Archive for the ‘Chelation’ Category

Getting the Most from Behavioral Therapies

Sunday, March 26th, 2017

The ever-increasing number of children who experience significant developmental problems requires a proportional addition of skilled professionals for assessment and intervention.

At The Child Development Center, we have noted the emergence of certain patterns of treatment choices. Intelligent, involved parents express their concern about the paucity of well-trained professionals, the cost of treatment, the lack of insurance, and frustration with the speed or course of their child’s progress.

Applied Behavioral Analysis
The general consensus is that the proven protocols of behavioral intervention are most likely to result in significant symptom reduction in patients with ASD. As reported in the 2001 publicationEducating Children with Autism, “teaching parents how to use pivotal response training as part of their applied behavioral analysis instruction resulted in happier parent-child interactions, more interest by the parents in the interaction, less stress, and a more positive communication style. The use of effective teaching methods for a child with autism can have a measurable positive impact on family stress. As a child’s behavior improves and his or her skills become more adaptive, families have a wider range of leisure options and more time for one another… To realize these gains, parents must continue to learn specialized skills enabling them to meet their child’s needs.”

Why does utilization of ABA lag behind other treatments
in so many regions around the country?

The prevalence of children with autism is outstripping the number of qualified, interested therapists. Economic pressures appear to dictate direct provision of services by paraprofessionals who are properly supervised. Therefore, the most efficient providers frequently observe, evaluate, and mentor the less-experienced staff. For-profit companies may find such practice difficult to maintain.

Insurance companies regularly find a way to weasel out of their commitments, many times in spite of outside mandates or even advertised benefits. Denial of payment for services may take the form of incorrect coding, credentialing, and timeliness of payment. Providers are, therefore, less likely to accept their (lack of) coverage.

There are a variety of types of behavioral intervention; including DTT, EIBI, PRT, VBI, DIR, TEACCH, OT, Sensory Integration Therapy, Speech Therapy, and PECS. Devotees of each claim superiority of their strategy. Such a smorgasbord may confuse even the most attentive parent.

Discussion
Recovery from the major challenges that accompany an autism diagnosis is an exhausting journey for the whole family. Traditional therapies are the proven tools to enable a successful transformation. They are an important consideration that must be offered to every patient. Parents should use their common sense, plus their unique understanding of the child, to assess whether the plan of action really applies. Does the suggested intervention make sense? Does the child ‘click’ with the therapist(s)?

When professionals continue to insist that 1) you are not doing the right thing at home or 2) your child can’t improve in some particular function, it’s imperative to seek additional assistance. Maybe the provider is correct, but little progress will occur if the parties continue to debate.

I often advise parents who are concerned about some ‘magic’ 25-40 hour ABA requirement, that a good OT, or PT, etc., has learned to be effective by utilizing a variety of techniques. Therefore, you can add up the various interventions, and will frequently find that you don’t need to feel guilty about that numeric stipulation.

As children improve, the challenges of proper socialization and self-control become the most difficult and lingering concern. This may require an entirely new and unique skill-set to come to the fore.

Conclusion
All interested professionals; including chiropractors, acupuncturists, alternative and traditional practitioners, can be important members of the village trying to get your child on the right track. Because the present state-of-the-art is in such flux, the correct combination of traditional and alternative protocols provides the best chance for a successful outcome.

A(nother) Laboratory Test(s) for Autism

Sunday, March 19th, 2017

A key piece of the autism puzzle appears to have been confirmed in an article published this week in the Public Library of Science Open Access Journal, Computational Biology. The title of the article is Classification and adaptive behavior prediction of children with autism spectrum disorder based upon multivariate data analysis of markers of oxidative stress and DNA methylation.

The news has already been reported in popular media as “A Blood Test for Autism“. Here is my clinical interpretation.

The Study
The data was collected from patients in previous studies, and included 83 children, aged 3-10 years, with ASD. Utilizing very dense, complicated statistics that were based on biochemical laboratory data, researchers identified neurotypical vs. autistic individuals, who already had the diagnosis, based on conventional developmental testing.

The chosen pathways evaluated abnormalities in methylation, an epigenetic function, and detoxification.

Specificity and sensitivity were very reliable, “96.1% of all neurotypical participants being correctly identified as such while still correctly identifying 97.6% of the ASD cohort.”

Discussion
Contrary to what the headlines proclaim, this is not a single test; it’s research material that is based on a number of not-yet-readily-available laboratory findings.

The biomarkers represent a final common pathway, not necessarily a cause. Although the data correlated with autism ‘scores’, it really wasn’t meant to discriminate for the various kinds of developmental challenges, such as those children who are mostly aggressive, immune, apraxic, or suffer gastrointestinal abnormalities.

Such an analysis begs the question, “Can it be used for prospective improvement – to follow course of the condition?”

