Posts Tagged ‘Attention deficit’

Autism, Inoculations, and Fantasyland

Sunday, January 25th, 2015

Recent news about the increase in measles that has sprung up in California, has brought about the usual media finger-pointing, claiming that the cause is unvaccinated children whose parents unnecessarily worry about the risk of autism.

As documented in my previous posts on this topic, this physician believes in the value of those twentieth century miracles. Nonetheless, a lingering question remains, “Are all of the vaccinations safe and effective for all young children?”

The Three Main Reasons for the Measles ‘Outbreak’

Lack of Knowledge

We really don’t know the reason(s) for the newest episode. The increase may have little to do with lack of compliance by anti-vaccination zealots. Many of the infected individuals were Disney workers who had probably already been vaccinated, and were no longer immune. Plus, the venue is an international attraction, with visitors from all over.

The Wakefield Effect – Any time there is any story involving vaccines and ASD, the controversial and now-infamous British study that implicated measles virus as a possible cause, seems to mar all perception and reason. Media pundits are quick to avail themselves of that ill-fated research.

Conventional medicine is still debating whether increases are merely due to changes in diagnostic criteria. Every week a new association pops up; including maternal weight, paternal age, environment and toxins, stress, and circumcision. If compliance is the issue, certainly such confusion shakes one’s faith in the ‘science’.

Polarization

The experts would have a great deal more validity and success, if they could add more understanding and kindness to their approach. Those who question the status quo are considered kooky, ignorant and ill-informed. That creates more polarization, with fewer parents possibly choosing to vaccinate.

Pro-vaccination declarations are rarely equivocal, and conclusions no longer contain the statement, “The topic deserves further study.” Anti-vaccination supporters suffer a similar shortcoming, and conspiracy theories are a scientific distraction. There doesn’t seem to be any compromise position.

Issues, such as the recent CDC whistle-blower case, or reports of safety violations have not been adequately addressed.

There still aren’t any definitive, prospective, randomized, controlled, double-blind crossover studies with long-term outcomes evaluating various vaccine schedules to document safety. Holistic medicine is frequently chastised by the establishment for such an omission in alternative protocols.

Lack of Confidence & Trust

A great deal of money is handed to drug manufacturers to manage these vaccination programs. Concerns abound about whether large multi-national companies always have our best interests in mind.

The Flu vaccine fiascos that permeate each winter do not engender a great deal of confidence about how our medical establishment handles the inoculation issue.

The government continues to send out inaccurate and conflicting messages regarding our public health. Antibiotics in our food are proven unsafe, but the practice continues. There were 2 cases of ebola and Congress appointed a ‘czar’, but they couldn’t confirm a Surgeon General.

Public trust in the FDA and CDC has been eroded by frequent lapses in judgement and execution.

Conclusion:
The vast majority of the scientific literature is quite insistent that there is no relationship between the present vaccine schedule and ASD. To all of the experts, ‘true’ scientists, and colleagues – I get it!

That fact remains that there are too many parents who have noted developmental regression proximate to a childhood vaccination. They deserve better answers.

Autism, ADHD and Circumcision

Sunday, January 18th, 2015

New information has been forthcoming from a Danish database lately, specifically involving autism. This study represents data involving more than 1/3 million children, entered from 1994 to 2003 .

As might be expected, an eye-catching array of media headlines followed the paper entitled, “Ritual circumcision and risk of autism spectrum disorder in 0- to 9-year-old boys: national cohort study in Denmark”.

The Results:
All of the circumcised boys had an increased relationship to ASD. Some adjustments (birthweight, APGAR score, etc.) were accounted for, while other known, possible associations were not (pain relief, living near pollution, diet, e.g.).

Additionally, circumcised boys in non-Muslim families were also more likely to have an ADHD diagnosis.

Other Research:
A 2013 study looked at the increasing incidence of ASD since acetaminophen (Tylenol) has been routinely used for pain relief during circumcision. The authors suggested “… the need for formal study of the role of paracetamol in autism.” In other words, they looked at the problem from the other direction; and when pain relief was provided, autism increased.

