Archive for the ‘Asperger’s Syndrome’ Category

MAPS Fall ’14 Conference

Saturday, September 13th, 2014

Twice a year, doctors who are interested in understanding and treating children with complicated developmental issues, convene under the direction of the Medical Academy of Pediatric Special Needs. This is our opportunity to stay up-to-date about the latest protocols, and to speak with specialists from all over the world.

In addition to introducing the biomedical approach to professionals and providing a venue for the spouse and kids, the program includes ‘advanced’ tracks. The highlights of those lectures will be reviewed.

Day 1
Dr. Anju Usman – Down Syndrome
“What does that have to do with autism?” Learning about one neurologic childhood condition helps elucidate normal vs. abnormal structure and function. Besides, there are more than a few patients who suffer from both.

The ever-changing basic science of the brain was reviewed. A medical workup is similar; requiring genetic, metabolic, immune, and gastrointestinal evaluation. Conversely, having discovered treatment for the mitochondrial issues in ASD has successfully addressed various problems for Trisomy 21 patients, as well.

Dr. Giuseppina Feingold – Cerebral Palsy and Seizures
Again, understanding seizure activity in a condition where it is not uncommon, helps our understanding about convulsions in ASD. The lecturer, a pediatrician who practices alternative medicine in a very conventional setting, described her experience with her own child, who has CP.
A thorough review on the use of HBOT for CP was presented.

Dr. Mukherjee (New Dehli) and Dr. Marois (Quebec) followed with their research and positive experience managing CP with HBOT. Somehow, their findings have been misunderstood and misrepresented by the conventional medical community, for variety of reasons.

Dr. Kenneth Stoller reviewed his clinical knowledge and experience with Fetal Alcohol Syndrome. He has successfully treated patients with HBOT and Oxytocin, and has published that research.

Case presentations and discussions – sharing our medical experiences – finished out the day. The 2000 pound gorilla in the room? (hint – it has something to do with autism). Data is lacking.

Day 2
Very exciting! This day’s lecturers are rockstars, as far as researching, teaching, publishing and treating the group of conditions that present as a post-inflammatory encephalopathy. It is rare to be among such experts, so freely discussing their findings and opinions.

The moderator, Dr. Nancy O’Hara described her extensive experience treating patients with these disorders, including her own son. Details are provided about an accurate description, differential diagnosis (“What else could it be?”), laboratory ‘workup’, treatment options (including an additional lecture covering nutritional support) and outcome.

Dr. Tanya Murphy presented a fascinating talk about the overlap between antimicrobials and psychotropic medications. Specifically, certain antibiotics can also have neuropsychiatric effects. Conversely, psychotropic drugs have effects on the inflammatory system. This finding helps explain why the disparate group of medications that we use may have similar effects.

The inventor of the term, Dr. Sue Swedo, a Director at the NIMH, presented the latest about PANDAS. She described the areas in the brain where tics and OCD behaviors lie, and how this manifests as a condition for doctors to investigate, with treatment guidelines.

Professor Madeleine Cunningham, a researcher for over 35 years, gave an elegant presentation that documented the presence of autoantibodies in certain patients’ blood and the CSF, offering evidence that those chemicals signal (or are blocked from) neuronal cells. This work helps our understanding of many of the movement disorders, from Tourette’s to PANDAS.

Case presentations and videos completed the afternoon. The take home message was that doctors should stop asking the question, “Do you believe in PANDAS?”

Day 3
Inflammation

Dr. Rodney Dietert conveyed his understanding regarding the complexity of the functional immune system, and the relationship to non-communicable chronic disease. “The tie that binds,” according to the Chief of Immunology at Cornell.
He presented with the passion and knowledge that only a man who has spent his lifetime in this research could bring.

Harvard celiac researcher, Dr. Alessio Fasano, presented Intestinal Permeability, Antigen Trafficking and Inflammation. The subtitle, “The gut is not like Las Vegas, what happens in the gut does not stay in the gut,” tells the whole story.

Canadian naturopathic physician, Dr. Zayd Ratansi spoke about HBOT and Inflammation. There were lots of associations with medical conditions such as wounds, pain, trauma, cystitis and CP. The only slide about ASD and HBOT slide was Dr. Rossignol’s controversial multi-center report.

