Archive for the ‘>ALL<’ Category

Worried About Autism – Where to Begin?

Saturday, April 19th, 2014

Not uncommonly, The Child Development Center receives emails such as this one:
Stumbled upon your website, and I have found it to be very informative. My 3 year old has just been diagnosed with Autism, although I do not really believe that he is autistic, because in some rare moments, I find he displays “normal” for lack of a better word, tedencies. He makes eye contact, he tries to express himself, he doesn’t point, but shows me where he wants to go and what he wants. Although, at the same time, many of the other signs are obviously there. Anyways, my reason for emailing you is that we live <<outside the US>>, and I wanted to know if there are any practitioners that you could recommend that we see in our neck of the woods?

In the past, parents would seek assistance and counsel from their child’s pediatrician or family physician.
Doctors take note: this is a serious shortcoming on our part if we do not understand how to diagnose, work up, treat and counsel families about the most important childhood epidemic of the 21st century.
Specialists take note: giving a parent a ticket for various therapies will not stop the family from seeking other opinions and treatments.

Step 1: Use an online tool, such as the M-CHAT, to learn if the child fits criteria for autism. The diagnosis is imprecise, at best, and misleading, at worst, because families may feel hopeless and believe that Rain Man is their child’s future. The behaviors that rule the diagnosis IN are the important ones, not the activities that do not fit the general perception of this disorder. In the case above, the child is starting to develop more typically by pointing and making eye contact, which is a positive sign toward recovery. What should concern any family (and the doctors) is lack of speech (or loss, even worse), and the “other signs that are obviously there.”

Step 2: If you can, find a knowledgeable practitioner with proven results. At the last meeting of Special Needs Pediatric doctors, there were fewer than 150 participants. Admittedly, there are simply not enough specialists for a condition that affects 1/68 children. The best place to start is the clinician directory at www.medmaps.org. Choosing one of the MAPS members will assure you that the clinician has studied (and been tested on) multiple courses in the most basic and advanced science of ASD.

Step 3: List all of the child’s other medical conditions and work with your pediatrician to address them. Diarrhea, constipation, reflux, asthma, eczema, allergies, recurrent infections may be the primary reasons for behaviors, such as aggression and fog, assigned to the ASD diagnosis. Ask the doctor to check the complete blood count, vitamin D levels, liver, kidney and thyroid function. Get an audiology examination. For the extremely restless, melatonin is a great anti-oxidant and sleep aid.

Step 4: Don’t give your child PPIs for GERD (smaller, frequent feedings and proper positioning), or Miralax for constipation (try probiotics and fiber). Refuse to give antibiotics with every fever elevation or ‘cold’, and question ALL medication advice, such as pre-treatment with Tylenol, or giving vaccinations while the child is ill.

Step 4: In the absence of any other assistance, at least try the gluten free-casein free diet for a few months. What have you got to lose? And, while we’re on the subject of diet, the fewer toxins the better. Try not to cater to the child’s favorite foods, if they are full of sugar or artificial coloring and flavors. Children do not know what is best for them. Especially if outdoor play is minimal, supplement with multivitamins, including C and D3, and fish oil.

Step 5: There is no magic pill, so far. Start appropriate therapies, such as speech and language, OT or behavioral intervention as soon as possible. Your healthier child will progress much faster when proper behaviors are emphasized. Rethinkautism.com can be a valuable tool, particularly when a therapist is not available.

Parents who seek opinions about their child’s unusual development are probably thinking autism, somewhere in the back of their minds. However, after experiencing the denial that is part of the grieving process, the reality of actually believing the diagnosis has to motivate parents to research, ask other parents and take action.

Even for families living in the remotest locale, something can be done to help your developmentally high-risk child.

Autism Un-Awareness

Saturday, April 12th, 2014

March 27-March 29, 2014. The MedMaps.org meeting of Special Needs Pediatricians in California.

Friday, March 28, 2014. The CDC announcement that “about 1 in 68 children has been identified with autism spectrum disorder (ASD)…”

Wednesday, April 2, 2014. Autism Awareness Day (and Month).

