Posts Tagged ‘advice’

Probiotics for Autism

Sunday, July 20th, 2014

One of the most effective treatments that MAPS doctors utilize to address the signs and symptoms of autism is probiotic supplementation.

What they are
Fermented foods, such as cheese, yogurt and kefir, for example, contain microbes. Over 100 years ago, researchers at the Pasteur Institute discovered the role of gut bacteria and demonstrated their importance to proper immune system functioning, as well as digestion.

In the second half of the 20th century, as antibiotics became popular, the simpler, more natural probiotics took a back seat. The overuse of prescription medication and routine use of genetically modified foods has altered a symbiotic relationship that existed since the earliest humans.

The term is now used to describe proprietary microorganisms (bacteria, fungus) that are ingested to help create a healthy mix of G-I flora.

What they do
The bacteria inside our gut outnumber the cells in the rest of our body. The modern term “microbiome” describes the complicated interplay between those microorganisms and the various cells in our digestive environment. There are profound effects on the functioning of our immune and nervous system.

Altering this delicate relationship has downstream effects, such as chronic infections, auto-immunity (?self vs. non-self), nutritional deficiencies, food allergy, and digestion.

Probiotics offer the potential to re-invigorate a depleted microbiome and alter the downward spiral, resulting in better stool patterns, fewer infections, improved nutrition, less distraction and disrupted behavior.

What About Autism
Patients with ASD appear to represent a percentage of the population who are susceptible to interruptions in the microbiome. The association of the core signs and symptoms of autism with immune irregularities, abnormal digestion, chronic infections, antibiotic over-prescribing, nutritional deficiencies, distractibility, poor tone and developmental delay is conspicuous.

Probiotics have been a mainstay of biomedical treatment because they are reasonably priced, safe and effective.

Side effects
After initiating appropriate probiotic therapy the clinical course is variable. Some children have no apparent change, at first. Other patients seem to have 3 to 5 to 7 days of die-off, as healthier organisms vie for the food supply and toxins are released.

Diarrhea, constipation, flatulence, silly behavior, rashes, poor sleep, aggression and regression are possible symptoms in the earliest phase. When behaviors become too intense, (oral doses of ) activated charcoal can sometimes temporize, as the healthier bacteria take hold and survive.

After a variable amount of time (depending on the age of the child and the presence of G-I symptoms), most parents report a lifting of their child’s ‘fog’, improved eye contact, and the initiation of communication.

Which is the best one
There is a general belief that probiotics are ineffective because the microorganisms do not survive the trip all the way down the digestive system where they need to take up residence. The best way around this issue is to pick products with a very high density of cells. There are trillions of bacteria in the body, and it appears that many billions are required to do their job.

Likewise, the body contains a variety of bacterial types. Look for products that contain an assortment of healthy organisms. Biomedical protocols often include the use of Saccromyces, which are supposedly ‘healthy’ yeast. At The Child Development Center, there are many children who demonstrate anti-yeast antibodies, so that is only utilized in a pinch.

Conclusion
Addressing the HIV-AIDS epidemic improved medicine’s abilities to understand viruses and the immune system. So, too, is our increasing understanding about the mysteries of autism assisting in a better understanding of a variety of gastrointestinal and allergic disorders.

Autism – The Money Issue

Sunday, July 13th, 2014

While ‘expertscontinue to debate about the autism epidemic, parents are paying the price.

This week, the Journal of the American Medical Association published a study from the US and UK that documented a cost of (US$)1.4 million over a lifetime, if there was no intellectual disability. That’s seventeen thousand extra per child per year – 1/2  of the US median income. Add another 1 million dollars if mental problems persisted (46% in one study).’

Of course, I’m preaching to the choir here. Families are well aware of the financial burdens. The problem seems to be that the medical profession is clueless. Parents are told to get therapies that are very expensive, and even if they are ‘covered’ by insurance, the co-pays can be prohibitive. And, if the child fails to meet intellectual milestones? More therapy.

In 1987, Dr. Louvaas reported, “Follow-up data from an intensive, long-term experimental treatment group (n = 19) showed that 47% achieved normal intellectual and educational functioning, with normal-range IQ scores and successful first grade performance in public schools. Another 40% were mildly retarded and assigned to special classes for the language delayed, and only 10% were profoundly retarded and assigned to classes for the autistic/retarded. In contrast, only 2% of the control-group children (n = 40) achieved normal educational and intellectual functioning; 45% were mildly retarded and placed in language-delayed classes, and 53% were severely retarded and placed in autistic/retarded classes.