Dr. Russell Blaylock, a neurosurgeon, researcher and author, spoke about Immunocytotoxicity in CNS Disorders, elucidating how inflammation is handled in the brain.
He explained why/how systemic disturbances activate the CNS immune system. In turn, ASD patients with inflammation, perhaps elsewhere, have behavioral signs and symptoms. Comments were offered about the risks of the present vaccine schedule on the developing brain.

Although I can’t report that there was a great deal of specific day-to-day information, there was a lot of food for thought, networking, and the knowledge that there an increasing number of serious professionals working on your kids’ difficulties.

Smartphone Rules for Autism

Sunday, July 27th, 2014

There are a multitude of programs designed to engage, and hopefully enlighten communication-challenged youngsters. A great place to start is Autism Speaks’ Autism Apps webpage. That site contains a preferences filter, research ratings, and nearly 600 choices, as of this story.

The most affected and youngest patients with ASD seem to easily learn to navigate to their favorite game or YouTube video. Their facility in this arena frequently exceeds neuro-typical peers.

Since the landscape changes so quickly, specific programs are really not the issue. We have observed a new phenomenon of persistent play in developmentally delayed children who have easy access to their parents’ iPads, iPhones, etc.

Here are some of the issues that parents might consider when the child grabs for that partially broken, heavily armored, totally smeared and nearly unreadable device:

Even 1-year-olds are able to navigate the system. Parents should make sure that children are not merely doing visual-auditory stimming. What appears so cute, at first, can become a major annoyance. For some, just the credits of a favorite video or a certain song may seem quite fascinating. That is just a digital version of watching wheels, or a ceiling fan, spin. It’s not really play, and the time spent with this entertainment should be kept to a minimum.

Metabolic abnormalities found in our patients include a number of nutritional deficiencies. Vitamin D activation comes from the sun, not an iPad screen. Children must go outdoors and exercise. As old-fashioned and paternalistic as that aphorism sounds, it should be heeded, if parents have a sincere desire to help their children enjoy good health.

Try to avoid allowing such a compelling device to become the babysitter. With all of the variety, every child can find one or more apps that tickles their fancy. Busy parents may see the activity as a short break in their day – time to cook, take care of the other kids, or just relax. Unless the child is moved to another endeavor, the pattern could become a preferred, fixed, repetitive action that is difficult to manage.

Watching a small variety of videos, or various games on a device is still playing on the ‘pad. A core deficiency in autism is the existence of a narrow range of interests, so therapies should be targeted at promoting a diversity of experiences.

Apps that encourage learning basic concepts, such as number, color, letter and word recognition, can be a great educational aid. Once those skills are mastered, communication, starting with pointing, and skills that lead to sharing would be ideal.

The ultimate goal as toddlers mature is to be able to learn in a classroom with human teachers and classmates. Electronic programs can help prepare kids for the academic environment, but do the stated gains of any app promote the skills needed to succeed in school; such as, attending to the teacher, following verbal directions, and playing with other children?

Take advantage of this learning opportunity. Help your youngsters to get some socialization out of their digital experience. Join them as they master the games, and try to work on understanding how the app is somehow connecting to your children’s brains.

Smartphone rule #1, is… don’t let the smartphone rule.

Autism Treatments – Natural or Artificial ?

Sunday, July 6th, 2014

The advice given by autism specialists is often subject to second opinions, by just about anyone and everyone. It is not the fault of families who seek more information, nor the doctors who are working to understand the situation.

The conventional medical community has been slow to respond to the epidemic (yes, Virginia, there is an epidemic), with very little information about precise diagnosis, etiology, treatment, or prevention. This has led to a situation in which anyone who even knows someone with ASD, saw a story on TV, the web, or has an affected child (improved or not) has advice. Also, the Internet is a sponge, soaking up stories consisting of unequal proportions of fact vs. folklore.

Diet
Children who test positive for antibodies against specific foods should avoid them. This will result in less inflammation, and therefore more energy for growth and development. The only remaining question should be whether or not there is improvement in some of the signs and symptoms of autism. Parents are a pretty good judge of this.
ASD patients who abstain from foods that lead to elevated levels of morphine due to the incomplete digestion of wheat and/or dairy (“leaky gut“) have a much better chance of getting out of their ‘fog’, leading to improved eye contact and socialization.
The ‘concern’ by the conventional medical community that specialized diets will cause nutritional deficiencies can easily be handled by laboratory evaluation, and intervening with appropriate supplements. Oh, and btw, when was the last time the pediatrician tested for any of these nutritional markers, anyway?
Parents can assess whether simple sugars, such as glucose or fructose, lead to hyperactivity. Importantly, foods that contain artificial colors or flavors represent an extra burden for the body to detoxify.
The reason that the families at The Child Development Center continue to administer restrictive diets is that they see the improvements in their children’s behaviors. Diets are a pain in the ass, but they work.

