Posts Tagged ‘Attention deficit’

Practicing Autism Treatment

Sunday, June 12th, 2016

The identification of supplements, medications, or protocols that demonstrate safety and usefulness in each individual patient of a certain age and sex, who exhibits a specific set of signs and symptoms, is certainly the most daunting part of this new practice of Pediatric Special Needs medicine.

This week, we received some great news about two of our patients with significant speech delay. Both have been has been getting treatment at The Child Development Center for ~18-24 months, experiencing significant speech apraxia that has been resolving only very slowly, in spite of the usual alternative protocols.

 5 year-old Harry:
Hello Dr. Udell,
I met Billy’s mom, who also sees you. Also by chance, ironically she goes to the same speech therapy place as Harry. We started talking and she suggested I put Harry on a special diet. I have amazing news to report. I am not sure if it is coincidence, but I put Harry on a very strict Gluten free/Casein free/Soy free/Sugar free diet this past Saturday (6/4) and on 6/7 he started talking!!!! He is mostly repeating when I prompt him, most of the language is prompted and a lot of it is not completely clear, you can make out what he is saying though. Very similar to when a child first starts talking. He has said in excess of 70 new words in the past 2 days, not including words he is repeating!!!! I am so excited. I am not sure if you can review the supplements he is taking and let me know if you want me to change anything?? Do you want me to give more B12 shots?? He is currently taking them twice a week. Now that he is “talking” I am not sure if we should alter anything and wanted your opinion/advice. I am going to stop in shortly to pick up more glutathione so please let me know… His bowel movements are improving/changing as well. Please let me know what you think and I will bring him with me next week when I pick up more supplements and have him say “hi” to you…. literally!!!!

 Thank you so much Dr. Udell!!!
Dr. U
What a great response… honestly, it’s hard to know why, ’cause he didn’t show a significant IgG elevation against those foods..
It’s peculiar that for some, an SCD diet, GAPS diet, or other specific protocol, helps so much and others not at all.
I would just continue whatever you are doing right now without any changes.
Thanks so much for this information.
As long as you do not mind, I plan on using this as a blog – I will, of course, leave the names anonymous… but it would help so many others re-double their efforts.

Mom
Absolutely, and you can use our names, I don’t mind! (anonymity anyway). I am all for helping as many people as I can with whatever information necessary! I am so grateful to you Dr. Udell for all you have helped us with, I know its still a long road but I am more hopeful then ever. Let me know when you would like to see him next. I will see you sometime next week when I stop in to pick u more GSH…..

 7 year-old Bobby:
Hello wanted to share great news. Bobby scored above average in Reading Comprehension and average in Math. He was promoted to first grade with no issues. Next year he will be in a  Gen Ed classroom for 90 minutes, 5 days a week. He will also share specials and events with his Gen Ed class. 

The teachers wrote, “In the past year, Bobby has come such a long way! Beyond our expectations. God is good. First grade, here we come!!!!”
We would like to thank Dr Udell and his wonderful caring team!  We feel blessed!
Dr. U
What great news… Thanks to all your persistence and hard work, as well.
Really appreciate this update.
Regards,

Discussion
Autism recovery is a marathon, not a sprint. Parents are sometimes quite frustrated when they observe only a fraction of the improvement that they had expected, after only 3 or 4 visits over 6 or 9 months.

Those who discontinue modern alternative autism treatments, delivered by a trained, experienced medical practitioner, are relinquishing valuable time and opportunities for improvement.

Conclusion
The time that it takes to demonstrate improvement varies greatly from patient to patient. Often, the real miracles are the ones that percolate, not the occasional ‘great responder’ who gets better after one or two treatments (as seen on YouTube, of course).

When asked about which intervention generated the most improvement, many parents declare, “Im not sure what made my child better. It was a combination of the doctor and all of the various therapies.”

As long as medical intervention is affordable, safe, and effective, being part of the team that leads to improvement provides more than enough encouragement to continue the fight.

Folate Issues and Autism

Monday, May 30th, 2016
popeye

Highest level in food is spinach, but multivitamins and Ready-to-Eat cereals represent greatest intake.

