Archive for the ‘News-Maybe-Worthy’ Category

Recent Research about MRIs for Autism

Sunday, February 26th, 2017

Since the outbreak of autism, various attempts have been made to utilize modern imaging techniques to provide a more precise diagnosis. Here are two recent stories that warrant recognition and comment.

Relationship between brain stem volume and aggression in children diagnosed with autism spectrum disorder is not the first of its kind to describe an inverse correlation between the size of that part of the central nervous system and ASD. However, it is the first to possibly relate increased aggression with a measurable parameter.

One expert describes, “The brain stem serves as a bridge in the nervous system. All the fibers that go from the body to the brain and vice versa go through the brain stem. It sits at the top of the spinal column in the center of the brain… handles basic functions like breathing, swallowing, heart rate, blood pressure, sleeping and vomiting. The brain stem does not play a part in higher cognitive functions…”

The authors concluded, “Understanding brain differences in individuals with ASD who engage in aggressive behavior from those with ASD who do not can inform treatment approaches.” Indeed, disruptive behaviors describe a type of autism that is particularly difficult to address, and may even require potent medications.

The second article was Early brain development in infants at high risk for autism spectrum disorder, in Nature. The research revealed that surface area enlargement between 6 and 12 months precedes brain volume overgrowth observed between 12 and 24 months, which was linked to the emergence and severity of autistic social deficits. “These findings demonstrate that early brain changes occur during the period in which autistic behaviors are first emerging.”

The good
Both investigations serve to encourage the idea that timely detection leads to earlier intervention, which leads to improved outcomes. Even that obvious fact continues to be debated in some forums.

The bad
These studies are descriptive, and so they do not provide answers about cause and effect, form as relates to function, underlying genetic, nutritional or toxic states. There are many presentations of the condition, and research generally tries to get as homogeneous a group as possible – perhaps not representative of a larger group. More information is required to deduce practicality or therapeutic intervention.

The ugly
Emily Willingham, ‘science’ writer at Forbes.com, used the latter study to ‘prove’ and promote her vaccines-are-safe-for-all-kids campaign. Not a word about ‘shots’ was mentioned in the entire article, and this pro-inoculation zealot found a way to insert that thought into unsuspecting readers, in her piece entitled, “An Unexpected Takeaway From The Early Autism Diagnosis Study”. Yep, Em, that was unexpected!

Conclusion
One investigation delineated decreased brain size in one region, and the other demonstrated increased overall brain volume. A recent paper about neuro-imaging technology offered this advice: “… heterogeneous and definitive neural correlates in ASD have yet to be identified… findings from multiple independent neuroimaging meta-analyses in ASD appear discrepant…”

Such research represents further attempts to explain the medical issues. This should encourage other universities and research institutions to explore these topics, as well.

As is frequently the case, for now, the use of MRI technology to elucidate the pathophysiology and diagnosis of ASD deserves further study.

What to Expect from Biomedical Treatment for Autism and ADHD

Tuesday, February 21st, 2017

As in any medical condition, it is entirely fair for parents to inquire about the timing of improvements, after undertaking biomedical intervention to improve signs and symptoms in their children who are affected with ASD. “How will we know if it’s working? When will my child get better?”

Factors affecting speed of recovery
How severely the child scores, according a standardized test for autism, is a major factor in assessing the time it may take for reversal of symptoms. For those in denial, this can be a wake-up call. For the parent who ‘already knew’, it represents a starting point. The time that it will take to observe improvement is generally proportional; from mildly affected to very disturbed development, taking from 6 months to many years until improvement is noted.

Perhaps interestingly, children who score very ‘low’ (few autistic characteristics) may turn out to take more time than might be expected. That could be due to the mysterious nature of their particular developmental delay, and ‘putting our finger’ on how to address individual obstacles takes investigation and various trials.

The degree of a child’s inability to communicate – from the severity of speech apraxia to social isolation – is proportional to the time it will take for advancement. Whether due to biomedical intervention, or just maturation, it becomes extremely worrisome if this achievement takes more than 18 months. After initiating biomedical intervention, kids who simply begin to even copy the therapist will make faster gains.