Sleep
A clerk at Whole Foods told one of our parents that, “The doctor is wrong about melatonin – Valerian root is much more natural.” Melatonin is the chemical that our brain utilizes to control our daily rhythm of waking and sleep. The synthesis of melatonin is fairly simple, and the product is exactly the same as what the brain produces. Valerian root is extracted from a plant, and contains over a dozen different chemicals, some of which may actually worsen symptoms of ASD. The salesperson, etc., assumes absolutely no responsibility for that erroneous opinion.
Chamomile tea is fine, especially for relaxation, and so it may decrease sleep latency (the time it takes to a fall asleep). But, it is a plant product, as well.
Warm epsom salt baths prior to bedtime are great. However, this is not because it sucks toxins out of the brain. Who doesn’t get relaxed from a warm bath, especially those with sensory overload?

Anti-fungals
First, let’s not forget that pediatricians have been overdosing your children with antibiotics for years. Additionally, there are steroids and antibiotics in practically everything that we eat. It is no surprise that yeast overgrowth could be the natural outcome in such a circumstance.
Second, fluconazole (diflucan) is a preparation that The Child Development Center has been utilizing for years without any problems. Hepatic toxicity is avoided by checking liver function tests prior to prescribing the medication; and periodically, thereafter, depending on how often the child requires it.
Potent probiotics and avoiding further antibiotics are the surest way to avoid future yeast overgrowth.
We have explored many ‘natural’ products, including citrus seed extract, circumin, uva ursiturmeric , and others. When ‘yeasty behaviors’ ensue, it is best to ‘bite the bullet’, and give the medicine.
Conversely, stronger medications, such as ketoconazole and Lamisil do not seem warranted.

B12 Shots
“Do we really have to give those shots? Aren’t there oral supplements that have plenty of B12.”
The problem with water-soluble vitamins is not getting them into the body, it’s the prevention of rapid removal. Depositing this useful, safe supplement into fat (the tush), will enable a 2-to-3 day release into the bloodstream. You can’t keep a lollypop in your mouth all day long.
Most importantly, addressing G-I health and optimizing mitochondrial function (with oral glutathione), prior to administering methyl B12, optimizes the chances that this protocol will be successful.

Conclusion
Too few professionals are practicing the medicine discussed by the members of Medmaps.org. We spend hours learning about basic science, months reading and evaluating research, and years treating patients and advising parents. Once a doctor arrives at a your child’s diagnosis and other key issues, a course of action is suggested that produces tangible improvements for many.

Families who are fortunate enough to find a competent physician will do best to take the well-meaning advice offered by others, and the information found on the Internet, with more than a few grains of salt. Concern about whether a treatment is ‘natural’ is not nearly as important as safety and results.

I Flunked the IEP

Saturday, June 14th, 2014

At this time of year, when Individualized Educational Plans are discussed and recommendations are offered about the coming year, parents are often unsure about optimal placement for their children affected with ASD.

If assigned to an Exceptional Student Education classroom with disruptive students, will their child copy the behaviors, in order to gain attention? Is being exposed to a great deal of ‘stimming’ a cause for concern? Will nascent speech be nurtured in a more neuro-typical classroom or ignored in a apraxic group? Are there youngsters who will become friends or others who promote bullying?

This is the conundrum faced by the parents of many of our recovering patients. The medical side of autism and ADHD is my primary concern. However, one family insisted that I voice my opinion regarding their 5-year-old’s upcoming formal classification. I agreed to assist by speaking with the appropriate school staff, including the teachers, administrators, school psychologist, and therapists.

For the first 20 minutes or so, each professional detailed, “hyperactive,” “lack of focus,” “easy distractibility,” and academic performance issues.

“What is your opinion, Dr. Udell?”
My answer, “It sounds as if you are describing the child’s immaturity.”

I expressed that the majority of medical professionals who heard these concerns would most certainly recommend stimulant medications (e.g. Adderall, Ritalin); if not now, then within the next few years. “Oh, no, Dr. Udell,” was the answer. “That’s not what we meant!” Regardless of staff intentions, most pediatricians, child psychologists, psychiatrists and child neurologists give the knee-jerk response – meds.