Conclusion
The modern epidemic of childhood autism is extremely complicated and difficult to pin down for research purposes. This study renders a modern means to evaluate a myriad of variables. The metabolic pathways under scrutiny represent a confirmation of the roles of genes and toxins.

As with other ‘earliest diagnosis’ studies, this paper serves to solidify the concept that earlier diagnosis should lead to earlier interventions, with improved outcomes.

For those of us who are practicing ‘alternative’ medicine, it is comforting to rediscover that the treatments included in our modern arsenal of biomedical protocols are consistent with these findings.

Medical Academy of Pediatric Special Needs Spring 2017 Conference

Sunday, March 12th, 2017

At the conference with Yale prof Dr. Sid Baker – one of the originators of biomedical treatment

If practitioners wish to become more effective in the diagnosis and treatment of children who suffer developmental challenges, it will require a new paradigm. Therefore, attending conferences, such as the Simons Foundation for Autism Research, the Autism Research Institute, and the Medical Academy of Pediatric Special Needs, is essential to acquiring that knowledge.

This year’s advanced sessions introduced a completely new functional medicine topic – Hormones from Pregnancy to Teens. Dr. Cindy Schneider examined the differences between the brain anatomy, physiology, and chemistry that might explain how ASD affects males vs. females, and the consequences as we age. Additionally, there are the special complications incurred throughout puberty, with important implications regarding effective treatments.

Dr. Stephen Genuis‘ presentations, Hormone Disrupting Agents, provided a fascinating complement to that lecture. He highlighted the chronic nature of ASD, and the disrupting effects of toxic agents in our modern environment. A key component is the toxic load; if topical agents represent ounces, ingested compounds represent pounds, and the air that we breathe can be expressed in tons of potential poisonous compounds. And, it takes months or years to eliminate what takes days or weeks to ingest. He also pointed out that medical school curricula and training in toxicology is woefully inadequate.

Dr. Lynne Mielke rounded out the day by submitting actual case histories of young people with mysterious medical problems. Her background includes personal experience, extensive knowledge and patient care. This physician’s psychiatric/neurological point-of-view was especially insightful and provided valuable material that directly applied to the audience’s practice population.

Day 2
Another novel and exciting topic was Preconception Care: A New Standard of Care in Maternal-Fetal Medicine. Dr. Genuis discussed the increased risks of preterm birth, Caesarian section delivery, and chronic childhood illness, such as cancers, diabetes, autoimmune conditions, autism and  ADHD.
He presented the emerging research of toxicant exposures and nutritional deficiencies that continue to escalate. Metabolic disruptions may easily ensue, leading to many of the persistent disorders that are now experienced by an increasing number of children, although they may look perfectly normal at birth.

Such difficulties seem imminently preventable in the population, and there appears to be a lack of awareness in the majority of obstetricians. Even fathers who are exposed to toxic agents may become a vector for such later difficulties. Dr. Genuis then discussed the means to eliminate the myriad of  toxins – mostly by sweating, but some by other means, such as fasting or medication.

Dr. Elizabeth Mumper followed with an in-depth discussion about the lack of awareness of proper nutrition, environmental factors, the hazards of indiscriminate use of antibiotics, and poorly researched vaccinations, which appear to be significant factors leading to autism. She even offered another alternative schedule for high-risk infants and toddlers.

Nutritionist Robert Miller presented a very dense lecture, attempting to answer the complicated question, “What can be done about all of those new-fangled genetics tests?” Suffice it to say, that offering will take some time to digest.

Day 3
The lectures consisted of an assortment of the faculty’s most difficult cases. Experts included Drs. Baker, Frye, and Neuenschwander; and the audience wasn’t too shabby, either. Case histories were offered about families who experience unimaginable, incomprehensible challenges; from self-mutilation, to children attempting suicide (sometimes, successfully), to attacks on their caregivers.

The take-home items from such discussions are simply, “How can we prevent this, and successfully treat our population?”

Conclusion
It’s fortuitous that Dr. Ratajczek’s article, which examined the research about vaccine safety, was published at the time of this seminar. Participants have been wringing our hands about the ‘disconnect’ between what we (and many parents) experience every day, and conventional medicine’s dogma. The article might act as fuel-to-the-fire for some, be ignored by the majority, but represents some slight measure of vindication for our hard-working tribe.

We are getting only marginally closer to our understanding about the cause(s), treatment(s), and prevention(s) for autism. Much more research is needed. The Medical Academy of Pediatric Special Needs provides a valuable platform for presenting, evaluating, and disseminating such expertise.

Fecal Transplants and Autism Therapies

Sunday, January 29th, 2017

Recent media attention about a study involving a small group of children with ASD, who were treated with a specific protocol that included fecal transplantation, has spawned a slew of questions about this complicated protocol.
TheAutismDoctor response (so far):

What do these other autism therapies have in common?

