 |
|
Studies have shown that over 550,000 children in the United States have been diagnosed with Autism Spectrum Disorder. In 1997, "Pedriatric News", a conventional pediatric magazine mailed monthly to primary care pediatricians stated that there was a 100% increase in the diagnosis of Autism from 1990 to 1995. As of 1997, the significant increase was attributed to physicians being more aware of making the proper diagnosis. "AMA News" reported that the diagnosis of Autism, ADHD and Learning Disorders had increased 20% over the previous eleven years. The California Department of Scientists reported that in the last eleven years, there was a 273% increase in the diagnosis of Autism and close to a 2000% increase in the diagnosis of ADHD, Learning Disorders and Autism. It is now becoming quite obvious even to medical experts that the rate of Autism has dramatically escalated in the 1990s. It is my opinion that there are two subsets of Autism. The first, which would not account for a dramatic increase, is children who are destined to have Autism at birth, a "metabolic/genetic problem." To account for the dramatic increase in the diagnosis of Autism, a significant number of children appear to have Autism caused by an immune system stressor. Environmental pollution, (especially pesticides), immunization reactions, diet (especially starting cow's milk at approximately one year of age), frequent use of antibiotics to treat Otitis Media during the 1-1/2 years of life appear to be significant risk factors. In general, children with the "genetic/metabolic type" who have delayed development before 12 months have a more ominous prognosis. In contrast, children with the later onset, who are noted to have normal development followed by regression of speech, cognitive skills, and social skills after one year of age often have a much better prognosis. In general, the earlier the diagnosis is made with medical intervention, the better the prognosis. A common medical history is a child with an increase in ear infections requiring multiple courses of antibiotics who has been started on cow's milk by one year of age. There is often a positive allergy history with multiple complaints--eye, ear, nose and respiratory allergy, gastrointestinal complaints (abdominal pain, limited appetite), increased food cravings (especially milk, wheat, and sugar), urinary symptoms (frequency), muscle and joint pain, and of most significance the central nervous system. Often there is a regression in speech, cognitive and social skills. Children with this profile usually by 18-30 months of age receive a diagnosis of Autism Spectrum Disorder. In recent years a growing number of parents point at the MMR vaccine as the root cause of Autism. For at least the past 10-15 years young children have been receiving many combined vaccines before age two. This includes 3 Hepatitis B, 4 DPT, 4 Polio, 3 HIB, Chickenpox and the MMR vaccines by age two. By the time the MMR is given at approximate 15 months, most children have already received at least 10 immunizations. Perhaps a child's immune system is not ready at 15 months of age. Most, if not all, autistic children have sensory integration issues with hypersensitivity to sound, touch, taste, pain and/or a vestibular proprioceptive component. These children are also susceptible to environmental chemical insult, especially pesticides and food preservatives. I have yet to see a child with Autism Spectrum Disorder who did not have sensory modulation issues. The most prominent is sensitivity to sound as many children with Autism hold their ears. One should look for Auditory Processing Disorder as a primary component in the diagnosis of Autism Spectrum Disorder. Dysbiosis/Leaky Gut Syndrome
Casein/Gluten-free diet Other children respond to limiting sugar, milk products, baked goods, junk food, craved food, preservatives, and artificial flavorings. Supplements to consider include B6, magnesium, calcium, DMG, Super Nuthera, Amino Acids, Antioxidants (Beta Carotene, Vitamins C and E, Selenium), Phosphatidyl Serine, Piracetam, Digestive Enzymes, L-Glutathione, CoQ10, Ginkgo, Essential Fatty Acids (especially Omega 3), Folic acid, Biotin, Inositol, B Vitamins (B6 as well as B1, 2, 3, 5, 12) and Vitamin D. An anti-candida program should include probiotics to control bacteria and yeast imbalance in the GI tract by competing with candida for sugar. This includes FOS (fructooligusaccharides) to promote the growth of good bacteria. A probiotic should contain Lactobacillus, Bifidus and FOS). Other supplements to control yeast include garlic, grapeseed extract, caprylic acid, Pau D'Arco tea, Olive Leaf Extract, Oil of Oregano, MCT