Autism Spectrum Disorders Cont.
There are often overlapping definitions for similar developmental conditions (e.g. Asperger’s Syndrome, PDD, and autism). Very often, even practitioners are uncertain which classification to use. Over the past twenty years, many sub-classifications for autistic-like behaviors have emerged because children did not fit neatly into the autism category. In the realm of clinical practice, we do not consider labels critical unless they add a dimension of usefulness to the actual act of helping the patient. It doesn’t matter what label you use: if you do not treat the underlying metabolic problems, behaviors will very likely not improve to an optimal level.
The good news is that autism is better understood now than it was many years ago when it was thought to be the result of a cold mother-child relationship. It is now known that there are many components to this problem—digestive, genetic, metabolic, environmental, biochemical and sensory—and that in some cases, with early and aggressive intervention, there can be a reversal of the condition.
Treatment must be approached from many angles. Our treatments address multiple factors that are known to have impact on behavior and learning. One of our earliest studies (1992) yielded the information that a healthy digestive tract and immune system and proper nutritional interventions coupled with sensory integration (visual, auditory, gross and fine motor) can cause a great improvement in reducing echolalia (repetitive parroting of what others say), increasing vocabulary, eye contact, and socially appropriate behaviors.
Among the factors which have been connected to autism (not necessarily cause and effect) are:
- Antibiotic Overuse
- Chemical Toxins
- Contaminated Immunizations-(Vaccination of immuno-incompetent individuals)
- Digestive System Dysfunction
- Endocrine System Dysfunction
- Food Allergies and Sensitivities
- Heavy metal toxicity
- Immune System Dysfunction
- Improper or Inadequate Brain Circulation (Hypoperfusion of Frontal Lobe)
- Inadequate Brain Development & Brain Injury
- Metabolic Dysfunction affecting Lipids, Amino Acids and Carbohydrates
- Nutritional Deficiencies Secondary to Poor Nutrition & Malabsorption
- Parasites, Pathogenic Bacteria, Pathogenic Fungus and Viruses
- Sensory Anomalies (usually hypersensitivity of hearing, smell, taste, and sensation accompanied by visual distortions)
- Structural and Autonomic Dysfunction
Since our earliest studies, we have added much to our body of knowledge. In order to properly assess each patient, we require a number of tests. We have listed below some of the steps we currently use in the assessment and treatment of autism and developmental disorders. Of course, the customized treatment plan can only be designed after a complete history and physical, meeting with the child’s parents, and metabolic testing.
Treatment Based on Your Own Metabolic Profile
There is wide variation among the spectrum disorder patients. Because no two patients are alike, it is important to have objective testing that measures the various metabolic variables essential for treatment. We create a personalized program based on the results of testing. The first three weeks of the program are designed to ease you into the changes that will eventually get you to your goal.
The foundation of our treatment is correcting digestive function, correcting nutrition/diet, administering heavy metal detoxification through chelation, and boosting the immune system through allergy therapy and proper nutrition. We also offer Auditory Enhancement Training (AET) to assist with your treatment. In addition, we highly recommend Applied Behavior Analysis therapy (ABA), visual correction via special lenses, and speech therapy. Although we do not offer these latter services at our offices, upon your first visit we will recommend providers that will meet the needs of your child.
What Tuned Us in to Digestive Function Testing?
In the late 1980’s Dr. Kotsanis became very ill. He had colitis-like symptoms and was losing weight; he was low on energy and unable to tolerate his normal diet. In addition to the fact that he was a board certified head and neck surgeon, he was also trained as an allergist. He was found to have numerous food and environmental allergies and sensitivities, which conventional methods could not address. Dr. Kotsanis was, however, not a conventional allergist. He subscribed to the otolaryngic and environmental allergy academies. His training included awareness of environmental toxins as well as nutritional treatments. As it turned out, this saved his life. The foundation of many of the treatments we used to help environmentally sensitive and food-sensitive patients centered on addressing their digestive malfunctioning.
The Importance of Digestion
Since 1992, when we began working with the digestive tracts of autistic individuals, it became obvious that there was a very close link between digestion and behavior. Dr. Kotsanis was among the first doctor to make this connection, and the protocol that he used in 1992 became the foundation of the DAN protocol, which resulted from a meeting in Grapevine, Texas in 1995. The link between behavior and digestion is not restricted to the condition of autism. Digestion and nutrition also affect other behavioral and health conditions (e.g. ADD, ADHD, hyperactivity, depression, allergies, chronic fatigue, cancer, and schizophrenia). The study yielded the information that behavior improved when digestive malfunctioning was addressed and proper nutrition was administered. Since those findings, new findings linking digestion to behavior have confirmed our work.
THE DIGESTIVE SYSTEM (Proper Digestion)
The Significance of Elimination
The body’s immune competence and general ability to function properly are directly tied to its ability to eliminate waste and toxins. Great attention must be given to correcting digestive function as a necessary step in treating autism, Asperger’s, ADD, ADHD, tics, Tourette’s, and other related disorders.
Autistic spectrum individuals have an impaired ability to eliminate wastes. This buildup eventually causes a cascade of other problems. Allergies are a symptom of excessive buildup (toxicity) and can also be made worse by “leaky gut,” which itself can be a symptom of excessive antibiotic use. Of course, the digestive system is a main elimination system and has in the past been investigated for its role in autism. While our center has been doing research in this area for over 18 years, we continue to implement innovative scientific techniques and incorporate the findings of others.
