Archive for the ‘Vaccines’ Category

Worried About Autism – Where to Begin?

Saturday, April 19th, 2014

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

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

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

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

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

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

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

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

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

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

Autism Un-Awareness

Saturday, April 12th, 2014

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

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

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

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

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

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

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

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

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

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

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

New shit happens.

Is Tamiflu for You?

Friday, February 7th, 2014

As a physician who cares for at-risk infants and children, I am frequently asked to weigh in on the topic of flu vaccine and the medication, Tamiflu.

Ever since the introduction of Oseltamivir Phosphate, an anti-viral preparation to ‘cure’ influenza, controversy has ensued. There are a number of websites that discuss the issue in detail, pro and con.

Forbes magazine, which generally takes fairly conservative positions, recently published “The Myth of Tamiflu“. The FDA doesn’t seem to have a problem with it; even recommending Tamiflu for infants as young as two weeks.

Consumer Reports, recently concluded, “Not unless you’re very sick with the flu or … are otherwise at high risk.” That respected medical journal’s opinion was to administer Tamiflu to the group that might get ‘sickest’ from the disease.

Cost(s):
A typical course has been reported to cost $120, more or less. For an entire family of 4 or more, it becomes fairly pricey.
Does Medicaid or insurance pay? If they are willing to cover (call, push buttons, and argue at your own peril), you may have to wait until the prescription is authorized; thus, mitigating the “at the earliest sign of the flu” advice. Co-pays can be more expensive as well, e.g. $25 or more. Keep your Tamiflu coupons handy.

Benefit(s):
Symptomatic relief occurring 1-2 days (out of 1-2 weeks of influenza) sooner is possible, but that is no certainty. The condition may not be the ‘flu’, the virus strain may not show responsiveness, or the patient waited too long to initiate treatment.
Additionally, I am sure that Roche has a ‘Days of Reduced Productivity From the Influenza Virus’ PowerPoint slide to persuade beaurocratic personnel that their concoction is worthwhile.

Risk(s):
Warnings listed in the Physician’s Desk Reference include:
• Severe allergic reactions.
• Serious skin reactions.
• Neuropsychiatric events, signs of abnormal behavior – how can you tell about this in your ASD affected child?
• Dyspepsia (upset stomach), with increased rates of vomiting - which is a common symptom in children, and many with autism.
• Diarrhea – another frequent physical sign in our high-risk patient population.
• “Caution in nursing” -  but it’s recommended if you’re pregnant? Also, most babies should be nursing; so, it’s OK as a liquid, but not OK in breast milk?

The Genentech website cautions:
“People with the flu, particularly children and adolescents, may be at an increased risk of seizure, confusion, or abnormal behavior early during their illness.”
“The most common side effects are mild to moderate nausea and vomiting, diarrhea and stomach pain.”

Conclusions:
So far, the risks appear to outweigh the benefits of Tamiflu. The cost seems high, considering that the drug only results in a possible, slightly shortened course of the flu. There are important lingering questions; including, whether there are fewer complications and deaths.

Long-term outcomes will have to wait until Tamiflu is used long term. This medicine was not available in the last century, begging the question of how there could be truly valid safety information when this antiviral is administered to a 2 week-old infant.

Recommendation:
Healthy older children and adults who exhibit the onset and suffering, or wish to prevent the flu in their virus-ridden environment, and can afford it, might give it a try.

My preference is to prescribe Tamiflu to those who are not pregnant, breast feeding, or very young children, in the hopes of preventing infectious transmission to those who are at increased risk for complications, without incurring the risks of the drug.

The greatest benefit that I can see is to the pharmaceutical company Roche,
and its member company Genentech.

Emails from a Parent Concerned about Autism

Monday, January 13th, 2014

We get emails galore at The Child Development Center. The following exchanges (which took place over 7 months) are from one insightful, articulate and appropriately concerned mother.

Such correspondence is representative of the majority of questions that accompany this complicated process of improving health so that therapies can take hold and reverse the signs and symptoms of the epidemic that is presently called ASD. This Mom covered it all!

Mom: Hi doctor… I’m just scared that my son won’t play like other kids.  I get depressed sometimes about this but do you think my son will be normal again. Do you think my son will be ok ? Will he talk soon?