In 2010, Dr. Grenpeesheh, “… completed a study which found that 6 out of 14 severely autistic children who obtained treatment by CARD had fully recovered.That’s 43%. 

Regardless of the exact diagnosis, the reasons for increasing numbers, and questions about ‘recovery’, the lifetime costs of caring for more than half of the patients with ASD are considerable.

The commentary in that aforementioned issue of JAMA was entitled Autism – Moving Toward an Innovation and Investment Mindset. The Drexel University professors wrote, “…We wish to reflect further on the conceptual and measurement advances needed to reach a point where we can meaningfully link investments in services to life course outcomes…”

This is an indication that conventional medicine will be forced into evaluating the epidemic from the financial side, even as science fails to provide data supporting flawed theories. “… This accomplishment is especially remarkable given the challenge presented by a profound lack of infrastructure for routinely monitoring costs and outcomes in people with autism spectrum disorders.”

An important finding in the study was that the second highest cost of autism was lost productivity to family members who must care for an affected patient. That means that earlier diagnosis, with prevention of long-term disability, and the amelioration of intellectual disabilities, will have the greatest effect on decreasing costs.

I am not qualified to offer financial planning advice. There are experts on that side of the equation. Given the present state of our understanding about the cause(s) and useful autism treatment(s), such assistance in assuring your child’s future may prove valuable.

Protocols provided by MAPS physicians are certain to impact these tremendous expenses. At The Child Development Center, we have been very successful at achieving neuro-typical educational status by 1st to 3rd grade in the majority of infants and toddlers. That is a tall statement to make, and it is not offered lightly. Biomedical protocols involve a great deal of work by the families and counseling by the staff. Traditional therapies, such as behavioral, physical, occupational, and speech are a necessary accompaniment to assure improvement.

As noted in the editorial, “We need to recognize innovations that are already occurring in community settings and establish ways to learn from them about what works for whom. Accumulating practice-based evidence will require mutually beneficial partnerships between researchers and community health care… This approach would foster active learning from experience.

As in other medical conditions, such as hypertension-arteriosclerosis-heart disease or the HIV epidemic, a sizable cost savings may be the initial driving force to accurate diagnosis and effective treatment. If that is the impetus resulting in better medical care for autism, that’s OK, as well.

Autism Treatments – Natural or Artificial ?

Sunday, July 6th, 2014

The advice given by autism specialists is often subject to second opinions, by just about anyone and everyone. It is not the fault of families who seek more information, nor the doctors who are working to understand the situation.

The conventional medical community has been slow to respond to the epidemic (yes, Virginia, there is an epidemic), with very little information about precise diagnosis, etiology, treatment, or prevention. This has led to a situation in which anyone who even knows someone with ASD, saw a story on TV, the web, or has an affected child (improved or not) has advice. Also, the Internet is a sponge, soaking up stories consisting of unequal proportions of fact vs. folklore.

Diet
Children who test positive for antibodies against specific foods should avoid them. This will result in less inflammation, and therefore more energy for growth and development. The only remaining question should be whether or not there is improvement in some of the signs and symptoms of autism. Parents are a pretty good judge of this.
ASD patients who abstain from foods that lead to elevated levels of morphine due to the incomplete digestion of wheat and/or dairy (“leaky gut“) have a much better chance of getting out of their ‘fog’, leading to improved eye contact and socialization.
The ‘concern’ by the conventional medical community that specialized diets will cause nutritional deficiencies can easily be handled by laboratory evaluation, and intervening with appropriate supplements. Oh, and btw, when was the last time the pediatrician tested for any of these nutritional markers, anyway?
Parents can assess whether simple sugars, such as glucose or fructose, lead to hyperactivity. Importantly, foods that contain artificial colors or flavors represent an extra burden for the body to detoxify.
The reason that the families at The Child Development Center continue to administer restrictive diets is that they see the improvements in their children’s behaviors. Diets are a pain in the ass, but they work.

Sleep
A clerk at Whole Foods told one of our parents that, “The doctor is wrong about melatonin – Valerian root is much more natural.” Melatonin is the chemical that our brain utilizes to control our daily rhythm of waking and sleep. The synthesis of melatonin is fairly simple, and the product is exactly the same as what the brain produces. Valerian root is extracted from a plant, and contains over a dozen different chemicals, some of which may actually worsen symptoms of ASD. The salesperson, etc., assumes absolutely no responsibility for that erroneous opinion.
Chamomile tea is fine, especially for relaxation, and so it may decrease sleep latency (the time it takes to a fall asleep). But, it is a plant product, as well.
Warm epsom salt baths prior to bedtime are great. However, this is not because it sucks toxins out of the brain. Who doesn’t get relaxed from a warm bath, especially those with sensory overload?