Pretty much, such news should have set off a call to action, don’t you think? Yet, there seems to be very little traction. We’re already into the 3rd week of the month, and it doesn’t seem that publicized questions go beyond, “So, do you really think that there is more autism, or have we just changed the criteria?” And, as always, the vaccination issue… Or, nothing.

With deference to those with autism who are pleased with their life and lifestyle, what other childhood epidemic has gotten so little attention? In my youth, polio created summertime panic for our mothers and we were often kept indoors (and that was pre-ac, where I lived). In 1952, at its highest incidence, combined cases (paralytic and non-paralyzing) occurred in ~58,000 out of a population of 158 million people, with approximately 37 million susceptible youth. That was a risk of 1 per 2000 children.

Some may argue that, “Polio carried the risks of death or paralysis, this is just autism.”
“Just autism,” is not a term that I have heard any parent express.
Ergo, we need to erase Autism Un-Awareness.

Knowledge and experience will get us beyond this rhetoric. The first part is expanding daily. The associations between autism and inflammation, G-I heath, environmental toxins and genetic susceptibility continue to be re-confirmed in the conventional scientific literature.

Parents now request much more information about pre-pregnancy and maternal health. Families bring younger and younger children for evaluation. Developmental delays that were previously considered as ‘minor,’ or ‘normal’ may get evaluated and addressed. Sadly, the pediatric community continues to follow a more traditional course in the diagnosis and treatment of this epidemic. Children, nowadays, don’t appear to simply ‘outgrow’ slow language development in the presence of some repetitive or unusual movements. Medical evaluation and intervention does not appear to be consistent with their version.

With so few practitioners willing to learn about and tackle this condition in an aggressive and non-traditional manner, experience is evolving at a slower-than-expected pace. Technological tools, such as relational databases, can play a significant role as conventional medicine catches up with the explosion of cases in such a disparate group of patients and practitioners. Autism360.org is a great example. (Thank you, Dr. Baker)

I’m not quite certain what percentage increase it will take to sway the general population that we have a real problem on our hands. Maybe it won’t be a percentage at all. President Roosevelt’s story warned a previous generation about polio. In 1963, the plight of President Kennedy’s premie spurred the development of NICUs with trained specialists to solve the problems of prematurity, while preserving healthy development. It took Magic Johnson to get the public riled up about HIV and the risk to the entire community. Angelina Jolie exposed the BRCA gene, etc.

Real autism awareness will come when we stop asking the old questions and start considering the condition(s), as it (they) is (are). What we call ASD is a new disorder in a new century. Autism was around and has been creeping up on us.
Speaking of polio, epidemics were virtually unknown in the US until the 20th century.

New shit happens.

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.

Vitamin B12 and Autism Stories

Saturday, March 22nd, 2014

The topic of methyl B-12 injections, administered to help induce Speech and Language, and to address other autistic behaviors, is among the most popular web searches that parents undertake in order to help their affected offspring.

These are some of the experiences of families who have explored this protocol, under the direction of The Child Development Center. Various common reactions are presented to assist parents who wish to learn about whether this could help their child, what resources are required, improvements to expect, side effects, and when to start and stop SubQ m-B12.

I can’t give those shots!
The advice that a parent will have to administer ‘shots’ to their fragile young child is rarely met with immediate acceptance. For that reason, there are various protocols that have been proposed to 1) lessen the pain to the child, 2) decrease the child’s anxiety, and 3) reduce the pain and anxiety of the parents.
Whenever possible, I request that Mom or Dad “Bite the bullet, and give a shot in the ‘tush’, upon awakening, two or three times per week (before school or therapies).” Having cared for many asthmatic and diabetic patients over the years, this is a small price to pay for such a large improvement.
One mother who took quite a bit of convincing over many months, recently thanked us profusely for finally helping reverse Junior’s speech apraxia.