Dr U: We will do our best… we are quite successful, so let’s see how the first couple of months go, and you will know much better.

Mom: He still he has not said a word yet.  Still in a bit if his world. I know you told me baby steps, but how long? A month, two months?  I’m anxious. Thank you for listening to me.

Dr U: Is he babbling any more, pointing, using signs… other signs of increased communication?

Mom: He moves his lips. On Saturday he said more. He doesn’t babble like a baby. He tries, but not that much comes out. He does point a lot.
Mom: Hi doctor I’m sorry again, but do you think my son will be ok like the other kids playing with them talking? I’m just worried. No words are coming out of his mouth.

Dr. U: That is what we are working towards. It is months that matter, not days or weeks.

Mom: What is asd tympanostubi is that something bad what?

Dr U: Huh? I think that you mean tympanostomy tubes… surgical placement of venting ducts in the ears for children who suffer repeated ear infections. In the past several years, I have become more comfortable with the procedure, especially since it decreases the intake of antibiotics.

Mom: It has been two going three weeks and nothing yet… Do they get more aggressive when taking that probiotic, like… crying, or wanting to talk but can’t. You know what I mean, right? When should I expect him to talk? Do you think he will talk before he turns 3 or after? He’s a very intelligent boy. He knows his alphabet, numbers for his age. He’s intelligent but the thing is, he has to talk and play more – run, jump – more activities outside, so he exercises. Is he lazy? He wants to be sitting all the time.

Dr U: Yes, the change in behaviors could be due to the probiotics, and his new development. So, I can’t guarantee or predict the speech, I can only promise that we can make him healthier and that should lead to typical development.

Mom: Thank you for responding fast, but, what did you mean when you said that you can’t guarantee speech? That he won’t talk at all or he will? Will he be running like other kids do?

Dr U: You worry a lot… that’s what a mom should do. Please keep doing the protocol and we’ll talk at the visits in more depth.

Mom: Yes I worried a lot…But you are not answering my question. Will my son talk soon or not? What did you mean by “I can’t guarantee or predict speech”?

Dr U: I want to be honest and reasonable. No one can predict those things with certainty. Again, let’s wait until the next visit and see the progress and we will be able to tell you more.

Mom: I was reading about vaccines – do they cause autism? Do they contain Thimerosal? What About MMR? When he turns 3 years what should I do? With the blood work will you tell me if it was the vaccine that caused autism? Or was it genetic ? I read so many stories of autism that everyone tells you different stuff about it that makes me scared.

Dr U: Since you are on the ‘net already, please read my blog(s) about this complicated issue.

Mom: Is Asperger’s the same as autism? When you said << my child >> has mild-to-moderate autism what does it mean autism spectrum or Asperger?  I was reading on google…

Dr U: Autism is one of the reasons for delayed development in childhood. Asperger’s may be one kind of autism. Mild to moderate means that there are behaviors that are good, and some that need to get corrected. If you want to read the Internet, www.theautismdoctor.com is very accurate.

Mom: When do I have to stop the probiotic? When he gets constipated he is acting very alert and hyper – it’s that ok?

Dr U: Please, don’t stop the probiotic… If things are ok we will move forward with this protocol.

Mom: How did the blood work come out? Can you tell me something?
Mom: I have some questions about the vitiams b12 injections; will that hurt, will it burn when the liquid is going in? Will my son be safe ??? I’m scared if I have to inject him. How will I do? Are those injection inside his skin like a vaccination – please tell me more about it??? My son will start school but won’t be able to talk. Also, he will be getting his tubes next week, what should I do?
Mom: I want to ask you if hepatitis A vaccination is ok – that’s what he’s going to be getting. He will start School pretty soon. One more thing is the b12 subcutaneous – will that hurt if we don’t inject the right way? I’m afraid to inject my son – it is going to be my responsibility, if something happens to him. I don’t want anything to happen to him. Is that safe? I know I asked you that already, but my son is in your hands and I still don’t see any talking yet – no mouth movement. So, hopefully, with the school and the b12, there will be more improvement. He will also be getting his tubes in his ears next week.

