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Impaired Smelling as a Social Impairment?

Megan SmellBy Teresa Conrick

The photos you see are of my daughter, Megan.  She has a diagnosis of both Autism and Autoimmunity.  Megan smells things, people, and herself in an exaggerated and frequent way.  She is not alone as it is a symptom of an impaired ability to smell correctly. Many of the children have played with feces, sipped Pine-Sol like lemonade, or sniffed dirty socks and armpits without blinking an eye. It is not news to me as I have seen it for years.

There is a new study out about autism and smelling, A Mechanistic Link between Olfaction and Autism Spectrum Disorder.  From the researchers:

“…Here, we set out to test the hypothesis that the sniff response will be altered in children with ASD. Notably, we do not hypothesize that children with ASD will be unable to sniff, but rather that they will generate an inappropriate sniff given a particular odor…These results imply an altered olfactory response that is evident in children with ASD and is more pronounced with increased autism severity….. “

Furthermore from the study – “the sniff-response measure is reflective of the mechanism involved Megan Smell 3 with the social impairment that is at the heart of ASD.”

I disagree and challenge that idea.  I believe that the issue of smell is NOT related to social impairment but of smell dysfunction and quite possibly a consequence of an impaired MICROBIOME.

Is it possible that because the authors went the social impairment route instead of connecting physiological dots, the conclusion will be different?  I think, yes, it will. We instead should see a different picture, which will require a MEDICAL SOLUTION and not a social impairment therapy.

AUTISM - Damaging Bacteria in the Gut

The mounting evidence of increased pathogens and decreased commensal bacteria in the gut of children diagnosed as AUTISTIC, is indicative of the reality of how ill many of them are, and many researchers think it explains the behaviors of Autism:

Megan Smell 2Autism Study: More Evidence Linking Altered Gut Bacteria to ASD - Researchers say that gut bacteria more abundant in some individuals with autism produce waste products that may affect brain activity

Autism’s Gut-Brain Connection- The different gut bacteria in autistic individuals may be contributing to the disorder. “Today autism is treated primarily through behavioral therapy. But the new study suggests that treatment may one day come in the form of a probiotic—live, "friendly" bacteria like those found in yogurt. "If you block the gastrointestinal problem, you can treat the behavioral symptoms…”

Gut Bacteria May Play a Role in Autism - Evidence is mounting that intestinal microbes exacerbate or perhaps even cause some of autism's symptoms

There are 90 more studies on Pubmed regarding Autism and the Microbiome and over 300 looking at Autism and Bacteria. Let’s take a closer look at one example, p-Cresol ,  as we connect the dots here.

Bacteria’s Toxin Found in Autistic Children:  P-CRESOL

Urinary p-cresol in autism spectrum disorder. (2012)– …the largest and most widespread source of this compound is represented by some gut bacteria which express p-cresol synthesizing enzymes not found in human cells. Urinary p-cresol and its conjugated derivative p-cresylsulfate have been found elevated in an initial sample and recently in a replica sample of autistic children below 8 years of age, where it is associated with female sex, greater clinical severity regardless of sex, and history of behavioral regression. Potential sources of p-cresol excess in ASD, such as gut infection, chronic constipation, antibiotics, abnormal intestinal permeability, and environmental exposure, are being investigated. P-cresol may contribute to worsen autism severity and gut dysfunction, often present in autistic children.

Urinary p-cresol is elevated in small children with severe autism spectrum disorder.(2011) 

Urinary p-cresol is elevated in young French children with autism spectrum disorder: a replication study. (2014)

Potential biomarker found in urine of children with autism (2010)    - Young children with autism have high urine levels of a compound that is likely to be a product of gut bacteria…The compound, P-cresol, "can in no way be produced by human metabolism," says study leader Antonio Persico, associate professor of physiology at the University Campus Bio-Medico in Rome. Only certain species of bacteria — particularly Clostridium difficile, which is found in the gut but can be harmful at high levels — have the enzyme necessary to make the chemical……That might mean either that these children with autism are more susceptible to infection with P-cresol-producing bacteria, or that their intestines are more permeable, allowing more P-cresol to pass from the gut into the bloodstream."These are not trivial levels," Persico says — in fact, they're similar to levels seen in patients with kidney failure. "P-cresol is pretty nasty stuff." P-cresol is chemically similar to phenol, a corrosive compound. Animal studies also show that it is toxic, perhaps acting by interfering with mitochondria, the centers of cellular energy production and metabolism….