Self-injurious behaviors and aggression greatly impede advancement in all domains. Such conduct is frequently gut-related, so a thorough workup and effective treatment should take precedence over any other interventions. The time it takes to get this system under control is predictive of speedier success.

Factors not necessarily related to timing of improvement
Intelligence is not in question for most patients. In fact, it seems that the brightest kids are the most likely to manipulate their family and therapists, sometimes slowing down their own improvement. Often, behavioral intervention (of some type) is key to achieving compliance and self-control.

Sensory issues may continue for many years, even after the children are mostly ‘better’. In fact, this may be the lingering issue for which parents seek treatment, and a major cause of inattention and social anxiety.

Immaturity is common, leading to tantrums and issues with self-control, and proceeds slower than neurotypical children. Peer pressure from role models and family members accelerates this troublesome problem.

Discussion
It is sometimes difficult to get our heads around the chronicity of this developmental condition. All children experience good days/ bad days; it appears exaggerated with ASD, and some medical problems recur (yeast, e.g.).

When first diagnosed, if a parent could be certain that their child may only experience leftover sensory, hyperactive, or focus issues, they would probably be okay with that future. Not all patients suffer even those lingering difficulties.

Many families have witnessed accelerated development resulting from biomedical intervention. Parents, teachers, and even doctors will avow visible progress.

Conclusion
Autism is a collection of conditions that emanate from a variety of sources. As the diagnosis becomes more precise, outcomes will be based on information, such as genetics, metabolism, and immune function, and expected outcomes will become more accurate, as well.

I advise parents to watch for little goals.  ‘Recovery’, ‘reversal’, ‘optimal outcome’, ‘normal’ are journeys that begin with small steps.

Frustrating as it may be, regardless of speed, it is the sustained, forward trajectory of development that appears to be of upmost importance as parents consider, “Will my child make it?”

Processing Disorders are Autism

Sunday, February 12th, 2017

With all of the professionals who care for individuals experiencing signs and symptoms that are presently classified as ASD, it isn’t surprising that the organization of problems reflects the point of view of each discipline.

To the extent that nomenclature describes identifiable, clearly understood pathways, it can improve our understanding of function (or the lack thereof), as it relates to structure (but not necessarily vise-versa). Often, however, researchers utilize long, complicated terms that merely restate the obvious. Such designations may not provide additional insight, which is sorely needed if we are to reverse the named condition.

Selective eating disorder = picky eater

Visual processing disorder = sees things differently

Auditory processing disorder = hears things differently

Sensory processing disorder = feels things differently

Oppositional defiance disorder = responds to everything the opposite way

Attention deficit disorder = won’t focus on non-preferred activities

Hyperactivity disorder = can’t sit still

ADHD = both of the above

Sleep disorder = takes longer to fall asleep, wakes up frequently, or both

Social anxiety disorder = uncomfortable around others

Obsessive compulsive disorder = repetitive behaviors and restricted interests

Cognitive processing disorder =?Executive functioning disorder = ?Motor planning disorder = ?expressive language deficiency = ?receptive language disruption = ?doesn’t (appear to) learn/listen/remember.

Discussion
Each of these labels accurately reflects some condition frequently experienced by individuals with ASD. Professionals may utilize such information to address a patient’s issues, but it can be quite confusing when complex jargon is invoked to explain an intervention to the family.

“Why is my child exhibiting this aberrant behavior?” Until much more research identifies actual, measurable, specific physiological states, my response is, “Signals sometimes go to the right place and can perform the appropriate function, the wrong place and lead to an incorrect response, or just bounce around and diminish.”

At least, an understanding about, and explanation of, similar terms utilized by other disciplines would ease parents’ concerns that, “Somebody missed something,” about their child.

Conclusion
I recently spoke with a mom who was told about a feedback loop issue in her child with motor planning deficiencies and sensory processing difficulties. Each therapist provided a valid diagnostic label. I suggested that she focus on the skills required in order for her 4 year-old to play with other children.