Dr U: Hepatitis A vaccine seems to be important – there was recently a HepA outbreak from some frozen berries in the western US. The mB12 shots shouldn’t hurt – think about a diabetic child who has to get 3 or 4 shots per DAY!

Mom: I’m a little bit concerned. My son has been bleeding  from his nose for two days. Could that be ’cause he is taking too much vitamins, or what could that? He bleeds, but not too much just from one nostril and that’s it. 

Dr U: It is normal, your son’s blood count is OK, and it isn’t the vitamins.

Mom: My son had his ear tubes put in already and everything went great. But I’m still concerned that he’s still bleeding from one nostril. I’m going to make a doctor appt. That is not normal for him to be bleeding and it started when we gave him all that vitamins. I’m not to sure about giving him to much vitamins. What do you think?

Dr U: I think that, if his development is moving along in a good way, you should stay that course.

Mom: But the thing is he’s not talking yet. No mouth movement yet.
Mom: I was given my son the medicine melatonin with yogurt but he threw up. What should I do?

Dr U: Some patients have even put it on pizza (not too hot though), so it should work in anything – not sure why he vomited, but maybe try it in something else and let me know.

Mom: I got the injections already. Should I start on Monday or wait another week with melatonin? What do you think?
Mom: I need a letter from you with the diagnosis, so he can get more therapy. Please, if you can fax it to me… Anther thing I wanted to ask you is how long does it take for the vitamin b12 injections get effective for my son to talk or say at something? I’m very disappointed ’cause it still hasn’t worked yet. He has gotten two injections already on Monday it will be his third one. Please let me know if I’m doing something wrong.

Dr U: Letter created and sent, 3 days later.

Mom: We have a problem. The last injection he had, he got so tight that that fluid was coming out again. What should I do? The nurse does not want to inject him any more. If you tell one of your employees to come to my house in the morning to inject my son,  please, I will pay them. We can’t – he’s to strong he gets very tight muscle contraction and the fluid comes out help please… I hope you got my message earlier. I need to know what to do so my son doesn’t get so tight that his muscle contracts and so the fluid starts coming out… I’m very depressed and anxious and it is to hard for me to stick him. Please call.
Mom: Thanks. I saw some videos, but my concern is how long will it take him to talk? There have been 3 shots already and still nothing is coming out from his mouth. How long after do I have to wait? Sorry I’m being annoying. The thing is, I’m concerned that my son is not talking yet. What else does he need for him to start talking? 1. B12 shots 2. Therapy 3. ——– I don’t know please tell me?

Dr U: You are not annoying… you are an appropriately concerned mom. I just can’t guarantee what/when is going to be the key to helping speech and language. My experience is that it can take up to 8 shots (1 month), but improvements happen before that (more verbal, singing, eye contact). So far, we’ve been doing OK. This is difficult, but if you and the family are seeing some progress, that should help you get the support that you need to see this through.

Mom: I wanted to know if I should do an MRI? I just want to know how much he has and everything. What does a MRI tell you about autism? I made an appt for the MRI. They said it will take up to two hours for the MRI ’cause they order the BAER. What do you think  - can he be put to sleep for two hours? She said first they give him something liquid to calm him down, then either IV and the mask. What do you think? I’m just scared?

Dr U: The MRI will probably show no abnormalities – if the child has never had any seizures, this would be even more likely to be negative. With that in mind, I do not see the need for an MRI at this time if you are concerned about the anesthesia.

Mom: Hi doctor I have few concerns. I want to enroll my son in ABA, but they don’t take my son’s insurance. So I have to pay out of my pocket and you know that program is expense. But my concern is, when they asked me who was the doctor who diagnosed my son with autism, when I said your name, no one has heard about you. They asked me if you are a psychologist or a neurologist. When I say a DAN doctor, they don’t know…What am I supposed to show those people?

Dr U: This spawned a flurry of email and faxes to demonstrate that I am a medical doctor, Board Certified in Pediatrics and Neonatal Perinatal Medicine, with my most recent special training provided by the Medical Academy of Pediatric Special Needs.

Mom: The ABA therapist came over and did and evaluation… The reason why I’m writing you is cause she also mentioned to me about speech apraxiaShe asked me to tell you if you can diagnose him with that so I can give it to CMS Title 21 to the insurance company, so they can approve more hours in speech.

