I hadn’t thought of it that way
“‘Striking good hair days and bad hair days’”: That is how Harvard neuroscientist and Massachusetts General Hospital neurologist Martha Herbert suggests that certain environmental factors might “influence an autistic child’s health and mental state” in today’s Boston Globe. Herbert and a number of others researching possible connections between the environment and autism are quoted in the article, Under Suspicion: Researchers now believe that autism can be caused by genes in combination with environmental triggers. The question is, what are those triggers?, which also refers to the MARBLES (”markers of autism risk in babies-learning early signs”) study being conducted by the University of California at Davis M.I.N.D. Institute.
As far as Dr. Herbert’s reference to “good hair days and bad hair days” to describe why (as I gather from her analogy) autistic children might seem to have (for instance) a day when they speak well and are focused and at ease, and then a day of crying, anxiety, and tantrumming: As my son Charlie has a buzz cut (courtesy of Michael the Barber), he pretty much has only good hair days, though the salt water from the ocean is making it stand up a bit more.
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POSTED IN: Cause, Environment, Metaphor
30 opinions for I hadn’t thought of it that way
daedalus2u
Aug 13, 2007 at 10:46 pm
That how “good” children do is changable from day to day, shows that there is something that also changes from day to day that affects it.
One of the most reliable ways to have a “bad day”, is to put the child under stress. Stress is a low nitric oxide state. Sufficient stress will cause a melt-down and a “bad day”. A low stress day tends to be a “good day”.
Since nitric oxide is involved in hundreds of pathways in neurology, endocrinology, immunology and metabolic physiology, a disruption in nitric oxide physiology could have just about any effect.
Since every effect that is observed in ASDs is consistent with a reduction in NO, perhaps NO physiology is something that should be looked at?
Kristina Chew, PhD
Aug 13, 2007 at 11:00 pm
Perhaps you might contact Dr. Herbert about NO?
Joeymom
Aug 13, 2007 at 11:39 pm
Don’t we ALL have good days and bad days? Why do people think autistics would be any different in that regard?
Kristina Chew, PhD
Aug 13, 2007 at 11:50 pm
I can cite environmental factors as having some impact on my own days—I’ll admit to not being fond of humidity, same as Charlie!
candy
Aug 14, 2007 at 8:50 am
I like the “good/bad hair day” analogy…it’s something we all can relate to….whether we have a dx or not! My 8 year old Matt (pdd-nos, social anxiety disorder, poss. mood disorder, etc….it’s all maddening!!!!) has always referred to things as the best or the worst…nothing in between. Best hot dog he has ever had in his life or the very worst. He either loves you to death or hates your guts. While he feels the very same feelings as we all do….they are so very, very exagerated!! Let’s face it, he’s “wired” differently. Helping him to see the “grey” , not just the black and white, is a daily deal. When always trying to explain why he does the things he does and feels the way he feels…I shall now simplify it with the good hair day/bad hair day comparison…it is a light-hearted way of describing a very complicated condition to those not walking beside me down this road. Thanks for the post.
daedalus2u
Aug 14, 2007 at 8:50 am
I have been in contact with Dr Herbert about NO and autism for over 3 years.
The important observation about ASDs having good and bad days, is that the “severity” is not contstant. A person’s genes don’t change from day to day, neither does the major neurological structures of their brain. If the “severity” is changing day to day, those changes must be due to something else, something other than genetics or neurological morphology. If you can find the source of that variability, it may be possible to drive it to one extreme, so that children only have “good days”. What might be the long term effect of only “good days”? Probably a very good thing.
I think the source of that variability is basal NO.
natalia
Aug 14, 2007 at 9:21 am
i once heard a saying from jewish friends or relatives: “Jews are just like everyone else, only more so.” maybe this could sometimes apply to the autistic ‘way of being’ also?
natalia
Aug 14, 2007 at 9:24 am
PS: why did it take me so long to remember this?! for a long time i have always referred to myself (as well as family and even students) as having a “good-brain-day” or a “bad-brain-day”.
brain is close enough to hair, being just the other side of the skull…
Leanne
Aug 14, 2007 at 9:35 am
I perceive Patrick as being pretty consistant. He bumps along in life just like any of us. When a situation presents that he can’t cope with, he has an off moment(minute/hour/several hours).
But I wouldn’t say it’s a bad day because he was challenged by an experience and a good day because he wasn’t; although I guess that’s how they’re normally catagorized. He’s just not that different from day to day….or, as I said, that’s how I perceive it. For him the inconsistancies in his life seem to come from external stimuli (which ones he’s exposed to on a given day) and how he reacts to them (which is normally pretty predictible…by us and him).
He also never has a bad hair day….as long as it’s not haircut day.
Kristina Chew, PhD
Aug 14, 2007 at 9:58 am
Dr. Herbert and the other scientists need to—not that they don’t, but the article does not reference this—take into account all the other factors that can affect a child or anyone’s functioning. Sure, the environment; a child could also be affected by things that happen at school, changes in routine, etc.. And the “hair” analogy needs much more context, as do some other statements in the article.
daedalus2u
Aug 14, 2007 at 3:01 pm
The problem with the doctors and the other scientists is that they can only apply the knowledge they have, and there is vastly more information available than anyone can possibly understand and appreciate, and what is unknown is many many orders of magnitude greater than that.
