Comprehensive Treatment for ASD Children: A Logical Approach

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Our Approach

Importance of Labs and Nutritional Evaluation

So, where do we start? I would like to first emphasize the importance of laboratory testing to assess your child’s individual, biomedical needs. My approach to treatment begins with addressing biomedical needs to restore gut health, nutritional deficiencies, mitochondrial function, immune regulation, detoxification pathways, and rehabilitate neurological activation. Once lab results are received, many answers to your child’s autistic symptoms will be brought to light. For example, does your child exhibit symptoms, such as constipation, bloating, abnormal stools, sleep difficulties, and/or emotional problems? These symptoms may be associated with bacterial dysbiosis, indicated by an elevated DHPPA biomarker, or leaky gut, which is indicated by an elevated 1-methylhistidine biomarker. Laboratory results help us create effective treatment plans; they are equally important to evaluate efficacy of treatment.

Mitochondrial dysfunction has been identified as playing a role in ASD [Cassels, 2008]. Richard E. Frye, M.D., Ph.D. of University of Texas Health Science Center has done great work illustrating how mitochondrial dysfunction, caused by environmental toxins and / or genetic defects, can lead to the production of free radicals, which cause oxidative stress, inflammation, and eventually cell damage and cell death. Many Defeat Autism Now doctors, including myself, often use the following supplements to support mitochondrial function:

Moderate protein intake as it is metabolically expensive to get rid of ammonia. Add Yucca with protein meals for help with ammonia [Filipek, 2004]

Biomarkers used to evaluate cellular energy and mitochondrial function include, but are not limited to the following:

If your child has abnormalities in these markers, it is possible he/she may have less than optimal mitochondrial function or an oxidative phosphorylation disorder. Oxidative phosphorylation disorders have been identified with developmental regression and mitochondrial dysfunction [Poling, 2004].

Oxidative stress is a huge problem in many children on the autism spectrum, as well as for those suffering with ADHD [Patel, 2007]. If your child has any of the following abnormal biomarkers, he/she may have elevated oxidative stress:

Laboratory markers are very useful not only for creating treatment plans but to monitor them as well.

Dietary Intervention

Choosing an appropriate foundational diet can be a daunting task, and changing a child’s diet can be a formidable obstacle. With this being said, it’s important to make sure the diet you choose is going to be worth the hassle and expense needed to implement it. IgG/IgE testing can be very beneficial in detecting foods and environmental allergens/intolerances that may be causing inflammation and immune dysfunction. The gluten-free, casein-free diet (GF/CF) has been one of the most successful treatment options, noted by the Autism Research Institute with a 69% favorable response out of 3,593 children. A simple urine test can check to see if your child has elevated peptides to gluten and casein. The results of this test can help determine if your child would benefit from a GF/CF diet. Often, parents are not aware their child may be lacking adequate nutritional intake, due to multiple food allergies/intolerances [Compart, 2006]. Our nutritionist, Laura Kopec, MA, CNC, helps parents by creating nutritionally balanced meal plans, designed to meet your child’s daily nutritional needs, while avoiding the dietary constraints and minimizing exposure to oxalates, yeast, and any other problematic substances.

Identifying Appropriate Supplementation

I am always amazed to see parents come in with a list of supplements, pages long, with little rhyme or reason for taking many of them, other than the fact they heard one supplement or another had helped someone else’s child. This line of thinking can be ineffective as well as costly. For instance, bacterial dysbiosis may be caused by a deficiency in beneficial flora (probiotics), pathogenic bacterial overgrowth (pseudomonas), yeast overgrowth, or any combination of these three. Many parents know that probiotic supplementation is beneficial in treating bacterial dysbiosis. However, to effectively treat this condition, we must supplement with the appropriate strains of probiotics to restore the deficiencies, as indicated by your child’s comprehensive stool analysis (CSA). We must also give the antibacterial and/or antifungal, most-effective in treating your child’s pathogenic bacteria and/or yeast overgrowth, as indicated by the sensitivity report in the CSA. In summation, addressing your child’s specific biomedical deficiencies will determine not only what supplements to give your child, but also what dosages are needed for those supplements to be effective. Treating children with this kind of biomedical efficiency will increase your child’s chances of normalizing their autistic symptoms.

Integrating Active Therapy/Functional Neurology

Active therapies, such as OT/PT/Speech, are pursued once your child’s biomedical needs are identified and are being addressed. Recent neuro-imaging research (fMRI & SPECT) has indicated many common neurological deficiencies in ASD children. Cerebellar and frontal lobe activation deficiencies have been identified in children on the autism spectrum [Ashley, 2010]. These deficiencies can lead to balance & coordination problems (ataxia), motor-planning deficiencies (dyspraxia), sensory processing problems, and so on. Abnormalities in the cerebellum affect motor, sensory, language, cognitive and attention function, as well as cortical development [Kranowitz, 2005].

Functional neurological testing can help us identify the previously mentioned deficiencies and allow us to create a rehabilitation plan to help restore appropriate neurological activation. Children on the autism spectrum have down-regulated parasympathetic function and increased sympathetic tone [Ming, 2006]. Utilizing functional chiropractic neurology methods, supplementation, as well as active therapies, we focus on suppressing the sympathetic (fight or flight) nervous system and activating the parasympathetic (calming) nervous system. This can help children with hyperactivity, attention problems, and anxiety. Cerebellar dysfunction has been implicated as a common factor in autistic children and has been addressed multiple times in the medical literature [Harada, 1998]. Children with cerebellar dysfunction will present with balance and coordination deficiencies (ataxia) [Schmahmann, 2004]. The cerebellar contribution to cognition is one of modulation rather than generation. Disorders of thought and emotion are clinical manifestations of cerebellar deficits in the cognitive domain. The cerebellum performs the same computations for associative and paralimbic functions as it does for the sensorimotor system. Consider this the balance, tone, coordination and equilibrium of our emotions/personality [Schmahmann, 2004]. This research makes the connection between balance and coordination problems, and learning, behavior, and emotional or mood disorders.

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