Recommendations:
Be realistic about what goals YOU expect in the next school year. For young children, speech acquisition and play are the most important skills. Occasionally, no school is likely achieve these goals, and parents should consider other options (home with appropriate therapies).

The school is expected to document progress in fine motor skills (e.g., drawing, writing, cutting), group activities (circle time, following directions) and academic skills (letters, colors, reading).  Will your child “make it” in that environment, or are those the biggest weaknesses?

Auditory, visual and sensory processing difficulties need to be addressed in order for children to succeed in a neuro-typical setting. Extra attention outside of school (OT, PT) can provide significant benefit.

The proven therapy for behavioral difficulties is ABA. Disruptive conduct cannot be ignored in a neuro-typical classroom, so any behavioral resources that the family can provide are paramount. Habits (such as face and hair ‘touching’) that appear “cute” in a toddler, may be unsettling in a 6-year-old, more-than-troubling in a pre-adolescent, and out-of-order in a teen.

When the teacher says, “Look at the chalkboard,” Junior has to respond appropriately. Kids need to look like they are attending, even if they aren’t. Often, the situation is quite the opposite – the child is listening, but adults misunderstand.

Don’t compare your child’s progress to that of the others in the class. Keep your eye on the main goals – independence and productivity.

Don’t have your doctor attend – I was an unhelpful distraction.
It’s back to letter writing for my practice.

In the best of circumstances, most children who are recovering from their ASD would do best in a neuro-typical classroom, with pullouts for extra services and tutoring, and a shadow to redirect. Obviously, that requires significant resources and the school’s cooperation. However, the need for stimulant medications would be greatly reduced.

It’s Not the Asperger’s Syndrome

Sunday, June 1st, 2014

Let’s face it; anyone who goes on a shooting rampage has some mental illness. Often, it seems there was a history of family turmoil, few friends, bullying, and lack of empathy. That does not define Asperger’s Syndrome, which is a developmental disorder.

Recent sensational violent acts by young men could be due to a number of conditions, including:
∗ ADHD with feelings of inferiority because of poor performance
∗ Schizophrenia
∗ Personality disorder
∗ Watching violent video games
∗ Oppositional Behavioral Disorder
∗ Acute or transient reactive psychosis
∗ Reactive Attachment Disorder
∗ Subject to abuse
∗ Temporary insanity
In deranged individuals, such as the Connecticut and California shooters, psychiatrists would probably entertain even more possibilities.

There is no precise manner to define Asperger’s Syndrome after someone expires. The conditions that explain impulsive conduct are inaccurate, at best. Psychiatric diagnoses need to be assessed in real-time by documentation of signs and symptoms. Regarding the recent carnage, family members (and their lawyer) reportedly claimed that Elliot Roger was “on the spectrum,” and suffered a long history of mental difficulties.

How about focusing on the histories of mental illness
with easy access to firearms?

The Autism Epidemic that has blighted the child development landscape of the 21st century is a mystery, with vague descriptors and the recent inclusion of many other developmental problems, including Asperger’s and PDD-NOS. The public is left to wonder, “Why so many killing sprees?” The media is quick to supply an answer, “Perhaps it is those autistic (Asperger’s) kids!”

I have examined scores of patients who fit criteria for the disorder. Effective communication is difficult; some are depressed, some understand and address their challenges, and others who say, “That is the way that I am.”

Key traits include early developmental delays, an unusual affect, restricted interests, decreased eye contact and sensory issues. They are usually very standoffish individuals who feel uncomfortable outside of their usual environment.

There is not a great deal of published information about the association between violence and Asperger’s syndrome. In one study, 31 of 37 of the patients (85%) had a possible or probable comorbid psychiatric disorder.

A 2010 follow-up paper concluded, “The mean percentage of registered convictions was similar to that in the general male population of Austria over the studied time period. A qualitative assessment of offence types in Asperger’s former patients suggests that the nature of offences does not differ from that in the general population. In this original cohort of Asperger’s patients, convictions were no more common than in the general male population.

We should be very skeptical about media pundits’ experience, statements and motives. Sensational reporting is unfair and irresponsible because it assigns to Asperger’s patients a stigma that they do not deserve. There are many more examples of productive individuals than violent criminals committing heinous acts due to their autism diagnosis.

