Reading the article, it turns out the one twin who is "more autistic" had a hole in his heart that surgery had to correct. So I suspect the actual issue here is something simpler like a difference in brain development because of the difference in the amount of blood flow.

That’s possible but he did get crazy antibiotics as well.

FTA: “The infection was from drug-resistant staph bacteria. So John went back to the hospital and spent a month on powerful antibiotics pumped directly into a vein near his heart.”

...or just being in the hospital environment for a month. The older theory they mentioned here:

> "The earliest twin studies really helped to debunk this theory that autism was caused by parenting," Morris says. Under this theory, moms took the brunt of the blame, supposedly for being "cold and distant and detached from their child."

...might not be entirely wrong. They've since shown genetics is a factor, and I'll ignore the institutionalized misogyny part, but being in a hospital for a month probably did mean having much less parent/care-giver interaction/touch during a critical period, and who knows how much of an effect that could have.

This has been studied a lot in child welfare and is not currently believed, afaik. The diagnosis of reactive attachment disorder is acknowledged to have many overlapping symptoms with autism, but expressly differentiated as a condition.

> Under this theory, moms took the brunt of the blame, supposedly for being "cold and distant and detached from their child."

Before the heredity nature of autism was accepted, this was the school of thought (“refrigerator mothers”). But in truth, it’s neurodivergent parents having neurodivergent children, and society punishing the parents (namely mothers) for their inability at providing the “expected” nurturing conditions.

Tied back, atypical behavior.may create neurodivergent conditions, but one would expect children of aurististics to seek less overall care which doesnt support the hypitheses that antibiotics are causing aitism as this thrwad started

My theory is that this causation is flipped. Something about whatever the precursor to autism is causes the body to experience more physical failures or malformed structures.

Something like whatever mechanisms decode structure from the genome are faulty and produce slightly wrong structures throughout the brain and body.

Anecdotally, I see a higher rate of general illness and physical birth defects in autistic people.

There appears to be some correlation between Ehlers-Danlos Syndrome and autism

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7711487/

It makes a certain amount of sense that a collagen / connective tissue disorder is going to have wide-ranging effects, including the nervous system

Another way to think of this is that 'autism' is a broad series of disorders where individuals do not follow the social-relational cues we expect. There are many ways to violate unspoken social expectations, so there should be many ways to be autistic.

In this setting, it's not unreasonable that any genetic syndrome would be more associated with autism; indeed, it's more interesting to find lesions that have a lower proportion of autistic carriers compared to the general population.

Yeah, I suspect it's quite likely that autism is correlated with/caused by genetic disorders in general, rather than being its own thing that just happens to be comorbid with a suspicious number of other disorders.

There's too many correlations that aren't common enough, I really think we've got the causality backwards. But then again I don't know anything

Wow, I'm hypermobile and my sons have what appears to be mild autism (see my other comment above). Yet more to unpick!

There’s a correlation between autism and mitochondrial dysfunction:

https://www.nature.com/articles/mp2010136

> Most ASD/MD cases (79%) were not associated with genetic abnormalities, raising the possibility of secondary mitochondrial dysfunction. Treatment studies for ASD/MD were limited, although improvements were noted in some studies with carnitine, co-enzyme Q10 and B-vitamins. Many studies suffered from limitations, including small sample sizes, referral or publication biases, and variability in protocols for selecting children for MD workup, collecting mitochondrial biomarkers and defining MD. Overall, this evidence supports the notion that mitochondrial dysfunction is associated with ASD. Additional studies are needed to further define the role of mitochondrial dysfunction in ASD.

FWIW, I have identical twin sons who probably have mild autism. One had an umbilical hernia like the lad in the story. They both had a couple of other small developmental anomalies. But they were both slightly premature (like most twins) and shared a womb. So what's the driver here? One of the above, or possibly the hormones which they were (incorrectly) given to promote lung function? There's a lot to unpick.

Isn’t it common to be given a lot of antibiotics when you get a surgery?

I had a fairly significant surgery at a premiere US hospital including several days of recovery in the hospital and didn’t get any antibiotics after the fact. They could have injected me with something during the actual surgery, but it didn’t show up on the bill.