Dr. U: Speech is one of the earliest communication skills. Next, comes understanding. Sometimes, understanding comes first, and then the child can become very agitated, and display other behaviors. Yes, speech apraxia - the inability to speak – is a concern. I have documented this diagnosis in your child, already. I think that the course that we are pursuing gives children the safest and most reliable choice, and I am glad to review other options with you. Of course, S&L therapy is indicated.

Mom: But do you think that he will not talk at all ever? What do you think ? What else should I do? Put him in more speech therapy, like I was told by a speech pathologist ? Like you said, this is a major concern. Will he talk ever?

Dr U: Well, that is why we are giving any protocol that is reasonable and successful the best chance. Speech and language therapy, in addition to the biomedical, is ‘what the doctor ordered’.

Mom: I was reading your article on autism and apraxia was is the difference between those two? Is that something that autism kids have also ? Or is that a different diagnose ? Can my son get worse or better in the future? Will the Aba, plus speech and Ot therapy help him get better or will he need something else?

Dr U: Speech apraxia – the inability to speak when you want to – is one of the symptoms of autism. The biomedical protocols that we are doing, plus ABA and Speech and Language therapy is the most likely to have success. All of the other protocols that are out there are VERY EXPENSIVE (> $4000 up to $20,000) and have not been documented to work. There are no pills for this and you can’t buy your way out of autism/apraxia.

Mom: What else can I do for my son? Speech aphasia is that something to worried about?

Dr U: Yes, speech apraxia – the difficulty with your child’s delayed speech – is something to be concerned about. We are doing our best.

These are the exact thoughts and letters of every one of our families. Autism, especially when there is speech apraxia, is one of the most difficult diagnosis I have ever encountered, as far as 1) the reason for the problem and 2) the treatment(s).
Parents, I understand your worries.

The Polarized World of Autism Diagnosis and Treatments

Monday, November 4th, 2013

Last week, Forbes’ science writer, Emily Willingham, decided to spice up Halloween with one of her usual autism-themed stories. How timely. The 5 Scariest Autism ‘Treatments’ warned readers that there are money hungry snake oil salespeople posing as caring practitioners, who are scheming to steal your money without a shred of scientific proof that their protocol is either safe or effective.

The story might have actually been newsworthy had she been more up-to-date by including such controversial protocols as Fecal Transplantation or Worm Therapy. Anyway, I felt the need to write that we can’t merely dismiss families with overwhelming problems as misguided idiots who can’t figure out that dipping a kid in chlorine is probably not a good idea. Don’t worry Emily (and the other “pro-science commenters”), MMS never had any real traction.

I replied that her ‘Scary Story’ was missing the point. Autism leads to desperation, born of mis- and missing information, about everything ASD; from diagnosis, to incidence and prevalence, to DSM IV vs. DSM-5, to… What the hell, when are you doctors gonna get your act together and help us?

The re-replies displayed a surprising degree of vitriol. All or none, black or white. Do I support Dr. W’s position or not? TheAutismDoctor.com is an entire website consisting of hundreds of pages of hyperlink-supported information about all of my experience over a 36-year medical career. I address as many of the controversial and cutting-edge protocols as I can research. I figure that castrating your child is going to be pretty extreme to any parent, so I don’t cover it unless queried.

I wrote that the conventional medications are not only ineffective for correcting core signs and symptoms, they may be harmful and even deadly. That leaves families concerned about believing the ‘regular’ doctors who suggest giving potent CNS drugs to their young child. Many feel that exploring alternative treatments is their only alternative.

How many patients have I listened to, who have complained that, “We have been doing ABA, S&L, PT, OT, etc., and we hoped to see more progress”? That’s it? No fighting for your kid. No trying to figure out why your beautiful child isn’t keeping up. That’s what one of the commenters commented. “As a doctor you should know that conventional, evidence based medicine has no interventions that address the core symptoms of autism. Parents do not “turn to unconventional therapies.” They are persuaded that conventional medicine is wrong about autism by purveyors of therapies.” Even if he actually believes what he wrote, if he had an affected child, his spouse (or vice versa) would seek further information.

