Archive for the ‘News-Maybe-Worthy’ Category

Docs, Glocks and Autism

Thursday, July 30th, 2015

gunMiami Herald
July 28, 2015
Appeals court upholds doctor-patient gun law

According to the article, “The law subjects healthcare providers to possible sanctions, including fines and loss of license, if they discuss or record information in a patient’s chart about firearms safety that a medical board later determined was not “relevant” or was “unnecessarily harassing.” The law did not define these terms.”

The law did not define these terms
It has been reported that U.S. Circuit Judge Gerald Tjoflat, the author of the majority opinion, understands that, in a patient at-risk for suicide, this might be a valid medical concern.

How about this case?

A fifteen year-old male who suffers from moderate-to-severe autism (or any other medical – psychiatric condition), takes Zoloft for aggressive behaviors, perseverates on violent video games, and doesn’t seem to grasp the line between fantasy and reality.

Would it be fair to say that a discussion by the physician with the parents about weapons in the home is appropriate?

The risk factors

  • The patient’s sex.
  • The person’s age.
  • Medication(s) use. There is even a ‘Black Box’ warning on SSRIs about the increased possibility of suicide.
  • The predilection for violent video games related to behaviors.
  • The teen’s inability to discern reality vs. fantasy. When asked, “Who is your best friend,” for example, one patient responded with the name of person who he had never met.
  • Constant bickering with parents over school.
  • A loaded gun in the house.

Discussion
Such a situation might be equally as valid when a patient experiences conditions other than ASD. Indeed, people ‘on the spectrum’ are probably less likely to act with outward aggression. Certainly, a discussion about elopement is absolutely a necessity in the face of autism, as are questions about a pool safety and the ability to swim.

Surely, there are a gaggle of gun-toting attorneys who can poke holes in my case. After all, I’m just a healthcare provider.

The lawyers representing the doctors got it wrong. This is not about the first amendment rights of physicians to discuss the issue of guns. This is about public safety. And, let’s face it, when it comes to vaccinations-for-all, as an example, there’s no problem protecting the herd.

Perhaps just as certain, is the possibility that, should a shooting death occur in this scenario, a lineup of litigators would appear on the radar screen, accusing the (ir)responsible doctor of not taking the obvious and necessary steps to prevent such a tragedy. “An Accident Waiting to Happen,” might be the headline.

Conclusion
This is an insane law that supports the NRA’s unyielding position about the rights of gun ownership. It is proof of how corrupted our system has become, due the superabundance of lobbying money.

Gun control is what we need, in the face all the senseless shooting deaths by too many young men, who obviously have mental challenges. However bizarre, it is a standing law that has now been upheld by the Florida Court of Appeals.

More information will be required to illuminate the holes that are created by this imprecise lawyer-speak.

The Media and Autism

Saturday, July 11th, 2015

Emily Willingham, Forbes blogger and self-appointed autism expert, couldn’t let the story about the death of Dr. Jeffrey Bradstreet pass without injecting her two cents.

Dr. W commenced her comments with a 2,000 by 1000 pixel, scary picture of a syringe and needle. I never saw that photo at the beginning of one of her ‘Vaccination is Perfectly Safe‘ stories. She went on to detail the nefarious activities of a doctor administering a dangerous serum to unsuspecting patients. Em, have you ever heard of botox?

Conjecture, innuendo and professional jealousy notwithstanding, Dr. Bradstreet was the parent of an autistic son, and an early adopter, researcher, and lecturer of biomedical treatment for the disorder. He popularized medical evaluation and protocols to address metabolic variations at a time when the generally accepted cause of ASD was considered to be bad parenting.

All but the most conventional treatments are presented as kooky at best, harmful to patients at worst, and a waste of time and money. Some of the latest national news headlines regarding autism will illustrate:

  • ABC – Jim Carrey Apologizes for Posting Photo of Autistic Boy
  • CBS – Authorities: Anti-vaccine doctor dead in apparent suicide
  • CNN – Another study finds no link between MMR vaccine and autism
  • NBC – ‘You Don’t Outgrow Autism’
  • Fox – Woman says diet is healing son’s autism

Perhaps this situation, more than any other circumstance, hinders further worthwhile (i.e. causes and treatments) autism research. Headlines are made when a researcher is proven incorrect, statistics are questioned, and even a teen’s murderous rampage is presaged with possible links to Asperger’s Syndrome.

