Dr. Mark Geier, Dr. Janet Kern and David Geier conduct a ground-breaking cross-sectional cohort study of health, physical and behavioral problems in individuals with autism.

1. EVALUATING
AUTISM
SYMPTOMS
RESEARCH BY DR. MARK GEIER, DR. JANET
KERN, AND DAVID GEIER

2. THE PURPOSE
The autism spectrum disorder (ASD) is a neurodevelopmental
disorder that impairs an individual’s ability to communicate,
socialize, and behave. These three categories have been the
primary components of ASD diagnosis. However, many
individuals with ASD have also reported health, physical, and
behavioral symptoms as well. The limited research that has
been conducted regarding these symptoms has been done by
studying each individually.
Dr. Mark Geier, who has conducted extensive vaccine and
autism research, his son David Geier, and Dr. Janet Kern set
out to evaluate health, physical, and behavioral symptoms in
conjunction via a cross-sectional cohort study. Their 2012
paper in the Maedica Journal of Medicine is the first-ever study
to evaluate these categories on a systematic and quantitative
level.

3. THE PURPOSE
The health, physical, and behavioral symptoms commonly
reported in ASD individuals that the Geiers and Kern were
interested in examining included:
• Trouble sleeping
• Hyperactivity/lethargy
• Gastrointestinal disruption
• Anxiety
• OCD
• Aggression
• Self-harm

4. THE EXPERIMENT
Participants of the study included individuals that were diagnosed
by the DSM-IV to have either ASD, Asperger’s Syndrome, or a
pervasive developmental disorder not-otherwise specified (PDD-
NOS).
The 54 total participants were verified to lack a history of the
following disorders: Fragile X disorder, cerebral palsy, fetal
alcohol syndrome, Lesch-Nyhan syndrome, tuberous sclerosis,
seizure disorder, PKU, or disorders resulting from a mother’s
drug use.
Participants ranged in age from 2-16 with a mean age of
approximately 6.

5. THE EXPERIMENT
How were the 54 participants examined for behavioral, physical,
and health symptoms?
All participants were first evaluated by Dr. Kern using the
Childhood Autism Rating Scale (CARS). Dr. Kern has significant
experience evaluating children with ASD. The CARS is an
assessment that rates individuals based on a variety of
characteristics to determine the severity of their disorder. Each
of the 15 categories of the assessment are rated between 0 and
4; the higher a score, the more severe a symptom.
Dr. Kern used the CARS assessment to quantify behaviors like
emotional responses, activity level, the ability to adapt to
change, the ability to relate to people, and verbal
communication, among others.

6. THE EXPERIMENT
Participants were then evaluated by parents using the Autism
Treatment Evaluation Checklist (ATEC), which is specifically
designed for use by parents, teachers, and others who have
been able to observe ASD children over the course of an
extended period of time.
The ATEC is comprised of 4 assessment subtest categories:
Speech/Language/Communication, Sociability,
Sensory/Cognitive Awareness, and Health/Physical/Behavior.
Multiple items are assessed within each larger subtest.
Like the CARS assessment, the higher a total score, the more
impaired an ASD individual is determined to be.

7. THE EXPERIMENT
Within the ATEC assessment, the physical and health subtest
specifically included examination of the commonly reported
health conditions in individuals with ASD previously
mentioned (sleep disorders, incontinence, OC behaviors,
anxiety, etc.).
In total, 10 health subcategories were examined using ATEC.
Each subcategory was given a score from 0-3 to reflect the
severity and frequency of the health condition.

8. THE RESULTS
What did the Geiers and Kern find?
By the numbers:
48% of participants had GI disruption
41% experienced incontinence
67% were hyperactive
89% had behavioral problems
92% demonstrated obsessive compulsion
94% had eating disorders
57% had trouble sleeping

9. WHAT IT MEANS
These findings provide a clear indication that a significant
number of ASD individuals suffer from serious physical, health,
and behavioral symptoms. These specific symptoms are not
currently a part of the ASD criteria for diagnosis, which means
that a large aspect of diagnosing ASD goes unaddressed and
therefore largely untreated.
For each of the symptoms assessed, previous research offers
highly similar findings. For example, 67% of the children in the
study were found to be hyperactive, which is consistent with
what researchers Charnsil and Sriapai previously found.
Overarching consistency with previous findings reflects that
these results are not anomalous.

10. CONCLUSION
The Autism Spectrum Disorder is not just a psychiatric disorder.
Individuals with ASD suffer from health, physical, and behavioral
conditions that more significantly increase their risk for death
than do the three symptom categories that are currently used to
diagnose ASD.
By recognizing the presence of these serious conditions,
doctors should begin diagnosing ASD using the ATEC
assessment to evaluate these conditions. Researchers and
physicians should also begin to work towards developing viable
treatments.
The Geiers and Kern believe that more longitudinal evaluations
of health, physical, and behavioral conditions in ASD individuals
will be of further value to their investigation.