•Probiotics – healthy bacteria (and, sometimes yeast).
•Prebiotics – food that fosters better bacteria.
•Special diets- nourishment that helps to reduce toxins, bad bacteria, or yeast.
Helminth therapy – administering live intestinal parasites into a patient’s stomach to reset the micro-biome.
Digestive enzymes – fostering more complete breakdown of foodstuff. This includes CM-AT powder; an experimental protocol utilizing “… a proprietary enzyme that is designed as a granulated powder taken three times daily.”
Turmeric, resveratrol, acai, and other antioxidants.
•Anti-fungal and antibacterial medications and supplements.

RIGHT! They all contribute to improved gastrointestinal health.

What else do they have in common?

•Physicians who explore and treat the enteric system to reduce negative behaviors know the success of such a protocol. However, this view is not a popular subject in the scientific literature, nor commonly accepted by the conventional medical community.
•Such interventions are generally short lived, with frequent recurrences.
•Improvements may seem to diminish with subsequent treatment.

Even hyperbaric oxygen therapy, stem cell therapy, chlorine dioxide, and chemical chelation may achieve their gains through this pathway.

How do they differ?

•Some protocols make some patients better, some have no effect, some produce adverse effects.
•Some are relatively inexpensive, other may cost thousands of dollars.
•They achieve change by a variety of biome-altering methods.

What is a Fecal transplant?

•Simply put, this treatment involves taking fecal material from a healthy individual, and transferring it into another individual’s intestines, by a variety of means, including pills, naso-gastric tubes, and colonoscopy. The procedure was first documented more than 60 years ago.

•For severe gastrointestinal problems in adults, the procedure was reviewed earlier in this century in the journal Clinical Gastroenterology. “This form of therapy has now reached primetime and should be used in any patient that has been resistant to therapy of recurrent attacks.”

What was this research?

•18 children, aged 7-16 years, with ASD and moderate to severe GI problems, were subjected to a “… modified <fecal microbiota transfer> protocol… involved 14 days of oral <antibiotic> treatment followed by… fasting with bowel cleansing, then repopulating gut microbiota by administering a high initial dose of Standardized Human Gut Microbiota… either orally or rectally followed by daily, lower maintenance oral doses with <antacids> for 7–8 weeks… Participants were followed for an additional 8 weeks after treatment ended…”

•”Substantial changes in GI and ASD symptoms were observed…  and those improvements were maintained after 8 weeks of no treatment… Only two… were designated as non-responders…”

Discussion
The authors in this paper noted that, “… it appears likely that extended treatment… over many weeks, as done in this study, is necessary to observe these benefits.” They concluded that, “While this study was an open-label trial that is subject to placebo effects, these results are promising and provide a crucial step for understanding the connection between the microbiome and ASD. A randomized, double-blind, placebo-controlled study is the next step to investigate the value of Microbiota Transfer Therapy in treating children with ASD and GI problems.”

For the foreseeable future, Fecal Microbiota Transplantation (FMT) will not be covered under health insurance. Presently, the cost for eradication of Clostridia difficile (a common organism that causes severe bowel disease) exceeds $3000 for short term treatment.

Conclusions
FMT represents a promising remedy for many of the disruptive behaviors that patients may exhibit. At the very least, it assists in heightening the awareness of the gut-brain connection, especially in ASD.

While parents are all desperate for a cure, this may simply represent another link in the chain that points to gut health as a major contributor of signs and symptoms involved in one type of autism. More research about this therapy needs to be undertaken before safety and efficacy can be assured.

Because of the required resources and time, it will take a while for this treatment to take hold, even by doctors who specialize in this type of patient.

As an increasing number of parents wish to explore this option, with practitioners who are available to work with them, valuable information will be gained for the multitude of other families who seek relief from this modern developmental disorder.

Practicing Pediatric Special Needs Medicine

Sunday, December 11th, 2016
staff2016

(L-R) Karen, Lisa, Dr. Udell, Isabella, Dr. Sherry, Ashly (Front) Julian & Jovi

I’m not a big fan of posting patient testimonials. Fake news is in the news, and it’s pervasive. Plus, it seems unlikely that any practitioner would post negative information about their own practice.

On the other hand, many Googlers, my wife included, see such information as valuable insight into how the doctor practices. Readers may gain confidence that a visit could be a worthwhile pursuit. Here is a sample of this year’s correspondence at The Child Development Center:

Feeding
It is now 4 weeks since she started accepting solids foods, both during feeding therapy and at home. I was so exited that I decided to lower her puree intake as the days kept passing; to the point she was on straight solids for the past 2 weeks.
She is also talking way more than ever, which it is also a change that occurred at the same time she started eating solids. She is expressing herself in 2- 3 word sentences.