Just because Asperger’s Syndrome is the “diagnosis du jour,” it doesn’t mean that there is a shred of proof that affected individuals commit brutal crimes or that they are any more prone to such violence than those who are not so classified.

The Autism Wars: Frank Bruni vs. Jenny McCarthy

Friday, May 2nd, 2014

Perhaps to mark the end of Autism Awareness month, but seemingly out of the blue, New York Times op-ed contributor, Frank Bruni, decided to weigh in on the vaccination-autism non-connection issue with this April 21, 2014 article. He accused Jenny McCarthy of being an “agitator… the intemperate voice of a movement that posits a link between autism and childhood vaccinations and that badmouths vaccines in general, saying that they have toxins in them and that children get too many of them at once.”

In this corner – Foodie Frank
Who is Foodie Frank to attack Gorgeous Jenny? His bio in the Times describes, “Over his years… he has worn a wide variety of hats, including chief restaurant critic… Rome bureau chief…  also written two New York Times best sellers: Born Round (“as in as in stout, chubby, and always hungry”), and Ambling Into History, (about George Bush)… coauthor of A Gospel of Shame: Children, Sexual Abuse and the Catholic Church.” Wikipedia adds that he “… became the first openly gay op-ed columnist…” of the Times.

Nothing in Mr. Bruni’s curriculum vitae points to any learned knowledge of science, biology, immunology, ecology or child development. The only extant association between Mr. Bruni and autism is this vacuous article that he penned. There is no evidence that he possesses any special information. Oh, that’s right, he did say that Yale’s autism expert, Dr. Fred Volkmar, told HIM that the vaccination controversy “diverts people from what’s really important, which is to focus on the science of really helping kids with autism.” A diversion from the important stuff, huh? As in, this bullshit op-ed story.

And, in this corner – Gorgeous Jenny
And what role does Jenny McCarthy play in this complicated, emotional and misunderstood quagmire that is the present autism epidemic? Her pediatricians didn’t even know what she was talking about when her child was diagnosed with autism. The conventional medical community says that, “Autism is what it is… you got what you got… deal with the situation and get (really expensive and difficult-to-find) therapies. Good luck.”

Parents are admonished not to listen to anyone who says that they can help with medical treatment, other than the standard psycho-stimulant meds. Even if Mom witnesses a change (from a GF/CF diet, e.g.), professionals warn that “It’s probably just a coincidence, like that disproven vaccination theory.”

Ms. McCarthy warned the country and the world that a storm was coming. Regarding ASD, doctors have displayed ignorance at best, and have even caused harm, due to delays and misdiagnosis. And, while we’re on the subject, if it turns out that her son, Evan, has one particular version of autism, that hardly constitutes some sort of fraud for the purpose of gaining visibility. Smack of bullying, Frank?

The child’s complicated diagnosis – made by the doctors –  doesn’t make McCarthy someone “who sows misinformation, stokes fear, abets behavior that endangers people’s health.”
Only the CDC, FDA, and AMA are allowed to do that.

I have been witness to the miraculous improvements served by childhood vaccinations. I recommend them to our patients; perhaps more diligently than might serve the ‘herd’, however, in susceptible individuals, doctors need to be very conservative. It shouldn’t be so complicated for the medical community to produce independent, prospective studies about the present vaccine schedule with 3 year follow-up aimed at developmental outcome, especially as it applies to higher risk infants.

No Winner is Declared
My advice is for Mr. Bruni to go back to his core competencies, Ms. McCathy to continue to fight for her child and help raise money for autism awareness-treatment-and-prevention, and for medical science to work on a better explanation(s) for this epidemic.

An agitator produces lots of heat with little light.
What a desperate mother does, is search for answers why her perfect, beautiful toddler became non-responsive and stopped talking.

Vitamin D for Autism and ADHD

Sunday, April 6th, 2014

One of the more common out-of-range laboratory findings in the children who come to our clinic is a low vitamin D level. Learning about the myriad effects of this important nutrient ought to encourage parents to ask their pediatric specialist to check the blood concentration when evaluating patients with ASD or ADHD.

Effects:

  1. Vitamin D enhances the intestinal absorption of:
    1. Calcium
    2. Iron
    3. Magnesium
    4. Phosphate
    5. Zinc
  2. It is involved with the immune system:
    1. Normal functioning
    2. Inflammatory response
  3. There are effects on neuromuscular functioning.
  4. Bone mineralization is influenced.
  5. The vitamin is involved with modulating genes that regulate cell growth, proliferation, differentiation and death.