Rather than invoking esoteric, complicated language as to theoretical cause, the focus should be on assisting patients’ ability to achieve required skills, such as spontaneous speech, self-control, eye contact, motor proficiency and socialization.

Smooth, efficient processing between our body and brain is the goal. In human development, when systems fail to mesh in the correct fashion, what we observe is called autism.

Optimal Outcome for Autism

Sunday, February 5th, 2017
1/30/17 Email to TheAutismDoctor.com 
Hello, 
I am a student doing a research paper on the over-diagnosis of autism. Do you think the over diagnosis of autism is rising? …Thank you and your response is greatly appreciated!

Dr. Udell
There is a controversy about whether or not autism is being ‘over diagnosed’, or it is simply being recognized more accurately. If earlier recognition of the problem results in fewer children with school problems, it might not matter what the condition is called.

With all of the confusion about autism diagnosis, it probably isn’t that surprising that a youngster in today’s world, writing a school report on autism, chose ‘over-diagnosis’ as her main focus.

Over-diagnosis?
Last year, a paper entitled, Diagnosis lost: Differences between children who had and who currently have an autism spectrum disorder diagnosis was popularly presented as, Government Study Suggests Autism Overdiagnosed.

Research appearing more recently, Evidence of a reduction over time in the behavioral severity of autistic disorder diagnoses could have engendered a similar conclusion.

Changing the paradigm
Appearing in Policy Insights from the Behavioral and Brain Sciences was an important document that will further diagnosis and treatmentOptimizing Outcome in Autism Spectrum Disorders.
ASD can result in a wide range of outcomes,
from need for lifelong care to successful adult functioning.

Intensive behavioral intervention can change the course of development and outcome, especially if intervention begins in early childhood.

To receive effective early intervention, the individual
must be detected, and then diagnosed early.

Screeners for autism are effective; some concerned stakeholder organizations endorse universal autism screening at 18 to 24 months.

Children from economically disadvantaged or ethnic minority families are detected and diagnosed up to 2 years later, delaying their access to intervention and limiting their outcome.

To detect ASD in early childhood and reduce treatment disparities, physician surveillance and elicitation of parental concerns should be augmented by universal screening.

The author concluded:

“The cost of effective early intervention is significant; however, the impact of failing to provide this intervention in long-term costs and unrealized human potential is much greater.”

This week, ScienceDaily reportedResearchers outline new policies for earlier detection of autism in children. ABC News reported, “Autism diagnosis spike linked to change in understanding of spectrum, study finds.”

Much better!

Discussion
This information should improve our understanding of the true spectrum of signs and symptoms that are characterized as ASD, and provide methods to address the situation.

It outlines clinicians’ early responsibility to assist the family in checking for red flags; over-diagnosing, God forbid, a newly perceived developmental anomaly. Nomenclature notwithstanding, there are delays that can be ameliorated, especially with earlier recognition.

Conclusion
Importantly, these guidelines expose what children need, if not precisely how they arrived with the developmental challenges. From a biomedical standpoint, it highlights a pediatric specialists’ need to understand an appropriate workup, rather than an old-fashioned hand-off to another specialist.

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.

Susceptibility Factors for Autism

Sunday, January 22nd, 2017

For over twenty years in the last century, I spent my medical training practicing the care and feeding of sick infants. Studies that tie events in the perinatal period to autism carry particular significance. To the extent that research identifies supplements, medications, procedures and interventions, by altering suspect behaviors, we are encouraging ASD prevention.

Here is some recent information that deserves discussion.

Meconium exposure and autism risk.
“Children exposed to meconium were more likely to be diagnosed with autism in comparison with unexposed children… Resuscitation of neonates with respiratory compromise from in utero meconium exposure may mitigate long-term neurodevelopmental damage.”

There has been some debate in the past decade about whether the removal of stool from the windpipe of children who experience some type of stress in the womb prior to birth is the best course of action. This study supports the protocol and also highlights the improvement when a trained clinician examines the newborn’s trachea and takes appropriate action.

