In Hong Kong we had the opportunity to meet with Dr. Virginia Wong’s research assistants at the Duchess of Kent Children’s Hospital in Sandy Bay. Our main focus for the morning interview was their clinical research and findings about tongue acupuncture that was recently presented at a parent’s conference on World Autism Day.  Relatively unknown and unpracticed in the western world, the use of tongue acupuncture as a means to alleviate symptoms of autism plays an important role in China.  Here in Hong Kong, traditional Chinese medicine is an integral part of everyday medical practices. So as autism has recently become more prevalent, it was only natural for Chinese doctors to pursue other means of treatment for the symptoms of autism.

To understand the effects that acupuncture has had on children with autism symptoms, it is best to first learn about the steps taken to diagnose and treat an autistic child in the Hospital. 

Step 1: Diagnosis

-          Parents will receive a referral from their pediatrician to take their child to the Child Assessment Center at the Duchess of Kent Children’s Hospital.

-          One of seven centers doing autism assessment in Hong Kong – Special services are funded by the government and is part of parent’s health care program.

-          All Child Assessment Centers in HK us ADOS to diagnose (http://en.wikipedia.org/wiki/Autism_Diagnostic_Observation_Schedule)

-          After diagnosis, the child undergoes a number of private sessions to determine if they are a candidate for acupuncture.

 Step 2: Treatment

-          The course of treatment ranges from 12 to 24 sessions depending on the subject’s age and level of autism.

-          Acupuncture points vary per treatment of social interaction, attention span, language comprehension and physical development.

-          Acupuncture in five areas of tongue, 5 times per week for 40 sessions.

-          Needle not fully inserted, only quick in and out, not painful for child.

 Step 3: Results

-          When combined with western approaches, tongue acupuncture has presented significant findings.

-          A PET scan of the brain is done before, during and after treatment.  In 2 weeks, certain areas of the brain are more active (by .0003%).

-          Eye-hand coordination improvements and hand flapping stopped during treatment.

-          Use of speech improvement and decrease in repetitive behavior.

-          Duchess of Kent has collaborated with another hospital that has done acupuncture in the head, hand, foot and ear.

-          Acupuncture for autism is still new and experimental and few cases have been seen, with only a small percentage of improvements.

-          Still testing why some children respond better to acupuncture than others.

 EARLY INTERVENTION

Another interesting topic of conversation during our meeting was Early Intervention and how doctors and hospitals have created many programs for autistic children under the age of three.  There are currently no government services for autistic children under the age of three, but the Duchess of Kent Hospital offers private 8 week training programs using the A123 approach.  This new program created by doctors in Hong Kong is detrimental to the development of a child with autism. The sooner a child is diagnosed with autism, the sooner treatment begins and the better his/her chances of improving symptoms.

 The A123 program was also presented on World Autism day and involves the improvement of eye contact, gestures and vocalization in autistic children ages 3 and under.

-          Eye Contact: Doctor’s will call child’s name and hold out their favorite toy.  Once child makes eye contact, doctor will give them the toy = Reinforcement.

-          Gesture (Pointing): Use of bubbles and posters to teach children how to point with index finger and say “want” = Association. The ability to point to object, after 2 or 3 times child will learn to point to what they want instead of grabbing = Behavior Modification.

-          Gesture (Hand): Also teaching to open palm and say give, other than screaming when child wants something.  This alleviates stress on parents and reduces frequency of temper tantrums.

-          It is difficult to work with older children, although some 4 year olds have been allowed into the program.

Once again, thank you to Stella, Queenie and the entire team!

Shanghai has some of the most beautiful and interesting architecture in the world, so on our first day in this big city we decided to head to Xanadi Square for a small lunch. Shanghai has built many small “cities” within a city, all complete with ridiculously large shopping malls. The Chinese LOVE to shop, and there are millions of them. Consequently China has about 40 cities with a million or more people. Shanghai is one of the larger cities and therefore boasts “many many” (as the Chinese would say) street markets. We spent the rest of our day wandering through secret doorways and side streets in Shanghai’s markets and passing by the endless amount of street vendors selling everything from roast octopus on a stick to Chinese fans. Not only does Shanghai have entire streets dedicated to shopping but also entire streets dedicated to food. Our hotel was located near one and so we wandered over at night when Shanghai comes alive with fluorescent lights that beckon you to each restaurant. We decided to eat at a 3 story Chinese restaurants complete with tanks full of fish and sorts, all ready to be cooked and brought directly to our plates. As seeing our dinner before we ate it did not sit right, we opted for chicken and noodles instead.

The next day we sought out a local ferry to take us to Dongtan – an island near Shanghai where the first “green” city in the world will be built. Construction has not begun on the island as of yet, a few small villages and vast wetlands are all that exist at the moment. We spend the afternoon exploring the untouched island taking pictures and writing down bits of information for an article Patrick will write about Dongtan. In one of the “bird sanctuaries” we are not able to spot any birds but we do happen upon the strangest animals I have ever seen. Little fish in shallow muddy water with two feet! The strangest things with big round eyeballs on the tops of their heads, they looked like they were straight out of an episode in the Simpsons. My guess they are mutants because of the high amount of pollutants in China’s air and water.