oil and Candicin. Regarding antifungal medications to control yeast, Nystatin should be considered first since this medication is nontoxic, stays in the gut, is not absorbed in the blood and does not adversely affect the liver. Unfortunately, over the past ten years there has been an increase in candida resistant strains to Nystatin. Of Diflucan, Nizoral, Sporanox and Lamisil, I personally prefer Diflucan at a dosage of approximately three milligrams per kilogram. If this medication is used three months or longer, liver function tests must be checked to be certain Diflucan is not adversely affecting the liver. Nizoral, Sporanox, Lamisil would also require liver function tests every three months. Therapies: Speech therapy, occupational therapy and approximate school placement remain priorities. Other medical approaches to consider include:
Medications:
Lab tests to consider include the following:
Books:
Secretin
As of 1998 of approximately 250 children were treated with secretin. By October over 3,000 children with a diagnosis of Autism Spectrum Disorder have been treated with IV Secretin. The function of secretin is to neutralize gastric acid. With an acid ph from the stomach, secretin is released from the small intestine. Digestive enzymes are normally secreted by the pancreas to digest food from the stomach to the small intestine. By the fall of 1998, a number of children were reported to have improved language and social skills. Theories at that time included decreased production of Secretin, ineffective secretin and a direct effect of secretin on the brain. By the fall of 1998, IV secretion's adverse reactions were very few and far between. Primarily, hyperactivity, insomnia and temporarily flush of the chest were reported. Dr. Andrew Wakefield, a researcher from United Kingdom, who has specialized in Crohn's and Colitis reported 55 out of 57 gut biopsies revealed +measles vaccine in children with Autism. Dr. Wakefield's study confirms parents' observations that Autism frequently develops after the MMR vaccine. As of the fall of 1998, improvement with secretin reported included the following:
Patient Histories #1. Marshall. This is a four year old male with normal speech--by age two, there was concern with language with no expressive language. This was followed by a steady decline of behavior with increased squealing, temper tantrums, hyperactivity, erratic sleep, and decreased participation in school. From 1/98 to 2/98 negative lab tests including Fragile X, hearing test and MRI were all normal. This child was seen by me in my office 4/98 with a history of decreased attention span, aggressive behavior, sensitivity to sound, sleep disorder, perennial nasal stuffiness (increased during pollen season), allergic shiners since infancy and asthma. Physical exam revealed nasal turbinates +3 and allergic shiners. Marshall was treated with sublingual immunotherapy for his food allergies. One month later, mood and attention span were markedly improved with almost no squealing. At that time urine organic acid showed a yeast overgrowth and an extremely high Arabinose level of 3,267 (normal range 0-115). Comprehensive digestive stool analysis showed yeast and lactobacillus. This child was started on Super Nuthera and the Feingold diet as of 5/98. In 6/98, Nystatin, a casein/gluten free diet, and digestive enzymes were started. In 8/98, Marshall came back to my office and allergy tested for inhalants and molds and received his first IV Secretin from Dr. Karoly Horvath at the University of Maryland. Prior to Secretin--allergies, attention span, and behavior had all markedly improved with no ritualistic behavior. However, there was also no expressive language. Two days after receiving IV Secretin at the University of Maryland, Marshall counted his family members one-two-three. 2-1/2 weeks later, he was saying 10-15 words with 4 short phrases counting 0-5, was interested in potty training, had normal bowel movements and improved socialization, better participation in school and sleeping improved. At that time, repeat organic acids showed Arabinose decreased to 153. Shortly thereafter, the parents realized that their 4-1/2 year old was developmentally entering the terrible twos. His parents thought the allergy immunotherapy and dietary changes had improved behavior and a significant decrease in hyperactivity and squealing. However, it took the IV secretin to help his speech. #2 K.A. is an 11-year old female with severe Autism with marked delays in language and coordination; her history includes an increase of ear infections up to her first 18 months. PE tubes at 18 months did help. K.A.'s development arrested at 18 