Folinic Acid Shown Effective in Autism
Folate is a vitamin that takes several forms as it becomes active in the formation of antioxidant products involved in the B12 pathway. A recent study identified that, “Folinic acid improves verbal communication in children with autism and language impairment: a randomized double-blind placebo-controlled trial.” Various preparations containing a high dose of this supplement are becoming available at more reasonable prices.

This intervention could be important for all ASD patients who experience speech apraxia.

Folate Receptor Antibody Test (FRAT) now readily available for blood
Although the knowledge that deficiency of, and antibodies to, some form of folate may exist in, and be responsible for, some types of ASD, the reality has been that performing a spinal tap (putting a needle in the spine) on children was possibly risky and impractical.

A company has come forward with a reasonably priced, useful blood test that accurately reflects binding and blocking antibodies in the central nervous system. The implication is that providing relief for this condition will result in improved signs and symptoms for affected individuals.

Vitamin D Supplementation for Autism
The significance of this recent study cannot be over-emphasized. Pregnant women should be tested for levels, and treated appropriately. And, all diagnosing clinicians should understand that, along with making an accurate diagnosis, the medical workup should include determination this important nutrient.

Conclusion
Finally, here is some good news surrounding the research of autism cause(s) and treatment(s).

Good Doctors for Autism and ADHD

Sunday, January 15th, 2017

The Best Autism Doctors has been a popular story on this website. My point was that patients need a competent clinician, and that ‘BEST’ is not necessarily relevant, necessary, or attainable for each child. Considering these issues will help a parent make a more informed decision.

All doctors
‘Good’ doctors thoroughly address your specific problems, so their knowledge and abilities are of upmost importance. Patients expect a clean, well-run office, with friendly, competent, respectful staff and up-to-date equipment.

We want caring clinicians who give us the time to explain our problems and really listen. Patience is key. We expect calls to be returned, especially regarding test results – with kind, compassionate responses. We want to be able to refer this professional to others.

Autism specialists
The qualities that make an effective doctor for patients with ASD and ADHD should also include the following:

Adequate observation by the treating physician. Remember, if you’ve seen one child with autism… Personnel trained to recognize ASD may not necessarily consider metabolic or gastrointestinal conditions, so collaboration with the doctor is paramount.

Up-to-date labs, individualized for each patient, with regular testing should be performed. A recent study demonstrated that traditional specialists  “… fail to order tests that should be routinely performed and often order tests that are not routinely indicated yet are neither benign nor inexpensive. Recommended molecular genetic tests are often not ordered.”

Doctors who successfully treat patients with ASD have an extensive education, experience, and devote the time to rigorous continuing education. For parents wishing to go to the ‘best’ autism doctors, membership in the Medical Academy of Pediatric Special Needs should be prerequisite, until some better medical society comes along.

Especially regarding the expenses associated with an autism diagnosis, supplements need to be made available at a fair price. There are thousands of products that claim better toleration, improved absorption, fewer side effects, etc. Your ‘good’ clinician is best suited to make the correct choice. Also, there should be a willingness to explore alternative preparations that make sense.

Interventions that are tailored, not only to a patient’s symptoms, but reflect underlying, treatable problems. As one protocol fails to demonstrate effectiveness, the approach should be altered – sometimes frequently. Professional explanations, appropriate literature, and use of web information goes a long way to reducing the confusion of this difficult developmental diagnosis.

Close follow-up of the clinical course, response to treatment, and childhood development can fashion an improved outcome. Therefore, some method of reasonable response time to emails, phone calls, etc. is an important feature.

‘Good’ doctors show a willingness to collaborate with the traditional therapies and therapists. An experienced staff, who frequently are well-versed in autism, can be a great resource regarding such advice. Parents frequently have questions about issues, from academic environments to alternative treatments.

Regarding the use of supplements and medications, “starting slow and going low,” offers the best opportunity for the parents – the patient’s expert – to report positive and negative results. Complex and/or confusing protocols may lead to more negative results than necessary. Parents should understand specific directions, with as few changes as possible prior to instituting another shift.