(May 30th – June 2nd)
In continuing Patrick’s quest for “green” interviews to add to his growing bank of intelligent articles, we stop by Arup’s Shanghai offices. To fill you in, Arup is one of the biggest architectural firms in the world, with their recent claim to fame being the Beijing 2008 Olympic “bubble building” – we even got to view the model at their offices. They have offices all over the world that employ some of the most creative architectural minds, and thankfully it only took a little convincing for Patrick to meet with the project manager for 20 minutes. Great Success!

We spend the rest of the day exploring different parts of Shanghai and marveling at the contrasts between old and new. The city exhibits so much modernity, but at the same time you can turn a corner and an ancient temple sits in front of newly built skyscrapers in the background. Our exploration was capped off by Patrick confronting a candy shop owner who over charged us for gummy bears we didn’t even want. Are you sensing a pattern here? The Chinese love to cut corners and are sneaky about charging you that extra Chinese Yuan, but we are catching up to you! That evening we ate at a vegetarian restaurant, these are popular and everywhere in China, serving up all the “mock” meat you can think of – chicken, duck, pork etc. We ordered the chicken and I swear it tasted like corn dogs, strange.

The next day we indulged ourselves in more architecture, as this city was handing it out by the handful. We strolled “The Bund” which is famous in Shanghai and host some of the most ridiculous buildings you have seen along the river. The skyline is outrageous, you could literally stare for hours at the space age lights, and we did. We took the Bund Sightseeing Tunnel which takes you underground and “through” the river to the other side. Below ground was a whole tram system set up to carry you from one side to the other through electric lights and laser beam shows. Still, the best part was just to mosey down the concrete path by the water and check out the action. We also fit in some cute couple shots, awww!

Today we fly to Guillin to make our trek to Yangshou. But the journey would not be complete without a quiet meal disturbed by my “new friend” who decided that our table was also hers. While I am finishing my drink she slams her bags down and takes a seat, and in my head I am thinking “How nice of you to join us!” Patrick could not help but take a picture, she does not look too happy. We laugh every time we look at it.

(June 2 -4th)
From Guillin we are able to make our way to the quite mountain town of Yangshou, China. After spending the last few weeks in large cities we decided we needed and break and so we headed for the countryside. What we didn’t know is that every city in China, no matter how remote, is filled with people. They all want to take pictures with you, and they are everywhere! Which I guess makes sense considering the country’s population is almost 1.4 billion people. Yowza.

Even so, the small village of Yangshou has enough charm to keep us occupied for a few days. The town is littered with small coffee shops that fashion foam hearts on their lattes, locally owned book exchange stores where the owner will fry you an eggroll if you ask, and restaurants overlooking limestone karsts that serve banana pancakes all day and night. Our favorite was a store selling obviously fake sunglasses, including a pair of green Prada’s that the two ladies insisted were the “new style.” Everything is ALWAYS the new style. Persuaded by their excellent sales skills, we fell victim and posed for a few photos. Classic.

My absolute favorite part of Yangshou was that you could rent bikes for $5 dollars a day to explore any part of the countryside you wanted to. Once you got away from the shops and restaurants and into the countryside, the scenery was absolutely beautiful. We biked past rivers, water buffalo, village huts, and the occasional bamboo boat floating lazily under the hot sun. Thankfully a lot of our bike riding was downhill, sending cool breezes across our face and through our hair. The experience was amazing and one to be remembered.

After settling in for the night in our traditionally decorated hotel room we awake the next morning and decide to explore and visit the Forbidden City. Completely surrounded by a moat, the Forbidden City was just as its name says “forbidden” to all outsiders for many years and was home to the emperor of the Ming and Qing Dynasties. The sheer size of this large tourist attraction was unbelievable – we would know because upon arriving at the wrong entrance, it took us almost an hour to walk to the other side of the City to gain access at the correct entrance. In order to blend in with the dozens of tourists who flood this place daily we purchased some earphones and an audio guide, it was a good look. We spent our day under the intense summer heat and amongst throngs of Chinese tourists who will push you, literally, out of the way with their umbrellas to look inside one of the dozens of temples. The architecture was beautiful with classic Chinese roofs, large stone staircases, red, greens, and gold colors, and of course Patrick’s favorites where the Chinese Lions who protected each of the sacred temples. Even better was Tiananmen Square, the largest square in the world (take that Europe!) with the HUGE picture of Chairman Mao.

