Posts Tagged ‘Attention deficit’

Vitamin D for Autism and ADHD

Sunday, April 6th, 2014

One of the more common out-of-range laboratory findings in the children who come to our clinic is a low vitamin D level. Learning about the myriad effects of this important nutrient ought to encourage parents to ask their pediatric specialist to check the blood concentration when evaluating patients with ASD or ADHD.

Effects:

  1. Vitamin D enhances the intestinal absorption of:
    1. Calcium
    2. Iron
    3. Magnesium
    4. Phosphate
    5. Zinc
  2. It is involved with the immune system:
    1. Normal functioning
    2. Inflammatory response
  3. There are effects on neuromuscular functioning.
  4. Bone mineralization is influenced.
  5. The vitamin is involved with modulating genes that regulate cell growth, proliferation, differentiation and death.

Metabolism:
The sequential manner in which this hormone-like vitamin gets into the body, and becomes active, helps explain possible reasons for insufficiency, and observed effects.


 

Dietary Sources:
According to an interview on WebMD, “Surprisingly few foods contain vitamin D…” Dr. DeNoon lists “Super foods,” such as (wild caught) salmon, mackerel, shellfish and mushrooms. Mostly, though, humans were built to get our vitamin D through the skin, so foods are now fortified to make up the difference.
Based on bone health, and given acceptable calcium levels, dosages of 600 IU/d for non-seniors “meet the requirements of at least 97.5% of the population…” BTW, the RDA for vitamin D was derived based on conditions of minimal sun exposure.
There is apparently conflict among the experts, however, about the definition of standard levels. Recommended intakes for infants and children vary from 400IU to 1000IU per day, with unanswered questions about increases.

You can take too much:
This is a fat soluble product, meaning that it can accumulate and become toxic. That is why a doctor should evaluate and follow levels, especially in high-risk children.

Evaluation:
The laboratory evaluation is usually done by testing for blood levels of 25-hydroxy Vitamin D, which is NOT the active form. A calcitriol (1,25 di-hydroxy Vitamin D) level must be ordered separately. The results, and variation from the standards vary, depending on the laboratory. Calcium, zinc, iron and magnesium may be checked, as well.

Autism and ADHD
ASD patients do not represent a ‘normal’ population. RDAs are, in my opinion, the amount below which some neuro-typical people can get symptoms. It seems to me, “Low normal,” is “low.”
There are numerous reports of children spending less and less time outdoors in physical activity,
especially those ‘on the Spectrum’.
Many kids are picky eaters or have been placed on restricted diets
that might affect absorption and levels.

The dermatologists have warned about the dangers of ultraviolet exposure, so SPF 188 was invented and applied copiously.
Often, children have eczema and other skin conditions that
might interfere with normal metabolism.

The conversion of chemicals to the active form assumes a healthy circulation, liver and kidneys. Many of the patients do not appear in optimal health.
There are genetic disorders of calcium metabolism
that present with autism.
There is even evidence that maternal levels may play a role in ASD.

Mostly, however, I am not sure why
so many patients exhibit decreased vitamin D levels.

Treatment:
Children with values that are at, or below the low range of ‘normal’ (depending on the lab), are usually given”D3,” 1,000 – 2,000 IU extra per day.

Treated patients are re-evaluated by periodic testing, plus documentation of daily supplemental intake.
Positive effects, such as a healthier immune system, are usually noticed within a month or two of getting the correct dose. Sometimes, sleep improves (try giving at night). The other therapies appear to work more efficiently; there appears to be better cognition, focus, and eye contact as vitamin D levels are normalized.

Conclusions:
It is difficult to sift through, and pinpoint, the specific biomedical intervention that leads to healthier and happier children. “Documentation,” as they say, “is lacking.” It certainly feels as if adding vitamin D3, when it is low or deficient, helps practitioners achieve improvements in signs and symptoms of ASD.

Oral supplementation is inexpensive, usually well-tolerated by the child, can be followed by documenting the course of treatment and laboratory confirmation.

Autism Conference 2014

Sunday, March 30th, 2014

This conference represents a major opportunity for serious professionals who want to learn about state-of-the-art autism diagnosis and treatment. Other pediatric specialists should take note that the Medical Academy of Pediatric Special Needs is a formal, scientific forum for doctors who wish to care for complicated cases.

Day 1 – ADHD Sessions
Dr. Elizabeth Mumper (Rimland Center) reviewed neurotransmitters. Her focus then shifted to the pressure that Big Pharma has (openly and clandestinely) foisted upon parents, patients, and doctors to diagnose ADHD and prescribe medication. Plus, there is a lack of research demonstrating long-term improvement from these pharmaceutical products.
The disorder is better characterized as a network-communication problem, rather than focusing on one or two specific areas of the brain.
Dr. M then reviewed treatable, metabolic causes of behaviors that may be diagnosed as ADHD. Therefore, the signs and symptoms deserve an appropriate workup; not merely a knee-jerk Rx for stimulant medication.

