Tuesday, October 25, 2011

Lung Abnormalities in Children with Autism?

I have no idea what the significance of this could or would be but a presentation at CHEST 2011 suggests that children with autism might have a strange abnormality in their lungs.  From a summary of the finding in U.S. News & World report -
In a typical lung, the windpipe, or trachea, branches into two main stems. From there, airways branch off the stems much like tree branches in a random, asymmetrical pattern, said Stewart, a pediatric pulmonologist at Nemours Children's Clinic in Pensacola, Fla.
But in the autistic children, those branches were instead doubled up and symmetrical. And the branches were smaller -- whereas in a normal lung you might have one large branch jutting off, in the autistic child, she'd see two, smaller branches instead.
The abstract of the presentation is below.

Can Bronchoscopic Airway Anatomy Be an Indicator of Autism?
Barbara Stewart, MD
Nemours Childrens Clinic, Pensacola, FL

PURPOSE: The purpose of this study is to investigate possible correlation between certain airway anamolies and a definitive diagnosis of autism and/or autistic spectrum disorder.

METHODS: IRB approval was obtained for a restrospective study to evaluate 49 patients with a diagnosis of autism or autistic spectrum disorder. These patients were seen in the pulmonary clinic with a diagnosis of cough that was unresponsive to therapy and who required further pulmonary work-up. Bronchoscopic evaluation of the airway was included as part of that work-up.

RESULTS: Bronchoscopic evaluations revealed the presence of initial normal anatomy followed by double take-offs in the lower airway (or "doublets") in 100% of the autistic population studied.

CONCLUSIONS: There appears to be a correlation between autistic spectrum disorder and airway anatomy. This is a small study of 49 patients. More investigation is warranted.

CLINICAL IMPLICATIONS: At present autism is diagnosed through subjective observation of "autistic behaviors." Autistic children with cough may be diagnosed objectively.

DISCLOSURE: The following authors have nothing to disclose: Barbara Stewart, Barbara Stewart

No Product/Research Disclosure Information

doi: 10.1378/chest.1120025


  1. 49 subjects at one local hospital/clinic? Darn tootin' more study is needed! I'll bet 100% of the subjects were human, too.

  2. ps - this is what you get with the "Dx du jour" factor: guaranteed funding/publication is you have Autism in you study title. Feh.

  3. Actually, if you read the US News blurb you would see that she said she looked at 300 typical kids as well and none of them had this abnormality -

    "Stewart went back and looked at the bronchoscopy results of 49 children with autism spectrum disorder and more than 300 kids without the condition. She found that all of the kids with autism had what she calls symmetrical "doublets" in their airways, while none of the normally developing kids did."

    Clearly, more study (and replication) is needed but I wouldn't be so quick to dismiss this as someone who just wants to get published.

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  6. Now what?
    Should we start HBOT?

  7. DanK,

    I don't think starting HBOT just because of this would be a good idea. As far as I understand it (which isn't that far), there is nothing in this finding that is suggesting that lung function is impaired.

  8. Thinking critically what tells us this is actually a bad thing?

    They're symmetrical! In organisms symmetry=efficiency. This suggests this isn't an "abnormality" this is a lot like the special abilities autistic people have only with our lungs.

    It makes sense they would be smaller. The mind and body are connected. I surmise that part of what makes me think so fast is that the brain somehow can tell subconsciously where to move air through those airways and coordinate the movement of the blood stream in order to help the brain think in real time.

    I really think that's all there is to it. We're wired and structured so that energy/information passes through our bodies very fast so we wind up getting overwhelmed with information. But imagine trying to learn how to use your brain from homo erectus.

    Those who are more ahead neurologically or in any trait are going to show some kind of functioning problem along with it since society is geared towards "normal", not towards "superb" not towards "excellent" but mediocre "normal" in spite of it collectively professing to all want more than that disagreements over what exactly that is causes stagnation.

    I'm not saying we are more evolved than others, but that autism is an important trait in evolution like other important traits and we should allow it to evolve naturally and come together with complementary traits as it goes along.

    1. I agree with you 100%. I feel I'm above average in many things but on the surface I'm a mess.

  9. Anonymous,

    I hope your comment was meant as a joke because it is wrong in just about every aspect. Autism is a developmental disorder and has nothing to do with evolution.

    1. Darwin's theory. I have a child with moderate autism. I've tossed that theory around in my head for years. Evolution isn't only improvement. There are usually drawbacks. Yes, there are certainly disadvantages to having autism. My brother has it and his comprehension of things like quantum physics and other things that most people would just shut down trying to understand are very easy for him. I think I may have a touch of it and I have my extensive creativity,empathy and also have above average comprehension skills; although we both struggle with mundane tasks and skills that other people seem to have no issues with. We lose things constantly,have issues with focus, become overwhelmed easily, anxiety, crappy time management skills and are always late to everything, no sense of direction etc.

      My son, he doesn't speak often at all and is considered nonverbal but he could be a human metronome with how perfectly he drums on things, he can sing and will play instruments, an amazing memory and impeccable balance... I'm not saying it IS evolution, but it is possible.

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