Discussion:
The Danish investigation contains a most glaring conclusion that makes the data-in-question eminently quotable, “We confirmed our hypothesis that boys who undergo ritual circumcision may run a greater risk of developing ASD.” I wrote to ask the principle author, Dr. Morten Frisch, about this.

The doctor took the time to respond to a number of questions about the information. He seemed to be somewhat sensitive that such controversy has surrounded these (admittedly) two highly emotional topics, and he is taking plenty of outside criticism. Furthermore, Dr. Frisch has assumed an “I’m-just-the-messenger” attitude about the conclusion.

For me, a major sticking point is a design anomaly which brings the entire report into question. Specifically, children who hadn’t been circumcised but were autistic were considered as not autistic until they got the operation, for the purposes of the data analysis.

For example, a seven-year-old who already had autism didn’t get classified that way, until he was circumcised at 7, (which is clinically impossible).
My question, “If a study shows that I am an architect, not a doctor, isn’t the study flawed?”
Dr. Frisch’s response, “No, in your example the methods would not be ’flawed’, but ‘imprecise’.” Either word – it’s inaccurate. The product only represents a mathematical reality.

Conclusion:
Male circumcision and autism are both very controversial issues. Supporters for various points-of-view will use self-selected segment(s) of the data to fit their particular pro or con argument.

The practice of male foreskin removal is decided according to family, friends, folklore, culture, customs, and cosmetics. The present medical evidence is far from conclusive.

Regarding the cause and prevention of autism, the more significant medical information is that vigorous scrutiny and intervention in a young infant’s nutritional and developmental status is the most successful means to fend off possible delays.

As for the present study? “There are lies, damn lies, and statistics.” (Mark Twain)

Ten Ways Pediatric Neurologists Can Help Autistic Patients

Monday, December 8th, 2014

With all due respect to the intelligence of physicians who take specialized training in child neurology, it appears that there is often some disconnect between their knowledge about autism and the approach to the families and patients affected by this modern epidemic.

10•Making the diagnosis and giving some tickets for therapies is not enough. Questions such as, “How did my child get this? How many get better? What other things can we do? Are there any tests? Where can I go for more information?” are sure to follow the diagnostic impression. At least, provide useful answers for those interrogatories.

9•The child neurologist has the opportunity to assess the risk of anesthesia versus the poor yield of an MRI. Likewise, assisting in the consideration of a short-term EEG, when there is no indication of seizure activity. Those technologies are not a diagnostic workup.

8•There is more than one kind of autism. There should be careful exploration about specific difficulties with the skin, gastrointestinal system, or frequent infections.

7•Neurologists are in a position to provide valuable assistance regarding various alternative treatments’ risks and expense. An off-hand dismissal about therapies to address other co-morbid conditions does not enhance that specialist’s stature in the eyes of the parents.

6•It might be helpful to suggest simple, possibly helpful treatments, such as dietary restrictions. What is there to lose? For the physician who is truly concerned about key deficiencies, this would be a good opportunity to check the child’s nutritional status with some blood work.

5•Doctors who continue to repeat, “You are doing a great job,” at each visit, with little documentation of change, are less likely to experience further visits.

4•In addition to the usual Fragile X-boy-test and Rett’s-girl-test, the neurologist can order a ‘chromosomal microarray’. Copy number variation affects up to 15% of ASD patients. Insurance companies pay for this. Although the results may not be valuable today, that knowledge may be quite important as our understanding about autism evolves.

3•A screening laboratory evaluation for anemia, kidney, thyroid, and liver status may yield a great deal of information. Even if the busy doctor cannot act upon abnormalities, they can be conveyed to the pediatrician.

2•Expressions such as, “I’m willing to say developmental delay,” or “We have to wait to give you a diagnosis,” are for the previous century. In young toddlers, communication is in its most formative stage. “Let’s err on the side of caution, and make sure that you get S&L, OT, ABA, right away.”