Dr. Dan Rossignol summarized the most recent and pertinent literature about laboratory assessment for ADHD. A reasonable medical workup was presented, so that treatable conditions can be identified.

Dr. Nancy O’Hara followed with her interesting proposals about non-drug interventions, including dietary changes and addressing environmental issues.

Dr. Stuart Freedenfeld spoke about the forces that drive the diagnosis, many of them non-medical and more related to socio-economic status, especially as regards pharmaceutical intervention.

Case presentations and discussions filled out the rest of this first day.

Day 2 – Environmental Medicine Sessions
Dr. O’Hara reviewed detoxification physiology and the factors that might affect normal functioning, including genetic variation and the myriad of toxins in the air, food and water. Poisons have detrimental effects on mitochondrial operation, the CNS, and can lead to thyroid disruption, altering normal physiology. Various helpful interventions were offered.

Dr. David Quig reviewed laboratory assessment of metal exposures and the concept of body burden. Single toxins can be detrimental, but there are many environmental poisons that multiply negative effects, called the Multiple Hit Phenomenon. He discussed the issue of net retention of toxins, and various therapeutic modalities.

Dr. Stephen Genuis expressed his opinion that airborne pollution represents the most important source of toxic load, resulting in chronic illness for the mother, child, and future generations. He also introduced the topic of ‘nano toxicity’, new pollutants of very small molecular size, in bedding, for example. Evidence for direct and indirect effects of the ever-increasing burden of toxins on multiple body systems was reported.

Dr. David Dornfeld added to our knowledge about total body burden of multiple toxins. He also discussed various forms of detoxification, including chelation – the active removal of heavy metals with chemical compounds.

Case presentations and discussions followed.

Day 3 – Plenary Session
Dr. William Parker spoke about “Post-industrial factors underlying immune system destabilization and subsequent inflammatory diseases point toward dramatic changes for medical practice in the near future.” His discussion was about the manner in which modern society has disturbed our microbiology and the effects that has had on the immune system and created a whole host of auto-immune conditions.

Dr. Paul Schreckenberger gave a fascinating talk revealing that, contrary to common scientific belief, urine is NOT sterile. The take home point was thathere is whole host of new thoughts about the human microbiome (our micro-organisms and their genetic components). There is a need to identify new species and get a better understanding of good and bad bacteria.

Dr. Michael Cabana presented the evidence about the use of probiotics and the effects of ameliorating auto-immune conditions, especially asthma. Important variables are when the supplement is delivered and the requirement for high potency products.

Dr. Rossignol presented the evidence for HBOT to address gastrointestinal inflammation.

Dr. Bob Sears gave a lecture about thyroid disorders and the ‘workup’ to assess thyroid function.

Finally, Dr. Rossignol presented evidence about the newest therapies for autism.

Conclusions:
Coincidentally, this conference commenced even as the CDC announcement that 1/68 children are now affected with ASD. Each year, it seems, the numbers can’t possibly go any higher, but they continue to rise.

The professionals who attend this conference are serious about getting a better understanding about this epidemic and trying to help, and I am proud to be part of that group.

Autism Goals

Sunday, March 2nd, 2014

An important barometer in the current treatment of ASD is the creation of an IEP and the achievement of stated goals. While it is necessary to document progress, the present mechanism may not always engender enough of the kinds of skills that are needed in the real world.

As children improve from the conditions that surround ASD, IEPs notwithstanding, these age-appropriate activities of daily living must be achieved:

  1. The ability to get ready in the morning.
  2. Getting out of the house, into the car, out of the car and into the school, without a major meltdown.
  3. Following the directions of school personnel.
  4. Being able to sit, fairly still, for varying periods of time. Or, at least stand there. Or, at least not be disruptive.
  5. Learn a new activity, or practice a necessary skill.
  6. Transition to another exercise, which may be more difficult (or impossible), or less-preferred.
  7. Kids learn how to be kids from each other. So, children need to show and share.
  8. As development proceeds, children display a desire to watch others play, engage in play, and even initiate.
  9. Getting out of the school, into the car, out of the car and into the house, without a major meltdown.

Academic achievement is the standard for neurotypical patients. For the autistic child, socialization will bring the maturity that can create significant progress.

Does my child meet the following criteria?

Does the child turn to voices and especially their name? “Your son won’t listen,” or “Your daughter doesn’t pay attention,” is a common concern. That is especially frustrating for those amazing kids who hear and take in everything, but are believed to be ‘slow learners’. The IEP goal? “Your child will turn to their name most of the time, when they are called, without prompting.”

