the diagnostic criteria and the dependence on behavior modification strategies
might lead one to believe that autism, PDD, and Aspberger’s have psychological
origins, there is overwhelming evidence for physiologic causes. One study showed stunted branches in the
nerve cells of an area of the brain called the hippocampus. Many of the children have enlarged craniums
(skulls) and there may be a correlation to a certain gene mutations (Apo E4,
Glutathione, etc). It is unlikely there
is a single causative abnormality.
Rather there are multiple factors that all ultimately cause
neurotoxicity with a common clinical outcome:
- Oxidative Stress
- Methylation and/or
- Toxic Metal poisoning
- Immune System
Inflammation and/or infection
now my suggestions are 1) optimize physiologic processes; 2) promote
detoxification; 3) modify and strengthen appropriate behaviors; and 4) be
diligent in searching for possible underlying causes. www.thriiive.com
is an excellent resource.
and/or Exacerbating factors that lead to ASD through the above mechanisms
q DIETARY FACTORS: Food additives, impaired simple carbohydrate
(glucose) metabolism, and food allergies/sensitivities. The most common intolerances are
gluten-containing grains (Wheat (durum, semolina, kamut, spelt), rye, barley, triticale,
etc) and casein (a milk protein).
Healing the intestines is a by-product of proper diet. Many parents are finding the Specific
Carbohydrate Diet an excellent guideline to heal the intestines, improve
behavior, and provide balanced nutrition.
INPUT IMPAIRMENT: Chronic fluid retention in the middle ear -
children with moderate to severe hearing loss tend to have impaired speech and
language development, lowered general intelligence scores and learning
difficulties. Visual abilities such as
integration, tracking, etc. play a significant role.
DEFICIENCIES: Almost any nutrient
deficiency can impair brain function. Iron
deficiency is the most common nutrient deficiency in American children and is
associated with marked reduction in attentiveness, less complex or purposeful,
narrower attention span, decreased persistence and decreased voluntary
activity. Correction of even subtle
nutritional variables exerts a substantial influence on learning and
behavior. Zinc and sulfur are also commonly
ELEMENT & CHEMICAL EXPOSURE:
There is a strong relationship between childhood learning disabilities and body
stores of heavy metals, particularly lead.
Copper toxicity with elevated ceruloplasmin levels has been considered
of possible significance since catecholamine-synthesizing enzymes are activated
by copper. Aluminum interferes with the
citric acid cycle (alpha-ketoglutarate) and thereby reduces energy production
from foods. This has been shown to
influence mood, energy levels. Antimony
interferes with monoamine oxidase and cholinesterase. Mercury is not uncommonly involved. Chemical
q CANDIDAL OVERGROWTH:
there is a substantial amount of clinical observations that support the
effect that byproducts of bowel candida and/or other fungi overgrowth have on
the nervous system and behavior. Gastrointestinal
health plays a key role in many chronic illnesses.
AMINO ACID METABOLISM: serotonin metabolism may be an avenue of
exploration based on the occasional response to SSRI's like Prozac. Experts estimate that 25-30% of children with
PDD have elevated serotonin blood levels and low brain levels. The source is thought to be from an inflamed
GI tract, food reactivities, and/or malabsorption. The effects could be manifested as light,
sound, and external stimuli hypersensitivity.
The metabolism of sulfur amino acids are often abnormal with low levels
of cystine and cystathione which in turn could reduce the body's ability to
perform Phase II detoxication and allow toxic by-products to accumulate in the
brain. Methylation plays an important
role in brain function and is an area that shows promise in developmental and
DYSREGULATION: It is not uncommon for the onset of autism to occur after a
viral episode or an immunization. There
is ongoing work that suggests the abnormal response to measles and rubella vaccination
(part of MMR) plays a role. Synergistic
toxicity of the mercury preservative may occur in certain children, which
explains why the reaction does not occur in all children.
FATTY ACID METABOLISM: Data suggests
very long chain fatty acids (VLCFA) are
disproportionately elevated in many children with autism and indicate a
deficiency in peroxisomal b-oxidation. This in turn
leads causes an accumulation of VLCFA, which is toxic
to the nervous system. In my experience,
supplying the essential fatty acids (omega-3 and omega-6) in the right
proportions provides some of the most satisfying responses.