1•There are studies to show that patients can recover. Knowledge about that research and successful outcomes provides real hope for bewildered parents.

‘Tis the Season to be Yeasty

Sunday, November 30th, 2014

seasongreat“Why does the yeast keep coming back? When will we be able to stop worrying about that?” Those are oft-repeated concerns from many parents of patients with ASD, who have noted remarkable improvements when their offspring no longer suffer from fungus.

At certain times of the year, more ASD patients seem to appear who display signs and symptoms of gut yeast. This list explains some underlying causes for this phenomenon. It can be sung to the tune of the Christmas Song or Dreidel Dreidel Dreidel.

Families travel. It is unlikely that they will come upon a road sign advertising “GF/CF/SF/SCD Fried Chicken”.

Likewise, running out of magic medications or significant supplements may lead to an increased chance of a yeast outbreak.

There are relatives who do not believe that food affects behaviors. Some try to sneak forbidden substances, just to prove that ‘The Diet’ is unnecessary. By the following day, there are often many new believers.

Traditional seasonal foods are usually not part of a restricted diet. In an effort to make the situation more ‘normal’, unfamiliar foods are provided that may lead to constipation or diarrhea.

Refined sugar and high fructose corn syrup are ubiquitous in processed foods. Yummy desserts can yield yucky, yeast-disturbed sleep.

Changes in weather often accompany a higher risk of viral and bacterial illness. Fevers and ‘colds’ frequently lead to antibiotic overuse that may result in yeast overgrowth.

“You’ve got to let them be kids,” said one parent who relented about the key lime pie. Another one lamented, “I paid for that ice cream cone – for a week!”

School personnel get relaxed about the diet in susceptible kids. Daily celebrations make the forbidden fruit even more appealing.

Junior has lots of new stuff (toys, packages, etc.) to put into his mouth. This provides an opportunity for a multitude of strange flora to explore your child.

Environmental alterations take place; such as a Christmas tree, ornaments pulled from the top shelves, and warm clothing exhumed from rarely-visited closets. This provides plenty of moldy allergens to over-tax the immune system.

Schools, homes, churches, etc. turn on the heating system for the first time; expelling blasts of spores. This may occur in climates as diverse as warm, wet Florida, or the chilly nights in dry Arizona.

With autism, the extra social and academic challenges at this time of year are overwhelming. This can lead to anxiety, poor(er) eating, aggression and sleep disturbance – giving the appearance of ‘yeasty behaviors’, even if that is not the cause. Family problems can produce a similar picture.

What to do about it:
Parents should not despair about this situation. Yeast in the G-I system is one of the few causes of the signs and symptoms of autism that CAN be successfully treated with safe and effective supplements, diet and medication.

This is a great time to provide natural anti-fungals, such as vinegar, garlic, olive leaf, etc., to the extent that products are palatable and well tolerated.

Under the supervision of an experienced physician, a course of a prescription anti-fungal may be just what the doctor ordered as a holiday ‘chaser’ for ASD patients affected with yeast.

Fish Oil for Autism and ADHD

Sunday, November 16th, 2014

It seems that the less that is scientifically certain about a nutritional supplement, the more Internet pages are devoted to convincing surfers about its value to your health.

On the other hand, certain food additives hang on because they appear to have merit. Fish oil, for example, has been a mainstay. In addition to health benefits for heart disease, depression and dementia, improvements have been documented in behavior, ADHD, communication and cognitive function – many of the core symptoms of ASD.

The Basics: (for our purposes)
The brain is rich in fats. They are membrane-stabilizing, anti-oxidizing, electricity-enhancing, chemical-carrying, and account for most of the weight of our CNS.

A healthy metabolism requires dietary polyunsaturated fatty acids (PUFAs). One designation (Omega 3-6-9) describes the organic composition. Another important classification describes the size of the molecule (α lipoid acid-> EPA-> DHA).

There is evidence of differences in the PUFAs of people with ASD. The inference is that function can be normalized with dietary intervention by re-establishing typical levels and ratios.