Regardless of the manner in which autism as a medical condition got so far off track, a new attitude needs to accompany the message that academics, practitioners, parents and charities project. Even skeptics who questioned the HIV/AIDS situation abandoned the ‘it’s their own fault’ line of thinking.

What can be done?

Autism foundations need to work together. Autism Speaks, The Autism Foundation, Autism Societies, and Local chapters have to find a way to advance positive publicity and useful information. There is little room for discord at this time. An unpopular stance, perhaps, but it can only help in the search for effective treatments.

Researchers need to get out in front of the media so that the epidemic proportions are clear, and that real work is being done to further study. Disagreements, such as increased incidence only being a perception, have already been addressed by the CDC.

Knowledgeable parents are doing the most effective job of finding professionals and insisting on protocols to help their affected offspring. Doctors need to join in this effort and announce the remarkable improvements that occur when biomedical and conventional treatments are combined.

Neurologists need to get on board. Frequently, parents are admonished that, “Nothing more can be done.” Improvements following biomedical protocols are either dismissed as coincidence, imagination, or magic.

Other specialists need to get on board. This means that allergists, pediatric psychiatrists, immunologists, dermatologists, gastroenterologists, and pulmonologists, have to broaden their knowledge base and focus on the patient, not their particular subspecialty. Too often, parents are only informed that the problem does not lie in their domain.

Pediatricians and family practitioners need to get on board. This is the childhood epidemic of our time, doctors; embrace it, learn about it, and take the time to talk to your families.

Autism heroes, such as Temple Grandin, Drs. Martha Herbert, Susan Swedo, Robert Naviaux, Richard Frye, and Jill James are modern medical role models for the next generation. The media, including Forbes, needs to highlight these personalities, rather than obfuscating this important issue with titillating stories and dogmatic posturing.

Conclusion
People who have Parkinson’s disease are not Parkinson’s experts, nor are people with cancer oncology specialists. Lorenzo’s oil is the exception, not the rule. Insiders and outsiders alike, need to embrace those who are doing real work to solve this problem.

The autism community includes a large, diverse population of well-meaning, knowledgeable and competent people. Together, we will understand and conquer this devastating scourge on our youngest constituents.

Wouldn’t it be nice if the media extended a helping hand?

What Pediatricians Can Do About the Autism Epidemic

Saturday, June 27th, 2015

Pediatricians are the first line of defense against childhood conditions that have lifelong effects. Traditionally, that has included the Denver Developmental Exam, frequent doctor visits in the first few years, and vaccinations to prevent childhood diseases.

News Flash
There is an epidemic of childhood conditions that include ADHD and ASD, conflicting opinions notwithstanding. That means that pediatricians ‘stand at the door’, and are responsible for prevention and treatment, no matter how much they resist this reality.

Stay up to date on pertinent literature. As the HIV epidemic began to emerge, medical science experienced a quantum leap in our knowledge about the immune system. Similarly, the increasing volume of parents who are concerned about their children’s delayed speech, lack of focus, and hyperactivity, demands more research and knowledge and less kindly reassurance, which is based on the experience of the previous century.

Carry a high index of suspicion. Five or ten minutes spent with a parent and child is not enough time to perform a thorough physical examination and elicit pertinent clinical information. The visit should include a documented nutritional summary.

Make a presumptive (if not definitive) diagnosis. Parents need information, and the child’s pediatrician is the expert. It’s fairly simple – delay in communication, repetitive behaviors and lack of socialization demand an explanation and exploration. Loss of language, lack of eye contact, and poor tone are red flags to be explored, not ignored.