I found an ad for oral stuff that is well-absorbed and supposed to be just as good.
This is the usual complement to the first reaction.
B12 is a rapidly absorbed, water-soluble vitamin. Any form, even lollipops will get into the bloodstream quickly. It is the speed with which the vitamin leaves the body that mandates an alternative route of administration. Therefore, deposited in, and slowly leaking out of the fatty tissue (if your kid has any), does the trick.
You can’t keep a sucker in your mouth all day (and night) long.

How long will we have to give these shots?
The short answer is “Until you are satisfied with improvements in communication and the treatment no longer seems to be helping.” Another useful response is, “Consider discontinuing mB12 when stimming becomes more disruptive than language acquisition.”
I find it peculiar that parents pose this question at all. Try asking the pediatric neurologist, “How long will we have to give Ritalin?”
Although some children continue this treatment for years, it usually requires much less time.

What are the side effects?
Stimming. And more stimming. Whole body stimming, then oral ones. Chewing. Chewing on everything. Pushing on the chin. Vocal stims, including shouting, barking, echolalia and scripting.
Also, we have seen amplification of ‘yeasty’ behaviors, such as silliness, outbursts, poor sleep and hyperactivity.

With methyl B12 treatment, this caveat cannot be overemphasized:
In order to observe this therapy’s optimal effect, gastro-intestinal health needs to be optimized.

I haven’t seen any progress yet.
It takes about 2-4 weeks to begin to observe improvements. However, there are many factors that affect timing, and sometimes progress depends on the eye of the beholder. Expected advances depend on the present skill set.
Recovering from autism is a process, and gains generally occur in small increments. Some children show significant increases in communication in the first few months, and others take a bit longer.
For many, the initial signs that the vitamin is actually working are behaviors that some might consider regression, such as oral-motor overstimulation. Parents, let’s not to try to fix what ain’t broken.
In the face of little or no gain in communication, experienced practitioners will search for other co-morbidities or provide supplements to enhance the intervention.

It worked so well that we decided to stop all of the other supplements.
Mono-therapy with subcutaneous injections of methyl B12 is not a preferred protocol to successfully treat autism.
Gut health must be monitored and maintained, usually with probiotics and sometimes anti-fungal medications.
Investigating and addressing deficiencies of minerals and other key nutrients is equally important for treating other signs and symptoms of ASD, particularly inflammation and oxidative stress.
Food and environmental allergies will often respond to therapeutic interventions beyond mere B12 administration.
At The Child Development Center, we have noted that assuring adequate reduced glutathione (by oral administration) optimizes this treatment.
Please, ladies and germs, don’t stop the other supplements! And, certainly, continue the traditional therapies.

You can’t do this at home
The reason that I keep utilizing the medical term “subcutaneous injections of methyl-cobalamin” is because it is a medical treatment. Parents are less likely to be successful if they attempt this vitamin supplement without professional assistance.

Pediatricians must learn that autism is not merely a diagnosis to be ruled out by the neurologist, and specialists need to know that a medical workup and modern treatment protocols can be more effective than conventional therapies alone.

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.

Earliest Autism Red Flags Requiring Intervention

Sunday, March 9th, 2014

There are a variety of reports about the early warning signs and symptoms of autism. It’s complicated, and ‘researching’ the literature does not confer a degree in childhood development. So, parents are left to question whether pediatricians are correct when they announce, “Well, let’s wait six months and see what develops. It’s probably nothing, and your child will be OK.”

Rather than merely list the ‘Top Ten Warning Signs,’ I have assembled a matrix to assist families. This is based on the clinical presentations of more than 1,000 patients, since being part of the autism clinic at the  Child’s Diagnostic & Treatment Center, in 2007.