Anti-fungals
First, let’s not forget that pediatricians have been overdosing your children with antibiotics for years. Additionally, there are steroids and antibiotics in practically everything that we eat. It is no surprise that yeast overgrowth could be the natural outcome in such a circumstance.
Second, fluconazole (diflucan) is a preparation that The Child Development Center has been utilizing for years without any problems. Hepatic toxicity is avoided by checking liver function tests prior to prescribing the medication; and periodically, thereafter, depending on how often the child requires it.
Potent probiotics and avoiding further antibiotics are the surest way to avoid future yeast overgrowth.
We have explored many ‘natural’ products, including citrus seed extract, circumin, uva ursiturmeric , and others. When ‘yeasty behaviors’ ensue, it is best to ‘bite the bullet’, and give the medicine.
Conversely, stronger medications, such as ketoconazole and Lamisil do not seem warranted.

B12 Shots
“Do we really have to give those shots? Aren’t there oral supplements that have plenty of B12.”
The problem with water-soluble vitamins is not getting them into the body, it’s the prevention of rapid removal. Depositing this useful, safe supplement into fat (the tush), will enable a 2-to-3 day release into the bloodstream. You can’t keep a lollypop in your mouth all day long.
Most importantly, addressing G-I health and optimizing mitochondrial function (with oral glutathione), prior to administering methyl B12, optimizes the chances that this protocol will be successful.

Conclusion
Too few professionals are practicing the medicine discussed by the members of Medmaps.org. We spend hours learning about basic science, months reading and evaluating research, and years treating patients and advising parents. Once a doctor arrives at a your child’s diagnosis and other key issues, a course of action is suggested that produces tangible improvements for many.

Families who are fortunate enough to find a competent physician will do best to take the well-meaning advice offered by others, and the information found on the Internet, with more than a few grains of salt. Concern about whether a treatment is ‘natural’ is not nearly as important as safety and results.

A PANDAS STORY

Sunday, June 29th, 2014

The nomenclature assigned to the condition broadly described as ASD is bound to become more precise as our understanding improves. PANDAS-PITAND-PANS are names for a group of medical disorders that present as autism ‘on steroids’.

The conditions are believed to follow some type of autoimmune activation. In the case of PANDAS, a common bacteria (the kind that causes strep throat) is the suspected offending agent. PITAND was suggested when the infection is unknown, and PANS implies that other agents may be the problem, as well.

They all share the common presentation of intense repetitive behaviors and aggression (described as obsessive-compulsive) in a cyclic fashion with periods of exacerbation and relative remission, in the pediatric age group. When the disease affects autistic patients, it is quite often difficult to differentiate from an increase in ASD behaviors. Patients who exhibit severe tics may be thought to have Tourette’s Syndrome.

The disease was first documented in 1998, and has since taken on a cult-like aura. Doctors ask each other, “Do you believe in PANDAS?” Families who have become more knowledgeable seek the few physicians who diagnose and treat these related disorders. Therefore, the term is subject to The Wakefield Effect (any unconventional theory or treatment for autism is considered to be foolish and useless, possibly leading to greater harm).

Nevertheless, 16 years ago, Dr. Sue Swedo described a “homogeneous patient group in which symptom exacerbations are triggered by GABHS infections.” That post-streptococcal symptom complex is not unlike the Rheumatic Fever epidemic of the 1930’s and ’40s, where heart valves are the target. Some believe that morphed into a specialized kidney disorder in the latter part of the last century.

Add a few more antibiotics, steroids, altered bacteria and pollution.
Voilà – a novel version of the same auto-immune disorder in a new era.
This time, the brain and gut are the targets of antibodies gone awry.

Diagnosis
A youngster with a fever and sore throat, followed shortly thereafter by an acute exaggeration of compulsive and disruptive behaviors, describes a less-than-typical clinical picture. A more common presentation is when a moderate-to-severely affected child, thought to ‘only have’ ASD, begins to deteriorate in subtle ways. The family may seek behavioral or biomedical relief, such as treating suspected yeast, or neurological evaluation and medications.

A positive throat culture is not a de rigueur finding; the additional names (PITAND and PANS) have been added to account for the symptom complex occurring in the absence of any proven infection. Also, bacteriological testing will usually be negative by the time the diagnosis is suspected, and is only possibly helpful in the acute phase. To be clear, a negative throat culture does not mean the patient doesn’t have the condition, and a positive one does not prove it. PANDAS is, therefore, a clinical diagnosis.