We are happy that the unusual behavioral issues receded and please send us the gluten-free letter so the nurses office can have it on file as they need it.

Speech
My child is doing well. He started singing and talking more, but his stomach is bloated for a few days already, any suggestions?

Yes, she is babbling more and using more consonant sounds.

She is doing well in her ABA and lets talk program.  She is reading short phrases and spontaneously saying one to three words with some cueing.  Saying more than 50 words and singing a bit.

She is babbling more and  is now mimicking certain animal sounds…in her own way. 🙂 She  is  also practicing no and is babbling a lot under her breath. She is not saying any words consistently, but I feel like we’re almost there.

I have amazing news to report. I am not sure if it is coincidence, but I put him on a very strict Gluten free/Casein free/Soy free/Sugar free diet this past Saturday he started talking!!!! He is mostly repeating when I prompt him, most of the language is prompted and a lot of it is not completely clear, you can make out what he is saying though. Very similar to when a child first starts talking. He has said in excess of 70 new words in the past 2 days, not including words he is repeating!!!! I am so excited.

The child is saying Mom and Dad in context!!!! She’s been  practicing both for a few days and now says it when she sees us…

Methyl B12 injections
That would be great if you could check if we previously tested for MTHFR. If not, I think I’d like to test for it… Also is there a way to further check for B12 deficiency?

She is doing great with her b12 shots in combination with folinic acid. I noticed improvements after the first shot.

Naltrexone
… We also decided to continue with the LDN because we believe it’s working. It seems as most of the remaining “fog” has lifted, he’s more social, more aware, has better eye contact and his processing seems better (even though there’s still room for improvement)…

He has been taking the Naltrexone nearly a month now. I do see improvement as far as expression and vocalizing full sentences when asked a question. I also feel his vocabulary has also expanded.  It may not be drastic but I feel he has improved since he has been taking the Naltrexone.

We are at 6 weeks of LDN. This has been the key it seems like. It seems in the past week vocabulary has been off the charts! It’s great! One thing I can recommend is the pharmacy makes a big difference.

Health
Just wanted to let you know that my child is doing great. I noticed his cholesterol finally went up to 157. He is labeling now, he started asking with his words for juice, cookie, outside etc. every day a new word. The school therapist came out to tell me how he is like a different child. He is responding to give me hi fives. I just wanted to thank you for bringing him back. He is such a smart little guy and I can see his little personality emerging. He is even fighting back his big sister when she takes his toy away.

I think he is doing well with the Levothyroxine 37.5 mcg. Maybe you can ask for 25mcg 2x a day so they don’t give me 50mcg pills. 

Started NAC 2 weeks ago. First week with 1 capsule. She responded very well. We noticed increased receptive skills, more independence, increase ability to answer questions and more spontaneous speech. She also has not had any accidents since we started (potty). No negative behaviors or stimming was noted. I started 2 capsules on week 2. First day great. Second day increased irritability… 

I had this urge to share this info with you this morning, partly because it’s so positive and also because we are seeing things we’ve never seen, since he’s been on the Vyvanse.  The picture is of him playing soccer with his dad this morning, after he made his own scrambled eggs for the first time. This is a first!
He just seems a lot more motivated and wants to do more things.
In general, a lot of improvements to celebrate. The downside, which you did mention to me were all spot on. For him it’s loss of appetite (positive, oops) and also he is very emotional. Any little issue can set him off and have him in tears.
His teacher briefly mentioned seeing improvements too, more calm and focused.
So, so far so good and I feel like I made the right decision in giving meds a go.

Following your advice, I asked the neurologist to do a new VEEG. Guess what..! You was absolutely right…! He’s still having seizures internally, even though they’re not perceived to the eyes…..the activity is mostly coming from his brain left side… The doctor also asked me for your email address to get in touch with you and provide you with more detailed information…Ps. I feel blessed for having you as my son’s doctor…

Sleep
Clonidine did not work in keeping him asleep. We tried it for 2 weeks with no success. Discontinued. Benadryl with melatonin is what we’re giving him now. It helps him fall asleep very easily, although kept him asleep about 50% of the time. He’d wake around 2-3 am looking for mom or dad and have difficulty falling back asleep. We’ve started locking him in his room at night after bedtime routine (with melatonin and benedryl and picture schedules) and he’s stayed asleep the last 2 nights! 12 hrs last night! Fingers crossed for continued success.

He slept all night and is happy and full of energy today. Thank you!

Sensory
I wanted to tell you what the child did today. Taking him for a haircut is a horrific experience. We are all on the floor holding him down – 4 of us- while he struggles and screams. It has always been like this. Well, today, I took him myself to the barbershop… He walked in and went right to the chair and got up there and put the apron over his lap.  I sat down and pretended to read magazine. Praying!   The two barbers ( one cut, the other stood in front of him) and started using clippers. He sat there and did great!!! 15 minutes total – we were in and back out in the car!!  I never even got up out if chair!!  A miracle!   Hair looks great!!  Can you believe it!!  I’m so thrilled!!