Shortly, the comments turned to a discussion about vaccinations. I was accused of “pandering to my base” and “shamelessly trying to steal readers” from the Forbes blog. Parents of special-needs children will continue to search for answers and help. Pedantic warnings from non-practitioners and ESPECIALLY the non-involved are not welcomed advice. Working with a trusted professional is their best hope.

I thought that my reply was completely noncontroversial. Who could argue with the dilemma faced by today’s affected families? The Home page of this website states “I hope that my essays and our discussions breathe a breath of fresh air into the polarized world of autism diagnosis and treatment.”

It seems that there is still more work to be done in order to bring all interested parties toward a more reasonable and compassionate position.

Preventing School Illness in Autistic Children

Sunday, August 25th, 2013

The cooties are coming! The cooties are coming! Children who are ‘on the Spectrum’ are less likely to notice and / or complain about aches and pains, and are certainly less capable of expressing such discomfort. So, here are some tips about how to help your special kids, and prevent that ‘sick all year’ experience.

Many of the children have not been fully (or, for some, ever) vaccinated. That means that parents should be extra careful about sending ‘possibly’ sick kids to school, or even sending the children when there are other students or teachers who are sick. Yes, this is a big inconvenience, but it is the price to pay for the lack of immunity.

While ASD children are on the road to improvement, I am not a fan of influenza vaccinations. The shots produce 100% chance of extra inflammation, but only reduce, rather than prevent, the chance of getting disease. Therefore, it is prudent to make sure that the rest of the family – parents, grandparents, and healthy siblings – gets vaccinated, in order to decrease the chance that they may catch the flu and pass it on to a special-needs child.

ASD patients are usually finicky eaters, and many suffer from gastrointestinal problems. Many of our patients have been found to have very low levels of nutrients and vitamins that are important in handling inflammation and reducing the severity or length of an infection. Accordingly, make sure that multivitamins are included in the diet in order to optimize nutrition.

Many patients have significant food allergies that cause inflammation and interfere with neurologic improvement. Parents need to stay the course and resist the temptation to let the child eat junk foods or the usual fare that gets served at school. Older children are prone to cheat, lie and steal the foods that they should not ingest. Our office provides notes to teachers and administrators requesting their support to achieve the goal of optimizing outcome in special-needs children.

It is not unusual for ASD children to drink fewer liquids and become dehydrated. Their ability to flush bacteria and viruses is therefore, less and could result in more infections, or a decreased ability to clear any illness. Make sure that they have plenty to drink while at school, and ask the teachers to encourage this simple task.

The importance of a good night’s sleep cannot be overstated. It has been demonstrated that ASD patients are less likely to have enough hours of sleep, and especially REM sleep, which is the time when the memories of the previous day are supposedly solidified in the CNS. Therefore, we recommend the use of warm nighttime baths (epson salts are fine, also), melatonin and other natural supplements in order to optimize the benefits of this activity. Waking up refreshed and happy is sure to help anyone have better focus, attitude and attention for the rest of the day.

Check the backpack and other school supplies and clean them thoroughly. Also, if the school is not providing hand sanitizers, families can help by providing it for the classroom and asking the teachers to use it themselves and to demonstrate to the children. By visiting the classroom from time to time, parents may get a sense of where the cooties are most likely to hide, and to provide some suggestions for improved cleanliness.

Finally, make an effort to allow your children only to return to school when they have a normal temperature and are symptom-free. “Easier said than done,” you may claim, but re-infections and lingering illness will only prolong the suffering and decrease the number of productive school days.

The Different Kinds of Autism

Sunday, August 11th, 2013

When medical science finally settles on more precise terms for the epidemic that is presently called ASD, we should also be able to recognize and appropriately treat the various expressions of the disorder. This is important as it relates to interventions that address specific problems, such as in the G-I tract, and their downstream consequences, such as disruptive behaviors. The categories are not exclusive, the list is far from complete, and I hope to expand on this topic in the future.

1. ‘Typical’ (present from the earliest stages of development) and Regressive types. I’m not so sure that the only difference isn’t timing; i.e., when the patient became affected. Parents may be more likely to identify the latter type in association with childhood vaccinations. Otherwise, there aren’t big differences in presentation or the ability to diagnose underlying problems that are amenable to treatment.

