Benefit of Microbiota Transfer Therapy on autism symptoms and gut microbiota | Hacker News Reader

Benefit of Microbiota Transfer Therapy on autism symptoms and gut microbiota

nature.com

216 pointsblockmarker142 comments

(1) This isn't Nature, it's SciRep. Don't get distracted by the URL.

(2) Nature is an extremely high impact factor journal. However, it's ... not really a medical journal. Nor a psych journal. Nor a developmental peds journal. It's a basic sciences journal. What I mean to say is, even if this were Nature, it'd be a super high-impact journal that isn't actually read by clinicians who would be best positioned to criticize the study.

(2a) For instance, their bowel transfer prep involved a clean-out with a two week course of vanco. The only bowel bugs it's used for are c. diff colitis and staph aureus enterocolitis. The reason it's really only used for that is because it really doesn't touch any other common bowel inhabitants. It's useful for those because it doesn't absorbed very effectively, so if you've got C Diff sitting in the bowel lumen, great, send a wash of vanco down the pipe. But, uh, for any other bugs in the gut? It's not even second line. So, how weird that it would be used to knock out pre-existing gut flora and "suppress pathogenic bacteria." C Diff and MRSA are not the leading pathogenic gut bacteria. The pre-existing flora are predominantly anaerobes.

(3) An unblinded, uncontrolled trial of a disease whose symptoms are highly subjective in measure? Excellent. I'm sure they took measures to ensure they weren't influenced in their subjective analys-

(3a) Oh. The senior author has a bunch of patents out trying to commercialize probiotics for autism.

(3b) Oh, they used the PGI3, CARS, SRS, and ABC scores. I guess if you fill out enough bubbles you can overcome the fact that those are still subjective enough that they're shit for an open-label trial. Whoops.

I don't mean to be overly dismissive. It's a fine pilot. The results are interesting enough that I'd want to see a real study tackle this. My comments are mostly aimed at the prevailing sentiment here taking this at face value.

Do you know/understand how this study deals with regression to the mean? I can't figure it out from reading it.

Also, what exactly is SciRep?

Regression to the mean is briefly touched on (although they don't call it that) near the end of the "Results and Discussion" section.

tl;dr: "In this other observational study, many subjects with autism didn't improve over time on a different metric, so the improvements in our metrics were probably because of the treatment and not spontaneous. Also, we asked the parents if there was any regression to the mean, and they said no."

Is SciRep the equivalent of "Op-eds"?

As for one of the senior authors filing a patent for commercialize probiotics for autism, shouldn't there be a mandatory disclosure in their papers that have a conflict of interest?!

Publishing companies tend to create many journals for different (sub-)communities and also numerous other reasons. Nature Research (the company) has next to Nature (its most well known journal) many smaller ones, like Nature Biotechnology, Nature Communications or in this case Scientific Reports. Some are well regarded (e.g. Nature Biotechnology, Nature Communications). Scientific Reports has a comparatively low impact factor, which has furthermore dropped every year in the last few years. Impact factor measures the average number of citations a published paper receives. Its impact factor of 4 is not very impressive. The main Nature journal has an IF of 41 (Nat Biotechnol has 35 and Nat Comm has 11).

In this article the patent applications are disclosed in the Competing Interests section. The readers can draw their own conclusions from those. It would be very unusual for a journal to not demand a declaration of conflicting interests.

From the article:

> Further research with a placebo-control arm is warranted

IIUC they don't have a control group. They don't have a control group!!! Reading again your comment, you wrote this in point (3) and (3b), but it needs a few more exclamation marks.

That sentence doesnt end there. It also includes, "double blinded".

Again, parent poster mentioned this but as you say, more exclamation marks are needed.

> What I mean to say is, even if this were Nature, it'd be a super high-impact journal that isn't actually read by clinicians who would be best positioned to criticize the study.

More importantly, the peer-reviewers are likely scientists, not physicians. This can make a subtle difference in how and what they review.

But you did a great job listing out some of the shortcomings!

I was going to ask, this sounds overly dismissive, but then I read your last paragraph.