‘Good’ autism doctors advise about the efficient use of resources. There are a myriad of interventions, from affordable and readily available vitamins, to expensive hardware and complicated procedures. Due to a paucity of repeatable research, the doctor who studies all possibilities, and understands a family’s resources, can give the best advice. Also, referral and willingness to collaborate with appropriate medical sub-specialists will streamline the process of recovery.

Conclusion
Indeed, even the BEST autism doctor may not be able to assist a severely affected patient. Understanding and effectively treating speech apraxia, repetitive thoughts and behaviors (scripting and stimming), and aggression may be beyond our science, at this time.

This does not mean that parents should not continue to search for better treatments, but that a reasonable workup by a competent, caring clinician who persists in exploring ongoing problems may provide the most effective treatment available.

Becoming a good doctor for this mysterious diagnosis is not so much,
“Thinking outside the box.”
Successful results occur when professionals
Connect the dots • — • — •

TheAutismDoctor’s Top Stories

Friday, December 30th, 2016

As I have previously explained, I produce this blogpost for 4 principle reasons; to learn, to teach, to offer a middle-ground, and to ventilate about the less-than-state-of-the-art medical care offered to patients with autism and ADHD. Here are my picks for 2016’s most useful stories:

January
In An Autism Prevention, we learned about medications taken during pregnancy that could be contributing to the autism epidemic. Pharmaceutical preparations that have become ubiquitous in this century are suspect. Reducing their intake could result in a decrease in the number of new cases.

February
Americans With Autism Act. This was my opportunity to blow off steam about a local fight to get a student with ASD the necessary and deserved services. The outcome was in direct conflict with decades-long evidence that ABA works.

March
I often give advice about the difficult problem with Speech Apraxia. This article lamented the sad state of affairs regarding scientific identification of the problem, let alone workable solutions.
(Happily, this situation has been somewhat addressed in this recent, randomized study utilizing folinic acid.)

April
Vaccination Redux was this year’s best effort to explain my position on the childhood vaccination schedule. What can I say? The problem won’t be resolved by bullying or vaccine industry-supported research. BTW, I am not against childhood vaccinations.

May
Folate Issues. Folic acid has been in the news throughout the year. This story was about too much of a good thing, if taken during pregnancy. Obviously this vitamin, and the pathways that are involved, are very important to our understanding of the autism mystery.

June
The importance of Genetic Testing in Autism was my opportunity to spread the word that a modern medical workup should include appropriate laboratory testing, including a chromosomal microarray. The subject material is dense, but key to understanding one group of autisms.

July
Acetaminophen and Autism presented scientific evidence to warn about the casual us of this potential culprit. Four studies were made available, so pregnant women should take note, and seek more acceptable alternatives for relief.

August
In Digital Devices and Autism, I expressed my opinion to the frequently asked question, “Is it OK to give junior the iThing?” Children who seem to gain real academic benefit are few. Mostly, iStuff provides no imagination and no socialization, fueling core deficiencies in ASD.

September
Processing Disorders and Autism, crystallizes a decade of my understanding about this set of childhood developmental and physical disorders.
By connecting the dots about the various maladies that affect patients, such as sensory processing, GI problems, and low core muscle tone, we achieve a greater understanding about the causes, and downstream behavioral effects.

October
Just in case pediatricians haven’t noticed the epidemic, and because the US Preventative Task Force has recommended against formal testing, I continue to write at least one Early Signs post each year, to enlighten the unenlightened.

November
Medical school exposes students to very-little-to-zero information about alternative healing services; such as chiropractic, naturopathic, and homeopathic remedies. This story was about my research and experience as relates to the turmeric plant. Its antioxidant properties have helped our patients with gastrointestinal, behavioral and even developmental challenges.

December
A bit of levity. I have spent months perfecting the 12 Days of Autism Christmas.
Perhaps, next year I’ll attempt to furnish new lyrics for Dreidel, Dreidel, Dreidel.

Conclusion
This is TheAutismDoctor’s year-end opportunity to rediscover the polarized world of Special Needs Pediatric diagnosis and treatment. My articles take a great deal of time, study, and thought. So, they are all important to me, and should be helpful for families and professionals, as well.

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.

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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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