Posts Tagged ‘autism puzzle’

Autism Treatments – Natural or Artificial ?

Sunday, July 6th, 2014

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

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

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

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

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

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

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

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

A PANDAS STORY

Sunday, June 29th, 2014

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Ten Things All Pediatricians Should Know About Autism

Saturday, June 21st, 2014

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

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

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

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

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

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

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

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

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

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

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

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

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

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

The Effects of Soy on Patients with Autism?

Sunday, June 8th, 2014

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

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

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

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

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

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

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

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

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

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

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

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

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

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

It’s Not the Asperger’s Syndrome

Sunday, June 1st, 2014

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

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

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

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

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

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

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

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

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

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

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

Miracle Mineral Solution Treatment for Autism

Saturday, May 24th, 2014

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

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

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

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

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

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

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

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

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

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

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

International Meeting for Autism Research 2014

Sunday, May 18th, 2014

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

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

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

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

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

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

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

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

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

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

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

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

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

You can access the research abstracts here.

Autism Wars II: The Wakefield Effect

Tuesday, May 13th, 2014

This month, Pediatrics published a paper indicating that there was, in fact, a “greater prevalence of GI symptoms among children with ASD compared with control children.” 
OK, so far.
Not really groundbreaking information, but it did appear in a mainstream, well-respected, scientific journal.

Somehow, the authors felt compelled to include an opinion that the medical profession has been delayed in studying this gut-autism association. The Discussion section includes, “Previous controversy surrounding the MMR vaccine and proposed causal link between ASD and infection of the GI tract probably deterred investigators from dedicating resources to examine GI functioning in this population while fostering uncertainty in the ASD community regarding the validity of this line of inquiry.
Not OK.
Investigators are not prevented from pursuing certain lines of thinking. In fact, there are several follow-up studies challenging the original postulation. That’s science, right?

Shortly thereafter, Forbes autism blogger, Emily Willingham, followed with a piece actually naming the culprit. She tattled that it was the nefarious Dr. Andrew Wakefield. He is the British pediatric-surgeon-gastroenterologist-fallen-from-grace who has been accused of concocting the measles-vaccine-autism association in order to gain riches and international fame. Thanks, Em, otherwise we wouldn’t have known who they meant.
Really not OK.
The science writer penned another less-than-illuminating piece. She posited her somewhat unconventional point of view that anxiety is the cause of many G-I disturbances, rather than the other way ’round. What has that got to do with “Blame Wakefield For Missed Autism-Gut Connection”? Has that delayed ‘Dr.’ W’s research, as well?

Yikes.
Can we get some facts straight here?

Fact: The title of the original article in question was, Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children.
It began as a series of case reports, which has been totally blown out of proportion. Some of the patients had an autism diagnosis, assigned by other specialists.

Fact: The conclusion of that paper, We have identified a chronic enterocolitis in children that may be related to neuropsychiatric dysfunction. In most cases, onset of symptoms was after measles, mumps, and rubella immunisation. Further investigations are needed to examine this syndrome and its possible relation to this vaccine.”
Does that sound like science or sedition?

Fact: Dr. Leo Kanner, father of modern child psychiatry and inventor of the “autism” classification in the 1940′s, first reported on 11 patients, 8 of whom had G-I signs and symptoms. He called the problem a psychiatric disorder. That delayed correct diagnosis and treatment for about 50 years (and continues to slow the process because of the ASD inclusion in the Diagnostic and Statistical Manual of Mental Disorders).
Anyone angry about that?

Fact: Bruno Bettelheim helped prolong the ‘Refrigerator mom’ theory throughout the 60′s and beyond.
With a thick Austrian accent and faked credentials, he appeared on talk shows and became famous with that stupidity, not infamous.

The Wakefield Effect
Why is there such an emotional connection with this condition? It’s the Wakefield Effect. Because of this debacle, anything having to do with autism that is not sanctioned by the mainstream is considered an aberration; including special diets, yeast in the G-I system, vitamins, and toxins in the environment. Regarding certain establishment fixtures, such as vaccination, anyone who pursues a course of action other than the teachings of the Church (Big Pharma+ Conventional Medicine) is to be expelled from the religion and sent packing to other ports of call. With the availability of the Internet and Social Media, innuendo turns into truth.

I have met Dr. W and heard him speak several times. He is good-looking, articulate, charismatic, and tells a compelling tale. He probably could have continued his research, and even received funding, if he had followed his original work with more humility and sense of uncertainty. If this was a hoax or part of some grander plan, it has certainly failed as he (and his work) falls into obscurity.

Rather than discuss biology, genetics, objective research strategies and prospective trials that could assure safety and effectiveness, the public is fed dogma and discord. The wrong line of reasoning is being followed and now appears in more diverse venues, including popular, financial and even scientific publications.

Perhaps it is less interesting and more complicated, but the best antidote to the Wakefield Effect is for medicine to drop this non-issue and move on. The media wants controversy, but parents want answers.

A Mother’s Intuition About Autism

Saturday, May 10th, 2014
Mother's Day 2014

Mother’s Day 2014

Every new patient at The Child Development Center has a unique history and physical presentation. Often, however, the children share the experience that their mother:
a. Already knew, or highly suspected, ASD, and
b. Heard the doctors proclaim that they were “reluctant to make a diagnosis, at this time, because the child is so young.”

Is there any other serious medical condition that carries this ‘wait and see’ attitude? “It’s probably not cancer, so let’s wait a few months and see what grows.” “The eardrum looks red and is bulging, if the fever gets any higher we will consider antibiotics.” “I hear wheezing, call us in a day or two.” And vaccinations? The first one is foisted upon newborns, with many more to follow, in order to prevent disease.