Also I know SciRep is fairly new but isn't it still under the Nature umbrella? ie. There's still some peer review; the study is likely to be legitimate.

The authors are pretty explicit about the weaknesses in their study and I think that the flaws are reasonable for a pilot study. I'm surprised the authors didn't say anything about their conflict of interest though.

Showing a link between autism and the gut microbiome would be incredible. Obviously more work needs to be done before anything is concluded but this is a really interesting result.

I think he was understating. Dismissing this results is in fact the right approach for a scientist.

Agree, and furthermore, dismissing any single paper result without replication is the right approach for most scientists and (I'd argue) almost all non-scientists.

The publication incentives are extremely messed up and in favor of exciting results that aren't true.

(0) There's no control group. This isn't science.

Perhaps this paper is the 'observation of a phenomenon' which may lead (or has lead) to the formulation of a hypothesis.

Thus, this paper is saying what the scientific method should test next.

That was my impression as well. The tone seemed to be "we turned over a couple rocks and we think we noticed a couple things. We want to share that hike in the Autism woods."

The number of subjects was small. They even added: "We note that due to the open-label nature of this initial trial, all of the assessments are subject to placebo effect..."

The problem is that this kind of studies should be discussed only inside medical centers where the next more reliable studies are designed. The discussion with general public degenerates because most people don't understand the difference between a preliminary study and a good clinical study. You will see in a few days a press article in a major newspaper with the title "Fecal transplant cure definitively autism forever, scientist say" and I will cry.

This has already happened, and quack doctors are already using this to peddle fecal transplant cures on local autism groups.

Scientific method:

Step 1: Observation

Step 2: Hypothesis

Step 3: Test

great summary.

there are remarkable parallels to Andrew Wakefield's paper about autism, vaccination, and his hypothesis about the gut.

Perhaps this should have been published in the Lancet[1]

https://www.thelancet.com/journals/lancet/article/PIIS014067...

I have a very mild form of autism but I would say that I suffer from autism. I'm very sensitive to which environment I can be productive in and I need very clear protocols for human interaction. It's fine for engineering but I want to work more with people too (that's generally how you advance career-wise) and I have big problems knowing when to keep quiet in meetings and what topics for discussion are poor choices, even though I'm close to 30 years old now. If I could just be "normal" I think my life would improve immensely.

I say "I think" because I'm not sure if I would like losing the things that make me "me". A friday night just reading all kinds of odd books to learn new things is totally fine by me right now and even though I have problems regulating my emotions I can now, after decades of coping, channel them into passion to get stuff done. I do however think my childhood would've been much easier if I was somehow treated as a young child; the years of being bullied and not making friends have taken its toll on me, something I struggle with to this day in business settings when I have to deal with unfamiliar people.

Maybe the world needs more people like you. We have far enough "normal" people.

> A friday night just reading all kinds of odd books to learn new things

That's simply a hallmark of intellectualism, not autism.

Thanks for giving a diagnosis based on one sentence :)

What diagnosis? Your word, not mine.

My story is pretty much the same as yours, but I have an extra ten years on you. I've been able to get it under control (my career is really taking off now at the age of 39) by practicing it like any other skill. Mostly it's the art of omission; I consciously suppress my impulse to interrupt people in meetings and conversation by preparing a response in my head until they finish. This has the effect of making people think of me as a good listener, and also gives me time to cut their argument to shreds if they are spewing nonsense (the old maxim "don't interrupt your enemy while they are making a mistake"). Also, it's good to be thought of as the quiet smart guy. On the topic of inappropriate topics, I just don't say anything that isn't related to work in public conversations. Once you start getting close to people in a company you can usually talk about anything in private. All the "acting normal" can take a toll on you, though.

I know I have to get it under control like you, but it's super hard and it looks so effortless for other people. They can just sit there, take in all the nonsense people are spewing with a straight face and then send an email to the appropriate people about it. It takes me all the efforts in the world to do something like that, and it would exhaust me for hours afterwards.

It is easier doing it now at 29 than it was at 19, though. Maybe 10 more years of practice is all I need.