The workup includes evaluation of constitutional integrity (blood, liver, kidney, immune system). The most commonly accepted laboratory tests are the presence of elevated levels of anti-strep antibodies, anti-DNAse B and anti-streptolysin O, which are serum markers of recent exposure.

Treatment
Treatment is as frustrating and enigmatic as the condition. Although antibiotics are not suggested because of the timing of infection to symptoms, there are more than a few patients who have improved when treated with penicillin, etc. This suggests that organisms could still be residing in the respiratory system or in some part of the G-I tract.

Additional immunologic interventions include steroids, IVIG, plasmapheresis, and extreme behavioral interventions.

Prevention
Prophylactic antibiotics and periodic immunologic interventions have been utilized with varying levels of cost, risk and benefit.

Screening mechanisms have been proposed to reduce strep in the environment, with systemic or topical antibiotics administered to patients and family members, as needed. According to one expert, in a particularly difficult case, the offending cootie was discovered living on the family dog.

Outcome
Dr. Swedo has stated that 1/2 the children in an 8 year study had “lost their symptoms.” The outcome is quite variable, especially in patients who already suffer from other conditions, such as ADHD and ASD.

Conclusion
The name, PANDAS, is sort of an oxymoron.
There is nothing ‘cute’ about this mysterious autistic condition.
And, it is a bear to diagnose and treat.

Ten Things All Pediatricians Should Know About Autism

Saturday, June 21st, 2014

In the course of the detailed history that our parents provide concerning their infant’s development, I am (too) often struck by the lack of accurate advice offered by the former pediatrician. Yeah, the family no longer sees that doctor.

It probably shouldn’t come as such a surprise. ASD is THE major childhood epidemic of the 21st century, and the latest issue of our most respected scientific journal did not have a single article dedicated to autism. And, if you think that doctors merely used to “call it something else,” you have to explain why the incidence of “Mental Retardation” never approached 1/68 children.

It’s not just speech and language delay if a) the kid loses previously acquired words
and b) another symptom is present.

Other includes motor weakness, such as late sitting or walking, unusual crawl and decreased muscle tone. Signs may include torticollis (that starts after birth), plagiocephaly (infants paced on their back who don’t turn), GERD (weakness of the gstro-esophageal junction or diaphragmatic muscle), continuous drooling or poor chewing (oral musculature) leading to textural symptoms and restricted diet.

Other includes unusual behaviors. Pediatricians need to be concerned about extreme tantrums that proceed to self injurious behaviors. Head banging, continuous rocking, and chronic sleep problems should be investigated as red flags for ASD.

Other includes a paucity of social interaction as manifest by poor eye contact (especially loss of this skill), not turning to voices, and rejecting cuddling.

Other includes medical problems. Frequent infections, especially accompanied by numerous courses of antibiotics, may be a sign of impending regression; or conduct that may trigger it. Skin rashes diagnosed as eczema, significant environmental or food allergies, and asthma are often additional diagnoses, noted in our patients. Doctors should inquire about unusual stooling (constipation or/and diarrhea), including consistency or color changes.

Medical professionals who proclaim, “We have to wait to give you a diagnosis” are ignorant at best and detrimental at worst. There is no need to wait to be sure of the diagnosis. It is imperative to intervene at the earliest possible time, when socialization and communication are at the most formative stage.

Don’t wait to get a neurologist to confirm the diagnosis. True, they may provide important additional insights, especially if a seizure or other condition is suspected. Also, insurance companies usually demand their professional opinion to obtain certain tests, such as MRI, and referrals for therapy. Otherwise, they are generally of little assistance as far as elucidating the problem or offering useful advice.

There could be a need to see a genetics doctor. A number of ASD patients have major or minor identifiable genetic variations. One doctor told our Mom, “Well, if you aren’t having any more children, it really isn’t necessary.” So, if, in the next few years, a treatment becomes available for that specific condition – wouldn’t the parents want to know? And, if there are other patients out there with the same problem, the family might consider becoming involved in research or wish to join a support group. What happened to scientific curiosity and accurate diagnostic criteria?

The presence of one or two non-autistic behaviors does not rule out Spectrum Disorder.
Successful interactions are important clues about what pathways are functioning properly.

“He’s a boy, they talk later,” “She’s the youngest,” “The parents are spoiling the child,” “You speak two languages,” and “Don’t worry” are excuses for the previous century.