Requires intervention:   Requires further evaluation:
Poor suck, frequent formula changes. Later, not chewing.
Loss of eye contact, socialization, language
Gastro-esophageal reflux
Unusual, late, or no crawling
Family history of auto-immune conditions, plus S&L delays. Previously affected sibling.
The lack of joint attention, including pointing
Frequent antibiotic usage
Repetitive or unusual movements, incl. clenching, facial ‘tics’, or purposeless gestures of the arms and hands
Immune symptoms such as asthma, eczema, frequent infections
Restricted interests – only playing with one object, especially if it isn’t a toy
Motor delays, especially low core tone, including late sitting or walking
Not consistently turning to voices after 6 months
No babbling by 6 months, or no words by 14 months
Rarely smiling after 3 months
Persistent diarrhea or constipation

Males with undescended testicles or other urinary malformation

In the left column are behaviors that, by themselves, should encourage pediatricians to explore the possibility of ASD, and suggest useful interventions. It is simply not sufficient for doctors to placate parents about such atypical maturation.

In the right column are conditions that, when combined with other findings, should alarm parents and professionals alike to the fact that the child could be succumbing to the childhood epidemic of the 21st century. Underlying signs and symptoms, such as GERD, need to be explored – not merely ‘treated’ with B12-depleting PPIs – and dealt with to their successful resolution. Behaviors, such as infants not turning to their name, should be documented with audiology testing. Effective, proven interventions, such as OT and S&L therapy, should be initiated at the earliest time.

Importantly, any combination of symptoms in the first column plus others in the second, mandates evaluation and appropriate intervention at the soonest opportunity. Early recognition and therapy is paramount. For children presenting prior to age 5, The Child Development Center has been successful, over 90% of the time, in improving the conditions that are described as ASD, in selected patients. Children who respond to treatment can enter a neuro-typical 1st-to-3rd grade classroom.

The CDC reports an incidence of 1/88 children and 1/54 boys. This is 2014, these are not merely ‘soft signs’, and this list is meant to get the parent’s and pediatrician’s attention.

Autism Goals

Sunday, March 2nd, 2014

An important barometer in the current treatment of ASD is the creation of an IEP and the achievement of stated goals. While it is necessary to document progress, the present mechanism may not always engender enough of the kinds of skills that are needed in the real world.

As children improve from the conditions that surround ASD, IEPs notwithstanding, these age-appropriate activities of daily living must be achieved:

  1. The ability to get ready in the morning.
  2. Getting out of the house, into the car, out of the car and into the school, without a major meltdown.
  3. Following the directions of school personnel.
  4. Being able to sit, fairly still, for varying periods of time. Or, at least stand there. Or, at least not be disruptive.
  5. Learn a new activity, or practice a necessary skill.
  6. Transition to another exercise, which may be more difficult (or impossible), or less-preferred.
  7. Kids learn how to be kids from each other. So, children need to show and share.
  8. As development proceeds, children display a desire to watch others play, engage in play, and even initiate.
  9. Getting out of the school, into the car, out of the car and into the house, without a major meltdown.

Academic achievement is the standard for neurotypical patients. For the autistic child, socialization will bring the maturity that can create significant progress.

Does my child meet the following criteria?

Does the child turn to voices and especially their name? “Your son won’t listen,” or “Your daughter doesn’t pay attention,” is a common concern. That is especially frustrating for those amazing kids who hear and take in everything, but are believed to be ‘slow learners’. The IEP goal? “Your child will turn to their name most of the time, when they are called, without prompting.”

Do they make eye contact with other children, not just family members? This important social skill is a major first step in normal play. If you watch a group of 3 or 4 year-olds, they don’t ask, “Who wants to play chase?” There’s no memo or adult prompting; they just look at each other, screech, and start to run around. Finding social situations where your child can practice is so much more important than how well they play Angry Birds.

The ability to speak is paramount. That doesn’t mean hours and hours of Speech and Language Therapy by itself. The Child Development Center has seen hundreds of children who developed speech by utilizing a combination of therapies with medical evaluation and appropriate, effective interventions. Our older apraxic patients have different problems.

For children who can speak, do they use their voice at the appropriate times (naming, answering) or only when prompted? Is there a great deal of echolalia, saying the same sentence as the questioner? Does scripting seem to make sense and, at least, be in context, or does the conversation seem to be gibberish? These rituals are practice, not to be discouraged, but the child must generalize language to appropriate situations. Kids judge other kids.