> A friday night just reading all kinds of odd books to learn new things

I think that's just you(nothing wrong with that), a man i used to know has it he'd rather just party(nothing wrong with that either).

Never formally diagnosed but I had similar difficulties to yours and it had been brought up to me multiple times that I probably had some form of ASD.

I am a dev and probably had quite similar experiences to yours in meetings in my first couple office jobs. What made a profound difference for me was adopting empathy as an intellectual practice. I have never once "experienced someone's feelings as if they were my own" so I long regarded myself as being naturally deficient in empathy, but it also didn't seem very important to my engineer mindset.

The habit I cultivated was to simply compile lists of rules, not written, just in my head. Things to say, things to not say, and how to say what you need to say and when. How people react, etc. It meant paying close attention and making guesses in a way that did not come naturally to me at first. It took a lot of effort to build up these habits. I did not realize just how self-focused and self-centered I was as a human being.

After doing this for a while, without really trying, general principles emerged from my compiled rules. These, combined with my efforts at paying attention to people, really turned things around for me in a profound way. People really began to warm up to me, and most importantly, my interactions almost completely stopped being surprising and painful, due to me knowing a lot more about how to get along unselfishly. I avoided learning this for a long time, because I think I assumed I would end up spending my days just pleasing other people. A silly worry in the end.

The rules I compiled were an important middle step. It was applying the rigor and attention I usually reserve for interesting codebases or videogames, to getting along with humans. In hindsight it is perhaps not so surprising that with diligent effort I acquired a skill, but I cannot overstate how much I wish I had done this sooner.

I don't want to oversell it. It wasn't that I became an amazingly charismatic wunderkind, yet for the impact it made on my life, I may as well have. With great effort, in my mid 30s I reached the social starting line where most people (from my perspective at least) were lucky enough to begin.

It could be that I only managed this because my autistic behaviours had a different root cause or milder expression than someone else's. It could be that some forms of autism are purely viral and other ailments merely resemble it. In short, I don't know that anyone else can benefit from this, but am inclined to think that many could.

Also, FWIW, I wouldn't attach too strongly to this idea of "me" that you mention. I have had similar feelings in my journey, and the answer I found was to trust that whatever nebulous merit exists in this "me" concept, it will survive my efforts to improve myself towards a more healthy sociability. Your "me" might be holding you back.

Incidentally, per the main topic, as a result of my other health issues gut flora had entered my radar and I've encountered a lot of similar, potentially promising, claims about the brain gut connection. I personally think there's something important there to be found but we haven't had the right studies done to really sort it out. If this study was an important step in that process, great I guess, but like others have said, I would have preferred they had done a more useful study on the subject, that would propel our knowledge further, faster.

For all the mystery surrounding ASD, one thing I feel absolutely certain of, is that it is causing a lot of suffering that will become unnecessary once it is more thoroughly understood. The sooner the better.

I have diagnosed ASD, and such a thing would be incredibly helpful to me. I know that this is a hard ask, as it would imply a lot of writing, but could you tell me your rules? It would be incredibly useful to me.

"If someone is about to give birth, don't say "I hope it doesn't claw it's way out and kill all of us" in the hospital room with the expectant mother"

I really struggled to find appropriate outlets for my humour for a lot of years...

"When people you know say "hello" what they are really saying is "are you still friendly since the last time I've seen you?" so just say Hi with a hint of warmth if you can manage it, because people are never going to stop greeting you anyway, there is no way to recoup the cost so might as well let them know "yeah, we're still cool""

For a while, I had the charming habit of refusing to return greetings, because I felt they were bothersome, inefficient and unnecessary.

The rules themselves are each tailored to some particular misstep I have made. The principles that emerged really were kind of basic stuff good parents, teachers or Mr. Rogers teaches you. That being less selfish is wise, paying attention to people is rewarding, and that there is a very big difference between listening to someone and waiting to speak. The principles are only words, and the rules are too specific to my own experiences to really translate. What matters is the intuition I had been building up from the moment I decided for myself that this problem was worth the effort.