The only disappointment to walking in the same footprints as the great Chinese emperors was the stunning amount of air pollution. We were definitely not prepared for the thick yellow smog that would soon overtake our entire travels through China (Los Angeles has nothing on China). Still, we could not let pollution or acid rain ruin our stay; we were dedicated to the ultimate China experience and what better way to do this than to eat some traditional Chinese food. Throwing our guidebooks aside, we walked down the street in search of the perfect restaurant. We stumbled upon a large open restaurant filled with locals and a large sign in Mandarin on display outside, no English here – this was the place! The menu was extensive, the biggest menu we have ever seen, a book filled with numerous pictures of roast duck, fried pork and the occasional mention of “shark fin soup,” “roast pig knuckles” or my favorite “slightly overcooked balls.” We were quick to play it safe, ordering fried rice, chow mein, dumplings, a vegetable dish and two large beers from our looming waitress who demanded “MONEY NOW” right when we placed our order. We could not help but laugh at the lack of please and thank you’s, China is hilarious! The best part was that our four plates of food and two giant drinks were $8 US dollars. We love this place.

(May 24th -25th)
The next day we venture out to some of the infamous Chinese street markets. First stop is the outdoor Puanyuan Market. Close your eyes and imagine intense heat, rows of hawkers under umbrellas selling everything from red Chairman Mao alarm clocks to large jade Buddha statues, people pushing and yelling, bargaining, sweating, spitting and hunching over plates of noodles with chopsticks slurping away the afternoon. This is China. And to add to the experience we buy a plastic bag full of fresh homemade dumplings from an old woman off the street for 15 cents, the perfect chopstick lunch. Yummy!

Next stop is the Temple of Heaven, a beautiful display of more ancient Chinese architecture with long hallways stretching between each temple door. The open hallways are filled on weekend afternoons with GREAT performers, dancers, singers and the occasional raucous group of men playing Chinese checkers or a game of cards. The main attraction of the Temple of Heaven is the climb to the Circular Mound Altar, where the Emperor stood between Heaven and Earth, almighty above everyone else, it is rumored that even your voice becomes louder when you speak upon it. I personally could not hear my voice over the umbrella brigade of Chinese tourists, but the thought was nice. After many uses of my elbows and other limbs to push, I triumphed over the squad of red vests to my right and landed on top of the Circular Mound Altar, VICTORY!

(May 26 – 27th)
Today is our favorite part of Beijing; we get to see the Great Wall of China! Thank goodness for a nice couple we met at our hotel, Mark and Alana from New York, who told us about the best part of the Wall to visit. Thankfully Alana has been to Beijing 3 times and filled us in on the most crowded and touristy parts of the wall, telling us to steer clear and that a much better and quieter part of the wall was just as accessible. We hired a taxi to take us to the wall for the day, the only option since we were not one of the dozens of tour groups who flood the Badaling portion of wall every day. After the hour and a half drive we pulled up to the bottom of the hill and as we hiked to the entrance our excitement was building. After arguing with a cranky restaurant owner about over priced dumplings, we decided to be adventurous and hike up to the 1,000+ steps to the wall rather than taking the “lazy people” tram. The hike was strenuous, but worth it. We arrived at a part of the wall where literally nobody was, and immediately said hello to our favorite Deli back home. We spent the day under China’s summer heat, sweating and straining to see other parts of the wall through the thick yellow fog that surrounds Beijing. We hiked from the top to the bottom of each part of the wall, climbing some of the steepest steps I have seen. To even imagine how the Wall was built by hand with no machines is just incredible. Even better was knowing that we were walking the same steps that some Chinese warriors used to defend themselves against Mongolian attacks. We pretty much had the wall to ourselves, it was amazing; an experience that I recommend to anyone who would enjoy a slice of history.

That night we enjoyed one last good dinner before saying goodbye to Beijing. Mark and Alana took us to a riverside meal where we enjoyed strange pizza concoctions over good conversation and laughed about the “Engrish” menu. We said good bye to our new friends and hello to Shanghai tomorrow!

The Stars and Rain School in Beijing, China has worked for over 15 years to make a difference. There are hundreds of thousands of families in China who are affected by autism and face a desperate situation. They have little or no knowledge of autism and do not know how to teach or cope with their child. Also, these families are largely excluded by a society that does not understand or accept them. It is widely understood that autism in China is “in need of more attention.” (http://www.chinadaily.com.cn/citylife/2008-04/02/content_6586642.htm)

The Stars and Rain program was the first nongovernmental organization in the People’s Republic of China to address the needs of children with autism. The founder of Stars and Rain, Tian Huiping (Hope), is an amazing woman with an amazing story (http://www.expatsinchina.com/life/education/special/xingxingyu.html). Tian is a true pioneer and inspiration to others around the world. Through my research I have found that the Stars and Rain program is the only school in China dedicated to helping parents understand autism and to helping their children overcome their symptoms. The parents are able to develop their own skills to educate their children. The school has helped over 2,000 families to date and has set a foundation for more success, knowledge and education to come.

I invite you to read about the Stars and Rain School and to pass on the word that it only takes one person to inspire hope and to create change for autism in our world.