Investigation of the relation between anaerobic bacteria genus clostridium and late-onset autism etiology in children. (2014)   -  Data obtained from this study support the existence of a significant correlation between autism etiology and anaerobic bacteria.

Connecting the Dots: Autism, Clostridium, P-Cresol, and Olfactory Dysfunction

Olfactory issues are found in some other neurodegenerative diseases such as Parkinson’s, Alzheimer's disease (AD), idiopathic Parkinson's disease (PD), parkinsonism-dementia, amyotrophic lateral sclerosis (ALS), essential tremor (ET), multiple sclerosis (MS), progressive supranuclear palsy (PSP), and schizophrenia (SZ) .  The research on these diseases, like Autism, is exploding regarding the MICROBIOME. The authors of these research papers do not mention social impairment but instead are looking at olfactory dysfunction as an opportunity to help those afflicted with these diseases and to hopefully prevent new cases, as shown by this quote regarding olfactory dysfunction and Parkinson’s Disease -- This may also give rise to clinical studies which allow administration of neuroprotective substances in individuals with, for example, unexplained smell loss. Up till now, therapeutic studies with neuroprotective agents in hyposmic  (a reduced ability to smell and to detect odors.) PD patients are currently underway and may help us to evolve preventive strategies for PD in future. Why is Autism not afforded the same research outcomes?

So, P- Cresol is “pretty nasty stuff” and the studies in Autism found “These are not trivial levels” plus “— in fact, they're similar to levels seen in patients with kidney failure.” To follow the dots, we need to look for a moment at those with kidney failure:

“The relatively high concentration of toxins in the bloodstream and kidneys in the disease state (e.g., 186 µM for p-cresol [15]) also suggests the possibility that they could out-compete other odorants for binding sites on OBPs. In this case, if a toxin associates with an OBP, the OBP may be inhibited from performing its normal function in capturing odorants (like vanillin) to transport to olfactory receptors……the data support a mechanism by which uremic toxins could saturate available OBPs, thereby preventing their participation in the transportation of other odorants, and resulting in the anosmia reported for patients with renal disease.” 

What that means is that those who suffer kidney disease also have olfactory dysfunction (anosmia- the clinical term for the inability to smell).  Much evidence points to P- Cresol as a culprit.  So could P- Cresol in children diagnosed with autism - children who have a MICROBIOME that harbors Clostridium based on numerous studies -  cause some of the symptoms seen in the children and in particular, olfactory dysfunction?

Assessing the role of p-cresol tolerance in Clostridium difficile.  

C. difficile is among only a few bacteria able to ferment tyrosine to p-cresol, a phenolic compound that is toxic to other microbes via its ability to interfere with metabolism. Therefore, the ability of different C. difficile strains to produce and tolerate p-cresol may play an important role in the development and severity of C. difficile-associated disease….

And here is a biological picture of how P-Cresol can affect smell:

"Retained uremic toxins not adequately cleared with dialysis may undermine the integrity of the olfactory epithelium and olfactory bulb and malign central olfactory processing."

Interestingly, most of the children tested in A Mechanistic Link between Olfaction and Autism Spectrum Disorder  , had an average age of 7. Coincidentally, the researchers on P-Cresol and Autism noted:

Puzzlingly, the difference in urine P-cresol disappears in older children — among those 8 and older, children with autism have the same levels as do controls. "We have no data at this point to explain this finding…..”    It would be a helpful study to see both the P-Cresol levels in these children as well as their olfactory functioning.  Could they be related?

Don’t get me wrong.  I am glad for research that can help identify children earlier BUT the conclusion of the study does not delve into WHY the children have olfactory dysfunction.  Autism again, is looked at as a social misfit instead of a medical condition:

“Here, we end in speculating that our results offer a novel additional possible link between impaired IAMs and the social impairment of ASD. Specifically, increasing evidence implies that social chemosignaling is a meaningful component of human social interaction [42, 43] Critically, olfaction and odor are used to gage [44] and influence [45] the emotions of others and thus play a meaningful role in social communication. We propose that the altered IAM that is the sniff response leads  to altered olfaction, which contributes to impaired social communication.”