I hope it helps.

That does help, thank you. The "hi" insight is great. I will endeavour to understand more things myself. Thanks.

Prior to the study, 83 percent of participants had "severe" autism. Now, only 17 percent are rated as severe, 39 percent as mild or moderate, and incredibly, 44 percent are below the cut-off for mild ASD. https://newatlas.com/fecal-transplants-autism-symptoms-reduc...

Prior to the 18 patient study of rapidly growing teenagers, with subjective rating scales performed by unblinded investigators, 83 percent of participants had "severe" autism. Now, only 17 percent are rated as severe, 39 percent as mild or moderate, and incredibly, 44 percent are below the cut-off for mild ASD.

Just adding context.

How many would have been expected to get cured without any action at all ? (because Autism does mostly resolve itself, either "for real" or because the patients learn to mask it well enough to "not have symptoms")

But two years is a very short time. I have a mild form but it still took me decades to get to where I am today. People don't suspect I'm autistic and are surprised when I say it, but I'm absolutely exhausted from a day of masking it at work if there's a lot of meetings with new people.

> Autism does mostly resolve itself, either "for real" or because the patients learn to mask it well enough to "not have symptoms"

Having worked with autistic youth before, that's simply not true. First, autism is not a disorder that can be cured but worked with. Second, it doesn't do it by itself, but _can_ get better, with different approaches, and most of them involve hard and persistent education work. Lastly, the part of the spectrum that can look as if they were "normal" is a rather small proportion of the whole ASD.

Ah come on, be fair. Every psychiatric disorder has a pretty high chance of getting resolved without any action from outside. Very few people actually succumb to them.

Furthermore, especially with psychiatric disorders, there is a high percentage of patients that aren't helped, but exactly the opposite, by treatment. That systematically get worse because of treatment.

(I do not claim this is easy or pleasant for the patient, merely that it happens. Furthermore in the more common cases where treatment makes the patient worse it is also incredibly unpleasant, unfair and entirely terrible for the patient)

(and of course you could correctly claim that this is even true for cancer, and it is. However for cancer the percentage of patients that get better without treatment is something like 0.2% up to 4% depending on the cancer, whereas for psychiatric disorders the amount of people that recover without treatment is easily > 90%)

Source for any of this? 90% is a number you should be getting from somewhere, and it sounds unbelievably high.

I would go even further and call it "dismissively" high.

I don’t think what you’re saying is accurate or appropriate for autism.

Originally I posted a longer response, but it's not worth breaking down because the original content is complete, unfounded nonsense. It's the kind of thing you'd read on an anti vax facebook page.

No, the vast majority of those with psychiatric disorders do not recover without treatment

No, there is not a high percentage of patients that get worse because of treatment

Either a source needs to be posted or the comment should be deleted because it is completely false, not adding to the discussion, and incredibly dismissive of those experiencing psychiatric problems or seeking psychiatric treatment

Autism is not a "psychiatric" disorder, it is a developmental disorder with neurological and physiological symptoms.

That is an excellent question.

It depends on how they selected the subject of the study [1] and how accurate is the evaluation at the beginning and the end of the study [2].

That's why they need a control group, that is selected at random, so you hope that the cure rate in the control group is the same than in the main group if they didn't get the treatment.

Also, the groups must be double blind so when the doctors evaluate the results don't know if the patient has been treated or not, and they use the same criteria.

[1] Did they select only the mild case? Did they exclude the mild cases? Average age of the group? How much personalized help they can get to interact with other persons? Did other part of the study affect them? (Something like a minimal medical attention when they visit a nurse each month for minimal checks.) And a few more, that probably nobody know ...

[2] Some symptoms are crystal clear, and some are more fuzzy.

Re double blind etc.. Not for pilot studies where one errs on the side of excluding null results in order to get the required funding to study something properly. Without pilot data, one judt wont get the grant that would play for the clinical trial

Those labeled as "severe" aren't remotely likely to have their autism "resolve itself". Those labeled severe have the types of behaviors that tend to remain through the years. Children who are prone to self-injurious behavior, in my experience (two kids with autism, lots of exposure to other severe cases in the community), don't tend to outgrow it.