Physiology is inherently chaotic, as in the “butterfly effect.” Tiny non-measurable differences affect things which affect other things, which affect other things, and a few months later the end result is inherently unpredictable.
Most things that can affect development are unknown. How they can affect development is unknown at what dosage, timing, etc.
There are likely millions of factors that “could” be important. It is simply not possible to take all of them into account individually, let alone if they interact (which they most certainly must do).
For basal NO, the main sensor, soluble guanylyl cyclase, is 50% activated by a NO concentration of 0.6 ppb by weight. There simply isn’t a technique to measure that on the length and time and concentrations scales that we know are important.
Regan
Aug 15, 2007 at 9:07 am
I would love to meet the person who has never had a bad hair day or a bad brain day. If something existed that equillibrated everyone’s mood, the planet would be a happy place.
There may very well be things going on inside, but sometimes I have a “doh” moment where I have to step back and evaluate my mood or what is else is going on in our family.
Very occasionally it’s a mystery, but oftentimes it can be traced back to the plain Jane things happening in the day, picking up on our bad mood or anxiety (bad brain day on our part), being hungry…or oftentimes the prelude to coming down with a cold or the flu.
daedalus2u
Aug 15, 2007 at 3:02 pm
Let me try and clarify what I was trying to convey. Fluctuations in physiology are inevitable and unavoidable. The myth of “homeostasis” is just that, a myth. It does not happen. There is nothing in physiology that is “static” or in “stasis”. All of physiology is in a state of flux, with stuff going up, stuff going down, stuff staying the same, stuff going sideways. This occurs at all different time and length scales in all different parts of the body.
When one thing goes up, another thing goes up too, and something else goes down to compensate. Where the myriad different pathways trigger other things to go up or down, depends on the signaling between the pathways.
A very important class of pathways (which includes thousands of different pathways) are those mediated by nitric oxide. That is the focus of my research. When basal NO is “off”, the “setpoint” of each and every one of those different pathways is “off” too. In other words, the signaling between the different NO pathways is the NO concentration. Each NO sensor only senses the sum of NO from all sources and removed by all sinks and integrated at the location of the NO sensor. A change in the basal NO level will therefore change the onset time, the range, and the duration of every NO signal with no threshold.
On a “good” day, everything is working well, and in “sync”. When things get out of “sync” is when bad stuff starts to happen. The more stuff is out of “sync”, the worse the day is.
When the signaling is out of “sync”, the only way to fix it is to get the signaling back into “sync”. That is not easy. The signaling is extremely complicated and conveys complicated information. It is the information that is important, and that information is encoded in myriad different ways by the different pathways. This is one reason that virtually all treatments have side effects. The treatment affects the information coded in different pathways differently. Some is improved, some is degraded. It is completely unreasonable to suppose that any artificial treatment can restore normality to something as complicated as physiology. It is like expecting to “improve” the operation of your computer by changing voltages on wires without knowing which wire is carrying what signal where to do what.
That is what the DAN! people are trying to do, control physiology artificially by giving supplements of this and that, but with no understanding of how physiology works normally, and no understanding of what the supplements are doing in which tissue compartment at what time. Physiology is far too complicated to attempt to regulate artificially.
Chuck
Aug 15, 2007 at 3:24 pm
DAN doctors are no different the regular doctors in their physiological treatments of neurological disorders. Some DAN/regular doctors are better then other DAN/regular doctors. Some DAN/regular doctors shouldn’t be allowed to treat any neurological condition.
Bonnie Sayers
Jun 8, 2008 at 5:29 pm
A lot of talk about barometric pressure having an affect on kids with autism. I know daylight savings time hits Matt hard for a week preceeding and then after. I have been sneezing for two days and claritin is not helping any. I recently moved the bed and Matt seems to sleep longer now and calmer during the day. The night light is farther away and makes the room darker, but Nick does not like that.
Ed
Aug 17, 2008 at 1:49 pm
When the CDC announced that there is an autism epidemic, they did so only reluctantly because epidemic means that there has to be an environmental factor that covers the time and the space of the epidemic. They have no culprit and that leaves a vaccuum that gets filled by the best fit, vaccines. Unless and until another culprit is found that fits the time and the space of the autism epidemic, the autism-vaccine debate will continue.
Kristina Chew, PhD
Aug 17, 2008 at 1:52 pm
There is no autism epidemic.
Ed
Aug 17, 2008 at 2:34 pm
No? The most comprehensive study on that was done by the California School System. Their conclusion is that there is an autism epidemic and that it cannot be explained with changes in the diagnostics. It was this study that prompted the CDC to come out in Feb, 2007 and say that there is an autism epidemic.
I was there with my son at the front of the bow wave when the rate was proported to be 1/2500. I saw schools of 250 with more than one autistic child by the original definition.
Your opinion does not agree with the most comprehensive study done or with my personal observations.