He is actively engaging all his OT/SP skills daily to which EVERYONE that knows him is astounded by the change in him.

You don’t have to write me back but from the first day,  Neuroprotek has made a difference! I’ll keep you posted,  thanks so much. 🙂

Yeast
He’s back on diflucan for almost 2 weeks now and overall much better.

We have seen tremendous improvement since starting the Fluconazole last week. The child has been more engaged and is no longer stuck in his room playing with only his trucks. He is much more vocal, interactive and responsive to his environment and we have had many playful back and forth conversations and games with him. His articulation has improved also, and I can understand him again. He is talking more, initiating more and analyzing his surroundings and comments from other people in the house!

He is doing a lot better!!!! His stomach seems to be much better anyways and much happier guy overall. I actually got the diflocan filled only today so I will touch base in the next few days. I love you all and I’m so grateful that my child is in the right hands now and on his way to great things.

Poop
Ever since we started the vitamin c , his poop is soft and easy to push out.

… Our child has been doing quite well. She is now TOTALLY potty-trained and is doing well at her new school which is accommodating her in inclusive classes. So now we are focusing on her speech. 

She had a great soft BM within just a few hours of the first dose of the lactulose. She was so happy she shouted Yay! Thank you again Dr Udell!  We are so glad to have you in our life!

This evening he went to the bathroom. A full size sample. I attached a photo. (I get lots of pictures of BMs).

Education
Sending you some pictures of the homeschool room.  We started on 1/4/16.  My child was able to sit through 3 1/2 minutes of calendar time on that day.  As of today, she is up to 19 minutes of calendar time, with a goal for the year of 20 minutes.

The teacher told me today that for the first time he asked for water, fully engaged with the class and the activities, play in the kitchen – he made pizza and served his classmate, fully verbal interact… she put tears in my eyes.

Just wanted to send you a video of him reading (“memorized”) the brown bear book. He’s talking a lot and wanted to share. Hope all is well.

Wanted to share great news. He scored above average in Reading Comprehension and average in Math. He was promoted to first grade with no issues. Next year he will be in a Gen Ed classroom for 90minutes, 5 days a week. He will also share specials and events with his Gen Ed class.
We would like to thank Dr Udell and his wonderful caring team! We feel blessed!

Guidance & Communication
Thank you for all your help and advice…

I will be so grateful thank you so much for all of your guidance and help my chid is doing much better each day and I know this journey is going in the right path.

Let me know your thoughts.  Thanks again Dr. Udell.  I am so grateful for your dedication and knowledge.

Dr. Udell – thank you for getting back to us so soon. I will communicate with the office tomorrow.

Thank you for always keeping my child’s best interest at heart.

Thank you for all you do for my little girl and for the rest of your patients!
I have referred you many times in past few months because I believe you are saving so many kids when no one else will.

You need to be a part of a contest for one of the highest quality websites
on the net. I’m going to recommend this site!

Conclusions
Of course, not all of our work results in such positive stories. However, by answering the calls and emails, and staying up-to-date with the science and the families, we continue to have an increasing number of children who experience improvement, if not complete resolution, of their childhood developmental challenges.

Many thanks to my amazing families, the patients, and our wonderful, caring staff.

Flu Shots in Pregnancy May Increase Autism Risk

Sunday, December 4th, 2016

jamaThe Journal of the American Medical Association recently published a study entitled, Association Between Influenza Infection and Vaccination During Pregnancy and Risk of Autism Spectrum Disorder.

Whispering Down the Lane
Health News from NPR, Fox News, Medscape.com and even the American Academy of Pediatrics echoed each other, claiming the paper offers proof of the flu vaccine’s ‘safety’ when given during pregnancy.

Do these reporters really read the research? I reviewed the same literature, and decided that the title of this post should highlight the opposite position.

Results
1. “…maternal influenza infection during pregnancy was not associated with increased autism risk.”
If a pregnant woman gets the flu, the child is considered safe from the standpoint of developing ASD. This is not necessarily supported by other research (1 , 2, 3, 4), but this finding provides some level of comfort.

2. “There was a suggestion of increased risk of autism spectrum disorders among children whose mothers received an influenza vaccination during their first trimester…”
At the earliest time in gestation, many women may not be aware of a pregnancy, which might be risky, if they receive the ‘shot’. Fudge factor: “…the association was statistically insignificant after adjusting for multiple comparisons, indicating that the finding could be due to chance.”