Those that you see able to 'mask' their symptoms are generally on the opposite end of the spectrum, sometimes referred to as 'high-functioning'. That requires a level of self-awareness that many of the lower functioning spectrum seem to lack.

One of the major problems with autism diagnoses is that there are lots of people who see the higher-functioning members of the autism community as the norm, whereas there are a fair percentage that are essentially permanently disabled that will likely be unable to contribute to society in a measurable way.

>Autism does mostly resolve itself, either "for real" or because the patients learn to mask it well enough to "not have symptoms"

This is absolutely not true for the vast majority of those diagnosed with ASD

it's easy to achieve incredible results using uncredible methods.

Gut microbiome diversity has been declining for years in the general population.

Could this be an additional factor (next to better diagnostics) in the increasing prevalence of ASD?

when i read this i saw no mention of a control group?

No, and the last sentence acknowledges that this should now be repeated more rigorously

A bit strange that this was accepted in "Nature" then (?)

Not really. It's common to accept papers based upon some function of Interesting & confidence, as long as the papers are very clear about their significance (or in this case, lack of a control). this kind of preliminary study is important in being able to make a case for funding a much larger formal study.

It is a hot trend to correlate things to gut biome. Even so, the fact so many researchers are able to do so is quite interesting.

It has been hypotesized that autism increase in the last decades might be correlated with the increase in the use of pesticides. Early damage in nervous system that leads to a permanent particular architecture in the brain and all the stuff.

Some gut bioma could theoretically be slightly better than other to deal with it. Some bacterias could be more efficient metabolizing some damaging products in our diet into other not so bad or even inocuous. Is teorethically possible.

Both problems could be related and in this sense is a pretty interesting field. They could just give to an artificial gut bioma in a petri dish some diluted compounds, (or just give some autist children organic cultured fruits and keep it in a pesticide free environment) and see what happens

Is there any evidence that the amount and types of pesticides used today are more damaging than those used 30 years ago? Or 60 years ago?

Gut feeling: regulatory environment is a lot more strict these days, so we're probably a lot better off with today's pesticides than whatever straight-up toxic chemicals were used in the past. I bet if we started looking we'd see things like arsenic and similar used in the past.

Don't need to be more damaging. Can be harmful in a different sense.

This is not Nature, this is "scientific report", which is not a bad journal but no Nature either.

Slight clarification: The journal is called Scientific Reports, which as you correctly emphasize is very different than the journal Nature even though they are owned by the same company. The articles are still called "articles" though.

It's basically Springer-Nature's answer to PLoS One. As long as it's not obviously crazy, anything goes.

This doesn't look very convincing though. Without a no-treatment or sham treatment control, the results could be placebo effect, reversion to the mean on their metrics, or due to the antibiotic treatment rather than the transplanted gut bacteria, or a just a statistical fluke with this small population.

One thing that stands out to me is the lack of difference in developmental age between 8 weeks and 2 years after treatment. I find it hard to understand how that would occur under the model where this treatment does something.

Nature Scientific Reports, not the same.

In fact, "Nature" isn't even in the office journal title, unlike basically every other journal owned by the Springer Nature publishing company, e.g., Nature Communications, Nature Chemistry, Nature Methods. This highlights that it's considered to be a significantly lower tier in prestige, and the acceptance rates are much higher. Which is why I've published there :D

Scientific reports is a nature family journal somewhat akin to Plos One (very little importance review). It should set some warning lights on.

It wasn’t.

This is Nature Scientific Reports, a low impact journal.

But the results are very strong. In the treatment group, almost 1 in 5 patients went from severe autistic symptoms to normal (clear). And almost 2 in 5 patients went from severe to mild.

This begs the question, is any other treatment known to produce such strong results?

Given the method of measuring the results I'm not sure we can know anything about how strong the results are without a control group. It seems there is a deal of subjectivity in interpreting the results, and when this is the case crazy stuff can and does happen, regularly.