My conclusion is that Autism deserves to be evaluated and judged as a disease, just like Parkinson’s, Alzheimer’s, or Multiple Sclerosis.  Since we know that P-Cresol is dangerous to these children, I would hope that researchers will look to WHY it is there and HOW to stop it.  I thought this study pertinent to that point:

Effects of synbiotic treatment on serum level of p-cresol in haemodialysis patients: a preliminary study  

BACKGROUND: para-Cresol, which is present in the blood mainly as p-cresyl sulphate, is a protein-bound uraemic toxin that is produced in the intestine by certain intestinal bacteria, and its production is affected by various intestinal environmental factors. Patients with end-stage renal disease who are undergoing haemodialysis (HD) often have defective bowel function leading to abnormal defecation. Since treatment with synbiotics (SYN), which are a combination of probiotics and prebiotics, is reported to improve bowel habit, we examined the effects of SYN on the serum p-cresol level in HD patients….CONCLUSIONS: It was found that uraemic toxin, p-cresol, was associated with constipation and that SYN treatment resulted in normalization of bowel habits and a decrease of serum p-cresol levels….

Describing Autism as “social impairment” only scratches the surface.  Our children deserve much more.

Teresa Conrick is Contributing Editor to Age of Autism.


eddie Sotolero

The olfactory senses are one of the most primitive senses we have. IN autistic people these sense often trigger aggressive and self harm behaviors, yet because this is so complex and requires constant analysis and monitoring we aren't gathering the proper data, thus, autism research is thwarted on so many levels.


Thanks for the article.
Raises so many questions. Toxins, metals, enzymes, good bacteria bad bacteria, calcium channels-wondered too if the gut opiod receptors might somehow be involved.

Angus Files

This clinic is getting some good reports for anyone who is interested in FMT...well worth a read if nothing else.


Still learning

Your information on the connections between gut bacteria and smell is fascinating. I imagine you are also aware that a simpler explanation also exists. Mercury exposure alone is clearly linked to a impairments in the sense of smell.

Shelley Tzorfas

A major issue at play is that they are trying to keep Autism as a Psychiatric Disorder so that it will continue to be in the DSM5 or future issues when it is a Physical illness mostly from Aluminum, Thimerosal, ether, cells of pigs, cows, monkeys, rats, dogs, insects,, formaldehyde and other toxins.

Imagine if a child nearly died from ingesting a peanut ( Peanut by products were shot into babies) and there was a life threatening anaphylactic reaction. Perhaps the researchers who were paid by the pharmaceutical industry would think,"Oh she just wants attention." That would be as unimaginable as calling a smelling issue a social illness when we all know that it is medical!


Lisa; Yeast infections comes about because of anemia. Anemia is caused - according to doctors bleeding - but no mention that celiacs and gluten sensitivity causes anemia.

Anemia causes itching some times and makes us think we have a yeast infection too, by the way. This might be useful information -- it would have been for me and my family.

According to my Mother-in-law, a dietitian; as she watched me struggle to get my kids to eat their liver-- that low iron or B 12 or B 6 cannot be replenished by food alone, but requires supplements because there is an absorption problem in the gut that caused it. She told me this back in the 90s.

Dr Fansano's cholera vaccine - in Scientific America article stated that it caused celiacs. He said it was gluten combining with some kind of immune thing in our gut, and he called -that gut immune thing zonulin..

My identical twin nephews that have autism - and are now in their late 20s - only one has developed a restrictive esophagus- it has been stretched twice now in the last year and he still can only eat - - drink milk and chicken soup They are now giving him some high powered - not sure - steroid of some kind -would be my guess. They say it is caused by a food allergy and suggest elimination diet to find out -- starting with gluten and milk -- but it could be eggs, seafood -- well there is a rise in this kind of thing in the population of young adults. There are several U tubes on it now and some young adults and teenagers have given up food all together; and have had a feeding tube put in the wall of their abdomen and are fed amino acids -- Oh, and they talk some kind of medicine for it - probably steroids.

They say to eat sauerkraut and kefir but I just can't!
The reason that the gut microbes that we are suppose to have is not there is because?

Brian injuries will cause stomach problems.
Damage to the nerves can cause GI problems.