Children who aren’t speaking by the middle of their second year deserve the pediatrician’s immediate attention to ascertain whether there are other comorbid conditions, and investigate pertinent intervention(s). Parents who continue to have doubts should seek another physician, especially one who specializes in childhood development.

Regardless of an “official” diagnosis, initiate appropriate therapies. Stat.

I Flunked the IEP

Saturday, June 14th, 2014

At this time of year, when Individualized Educational Plans are discussed and recommendations are offered about the coming year, parents are often unsure about optimal placement for their children affected with ASD.

If assigned to an Exceptional Student Education classroom with disruptive students, will their child copy the behaviors, in order to gain attention? Is being exposed to a great deal of ‘stimming’ a cause for concern? Will nascent speech be nurtured in a more neuro-typical classroom or ignored in a apraxic group? Are there youngsters who will become friends or others who promote bullying?

This is the conundrum faced by the parents of many of our recovering patients. The medical side of autism and ADHD is my primary concern. However, one family insisted that I voice my opinion regarding their 5-year-old’s upcoming formal classification. I agreed to assist by speaking with the appropriate school staff, including the teachers, administrators, school psychologist, and therapists.

For the first 20 minutes or so, each professional detailed, “hyperactive,” “lack of focus,” “easy distractibility,” and academic performance issues.

“What is your opinion, Dr. Udell?”
My answer, “It sounds as if you are describing the child’s immaturity.”

I expressed that the majority of medical professionals who heard these concerns would most certainly recommend stimulant medications (e.g. Adderall, Ritalin); if not now, then within the next few years. “Oh, no, Dr. Udell,” was the answer. “That’s not what we meant!” Regardless of staff intentions, most pediatricians, child psychologists, psychiatrists and child neurologists give the knee-jerk response – meds.

Recommendations:
Be realistic about what goals YOU expect in the next school year. For young children, speech acquisition and play are the most important skills. Occasionally, no school is likely achieve these goals, and parents should consider other options (home with appropriate therapies).

The school is expected to document progress in fine motor skills (e.g., drawing, writing, cutting), group activities (circle time, following directions) and academic skills (letters, colors, reading).  Will your child “make it” in that environment, or are those the biggest weaknesses?

Auditory, visual and sensory processing difficulties need to be addressed in order for children to succeed in a neuro-typical setting. Extra attention outside of school (OT, PT) can provide significant benefit.

The proven therapy for behavioral difficulties is ABA. Disruptive conduct cannot be ignored in a neuro-typical classroom, so any behavioral resources that the family can provide are paramount. Habits (such as face and hair ‘touching’) that appear “cute” in a toddler, may be unsettling in a 6-year-old, more-than-troubling in a pre-adolescent, and out-of-order in a teen.

When the teacher says, “Look at the chalkboard,” Junior has to respond appropriately. Kids need to look like they are attending, even if they aren’t. Often, the situation is quite the opposite – the child is listening, but adults misunderstand.

Don’t compare your child’s progress to that of the others in the class. Keep your eye on the main goals – independence and productivity.

Don’t have your doctor attend – I was an unhelpful distraction.
It’s back to letter writing for my practice.

In the best of circumstances, most children who are recovering from their ASD would do best in a neuro-typical classroom, with pullouts for extra services and tutoring, and a shadow to redirect. Obviously, that requires significant resources and the school’s cooperation. However, the need for stimulant medications would be greatly reduced.

The Effects of Soy on Patients with Autism?

Sunday, June 8th, 2014

The less known about a topic, the more the Internet will fill in the blanks, whether or not it represents the truth. So it goes with soy products, especially as regards patients with ASD.

On one hand, parents are advised that their child should avoid casein (a milk protein), but the closest dietary substitutes for yogurt, milk and cheese are typically soy based. On the other hand, there are numerous experts with opinions and stories that warn about a multitude of evils associated with this ubiquitous foodstuff.

? Estrogen Effect
Infants fed soy formula can achieve a significant level of estrogen-like hormones. Recent information links such components to reduced fertility, earlier puberty and disrupted prenatal and early development. There is a paucity of human research, however. Consequences in autistic children are yet-to-be-discovered, and soy components do have positive, anti-oxidant properties.

? Morphine Effect
The production of morphine compounds from inadequate digestion of wheat and dairy is a controversial topic. Nevertheless, at The Child Development Center, a GF/CF diet in children who test high in morphine metabolites is key in reducing the ‘fog’ that prevents normal socialization. Although less identifiable, high intake of soy can sometimes produce these same effects.