Study after study documents important gains that come from early intervention for developmental delays. Despite that, there are neurologists and psychiatrists who continue to claim that “You can’t make the autism diagnosis before the age of 2 or 3.” That imposes a waiting period, postponing intervention at the most critical juncture of development.

In order to assign an accurate diagnosis, both the DSM IV, and the present iteration of the Diagnostic and Statistical Manual of Mental Disorders 5.0, contain the stipulation that delays should be noted in early childhood. The previous manual stated, “Delays or abnormal functioning… with onset prior to age 3 years… ” The present DSM 5.0 describes, “Symptoms must be present in the early developmental period (but may not become fully manifest until social demands exceed limited capacities, or may be masked by learned strategies in later life).” There is no mention of a waiting period.

Yet, in the midst of this epidemic, and with all of the press coverage about the rise in autism, mother is usually the one who makes the diagnosis. Is it any wonder that the parents go to the Internet to get their information or seek alternative treatments when the doctors weren’t even willing to assign a diagnosis, let alone suggest any therapy?

At our Clinic, there are now many younger siblings of children who carry a ‘Spectrum’ diagnosis. Some demonstrate developmental red flags. A 2 year-old male who doesn’t speak and walks on hs toes but shows good eye contact. A 1 year-old female who turns to her name, but doesn’t stand or vocalize. A six month-old boy who suffers from GERD, eczema and chronic diarrhea.

The youngsters were all high-risk and the mom couldn’t sleep, worrying about the future. What is wrong with offering immediate action targeted to specific symptoms? The youngest children can use a probiotic, stop using PPIs and stay away from antibiotics. The older ones need speech and language, OT, ABA and/or PT. STAT.

These are real examples of some brothers and sisters who have gone on to neuro-typical development. Did earlier intervention prevent autism? Bottom line – who cares?

Try this analogy: It is the Middle Ages and The Plague has struck several neighboring cities. The first sign is a flu-like illness that rapidly advances, ending in death. So, when a local sufferer visits the doctor because of a runny nose and sore throat, the physician should be thinking “The Black Death,” not a cold.

Twentieth century poet Helen Steiner Rice wrote, “A mother’s love is patient and forgiving when all others are forsaking, it never fails or falters, even though the heart is breaking.”  When Mom thinks that something is wrong and the doctor dismisses it, saying “It will probably will go away,” families should run, not walk, to a professional who will listen.

Happy Mother’s Day
f
rom Dr. Udell
and the staff at the Child Development Center

Autism Un-Awareness

Saturday, April 12th, 2014

March 27-March 29, 2014. The MedMaps.org meeting of Special Needs Pediatricians in California.

Friday, March 28, 2014. The CDC announcement that “about 1 in 68 children has been identified with autism spectrum disorder (ASD)…”

Wednesday, April 2, 2014. Autism Awareness Day (and Month).

Pretty much, such news should have set off a call to action, don’t you think? Yet, there seems to be very little traction. We’re already into the 3rd week of the month, and it doesn’t seem that publicized questions go beyond, “So, do you really think that there is more autism, or have we just changed the criteria?” And, as always, the vaccination issue… Or, nothing.

With deference to those with autism who are pleased with their life and lifestyle, what other childhood epidemic has gotten so little attention? In my youth, polio created summertime panic for our mothers and we were often kept indoors (and that was pre-ac, where I lived). In 1952, at its highest incidence, combined cases (paralytic and non-paralyzing) occurred in ~58,000 out of a population of 158 million people, with approximately 37 million susceptible youth. That was a risk of 1 per 2000 children.

Some may argue that, “Polio carried the risks of death or paralysis, this is just autism.” “Just autism,” is not a term that I have heard any parent express. Ergo, we need to erase Autism Un-Awareness.

Knowledge and experience will get us beyond this rhetoric. The first part is expanding daily. The associations between autism and inflammation, G-I heath, environmental toxins and genetic susceptibility continue to be re-confirmed in the conventional scientific literature.

Parents now request much more information about pre-pregnancy and maternal health. Families bring younger and younger children for evaluation. Developmental delays that were previously considered as ‘minor,’ or ‘normal’ may get evaluated and addressed. Sadly, the pediatric community continues to follow a more traditional course in the diagnosis and treatment of this epidemic. Children, nowadays, don’t appear to simply ‘outgrow’ slow language development in the presence of some repetitive or unusual movements. Medical evaluation and intervention does not appear to be consistent with their version.

With so few practitioners willing to learn about and tackle this condition in an aggressive and non-traditional manner, experience is evolving at a slower-than-expected pace. Technological tools, such as relational databases, can play a significant role as conventional medicine catches up with the explosion of cases in such a disparate group of patients and practitioners. Autism360.org is a great example. (Thank you, Dr. Baker)

I’m not quite certain what percentage increase it will take to sway the general population that we have a real problem on our hands. Maybe it won’t be a percentage at all. President Roosevelt’s story warned a previous generation about polio. In 1963, the plight of President Kennedy’s premie spurred the development of NICUs with trained specialists to solve the problems of prematurity, while preserving healthy development. It took Magic Johnson to get the public riled up about HIV and the risk to the entire community. Angelina Jolie exposed the BRCA gene, etc.

Real autism awareness will come when we stop asking the old questions and start considering the condition(s), as it (they) is (are). Autism was around and has been creeping up on us. What we call ASD is a new disorder in a new century. Speaking of polio, epidemics were virtually unknown in the US until the 20th century.

New shit happens.

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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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