Can you clarify what you are saying about the method of measuring results?

The study evaluated the severity of autism symptoms (using subjective questionnaires) before and after the treatment, but didn't compare those results to a control group of people who weren't treated the same way.

It's like finding a couple dozen people with the flu, feeding them chicken soup, and then reporting that a month later they feel healthier, so the soup must have helped. Maybe it did, maybe it didn't, but you didn't measure that so you don't know.

I asked as an aside to the matter of control group - what is considered "given" about "the method of measurement" ?

According to this professional medical trial, the recorded ASD scores are "based on the Childhood Autism Rating Scale (CARS) rated by a professional evaluator"

You should have specific knowledge of that evaluation in order to criticize it as relying on "subjective questionnaires" and shouldn't introduce doubt by simply stating something as "given".

It would be interesting to see if this has similar effects on other candidates that have other mental symptoms classified as mental illness. ADHD, ODD, OCD, Bipolar, Depression etc.

I have two children with combinations of these symptoms and it's staggering how many of the symptoms could be interpreted either way depending on the classifying doctor's specialty.

With my new growth serum 90% of children in my study grew 1 foot or more over 2 years.

No need for a control group the effect is so strong!

> But the results are very strong.

Great, so we have a study showing that either the treatment or the placebo effect is very strong. Wait, that's not very useful, isn't it?

The methodology is so weak that it's impossible to know whether the results were strong or not.

Studies of psychological conditions are notoriously hard because much of the quantification is subjective, but this study wasn't even blinded and had no control.

Sans control group the results are non existent. There is no spoon. Hence it’s equally strong and week.

Well i could tell uou from data i am working with that improvements in ASD are not that frequent and not of such magnitude. Obviously this could be an issue with their coding, but just for context, those changes are not typical seen in other cohorts. Proper funded study now needed. Longitudinal clinical trials are not cheap.

I agree. Improvements in ASD are uncommon. You know what is common? Industry driven undisclosed Gut bacteria related shit science.

Lot's of scientific studies have no control groups.

Not good ones.

Any study attempting to show or imply causation needs to control for confounding variables; this is statistics 101. Usually you do this with an aptly named control group.

If you don't have that control, you're left with "either my results are meaningful or else (very likely) there is a confounding factor." Great, that's not very useful.

Not a single study on the efficacy of vaccines has had a control group. When I asked why, I was told it was "unethical".

So either, vaccine studies are "not good ones" as you say, or you perhaps have overlooked something?

LMGTFY

It was difficult, but I got these two:

(1954) Salk study of anti polio vaccine: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1114166/

(2009) Pregnancy and infant results after anti human papillomavirus: https://www.ncbi.nlm.nih.gov/pubmed/19935017

There are probably more, but they are difficult to find.

Neither of these studies did they control for who was exposed to the actual disease.

As far as I have found, the only experiments that did do this were completely unethical, and have not been repeated in modern western science: (that I know of)

https://encyclopedia.ushmm.org/content/en/article/nazi-medic...

http://www.auschwitz.dk/Bullenhuser.htm

The control group was exposed to the actual disease at the same rate than the treatment group. The idea is that both groups get almost the same treatment.

If the groups are big enough, you expect from statistic that both groups would have a similar number of ill people without treatment and a similar number and type of "sede effect"without treatment. So the difference can be atribute to the drug/vaccine, if statistically significant.

A study were all the participants are exposed on purpose to the disease is very difficult to justify, with or without control group. Perhaps a vaccine for a strain of cold, that is an illness with a very low rate of deadly complications?

>The control group was exposed to the actual disease _at the same rate_ than the treatment group.

Can you show me where this is demonstrated?

>A study were all the participants are exposed on purpose to the disease is very difficult to justify, with or without control group.

I agree, solid scientific study on vaccines is nearly immoral.

So from a dispassionate scientific perspective, it seems reasonable to state the science on vaccines is not settled.

Maybe offtopic, but reinforces the gut-brain connection: The purported benefits of the ketogenic diet [1] to some epilepsy patients seems to be mediated by the gut bacteria [2].