Metabolism:
The sequential manner in which this hormone-like vitamin gets into the body, and becomes active, helps explain possible reasons for insufficiency, and observed effects.


 

Dietary Sources:
According to an interview on WebMD, “Surprisingly few foods contain vitamin D…” Dr. DeNoon lists “Super foods,” such as (wild caught) salmon, mackerel, shellfish and mushrooms. Mostly, though, humans were built to get our vitamin D through the skin, so foods are now fortified to make up the difference.
Based on bone health, and given acceptable calcium levels, dosages of 600 IU/d for non-seniors “meet the requirements of at least 97.5% of the population…” BTW, the RDA for vitamin D was derived based on conditions of minimal sun exposure.
There is apparently conflict among the experts, however, about the definition of standard levels. Recommended intakes for infants and children vary from 400IU to 1000IU per day, with unanswered questions about increases.

You can take too much:
This is a fat soluble product, meaning that it can accumulate and become toxic. That is why a doctor should evaluate and follow levels, especially in high-risk children.

Evaluation:
The laboratory evaluation is usually done by testing for blood levels of 25-hydroxy Vitamin D, which is NOT the active form. A calcitriol (1,25 di-hydroxy Vitamin D) level must be ordered separately. The results, and variation from the standards vary, depending on the laboratory. Calcium, zinc, iron and magnesium may be checked, as well.

Autism and ADHD
ASD patients do not represent a ‘normal’ population. RDAs are, in my opinion, the amount below which some neuro-typical people can get symptoms. It seems to me, “Low normal,” is “low.”
There are numerous reports of children spending less and less time outdoors in physical activity,
especially those ‘on the Spectrum’.
Many kids are picky eaters or have been placed on restricted diets
that might affect absorption and levels.

The dermatologists have warned about the dangers of ultraviolet exposure, so SPF 188 was invented and applied copiously.
Often, children have eczema and other skin conditions that
might interfere with normal metabolism.

The conversion of chemicals to the active form assumes a healthy circulation, liver and kidneys. Many of the patients do not appear in optimal health.
There are genetic disorders of calcium metabolism
that present with autism.
There is even evidence that maternal levels may play a role in ASD.

Mostly, however, I am not sure why
so many patients exhibit decreased vitamin D levels.

Treatment:
Children with values that are at, or below the low range of ‘normal’ (depending on the lab), are usually given”D3,” 1,000 – 2,000 IU extra per day.

Treated patients are re-evaluated by periodic testing, plus documentation of daily supplemental intake.
Positive effects, such as a healthier immune system, are usually noticed within a month or two of getting the correct dose. Sometimes, sleep improves (try giving at night). The other therapies appear to work more efficiently; there appears to be better cognition, focus, and eye contact as vitamin D levels are normalized.

Conclusions:
It is difficult to sift through, and pinpoint, the specific biomedical intervention that leads to healthier and happier children. “Documentation,” as they say, “is lacking.” It certainly feels as if adding vitamin D3, when it is low or deficient, helps practitioners achieve improvements in signs and symptoms of ASD.

Oral supplementation is inexpensive, usually well-tolerated by the child, can be followed by documenting the course of treatment and laboratory confirmation.

Autism Conference 2014

Sunday, March 30th, 2014

This conference represents a major opportunity for serious professionals who want to learn about state-of-the-art autism diagnosis and treatment. Other pediatric specialists should take note that the Medical Academy of Pediatric Special Needs is a formal, scientific forum for doctors who wish to care for complicated cases.

Day 1 – ADHD Sessions
Dr. Elizabeth Mumper (Rimland Center) reviewed neurotransmitters. Her focus then shifted to the pressure that Big Pharma has (openly and clandestinely) foisted upon parents, patients, and doctors to diagnose ADHD and prescribe medication. Plus, there is a lack of research demonstrating long-term improvement from these pharmaceutical products.
The disorder is better characterized as a network-communication problem, rather than focusing on one or two specific areas of the brain.
Dr. M then reviewed treatable, metabolic causes of behaviors that may be diagnosed as ADHD. Therefore, the signs and symptoms deserve an appropriate workup; not merely a knee-jerk Rx for stimulant medication.

Dr. Dan Rossignol summarized the most recent and pertinent literature about laboratory assessment for ADHD. A reasonable medical workup was presented, so that treatable conditions can be identified.