Main Page: http://www.guduzh.org.cn/Default.aspx?alias=www.guduzh.org.cn/English
In Chinese: http://www.guduzh.org.cn/

The next morning, still jet lagged, we wake up at sunrise (not by choice) and decide to take advantage of the situation by spending the whole day exploring the city. First on our list is the Sunshine City Building, 80 floors that includes our hotel as well as a huge underground shopping metropolis that links to the closest metro stop almost 6 blocks away. Tokyo has dozens of these underground shopping malls and underground walkway systems to and from metro stations and major landmarks, which is a smart way to divert crowds from the already packed streets (and also serves as an alternative route if it is raining). We learned of this advantage our first day when a typhoon hit off the coast of Tokyo causing heavy rain with violent winds and broken umbrellas. It is amazing that you can get just about anywhere in Tokyo by walking underground through giant clean tunnels that house excellent restaurants and shopping. The metro system itself is meticulously clean (the opposite of subway stations in New York) with places to shop and eat. Some of the best sushi we had was $3 in a subway station that was clean, fresh and amazing. We used the subway all day, to take us to our destinations of choice among crowds of polite Japanese.

Our first stop was the Tokyo National Museum located in Ueno Park. This museum housed the Japanese Samurai exhibit that was quite interesting. We also had a little fun. After taking most of the morning to explore the museum and its thousands of Japanese artifacts, we had worked up a hunger and craved good fresh sushi. So we headed to the famous Tsukiji Fish Market. Although the market closes in the morning, if you explore the back alleys nearby you find dozens of restaurants serving fresh fish from the morning = the freshest fish in the entire world. Our lunch was beyond the best sushi we have ever had.

After lunch, we headed over to Roppongi Square to marvel at the high buildings. At dusk we head to Shibuya, with a quick metro ride over. We are also beginning to notice that people sleep everywhere and anytime in Tokyo. Whether it be in a museum, a parked car, their motorbike or the subway they have no shame in taking a quick snooze in public. Is it because everyone is so hard working in Japan? Whatever the reason, we scored some amazing photos of this phenomenon. Anyway, on to Shibuya Crossing – the biggest crosswalk in the entire world. We decided to post ourselves here for a couple hours to watch the chaos. Millions of people cross this crosswalk everyday and it is amazing to watch when the light turns green. Patrick and I played a fun game of “Where’s Waldo in Japan” with Patrick as the lead role. Can you find him in this picture? I swear it was really funny at the time. We dubbed ourselves “Patzilla” and “Blondzilla”. We also took the time to marvel at the incomparable Tokyo style of dress among young twenty year olds on the street. We have never seen the style of dress or hairstyles quite like the young Japanese. It was pure entertainment. A great end to a great day.

(May 21 – 22nd)
The next morning the sun came out, so we headed to a large park near Shinjuku and Shibuya complete with Japanese, French and English gardens to wander around in. The best part of the afternoon was a group of well-behaved and exceedingly cute school children in green, blue and orange uniforms who followed each other in single file lines and waved hello to us as they passed over the Japanese bridges. I am convinced that Japanese children are the cutest little things. We enjoyed the peaceful garden for most of the morning, exploring pathways, wandering the extensive rose gardens and peeking our heads into Japanese Tea houses. The park was also a local spot for artists to sit, sketch and paint some of the beautiful scenery.

After the park we started our search for some traditional ramen noodle restaurants, which proved to be really easy – all we had to do was follow the “slurping sounds.” The Japanese are really into their noodles, and with chopsticks in the right hand and spoons in the left, they slurp away piles of noodles on their lunch break. We ducked into a small ramen restaurant with no English menu, but the smells where so amazing we pointed to what looked good. It turns out that the Japanese do ramen just as well as they do sushi, because our lunch was delicious. We watched the locals sitting next to us to master the chopstick, spoon and slurping techniques.

We then made our way over to Sensoji Temple and the surrounding shopping streets. Here, you can not only shop for souvenirs such as chopsticks, fans and Japanese lanterns, but you can also sample local food and drink. We enjoyed some hot pressed cookies fresh off the “cookie machine,” which was very popular, and also sampled some delicious fresh green tea served by smiling Japanese ladies in traditional robes. 

Our next stop was the most exciting part of our short trip in Tokyo because we had tickets to Sumo! Keep in mind that Sumo only happens once a year, and unlike American football and basketball that lasts a whole season, Sumo only happens for a mere 8 days. Our timing in Tokyo couldn’t have been more perfect. After finding our seats, we settled in with some Japanese beer and spent the remainder of our afternoon watching these giants wrestle each other in the ring. After hundreds of years, the tradition of Sumo is still the same, including their traditional garments, the presentation and the salt-throwing before each match. We truly felt blessed to be watching such an ancient tradition in person. We capped the night off with another cheap but excellent sushi dinner (you can never have enough sushi) and bid our farewell to Tokyo, sad!

