Summer in the City

Typical children usually enjoy their long summer break and once they are teenagers they do not need much supervision; that is not the case with people with more severe autism. Most kids with this kind of autism are counting the days till they can go back to school. 

 In the US, many such people have an extended school year, which keeps them occupied, but this does not exist in most of the world.  The US actually has a very short standard school year, just 180 days; in Japan they are in school for 220 days a year.

This year Monty, now age 15 with ASD, has been much more energetic since he started taking a little scoop of Agmatine before breakfast, 11 months ago. He now completes a lot of physical activities, by anyone’s standards.

He enjoyed running at school last year and was good at it, so I started taking him to a running track in the holidays. It is 1.2km (0.75 miles) long and runs through a forest, so it is mostly out of the sun.

The first step was to decide not to run with him; one risk of having so much 1:1 attention is that you grow up not being able to cope without it.

People with autism do wander off, they get side-tracked, they can get into awkward situations with strangers, but at the same time you do want your child to develop independence. Monty had a yellow shirt on and by standing in the centre of the running circuit; I could see him much of the time through the trees. Since the circuit has a red surface and most people are running the same way around it, it would be hard to get lost.

Monty never got lost and just counted out loud the number of each lap, as I waited at the start point. We soon agreed that running four times round the track is what he would do.  After a pause and a shower it was off for swimming and he now does this quite seriously.

Monty’s school assistants come in the summer, and they also got into the exercise program.  Monty never mastered riding a bicycle till this summer, but after two months of practise in the mornings, today he made a 7km (4 mile) circuit round a lake.

Another day he made two laps (14km /8 miles) on rollerblades.

This level of activity might be nothing special for a typical teenager, but it is a big change for Monty.  It is also very hot - 33 Celsius/92 Fahrenheit, when he is out.

It is much easier to be accepted by typical teenagers when you have some skills they can relate to, even if big differences remain.

One morning Monty was out with his assistant where a basketball team were having their training run on another circuit. These were large 2m (6 foot 6 inches) tall giants, compared to Monty. What would they make of his intrusion into their training? Monty’s assistant explained to the basketball coach and then every time Monty completed a lap and shouted out the lap number the older boys cheered.  That is what I call inclusion and everybody was happy.

Exercise has numerous benefits and where we live most children are very active; overweight kids are a tiny minority. Some do take it to extremes; Monty’s friend from the Netherlands came to visit and told us that her 16 year old sister is cycling to Rome (1,600 km or 1,000 miles). As you might expect, they are both tall and slim.

Fibromyalgia, Autism and President Putin

 

I introduced Fibromyalgia in my last post; it is an neurological condition that can cause some very strange symptoms, in addition to pain and fatigue.  I imagine that there are various different underlying causes and so, like autism, it is really a family of disorders with overlapping symptoms.

Surprisingly, at least one type of Fibromyalgia would appear to have similar causes to classic autism, but its onset is after the brain has fully developed.  As with autism, the approved medical treatments are all for the symptoms, rather than the underlying condition.  The underlying condition seems to be a neuro-endocrine inflammatory disorder, sometimes with channelopathies.

One very interesting finding is that exercise consistently helps with the symptoms of Fibromyalgia.  I was reading a paper just last week that showed that exercise (jogging) reduced autistic behaviors.  It has already been well established that exercise is almost as effective as drugs at treating people with depression.

Here are some links:-

Can exercise improve behavior? Help encouraging a child who has autism

Exercise in fibromyalgia and related inflammatory disorders: Known effects and unknown chances.

 

Exercise may be Just as Effective as Medication for Treating Major Depression

So what is the wonderful power behind jogging or swimming, you might be wondering?  Exercise and even passively experiencing a roller-coaster, or motor bike ride, releases certain hormones in your brain, which causes a cascade of changes to many other hormones and neurotransmitters.  Depression, fibromyalgia and indeed autism all include some central hormone dysfunction; shaking up the homeostasis by exercise seems to do good.

I did look, a long time ago, for studies that showed precisely which hormones are affected.  The problem is that hormone levels in the blood do not tell you the hormone levels in the brain; if they did, then there would be a lot of demand for neuro-endocrinologists.    The problem is the blood brain barrier  (BBB).

You can of course measure hormone levels in the spinal fluid, but I do not suppose many people would volunteer for such clinical trials.  As a result, any intervention in brain hormone levels is likely to be a hit and miss affair.  People have tried to do it, but unless you can measure the result scientifically, it will remain voodoo science.

Some expert autism physicians continue to maintain classic autism is not treatable; that would suggest to me, they have never tried.  You can very easily change brain homeostasis, but it might be for better or might be for worse - but you can certainly change it.  Even if you make it worse, you know that you have been able to change it; then it is just a matter of rethinking and trying again.  As a patient, you naturally expect the specialist to get it right with 90+% certainty.  Without being able to measure hormone levels in the brain, it is rather like target shooting, while wearing a blindfold.  Maybe there are some safe interventions that will work in everyone.  I prefer to limit this blog to things I can prove scientifically, so I will keep the rest for my polypill.

For the risk averse amongst you, I suggest you rely on exercise.  Unless you are completely unfit, it seems that exercise can only do good.  You will never know which hormone levels changed, or what neurotransmitter did what, but then you do not need to know.

President Putin

Monty, aged 10 with ASD, has an elder brother Ted, aged 13.  Ted loves history and is also learning Russian; he very much wants to go to visit Moscow and also Putin’s home town of St Petersburg.  Given the choice, he would undoubtedly go to Izhevsk , a city in the western Urals, home of the Kalashnikov factory and museum.

Ted was very impressed to hear Putin telling journalists in Sochi that he swims 1,000 metres every day.  Even the journalists were surprised, “every day?”; “yes, every day”.

So I told Ted, who does have some of the stranger symptoms of fibromyalgia, that I listed in my previous post, if Putin can swim 1,000 metres, then you can swim 500 metres every day.

Today was the first day of the new regime.