2. Girls and Boys. There is a difference because of the amount of aggression in many boys, and the relative lack thereof in the majority of girls. This was previously discussed here.

3. Major system involvement, including:

The G-I system is the most glaring problem. This has been written about at length, and throughout this website.

The CNS shows significant involvement. There could be seizures, staring spells, or other unexplained motor episodes. Treatment may involve anticonvulsants and often becomes fairly complicated.

The immune system is the presenting problem. Some patients have eczema covering their entire body, others may have asthma and many have frequent infections. Laboratory tests may identify an over- or under-functioning ability to clear inflammation. Enabling the patient to achieve better health often helps lessen or even ameliorate behavioral and other ‘autistic’ disturbances. The disorders known as PANS/PANDAS appears to be consistent with such impairment.

The muscular system functions inefficiently; as evidenced by low tone, poor chewing, clumsiness, extremely flat feet and/or poor posture. When patients can tolerate oral glutathione and subcutaneous methyl B12, there is often significant improvement in not only OT, but S&L as well.

4. Variations due to age at diagnosis and intervention. Evaluation and treatment is different for toddlers, adolescents or adults. As patients get older, more patience is required and the coping skills of the individual become more important in addressing and assessing therapies. The age at which children continue to suffer apraxia is especially important. Imagine the difference in outcome for children who have no speech even by 3rd grade as opposed to youngsters who only experience a 1- or 2-year delay.

5. ‘High-’ and ‘low-’ functioning individuals. I object to these terms because they are pejorative, judgmental and inaccurate. After all, there are plenty of ‘low-functioning’ neuro-typical people! Many patients have a great deal more awareness and skill than is apparent. More correct designations would be disruptive, aggressive, “extremely sensory” or “prone to wander.” Understanding and treating any identifiable underlying abnormalities often leads to significant functional improvement.

6. Patients who present with genetic variations. There are major problems, such as children who have Fragile X (males) or Rett’s (females) syndrome. Less obvious are copy number variations that may confer an inability to detoxify. Very small changes in genetic information magnify in importance as our environment becomes more polluted. This has been discussed in more detail here. Most of the time, there are no identifiable abnormalities.

7. Significant metabolic abnormalities, evidenced by under-functioning mitochondria, or out-of-range fat, vitamin or mineral levels. Such variations require investigation, and are often amenable to supplemental intervention.

8. Those who look as if they escaped traditional ASD. There is a small percentage of patients presenting to the Child Development Center of America who are brought in by the parents because of behaviors that, “You just can’t put your finger on.” Although these children may not have the traditional criteria of social isolation, repetitive behaviors and speech and language delay, they have other associated difficulties with hypotonia, poor sleep or frequent infections that have resulted in developmental challenges that are often characterized as either anxiety, focus or both.

It is neither fair nor accurate to state “‘DAN!’ doctors all do the same thing for the patients.” Any professional will have a starting point based on the chief complaint that is specialty-specific and subsequent treatments and labs depend on the response to the first line of treatment. Based on just these categories described above, and the doctor’s experience, there are a number of routes and variations that the workup and ensuing interventions might follow.

Families need an experienced practitioner to recognize the different presentations of autism in order to make sense of the complex matrix of signs and symptoms and to offer appropriate, effective, reasonable, reproducible and verifiable results.

 

More Vaccine Issues

Sunday, July 21st, 2013

This website is written to assist parents in making sense of the millions of ‘informational’ pages advising about the epidemic of ASD and ADHD. At The Child Development Center, childhood vaccinations only play a small part in the chief concern for the vast majority of our parents, and in the rest of the world it seems to present a major issue, so I write about this subject occasionally. However, just after my previous post on this topic, a research paper was published that begs my further attention. It appeared in the respected medical journal, Pediatrics, and is entitled Sick-Visit Immunizations and Delayed Well-Baby Visits.

The point of the article is that, when parents fail to follow the recommended immunization schedule because of a child’s illness, they are less likely to complete the full series (and so, be more vulnerable to preventable diseases). The implication is that, perhaps the ‘shots’ should be given anyway. “The substantial risk that infants will not return for a timely makeup well-baby visit after a sick visit should be included in any consideration of whether to delay immunizations.”