(May 10 – 11th)
Today we head to a section of town in Rio called Santa Teresa. A beautiful town filled with old colonial mansions and cobbled streets winding up to the top of hills that overlook the city of Rio. We take the metro into town to catch the 40 cent yellow tram up to Santa Teresa. True to the disorganization of everything in Rio, the line for the small tram stretches around the corner, and when the tram is boarded, twice as many people are let on then can fit.  People are hanging off from all directions the entire way up the narrow hillside, classic Rio. Santa Teresa so far, other than the beach, has become my favorite part of Rio. The scenery is classic colonial, with endless small streets to wander and enjoy.  Patrick and I immediately followed the sound of a samba band playing in a small café.  We climbed the steps and settled in to enjoy some live music. When some rain started to drizzle, we ordered coffee and hot chocolate to waste the day away under an umbrella surrounded by tropical rain and samba beats.

That evening we ate out at a local Churrascuria in Ipanema.  For those who do not know what a Brazilian barbeque is, let me explain.  The first thing they hand you when you walk in the door is a card that is green on one side for “yes, more meat,” and red on one side for “I am full and about to explode.”  This card is set out on your table, and when the green side is up, men in white shirts and black bowties parade around with giant sticks of meat and swords to cut you slices of whatever you fancy onto your plate. Even better, there is an all you can eat salad bar with veggies, and hummus, and deserts, and yes, even fresh sashimi and sushi. Is your mouth watering yet?  After we rolled out of the restaurant, we met up with Damon and Jackie and their friend Hanata (I probably spelled this wrong) for some late night samba music and dancing in Lapa.  Although most of our night was spent drinking, chatting and enjoying the action on the street, we also made it in to one of the samba clubs for some dancing.

The next day we arose and met with Damon and Jackie for some local brunch.  After taking it easy for the rest of the day we headed to the Faria Sao Cristavo on the outer border of Rio for some local music and dancing.  And when I say local, I really mean it.  We were the only gringos around hundreds of Cariocas dancing and drinking and having a good time.  The amazing thing about Brazil is that all people from ages 17 to 70 come to the same concerts and dance on the same dance floor.  The stage was taken by accordions, guitars, pianos and even a triangle.  The dance floor was filled with all people, all ages and all sizes.  Immediately, Jackie was swept on to the dance floor by a male suitor and then next it was my turn to spin around with a local. The boys got a kick out of this, and let’s just say that samba dancing should be left to the Brazilians.

(May 12 – 15th)
The next morning we say a sad farewell to our new friends Damon and Jackie and promise to keep in touch.  It is now off to a highly recommended, from locals and travelers alike, beach town of Buzios just down the coast of Brazil.  Patrick did some careful research to find a nice hotel with the best low-season discount.  Our beautiful Posada called Baia de Jao was everything we could ask for and more with panoramic views of the ocean and spectacular cliffs that hug the coastline.  To top it off, we have a hammock on our deck to relax and enjoy the evening sunset.

The next morning we head down to the beach, rent some chairs and nestle in for an afternoon of sun and stunning views.  We immediately make friends with Maria, a local lady selling some yummy fresh sandwiches that we savor for lunch. I immediately love Buzios, the town has a way of lulling you into a trance of relaxation.  The weather is perfect, the water is warm and the hours in the day go by slowly. Patrick even takes it upon himself to make friends with a local to skimboard for the afternoon.  Although we think he may have broken his board, everyone is still friends by the end of the day. We spend the evening shopping for Havaina flip flops and drinking fresh Mango smoothies.

On Tuesday we decide to rent a buggy, based on the advice of Damon and Jackie, to cruise around to all the islands beaches.  We obtained a map from our hotel, and trot down to the local rental place for our new vehicle.  A buggy, described at best, is a vehicle with no top, no windows and no doors that is perfect for cruising around a small beach town. We take off on our own beach journey and explore the hidden beaches of Buzios.  Most beaches are found by hiking up or down tiny overgrown trails, including one where we found one lone man selling caipirinhas, except the small beach was empty.  What a life! This guy just sits and does nothing all day.  Most of the beaches we explore are totally deserted, and some are scattered with a few people here and there. We finish the day off with some acai and dulche de leche ice cream while watching the sunset and reminiscing over our beach hikes. Sadly though, it is time to leave Brazil and South America!  Next stop is Asia.

(May 2 – May 4th)
On Friday May 2nd we leave on an early flight out of Sao Paulo to Rio de Janeiro, arriving in the early afternoon.  We catch a cab from the airport and hand the address of our apartment to the weary cab driver. Vamos a Praia! We arrive in town and the taxi slowly creeps down our street looking for our address. We find it, but the building looks more like an office than an apartment building. Hmmm, Patrick jumps out and walks inside… the cab driver pretty much throws us out of the cab with our bags on the street so it looks like we are stuck here.  Thank goodness, this is our apartment and we settle in, quickly changing into our suits to head to the beach.