I think this may be specific to Heart surgery.

I was given prophylactic antibiotics for prostate surgery. It might depend on the surgeon.

a lot and a heart artery drip for 30 days are orders of magnitude different in quantity

A friend underwent operation of his aorta. Post-surgery inflammation is an absolutely common complication and they dumped a lot of antibiotics into him precisely to reduce the risk. (If I understand correctly, it wouldn't be probably fatal, but very, very unpleasant.)

It is.

I think blood flow to the brain >> impacts of antibiotics is the likely order of magnitude of impact - though tough to tell.

correlation causation

Whenever I had (minor) surgery in France, I was given antibiotics "as a shield". I obviously do not know if this helped or not.

Now, French doctors were always very quick to prescribe antibiotics (as a kid I had plenty of them) and it took quite a lot of effort to change their(and parent's) mind. My children got much less, though they were almost never checked for virus vs bacterial infection.

This is Hackernews, where all major health issues are traceable to the gut.

Does that include mouth/teeth/saliva as part of the extended gut or are you talking stomach down?

All of them and also seed oils.

(I hope noone is taking this seriously..)

Would you also accept the nose-ear-throat-trachea-lung microbiome as well?

Also nose biome interacts with the finger and fingernail biome quite often.

I know I'll be downvoted, but I'll say it anyway.

What is never discussed, and isn't considered in this article, are certain types of other medical interventions - vaccination. Looking at certain (hard to find) videos by the deceased Dr Andrew Moulden, one is given some support for the theory that vaccines cause ischemia (small strokes). For the very young, the brain does not 're-route' and developmental milestones are simply missed, whereas in adults it's possible to relearn skills. Autism can be an impact, and one can also see physical impacts in the face, such as wonky smiles, wonky eyes, as different strokes cause various issues.

https://rumble.com/embed/ucfsd.v2n9tjk/

Amazingly enough, this Andrew Moulden is a completely unrelated person to Andrew Wakefield, with his own much more sincere but correspondingly more crackpot theory for why vaccines cause autism. I think it can be well summarized as “germ theory is wrong; germs (viruses and bacteria) don’t cause diseases, foreign particles entering the body causes them”. This claim is clearly and fundamentally wrong, just like the claim about neuroplasticity that you quote. There is no value in his work.

Very solid takedown of Wakefield: https://peterattiamd.com/briandeer/

While we're exploring the quack-medicine space, have we ruled out heavy metal poisoning? I'm surprised someone with an MD from the University of Hackernews hasn't recommended the Cutler protocol as a cure.

Moulden was a snake-oil peddling quack with a degree in psychology who was never licensed to practice medicine. He peddled something called "BrainGuard" that purported to diagnose autism by looking at a picture or short video of a child or even a baby.

https://web.archive.org/web/20100109213523/http://brainguard...

> YOU are Now the Expert: Now You can diagnose vaccine induced Alzheimer’s dementia (or autism) several years before the Medical Doctor’s do – amongst your family and friends. You can also diagnose Autism (as it is is happening) in newborns, babies, teens – common signs. LOOK here to learn and practice your skills – starting

He also hooked up with something called therapies4kids to peddle a suit that could somehow cure or alleviate autism: https://web.archive.org/web/20090925065222/http://www.therap...

https://vaccineconspiracytheorist.blogspot.com/2011/01/quack...

https://hatingautism.blogspot.com/2009/10/dr-andrew-moulden-...

> What is never discussed, and isn't considered in this article, are certain types of other medical interventions - vaccination

It's very frequently discussed.

The downvotes you're expecting are because this meme can be traced to a fraudulent claim in 1998: https://en.wikipedia.org/wiki/Lancet_MMR_autism_fraud

I declined the MMR vaccine at school because I was at school when that story came out, and at that point he and his claim were taken somewhat seriously.

(I did get the vaccine eventually).

> For the very young, the brain does not 're-route' and developmental milestones are simply missed, whereas in adults it's possible to relearn skills

That's the exact opposite of how it works. E.g. language acquisition in adulthood is much harder.