Sensory difficulties are a major hurdle for many ASD patients. Sounds may be too loud, lighting to harsh, and experiences so stimulating that children exhibit repetitive motor behaviors (stimming). For both the student and the classroom, addressing these issues (e.g., sensory diet) will make things go more smoothly.

Aggressive behaviors will not be tolerated for very long in any educational situation. Rather than making excuses for why your child behaves in a disruptive or violent manner (whether SIBs or directed at others), gastrointestinal health and ABA intervention is more important than any academic effort.

We are talkin’ ‘baby steps’ here. Autism is not someone’s fault. It is a condition of the 21st century that requires appropriate medical and therapeutic intervention.

Camel’s Milk for Autism

Saturday, February 22nd, 2014

Concerned parents continuously search for the key nutritional product(s) that might help their developmentally affected children. There are several reasons for this grail-quest.

Formost, in my opinion, is the paucity of useful information that has emanated, so far, from the medical community. If we were doing a better job, parents would be learning from their doctors, rather than the other way around. Not that we have been given much to work with. Far more money has been spent ensuring that Pediasure contains multiple flavorings than whether too much of it might be part of a vicious cycle leading to autism.

Next, is the relative ease with which sometimes rather exotic supplements can be acquired and administered. They don’t cost all that much money (compared to ABA, e.g.), might produce quicker results, and only have to be mixed with all the other stuff in the concoction that Junior calls his morning ‘smoothie’. Often, the logic is along the lines of the chicken soup theory. “It wouldn’t hurt,” in my grandmother’s vernacular.

The Internet is a magnet for inquiring families. How can you NOT just peek at a story that seems EXACTLY the same as your kid’s problem? Families don’t even need a doctor to give a diet a try. How can you NOT attempt to feed an affected child coconut oil, a FODMAPS diet, or omega3 fatty acid?

Sometimes, for various reasons, improvement could be related to the magic potion, or perceived changes could be merely coincidental. If a ‘miracle’ occurs, it can be broadcast on a world stage. That brings me to camel’s milkAt the last Medmaps.org scientific meeting, this topic was covered in some detail. I didn’t come away wanting to put a dromedary in the office. However, I’m not opposed to it, either.

The Good
It’s a great source of nutrition, is usually well tolerated, and there is not much in the way of visible allergic signs or symptoms. The milk won’t lead to casomorphin production (leaky gut, making children addicted and looking ‘stoned’), and (in the raw form) it contains protective immunoglobulins.
There are reports of improvement, some remarkable.
For parents who have reached the end of their rope because their child doesn’t seem to tolerate any other reasonable form of nutrition, it could be worth a try.

The Bad
Camel’s milk affords no allergic advantage over cow’s milk as far as folate receptor autoantibody formation, which plays a role in some types of ASD.
It is difficult to obtain (in the USA, at least). You need to join a ‘club’ (~$25) and swear to hold the producers harmless, should there be any problem. Then, there are the questions of whether to pick the homogenized vs. raw version, fresh vs. frozen, with or without kefir (containing grains for yeast fermentation). 

The Ugly
Best advertised web prices, sans shipping:

Source Approx. price per oz.
Cow (whole, pasteurized) $0.11
Pediasure $0.20
Almond, Coconut, Soy $0.04
Goat (whole, raw, from farm) $0.26
Goat (pasteurized) $0.17
Goat (evaporated) $0.13
Camel (fresh) $0.88
Camel (frozen) $0.63
Camel (frozen w Kefir) $0.94

Conclusions:
Specialized milk provides another potentially helpful alternative for certain patients. I firmly believe in optimizing nutritional support, but as long as there is no apparent harm, it’s just food. How does your child tolerate the various combinations of protein, fats, carbohydrates, vitamins and minerals? Measurements need to be documented along with the most important parameter, your child’s relief from autism. Patients at The Child Development Center are tracked by somatic, allergic and metabolic markers, as well.