Dietary sources:
Various mixtures derived from the ocean (cod, salmon, krill) and/or plants (flax, corn, nuts) are available. Claims about better stability, quality, purity, ingredients, absorption and disease-specific value are variously offered.

Particularly as regards a condition as multifactorial and enigmatic as ASD, this situation has resulted in a myriad of possible correct, useless, or even harmful choices.

Side effects:
WebMD lists a variety of adverse reactions, the most pertinent to the ASD population being:
G-I symptoms including burping, discomfort and loose stools
•Bleeding, including nosebleeds
PUFAs affect the immune system
•Heavy metal contamination
•Allergy to the source
•Exaggerating mental disorders
•Lowers blood pressure (many patients take bp lowering meds for sleep and anxiety).

Scientific papers reporting various dosages and formulations have demonstrated cautious safety, even in research that does not support assertions of improvement.

Results:
There is more than one study that refutes any positive effects, particularly in ADHD and ASD. There are few reports of gains in speech and language. Even the evidence offered by a popular vitamin company lacks specific supporting documentation.

Many children with ASD are on restricted diets or they are finicky eaters who could use the extra nutrition, anyway. Furthermore, there is a growing body of anecdotal reports and stories of improvement from various omega products.

There is theoretical and documented evidence that supports the proposition that this relatively safe and inexpensive nutritional supplement improves CNS functioning.

Conclusions:
Since we have limited ability to produce them, PUFAs are a dietary requirement. They are Essential Fatty Acids in various combinations, with confusing nomenclature. That situation often leads to marketing opportunities.

Little is certain regarding how this group of supplements affects patients with ASD. Users mostly rely on producer advertising for information and assurances about the “best” product.

In order to assess whether “it’s working,” caretakers should pay particular attention to gains in the most documented behavioral components, such as ADHD and aggression. Being aware of safe dosing and negative effects is valuable, as well.

Perhaps not producing as noticeable an improvement as other biomedical interventions, a high-quality oil that the child can tolerate (taste, smell), at the label-recommended dose, is a reasonable nutritional supplement for ASD.

The War on Autism

Sunday, November 2nd, 2014

In the 1980’s, President Ronald Reagan declared a ‘War on Drugs‘. The Global War on Terrorism was pronounced after 09/11/01. Early in this century, Bush 2 joined the war on HIV/Aids. This week, Obama named an Ebola Czar.

For some time now, the U.S. has only had an acting Surgeon General (Rear Admiral Boris Lushniak), because the nominee, Dr. Vivek Murthy, had the temerity to say that, “Guns are a health care issue.”

Is it any wonder that ASD has taken a backseat to other matters in our healthcare system?

More than forty years ago, Surgeon General C. Everett Koop challenged the tobacco industry juggernaut that assaulted the population of 20th century earth. He raised numerous warnings (including the dangers of second-hand smoke), and even changed the paradigms for advertising and labeling the product. In spite of some unpopular conservative views, especially regarding abortion, Dr. K was still considered America’s Doctor.

What does ‘declaring war’ mean?
It implies urgency. Somehow, more resources appear; including funding, infrastructure, media, etc. Priorities change. For ASD, a medical condition, personnel and materials would become focused on research to elucidate etiology, test treatments and evaluate prevention.

The ‘enemy’ is put on notice that the entire weight of the U.S. government is behind an effort to solve the problem. It worked when we landed a man on the moon, figured out the HIV epidemic, and Bin Laden. Autism is trickier because, like terrorism, it’s difficult to identify the opposition.

A ‘Czar’ is usually named. The Big Kahuna avoids Senate confirmation. Hopes are raised. There would be a commander to unify the disparate autism organizations.

How would the appointment of an Autism Czar help?
There would be instant recognition, finally, that there is an epidemic. Apparently, “ASD now affecting 1/42 males,” does not sound dire enough.

A true understanding of the costs should enlighten the prudent potentate about the enormous savings produced by early diagnosis and effective intervention.