Recent media attention regarding an association between supplemental folate (= folic acid) and the incidence of ASD has stimulated a fair amount of interest, with questions by patients, professionals, and acquaintances.

Findings presented this month by Johns Hopkins’ researchers showed that high levels of the vitamin increased the risk of autism, as did an excess of B12; and the combination increased the chances even more.

Folate
Highly processed foods are stripped of many nutrients, including folate. Additionally, antacid preparations decrease the absorption of many B vitamins.

Folate needs to be supplied in our diet to make and repair DNA, in order to promote cell division and growth, and to produce healthy red blood cells and prevent anemia. Symptoms of folate deficiency include weakness, nerve damage, confusion, cognitive deficits, headaches, mental depression, sore or swollen tongue, peptic or mouth ulcers, heart palpitations, irritability, and behavioral disorders.

First reported in the 1990’s, women who took daily supplementation around the time of conception and throughout pregnancy with a small amount (< 1/2 mg.) of folate experienced a decreased rate of central nervous system birth defects and developmental problems (review), including ASD .

Additional issues
Over 10 years ago, low folate levels in the cerebrospinal fluid were reported as a cause of autism, and there was a positive response to treatment with the active form of the vitamin.
Shortly thereafter, a proposed mechanism and discovery of antibodies against folic acid, especially in the CNS, were similarly implicated as a cause of developmental delay.
Plus, genetic alterations in the pathway leading to the active form of folate have been associated with an increased incidence of autism, as well.

Conclusion
Clearly, the addition of folate has been a major factor in decreasing the incidence of severe birth defects, such as spina bifida (opening in the spine), meningomyelocele (protruding sac), and hydrocephalus (water on the brain).

This latest study raises questions regarding ‘too much of a good thing’. Considering that ASD has reached epidemic numbers, it is time for doctors to begin screening women for folate and B12 levels, before and during pregnancy.

Diatomaceous Earth as Autism Treatment?

Sunday, May 15th, 2016

Parents frequently inquire about, and/or try, various home remedies. In a continuing effort to keep this site complete, by covering as many autism treatment modalities as possible, this discussion will be about diatomaceous earth.

What is DE?
“Isn’t that the stuff that you put into swimming pool filters?” Yes, but the supplement form is “Food Grade, 100% natural, with no side effects.” Except diarrhea, and a host of unstudied changes in fluids and minerals throughout the body.

OSHA and The National Institute for Occupational Safety have set limits for human exposure. Composition varies greatly. According to a prominent proponent, “Out of 600 deposits in the U.S., only 4 rate in purity by FDA standards to be labeled as ‘Food Grade'”.

History
The product was discovered over 150 years ago, and consists of the fossilized remains of millions of microscopic sea critters. According to Wiki, “…It is used as a filtration aid, mild abrasive in products including metal polishes and toothpaste, mechanical insecticide, absorbent for liquids, matting agent for coatings, reinforcing filler in plastics and rubber, anti-block in plastic films, porous support for chemical catalysts, cat litter, activator in blood clotting studies, a stabilizing component of dynamite, and a thermal insulator.”

Use in Health
There are claims of more than 1,500 benefits; including, lowering blood pressure and cholesterol, healing sore joints, healthier hair, skin, teeth, gums, and nails, better bowel movements and it is supposedly safe for pregnant women (no source).

Use in Autism
Agents that remove toxic metals – chelators – have been used as autism treatments since the turn of this century. When detoxification became a popular treatment, DE was introduced. As the issue of symptom-causing parasites (including fungi, viri, and bad bacteria) waxes, this cathartic product has received new mention. Anecdotal stories abound. Sensory issues, ADHD, behavioral disorders, and even speech, have apparently been changed for the better after administration, for some.

Discussion
A Google search for ‘diatomaceous earth’ and ‘autism’ returns >27,000 responses. A Google Scholar search for this supplement returns ZERO valid, scientific hits.