3. “Our findings do not call for vaccine policy or practice changes but do suggest the need for additional studies.”
Is that explanation supposed to make that make families feel more comfortable about this issue? How about this? One of the principle authors “…received research grant support from GlaxoSmithKline, Sanofi Pasteur, Merck, Pfizer, Protein Science, MedImmune, and Novartis.”

Other literature
Research demonstrating effectiveness of the vaccine, especially in the face of a specific epidemic is the principle motivation for the recommendation to vaccinate in pregnancy. The publications from the beginning of this century have demonstrated efficacy and safety for the mother and the baby. Previous studies have also shown an increase in small or preterm infants associated with influenza during pregnancy.

However, there is a lack of research regarding ASD outcome when flu vaccine is administered, and pharmaceutical industry funding is ubiquitous.

The flu shot is not recommended for children under the age of 6 months. It is advocated for pregnant women. So, it’s OK if you are a fetus? The use of acetaminophen for a fever, which is certainly a known complication of ‘shots’, has been identified as a possible contributor to ASD.

Conclusion
Whose interests are being served by the widespread use of these vaccinations? For the very old or infirm, it seems a reasonable option. Concerning the immunocompromised, even if herd immunity could be achieved (~90% vaccinated), that would only cover only a handful of the possible viral pathogens that exist – with new ones popping up every day.

The product generates billions of dollars for the drug makers. Money used to fund studies, such as these, needs to come from completely independent sources.

The present study indicates a slightly increased risk of autism from a flu vaccination given early in pregnancy. Since there is less evidence that the flu, itself, leads to significant developmental disorders, it appears that more information needs to be made available in the face of the modern autism epidemic.

Curcumin for Autism and ADHD

Sunday, November 27th, 2016
Turmeric plant

Turmeric plant

Over the past year, The Child Development Center has been successfully utilizing a natural supplement (Enhansa®) that appears to be improving the health of our patients’ gastrointestinal system, body and mind.

The turmeric plant and its product, curcumin, have been the subject of a number of media reports, lately. How can the preparation help patients with ADHD and ASD?

Turmeric subsoil stems>powder>curcumin molecule

Turmeric subsoil stems>powder>curcumin molecule

What it is
Turmeric is part of the ginger family, mostly known for its role as the main spice in curry. Curcuminoid compounds are utilized to treat a variety of medical conditions; including auto-immunity in the blood, rashes in the skin, problems with the gut, parasites within the body, and disorders of the liver, kidney, and brain.

Why it works
Many doctors ask, “How can one chemical help so many diverse conditions?”
An emerging theme in the practice of modern medicine is the ability of an affected body part to heal itself. Such a belief has been central to other therapeutic sciences for a long time. In that paradigm, natural substances that promote repair are at least as important as medicines that attack a presumed cause.

Turmeric contains curcumin, which possesses antioxidant and anti-inflammatory properties. Given that the compound successfully accomplishes those tasks, improvements in the efficiency and function of any organ throughout the body should be understandable.

How it is administered
Various preparations have been marketed as the ‘best’ formulation; including pills, crushed, with/without taste, and offerings from numerous manufacturers. Powder with black pepper is popular.

Similar to most medications, it is best to go ‘low and slow’. As the patient displays individual tolerance to a given pattern, the dose and/or frequency can be adjusted.

Effects
We have received lots of emails describing a variety of results – mostly positive, some negative, all instructive:
I have noticed great improvements in cognition and language with your suggested supplement. She seems a little more irritable, but the the gains are so good.
-The curcumin has been amazing. Improved language and cognition. Significant improvements.
-He felt warm for two days, but never registered a fever. He is doing amazing in school! He is now sitting with the other kids and doing his seat work. According to the school staff, they have witnessed attempts to talk and word approximations. The ABA therapist visited him at school yesterday, and reported the same. She is extremely pleased with his progress, and we are as well. I’m going to send you a picture.
-Our child reacted well to the turmeric and LDN compound. At first we thought he had a reaction to it, but he was getting sick. We have continued on the path and he seems to be reacting nicely. He is babbling much more and mood has improved…
-This supplement has been amazing so far at 75 mg bid. Her focus and sustained attention and receptive language are much improved and all her therapists across the board have noticed!
-It has been amazing. Improved language and cognition. Significant improvements.

Side Effects
I also wanted to ask, his poop has turned yellowish, it used to be dark brown. Is this normal with the supplements?
Changes in the color of urine and stool are due to the intense yellow color.
Our child was on the product for two days and an intense rash developed around his eyes! I stopped giving it, and it is slowly getting better.
Rashes are the most common side effect, so far. Reducing the dose often improves the problem, but close medical supervision is paramount.

Conclusion
As with all medical interventions, your child should be under the care of an experienced practitioner who can make specific recommendations. It is impossible to test all brands. Patients and problems are so diverse that, generally, doctors stick with the supplements with which we become most familiar.

