Posts Tagged ‘autism puzzle’

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.

Kids on the Calendar Year Cusp

Sunday, May 22nd, 2016

May is a key month for parents, administrators, teachers, pediatricians, and therapists to confer about whether Junior should start in PreK, or move on to Kindergarten. Which child should repeat 1st grade? Is the youngster ready for VPK? How about Middle school? What about those children whose birthdays fall between the cracks?

Having watched infants grow up for the past forty years, observing thousands of children who have developmental challenges, and  been part of raising two successful offspring of my own, I have formulated some questions that parents can use to assess school readiness.

As you consider the answers to these questions, you may see a pattern that helps you lean one way or the other to make the most successful choice.

  1. Maturity. I’m not talking about academics or IQ. Does your child play with other children of the same age appropriately? When a stranger enters the room, is the toddler likely to cry or run away? Can you leave the room without a meltdown?
  2. Compliance. Some youngsters at The Child Development Center have an incredible memory, are able to assemble complicated puzzles, and enjoy providing details about dinosaurs, or trains, for example. However, when the adult says, “Everyone in circle time,” they resist. The child who requires multiple prompts will do better with a reduced need for such a requirement; learn in a appropriate classroom setting with younger kids or a smaller teacher/student ratio.
  3. Self-control. As toddlers progress, tantrums should become less frequent, last for shorter periods, not include violence (against self or others), and become less dramatic. Parents often display some denial about this issue. “The teacher made him do this,” or, “Another kid took his favorite toy.” It’s the child response to that behavior that should be considered in order to guide the family to the appropriate setting.
  4. Abilities. I ofter hear the comment, “I know he can do <some given task> if you wants to!” The ability to perform, and the resulting behaviors – even when a task is non-preferred – is paramount. Ask yourself if the gross and fine motor skills that are expected in the next grade are appropriate to your child’s abilities. Then, choose the grade, school, setting, and available resources to get the child up to speed. Their ability to succeed has a great deal to do with future self esteem.
  5. Listen to the professionals who evaluate your child, but be aware of each one’s priorities. Administrators desire a smooth semester, teachers want children who listen, therapists often like to predict level of appropriate function. Parents know their children’s capabilities the best.
  6. Child’s size and sex. The smaller child who has all of the above capabilities will usually find a way to fit in. Indeed, the other students usually include, and even protect. But a child who is too large for a given grade may become a bully, or even be bullied, if they are not able to keep up. Plus, no doubt about it, girls are more advanced than boys.

Conclusion
This advice not only pertains to decisions concerning those who are developmentally delayed and challenged, but neurotypical children, as well. Especially for those whose birthdays put them ‘on the cusp’ between grades, considering such issues and responding appropriately can be even more important than academic concerns.

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.

Speech, Apraxia and Therapy

Sunday, March 20th, 2016
Cortical Humunculus

Cortical Homunculus – Large areas of brain map to oro-motor function and hands

Two major problems facing the youngest patients who are most affected with signs and symptoms of Autism Spectrum Disorder are aggression and speech. These factors shape socialization, the final step in ‘normal’ communication. Therefore, achieving self control and enabling speech is key to reversal.

Aggression
Often, combativeness appears to come from pain. Sensory overload, sinus problems, gastrointestinal discomfort (from reflux to abnormal stooling), infections and headaches can produce a variety of stimming behaviors; including lashing out against self and others. Combined with a short fuse protruding from accompanying sleep difficulties, the resulting picture is often misunderstood by conventional specialists who invoke potent CNS medications, only meant for adults.

So, the first step to successful intervention is the achievement of better health. Modern therapists who recognize this, and refer the children for appropriate diagnosis and intervention, will be rewarded with more attention and compliance.

Speech Apraxia
There is no other more perplexing condition associated with ASD. Almost all vertebrates exhibit the ability to utilize vocal communication. In humans, articulated speech should be a pre-wired state. Parents don’t teach Junior to speak at 12-18 months. He just talks.