q Food Sensitivities - There are many ways to try to assess food
hypersensitivity. Each has
limitations. Allergy skin tests are
rapid, inexpensive, accurate, and can be helpful when positive but do not
include non-IgE mediated immune reactions to foods or other ingested
agents. Blood tests include RASTs and
ELISA methods to detect allergies caused by IgE or IgG antibodies. Drawing blood is required, they can be
expensive, and are considered controversial in terms of their significance but
have the advantage of having a wider array of foods available than skin
tests. There is evidence IgG type blood
tests only indicate recent or recurrent intake rather than allergic or
hypersensitivity reactions. Other
immunologic tests include the ELISA/ACT that reportedly reveals other type of
immune reactions including those due to IgA, IgM, Immune Complexes, and/or T
cells. The test is expensive and
specific. None of the above procedures
identifies foods/items causing metabolic reactions that have no immune
basis. Muscle tests or other Applied
Kinesiology techniques can be of help but are dependent on the skill of the
tester and are considered invalid by most medical doctors. Electromagnetic and resistance type equipment
uses a similar basis for finding intolerances and remains dependent on the
skill of the tester, the device being used, and is controversial. A diet diary with food avoidance of
“high-risk” foods or by use of defined rotational diets often provides the most
convincing information. Even if the lab tests are negative, your child may
still have reactions to a particular food - the reactions may not even involve
the immune system directly. For this
reason, gluten and casein are always suspect because of their metabolic effects
in addition to any immune reactions they may trigger. 100%
avoidance and monitoring is the only way to be certain of food's effect on
Input Impairment - audiometry and
tympanometry are simple, inexpensive, and readily available. More sophisticated testing with neural
mapping of hearing and visual input may also be worthwhile. Functional vision problems should be
evaluated by a Developmental Optometrist as vision is more than simply having
20/20 eyesight. Visual processing is a
complex process involving over 20 visual abilities and more than 65% of all the
pathways to the brain. Nearly 80% of
what a child perceives, comprehends and remembers depends on the efficiency of
the visual system.
Deficiency - can be detected by a few
symptoms such as peculiar food intake habits and a few physical findings
suggestive of mineral imbalances. Common
laboratory tests of the blood, urine, and hair can also give insight into the
nutritional needs and metabolic status of the individual.
q Heavy metal
evaluation - Hair analyses are a
simple and inexpensive screening tool for heavy metals. When collected properly, hair samples give a
reliable indication of heavy metal burdens.
A urinary provocation challenge is a more sensitive test and involves a timed
6 hour urine collection after giving a chelating agent such as DMSA or NDF Plus
Drops that chelates heavy metals into the urine.
q Immunologic Assessment - initially includes looking for deficiencies, abnormal
responses to immunizations, elevated viral antibodies or replication, and
evidence of yeast overgrowth.
q Structural Abnormalities - some children with autism have disorders detectable
through imaging studies. If there is any
suggestion of injury, seizure activity, etc. a full diagnostic evaluation
should be performed.
q Dietary Recommendations - for all children limiting simple processed
carbohydrates (sugar, candies, sweets, etc.) is required without
exception. Specific foods based on tests
or observation at home plays a critical role in nearly every case successfully
managed. Some fats should be avoided by
all children canola oil, hydrogenated vegetable oils, and margarine. Appropriate alternatives include extra virgin
olive oil, organic raw butter, and flax oil.
Aspartame (Nutrasweet®, Equal®) may be a neurotoxin and must be
avoided. Gluten and casein avoidance seems
critical for the vast majority and therefore is mandatory.
q Nutritional Supplementation - A U.S.D.A.’s report on the vitamin and mineral
status of Americans eating a standard Western diet showed marked and widespread
nutrient deficits without overt signs of malnourishment or disease. Based on this data and many nutritional evaluations of
children with autism and other learning difficulties, specific and
individualized supplementation is always required. Zinc, sulfur, fatty acids, neurotransmitters,
and methylation are common areas that warrant specific attention.
q Detoxication - of heavy metals or organic toxins may provide
dramatic improvement. This is my opinion
provides the most consistent benefit of any intervention we offer. Reducing Candida or bowel bacterial overgrowth
also helps. Glutathione, both a nutrient
and a detoxification agent, is often associated with remarkable improvements. Unfortunately, intravenous glutathione is
much more effective than any other form (oral, inhaled, and transdermal) we
q Behavioral Interventions - although autism is not a behavioral problem,
programs involving discrete trials and sensory input benefits many autistic
children and can be an adjunct to other biological therapies.
ABA, MAPPS, etc. are often very helpful.
q Neuronal Pathway Stimulation - stimulation of the nerve cells may be accomplished
by fibroblast growth factor (FGF), neural trophic products, certain
phosphatides, and perhaps masking (which I do not recommend).
q Oxygen Therapies – hyperbaric, cyclic variation in altitude/pressure,
activated oxygen, alkalinization, ionized oxygen.