Nowhere in the discussion and conclusions that followed were the issues of fever, febrile seizures, or any developmental followup covered. The is no mention of how high a fever might be tolerable, whether the child was exhibiting other symptoms such as vomiting or diarrhea, the presence of fevers with previous vaccines, or what to do if there were any complications. Even in the full text, there is no advice to signify to parents that ‘vaccination anyway’ is not a recommended course. That isn’t necessary, I guess, since the lack of association between these toxins and autism is already a given for this vaccine Program Director (not a physician), who recommends AGAINST the AAP. Where are the ‘Champions of the Pediatric Way’ standing up to proclaim, “Wait, there is no research about safety and outcome to support your position!”

Such lopsided opinions by professionals are insensitive at best and ignorant at worst, and only serve to enhance the polarization of pro-vs.-con vaccination discussions. Here is some helpful advice to a family / physician who is trying to make sense of the immunization quagmire:

  1. ‘We could get ‘titers’ (levels of antibodies to diseases that the person already possesses) to see which shots are necessary.”
  2. “We could get a blood count and some blood studies to make you feel more comfortable about your decisions.”
  3. “We could take a more detailed history, including sleep, bowel function, eating problems incl GERD, frequent formula changes, other information that the modern mom knows and consider risk in this individual child vs. chance of significant exposure/disease in this child and try to let the present improvement play itself out.”
  4. “We could be part of a medical team that considers other experts, including the parents, in the decision about individuals.”
  5. “We could try to give as few at one time as possible (and, btw, MMR=3, not 1).”
  6. “Let’s talk about your particular child and your concerns and see which vaccinations are most important at this time and try to give the rest in as timely manner as possible.”

Here is my proposal regarding this piece of research:
Let’s do a randomized, controlled, prospective study of babies who get get treated with vaccinations while they are sick (no matter how sick), versus children who wait until they are well, and see if there are any side effects, such as high fever, seizures, other allergic disorders, or ASD. Who wants to be in the ‘vaccine anyway’ group?

The Vaccination Issue

Saturday, July 13th, 2013

I write this essay with great care and some trepidation, lest readers believe it to be either specific medical advice to patients, or sedition by the minions who worship Big Pharma. Any professional involved in this ASD epidemic can’t help but notice the number of parents who are certain that their beautiful child became harmed shortly after exposure to some vaccination. Traditional medicine remains convinced that any association with delayed childhood development is purely coincidental.

The twentieth century ushered a truly successful attack on feared diseases that had gripped previous generations of parents. Most of the well-accepted literature apparently supports the vaccinations, the present schedule, and most importantly, the lack of association with childhood developmental delays such as ASD.

However, I have become increasingly concerned about the quality of the information that the public is served by our government agencies. In giving advice to a national organization, CDC Committee member Dr. Mark Sawyer advised, ““We run the risk of contributing to the already present lack of full immunization if we stress too much on adverse events.”

Querying problems related to childhood vaccinations yields numbers as high as 18% “adverse events” in literature that supports the MMR. Further exploration about the presence of a febrile seizures (fevers are a frequent complication of vaccinations) as it relates to the risk of autism leads to more confusing information. How can pediatricians counsel that we know what we are talking about following the ‘Swine Flu’ Fiasco?

I don’t have a TheAutismDoctorVaccineSchedule.com website. I believe that, in today’s toxic world, it is possible that some vaccines have led to, or triggered, behavioral diagnoses in susceptible fetuses and infants. In my skewed population, only 1/20 parents who harbor that impression. The majority of our families either aren’t sure, or do not feel that it was the cause of their child’s (children’s) condition.

Our approach is to evaluate the family and the individual child upon whom the traditional vaccine schedule is about to be foisted, and make decisions based on present health, risk of illness, and risk of interfering with recovery. What are the child’s red flags? How old is the child and when did symptoms begin? How severely affected is this patient? What are the present primary behaviors and is the child improving? What other conditions does the patient exhibit? Are there any affected siblings or cousins? Has the child had any recent illnesses, and were there any unusual reactions to previous ‘shots’?