When given to the appropriate population, with close followup of the clinical course, adding curcumin to the treatment protocol appears safe, and can provide significant improvement for patients with ASD.

cumin

Cumin plant, powder, seeds

By the way
Curcumin is not cumin, which is a different spice that is derived from seeds. Both products are used in curry. They share many similar flavoring and medicinal properties.

 

Autism vs. Insurance

Sunday, November 13th, 2016

insurance4If insurance is a wager to cover the expenses incurred due to some rare, catastrophic event, then health insurance is only a distant cousin. It’s betting how much you will owe hospitals and doctors when you are un-well. For people who will never get sick or injured, medical coverage is unnecessary.

However, for an increasing number of modern families, an autism diagnosis will become a reality. The lifetime costs range from ~$1.5M – $2.5M, or more. Actuaries know this, of course. Presently, and for the foreseeable future, to the extent that is ‘allowed’, coverage will be significantly limited for medical conditions that fall under the ASD banner. It’s the insurance business.

How Not to Cover an Autism Claim
An underlying principle is that, the longer it takes to pay, the more interest is generated on a company’s reserve dollars. Any excuse to deny, therefore, can improve profitability.

Since coverage is provided based on the type of diagnosis, the more specific and verifiable, the less likely likelihood of a disagreement about expected costs. Autism is neither a precise entity, nor can it be confirmed with scientific instruments.

Even the usual and customary therapies, such as ABA, OT, PT, and Speech&Language are disputed. Insurance plans have gone kicking and screaming into paying for those proven services. Plus, the practitioner must possess the credentials that are acceptable to the payor. Barriers are erected at each step along the way.

Getting reimbursed for a proper workup can be difficult. An MRI or EEG may be customary, but not a genetic test or food allergy panel. Successful patient outcomes are not as convincing as university research. Funding for a study on dietary effects on behavior based on laboratory evidence carries little profit motive.

For ASD, the primary on-label medications are very potent and potentially harmful. Due to formulary limitations based on cost, practitioners are even instructed to prescribe a more dangerous drug over others that might be better tolerated. More effective and less expensive supplements are not even considered.

The Folate Example
For over a decade, variations in the genes that propel an important metabolic pathway have been tied to problems in patients with autism. That has not deterred insurers from denying reimbursement to the accepted testing laboratories – and increasing charges for out-of-pocket expense.

Utilizing a relatively inexpensive supplement, a recent study has demonstrated, “…treatment with high-dose folinic acid for 12 weeks resulted in improvement in verbal communication as compared with placebo…”

Not surprisingly, insurance companies refuse to pay for this medicine, either.

Conclusions
Families of patients with ASD already know that they must pay out of pocket for many of the treatments. If they work great, it’s worth it.

As new insurance products take shape, it may be a good opportunity to lobby nascent companies for improved coverage of all autism treatments that show validity. Showing a cost savings matters more to companies that intend to stick with an insured.

Measuring markers of autism, such as folic acid metabolites, for diagnosis and results of treatment, will go a long way toward discovering – and getting reimbursed for – newer interventions.

The role of prevention cannot be overemphasized. Our external and internal environments must be scrutinized. More appropriate standards created and implemented for safe food, air, and water, should reduce the cost of all health insurance.

Pediatricians and Autism

Sunday, November 6th, 2016

“I think that your toddler may have some signs of autism. That’s a complicated subject. I’ll give you a referral for…”

Sound familiar? Was that the first time that you heard what you (or your spouse) had suspected from a medical professional?

This story is not meant merely to ventilate. Education is the goal. The challenge is how to get an uninterested, overworked, under-reimbursed, skeptical group of intelligent individuals to pay attention. We are standing in the middle of the childhood epidemic of our time, and the professionals continue to worry that there aren’t enough vaccinated kids! It’s insane.

That was the ventilation part.

Education
At the first sign of a thyroid problem, e.g., a doctor doesn’t just send a patient straight to the endocrinologist. Rather, a baseline blood level is ordered, the results are evaluated in the light of the patient’s signs and symptoms. Next, the clinician is expected to explain all pertinent information, and refer to the most relevant specialist.

In the case of developmental delay, it seems that such a protocol is rarely followed. Even the expert (neurologist, or developmental pediatrician) seldom follows a prescribed course of action. An EEG and MRI? That depends on the family’s insurance status. Chromosomes or genetic testing? The usual advice is, if you aren’t having any more children, that won’t be necessary. Or, “The results won’t matter, anyway.”

External factors such as these should not be the determining factor in the 21st century workup of any patient, let alone a child whose growth is not proceeding in a normal fashion. A previous post details the top ten things all pediatricians should know about ASD. There is a workup to be done.

After a visit with the neuro-developmental doctor, a follow-up examination should take place with the ‘main’ practitioner, who ought to become the child’s medical advocate, rather than the parent. Pediatricians who believe that a family is ignorant or ill informed about the use of an off-label treatment need to learn more about all of the options, in order to assist the family in such decisions.