Do a proper workup. At least check the blood count, thyroid, liver and kidney function. What is over-kill about exploring vitamin and mineral deficiencies in a picky eater? Then, the doctor could evaluate whether appropriate intervention makes a difference in the signs and symptoms that concern parents.

Make appropriate consultations as early as possible. In a recent UC Davis study, six of seven high-risk children who received therapy alone lost the presumptive diagnosis. Parents will be more upset with the pediatrician who says, “Let’s wait,” and improvement does not occur, than one who advises, “Let’s err on the side of caution,” even if symptoms could have abated without intervention.

 Advise parents to try the gluten free – casein free diet for a few months. What is there to be afraid of? Uneasiness about creating a nutritional deficiency can be easily checked with laboratory evaluation and documentation of proper growth.

Perform an appropriate evaluation for associated signs and symptoms. Explore the cause of frequent infections, rather than responding with the knee-jerk reaction of prescribing antibiotics. Miralax® should only be given for brief periods and for occasional constipation, and isn’t even approved in children. GERD that is treated with antacid preparations can lead to vitamin deficiencies. Steroids may reduce skin rashes, but do not address to the root cause.

When a child has the diagnosis of ASD, the doctor should explore safety issues. Elopement is not uncommon, so family plans should be devised. Although learning to swim is no insurance against a tragedy, acquiring that skill helps provide some peace of mind. Incongruous laws notwithstanding, discussing gun security is a must.

Provide parents with a reading list. TheAutismDoctor.com is a good start, where discussions are presented to address the polarized world of autism diagnosis and treatment. When possible, the essays have hyperlinks to the original research. The Newsworthy tab includes the most recent and pertinent literature.

Become knowledgeable about the variety of protocols. The doctor who has read the literature (both pro and con) about alternative treatments is the only one qualified to give advice. Practitioners who assert, “I’m not aware of this or that treatment,” may be highlighting their ignorance, rather than providing up-to-date info. Therefore, unless the pediatrician knows about a therapy, the patient will surf the ‘net, and listen to the professional who does.

Video Games and Autism – ADHD

Sunday, June 21st, 2015

“Watching that TV is going to make you stupid!” Such has been the advice of older generations since the first Philco screens appeared in our living rooms over a half-century ago.

In 1980, University of Pennsylvania professors wrote in the Journal of Broadcasting, “…television has inhibited intellectual development on a broad social level; it discourages students from reading, fun concentration skills, and impedes the acquisition and practice of scholastic discipline.” Apparently, that advice was not heeded.

tv graph 1In 2004, a paper in the Journal of Genetic Psychology concluded, “In sum, children who watched more television tended to spend less time doing homework, studying, and reading for leisure. In addition, their behaviors became more impulsive, which resulted in an eventual decrease in their academic achievement.” Viewing continued to increase.

“Playing those video games is going to make you stupid!” Again, the advice offered by older generations since Super Mario became popular a quarter-century ago. TIME magazine reported that “… the average U.S. gamer age 13 or older spent 6.3 hours a week playing video games during 2013. That’s up from 5.6 hours in 2012, which was up from 5.1 hours in 2011. “

Differences have evolved, however, in society and technology, so that children of all ages may be at risk for impaired neuro-typical abilities, especially in the social domain.

The i-Differences

Ease-of-Use (for those under 40)
Doctors should research how Steve Jobs was able to reach the most basic areas of the brain. Easily managing the user interface is a skill that children barely out of infancy can achieve. It doesn’t make the child “…good with computers.”
Entertainment that comes with so many movements, bells, and whistles is very attractive to developing minds. Non-electronic toys require real imagination and encourage socialization. Previously, dolls and such that talked usually ‘sucked’ because they were boring. With iPhone, there are infinite possibilities.

Variety of Formats
No longer are kids sitting on the same couch doing the same activity. One might be texting her BFF while another is annihilating aliens on the big screen. On personal devices, it is not necessary for another human to be present. And, even if present, it is not necessary for someone to exist in the same room (or country).
This situation adds to the disconnection that already exists in our world. When asked, “Who is your best friend?” patients are frequently stumped.