Dr. Nancy O’Hara followed with her interesting proposals about non-drug interventions, including dietary changes and addressing environmental issues.

Dr. Stuart Freedenfeld spoke about the forces that drive the diagnosis, many of them non-medical and more related to socio-economic status, especially as regards pharmaceutical intervention.

Case presentations and discussions filled out the rest of this first day.

Day 2 – Environmental Medicine Sessions
Dr. O’Hara reviewed detoxification physiology and the factors that might affect normal functioning, including genetic variation and the myriad of toxins in the air, food and water. Poisons have detrimental effects on mitochondrial operation, the CNS, and can lead to thyroid disruption, altering normal physiology. Various helpful interventions were offered.

Dr. David Quig reviewed laboratory assessment of metal exposures and the concept of body burden. Single toxins can be detrimental, but there are many environmental poisons that multiply negative effects, called the Multiple Hit Phenomenon. He discussed the issue of net retention of toxins, and various therapeutic modalities.

Dr. Stephen Genuis expressed his opinion that airborne pollution represents the most important source of toxic load, resulting in chronic illness for the mother, child, and future generations. He also introduced the topic of ‘nano toxicity’, new pollutants of very small molecular size, in bedding, for example. Evidence for direct and indirect effects of the ever-increasing burden of toxins on multiple body systems was reported.

Dr. David Dornfeld added to our knowledge about total body burden of multiple toxins. He also discussed various forms of detoxification, including chelation – the active removal of heavy metals with chemical compounds.

Case presentations and discussions followed.

Day 3 – Plenary Session
Dr. William Parker spoke about “Post-industrial factors underlying immune system destabilization and subsequent inflammatory diseases point toward dramatic changes for medical practice in the near future.” His discussion was about the manner in which modern society has disturbed our microbiology and the effects that has had on the immune system and created a whole host of auto-immune conditions.

Dr. Paul Schreckenberger gave a fascinating talk revealing that, contrary to common scientific belief, urine is NOT sterile. The take home point was thathere is whole host of new thoughts about the human microbiome (our micro-organisms and their genetic components). There is a need to identify new species and get a better understanding of good and bad bacteria.

Dr. Michael Cabana presented the evidence about the use of probiotics and the effects of ameliorating auto-immune conditions, especially asthma. Important variables are when the supplement is delivered and the requirement for high potency products.

Dr. Rossignol presented the evidence for HBOT to address gastrointestinal inflammation.

Dr. Bob Sears gave a lecture about thyroid disorders and the ‘workup’ to assess thyroid function.

Finally, Dr. Rossignol presented evidence about the newest therapies for autism.

Conclusions:
Coincidentally, this conference commenced even as the CDC announcement that 1/68 children are now affected with ASD. Each year, it seems, the numbers can’t possibly go any higher, but they continue to rise.

The professionals who attend this conference are serious about getting a better understanding about this epidemic and trying to help, and I am proud to be part of that group.

Two Hundred Child Development Stories

Sunday, March 16th, 2014

This is my 200th official blog. Yay.

There were several reasons that I started writing back in 2011, and why I continue to produce these stories.

  1. To aid the constant Internet search that families go through in order to assist their developmentally-affected children. The reader’s ability to scrutinize the authority and basic science of medical information is proportional to the knowledge gained by “seeing it on the web.” Surfing is not research. I hope to provide a venue where readers can trust that the material is well researched and presented in a palatable form. Hyperlinks to the original articles are provided whenever possible. “Don’t argue with me,” I tell my skeptical colleagues. “Discuss it with the professors who wrote the paper!”
  2. My competition is the Internet. “My esteemed neurologist colleague,” who hasn’t changed his views on autism in the past 20 years, is still a respected professional. So, I write to enlighten and, hopefully, entertain, while making sure that TheAutismDoctor.com is accurate and up-to-date. If you can’t beat ‘em, join ‘em.
  3. Producing this blog is homework. Days, and sometimes even weeks, are spent thinking about, researching, writing and editing each story. I am encouraged to organize my thoughts and to learn about new subjects. To teach is to learn.
  4. I can refer to these discussions for patient questions and clarification. These stories can provide a valuable aid to understanding some very complicated subjects. Plus, I invite readers to ask their pediatrician and other medical specialists to examine this information.
  5. The Child Development Center is a single practitioner private practice. With a small, but interesting and interested support staff, we are busy taking care of the patients, not studying them. This is an effective setting to tell our stories.
  6. Through this website, families from all over learn about this enigmatic epidemic and explore effective treatment options. TheAutismDoctor.com reaches a worldwide audience. More than 150,000 visits have been recorded, there are now nearly 10,000 views per month, and the site remains high in Google searches. Importantly, I have the honor of caring for patients from around the globe.