? Allergic Effect
The association of food allergies in patients with autism has been a consistent finding (A, B, C, D, E). Sometimes, there is a significant elevation of anti-soy antibodies of various types (IgG, IgE, and subtypes). As in any auto-immune state, avoidance of the offending agent results in better health and improved response to conventional therapies, such as OT, PT, S&L, and ABA

GMO Effect
The new G-I paradigm considers the environmental microbiome. This includes the organisms of – and not of – us, as they interact in the larger intestinal environment. Microorganisms affect neural, endocrine, lining and muscle cells, finally communicating with the rest of the body. It difficult to believe in this generally-accepted modern view and not consider any previous research into the safety of Genetically Modified Food practically irrelevant.

I recently discussed this issue with two of our mothers. One was raised on a farm, and personally witnessed the changes to the family crop as the plants became resistant to… anything. “They are no longer the same!” said that parent. Another mom asked, “In a sense, isn’t everything genetically modified?” But, inserting a new genetic code artificially is un-natural selection. The downstream effects are potentially disastrous, particularly if childhood development was not a previously considered outcome parameter.

It’s not just soy, however. Although a great majority of the US soy is from genetically modified seed, many other crops have been altered, as well.

Conclusions
This plant product is one of the most utilized protein sources in the world. It is a natural food source for many species, and has been a staple in the human population. Clinical studies have shown that eating soy can lower cholesterol as well as the risk for certain types of cancer. Theoretically, it should represent a healthy nutrient.

Our microbiome is constantly being artificially altered with antibiotics, steroids, and a multitude of even more toxic and/or unknown substances. It’s difficult to imagine that such modification couldn’t affect certain growing minds and bodies – in, or out of the womb. Many of the concerns about soy can be aimed at a multitude of foodstuffs – plant and animal.
So, what’s left?

Negative effects notwithstanding, this is sometimes the lesser-evil in patients who demonstrate multiple food allergies but test low for soy and leaky gut. Choices need to be made in order for children to achieve a positive nitrogen balance, which should result in healthier growth and more typical development. When possible, parents can look for rice, nut and other acceptable substitutes.

BIG DISCLAIMER*
At The Child Development Center, a very effective method of addressing the assault on the human microbiome has been the addition of appropriate, potent probiotics with particular strains that improve each individual’s homeostasis. Sometimes, anti-fungals are required. Rarely, even anti-viral medications can be helpful.

It is a process that involves identification of flora before, and often after, intimating appropriate in individualized therapy.

*The information is presented for discussion purposes only.
This is not personal medical advice and not intended for specific patients.

It’s Not the Asperger’s Syndrome

Sunday, June 1st, 2014

Let’s face it; anyone who goes on a shooting rampage has some mental illness. Often, it seems there was a history of family turmoil, few friends, bullying, and lack of empathy. That does not define Asperger’s Syndrome, which is a developmental disorder.

Recent sensational violent acts by young men could be due to a number of conditions, including:
∗ ADHD with feelings of inferiority because of poor performance
∗ Schizophrenia
∗ Personality disorder
∗ Watching violent video games
∗ Oppositional Behavioral Disorder
∗ Acute or transient reactive psychosis
∗ Reactive Attachment Disorder
∗ Subject to abuse
∗ Temporary insanity
In deranged individuals, such as the Connecticut and California shooters, psychiatrists would probably entertain even more possibilities.

There is no precise manner to define Asperger’s Syndrome after someone expires. The conditions that explain impulsive conduct are inaccurate, at best. Psychiatric diagnoses need to be assessed in real-time by documentation of signs and symptoms. Regarding the recent carnage, family members (and their lawyer) reportedly claimed that Elliot Roger was “on the spectrum,” and suffered a long history of mental difficulties.

How about focusing on the histories of mental illness
with easy access to firearms?

The Autism Epidemic that has blighted the child development landscape of the 21st century is a mystery, with vague descriptors and the recent inclusion of many other developmental problems, including Asperger’s and PDD-NOS. The public is left to wonder, “Why so many killing sprees?” The media is quick to supply an answer, “Perhaps it is those autistic (Asperger’s) kids!”

I have examined scores of patients who fit criteria for the disorder. Effective communication is difficult; some are depressed, some understand and address their challenges, and others who say, “That is the way that I am.”

Key traits include early developmental delays, an unusual affect, restricted interests, decreased eye contact and sensory issues. They are usually very standoffish individuals who feel uncomfortable outside of their usual environment.