Games are Violent and Graphic
Similar concerns accompanied the warning about promoting violence in previous technologies. This time, however,  the viewer has control. There are blurred lines determining good and evil, spirituality, or even a sense of humor. A 2007 paper demonstrated, “… a physiological desensitization to violence.”
As 3D and VR improves, there are blurred lines about reality, as well.

Nature of ASD and ADHD
Anger, frustration, anxiety, lack of focus and attention, distractible, short-fuse, non-social, in-their-own-world, bossy, and sensory overload are not characteristics that a parent would ever want to encourage in a child who has developmental difficulties.
Sleep may be disturbed by a teen’s insistence on continuing play. Homework, already a non-preferred activity, may become a major distraction.
A new wrinkle in the video game arena is ‘you-tubing’ another player play. What is that about? Lots of teenage patients spend HOURS each day viewing this. “Why, I ask?” “It’s funny!” is a typical response. One parent offered, “He’s learning techniques.” I never got better at golf by watching golf.

Conclusion
On health-related issues alone, researchers noted, “… while television use was not related to children’s weight status, video game use was.”

The next generation of video experience represents a possible sea change for childhood growth and development. A recent analysis concluded, “The evidence strongly suggests that exposure to violent video games is a causal risk factor for increased aggressive behavior, aggressive cognition, and aggressive affect and for decreased empathy and prosocial behavior.

Pathological gaming has been noted in those who, “… spent twice as much time playing as nonpathological gamers and received poorer grades in school; pathological gaming also showed comorbidity with attention problems. Pathological status significantly predicted poorer school performance even after controlling for sex, age, and weekly amount of video-game play.”

Neuro-diversity may take years for understanding, and biases endure. This technological circumstance may be an advantage that encourages certain skills, but could be a deal-killer for others, especially those with academic and social challenges.

 

 

Best Summertime Activities for Children with Autism and ADHD

Saturday, May 23rd, 2015

It’s already the end of this school year. Many families (here, in Florida) have been through an IEP to determine services for the next semester. What is best? Often, it will involve some special education, possibly in an ESE classroom or GenEd with pullouts.

Yikes, it’s so complicated! Children are in a constant state of change. Summer activities have already been formulated, but there are many questions about what to do with the unstructured time. So, here is TheAutismDoctor’s top ten list of things to do this summer:

 Leave time for the kids to just be kids. Especially for children under the age of 5 years, academics can take a back seat to socialization.

 Children over that age often have difficulty focusing on non-preferred activities, and so will need to practice some of those skills, in order keep up. Pick the areas that are most challenging, and set aside some regular time for practice.

 Parents are frequently at odds about whether to let a child spend time doing digital ‘stimming’, such as watching favorite Youtube videos, or repeating Angry Birds. A useful compromise is to strictly limit those activities to very specific times. No deviations.

 Children should learn to swim. It may take a professional just to get the child into the water, but eventually, they all learn to love this activity. Although a parent is not assured that acquiring this skill can prevent a tragic accident, it may provide some measure of confidence.

 Together with the child, learn or practice a new, easy, outdoor hobby. This promotes better health and socialization. The experience gets the child on a more equal footing with the parent, as they explore activities such as fishing, boating, surfing, golf, biking, or hiking.

 Children who get to visit the family’s home state/country/old neighborhood thrive. The cousins are usually prepared, so the ASD kid has built-in playmates.

 To the best of your abilities, don’t give up on the diet and supplements.
It’ll be that much more difficult when you go back.

 This is a good time to give some of the alternative treatments, such as Low Dose Naltrexone or glutathione, a try. Negative reactions can be quickly identified, and there may be some surprising results.

 Give the stimulant and anti-anxiety meds a break.
Summertime isn’t that intimidating.

 Families who take vacations together have the best outcomes.

Talking At TACA

Sunday, May 3rd, 2015

I had the privilege of speaking at the Talk About Curing Autism Conference, which was held in Philadelphia this weekend (5.1.15).