Do they make eye contact with other children, not just family members? This important social skill is a major first step in normal play. If you watch a group of 3 or 4 year-olds, they don’t ask, “Who wants to play chase?” There’s no memo or adult prompting; they just look at each other, screech, and start to run around. Finding social situations where your child can practice is so much more important than how well they play Angry Birds.

The ability to speak is paramount. That doesn’t mean hours and hours of Speech and Language Therapy by itself. The Child Development Center has seen hundreds of children who developed speech by utilizing a combination of therapies with medical evaluation and appropriate, effective interventions. Our older apraxic patients have different problems.

For children who can speak, do they use their voice at the appropriate times (naming, answering) or only when prompted? Is there a great deal of echolalia, saying the same sentence as the questioner? Does scripting seem to make sense and, at least, be in context, or does the conversation seem to be gibberish? These rituals are practice, not to be discouraged, but the child must generalize language to appropriate situations. Kids judge other kids.

Sensory difficulties are a major hurdle for many ASD patients. Sounds may be too loud, lighting to harsh, and experiences so stimulating that children exhibit repetitive motor behaviors (stimming). For both the student and the classroom, addressing these issues (e.g., sensory diet) will make things go more smoothly.

Aggressive behaviors will not be tolerated for very long in any educational situation. Rather than making excuses for why your child behaves in a disruptive or violent manner (whether SIBs or directed at others), gastrointestinal health and ABA intervention is more important than any academic effort.

We are talkin’ ‘baby steps’ here. Autism is not someone’s fault. It is a condition of the 21st century that requires appropriate medical and therapeutic intervention.

Autism Review 2013

Sunday, December 29th, 2013

Here is this year’s crop of stories (listed in Medical News Today) that I consider to be the most informative, interesting, and likely to change the knowledge base concerning the epidemic of childhood signs and symptoms presently called Autism Spectrum Disorder.

January
Can Children Lose Their Autism Diagnosis? - Uh, yes. And, many more than this group reports.
New Gene Variants Linked To Autism Discovered - The perfect storm of environmental toxins and susceptible individuals (genetic variation).
Epilepsy Drug Linked To Increased Risk Of Autism - The perfect storm of environmental toxins (medication) and susceptible individuals.

February
Feeding Problems And Nutritional Deficits A Significant Risk For Children With Autism - Ya think?
Attention Deficits Picked Up In Babies Who Later Develop Autism - The ‘Spectrum’ diagnosis involves a combination of signs and symptoms, not just the ‘core’ deficits.
Help Needed For Youths With Autism Spectrum Disorder Transitioning To Adult Health Care - Transitioning in general, don’t you suppose?
Autism Study Finds Behavioral Therapy For Children Can Impact Brain Function - So, the autistic brain can exhibit plasticity. Just like every other human brain.
Brain Connections Differ In Kids With Autism - There were lots of brain connection articles this year. The problem is understanding WHY the brains work that way, since it’s pretty obvious that some circuits are crossed and/or missing.

March
Study By Kennedy Krieger’s Center For Autism And Related Disorders Reveals Key Predictors Of Speech Gains - This is why it’s so important for kids to play with others.
Suicide Ideation And Attempts A Greater Risk For Autistic Children - Why doctors shouldn’t put teenage patients on anti-psychotic medications.
Old Drug Offers Hope For New Autism Treatment - This article covers it all; inflammation, immunity, the environment, mitochondria, stress and recoverability. It’s just in a mouse model, but offers a unifying theory.
One In 50 Kids Has Autism In U.S., CDC - And, we’re still arguing the ‘E’ word (? epidemic ?)
Gaze Shifting Delay Has Potential To Diagnose Autism At 7 Months - Plenty of research about earliest diagnosis, not much about how to intervene.
Multiple Vaccines Not Linked To Autism Risk, CDC - So they keep telling us.

April
Link Between Autism And Increased Genetic Change In Regions Of Genome Instability - The perfect storm… you get it.
Minocycline Show Benefits In Children With Inherited Cause Of Intellectual Disability And Autism - Some assistance for patients with Fragile X syndrome, one of the known causes of ASD.
Study Shows Different Brains Have Similar Responses To Music - Love of music is universal.
Propranolol Could Improve Working Memory In Autism - Several of the older blood pressure medicines perform in some fashion to help affected individuals.
Taking Valproate While Pregnant Raises Autism Risk - Drugs taken during pregnancy may not be good for the developing brain. Well, at least it’s in print now.
A Newborn’s Placenta Can Predict Risk For Autism - Now, there’s an early predictor! Again, what to do about it?
Significant First Step In The Design Of A Multivalent Vaccine Against Several Autism-Related Gut Bacteria - Formal recognition that there is a gut-brain connection in autism.