There is not a great deal of published information about the association between violence and Asperger’s syndrome. In one study, 31 of 37 of the patients (85%) had a possible or probable comorbid psychiatric disorder.

A 2010 follow-up paper concluded, “The mean percentage of registered convictions was similar to that in the general male population of Austria over the studied time period. A qualitative assessment of offence types in Asperger’s former patients suggests that the nature of offences does not differ from that in the general population. In this original cohort of Asperger’s patients, convictions were no more common than in the general male population.

We should be very skeptical about media pundits’ experience, statements and motives. Sensational reporting is unfair and irresponsible because it assigns to Asperger’s patients a stigma that they do not deserve. There are many more examples of productive individuals than violent criminals committing heinous acts due to their autism diagnosis.

Just because Asperger’s Syndrome is the “diagnosis du jour,” it doesn’t mean that there is a shred of proof that affected individuals commit brutal crimes or that they are any more prone to such violence than those who are not so classified.

Miracle Mineral Solution Treatment for Autism

Saturday, May 24th, 2014

I hadn’t really expected MMS to gain any traction as a viable autism treatment. It seems complicated and scary, and the FDA first issued a warning about it four years ago. Perhaps there is no measurable re-emergence, but it seemed so when I attended the Autism Today Second Conference in Miami this week.

I sat among eighty mostly-bewildered parents, representing children who are so affected that they are attracted to outlier theories and treatments. This is largely because the information supplied by the conventional medical community is so woefully inaccurate, incomplete, and unproductive for many patients.

Due to some scheduling glitches, this conference ended up focusing on the very controversial topic of MMS. The treatment was explained by Ms. Kerri Rivera, “a biomedical consultant for an autism clinic in Puerto Vallarta,” and mother of recovered child. Her experience was then authenticated by Dr. Andreas Ludwig Kalcker, inventor of “The Parasite Protocol,” which is an essential element in the therapy.

The Chlorine Dioxide Protocol is not about bleaching your kid. That was the first message. Well, it’s not about making your intestines white, but the word does mean “to sterilize.” Anyway, that refers to sodium hypochlorite, according to Ms. Rivera, not the chemical that MMS is utilizing. In that sense, it’s not about dipping your child in Clorox. Except that Chlorine dioxide is used in “stripping textiles and industrial water treatment,” and it does involve purging and cleaning the “excess of pathogens.”

  • The diet – organic vegetables and meats. GF/CF/SF/sugar free (especially fruits).
  • Supplements – Stay away from all anti-oxidants.
  • Main Ingredient – Ocean water and acid (lemon juice, e.g.), to make a dilute solution of Chlorine Dioxide.
  • How it is administered – Doses and administration depending on a pre-established protocol, plus alterations depending on symptoms and response to treatment. In the gut, it is supposed to remove the biofilm and so expose organisms that get flushed through the G-I tract. Breathed into the lungs, it addresses asthma and bronchitis. The cutaneous route helps eliminate bad skin cooties and detoxify. Enemas and rectal suppositories to directly address lower intestinal issues. There is also and Eye and Ear spray form.
  • What happens – The elimination of bad bacteria (and, admittedly some good ones – but they have a product to fix that), viruses, fungi, and worms. Lots of worms. Plenty of worm pics. Worms that no laboratory in the world, apparently, can document.
  • Acceptable additional treatments listed as HBOT, chemical chelation and GcMAF, probiotics, l-carnosine, carnitine, plant fatty acids, GABA, digestive enzymes, tryptophan, DMG and TMG (the last 2 are anti-oxidant precursors).
  • She claims to have helped over 6000 families, and 131 cases of patients losing the diagnosis.

The ‘Parasite protocol’ was presented by Dr. Andreas Ludwig Kalcker, who recommends Chlorine Dioxide treatment.  He lists his credentials as, “… first licensed in economics and later in biophysics and alternative health (Ph.D)
Although his German accent is compelling, the science that he presented was not. He listed the symptoms of parasites and noted similarities to many autistic behaviors (?cause and effect?). He claims that his key discovery was that regressive autism is due to “Parasitological Vaccinosis“. That term describes toxins that are later released by parasites in susceptible children who become vaccinated.
He made many grand overstatements, using real research papers that only prove the one point, frequently mixing apples and oranges. Slides such as “Larval migraines induced by vaccine,” not only lack a scientific citation, I couldn’t find any match over the entire Internet.