Apraxia’ refers to the inability to perform a desired ‘natural’ motor activity, presumably due to difficulties with central nervous system processing. So, neuro-typical individuals do not have ‘trombone apraxia’ because there wouldn’t be a preexisting neural pathway for that activity (unless the person is a prodigy). Research must be targeted at unravelling this mystery. For the great majority of patients, it’s not Autism AND Speech apraxia. It’s autism. Furthermore, I don’t think that those newly minted Autistic Japanese monkeys are ever going to speak.

A scholar.google.com search for medical treatment of speech apraxia in autism returns few specific, well-proven, evidence-based choices. It appears that modern medicine does not understand the cause, or even the site of verbal malfunction in ASD patients, let alone pharmaceutical interventions.

Discussion
By the way, language does not appear to be the problem. It is common to hear parents exclaim that, “Grandpa (from Romania) and Grandma (Haiti) can tell him to do anything.” Additionally, there are patients with speech difficulties who spend hours on the Internet learning other languages, including those not even spoken in the home. Jake, our Practice Administrator’s son, was found practicing Japanese one day!

There is little doubt that the child’s ability to respond to the therapists’ prompts is directly related to the success of intervention. Parents have frequently observed children merely staring into space while the professional works, and may go years without improvement. Or worse, the child becomes belligerent as the S&L person approaches the front door, often leading to violent behaviors.

Conclusion
Biomedical intervention is available for the modern patient to address problems with muscle tone, fog, and processing, in order to better address oro-motor function, and therefore increase chances of successfully addressing this very symptom.

The experience at The Child Development Center of America, and with the doctors who practice under the auspice of Medical Academy of Pediatric Special Needs, has been consistent as far as the ability of methyl-B12 injections, to engender useful speech. When combined with good health and traditional therapies, this could be the best possible advice for confused but determined parents.

A Letter to Autism Researchers

Sunday, March 13th, 2016

The title of a recent article in the Journal of Pediatric Gastroenterology and Nutrition was Evaluation of Intestinal Function in Children with Autism and Gastrointestinal Symptoms. The headlines featured by most of the lay press, “Tests Show No Specific Gastrointestinal Abnormalities in Children with Autism.” Big difference.

The Study
According to the authors:
• There was no difference in the activity of the enzymes that break down key sugars in autistic vs. non-autistic children who are evaluated for gastrointestinal disorders.
• Specific biomarkers of intestinal inflammation were elevated equally in autistic vs. non-autistic children with GI signs and symptoms.
• Biomarkers of a ‘leaky gut’ were not found more frequently in autistic vs. non-autistic patients with similar symptoms.

Discussion
A scholar.google.com search for gastrointestinal problems in autistic children returns >24,ooo results. There are reports of poor oral-motor function, sensory issues of taste and smell, GERD, eosinophilic esophagitis, abnormal gut flora, chronic constipation, chronic diarrhea, alternating constipation and diarrhea, and delayed toilet training.

The authors noted that, “Common problems such as gastroesophageal reflux or constipation may present with atypical symptoms such as stereotypical behaviors, aggression, or self-injurious behaviors. Consequently, gastrointestinal problems that might be easily recognized in a neurotypical child may go undiagnosed in a child with autism.” They concluded, “There is no evidence to support that gastrointestinal disorders cause autism.”

This crystallizes what’s wrong with research in the ASD universe.
There isn’t one kind of autism. Addressing the individual co-morbid conditions frequently allows traditional therapies to take hold.

The diagnosis itself is a collection of signs and symptoms categorized in this manner, especially since the DSM 5.0 has included PDD-NOS and Asperger’s Syndrome under the Autism Spectrum. There are conditions that present primarily with aggressive or disruptive behaviors, genetic variations – large and small, immune system regulation difficulties, central nervous system abnormalities and seizures, significant skin rashes, and probably many more.

It is only a matter of time until a colleague announces to me, “Well, I heard/read/thought that it has nothing to do with the GI system.”

Conclusion
Even when respected professionals, such as Dr. Buie, et.al., research and document important information, it is frequently misunderstood by the general media to dismiss the tragedy of this epidemic.

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