Kristina Chew, PhD
Aug 17, 2008 at 2:56 pm
Here’s some more about the claims of the so-called epidemic of autism; school data are not the same as the kinds of epidemiological studies done by the CDC.
http://www.autismvox.com/the-claim-of-the-autism-epidemic/
Once again, no epidemic of autism.
Ed
Aug 17, 2008 at 3:16 pm
This is from the CDC. http://www.cdc.gov/media/pressrel/2007/r070208.htm?s_cid=mediarel_r070208_x
Kristina Chew, PhD
Aug 17, 2008 at 4:21 pm
Here’s some posts I wrote when those figures were released back in February of 2007.
http://www.autismvox.com/1-in-166-1-in-150/
http://www.autismvox.com/autism-is-an-epidemic-new-jersey-is-toxic-and-other-urban-myths/
http://www.autismvox.com/theres-something-about-autism-in-new-jersey/
Ed
Aug 17, 2008 at 6:12 pm
The point remains the same. Epidemic necessarily means that there is something in the environment. The change in numbers is not just a change in diagnostics. An epidemic means that there has to be something that corresponds in time and space. So now what?
Ed
Aug 17, 2008 at 9:29 pm
California keeps very good statistics on the autism epidemic. This is for the 2001-2002 year. Other years are available, but none illustrate as starkly the change in autism rate. http://dq.cde.ca.gov/dataquest/SpecEd/SpecEd1.asp?cChoice=SpecEd1&cYear=2001-02&cLevel=State&cTopic=SpecEd&myTimeFrame=S&submit1=Submit&ReptCycle=December
Try to make sense of these statistics with a change in diagnostics and it does not work. Diagnostics changes should increase the population in the same age group from one year to the next. That is not the way it goes. But see for yourself.
Kristina Chew, PhD
Aug 18, 2008 at 12:00 am
These aren’t statistics on an “autism epidemic,” but in the rise of children enrolled in special education. Concurrent with the rise in children given an autism diagnosis has been a decrease in the number of children diagnosed with learning disabilities and mental retardation.
http://www.autismvox.com/the-extraordinary-claim-of-the-autism-epidemic/
Ed
Aug 18, 2008 at 11:04 pm
California kept statistics of children with other disabilities and mental retardation. The data does not support your conclusion.
Your assertion that there is no epidemic is shared by many provaxers. Maybe you aren’t old enough. But as someone who was there for the bow wave of autism cases, I knew the time when I knew nobody with autism. I watched new cases of classic autism pop up around the local neighborhood. I watched the Autism Society of Colorado grow from a few members to a large organization. I watched the support structures here get overwhelmed with new cases. I was there when I neither knew any with autism or anyone who knew anyone with autism. I am here now when I know several in my local neighborhood with autism.
Your claim goes against my personal observations, it goes against the observations of the people who provided the services.
The California statistics only require one assumption to realize that the autism rate climbed radically. Autism is for life. Then the contrast between autism in the twelvth grade and the first grade in 2002 says it all. A shift in category does not explain it. California kept those statistics as well.
If there is no epidemic then there is no rise in autism rate to correspond with the rise in the vaccine rate. There is no vaccuum when vaccines are taken off the table. Vaccines and autism would not be related. None of that is relevant to whether there is an epidemic or not.
donald savitz
Aug 19, 2008 at 10:21 am
Ed. In what year do thank the bow wave started, because that is some thing thatno one wents to talk about. So if you could give a year it might let people know when it happened. That way more people may get a better prescriptive on the what is happening. That is why I always thy to give dates when some thing happened.
Kristina Chew, PhD
Aug 19, 2008 at 11:23 am
@Ed, What needs to be considered in your claim of an “epidemic of autism” is the significant changes in the diagnostic criteria for autism, as well as greatly increased public awareness. The diagnosis of autism was simply not as much used in the past; I do not think my son, who is considered “classically autistic today,” would have received an autism diagnosis in the past.
No epidemic of autism.
Ed
Aug 19, 2008 at 7:50 pm
Christina,
Do you think that a change in the autism criteria would affect the older children as well as the younger children? If it were a change in the criteria then there would have been a surge in diagnoses of older children. This surge does not exist. The wave rose in the younger children and the numbers tracked these children. A change in diagnosis criteria does not explain this.
BTW, all of this shows well in the California statistics.
Kristina Chew, PhD
Aug 20, 2008 at 11:51 am
Whether or not a family sought to have a diagnosis changed for an older child would depend on the family and how they thought a diagnosis might better help a child achieve services. And, more adults are getting an ASD diagnosis, or self-diagnosing. The children who were diagnosed under the broadened DSM criteria are now “older children”—my son’s age—plentiful in number.
More on this topic (especially on the difference between schools classifying students with an autism code vs. an actual diagnosis of autism) on today’s post.
Ed
Aug 20, 2008 at 11:54 pm
The point of the post was that in the statistics collected in 2002 there was no acceleration of in diagnoses for older children, only younger children. Your answer starts with the assumption that the only reason to get the diagnosis of autism is to gain services. My motivation in getting a diagnosis was to find out what was wrong and what I could do about it. I cannot imagine that the sole motivation for getting a diagnosis could be to get services.
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