months and by age 3, she was diagnosed with Autism. At age 9, she was thought to have the expressive language of a 2-year old and receptive language at age 5. Sensory issues included smelling foods, proprioceptive issues and sensitivity to light. Rituals included opening and closing windows, lining items up and stereotypic behaviors such as finger flicking. K.A. also had a severe sleep disorder and extremely difficult behavior. Prior to giving Secretin, I thought this child would require sedation. She was quite difficult at the initial visit. After giving the Secretin without sedation, two weeks later, I was in tears hearing from her mother the tremendous improvement she had made. Specifically, there was more interaction and an increase in pretend play the first day and in her mother's words, "She was dressing up every night, posing and smiling for the camera." Spontaneous language was improved. She was sleeping well for the first time in three years, wearing high heels called "cinderella shoes" and was very interested for the first time in the dog living next door. By the third secretin infusion, she was on a casein/gluten free diet and had started Diflucan. Her behavior, language and sleep were all markedly improved. By the end of the third infusion, she was playing ball with her family and setting up bases for baseball games. By May 1999, K.A. was rollerblading and throwing a ball. When upset, she had real tears. She even appeared to be aware that she was different from other children and was frustrated by this. #3 MB, a 5-year old seen on July 1998, had a history of frequent sinus and ear infections, obvious allergies involving multiple nasal symptoms, allergic shiners, asthma, and loose bowel movements. This child was developing beautifully until 15-18 months when after receiving the MMR, he developed temper tantrums, hyperactivity, spinning around in circles and he wouldn't play with toys. By age 3, these problems intensified. During allergy testing, this child showed bizarre behavior while testing molds. One year later, I have been informed by his parents that the Autism label has been removed, and he now appears to be out of the Autism Spectrum. MB appears to have had an immunization injury with a significant allergic history and is responding to diet restriction, well controlled allergies, appropriate supplementation program and IV Secretin. #4 Johnny is a child just over 2 years of age. This child at 11 months of age, within a one (1) month period, sat up, crawled, and walked. This happened while away from his home. There was concern that the house might be a problem. History included frequent ear infections, history of Croup as an infant, reactive airways that responded to Albuterol Nebulization, increased nasal allergies (including itching, drainage, sneezing and stuffiness) rubbing his ears a lot, eczema at birth with persistent allergic eczema in the elbow creases and behind the knees, and chronic loose bowel movements. Of particular interest is this child's 20+ year-old paternal uncle who has also been diagnosed with Autism and has a very similar history of allergies and infections. During allergy testing for molds, this beautiful 2-year old started "stimming" and doing bizarre things. We were able to find the right dilution for several molds and started sublingual immunotherapy. A casein/gluten free diet, appropriate mold immunotherapy, and IV Secretin is turning this child around. It turns out that the home that was built in 1983, had water in the basement for 2 years and in the area that little Johnny slept over, the free-standing water was below Johnny's bedroom. By July 1999, little Johnny's eye contact had improved, he was more affectionate, bowel movements had improved and he was sleeping better. I have yet to see a more clearcut allergy-induced developmental problem. PROGRESS REPORT As of May 1999, after treating 100 children with IV secretin, it was obvious that the key word to describe the improvements seen was increased spontaneity. Specifically children with Autism Spectrum Disorder shared problems with delays in socialization, cognitive and language but other than that, the complete history was required to recommend the best approach for each child. Based on the medical history, I attempt to find the underlying reason for each child's diagnosis of Autism Spectrum Disorder. These include (1) genetic (2) increased allergies, ear infections and subsequent yeast problems (3) chronic diarrhea which often occurs in the allergy/ immune system dysfunction group but can occur in other subsets (4) immunization injuries leading to a hyperimmune system and (5) brain injury with impaired myelin function (this group is more likely to have a seizure disorder). Treatment of children with autism should include based on the underlying cause:
As of January 1999, Dr. Bernard Rimland, Director of The Autism Research Institute, printed on the Internet that the IV secretin had "the most dramatic impact on children with autism than anything else and possibly everything put together but the answer is actually more confusing." Dr. Rimland also reported that he was unable to predict who would improve--low versus high function, diarrhea vs. normal bowel function, early vs. late onset, boys vs. girls, younger vs. older. The anticipated predictors have not proven valid but he did state 75% of the children had shown benefits from secretin. My assessment--
I personally prefer to give three infusions of IV Secretin over a six month period; then establish for each child what is the best approach with this medication. Some children are treated as often as every five weeks and some every few months. This depends on each child's specific medical progress. Regarding dosage, I usually start with two units per kilogram. October 1999 Medical Progress Controversies 1. Transdermal Secretin which has been advocated by Victoria Beck with the use of DMSO is certainly controversial. The concern that I have is impurities entering a child's body since DMSO is a very strong solvent and hasn't been studied in humans. FDA is very opposed to the use of DMSO in humans. Even if I thought that the DMSO would help, I cannot prescribe it for fear of losing my medical license. On the other hand, Ms. Beck's opinion is highly valued. It makes sense that receiving secretin on a daily basis, it may prove to be more helpful than the IV approach. I have used sublingual secretin successfully for several children after establishing the benefits and risks of IV Secretin. Some of the children I have treated have benefitted from this sublingual approach when used on a day to day basis. Transdermal Secretin is available in a number forms including a gel which can be prepared by a compounding pharmacy. The sublingual treatment is available in my office but is recommended on a patient by patient basis. 2. Secretin antibodies. Critics opposed to giving children secretin pointed out in 1998 a concern with secretin antibodies. This was a theoretical concern. Noting critics taking this stand, I have been ordering Secretin antibodies and mailing a blood sample to the University of Maryland where Dr. Horvath is conducting a study on Secretin antibody levels. To my consternation, since June 1999, a number of children I treated have developed borderline or elevated antibodies. However 10 of 11 who have had repeat antibodies have actually have lower levels after subsequent secretin infusions. After talking to Dr. Horvath on the phone and having the IV Gaspretin evaluated by him, I am still left with no specific answers. What I am now doing, is drawing baseline Secretin antibodies before giving any child IV Secretin. Then if the levels are borderline or elevated, I am checking them before giving Secretin at each follow up visit. 3. Digestive enzymes is another controversy. Dr. Horvath is opposed. On the other hand, a number of physicians advocate the use of digestive enzymes. In view of the gut/brain connection, I personally believe using digestive enzymes makes sense. Again, this is individualized on a patient by patient basis. 4. Sources of Secretin. IV Secretin is available from Ferring Lab, but remains in low supply. This was the original form used for the pork base. Unfortunately, Ferring Secretin costs over $200/75 units and often is unavailable. I switched to Gaspretin by March 1999 which we are obtaining from Japan. Although the manufacturer is in Japan, the pork source of Secretin is from Switzerland. I personally have found that the Gaspretin usually is just as effective as the Ferring Secretin and only costs $10.00 per 50 units. Several months ago, there was a study stating that the Ferring Secretin is four times stronger than the Japanese Secretin (Gaspretin and Secrepan). I find this very hard to believe. If I were to start children with Gaspretin at (8) units per kilogram instead of (2) units per kilogram, many children would have been hanging from chandeliers. I am sticking to the two (2) units per kilogram and gradually increasing up to as much as three (3) units per kilogram with Gaspretin if clinically indicated. Side effects. The primary side effects remain 1) hyperactivity and 2) insomnia. What is interesting is the number of children who before IV Secretin with significant hyperactivity and insomnia become calmer and sleep better. It is my opinion that for every child who becomes hyperactive and has insomnia, at least 2-4 are calmer and sleep better. Secretin may be an 3) immune suppressant as a number of children develop ear infections, etc. within (1-2) weeks of receiving IV Secretin. Antibiotics appear to negate the effects of IV Secretin. The 4) flush on the chest and 5) red lips does occur but is not a major concern. 