The problem originates with the fact that conventional – and even biomedical treatments – are not relieving enough people who display the signs and symptoms of ASD. Home remedies are attempted to fill the void. However, autism consists of many conditions, so comparing disparate treatments is nearly impossible, outside of a scientific study. Importantly, parents are not aware of the parameters to follow; including laboratory testing of electrolytes, minerals, and the health of key organs, such as the liver and kidney.

It has been the experience of many practitioners that such gut-cleansing treatments – from worms, to CD, to Miralax™ –  only help selected patients, and then, for a brief period of time. Plus, conditions may worsen. Expect a paucity of testimonials about those negative reactions. Plus only a few warnings appear in the web.

Conclusions
Practitioners should listen carefully to parents who discover supplements that improve their children with ASD. A variety of valuable information has been provided, moving successful protocols forward. Likewise, it is our job to consider the scientific implications, as well. Unregulated substances lead to metabolic consequences that have yet to be elucidated.

As with other alternative alternatives, more reliable data is needed before experimenting on our children.

Mothers Day Wishes

Sunday, May 8th, 2016

helpMomThis is dedicated to all of the incredible Mothers who deal with ASD and the associated symptoms every day. You are not alone.

We’re not seeking miracle cures
Just small miracles.

I wish that I had more time for…

My affected child, the other kid(s), my husband, myself.

Something is just not right with my child, I wish we could figure it out.

If he would only get ready in the morning, Such a battle.

If she would just say “yes” once in a while.

If they will just stop fighting all of the time.

If he could only remember what he just read.

If he would only have some friends.

The family doesn’t’ seem to understand our problems.

We haven’t taken a vacation since…

If she wasn’t so disruptive in school.

If we could just figure out how to get him to focus.

He keeps saying the same thing over and over.

Those ‘stims’ are driving us crazy.

If we could all only get a good night’s sleep.

He has had diarrhea ever since I can remember.

He eats so little, I’m afraid he’s not getting enough.

She seems to be sick all of the time.

The rashes don’t ever seem to go away.

When do you think she will say “mama”?

There used to be some words, but now there’s not even eye contact.

She doesn’t ever play with us.

I wish she would stop biting her arms.

I wish he would stop hitting his mom.

When do you think he will be able to crawl?

She couldn’t stand until she was 2.

I don’t know what he wants.

If the doctors would only figure out what is wrong. If they would only listen.

How is my child going to make it in: preK, K, first grade, middle school, high school, life?

We’re not looking for miracle cures, just small miracles.

Thanks for allowing us to help
Sincerely,
Dr. Udell and the staff at
The Child Development Center of America

Medical Academy of Pediatric Special Needs 2016 Spring Conference

Sunday, May 1st, 2016

Practitioners, such as myself, find that it is necessary to attend the bi-annual Medical Academy of Pediatric Special Needs conference for two important reasons. First, to listen to experts from all over the world present their knowledge and latest research. Second, to network with, and learn from, other like-minded practitioners.

What I Liked Best
This year, I chose the ADHD path. The workups that were presented tended to be somewhat complex, and perhaps unattainable for many patients. The bottom line was to get a medical evaluation. The differential diagnosis ranges from thyroid to PANDAS. Mostly all agreed that stimulant and psychotropic meds should not be the first line in treatment. One professor spent some time questioning the diagnosis, itself, and how the modern world has contributed to the epidemic.

What I Liked Least
Traveling all the way to Costa Mesa, CA. Course work is 8 hours per day, so no time for Disneyland, etc.

This Year’s Major Focus
Mitochondrial function continued to play a big role in the presentations. The advanced courses involved lots of methylation, detoxification, and energy production diagrams. The newest twist has been the addition of genetic testing to better determine the cause(s) of inadequately functioning biologic pathways. Single nucleotide polymorphisms (SNPs) and ‘epigenetics’ were the buzzwords – how individual genes interact with the environment and within the individual leading to dysfunction and downstream signs and symptoms.