May
Researchers Successfully Treat Autism In Infant - OK, so maybe you can do something about the earliest red flags.
Early Intervention Program For Children With Autism Found To Be Cost Effective Through School Years - More documentation such as this is needed so that governments, insurance companies, and the like will take notice.
Link Between Epilepsy And Autism Found - The literature reports that 40% – 80% of patients have seizures (much lower at The Child Development Center, however).

June
A Third Of Autism Cases Also Have ADHD Symptoms - It’s not ALSO, it’s an integral part of the picture for some children.
Autism Discovery Offers Hope For Early Blood Test And Therapeutic Options - One of the reasons that I prescribe tryptophan (5-HTP) to address some ASD signs and symptoms.
Racial And Ethnic Disparities Found In Gastroenterology, Psychiatry Or Psychology Care For Children With Autism - Yeah, professionals need to get on the same page.
Air Pollution Raises Autism Risk - The environment. Again.
Single Mutation Can Destroy Critical ‘Window’ Of Early Brain Development - Genes. Again.
Autism In Children Affects Not Only Social Abilities, But Also A Broad Range Of Sensory And Motor Skills - Recognition of signs and symptoms that every parent of an ASD child observes. More such information was published subsequently.

July
The Gut May Offer Clues About Autism - By now, even pediatric gastroenterologists should be getting the message.
Autism Training Program For Pediatricians Meets ‘Critical Need’ For Earlier Identification - Until now, I don’t think that my fellow pediatricians are doing such a great job at early diagnosis.
First Full Genome Sequencing For Autism Released By Autism Speaks Collaborative - This kind of valuable information is why all of the parties in the autism community should work together, rather than criticize each other in public forums.
Early Intervention Benefits Young Children With Autism Regardless Of High-Quality Treatment Model - So, if early intervention helps, and we can make the diagnosis earlier, then the situation should be improving. Right?
Oxytocin not found to offer symptom relief in autism - A bunch of these articles this year, both pro and con. My experience is that it does help in a small percentage of affected individuals.
Fresh fuel reignites Asperger’s debate - Combining two conditions that we don’t understand – couldn’t that make us twice as ignorant?

August
Oxytocin, the ‘love hormone’ may have relevance in autism - This was one of the ‘pro’ articles.
New research sheds light on previously under-researched area of study – females with autism - We really need more information about the difference between boys and girls with ASD.
Induced labor linked to higher autism risk - Here is my advice (as a Board-Certified Neonatologist): Have the baby when the time comes. Sometimes, Mother Nature does know best.
Risk of autism in further children – study findings - This is the type of information that prospective parents frequently seek, and little is really known.

September
Young adults on the autism spectrum face tough prospects for jobs and independent living - This highlights why early diagnosis and intervention are so vital.
Genetic disorder 22q could be misdiagnosed as autism - Or, this could be just one of the causes of autism. No?

October
Improving understanding of brain anatomy and language in young children - This is the type of knowledge that needs to be elucidated as we try to solve this puzzle.
New cases of autism in UK have levelled off after five-fold surge during 1990s - Well, good for England (if it’s true). This is not the case in the U.S., or most other countries, however.
Autistic children look less friendly to peers - And, vice-versa, I would say.
Web-based autism intervention tool shows promise - Lots of tech stuff for autism appeared this year. I still like Proloquo2Go the most.
Link examined between pregnancy weight gain and autism spectrum disorders - An even EARLIER diagnosis. How about a fetal Speech and Language therapist?

November
Health-care changes needed to help adults with developmental disabilities - Much more information needs to become available to address the growing numbers of older individuals with autism.
Autism increases risk for synaesthesia - Maybe shedding some light on the sensory issues in ASD.
Relationship between bedroom media access and sleep problems among boys with autism - As if parents didn’t know this! Well, it’s official, now.
Gender differences in gene expression in male and female brains - I’ve described this clinical difference before. There’s the “girl kind”, and the “boy kind”.
Autistic children’s ability to perform everyday tasks improved by occupational therapy - This one should help with insurance reimbursement.

December
Genes and air pollution combine to increase autism risk - Circling back… genes and the environment.
Brain function in children with autism improved by a single spray of oxytocin - It works. It doesn’t work. Which is it?
Autism-like behaviors in mice alleviated by probiotic therapy - Human probiotics, by the way.
Research linking autism symptoms to gut microbes called ‘groundbreaking’ -  Well, it’s important, but groundbreaking? This association has been ‘documented’ since the “Refrigerator Mom” days.
Hospital infection in pregnancy tied to higher risk of autism - Perhaps it’s the antibiotics that are given, not the infection itself?

Hopefully, 2014 will bring more in-depth research with targeted treatments, so parents will have an increased number useful protocols to assist their developmentally challenged children.

Pediatric Special Needs Include Autism

Saturday, December 14th, 2013

Recounting events that take place over just a couple of days at The Child Development Center provides me with the opportunity to paint a picture* about state-of-the-art medical care for complicated pediatric development. This is a newly emerging specialty, which is now presented as a fellowship of the Medical Academy of Pediatric Special Needs.