There would be a respected leader to delegate resources to the areas of most need. This individual also has ultimate responsibility for education, caring for older patients, and the most affected.

More medical specialists would get involved in the search for answers. Gastroenterologists, dermatologists, immunologists, child neurologists, and pediatricians would find increased incentives to join the autism battle.

Research leading to effective medications would speed up. The major complaint by drug manufacturers is that it costs >$ 1B to develop any new drug. Perhaps, as in other crusades, the ASD maven could cut through the red tape to get things moving.

Vaccination research would take a new direction. Increased resources should include the formulation of controlled, prospective, randomized, double-blind studies about the various components of the present childhood immunization schedule, dose and timing. This would go a long way to clearing up the many lingering concerns in this area.

Unification would provide a national infrastructure for tackling the situation. The evaluation of genetic, environmental, bacteriological, nutritional, and other important disciplines by the Boss and Joint Chiefs of Autism Medicine may be the best way to gain ground on the enemy.

The Czar would be responsible for making a difference in the autism epidemic.

There is no ‘War on Autism’.
But patients, families and practitioners – those who live and fight in the trenches – could certainly benefit from some reinforcements.

Sleep and Autism

Sunday, October 26th, 2014

Persistent, altered sleep is a common finding among young children who have signs and symptoms consistent with a diagnosis of ASD. This is a key difference from neuro-typical peers.

And, like any person, changes in quantity and quality can result in further downstream behaviors; such as, inattention, poor focus, and easy distractibility. The situation can further deteriorate into tantrums, a ‘short fuse’, aggression and injurious actions (against self and/or others).

Sleepchart

Data from Ruffwarg, et.al. Science 1966

What is disturbed sleep?
Not only do young children sleep much longer, more time is spent dreaming, which is an important physiological necessity and developmental component. Since there is practically no muscle movement during REM periods, toddlers should be sleeping “like a log.” Many affected youngsters do not exhibit such activity.

Latency is prolonged. The time that it takes to fall into a slumber should be <~1/2 hour, even accounting for a great deal of individuality. Nighttime awakening is frequent in infancy, but the child should quickly drop off again. Because this process takes time, naps include less REM sleep.

For ASD affected individuals, problems can persist even into later years.

What causes disturbed sleep?
Sleep apnea is a possibility, especially for some premies, or when allergic asthma or rhinitis are frequent occurrences. More often, signs and symptoms represent GERD (reflux), of varying degrees and varied causes. Really bad heartburn, and no way to tell anyone.

Diarrhea, constipation and bowel inflammation may cause sleep alterations, as well. Since G-I conditions exist so frequently in ASD patients, this is a significant area for positive intervention and change.

Other medical issues include frequent ear infections causing fever and pain, seizures, altered melatonin metabolism, other metabolic disturbances, methyl B12 ‘shots’, and even the stimulant medications that many physicians prescribe.

A ‘workup’ is in order for any child who displays altered sleep, not a pill.

What interventions are useful?
A quiet environment at a regimented time helps everyone achieve faster, more sound sleep.

Sensory therapies can result in significant amelioration of sleep issues. Warm epsom salt baths, reading, and brushing are further examples of effective interventions, in selected patients.

After a suitable evaluation, youngsters who suffer GERD and other G-I discomfort may get a great deal of relief by proper positioning, appropriate feeding (time and volume), and occasional mild antacids. Medications that decrease acid production, such as Prilosec or Zantac, should be avoided, because of alterations in normal gut flora.

If food allergies are identified, avoidance of offending agents can calm the gut and help sleep to take hold. Unusual bacteria or fungal overgrowth should be addressed with strong probiotics, and anti-fungals when indicated.

Melatonin is a popular, safe and useful supplement. After a thorough patient evaluation, a doctor should suggest dosing. Providing this valuable antioxidant at exactly the same time each evening is central to producing predictable results. When the maximum dose is not effective in maintaining sleep, adding the natural amino acid, 5-hydroxy-tryptophan, may help.