Topics That Were Discussed in Passing
Microarray genetic testing, covering multiple genes, did not play a big part in this year’s talks. Discussions about childhood immunizations underlie a great deal of the members’ conversations; specifically the lack of solid scientific evidence for safety in high risk populations. Attendees are not against vaccinations, by the way. Lyme disease was discussed in general, and as that inflammatory process relates to other infectious-metabolic conditions.

Subjects Not Formally Presented
GcMAF and nagalase levels. Some patients have indicated that a useful, safe supply may become available, so that will help determine future use. As well, chlorine dioxide, hyperbaric oxygen treatment, helminths, medical marijuana, and stem cell therapy were not offered by this year’s presenters.

Conclusion
It is disappointing to return from such conferences without that ‘magic bullet’. Just standing around, listening to Sid Baker speak about how he got interested in autism, or asking him how the ‘ion cleaning’ footpath worked, is worth the price of admission, however. This science started with Dr. Baker, and he continues to be an inquisitive, gentle force for hope, 40 years later.

In the absence of a sufficient population of scientists who are willing and available to address this modern epidemic of childhood developmental problems, this meeting stands as a bastion against the current state of ignorance.

The Autism Diet

Sunday, April 24th, 2016

There are specialty diets for just about every situation, including specific medical conditions. They developed as humans evolved and discovered nourishment that promoted longer, healthier lives.

Some address a particular population; the Feingold diet could be a godsend for ADHD parents. There are plenty of cancer treatment regimens. Paleo is popular. How long did cave men live, about 30 years? Copious cholesterol lowering protocols. And just plain diet diets for people to lose weight. They tend to be trendy like the Coffee Diet or The South Beach Diet.

The Autism Diet(s)
There isn’t really ONE diet that has been shown to work for all, and there are patients who do not respond to any nutritional alteration.
The variety includes:
Gluten Free / Casein Free Diet (GF/CF) – is one of the most popular and often successful. Parents frequently report that eye contact improves, the fog lifts, and some toddlers begin to speak.

Specific Carbohydrate Diet (SCD) – has many success stories. This fairly restrictive protocol makes it difficult to sustain, even for parents who see improvement.

Gut and Psychology Syndrome Diet (GAPS) – an offshoot of SCD. As in other therapies, the aim is detoxification and reduction of inflammation, leading to a abatement of signs and symptoms.

Dr. Udell’s Child Development Center Diet – Blood and urine testing is done first, looking for 1) a significant IgG antibody response to 90+ foods, and 2) the production of morphine from incomplete digestion of gluten and / or casein (leaky gut). Identification of offending fare is explained to the family, which often leads to a successful appropriate dietary intervention.

The Evidence
The diagnosis of ASD is imprecise, confounding the evaluation of any treatment modality. Lack of biomedical markers to identify patients’ level of involvement and response to change represents another significant challenge to the ‘evidence-based-medicine’ crowd.

Solid scientific scrutiny is lacking. However, there have been lots of coincidences where children improve. At least, the child’s stooling patterns may normalize, or toilet training becomes more successful. What’s the harm?

Discussion
There isn’t a great deal of evidence to support the notion that ingesting large amounts of Monsanto’s Round-Up could hurt us, but it is probably not a great idea. There are antibiotics in our food – proven to cause harm –  and the government has failed to respond.

It’s not proof that families seek, it’s change in their child. When a parent says that “After we started the diet, he seemed to wake up and words started coming,” anyone would stop and take note. To the conventional medical community, that is just another nut who probably doesn’t believe in vaccinations.

The criticism that such diets are nutritionally insufficient is spurious. Accurate documentation of somatic growth, plus pre- and post- laboratory testing confirms sufficiency. For those doctors who seem so concerned about this issue, why aren’t you already checking the nutritional status of your picky eaters?

Conclusions
Compliance is paramount for restricted diets to really work, so family resources and the patients’ age need to be considered when the professional recommends. 7+ year-olds (especially male) tend to cheat, lie and steal the yummier, forbidden fare. Likewise, preparing separate meals for a family of 6 can present a major obstacle.

Improvements are generally incremental; so diets might take time, perhaps months, and may need to be kept up for years. Children with ASD are usually sensory diners in the first place, so change is challenging.