Before we hit the sand, we hit up one of Rio’s infamous juice stops called Polis Sucos.  Keep in mind that the Suco Stands (Juice Stands) in Rio are not small time Jamba Juices, these places stock fresh Amazon fruit daily and so the smoothies are AMAZING. We order up mango and acai juices along with two meat and pineapple sandwiches. The thing to do here is stand while you eat at the counter and chat with your fellow diners. Our favorite was our guy behind the counter who didn’t speak English, and since we did not speak Portuguese we exchanged numerous thumbs ups for the next week.

The beaches here are everything you see in pictures and more. The next few days are sunny and temperate with some cooling winds along the sands of Ipanema Beach where we are staying.  Our apartment is a two block walk from the beach and we quickly learn our way around. Spreading down the entire beach of Ipanema are vendors who rent chairs for the day to locals and tourists alike. We find one we like for cheap and we set up our chairs.  The first thing I notice looking around is that everyone has their chair facing the street and not the ocean. Strange? You would think, but it’s because everyone is facing the west for the sun and away from the ocean. Too funny. 

On Sunday we head to Ipanema’s “Hippie Fair” just a 15 minute walk away in a local square. Vendors come here to set up shop every weekend to sell things from leather purses to glass jewelry to to Bahian food from the north. We spend most of the day here browsing and soaking in the culture before heading to the local grocery store to stock up on breakfast supplies.  Our mornings have become routine with tropical fruit, yogurt and cornflake breakfasts.  Instead of milk, Brazilians pour flavored yogurt over their cereal, tudo bem!

(May 5 – 7th)
The next day we spend at the U.S. consulate to obtain more passport pages for Patrick and the Chinese consulate to obtain our Chinese visas for the next leg of our trip. We make use of the metro and head to downtown Rio where building and concrete dominate instead of sun and sand.  The U.S. consulate was a success with more passport pages for Patrick.  The Chinese consulate was not so easy.  After spending the entire morning printing forms, completing forms, making reservations and printing reservations, then translating with the Chinese-Brazilian counter women who speaks no english, we learn that Americans cannot obtain a Chinese Visa in Brazil. WHAT! Yes our visas will have to be obtained in the United States. Ouch.

To shake off the frustration of no Chinese Visa, we head back to Ipanema for some much needed acai (a delicious purple Amazon fruit).  We take our sucos to go and stroll the beach at sunset with some beautiful views over Ipanema and Aproador, the neighboring beach before Copacabana. We also browse for a “man-kini” for Patrick, a must if you want to fit in on the beach here, where men stand and pose ALL day. And of course, because it is Cinco de Mayo (note: this holiday is not celebrated by South America), we decide to seek out a Mexican restaurant to celebrate over tacos and beer. Turns out there is only ONE Mexican restaurant in the entire city of Rio. So funny!  And so worth it! There is nothing like chicken fajitas and Mexican beer to end the long day. Aaah!

The next day we headed up to Pao de Azucar (Sugar Loaf Mountain) to enjoy some stunning views of Rio below. There are two cable wires connected from the tram station below to the top of the mountain above. These trams dangle from these wires and the enclosure is 360 degree windows for maximum viewing and vertigo, yikes!  Once at the top the views are stunning and we enjoy hot chocolate while watching the sun go down behind the beaches of Copacabana and Ipanema below. 

The following morning we are off to the beach again, which of course is our favorite activity.  The best part about the beaches in Rio is the local vendors who troll the beaches all day, back and forth and back and forth selling yummy coconut milk among other food, drinks and trinkets.  You may be thinking Mexico, where they sell horrible woven bracelets and water while yelling in your ear, but Brazil is completely different.  Not only are the vendor’s chants not annoying, but they are funny, and the stuff they sell is GOOD. There is fresh Acai (“Acai, Acai, Acai, the best… on the beach! Granola, y miel! Acai!”), or there is fresh grilled shrimp (“Camarao, Camarao, Camarao, Camarao”), the vendors yell over and over again. The beer is cold, the food is good and you can even buy clothes on the beach! Cute white linen dresses or any soccer jersey of your choice.  Our favorite was the huge man with the bathing suits. Our hero!

We packed up from the beach early today and headed up to Cristo Redentor (Christ the Reedemer) perched high above the city looking down on all of Rio de Janeiro. While we are taking our photos as the sun goes down, we are approached by an American couple whose camera battery died.  Discovering that we own the same Canon camera, we lend them our battery and a good conversation starts.  We share a cab with Damon and Jackie back down to Ipanema and agree to meet for drinks the same night. Drinks at a local brewery called Devassa are followed by a local samba jam session in Lapa.  Our conversations with Damon and Jackie were easy and natural, instant friends! Or as the locals would say, TUDO BEM!

(May 8 – 9th)
The next day we meet up with Jackie and Damon to go hang-gliding, something I have been waiting for and so excited about!  We take a cab down the beach in the late afternoon to the bottom of the cliffs to meet our instructor.  It turns out that the cab driver tries to rip us Gringos off by charging us hidden fees and dropping us on the wrong side of the beach. Patrick yells, and we trump off trying to obtain directions from locals who have no idea how to translate “hang-gliding.”  We finally make it to the spot and meet up with Damon and Jackie who are gliding down to the beach below.