The topic that I was asked to present was Mast Cells. Dr. T C Theoharides is a world’s expert on this subject, but couldn’t attend, so I was asked to lecture in his absence.

The Talk
Mast cells are a type of white blood cell that exist is various locations throughout the body, and are responsible for protection and healing. They do their work by discharging chemicals, such as histamine, from packets that are contained within the specialized cell.

Dr. ‘Theo’ has published a great deal of the research about these critters, and among his discoveries are the following:
 Mast cells exist in relative abundance in the skin, but also in key areas of the brain that ultimately affect sensory and cognitive function.
 The cells have an intimate physical and chemical relationship with the blood vessels, nerves, and other immune cells inside the brain.
 Mast cells function differently inside the brain than in the skin, releasing their chemical contents in different ways and with a variety of substances other than histamine.
 They could be responsible for ‘brain allergy’ and many of the signs and symptoms of ASD, such as brain ‘fog’ and irrational outbursts.
 Prevention of mast-cell release inside the brain may be a valuable tool in the treatment of autism.

TACA
The organization was founded at the beginning of this century as a parent support group to discuss the growing epidemic about which doctors and other professionals did not seem to have a clue – from diagnosis, to cause, to treatment or prevention.

The mission statement includes a belief “in early diagnosis, intensive therapies and medical intervention for children affected by autism. With early intervention, medical treatment unique to each person’s needs and necessary support services for families many children can improve greatly and some can recover from their autistic symptoms.”

“From a grassroots beginning in Southern California, TACA expanded nationwide and now has a physical presence via our Chapters in 23 states and a virtual presence in the rest of the nation.”

Final thoughts
In the beginning, there was ‘Defeat Autism Now!’  – a group of physicians (DAN! doctors) and parents, searching for answers about how to understand and help patients affected with ASD.

That organization has grown and given rise to the Autism Research Institute and The Medical Academy of Pediatric Special Needs. Now, Autism Speaks, The Autism Society of America, Generation Rescue, and many other local organizations have emerged, dedicated to bringing relief to this modern epidemic.

In the medical vacuum that has appeared since the rise of ASD, doctors have yet to really fill the void with solid research or reliable interventions. What the autism community needs is either a cohesion of the disparate charities that already exist, or a new entity that helps to raise dollars for primary and clinical research that yields even more knowledge and hope.

When Methyl B12 Doesn’t Work for Autism

Sunday, April 26th, 2015

pdr2The Physicians’ Desk Reference is the text that professionals turn to first, when checking on a prescription medication. Though it contains more a thousand pages describing 330 medications, the condition ‘speech apraxia’ doesn’t appear.

That means that conventional medicine has formally admitted that there is no pharmaceutical treatment for one of the core signs of significant Autism Spectrum Disorder. The result is that families will seek relief elsewhere.

The most studied and proven treatment is Speech and Language therapy, in some combination with other important traditional treatments, such as ABA or OT. Astounding recovery may take place, depending on how early a problem is recognized and addressed.

What happens when these modalities are not effective?
More therapy? Really?
That’s all you’ve got doc?

The use of vitamin methylB12 injections has shown safety, tolerance, and improvement in a subgroup of individuals in a 2010 study. At a recent MedMaps.org conference, it seemed to be the most utilized methodology by the experienced ‘DAN’ practitioners in attendance.

So, what if the mB12 injections aren’t working? 

1. Be patient. Depending on the child’s age, it could take up to a month or more of ‘shots’ to achieve perceptible results.

2. Be realistic about the next developmental step. Non-verbal children may simply exhibit increased oral ‘stimming’, including shouting, teeth grinding, making bubbles, drooling, or biting (just about anything). If the child already speaks, look for more words that require less prompting and new words to appear intermittently. The next step is speaking to toys and family members, and socialization may then generalize.

3. Don’t forget, we don’t teach toddlers how to speak, they just do it. Continue or even increase the Speech therapy. Achieving optimal health and the ability to learn must be complemented with proper instruction.

4. Suspect on-going inflammation. Yeast, bad bacteria, and food intolerance could be using up much of the energy that it takes for the correct areas of the brain to wake up.