Even in the absence of large, perceptible improvements, your healthier child can respond much more efficiently to the other therapies that assist in the journey towards recovery.

Vaccination Redux

Sunday, April 17th, 2016

TheAutismDoctor has been asked to weigh in on the recent media attention regarding the film Vaxxed, which was scheduled, but not shown, at this year’s Tribeca Film Festival.

Robert De Niro, who helped organize the exposition, announced that he has an 18 year-old son with autism, and felt that the point of view presented in the documentary was important enough to explore. However, he decided to pull the film because the controversy is so heated that it deterred the public’s enjoyment of the rest of the event.

Do Vaccinations cause Autism?
The topic has been covered in this venue over 35 times, so I’m fairly certain that another protestation will confer little additional sanity.

Regardless of the volume and frequency with which Jenny McCarthy, Robert De Niro or Dr. Udell voice the opinion that we are not against childhood inoculations, ‘anti-vaccination’ is usually the way that the information is characterized. Opinions are either, “All or none, for or against, pro-science or anti-vaccination, educated or ignorant, healthy or dangerous.” Such points of view offer no middle ground and so this dispute won’t go away any time soon.

Discussion
I posed the following question to the ‘pro-vax’ father of a 6-month old, “You are asked to enter your baby into a formal study in which there are two groups.”

Group A – Present Schedule

Start at birth (Hepatitis B in hospital)
Fever OK (give Tylenol)
Mild illness OK
9 or more components at once OK
Negative previous reaction OK
‘Make up shots’ (for missed doses) OK
Other medical conditions OK
Development not on track OK

Group B – Other factors considered

Wait to begin until infant is clearly healthy
No shots if child is sick
Fewer components at each time
No pretreatment with Tylenol
Medical evaluation if previous problems
Appropriate testing if medically unstable (e.g. frequent infections, premature, GERD, eczema, asthma, abnormal stooling…)

Dad’s answer? “The safe one!” Really? Is that the one that the ‘scientists’ and government say is all right? And by the way, even if a physician might answer the hypothetical by responding, “Group A is perfectly fine,” their partner would probably protest, “Are you crazy? Not my kid!”

When that scenario is too cumbersome to recite, I pose another question. “Which is a more reasonable statement? ALL vaccinations are good for ALL children ALL of the time,” or “SOME inoculations might not be good for SOME toddlers in SOME situations?”

If the answer is the latter, it begs the question, “Which ones, when, under what conditions?”

Conclusion
Childhood vaccinations have been a true victory for modern medicine. They have prevented a variety of devastating diseases suffered by so many for millennia.

This movie, subtitled, From Cover-up to Catastrophe certainly stokes the controversy, as does its outspoken lightning rod, Andrew Wakefield.

No matter how frequently, dogmatic or pedantic the ‘Vaxxers’ pontificate, this polarization will continue until we understand more abut the present autism epidemic. Once that diagnosis is accurately understood and described, ‘real’ science demands independent, prospective, randomized, controlled, double-blind crossover studies of each and every component of the modern protocol to prove safety and efficacy.

Echolalia in Autism

Sunday, April 10th, 2016

Among the variety of perplexing signs exhibited by patients with autism is speech repetition. Increased understanding of the genesis and purpose of reiteration of words or phrases assists in our knowledge of ASD, and in developing useful therapeutic interventions.

Definition
As applied to autism, echolalia is the immediate or delayed repetition of vocalizations. In our electronic world, sounds don’t only come from other people. Imitation is common as toddlers start to speak, but persistence beyond the age of three continues in 3/4 of children ‘on the Spectrum’.

Representative literature:
1969
Research described echolalia as a contrary language-related rationale emanating from the study and from the literature.

1981
It is argued that researchers who propose intervention programs of echo-abatement may be overlooking the important communicative and cognitive functions echolalia may serve for the autistic child.

1984
The diversity of delayed echolalic behavior is discussed in reference to its conventionality, the presence or absence of communicative intent, and its status as symbolic communicative activity.