Let’s take the poor parents, who have no idea about the correct vaccine course for their precious offspring’s present and future health, out of the debate, and ask your doctor’s opinion:

Little Johnny is 39 months old. He had loss of eye contact and disappearance of some late babbling in the month following a 15 month set of vaccinations including an MMR. Recently, he has been doing well in therapies, especially S&L, OT, and ABA. The child also happens to be followed by a holistic pediatrician, using a unique workup and simple medical interventions to address his autistic signs and symptoms – those same concerns that, last year, you dismissed.
Anyway, lately, Little Johnny has woken up from the fog, started to exhibit an increased level of speech, is interested in toys and other children, and shows genuine signs of improvement for the first time in what seems like years (well, it is a lifetime).

Should he get his booster shots now? Don’t try to argue with the professionals who would have you belittled, even by their staff, for being so ignorant as to question Medical Science. Just present this case (or explain your child’s particular issues) and ask god what he would do if this were his child. Better yet, ask god’s spouse.

Chelation Therapy for Autism

Saturday, July 6th, 2013

I routinely check autism websites and chat groups to gauge the landscape and better understand the community of families seeking relief from this devastating epidemic (and if you don’t think that autism is an epidemic, you have been living on Mars). On one listserv, a parent recently wrote, “I’m looking to start chelation on my daughter. Can anyone recommend a good DAN dr?” This request and the several responses that followed have led me to want to further explain my position about this popular autism treatment.

The first issue that I wish to comment upon is the precarious position that families are facing when THEY are the ones asking for specific treatment regimes, rather than seeking knowledgeable physicians who can offer various options their children. This is entirely the fault of the medical community who have been so slow to recognize and respond to the condition. When the only explanation for the child’s condition is that “It’s genetic” and the only treatment is “Find some good therapists,” desperate caregivers are sure to explore other options.

What parent of a child who has leukemia, for example, seeks out doctors for radiation treatment, even though the experts may counsel that chemotherapy is preferable? Sure, a sufferer of prostate cancer may choose microsurgery over radioactive seeds. But that is because there is an abundance of choices in a well-known condition, with documented evidence of outcomes in the various treatment alternatives. The patient in that case may wish to choose preservation of function over decreased risk of recurrence. Given so few choices for ASD, and so much information appearing on Internet websites, chelation will surely seem to be a reasonable treatment. The fact that the conventional scientific community is either ignorant or dismissive about removal of poisons only serves to steer the concerned family toward a different medical option.

We live in a toxic world. There are 85,000+ substances in the air, food and water that were not present (or only present in small amounts) in previous centuries. Unnatural material gets into fetuses as they develop, and the fragile infants and children have become the ‘canaries in the coal mine‘. On one hand is the growing number of children with ASD and ADHD and on the other hand is our poisoned environment – and medical professionals don’t see the relationship? Exposure to pollution and increased risk are reported over and over. There shouldn’t be an argument about this any longer. Which poisons, various combinations, at what levels, and the timing of the exposure(s) upon which susceptible individuals should be the subjects of intense study and treatment options.

There is more than one way to get rid of heavy metals. Chemicals are how we got here, so perhaps using chemicals such as DMPS, DMSA, or EDTA may not be the best method of detoxification. The body has a better way. It’s called glutathione, which is a natural protein that detoxifies – and not only metals, but all of the products that enter our body and cause tissue damage or prevent recovery. I have been using an oral glutathione preparation for years that is both safe and effective. There are various discussions about the ineffectiveness of the oral form, but The Child Development Center has seen over 1,000 children improve both signs and symptoms of their autism. Likewise, there is debate about increased yeast growth with such a preparation. However, antibiotic overuse is one of the most suspicious roads to the present epidemic, and anti-fungal treatment is often a successful method to treat that unnatural imbalance of gut flora.

The bottom line is not whether or not I am a fan of chemical chelation. What is most important is whether there are safer, less expensive, less invasive and more effective means to arrive at the same goal of detoxification to decrease the disorders and maladaptive behaviors that we call autism.

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Brian D. Udell MD
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Davie
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Email bdumd@childdev.org
Website http://www.childdev.org

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