed in the morning, do you say something like do you think I look fat in these pants? Or do you say, oh, I like the way I look?

Those kinds of messages can be very, very strong for a teenage daughter who's growing up and looking at her mother.

GUPTA: So here's some specific things she says parents can do help their teenagers. Focus less on weight and more on health. Encourage self esteem rather than looks. Buy healthier foods and snacks. Get active. Work out together. Buy a family membership to a gym.

Molly and her mother have created a healthy lifestyle. And they say dieting doesn't fit into their lives.

(END VIDEOTAPE)

GUPTA: Good luck, Molly. And that's really important advice I think for everybody.

Unfortunately, we're out of time for today. An exciting show, though, on tap for next weekend. We're going to look at some medical mysteries from people who have learned to feel no pain whatsoever, to a condition doctors argue doesn't even exist. We have the facts. We'll let you decide. That's next weekend at 8:30 a.m. Eastern.

Thanks for watching. I'm Dr. Sanjay Gupta. Stay tuned now for more news on CNN.

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