[1] https://www.epilepsy.com/learn/treating-seizures-and-epileps...

[2] https://www.cell.com/cell/fulltext/S0092-8674(18)30520-8

Also, parkinson: https://www.sciencealert.com/there-s-mounting-evidence-that-...

Also, schizophrenia : https://bigthink.com/surprising-science/schizophrenias-link-...

I wonder if there's any relation to taking oral antibiotics at a particular age, or mothers taking antibiotics?

I very much wonder that too.

I can't help but eyeroll at that dumb trope of people unwilling to accept the genetic link as someone actually autistic but it brings to mind a socratically trolling joke.

"Doesn't this imply that being neurotypical is the actual disease and we have the means to deploy a cure for it?" Not a serious position but one to hopefully get people thinking about norms.

What if one of the genetic links were related to the GI?

I think its because autism is something that gets thrown around everywhere these days. Im sure many are diagnozed with ADHD or similar condition on the autistic spectrum when in reality its probably more related to diet, upbringing etc.

Autism can be genetic for sure. But I think many are diagnosed on the spectrum to hastely.

It is on the first sentence of the Abstract: autism-like behaviors

>> Many studies have reported abnormal gut microbiota in individuals with Autism Spectrum Disorders (ASD), suggesting a link between gut microbiome and autism-like behaviors.

Autism Spectrum Disorder is autism (it is the formal name of the DSM 5 diagnosis) not merely “autism-like behaviors”.

That sentence seems to suggest that the study includes (also) "autism-like behaviors". I am not trying to redefine Autism Spectrum Disorder as I don't have knowledge to do so.

Yes, but my point is that a general state of malnutrition can give the same symptoms as autism, ADHD etc. I think the lack of gut bacteria could be more a symptom than a cause if you know what I mean.

When I was a child everybody thought I was autist when in reality I was just malnurished because I had a single mother who was up over her head in responsibility. If you dont eat right and maybe even live largely off sugar, you are bound to have attention span problems and blood sugar and mood like a roller coaster.

My comment was meant to agree with you and to point that the study seems to include patients that have "autism-like behaviors".

Just because something is natural doesn’t mean it’s optimal, nor does just because something is optimal mean it’s what people want for themselves, nor does just because something needs to be tolerated means everyone should want to bear such things for themselves.

> the genetic link

Don't jump to conclusions so quickly.

Things that appear genetic could be related to family traditions that children follow when parents, environmental issues that are common along family lines, bacteria shared among parents and their children, ect.

It is more something highlighted by the psychology of popular "theories". There ino consistency in blaming autism on "refrigerator mothers", heavy metals, vaccines, and diet except for what they are not - environmental instead of genetic. It is reaching and in a frenzied, hysterical denial like Continuum Magazine ending after all involved died of AIDS complications.

That sort of behavior suggests that they already know the answer is more likely than not genetic but they refuse to accept it because they don't like the implications. There are many things which should have broken said links but haven't - otherwise they would have played out already.

As my autistic SO said:

> Can't wait to see hysterical autism moms doing home enemas with feces, hopefully some anti-vaxxers stories as well trying to mitigate having to get their kid vaccinated for kindergarden.

Not fun for the children, but any case like this would bring it over the top and hopefully create a bigger uproar.

It’s an improvement on bleach enemas

All they needed was some good shit.

Jokes aside there has been plenty of research around insulin spike and how it is dependent on the gut bacteria and food you eat.

I've been pondering that the term "anally retentive" to describe a pattern of behaviour (totally unconnected to Autism) associated with strong disgust reflexes might itself be a symptom which happens due to poo retention, orderliness and extreme clensiness which reduces the diversity in gut bacteria.

I always figured this was to do with stress levels. More stress = higher muscle tone, more retention and less bowel motion. But yeah, you could be right, I see there could be a feedback there.

That sounds quite far fetched and completely unfounded in facts.

Btw Freud was wrong and his model of child development have been disproven for a hundred years now. Don't pay attention to stuff like "anal retentiveness", it's an inaccurate model of real psychology.

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