It is of utmost importance that patients receive a correct and precise diagnosis. That should lead to the most specific treatment(s), presumably with the greatest chance of success. Autism, unfortunately, is not a precise diagnosis. There are multiple causes for the unusual behaviors or physical properties that bring concerned parents and their children to our medical practice.

AM Any_Day: This was the third follow-up visit for a 3-1/2 year-old boy who has “escaped autism.” What a patient set of parents! They have understood the difficult journey, taking their at-risk child to the next developmental level, without the use of stimulant or anti-anxiety medications. In this case, the child demonstrated an inability to tolerate oral glutathione (for poor muscle tone). Only a course of anti-fungal medication complicated our otherwise positive road to a resolution of the majority of behavioral concerns.

Then, there was the second follow-up visit of a moderately affected 2 year-old. Four months earlier, he spoke just a couple of words, demonstrated repetitive arm and body movements and appeared in a profound fog. Now, the child interacts with his parents and is speaking. G-I problems were his main initial findings that, when addressed, assisted in his improvement.

This was followed by the fourth follow-up visit of a 3 year-old girl who first presented six months ago. As an infant, there was GERD, and speech was significantly delayed. This child’s food allergy panel was especially unusual. With strong probiotics, appropriate vitamins and supplements, plus occasional anti-fungal treatment, she has been able to make great strides toward an optimal outcome.

That afternoon: 4- and 6 year-old brothers whose level of complications equals the most difficult patients in the practice, from a diagnostic and therapeutic perspective. The older boy is brilliant but has behavioral challenges that are responding positively to treatment. The younger one has yet to show much positive response in his communicative abilities. Mom is incredibly knowledgeable and, together, we explore reasonable strategies to address their continued delays.

Following that, there was a Central American family whose 3 year-old son presented eight months earlier with moderate-to-severe ASD, including speech apraxia. We discovered his significant gluten, casein and egg allergies, and vitamin D deficiency. He presently has more than 100 words (español, por supuesto), makes eye contact and plays with his parents. Mom and Dad do not care that, “There are no studies demonstrating the efficacy of dietary interventions…”

AM Next_Day: New patient, a preteen with P.A.N.D.A.S. This story needs a blog of its own.

Another new patient, a 5 year-old with mild signs and symptoms of his earlier autism, treated with conventional therapies. Socialization and other behaviors concerned the parents enough to seek interventions while hoping to avoid stimulant and/or anti-anxiety medications.

And, it’s not even ‘hump’ day. Plus, there are all the calls, letters, charting, emails, labs and support personnel necessary to assist these determined families.

Each of these patients presented with a unique diagnosis requiring evaluation and treatment protocols that were unknown to me, ten short years ago. From this pediatric specialist’s perspective, there is a whole new world of complex developmental problems, and they require very special consideration.

*To protect anonymity, the dates and names of patients have been randomly selected

Escaping Autism

Saturday, November 16th, 2013

With increasing frequency lately, this medical practice evaluates another child who displays a combination of signs and symptoms that can best be explained by the term, “Escaping Autism.”

There appears to be some common connection involving the parents’ chief concerns, physical examination findings, laboratory results, response to treatment and residual behaviors. It is something that you just can’t put your finger on.

There may be sensory difficulties, problems with focus, heightened anxiety, ADHD, ODD, G-I issues (from GERD to constipation), allergies (from asthma to eczema), repeated ear infections, low muscle tone, poor sleep, very restricted diet, or decreased eye contact – in some combination that doesn’t seem to be supported as a separate diagnosis in the present scientific literature.

The condition is not “classical” autism because the patient lacks symptoms in one or all of the 3 key global domains (social isolation, repetitive movements or restricted interests, and the inability to communicate). Why not call it PDD-NOS? Actually, such a diagnostic assignment probably represents the present, most accurate classification. However, there are so many conditions included in that “waste-basket” category; it begs to be picked apart as more precise situations become apparent.

“Escaping Autism” represents a more simple, unifying proposal (Occam’s Razor). Such a diagnosis adds to the modern pediatricians’ toolbox by documenting identifiable signs and symptoms that may be amenable to effective medical interventions. This is a newly described association.

A “Spectrum” of difficulties that are now considered separate childhood disorders may also be viewed as a unified picture of multi-system involvement. This clinically distinct syndrome may change and evolve as the interplay of behavioral and/or functional changes mature in the individual patient.

Some good news is that, as in other medical disorders, the less severe the presentation, the smoother the clinical course. After all, mildly asthmatic patients who can be treated with inhalants and kept out of the hospital are a lot easier to manage than those requiring frequent therapeutic alterations. The professional workup should include routine blood tests and more, depending on the symptoms and practitioners’ findings. Appropriate interventions, based on clinical and laboratory data, would follow.