5. The suggested dosage is 64.5 mcg/kg subcutaneously every three days. That equals ~1mg for a typical 3 year-old. Many practitioners will increase the dose and frequency if there is little response.

6. Check for a problem in the pathway leading to glutathione production. A genetic mutation in the step that makes folinic acid (MTHFR), or too much tylenol blocking the normal formation, may be interfering with mB12 treatment.

7. The practitioner may wish to add to that detoxification channel with the use of DMG, TMG, and/or N-Acetyl Cysteine.

8. Other medications that the child is prescribed, such as stimulants and anti-anxiety preparations, may be impeding progress and interfering with recovery.

9. Parents are often confused about the various formulations of the vitamin; including sublingual, patch, pill, and lollipops. It is water soluble, leaves the body easily, and needs to be administered in a form that slowly leaks into the circulation. The successful substance is injected subcutaneously – under the skin and into the fat.

10. The preparation should be ordered from a reputable pharmacy that is familiar with the product. Simply changing the compounding dispensary may improve results.

Bottom line:
What do you do when the methyl B12 still doesn’t work for speech apraxia?
That is a very difficult problem.

Ten Reasons Why There Is No Autism Pill

Saturday, April 18th, 2015

“If you have seen one child with autism, you have seen one child with autism,” is an often-used aphorism. An important corollary: so far, there are only patterns to follow, and a single ‘cure’ may not be the cure.

There isn’t one kind of autism.
It’s like saying we’re going to find a cancer pill.

Controversies have existed from the first time the diagnosis was proposed; beginning with the ‘Refrigerator Mom’ theory, to the contribution of genetic influences, and the role of environmental factors (including the vaccination issues). The enigma has slowed research, while these matters are being sorted out.

Multiple systems are involved, including gastrointestinal, neurologic, muscular, and immunologic. That makes the documentation of recovery a moving target, reducing the likelihood that there is one pill.

There are multiple levels of system involvement, including genetics, proteins (proteome), metabolism (metabolome), body flora (microbiome) and those interactions.

Autism is freakin’ complicated.

The cost of researching, producing, testing and bringing a brand-new pharmaceutical exceeds 2.5 Billion dollars. Market size is important, and apparently 1/68 children does not meet that target. Unless it’s your kid.

Autism is freakin’ expensive.

There are no specific biomarkers, which are key laboratory or other diagnostic findings that identify a specific condition. That means there are few ‘levels’ to follow that identify severity or response to treatment.

The spectrum contains a variety of signs and symptoms that change over time and vary among individuals, including identical twins. There are various presentations, from mostly apraxia to mostly social isolation, and lots of combinations in between. That makes the evaluation and documentation of response to therapies problematic.

Since environmental factors have been implicated as an issue, it’s clear that pollution and toxins have been getting worse, not better. That has resulted in increasing numbers of affected people with more complicated problems. The light at the end of the tunnel seems to be moving farther away.

Conventional medicine isn’t leading the way, and falters even in the pursuit of assistance. Simply advising more therapy is frequently inadequate. Stimulant and other central nervous system medications can be a nightmare. The belief that ‘alternative’ therapies are kooky, or even harmful, polarizes – and little progress emerges.

There is an audible silence by way of a national voice towards solving this epidemic. When John Kennedy said we could get to the moon and back, America found a way. Autism needs more heroes, role models, and spokespeople.

All of that being said, it doesn’t mean that physicians cannot do appropriate testing to discover variances and abnormalities that are clues to downstream signs and symptoms to treat, and upstream interventions to alter the course.

In the absence of a pill, early detection and intervention successfully addresses many of the most debilitating and costly complications.

Real Autism Awareness 2015

Thursday, April 2nd, 2015

Autism Awareness is not just about slogans, license plates, Autism Walks, or assorted news stories. The term carries a variety of implications, including:

Public Opinion
Awareness will come when we quit arguing about whether there is an autism epidemic or not.