That’s actually a totally different story, this commenter is talking about a Canadian psychiatrist in the 2000s. https://doctors.cpso.on.ca/DoctorDetails/Drew-Jeffrey-Andrew...

I'm suggesting the second is a memetic descendant of the first.

Unless there were other ancestors of both?

> Being given antibiotics at such an early age will probably severely dysregulation gut microbiota.

It’s extremely common for young kids to receive antibiotics. In some countries, antibiotics are over the counter and many parents will give their kids antibiotics for nearly any infection. Antibiotic misuse is rampant in some countries where they aren’t gated behind prescriptions.

Any such link with autism would therefore be an extremely rare side effect. The rate of antibiotic use in children is far higher than the rate of autism.

I don’t think this case supports the antibiotic theory by itself at all. I think it’s confirmation bias because antibiotics are one of the current trending theories among mainstream discussion.

«So John went back to the hospital and spent a month on powerful antibiotics pumped directly into a vein near his heart.»

This is not «extremely common».

Sure, but if you want to water the claim down to the idea that only extreme doses of antibiotics have noticeable effect sizes then its not a relevant claim to 99.99% of the population.

No it is not, but ignoring the part about the severe infection require extended hospitalization and trying to reduce it all to “antibiotics” is extremely disingenuous.

Given that antibiotics are common but extreme infections and extended hospitalizations are not, why would anyone focus on the antibiotics as the root cause?

Not all antibiotics are created equal nor do they affect gut bacteria the same. There isn’t a singular scale for antibiotic power. Often, antibiotics are given via vein because they aren’t absorbed from the gastrointestinal tract, for example. This doesn’t tell us anything about the magnitude of impact on gut bacteria relative to an antibiotic that actually starts its journey in your gut.

This is a complicated case. Reducing the entire complicated episode to “it was the antibiotics” is extremely reductionist.

Antibiotics refer to a group of drugs. Eating food from the supermarket will expose a child to antibiotics. Different classes of antibiotics have a lifelong effects while common ones are quickier to recover from.

Wouldn't we see much lower rates in Christian Scientists?

Why would that correlate?

> Christian Scientists avoid almost all medical treatment, relying instead on Christian Science prayer.

https://en.wikipedia.org/wiki/Christian_Science#Healing_prac...

Hmm, on the other hand, using religion for medicine might also be a confounding factor due to less diagnosis.

Have literally never heard of that. Is there any area where this is prominent?

Have you ever heard of the The Christian Science Monitor? It's a mostly-respectable newspaper (now website) published by The Christian Science Publishing Society, the publishing arm of the church.

Christian Science is very much a dying religion, and is not "prominent" anywhere so I'm not surprised that you never heard of them if you're young. The mother church is in Boston though.

43 and grew up in the south, which is why I was surprised. Boston makes a little more sense though.

It’s possible but there was no explicit mention of this other than one receiving treatment they couldn’t avoid.

Isn't autism much older than antibiotics? I mean it couldn't be - I haven't actually researched it but I'm pretty sure autism is older than antibiotics.

Severity can be modulated by the environment, it’s not that autism didn’t exist it but we can say for sure that antibiotics didn’t make anyone worse before it was invented.

Pretty sure what is being asserted is that gut bacteria may influence brain function and antibiotics can have influence on gut bacteria. Those are both complex systems, so there could be many other factors as well as wide variations.

The gut microbiota shouldn't be affected by antibiotics delivered via IV.

This source says otherwise:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9896080/

Persistent neuroinflammation seems to be a more likely cause.

Not really.

"The infection was from drug-resistant staph bacteria. So John went back to the hospital and spent a month on powerful antibiotics pumped directly into a vein near his heart."

There are so many confounding factors here. Could be no connection to the episode whatever. Could be that the infection that required the antibiotics contributed to the autism. Could be the antibiotics contributed directly. Could be the overall trauma of the surgery, treatment and recovery.

Seems like the gut thing is the least likely culprit and requires quite a lot of creativity to even consider it.