Such information is not well-accepted in the conventional world. There might be a great deal of pushback from allergists, neurologists and other pediatric subspecialties. Negative initial responses may be misinterpreted as a sign that treatments are not proceeding on the correct path. Should there be a rocky course to recovery, families are less likely to remain patient, especially in a ‘higher functioning’, non-autistic individual. Plus, there is the chance that the child will continue to improve, with or without intervention.

Could these patients who have “Escaped Autism” represent the tip of the iceberg involving an emerging additional developmental diagnosis? Are such children the next “canaries in the coal mine“? Considering that ASD may represent the perfect storm, comprised of modern environmental stressors acting upon genetically susceptible individuals, one more genetic variance, or one more toxin, could result in additional parents who find their offspring have gone ‘over the fence’, so to speak.

As far as taxonomy goes, a clearer nomenclature will unfold as increased numbers of children demonstrate this cluster of symptoms and successful treatments come to light.
One of our patients has suggested that we call it NAUTISM!

Really Scary Autism Treatments

Thursday, October 31st, 2013
E. Willingham

E. Willingham

Emily Willingham, a Forbes blogger who frequently waxes less-than-sympathetic in her stories concerning autism, recently posted her Five Scariest ‘Treatments’. While I do not disagree with some of her picks, I take issue with the tone of the blog and the absence of recognition about the real culprits in autism treatment debacle.

Willingham displays an apparent lack of understanding about the frustrations suffered by the autism community, the paucity of useful research and treatment options, and the desperation of parents seeking answers. “Autism invites its share of quacks. In fact, it might have more quacks in its vicinity than a duck pond,” was her preamble to the story-in-question.

What about the most common treatment options? How scary are they? Although the conventional ‘autism meds’ may reduce some behavioral signs and symptoms, even proponents make no claim regarding improved speech and language, cognition or social isolation (that is, many of the core symptoms of autism).

  1. Risperdal – side effects include “agitation, anxiety, constipation, dizziness, drooling, drowsiness, enuresis, fatigue, hallucination, headache, increased appetite, increased/reduced blood pressure, increased serum prolactin levels, indigestion, insomnia, rapid or irregular heartbeat, restlessness, runny nose, sleepiness, vomiting, weight gains, withdrawal dyskinesias.” PLUS, it “…may mask signs and symptoms of drug overdose and of conditions such as intestinal obstruction, brain tumor, and Reye’s syndrome, may also cause difficulty when swallowing, which in turn can cause a type of pneumonia, may cause… a condition marked by muscle stiffness or rigidity, fast heartbeat or irregular pulse, increased sweating, high fever, and high or low blood pressure. Unchecked, this condition can prove fatal…”
  2. Abilify -”can cause the following side effects: headache, nervousness, drowsiness, dizziness, heartburn, constipation, diarrhea, stomach pain, weight gain, increased appetite, increased salivation, and pain, especially in the arms, legs, or joints. More seriously, it can sometimes cause seizures, slow, fast, or irregular heartbeat, chest pain, changes in vision, unusual movements of your body or face that you cannot control, high fever, muscle stiffness, confusion, sweating, rash, hives, itching, swelling of the eyes, face, mouth, lips, tongue, throat, hands, feet, ankles, or lower legs, difficulty breathing or swallowing, tightening of the neck muscles, tightness in the throat…A small number of children, teenagers, and young adults who took medications for depression during clinical studies became suicidal…”
  3. Prozac and Zoloft are the new kids on the block. I treat numerous youngsters who have been put on non-FDA approved medications by child neurologists and psychiatrists. The side effects are similar to those listed above, without any formal path for reporting adverse events. I suppose that the conventional doctors don’t have to play by the same rules as they espouse (as in, “there are no studies showing safety or efficacy…”).
  4. Pepcid, Prilosec, Zantac and Miralax®. I have included these gastro-intestinal preparations because, a) The need for such medication is an important, often ignored, clue to the type and cause of many presentations of autism, and b) Instead of exploring G-I signs and symptoms, traditional medicine often minimizes their significance or even compounds the situation with inappropriate drugs.
  5. Stimulants, including Focalin, Concerta, Vyvanse, Ritalin, and Adderall in various combinations, dosages, and frequencies. These are medications targeted to ADHD (hyperactive or focus) symptoms. Many ASD patients do not have autism AND hyperactivity (as a comorbidity); rather, they have signs and symptoms appearing as ADHD because of their delayed social development and resulting immaturity. Just because your child is stoned and more compliant, it doesn’t mean that the medicine ‘worked’.

Dr. Willingham is personally touched by, and has previously demonstrated understanding and empathy toward ASD patients and families. However, the autism community is not as ignorant, simple-minded, gullible or unaware as this expert cautions. It’s the vaccine effect. Anyone who doesn’t understand that all vaccines are good for all children all the time must be in need of her advice on all things concerning ASD.