We need to stop wasting time blaming Andrew Wakefield (the doctor from England who had the temerity to question the vaccine gods) for why we don’t have a cure for autism. If you want to blame someone, start with Leo Kanner and Bruno Bettelheim, who concluded that it was the result of faulty parenting.

Political / Legislative
This past August, “President Obama signed into law the Achieving a Better Life Experience (ABLE) Act, which will allow families with children with disabilities to save for college and other expenses in tax-deferred accounts. This piece of legislation is an important step toward empowering people with disabilities to achieve independence and affirms self-sufficiency.”

Insurance companies need to become more realistic about what services are required. The traditional therapies are effective, and should be reimbursed appropriately.

Autism awareness includes dealing with the situation of an aging ‘Spectrum’ population, and the resources that will be required.

Scientific
There will be more enlightenment when we stop focusing on the ‘anti-vaccine kooks’ and start researching an intelligent answer to the question, “Are all vaccinations good for all children all the time?”

We need to be cognizant that ASD continues to increase, and research has not yet uncovered the most basic questions of “Why, Who, or What?” “Where and When” is right here, right now.

Autism awareness includes mindfulness of the environmental impact.

Personal
Speaking of ‘awareness’, how about when a parent can go to the park and sit on a bench while the child plays (or tries to play) with the other kids?

Another example is the child’s awakening. Parents are thrilled when they no longer worry about elopement when the family is outside or in a crowd.

Finally, REAL autism awareness is when your child gives kisses and says, “Mommy, I love you!”

Autism Conference Spring 2015

Sunday, March 15th, 2015

The Medical Academy of Pediatric Special Needs provides this semiannual standard-of-care meeting, which is dedicated to teaching physicians and other practitioners who care for patients with ASD.

Various educational courses were offered, covering a variety of interests and experience. This being the 7th conference, an entire day was reserved for difficult clinical cases, discussed among ~30 doctors, who had previously passed the basic science courses.

Mitochondrial functioning played a significant role in this year’s presentations. The myriad of functions involved with these cellular power-plants was explored. This is a complicated topic that includes genetics (mitochondria even have their own chromosomes), over- under- and malfunctioning, environmental effects, cell-to-cell, cell-to-system and cell-to-environment interactions.

Impressions:
Prior to one of the lectures, there was a wonderful moment when Dr. Bob Sears, Dr. Jerry Kartzinel, Dr. James Neubrander, and Dr. Dan Rossignol were among those discussing the recent measles epidemic and what their practice was doing to address the situation. That conversation would have made a well-hit youtube video!

Another time I found myself eating lunch with Dr. Michael Elice, Dr. Stuart Freedenfeld, and other popular autism practitioners. There was a great sense of camaraderie and common purpose. This is one the few social experiences when doctors, such as myself, are not derided for our unpopular opinions.

Any new treatments?
Dr. Sid Baker, a true pioneer in the practice of the biomedical treatment for ASD, presented a wonderful historical perspective. Because of an earlier focus on autism as a genetic disorder, Dr. Baker opined that, “The last ten years have shown very little progress in the way of understanding and treatment of autism.”

One frequently discussed off-topic topic was the lack of research and safety of chlorine dioxide (ClO2), which is touted on the web as a helpful treatment. It is supposed to work by ridding the body of parasites. Ironically, however, one of the more popular new treatments involves helminth therapy (giving parasites to patients) to re-invigorate the immune system.

Conclusion:
It would be preferable if participants could return from such an educational experience with a list of novel therapies for our most challenging patients.

For now, learning key tricks and tips that address negative behaviors, or gut health, for example, are the order of the day. We learned about more precise lab tests, key findings that could point to more specific therapies, and important metabolic pathways that will help our patients, if not today, soon.

We consider what avenues to pursue, and those that need further evaluation. This organization is dedicated to providing well-researched medical solutions.

Because autism is so widespread, misunderstood, variable and mysterious, the ability to network with international experts and ‘pick the brain’ of those in the trenches is the most valuable feature that the conference provides.

“It’s supposed to be hard. If it were easy, everyone would do it”
Tom Hanks in A League of Their Own

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