With varying doses and results, supplements such as Valerian root, chamomile, passion flower, and kava have been recommended. GABA, an over-the-counter supplement, is a neurotransmitter that can either work quite well to assist sleep, or add to excitation in certain patients.

The most basic allopathic medication is Benadryl, an antihistamine that produces sleepiness. There are blood pressure lowering medications such as Clonidine®, Intuniv® and propranolol. These should be used short-term and the ordering physician should be alert to the cause(s) of the disturbance. Only rarely should strong CNS medications such as Depakote® be utilized. Sleeping pills that were meant for adults are just that – meant for adults.

Conclusions:
Unnatural quality and quantity of nocturnal activity often accompanies an autism diagnosis.

With such a plethora of downstream negative behaviors, interventions that reverse this situation are paramount to producing an effective autism treatment protocol.

Consulting with a knowledgeable, experienced clinician will yield the most valuable results.

Perhaps the most important improvement when affected children start to get an adequate night’s sleep is the positive effect on the whole family’s next day.

Autism, Broccoli and Cures

Sunday, October 19th, 2014

Sulforaphane treatment of autism spectrum disorder (ASD) made the news this week. According to Johns Hopkins’ researchers, an as-yet unavailable chemical derived from broccoli “…substantially (and reversibly) improved behavior…”

This is great news for parents and professionals who, for decades have been so deprived of clinical studies that are well – designed, performed, documented and published. Many families are now searching for the best way to get sprouts and seeds into their child with ASD.

Importantly, the proposed mechanisms behind the treatment lend mainstream credibility to the concepts of oxidative stress and the work of Jill James, who has published since the beginning of this century. “Sulforaphane, which showed negligible toxicity… upregulates genes that protect aerobic cells against oxidative stress, inflammation, and DNA-damage.”

The Good:
Supplements containing some of the chemical are for sale. There are ~1mg tablets, for example, that sell for ~30¢ each.  Broccoli seeds (the sprouting kind) are available for five bucks, though I’m not quit sure what to do with them.

One virtual vitamin shop advertises sulforaphane as AVMACHOL®, and that website is no longer available. It listed “365 mg of a proprietary substance made of 25mg of glucorapharin (the desired gluconsinolate form), broccoli sprout and mushroom extract.” One per day, @$ 1/per pill. Another lists Sulforaphane (From Broccoli), 0.4mg pill for only 4¢, but they were out of stock at this time.

The Bad:
There appears to be uncertainty regarding the bio-availability of the over-the-counter products. At it’s molecular weight (177 g/mol), and an average 100 uM dose (50-150 reported by researchers), it seems to represent a much larger dose (?~ 18 mg) than a broccoli side dish, or even the aforementioned supplements.

The Ugly:
Two of the authors in the study have explicitly rejected any claim to financial remuneration from sales of the expected product, due to “conflicts of interest.” Righteous! However, the son of one of those docs is the CEO of the new company.

Johns Hopkins University has U.S. patent applications and has licensed “… broccoli sprouts and seeds rich in glucosinolates… to Brassica Protection Products LLC.” That ought to raise the price.

Conclusions:
There are hundreds of patients who have been receiving reduced, (sulfur containing – cysteine boosting) liposomal glutathione for over 6 years, with great results. It turns out that the food with the highest known levels of glutathione – broccoli – works!

Parents who are already administering DMG, TMG, NAC, methyl B12, or reduced glutathione, should be alert for possible increased stimming with this added antioxidant.

At the very least, this information gives new meaning to moms who plead with their child to, “Eat your broccoli!”

Addendum:
Another opinion here

Why Don’t All Doctors Treat Autism This Way?

Sunday, October 12th, 2014

“If this protocol is so great, why doesn’t everyone know about it and do it?”

No answer seems to satisfy those who are firmly grounded in the old-time perceptions about ASD.  A patient’s (physician) family member raised this question recently, and it deserves a proper explanation.