We drive up 15 minutes in our instructors green truck to the top of the cliffs to get ready for our turn to glide. Alex, the instructor, explains everything in warp speed and before I know it he has me strapped in and we are running of a wooden platform into the sky, ahhh! I didn’t even have time to think and all of a sudden I am flying over a beach and buildings that look the size of ants below. As we come in for the landing, I swear that we are gliding at about 60 miles an hour and as my feet are ready to hit the ground I cringe.  But then Alex miraculously slows the “wings” and we come in for a soft landing.  Jackie and Damon are cheering and I have never felt more incredible about such a cool experience.  Now it is Patrick’s turn!  We settle into a table below and order some beer to wait for him.  Finally we spot him high above and notice that he is more out over the ocean than any of us. Which means Patrick will come in for a beach landing, what an incredible day. 

We take it easy that night and the next day we settle in at the beach again for some people watching. The culture in Rio is incredible, as people parade on the beach in next to nothing no matter the age or body type.  Everyone is so open and friendly here we only wished we spoke the language. At least we know the important words like “obrigada” for thank you and “bom noite” for good night!

International Worker’s Day is celebrated today on April 30, 2008 in Sao Paulo, Brazil and I am kindly invited into the home of Dr. Marcos Mercadente on his day off to learn about his autism work and research.  Dr. Marcos Mercadente earned his PHD at the University of Sao Paulo where his focus was OCD research.  Here, his studies of child psychosis are what originally attracted him to autism when the disorder was relatively unknown and little research had been done is South America. Dr. Mercadente also notably worked with Dr. Ami Klim, a researcher at Yale in the United States.  His post graduate work was completed at Mackenzie University in Sao Paulo after Yale in 2002.  Presently, Dr. Mercadente has developed a large research program at University of Sao Paulo that focuses on neurobiological studies (clinical aspects, research etc.).

Over the next few hours I learn about Dr. Mercadente’s influential research, studies and hypotheses as well as autism in the past, present and future in Brazil. As a conclusion to my South American research on autism, my interview with Dr. Marcos Mercadente opened my eyes to the importance of medical research for the future of autism.  Medical research is the engine of societal progress and the foundation for the understanding, diagnosis, treatment and cures for diseases.  A disorder as new and undiscovered as autism is in great need of doctors like Marcos Mercadente and others who are pushing the boundaries for a bright future.

Study:“Eye-Tracking” and Listening

Many of those who are close to autistic children have probably noticed their lack of eye contact in everyday life.  A child who has autism may seem very withdrawn and may not make eye contact with people or talk or play the way other children.  Eye-tracking research performed by Dr. Marcos Mercadente shows that the movement of the mouth when a person speaks is more exciting to an autistic child than the eyes.  In a study of 20 children, autistic and non-autistic, the subjects watch scenes from different movies and their eye movement was tracked by a machine that shows where each subject focused their eyes.  The focus of non-autistic children were on the eyes of the movie actors and the focus of autistic children was on the mouth.  This shows us that autistic children watch the world differently and that the area of the brain used by each child during the study was used much more by the autistic children.  So, what does this mean? It shows us that autistic children may have more neurons than non-autistic children. 

Although this may be true, another study Dr. Mercadente completed with a group in France that the part of the brain that is activated in a non-autistic child is not the same in an autistic child’s brain.  This team of doctors studied the area of the temporal lobe called the STS which is the area activated every time we listen to a voice.  Although this area of the brain was activated in non-autistic children, it was completely unused in the autistic child’s brain. This study suggests that a different part of the brain in used by autistic children when listening to someone’s voice and perhaps they do not connect words to the same part of the brain.

Study: Autism and Population

A pilot study in the small under-developed town of Atibaia, outside of Sao Paulo, screened 10,000 people and showed that 0.8% of the test subjects had either autism or aspergers.  This is in comparison to developed countries whose populations show 0.3% -0.6% of population diagnosed with autism or aspergers. Therefore, it is Dr. Marcos Mercadente’s hypothesis that the population in cities where people are more social (open to more social contact) are less likely to be diagnosed with autism.  If you were to look at the larger scale of comparing countries such as Brazil, Mexico and Venezuela, which country is the most “social” and which country has the most cases of autism and aspergers?  Is there really a correlation? This is a study that Dr. Marcos Mercadente hopes to tackle during his career. There are many broad implications at the time, but with the proper sample sizes and research team, a hypothesis can turn into a full-blown study.

Autism in Brazil

Like other countries in South America, it is the opinion of Dr. Mercadente that most teachers, doctors and parents are still uneducated as a whole about autism.  Brazil can even be considered one of the most advanced countries in South America with a high tolerance and acceptance for different personalities but still the disorder is relatively unknown and not talked about.  Although intervention and diagnosis tools are the same as in the United States (ADOS, ABA, PECS etc.) the cost for diagnosis instruments is very expensive and are not available in Portuguese.  As an example, a family can spend up to $6,000/month on one child and the costs are not covered by the government. Dr. Mercadente is currently working for political support in Brazil and is arranging meeting with the Government and Health Minister to push for funding.