6) Seizures--Two children have been reported to have Grand Mal seizures caused by IV Secretin. This was reported by Dr. Woody R. McGinnis on the FEAT Daily Online Newsletter on 10/27/99. I appreciate physicians who report side effects of a medical intervention to help parents determine what is best for their child. Another study reported in December 1999 included sixty (60) children with thirty (30) receiving placebo and thirty (30) receiving IV Secretin. This was a double-blind placebo-controlled study. However, researchers doing this study used human Secretin and only gave the treatment once in what appeared to be a rather low dosage. This group reported no difference between the placebo and the Secretin group. The point that I made on the Feat Network was that I was delighted double blind studies were initiated, but if you were to be doing a double blind study, why not set up the study based on the improvements noted by parents, teachers and physicians giving Secretin; that is, use the pork source which is, to date, the only form recommended for treatment. I would give it over three (3) times over six (6) months and use the therapeutic dosage--not just once in a less than therapeutic dosage. Other opinions: 1. Many of these children also have auditory processing problems. A number of children with primary sensory integration disorder/auditory processing disorder parallel the history of children with Autism but turn out in time not autistic. Again, a comprehensive history with followup is needed to determine each child's medical program. 2. Another opinion I have is that most of autistic children are not retarded. To this day, a majority of pediatricians, neurologists and developmental specialists believe that 75% of children with Autism Spectrum Disorder are retarded. I strongly disagree. 3. It is easier to see improvements in more impaired children with the use of IV Secretin. It just makes sense that children with chronic diarrhea, no language, severe behavior difficulties, and significant sleep problems are easier to track than a child who has language but lacks spontaneity in the use of language. Humor: Humor is very important in life, especially for the families dealing with a child with Autism. Two humorous anecdotes that occurred in my office over the past year include: 1) A 9-year old who not only had Autism but was very ritualistic with severe OCD, and had already become more verbal spontaneously with her first IV Secretin infusion. After the second one, I was amazed by the fact that she actually tried to cheat in the classroom by looking at someone's paper. Her dad stated that if it had been his older child, who did not have the Autism, he would have been very upset; but with this child who has Autism and OCD, he was delighted with this cheating episode. 2) A 12-year old who is nonverbal and on medication for Obsessive Compulsive Disorder, has become much calmer and happier after receiving IV Secretin. However, one day in the classroom, he was upset with the teacher and cursed her out on a word processor. Measured by the picture exchange method, this young man has an IQ of 150. It is my opinion that without this method of testing, this child would still be considered mentally retarded. Update October 1999 - IV Secretin
IV Secretin has been my first medical intervention that predated double-blind placebo-controlled studies (DBPC) to prove or disapprove the merits of a medical therapy. I know it has significantly helped at least 50% of the children I have treated. Several studies (all DBPC) already have stated that IV Secretin does not work. My conclusions are as follows: 1. If a researcher bases a study on a false premise, he will get a false answer. The studies to date have been destined for failure. If only the scientists had included clinicians who have seen positive results in the study design, I am certain these studies, designed properly, would be extolling the virtues of IV Secretin. 2. I have been wise to rely on the observations of parents to help me determine how best to treat each child who has Autism. Listening and learning is the key. For more information on Secretin or Autism, Contact Dr. Layton 1-888-337-2707. |
Autism Treatment Screening Survey
info@allergyconnection.com
Dr. Layton/Silesky Marketing