If families experienced more genuine understanding from the medical profession, and if the scientific community could spend more time on useful research into current and future treatments, there would be less need for all of those self-important warnings about which treatments NOT to explore.

Facebook Autism

Monday, October 14th, 2013

One of my primary purposes for publishing these stories each week is to be sure that interested readers have access to the most up-to-date and accurate information about the disorder that is presently called autism, including alternative points-of-view.

If a parent says that “I read something on the Internet about…” I inquire about the author(s), their education, their experiences with autistic patients and the outcomes that they may be claiming. After all, the statement that, “If you have seen one patient with autism, you have seen one patient with autism,” is not too far from the truth. On the other hand, if you have seen one thousand such individuals, you begin to get a sense of signs and symptoms that patients have in common, enabling professionals to pinpoint services that may lead to improved results.

TheAutismDoctor.com blog is popular, and often at the top of most Google searches regarding advice about the diagnosis and treatment of patients on the Spectrum. Childdev.org describes my medical practice, and is frequented by interested families and potential new patients. However, both websites rate at the low end of social media searches. I have Facebook Autism.

The disorder from which my Facebook sites suffer is repetitive postings, inability to communicate digitally and Internet social isolation. Classic symptoms. I recently became aware of multiple announcements that serve no purpose because requests and comments have gone unanswered (one was from April of last year). My inability to “get the word out” is because I hadn’t realized that I frequently post my new stories only on TheAutismDoctor.com and the public has not necessarily heard my voice. All of this has led to my social isolation, not being visible to many in the Facebook audience.

Therapy has been provided by Heather and Sean, my socially ultra-aware, twenty-something year-old children. “Da-aa-ad,” they ask, “you are so computer literate, why can’t you figure out how to manipulate social media sites?” Until now, I suppose I really didn’t understand the need, or care to navigate those waters. My comment that, “I don’t need more friends” has only served to prove their point.

So, there are now two official Facebook pages where titles will be posted and discussions can be shared. The Child Development Center of America page is concerned with my medical practice where we treat patients who have many diverse problems, such as genetic disorders, allergic problems, behavioral challenges and other developmental delays. The Autism Doctor is more specific to the areas of ADHD and ASD.

With these interventions, I hope to reverse the effects of my Facebook Autism as I reach for an Optimal Digital Outcome. Next stop, Twitter and mobile devices.

MAPS Fall Conference 2013 – Day 3

Saturday, October 5th, 2013
Last eve's Mojito Bar! We needed a break.

MAPS Friday Night Dinner

Saturday:

Allergies in Special Needs Children

Dr. Jeffrey Bradstreet - Introduction to Allergies in Special Needs Children
With a less-than-healthy intestine, there is loss of tight cellular junctions, allowing toxins and food proteins to be exposed to blood, leading to immune activation in susceptible individuals. Dr. B described inflammatory reactions in the gut and brain of patients with ASD. Eventually, behaviors, not merely mucus membranes, are affected. The presentation concluded with the case of an ‘allergy kid’ – a patient affected with autism who significantly improved with an aggressive workup and treatment of the patient’s immune system.

Dr. Dan Rossignol - Review of Nutritional Supplements for Allergies
…As always, a thorough, interesting and pertinent literature review. Supplements for allergies, which appear commonly in ASD patients, were reviewed. Seasonal behavioral regressions could be a clue to an environmental (over) reaction.
Dr. R discussed naturopathic supplements, many many of which demonstrate equal improvement to the traditional anti-allergy meds.

Dr. Theoharis Theoharides - Allergy of the Brain
The question to be answered, “Is a Subtype of Autism an Allergy of the Brain?” Dr. Theo showed that activation of specialized cells (mast cells), could occur in the absence of allergens (including stress, organisms, etc.). He helped discover that the manner in which the mechanism works is much more complicated than previously thought, and how that process leads to inflammation.
Further evidence was presented that allergic diseases have influence on ADHD and ASD. Mast cells exist in the lining of the brain, and what happens when they are activated could lead to symptoms. He concluded with a therapy that decreases mast cell activation (Neuroprotek, officially not mentioned by name). Oh well, he says any profit goes to charity, and I believe him.

Dr. Michael Elice - Treatment for Allergies
I saw a presentation by this allergist ~ 6 years ago, and his philosophy really set the stage for how I think about ASD.
Taking a detailed environmental history was stressed. “Autism Spectrum represents a collection of system disorders that are treatable and recovery is possible.”
He discussed traditional allergy testing and buildup of tolerance, but that takes time. “With a low ‘specific dose ‘intranasal therapy, responses are often observed in 2- 6 weeks as opposed to the 4-6 month buildup. This type of treatment has resulted in decreased hyperactivity, improved sleeping habits, better socialization and loss of deterioration during allergen exposures.”