Similar to the other countries I have visited, Brazil addresses the same problems:

• We do not know how many children have autism or aspergers in South America
• Finding the right education program is still a challenging task for autistic children and families.
• More funding is needed to do research.
• Teachers and Pediatricians are not formally trained.

The message that “awareness and knowledge brings change” is very important to remember.  The more we know about autism, the sooner we can diagnose and the sooner the child can be treated.  Autism is a global issue, and global awareness is the key to change.

Published Articles

Dr. Marcos Mercadente has sent me some selections of his published work.  If you are interested in any of the titles below, please email me on the Contact Us page and I will be happy to send you the full article.

1. Non-Autistic Pervasive Developmental Disorders
2. Neurogenesis in the amygdale: A new etiologic hypothesis of autism?
3. Saccadic Movements Using Eye-Tracking Technology in Individuals with Autism Spectrum Disorders.
4. Prevalence of Pervasive Developmental Disorder in Down’s Syndrome
5. Temporal lobe epilepsy and social behavior: An animal model for autism?

Contacts:
Dr. Marcos Mercadente: mtmerc@hotmail.com or mt.mercadante@uol.com.br

(ABRA) Associação Brasileira de Autismo (Deuzina)
Rua do Lavapes, 1123
Cambuci 01519-000
São Paulo, SP
BRAZIL
tel: 55 (11) 242 8822
fax: 55 (11) 270 2363
e-mail: info@ama.org.br
url: http://www.ama.org.br

AMA-Ba - Associacao de Amigos do Autista da Bahia
Rua Macedo de Aguiar, 98 - Patamares
Salvador, Bahia, 41740-085
BRAZIL
tel: 55 71 233-4177
email: info@ama-ba.org.br
 

I am very lucky and enthused to have contacted Dr. Walter Camargos in Belo Horizonte, Brazil who has developed a training video for pediatricians and professionals who lack the basic knowledge about autism.  I have learned from my research in South America that one of the biggest problems is the lack of educated doctors who are unable to recognize and diagnose autism. A pioneer such as Dr. Walter Carmagos has made it possible for professionals to learn firsthand from his educational videos.  I had the chance to interview Walter which I have posted below:

1. Can you tell me about yourself? How long have you worked with autism and where do you work (city and hospital)?  What is your main focus?

I have worked with autism for 15 years.  I currently work in Belo Horizonte in a public hospital in the capital, Minas Gerais.  My main focus of study is precocious diagnosis.
 
2.  How is autism treated and diagnosed in Brazil?

Brazil is a large country and treatments are the same as in the United States: ABA, PECS, ADOS, etc. Here in Belo Horizonte we have made great developments in the area of treatment and diagnosis. This knowledge is dispersed into other areas of brazil that are in need of assistance as well.
 
3. Why did you decide to make the video?

In the past 10 years I have had the chance to speak with many public administrative people who have said: “But autism is so rare … we do not have a real demand for special services for these people … when we have demand we can build these programs…” I have worked for more than 10 years in a child psychiatry public hospital in Brazil. Then I transferred to a pediatric hospital to teach them about the child psychiatry main / worse / disruptive disorders and autism is one of them.
In my hospital I see babies with neurologic disorders, mainly with autism.  As a recognized doctor for autism in Belo Horizonte and Brazil, I see many patients every day and almost all mothers speak badly about the pediatric doctor of their autistic child. I began to realize that many are not properly trained to recognize and diagnose autism.  So I decided act upon this problem by training pediatric doctors.
 
What is in the video?

In the video I show many kids with several autistic symptoms plus mothers speaking about the autism of his child.  My goal is to work with a federal government sector to distribute the video for free to schools and professionals.
 
4. What are the current problems with autism in Brazil? How can these problems be fixed?

We have come very far in Brazil. The clinical diagnosis of autism is not a problem now in Belo Horizonte
 
Our problem is:
1. Precocious diagnosis;
2. Fewer public services available to treat autism / PDD
I think that we´ll can fix it when the demand grows and becomes apparent, then we will have another problem: To train these professionals.

Dr. Walter Camargos Junior:
Telefone: (31)3261-5976
e-mail: waltercamargos@uaivip.com.br
LINK:
http://translate.google.com/translate?hl=en&sl=pt&u=http://topicosemautismoeinclusao.blogspot.com/2007/09/entrevista-com-dr-walter-camargos.html&sa=X&oi=translate&resnum=6&ct=result&prev=/search%3Fq%3DWalter%2BCamargos%26hl%3Den%26sa%3DG%26pwst%3D1

LINK:
www.cantodeanjo.blogger.com.br/2004_08_01_archive.html