I am making no point what so ever.
Except that there are oak trees and pine trees that will not grow with out the presence of certain types of mushrooms. They have known this since the 70s.
But no one has given the trees a vaccine that makes their immune system kill those special fungi, but we do know what happens when such trees are planted on strip mine soil that does not have this fungi that feeds special nutrients to the small root hairs of the trees - and it is not good.

I hope it is a missing something that can be replaced.


p.s. I didn't mean to just use the outside leaves! They're the ones with the natural probiotics. Use as much of the head as will fill your blender maybe about 2/3's. Add just enough water to blend.


Dear autismgoaway, here's an easy probiotic recipe. It's easiest to make with a vitamix, although a smaller blender will do. You just need to chop more and blend less at a time.

Chop up fresh red cabbage using the outside leaves with the white stuff (probiotics) on them. Add only enough water to blend. When blended, cover with a cloth and put in a warm place. Don't fill the jar all the way to the top.

Depending on how warm the weather, it will always be ready by the next day. Then cover and refrigerate. If You like it salty, add some seaweed after it has fermented. Refrigerate when fermented. This is from Ann Wigmore's recipe for Rejuvelac with cabbage instead of grain berries.

I sometimes add the powder from a capsule of saccromyces (spelling?) to make it ferment faster. It is very delicious with avocado.

I'm just thinking that the autism community could benefit from Ann Wigmore's work. She healed herself of cancer naturally.


I think it's the scientists who are suffering from social impairment.


The following video is called " Autism - The Fundamental Role of Gut Bacteria "

The audio isn't great, but it offers yet more compelling science connecting changes in gut bacteria to autism spectrum disorder

Denise Anderstrom Douglass

This is fascinating, and I want to read the links. And it makes sense. Thank you.

Angus Files

Very interesting Teresa many thanks.
We have a friend whose low functioning daughter who stands at over 6foot,comings rushing at everyone and anyone stops dead about an inch from your nose then starts to sniff..very daunting even when you know what's going to happen..because if she doesn't stop in her rush she is going to flatten messing.

Def the gut and a form of processing and understanding the smells into signals then messages to the brain..all the therapy in the world, ain`t gonna help it...



Thank you, Teresa, once again for your excellent reporting. Several years ago, when I first read "The Yeast Connection" and figured out that my multiple and ever-expanding health problems were likely being caused by yeast overgrowth in my gut, I remember being struck by Dr. Crook's mention of something I was experiencing that I thought at the time was totally unique to me: I could no longer tolerate the smell of any perfume. Even perfumes that I had always loved -- that were too expensive for me to purchase but that I enjoyed sniffing in the department store -- had come to smell God-awful to me. I couldn't for the life of me understand why. Crook said in "The Yeast Connection" it was yet another symptom of yeast overgrowth. Now that I have successfully treated my yeast overgrowth -- with anti-fungal medication, vitamin supplements, NAC, and dietary changes -- I am once again able to enjoy the scent of nice perfumes. (I am also enjoying fabulous health!)

Which brings me to my other point today: "The Yeast Connection" was published in the mid-80s. Upon its publication, the medical establishment promptly laughed Dr. Crook right out of town In his book, Crook had boldly claimed that many horrible, "incurable" diseases, ranging from auto-immune to autism to schizophrenia -- were caused by yeast overgrowth in the gut. Doesn't everyone find it rather ironic that now, 25 years later, the rest of the medical establishment is finally waking up to the existence of the microbiome and its influence on the disease process? Isn't this just "The Yeast Connection-redux"? Don't you think that scientists who are publishing these studies should finally give the credit to Crook in his death that he was owed in his life? Truly, he deserves a post-humous nobel, in my opinion. Instead, these scientists are acting like they've discovered something brand new.


Also -

in the classic article (for the New Yorker or The New York Times) from many years ago - Berton Roueche' told the story of a butcher who LOST his sense of smell and couldn't stand the smells around him, when he was working.

The title of the story comes from the butcher's sad comment: "All I could do was stand in the woods." (Where there were no city smells, no butchering smells.) Almost everything smelled bad to him, as I remember it.

The doctor kept giving the man more and more zinc -- (always with food, please) -- and eventually his sense of smell came back.

However . . . it is never just one thing. Never "just" zinc, or chloride, or potassium. Everything is connected to everything else.


When inquiring into sense of smell, start with the Monell Institute. Linda Buck was awarded a Nobel for her work.