Dr. Anju Usman - Low Dose Antigen therapy, also known as Ultra Low Dose Enzyme Activated Immunotherapy.
This is a broad-based treatment that is meant to desensitize to allergens (a bit differently than Dr. Elice’s protocol). Dr. Usman talked about environmental pollutants such as inhalants, products, chemicals and bacteria as well as food allergies.
She described a couple of patients in whom this type of treatment improved skin, G-I, and some behavioral signs and symptoms.

Dr. Richard Frye - N-acetyl-L-Cysteine Treatment in Autism
This learned child neurologist described the recent good news about successful treatment with NAC. The preparation is utilized in mitochondria, requires energy, and detoxifies. He described the ability to detect the subsequently derived protein, glutathione, in autistic brains, especially in those areas that seem to be functioning incorrectly in ASD. This reaction is helped by folinic acid and B12.
I questioned Dr. Frye about the use of glutathione itself (instead of its precursor), such as that which we use at The Child Development Center. His response was that he wondered whether or not balance is achieved with an oral glutathione. Is that all, doc? Well, he helped me with some other patients.

Dr. Dan Rossignol - Update on Clinical Findings and Treatments
This was a review of the 2013 literature about ASD.
First, there was a discussion about the new DSM-5 definitions, which may change the reported incidence of autism.
Then, Dr. Dan gave his signature rapid-fire, research-paper-a-minute (literally, 39 papers reviewed in 45 minutes), insightful, clinically useful, understanding of that research.

Acceptance by the AAP and the traditional medical community is important because it will help patients. Doctors need to be more open-minded and respect our colleagues and the other professionals who are addressing the autism epidemic.

The MAPS conference has gotten very green, btw. All of the material was downloaded from the Internet, saving lots of trees (hundreds and hundreds of pages provided to ~120 participants).

This was a great conference with the most up-to-date scientific information provided by experts who are helping to recover many affected patients. Plus, there was lots of networking and brain-picking.

Home, sweet Fort La-De-Dale. Starting Monday, more patients and a bit more wisdom.

Day #1 (click)
Day #2 (click)

Our Special Patients

Saturday, September 14th, 2013

Charlize, Age 9

I object to the term ‘low functioning’, as in “Billy has low-functioning autism.” After all, we don’t say that about neuro-typical individuals whose abilities may limit their options. And, “high-functioning” can be just as pejorative, considering that Temple Grandin is not really a ‘high-functioning’ autistic person, she’s a brilliant individual.

What is generally meant by the term-in-question is “Displays disruptive behaviors,” and/or “a severe lack of expressive language.” But, of course, we wouldn’t call a mute person ‘low-functioning’ (although not too long ago, people said “deaf and dumb”). Every child has special abilities, our job is to find and maximize them.

This week, The Child Development Center had the honor of taking pride in one of our patients who appeared on various popular media outlets, such as CNN, Good Morning America, local TV stations, and The View. Jacob made the news because of his abilities as a piano prodigy, while being an otherwise normal kid, except for his high-functioning autism, which was only presented as an undercard in the story. Way to go, popular media!

http://www.youtube.com/watch?feature=player_detailpage&v=yaVuDs9QHVk

Our practice helps care for a three year-old severely apraxic child who can play Bach on the keyboard, but never had a lesson. We have discovered some children with perfect pitch. Several patients have given piano recitals to large audiences. Another young man is a great public speaker. Karen, our patient and kind office manager, has a son with fantastic artistic talent, as well as being able to Xerox his works, sans a copy machine. The watercolor displayed here is but one of a number of amazing pictures by another young artist, who is our patient, as well. Plus, there are many more examples of remarkable children who have developmental challenges, yet perform unexpected tasks, both extraordinary and ordinary.

Your son or daughter who has been diagnosed with autism needs our help to discover the best means to achieve optimal health and persist in the desire to put things on the right track. Parents do their best. Resources, such as time and money must be allocated, especially when there are other children to be considered.

What is sorely lacking is the medical community’s support. Any time a child makes progress, “It would have happened, anyway,” claim the experts. In this case, an astute mother recognized unusual patterns in her child and, despite what the authorities diagnosed and advised, she sought further assistance. At first, things were not going perfectly well for our now-famous musician. The parents were supportive of everything that felt safe for their child, and biomedical interventions appeared to work great. Nevertheless, the conventional medical establishment continues to deny that alternative approaches have worth.

I’m not absolutely certain that every laboratory test was important, each dietary restriction appropriate, or the myriad of supplements and medicines all efficacious. But, children who are healthy thrive and respond to school, ABA, S&L, OT, PT and all the other therapies better.

The journey and the work are worth it, not just for the most talented, but for every child with developmental concerns. Just like in the neuro-typical world.

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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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