In the Q&A session, I asked a simple question, “131 ‘cured’ is the numerator, what is the denominator?” This resulted in Ms. Rivera and Dr. Kalcker blustering about how that number couldn’t be documented, and how it wasn’t really important. That begs the comment, “Well, if you don’t know how many have been treated in this manner, you also wouldn’t really know how many have experienced significant negative reactions.”

As expressed by top autism researcher, Dr. Martha Herbert, I do not believe that parents who attend these conferences are “gullible, dangerous, and/or don’t love their children, and the people who pass them off are snake oil salesmen.” I was there to learn about new ways to approach our most resistant patients, not to simply criticize. Avertising MMS in this manner is not the way to go about proposing innovative and controversial treatments. It promotes The Wakefield Effect.

Dismissing conventional medicine as being completely ignorant and challenging treatments from all sides takes strong scientific proof. Proof of concept in animal models and proof of efficacy and safety in appropriate human treatment trials. To be specific: no, I would not recommend this treatment for my patients. There is simply too much missing information. A few pictures of recovered children and parental testimonials should not sway a prudent professional.

At The Child Development Center, we have improved the lives of many of our patients by addressing and treating G-I health with a proven, safe, well-tolerated protocol. Nutritional status must be evaluated, treated and monitored. With appropriate behavioral therapies, child development gets on the right track.

For successful autism treatment, each piece in the puzzle has to fit into the bigger picture.

International Meeting for Autism Research 2014

Sunday, May 18th, 2014

My medical lifetime has experienced several epidemics. Although such problems are devastating to families, we learn a great deal of general science by uncovering the secrets of each new disorder. Think of Legionnaire’s disease (bacteria), the Norwalk virus, helicobacter (stomach ulcers), etc. Regarding the conditions that now fall under an autism diagnosis, these are exciting times for study and discovery.

At this conference there were 1800 attendees from all over the world, and nearly 1000 research papers. It has been great watching this organization grow; bringing advances to the science of autism spectrum disorders.

What I Liked:
This years Advocate Award went to Peter Bell. He is a true contributor to autism. More than simply offer an acceptance speech, he did a great job of expressing to this diverse, but research-oriented group, his “Top 10 List” for audience understanding. That included finding causes and treatments, environmental associations, lifetime services, and recognizing patients’ humanity, with the urgency that a only parent could feel and express.

Then, there were the short conversations with the presenters. I spoke with a pediatric neurologist who presented his work on Vitamin B12 and folic acid. Another was a social worker, whose study concluded that the new DSM 5.0 would result in fewer diagnosed cases. I couldn’t agree less, so I was able to discuss it.

At lunchtime, I sat with a distinguished, rather humble, retiring psychologist from a prominent New York clinic who said, “maybe 5% of our patients report G-I problems.” I took the opportunity to offer, “Gee, that is awfully low. I would sure like to test those patients with my protocol.”

I spoke with a young researcher whose paper detailed the changes in the neuron-type cells of the intestines, which is work that will elucidate gut alterations that might explain various autistic features.

There are so many young and promising minds. Just as HIV research enriched our knowledge of DNA, RNA and viral-human interaction, autism is enhancing scientific understanding of the development and function of the brain.

What I Didn’t Like:
There were few papers and presentations about environmental and epigenetic effects leading to the epidemic. For that matter, there was little discussion about the presence of an epidemic, though I suppose that would have been preaching to the choir.

Also, I think that there needs to be more work on how co-morbidities play into ASD. As a clinician, I find that problems, such as those in the G-I system, sensory difficulties, sleep disorders and anxiety, need to be studied as the very fabric of the condition.

Finally, this is not so much of a complaint, as a fact of life, but there is so much to read and learn in just a few days. There just never seemed to be enough time.

Best Thing at the Meeting:
Dr. Fred Volkmar, Yale autism expert, got a Lifetime Achievement award. He is an energetic and fascinating teacher who noted how few treatment studies are yielding success, especially compared to the explosion in the volume of research. Dr. V actually expressed his frustration that much of the work is not actually getting to the parents and the children.

This famous professor expressed an understanding of how parents seek Internet answers in the absence of viable medical alternatives, which is such a rare point of view in the academic world.

Conclusion:
The knowledge and information that ripples from this scientific meeting and the people who continue this work will make a difference. Perhaps not one particular study or that trial, but by their dedication to becoming part of the solution, parents can be assured that you have champions on your side.

You can access the research abstracts here.

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Brian D. Udell MD
6974 Griffin Road
Davie
FL 33314
Office phone – 954-873-8413
Fax – 954-792-2424

Email bdumd@childdev.org
Website http://www.childdev.org

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