When inquiring into sense of smell, perhaps start with chloride channels and potassium channels. Abstracts below are arbitrary but might lead to useful information.

Of course "social impairment" connection is either entirely wrong, or at least backward. That is, dysfunctional sense of smell might contribute its part to social impairment. Not the reverse.


Chloride accumulation in mammalian olfactory sensory neurons.
Kaneko H, Putzier I, Frings S, Kaupp UB, Gensch T.
J Neurosci. 2004 Sep 8;24(36):7931-8.
PMID: 15356206 Free Article

Calmodulin contributes to gating control in olfactory calcium-activated chloride channels.
Kaneko H, Möhrlen F, Frings S.
J Gen Physiol. 2006 Jun;127(6):737-48.
PMID: 16735757 Free PMC Article

Evidence for a role of GABA- and glutamate-gated chloride channels in olfactory memory.
Boumghar K, Couret-Fauvel T, Garcia M, Armengaud C.
Pharmacol Biochem Behav. 2012 Nov;103(1):69-75.
PMID: 22910533

Co-existence of cationic and chloride components in odorant-induced current of vertebrate olfactory receptor cells.
Kurahashi T, Yau KW.
Nature. 1993 May 6;363(6424):71-4.
PMID: 7683113

Nonlinear amplification by calcium-dependent chloride channels in olfactory receptor cells.
Lowe G, Gold GH.
Nature. 1993 Nov 18;366(6452):283-6.
PMID: 8232590

Neuronal chloride accumulation in olfactory epithelium of mice lacking NKCC1.
Nickell WT, Kleene NK, Gesteland RC, Kleene SJ.
J Neurophysiol. 2006 Mar;95(3):2003-6. Epub 2005 Nov 30.
PMID: 16319203 Free PMC Article

- - - - - -

Dual modulation of inward rectifier potassium currents in olfactory neuronal cells by promiscuous G protein coupling of the oxytocin receptor.
Gravati M, Busnelli M, Bulgheroni E, Reversi A, Spaiardi P, Parenti M, Toselli M, Chini B.
J Neurochem. 2010 Sep 1;114(5):1424-35. doi: 10.1111/j.1471-4159.2010.06861.x. Epub 2010 Jun 14.
PMID: 20557424

Ion activities and potassium uptake mechanisms of glial cells in guinea-pig olfactory cortex slices.
Ballanyi K, Grafe P, ten Bruggencate G.
J Physiol. 1987 Jan;382:159-74.
PMID: 2442359 Free PMC Article

Unique clustering of A-type potassium channels on different cell types of the main olfactory bulb.
Kollo M, Holderith N, Antal M, Nusser Z.
Eur J Neurosci. 2008 Apr;27(7):1686-99. doi: 10.1111/j.1460-9568.2008.06141.x. Epub 2008 Mar 25.
PMID: 18371079 Free PMC Article

The Olfactory Bulb: A Metabolic Sensor of Brain Insulin and Glucose Concentrations via a Voltage-Gated Potassium Channel.
Tucker K, Cavallin MA, Jean-Baptiste P, Biju KC, Overton JM, Pedarzani P, Fadool DA.
Results Probl Cell Differ. 2010;52:147-57. doi: 10.1007/978-3-642-14426-4_12. Review.
PMID: 20865378 Free PMC Article

Jeannette Bishop

There are days when I can absolutely agree that "social impairment" is "at the heart of ASD," that is as a society we are so socially impaired that we blindly chronically poison our young, seemingly with some degree of OCD about staying blind about it, and then perseverate on the effects on social interaction in those most impacted (if not in everyone).

I wonder if researchers would have any insight on what occurred to cause a child who never gave any indication that she had a sense of smell, to start screaming and running from the room when her mother is cutting up fresh garlic from a couple of yards away, this after a few weeks on GFCF+ diet?

cia parker

At the other end of life, inability to smell and taste things is an early symptom of Alzheimer's. My mother started saying nearly twenty years ago that her "taster" no longer worked, and she couldn't taste her favorite foods the way she used to. And she lost her ability to discern smells as well. When I later read that this was a common feature of Alzheimer's, I thought, well, it must be caused by the vaccine mercury poisoning which caused her impairment in smelling and tasting. It caused extremely severe permanent insomnia in me as well, suddenly, starting right after a fever pulled stored vaccine mercury from my bones. It took me MANY years to learn that the vaccine mercury was the cause. My father used to say to just relax and think pleasant thoughts and I'd be able to fall asleep. Ha ha. Later, when he was paralyzed by a mercury-containing flu vaccine, he developed severe insomnia, and now I realize it was from the goddamned mercury in all the yearly flu vaccines he got for twenty years.


