Imagine life as a magic picture — one of those strange patterns of swirls which takes three- dimensional form only when you focus away from it. What would it be like never to be able to see anything in its entirety — only a hand or an ear at a time, never the whole body? Life would be fragmented and confusing, like living in a Picasso cubist composition, or a Hockney collage of photographs.
That, according to one of America’s most pioneering researchers on the subject, is exactly what it’s like to be autistic. Mary Megson, a paediatrician, believes she has found a key to the symptoms of autism — a vitamin deficiency. What’s more, she has become convinced that the strange behaviours we associate with the condition have a simple source: the children’s inability to see normally. Treating autistic children with vitamin supplements, she says, has achieved such remarkable results that she has been able to talk to severely affected children about how the world changes once the manifestations of autism begin to diminish. “Within three days, most of the children I treat with cod liver oil regain eye contact,” says Megson, who heads the Pediatric and Adolescent Ability Centre in Richmond, Virginia. Lost eye contact is one of the main symptoms of autism, along with impaired communication and poor social interaction. “One of my young patients just stared down at his arms, and said that for the first time he was able to see his arms and his hands at the same time.”
In a week when the controversy surrounding the link between the MMR jab and autism has once again peaked, Megson’s work provides an eye-opening glimpse into the world of children affected by this mystifying condition. Like many of those investigating nutritional approaches to treating autism, Megson is a clinician who works with patients rather than a career researcher. She does not claim to have found the cause of autism, but she believes that she has pinpointed the mechanisms which cause many of the most troublesome and characteristic symptoms.
The key, she believes, lies in a deficiency of a natural form of vitamin A found in cod liver oil. In genetically susceptible children, she says, lack of this vitamin disrupts receptors in the brain causing vital mechanisms to be switched off. This blocks visual, sensory, language and attention pathways in the brain. Her theory has been backed by a recent double-blind placebo controlled trial (the scientific gold standard) of 38 children with autism, which found that those taking cod liver oil showed significant improvements in their abilities over six months.
Megson wanted to check if any genetic factors made her patients more susceptible to this deficiency, so she looked at their family histories and made a remarkable discovery. Up to three quarters of the children also had a family history of night blindness — where the eye is unable to adjust to dark conditions. “I wondered how this would affect their daytime vision. Our rod cells — which differentiate light and dark — are in the peripheral part of our eye, and cones, for colour, are in the middle,” says Megson. “My patients have poor rod function so they lose the shading and shapes of objects, and the only way for them to get that back is to concentrate on the peripheral. That’s why autistic children tend to look at you out of the corner of their eye. They ’re trying to get the facial shading.”
Other researchers have noted poor rod function in autistic children. It is also well-established that vitamin A is essential for proper rod functioning. Megson believes that a lot of what we regard as the strange symptoms of autism are, in fact, simply an attempt to interpret the world given these visual experiences. For example, a mother might take her autistic daughter to see her grandmother every week by the same route, but when she varies it because of roadworks, the child throws a tantrum. The girl, says Megson, is panicked because her pictorial world is suddenly turned upside down. She has little peripheral vision, so she sees her journey in a series of two-dimensional snapshots of the image at the centre of her vision. She has no sense of a wider picture and cannot detect movement. All she knows is that those familiar visual images she clings to have been taken away.
“Their visual field shrinks down to exactly where they are looking and everything loses subtlety, dimension and shading,” says Megson, who this month presented her observations to scientists, doctors and nutritionists at a seminar in London. This narrowing of their vision means that it is unlikely they will see something at the same time as someone is talking about it. That makes learning and understanding difficult, and is why autistic children often seem to be thinking in “monochannel”. The narrow visual field of television, however, allows them to put sounds and where they are coming from, together. That’s why the language they learn is often lifted word-for-word from TV.
Once on vitamin A, Megson says, this fragmented world begins to take shape. She recalls one ten-year-old boy who had refused to communicate since the age of four. His mother had night blindness, so Megson started the boy on cod liver oil. Within a week he noticed paintings on the wall at home. He ran across the lawn to the school bus rather than carefully following the path. Shortly after receiving another supplement to encourage brain receptor function, he pointed to a sweet jar and said: “Can I have a candy please?” It was the first time he had spoken in six years. It’s emotive and radical stuff, and it is also a hypothesis based mostly on the experiences of patients, and has yet to be proven scientifically. Yet it dovetails with other research demonstrating the benefits of fish oils and omega-3 fatty acids in moderating attention problems in children, and improving mental performance in adults. It also fits with what people with autism say about how they see their world. Temple Grandin, who has overcome autism to run a livestock business, wrote in her book Thinking in Pictures: “I create new images by taking little parts of images I have in the video library in my imagination and piecing them together.”
Paul Shattock, director of the University of Sunderland’s autism research unit, rates Megson’s work, even though it is unorthodox. His unit has now gained approval to conduct double-blind trials investigating the benefits of omega-3 and 6 oils. Her approach is useful, but not the whole answer, he says: “If cod liver oil was a cure, you wouldn’t have autism in Norway.”
Megson would agree. She’s continuing her research but it’s the response of her patients — not the demands of a research agenda — that motivates her: “I’ve been treating developmental disabilities for 25 years. The fact that I can now help people get better is wonderful.”
AUTISM FACTS
There is no known cure for autism, but structured support and education can maximise a child’s skills. A range of foods and supplements have been used successfully, but most have not been rigorously researched. contact the Autism Research Unit : www.osiris.sunderland.ac.uk/autism/