Personal Facts
My favorite posting is “Joe the Plumber“, one of my first literary attempts in this digital venue. It was an attempt to convince parents that there were doctors willing to assist in the recovery of their affected children.

The most difficult work was the HBOT series. Such a complicated topic cannot be understood by advertising, testimonials or word of mouth.

My most emotional stories are on Mothers and Fathers Day. One Dad told me that he keeps a copy of the 2011 posting by his desk whenever he needs a healthy reminder about how lucky he is.

The busiest single story is not even mine! I’m not sure how she does it, but this mother warrior tells a great tale and has attracted many readers.

The most popular over time is the information about methyl B12 injections. I continue to refine and update that page; as well as to report that, under professional direction, this is one of our most effective medical therapies.

I am rarely at a loss for words about the epidemic of childhood developmental issues. Loyal readers, have no fear: I have over 60 blogposts ‘in the can’, ready to be fleshed out, awaiting more information, and/ or more interest. There will be more conferences to report about, and new research to be presented and explained.

To me, these are more than just stories.

Ten Tips to Navigate the New DSM-5

Sunday, January 26th, 2014

DSM45A recent medical report predicts that the latest iteration of the criteria required to assign a formal diagnosis of ASD will result in a decreased number of reported cases. In their conclusion, the authors state, “this effect could be tempered by future adaptation of diagnostic practices and documentation of behaviors to fit the new criteria.”

The hype seems to be that there isn’t so much of an epidemic as advertised. Some think the new standards will be a more accurate reflection on the scope of the problem. It could mean that parents who believe their children need treatment will have less access to services, because required DSM-5 criteria may not be met.

Parents and practitioners need to understand the landscape because useful interventions might not be afforded to those who can benefit most. Therapies are more likely to be successful when there is less functional impairment.

For better or for worse, families that utilize, and/or expect to receive services, will probably experience little change.

These tips might help make sure that your children get the treatments they need.
1. It’s complicated. Try to familiarize yourself with the pertinent changes in the new criteria as they apply to your child. For evaluation and treatment purposes, don’t be concerned about other conditions that have been added or left out, if they are not your child’s issues.

2. Though Aspergers’ patients may be upset that there is no longer a defining nomenclature, communication disorders are now included in a much broader sense, actually. So, take advantage of available interventions.

3. Because PDD-NOS is now incorporated, developmental interventions should become available for a wider variety of conditions, which may not have been supported in DSM-IV. If your child has been given this diagnosis previously, and few/no services were offered, such inclusion should help.

4. Documenting the level of impairment requiring support is imprecise and quite subjective. Pointing professionals in the right direction will help ensure that services are ordered.

5. Although “impairments in communication” have been eliminated, there are several other designations that cover many commonly observed problems. These include deficits in conversation, relationships, and speech.

6. One requirement for diagnosis is the demonstration of “Restricted, repetitive patterns of behavior…” Just about all stimming is going to fulfill this criterion. Plus, sensory symptoms are now included.

7. ‘Social interaction’ continues to be a key issue for the ASD diagnosis. Clinically, kids who don’t/won’t play are a real challenge. Make sure that any formal assessments include this deficit, if it exists in your child.

8. It took 17 years to get to DSM-5. Supporting information appears to be more than 3 years old; so, in an evolving epidemic, we still might be missing the mark. The good news is that the powers-that-be seem to demonstrate an open mind, at least in the conferences that I have attended. Formal evaluations may require frequent revisions to stay up to speed on this moving target.

9. No longer should doctors assign the mushy “Oppositional, sensory, ADHD, poor focus, developmental delay” diagnosis. It’s called Autism Spectrum.

10. In this highly fluid environment, the doctors, teachers, administrators, therapists, and other professionals involved in your child’s care need to stay up-to-date, so that they can steer you in the right direction.

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Brian D. Udell MD
6974 Griffin Road
Davie
FL 33314
Office phone – 954-873-8413
Fax – 954-792-2424

Email bdumd@childdev.org
Website http://www.childdev.org

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