The Top Reasons That Everyone Doesn’t Do It
(Combine a biomedical and traditional approach to reverse autistic signs and symptoms):

Time:
An accurate diagnosis is only produced by a thorough history and physical examination. “It’s autism,” is not good enough. A real medical ‘workup‘ helps determine the type of autism and co-morbidies. That is only the beginning. The most successful outcomes occur when families are involved to assist neuro-typical development.

Today’s physicians simply don’t have the luxury to spend hours per case; unless they are cutting, injecting, or physically assaulting the patient. Time, itself, is undervalued, and few practitioners choose this route.

Money:
Many of the resources that are most effective in reducing the conditions that are diagnosed as ASD are either not- or poorly- covered, by insurance. That applies to professionals, therapies, laboratory testing, supplements, and often even pharmaceutical products. The extra costs for each affected child are in excess of $ 40,000 per year, $ 1.4M per lifetime, and $ 2.4M per lifetime if there is intellectual disability.

Only recently have early diagnosis and intervention produced documented improvement, and biomedical interventions appear to be an unproven and unwarranted cost.

Big pharma is not involved:
Ah, the autism pill. News Flash: Like cancer, there won’t be one kind of ASD, or one successful treatment. However, there is research about many of the conditions that present with similar signs, including genetic and mitochondrial disorders. That work is putting doctors on the right path. As explained at a recent conference, it costs more than $1B to develop a new medication that makes it to patients. To date, 1/68 does not appear to represent an adequate market share.

Plus, many of the successful autism treatments involve supplements that are not expensive or controlled by the drug industry. Doctors are not served a tempting lunch provided by the makers of probiotics or other over-the-counter remedies.

The Wakefield Effect:
Due to controversial statements by a now-infamous British physician, the new reason that, “There are no studies to prove that theory,” is fear on the part of researchers. Really? Then, there are vaccination issues. Furthermore, not unlike previous epidemics, such as HIV-AIDS, there are a multitude of potions, and practitioners who promote them, to fill the medical void.

Parents may be willing travel to abroad or offer unusual treatments, seeking an unproven therapy. They are not crazy, they are desperate. The biomedical treatments that produce results are often lost in such clutter.

Denial:
“Selling” a newly-elucidated medical condition is a problem for family members who don’t think anything is amiss, except their version of proper parenting. Add a dash of medical jargon, and, for some, that is more difficult to swallow than reduced liquid glutathione.

Furthermore, those times when children suffer negative reactions due to die-off or methyl B12 stimulation may be easily misunderstood as regression or worsening of behaviors. Again, such events require a great deal of physician-patient interaction.

Poor Advertising:
The Child Development Center has offered services to many Florida universities, with very slow progress. Perhaps there is resistance due to NIH (Not Invented Here), or the specter of evil as regards the practice of holistic, complementary and alternative medicine. The Medical Academy of Pediatric Special Needs provides peer-reviewed research and education. TheAutismDoctor.com has a healthy readership, but obviously not enough to change popular opinion.

The gut-brain connection, metabolic problems, toxic exposure, and positive outcomes in ASD have been documented for decades. More publicity nowadays requires a book (working on that one), or a television show.

The Short Answer:
The present state-of-the-art in autism recovery is early recognition, an individualized protocol, and a complicated ongoing process of medical and therapeutic interventions.
It’s not a pill.

MAPS Fall ’14 Conference

Saturday, September 13th, 2014

Twice a year, doctors who are interested in understanding and treating children with complicated developmental issues, convene under the direction of the Medical Academy of Pediatric Special Needs. This is our opportunity to stay up-to-date about the latest protocols, and to speak with specialists from all over the world.

In addition to introducing the biomedical approach to professionals and providing a venue for the spouse and kids, the program includes ‘advanced’ tracks. The highlights of those lectures will be reviewed.

Day 1
Dr. Anju Usman – Down Syndrome
“What does that have to do with autism?” Learning about one neurologic childhood condition helps elucidate normal vs. abnormal structure and function. Besides, there are more than a few patients who suffer from both.