2013
Utilizing Behavioral therapy:
… Stimulation and echolalia decreased during treatment, and appropriate behaviors increased.
… Spontaneous social interactions and the spontaneous use of language occurred about eight months into treatment for some of the children.
… IQs and social quotients reflected improvement during treatment.
… There were no exceptions to the improvement, however, some of the children improved more than others.
… Follow-up measures recorded 1 to 4 years after treatment showed that large differences between groups of children depended upon the post-treatment environment (those groups whose parents were trained to carry out behavior therapy continued to improve, while children who were institutionalized regressed).

The Autism Doctor’s observations about the condition:
lightbulb littleIt is not uncommon to observe parents who repeatedly prompt, possibly providing a template for that speech pattern. “Tell the doctor your name. Tell the doctor your name.”

lightbulb littleWhy does the behavior occasionally seem to arise out of nowhere? By observing children who are finally healthy enough to produce vocalizations, they are practicing – singing songs over and over, and stuff that just pops into their heads.

lightbulb littleThe core symptoms of autism include restricted interests and repetitive behaviors. Speech recurrence sometimes appears to represent those issues. Echolalia is not merely, “Not getting it.”

lightbulb littleWith the frequent use of digital media and the ability to observe and listen to scenes over and over, imitation follows naturally.

lightbulb littleSpeech delay, another common sign, results in paucity of language. Children who wish to communicate, but who only possess 30% of ‘normal’ vocabulary, may be repeating each phrase 3 times, just to make up the difference.

Conclusions:
Even today, echolalia is sometimes noted as non-functional at best, or possibly annoying at worst. After all, what parent hasn’t been driven crazy but the oft-repeated phrase, “When we gonna get there?”

As a clue to the deficiency of productive communication in ASD, this sign is important for our understanding of the bigger picture.

Strategies aimed at reduction ought to include expanding useful communication, rather than extinguishing, that vocal activity.

Neurodiversity and Autism

Sunday, April 3rd, 2016

Hands2We are not going to cure cancer. Eventually, medical science will successfully treat melanoma, breast cancer, or lymphoma. One disease at-a-time, with discovery and experience along the way. Likewise, there will come an understanding of the underlying causes, treatments and prevention for all the types and conditions that appear with signs and symptoms now considered ASD.

Calling the epidemic ‘Autism Spectrum Disorder’ is, paradoxically, both accurate and imprecise. It is valid to the extent that, given our present state of ignorance, there exists an array of individuals who fit a common diagnostic category. However, it comprises too many people with a myriad of conditions. Under the present state-of-the-art, there are those who are just, well, neuro-diverse!

Maybe it’s Asperger’s syndrome (OK to say, before DSM 5.0). Perhaps, it’s extreme ADHD, with a bit of sensory issues. There is oppositional behavior disorder, visual and/or auditory, sensory processing and executive function disorder. How about social processing disorder?

The A Word
A new BBC series entitled ‘The A Word’ was recently reviewed by the New York Times. While it’s admirable to expose the public to the challenges of families who are affected by this modern malady, as a pediatrician who has been practicing for over 40 years, the comments by one reviewer (who co-authored an article with his autistic daughter) gave me cause for concern.

“Years ago, black people or gay people were on telly purely as black people or gay people. Autistic people still are — they appear on programs purely as autistic people,” he said. “It would be great to see autistic people in TV dramas who are just there, like any other character.”

ARE YOU KIDDING ME?
Who ever said, “We need to hear more tuberculosis patients on the radio?” Or, “People with polio don’t appear enough on TV.” The scientific community astutely researched, understood, and successfully treated those emerging medical conditions.

It’s not just neurodiversity
This is why a more precise diagnosis is needed. So far, I see speech apraxia and oral-motor dysfunction (including extreme feeding disorders) as THE LINE. It impedes even the brightest and most talented of individuals.

In addition to the lack of communication, aggression (against self or others) is the most perplexing and difficult-to-treat feature of ASD. In toddlers, negative behaviors usually emanate from discomfort, pain, or unmet needs. It is the discovery and treatment of such co-morbidities that enables clinicians to successfully address those youngest patients. As children age, that lack of contact and the frustration that accompanies loneliness and isolation often result in tantrums or other negative behaviors.