Discussion
This year (Jan-Nov, 2016), there were eight articles in The Journal of Pediatrics specifically about ASD. That is less than one significant article per month in our major pediatric publication.

Autism Spectrum Disorders and Metabolic Complications of Obesity
Autism and antidepressant use in pregnancy
New rapid autism screening test
Applied Behavior Analysis as Treatment for Autism Spectrum Disorder
To Screen or Not to Screen Universally for Autism is not the Question: Why the Task Force Got It Wrong
Predictive Validity of the Modified Checklist for Autism in Toddlers (M-CHAT) Born Very Preterm
Reported Wandering Behavior among Children with Autism Spectrum Disorder and/or Intellectual Disability
Comorbidity of Atopic Disorders with Autism Spectrum Disorder and Attention Deficit/Hyperactivity Disorder

The best way to address this present state of outworn medical attention is to fund and publish more research. This involves a paradigm shift in the diagnosis and therapy of ASD. The condition is of multifactorial origins and consists of a variety of signs and symptoms that can be ameliorated.

Pediatric residencies must adopt a new clinical rotation for this important malady. Practitioners who do not believe that, in complicated medical conditions, their role should be ‘captain of the ship’, might consider other medical specialties that do not carry this type of obligation.

Conclusion
It is simply not enough for a present-day pediatric clinician to exclaim, “Well, I don’t know much about autism.” The preferable, and intelligent answer should be, “I’m going to have to do a bit of study about this condition. They didn’t teach us about this in med school, but it seems important.”

Perhaps parents can use this essay to inspire/challenge your doctors to develop a modern attitude toward this medical mystery.

Staffing for the Autism Epidemic

Sunday, October 9th, 2016

The Child Development Center has been blessed to experience a stream of wonderful, young, eager students wishing to learn about caring for special needs pediatric patients. Some go into ‘the business’, while others have gone on to a variety of great life adventures. We are also lucky to have our superb Practice Manager, Karen Vossen, who is an exemplary role model, teaching parents and staff alike, how to handle the patients.

gabiskywalker

The Force is strong with this one

Our latest graduate, Gabriella Tabib, has chosen to pursue this line of work. Here is what she wrote about her time here at The Center:

I started working with Dr. Udell during my final year of undergraduate training. After listening to many of my peers discuss their volunteering experience, I wished to intern, as well. I could see a passion in their eyes and I wanted that, too. But where was I going to start? Fortunately, I had an idea about what I wanted to do.

First, I wanted to work with children. Children are amazing. They are imagination unhindered. They are bottled potential. The ‘abnormal’ side of child psychology is just as fascinating. In high school, I had volunteered on a horse therapy ranch, working with children who had ASD, cerebral palsy, and Down syndrome. For my internship, I wanted to work in a similar setting.

I found a place at the Child Development Center of America. My job included interacting with the children while their parents spoke with Dr. Udell about the child’s diagnosis and treatment plan. My responsibilities included measuring the child’s height and weight, conducting ATEC scores when needed, and keeping them engaged for the hour. Dr. Udell used my observations to gauge their progress.

I came to realize that I had knack for connecting with children on the autism spectrum. I began to understand how they interact in, and with, the world. I saw stimming – not as an unhindered, reflexive process – but a means of communication. I saw double swirls and single palmar creases as signs of genetic links to that patient’s condition. I also learned what it meant to have a child with special needs.

Whether your child is neurotypical or not, parenting is a monumental undertaking. It is a full-time job filled with changing diapers, answering hundreds of questions, and chasing after them as they grow up right before your eyes. But what if toilet training takes longer than necessary? What happens when the ‘whys?’ never come? Learning that your child has autism is life changing.

I watched Dr. Udell guide many parents through understanding autism and innovative treatment options. He truly cared about every patient that came through his doorway. He treated each condition on an individual basis. His first question is not, “What helped all the other children?” Rather, he asks, “What seems to be ailing this child?” It opened my eyes to the true nature of psychotherapy and medical treatment. Considering each patient individually may be more time consuming, but it offers the best results.

I am truly thankful for the time I spent with Dr. Udell. I met so many amazing children and their families. I learned so much about the future of autism diagnosis and treatment, and how I can personally make a difference. I look to the future full of hope and inspiration.

Working at the Child Development Center has solidified my passion for working with children, especially those whose diagnoses lie ‘on the spectrum’. I can proudly move forward in my career, knowing that I gained such a wealth of knowledge and support. This experience will enable me to become a top-notch mental healthcare professional for all of my present and future clients.

Many thanks to you, Gabi.
Your intelligence, optimistic personality and inquisitive nature has helped our practice, as well!

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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
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