The ever-changing basic science of the brain was reviewed. A medical workup is similar; requiring genetic, metabolic, immune, and gastrointestinal evaluation. Conversely, having discovered treatment for the mitochondrial issues in ASD has successfully addressed various problems for Trisomy 21 patients, as well.

Dr. Giuseppina Feingold – Cerebral Palsy and Seizures
Again, understanding seizure activity in a condition where it is not uncommon, helps our understanding about convulsions in ASD. The lecturer, a pediatrician who practices alternative medicine in a very conventional setting, described her experience with her own child, who has CP.
A thorough review on the use of HBOT for CP was presented.

Dr. Mukherjee (New Dehli) and Dr. Marois (Quebec) followed with their research and positive experience managing CP with HBOT. Somehow, their findings have been misunderstood and misrepresented by the conventional medical community, for variety of reasons.

Dr. Kenneth Stoller reviewed his clinical knowledge and experience with Fetal Alcohol Syndrome. He has successfully treated patients with HBOT and Oxytocin, and has published that research.

Case presentations and discussions – sharing our medical experiences – finished out the day. The 2000 pound gorilla in the room? (hint – it has something to do with autism). Data is lacking.

Day 2
Very exciting! This day’s lecturers are rockstars, as far as researching, teaching, publishing and treating the group of conditions that present as a post-inflammatory encephalopathy. It is rare to be among such experts, so freely discussing their findings and opinions.

The moderator, Dr. Nancy O’Hara described her extensive experience treating patients with these disorders, including her own son. Details are provided about an accurate description, differential diagnosis (“What else could it be?”), laboratory ‘workup’, treatment options (including an additional lecture covering nutritional support) and outcome.

Dr. Tanya Murphy presented a fascinating talk about the overlap between antimicrobials and psychotropic medications. Specifically, certain antibiotics can also have neuropsychiatric effects. Conversely, psychotropic drugs have effects on the inflammatory system. This finding helps explain why the disparate group of medications that we use may have similar effects.

The inventor of the term, Dr. Sue Swedo, a Director at the NIMH, presented the latest about PANDAS. She described the areas in the brain where tics and OCD behaviors lie, and how this manifests as a condition for doctors to investigate, with treatment guidelines.

Professor Madeleine Cunningham, a researcher for over 35 years, gave an elegant presentation that documented the presence of autoantibodies in certain patients’ blood and the CSF, offering evidence that those chemicals signal (or are blocked from) neuronal cells. This work helps our understanding of many of the movement disorders, from Tourette’s to PANDAS.

Case presentations and videos completed the afternoon. The take home message was that doctors should stop asking the question, “Do you believe in PANDAS?”

Day 3
Inflammation

Dr. Rodney Dietert conveyed his understanding regarding the complexity of the functional immune system, and the relationship to non-communicable chronic disease. “The tie that binds,” according to the Chief of Immunology at Cornell.
He presented with the passion and knowledge that only a man who has spent his lifetime in this research could bring.

Harvard celiac researcher, Dr. Alessio Fasano, presented Intestinal Permeability, Antigen Trafficking and Inflammation. The subtitle, “The gut is not like Las Vegas, what happens in the gut does not stay in the gut,” tells the whole story.

Canadian naturopathic physician, Dr. Zayd Ratansi spoke about HBOT and Inflammation. There were lots of associations with medical conditions such as wounds, pain, trauma, cystitis and CP. The only slide about ASD and HBOT slide was Dr. Rossignol’s controversial multi-center report.

Dr. Russell Blaylock, a neurosurgeon, researcher and author, spoke about Immunocytotoxicity in CNS Disorders, elucidating how inflammation is handled in the brain.
He explained why/how systemic disturbances activate the CNS immune system. In turn, ASD patients with inflammation, perhaps elsewhere, have behavioral signs and symptoms. Comments were offered about the risks of the present vaccine schedule on the developing brain.

Although I can’t report that there was a great deal of specific day-to-day information, there was a lot of food for thought, networking, and the knowledge that there an increasing number of serious professionals working on your kids’ difficulties.

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