Discussion
By the way, the difficulty is with speech and communication, not S&L. Patients are not ‘confused’ by multiple languages, ‘spoiled’ by grandparents, or ‘isolated’ by numerous siblings. In our multi-cultural world, the most incommunicative children can follow directions given by a variety of non-English-speaking caregivers. Additionally, even sign language is difficult for those who are most affected.

I’m all for embracing the neurodiverse universe. Its inhabitants are interesting and have provided the horsepower for imagination that has helped change the world. When people who are different require special instruction or more understanding, popularizing their plight makes sense.

Conclusion
Doctors are not seeking to  ‘cure’ neurodiversity. On the contrary, we ought to learn about different brains and embrace their uniqueness. However, to the extent that autism is considered “Locked in autism silent prison,” practitioners need to understand and treat this enigmatic medical condition.

There is neurodiversity. And, there are autisms.

The Life Span of Autism

Sunday, March 27th, 2016

LifeSpanLast week, Autistica, a UK “… charity which both funds and campaigns for medical research to understand the causes of autism, improve diagnosis, and develop new treatments and interventions…” released a report that received worldwide attention.

Personal tragedies, public crisis
The urgent need for a national response to early death in autism.

The Report
Based on a recent Swedish study, these points were highlighted:
• Autistic adults with a learning disability are 40 times more likely to die prematurely due to a neurological condition, with epilepsy the leading cause of death.
Those without a learning disability are 9 times more likely to die from suicide.
 Autistic people die on average 18 years earlier than the general population.
For those with autism and learning disabilities, death occurs more than 30 years before their time.

As with any new alarming finding, the media reacted. One report began, “It’s only one study, but the results are disturbing.” That was one of the least sensational interpretations.

Previous literature
Comparative Mortality of Persons with Autism in California, published in 1998, demonstrated that, “Persons with autism are subject to increased mortality risk…”

Research “… to determine which causes of death are more frequent in persons with autism, and by how much, compared with the general population…” was further documented over 15 years ago. The doctors concluded, “… excess mortality was especially marked for persons with severe mental retardation, but life expectancy is reduced even for persons who are fully ambulatory and who have only mild mental retardation.”

Five years ago, another set of authors verified those statistics and recommended, “Various national health care and state developmental disability agency initiatives to reduce risk of mortality are described.”

Likewise, the increased mortality associated with epilepsy (convulsions of various and often uncertain origins) has been previously demonstrated.

The Response
Comments following the story as reported in Science magazine followed various lines of thinking. There was anger directed at doctors, frustration with government failures, exasperation over how long this information has taken to surface, and advice about treatment.

Individuals ‘on the Spectrum’ complained of depression and outrage was expressed by many. An AutismSpeaks vice president explained that, “we need to use caution when interpreting these data…”

Discussion
What is the life span in autism? The most precise answer ought to take into account what kind of autism (genetic, immunologic, metabolic, e.g.), and whether a patient continues to experience co-morbid signs and symptoms. Over-treatment with potent pharmaceutical preparations may contribute to the cause of the increased mortality. Or, caught early with appropriate intervention, the diagnosis can be lost, so ’cause of death’ should parallel the neuro-typical. 

It’s important to get the word out about the ASD epidemic. The media attention to this particular literature, however, is somehow more urgent because of the loss of life; not family and societal costs, nor the numerous qualities that are delayed or absent in the presence of signs and symptoms of autism.

Additionally, certain basic issues, such as improving the general health of those most affected with ASD, proper housing and nutrition shouldn’t require lots of resources to study and implement. Understanding epilepsy, seizure control and psychiatric care will, obviously, take more time.

Conclusion
Autistica appears to be doing valuable work to address this modern epidemic. The recommendations that were made at the conclusion of the report may actually get some traction, especially with the backing of Deutsche Bank.

So, to the extent that this predictable and pre-reported outcome amplifies the need for better answers, media attention to this side of the story should prove helpful.

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