Breast milk is the best milk. After that, pick the one that the baby enjoys, is non-allergic, in reasonable volumes, and produces growth and development in your child.

BTW, if you do choose it, the children may start to have a slightly camel odor.

Autism Injury

Sunday, February 16th, 2014

Autism is an injury. At least, it feels like that to me.
Injuries can be severe, moderate and mild.
Damage can be acute or smoldering.
Disturbances might arise in the womb, or occur up to 3 years later.
Recovery might be complete, functional, sub-optimal, or absent.
Improvement might be immediate, or take varying periods of time.
There would be individual responses to various methods of treatment.

Where does the injury occur?
Dr. Martha Herbert has written about a new paradigm, questioning whether autism is a brain disorder affecting the body, or a body disorder affecting the brain?
Systems of origin could be genetic or genomic, from the gastrointestinal to the musculo-skeletal system, to the nascent CNS, leading to downstream consequences that we are only now recognizing.
Disruption could occur somewhere in the body at a metabolic level, resulting in the mitochondrial under-functioning that is so prevalent in ASD patients.

What can cause the injury?
There is very little documented information about the cause(s) of injury.
Genetic variations may predispose individuals, resulting in links that interfere with detoxification or directly result in missing or mis-connections.
Toxins in the air, chemicals in the water, additives in our food, alterations in the food supply, and medications can cause or continue a vicious downward spiral.
Organisms such as resistant and / or pathogenic bacteria can lead to direct injury in the intestines. The possibility that over-usage of antibiotics has led to bacterial strains that have gone awry, and results in the malabsorption of nutrients that are especially important to susceptible individuals, seems too complicated an answer.
The consideration of a fungal etiology is dismissed, or ignored, by modern medicine.
Often, the possibility of a viral cause is considered sedition.

Preventing the injury?
Individuals at increased risk require identification and intervention.
GERD is not merely a symptom to be treated with PPIs.
Repeated ear infections should be investigated for immune irregularities, and ear tubes may be preferable to frequent courses of antibiotics.
Addressing poor nutrition with Pediasure may not only be ineffective, it may lead to unforeseen immune and metabolic consequences.
Rather than simply ‘treating’ constipation in infants with Miralax, which may intensify the problem, an investigation into the cause(s) of the problem and proper use of probiotics seems preferable.
Decreasing the intake of toxic substances such as genetically modified foods, artificial flavoring and coloring, and products that have been adulterated with pesticides, antibiotics, steroids and other ‘enhancements‘, is a reasonable strategy in this toxic century, and requires intense investigation.

Treatment of the injury?
First, there needs to be a recognition of the earliest red flags, so that intervention(s) – conventional and alternative – can be instituted immediately. “Waiting for the (ASD) diagnosis” is avoidance at best and potentially harmful because of delays in effective treatment.
Exploration of the underlying conditions that present as core tone weakness, G-I and feeding difficulties, immune system irregularities and sleep disturbances may successfully address signs and symptoms that are considered ‘autistic’. This will include doing a correct ‘workup’, rather than merely calling the patient autistic.

What’s next? 
We have a lot to learn about the signs and symptoms of childhood development of the millennials.
The concept that ASD is due to an injury is not new.
We need to stop arguing WHETHER there is an epidemic.
We need to consider vaccines as only ONE of the possible causes, not the only. I have examined many younger siblings in the practice who have never been vaccinated, yet still develop worrisome behaviors.
Conventional pediatricians, child neurologists, psychiatrists and other specialties need to come up to speed, instead of depending on older literature that does not seem pertinent to the modern condition.
All of the professionals who work with ASD patients, including therapists, medical doctors, naturopaths, homeopaths, chiropractors, teachers and administrators need to get on the same page. Or, at least, read from the same books.

This theory may not be correct.
So far, by treating the condition in such a manner, The Child Development Center has been very successful helping patients recover; if not yielding a cure, producing various levels of relief from the injury.

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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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