Thank you for setting things straight! I think the dysbiosis causes the sensory problems such as the sniffing. It is similar to how many of the kids will touch everything. The sensory problems are not fun for the kids or "interesting". They are an awful thing to experience. I find a lot of research tries to dehumanize our kids and say that their problems are due to a lack of social understanding rather than medical issues. This makes it easier for people not to care and for society to not look for ways to help find medical solutions. It's nice to see that more researchers are linking bad bacteria to autism. I wish they would also do studies that looked at solutions to dysbiosis. Isn't it morally imperative that they do so? My son did not respond to gut treatments and diets recommended by DAN doctors (at least not positively or permanently). I still believe that dysbiosis is his main problem. Why is it that the probiotics that they talk about in the studies are not available in the health food store or even for sale online? I wish there was more information about a greater variety of strains of probiotics. Maybe it could help more kids!

Theresa 66

Also a connection with metals and olfactory dysfunction...Our sons' cadmium was off the charts and there is an animal study about that one. Its sick the reporters can't find what I can just by searching on net. With very limited time, too. Of course, maybe they are "Bought" too. I dare You reporters to actually study our plight and see the damn writing on the wall. Instead of "Greater Good" they should just tell the truth and say its for the "Greater Greed".


I have an objection to these studies, and that's the continued obsession with young children. All studies about autism should involve adults. There may be quite a few differences between children and adults, but it you don't look, you won't find them. Real science requires the study of the entire population and not just a convenient subset. Cynical person that I am, I can't help but wonder what nasty things could be proven with adults that can be covered up by focusing on young children.


Yes, great article!

Those with Huntington's Disease also have olfactory impairment, and have a history of it before motor impairment sets in.

I think it could be important as an early indicator, a "red flag" if you will, maybe a more easily recognized sign than "eye contact" or "pointing to an object" for pediatricians.

If this was added to an autism checklist for babies, it could be a point in a decision tree leading to a test for p-cresol levels and immediate probiotic intervention.

I get the whole c-difficile connection, but I suspect that maybe we hear about that because c-diff already has a long history of mischief making and that future microbiome research could end up revealing other bacteria that produce the toxin and maybe other similar ones.

Which leads me to the question of epigenetics and how one can have biomarkers for something, but whether they are activated or inactivated depends on environmental triggers.

In other words, is whether p-cresol (or other toxins) is being produced by bacteria in the gut dependent on whether or not that bacterial strain(s) has been exposed to toxins such as mercury or aluminum or polysorbate 80 or formaldehyde, etc.

Also, if bacteria or virus developed p-cresol production as some sort of survival mechanism in their forced path towards survival through antibiotic/antiviral medication resistance or Glyphosate exposure genetic changes/resistance, and we know that bacteria in the gut share information, is the trait for p-cresol production then spread inside the gut?
(Did GMO food technonology accidently spread a p-cresol producing bacterial trait along with it's toxin producing genetic traits that were supposed to originally eliminate the need for pesticides because ...)

Hypothetically, could then vaccines be responsible for autism rates escalating in an epidemic like fashion because they are causing something like p-cresol production that could, hypothetically, be spreading through families, which are in close proximity to each other (making it mistakenly appear "genetic") but manifesting itself as different chronic diseases in people of different ages - such as all the other ones listed which also have olfactory issues. Or vice versa - if an adult has a vaccine, which results in p-cresol producing bacteria being created in their body, and spreads that bacteria in an unexpected way, what happens in the person/child who picks it up? Mother/fetus transmission? Many questions . . . Is there a connection between cancer and p-cresol?


Fascinating. Thanks Teresa. We call my son Sniff Sniff Sam. His smelling is at an all time high. Socially his obsessive smelling looks very odd and he clearly does not care. What drives the smelling may very well be physiological.

This was just posted on Mercola's site yesterday.


Great piece!! Yes! Autism should be studied as any other disease is studied. Linking smeel to social impairment is just twisted.

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