Some of the factors causing impaired elimination can include:
- Chemical & Other Environmental Toxicity
- Fungal Overgrowth
- Heavy Metal Toxicity
- Leaky Gut & Inflammation of Gut Mucosa
- Metabolic Abnormalities
- Overuse of Antibiotics
- Poor Diet and Nutrition Habits
- Prolonged Pervasive Inflammation
Comprehensive Digestive Stool Analysis (CDSA)
Disordered digestion is present in most cases of autism and developmental disorders. In our 1992 study, 92% of subjects had disordered digestive functioning. When the digestive malfunction in these subjects was treated, behavior improved. Changes that have been reported are:
- Better sleep patterns
- Better bowel habits
- More eye contact
- Better relationships
- Increased vocabulary
- Better attention
- Decreased fears
- Better problem solving
- More socially appropriate behaviors
Treatments of the digestive tract must be highly specific to the individual for optimal results. Toward that end, one of the most critical tests we do evaluates every facet of digestion, including enzymes, acidity, transit time, balance of normal flora, evaluation of abnormal organisms, parasitology, etc. All total, this test yields over 24 different measures of digestive efficiency.
The treatment derived from these values helps the child regain normal digestive functioning by healing the digestive tract; re-balancing gut ecology; cleansing any harmful fungus, bacteria or parasites; and then adding adequate nutrients. Once the digestive function has begun to be corrected, proper nutrition is introduced, and the process of healing begins. Regaining a normal digestive tract is the foundation of our treatment plan. Only then can nutrients be properly assimilated.
Parasites love your digestive tract. Parasitology deserves extra attention in the case of autistic and developmentally challenged individuals. While many people can appear to function normally while having parasites, there is an incremental improvement in behavior when parasites are cleansed in the developmentally compromised child. Parasites excrete their wastes into the children, who already have a compromised ability to eliminate their own waste. In some cases, parasite cleansing alone has produced stark results in improved behavior and health. When testing determines the existence of parasites, a sensitivity test helps identify what medication will successfully eradicate the pest.
Focused Nutritional Therapy
At the risk of stating the obvious, nutrition is critical—not just in the case of autistic individuals, but for everyone. Many researchers using a “shotgun approach” have tried numerous nutritional interventions that were successful some of the time. The problem with this general approach is that it is impossible to predict who will benefit. Our approach is more focused and highly specific to each child’s metabolic profile. We make nutritional recommendations that are derived directly from comprehensive testing and history.
Fatty Acid Assay
Since the brain and nervous system are composed of more than 60% fat, it is essential for the diet to contain the proper kinds and amounts of lipids, which will vary among individuals. Our center does a highly specific fatty acid test that evaluates different lipid and lipid metabolic values and ratios. The patient is directed to eat the proper fats based on the test results. Proper fats are necessary to keep the right permeability for cell membranes to allow food in and waste out.
Amino Acid Testing
The amino acid testing we do includes amino acid and metabolite values. As with the fatty acid test, we make adjustments in the diet to accommodate for imbalances. Here again, proper proteins in the diet are necessary in order to build healthy cells.
Heavy Metal Toxicity
In the medical literature heavy metal toxicity (especially lead, aluminum and mercury) has been linked to seizures, which are very prevalent in the autistic and developmentally compromised population. Even in instances where the child does not have seizures, the elimination of toxic metals has improved behavior. Metals are abundantly present in our world and can come from literally thousands of places (e.g. soda cans, deodorant, toothpaste, candy, cookware, air, water, paint, plumbing, etc.). Fortunately, there are a number of ways to accomplish the removal of these toxins. Dr. Kotsanis has over 18 years of experience using Chelation in both adults and children. There are a number of different chelating agents and methods. The method selected depends on which metals are being removed, issues regarding convenience, and the age and constitution of the patient.
Chemical Toxicity & Sensitivities
In our 1992 study, we verified the existence of chemicals, food additives, and food sensitivities in this population. Again, as with metal toxicity, there are numerous methods for chemical detoxification. Where the patient’s toxic chemical load is excessive, a series of massage and saunas may be prescribed. The patient’s excretory organs must be in good working order prior to beginning such a program. The best way to eliminate chemicals is through the skin by infra-red sauna.
IMMUNE SYSTEM ADJUSTMENTS
LDA (Low Dose Antigen Therapy)
LDA is a form of allergy therapy that has shown a high level of effectiveness in behavioral disorders. We have been using this treatment in our clinic since 1995. Treatment requires the patient to be present in the doctor’s office every two to three months for an injection. The treatments last for three years. After that point some people need boosters, while others can discontinue therapy. LDA works by manipulating cytokine production to block allergies.
Viruses have been found to be a factor in this population. We use medications and homeopathic remedies to deal with this aspect of treatment. Homeopathic treatments prescribed by our office can be administered at home.
Vision is an often-overlooked aspect in developmental disorders, since some of the children may not be able to effectively communicate any problems in this area. Yet more than 80% of all sensory input is visual. Therapeutic sensory integration lenses, prescribed by Dr. Collier, a functional optometrist, in addition to providing proper refraction (20/20 vision), also compensate for other anomalies. The therapeutic prescription produced in the lenses serves to disperse the light stimuli so that the image correctly reaches the retina. This helps coordinate the visual input of both the peripheral and central image formations to the brain. Once the light has reached the correct anatomical part of the retina, the retina will fire signals to the brain in the proper sequence. This produces a more accurate image. The special lenses thus change the timing at which an image reaches the brain. The examination does not require patient cooperation. It requires a visit to Dr. Collier’s clinic for examination by the optometrist.
Auditory training is extremely important in the treatment regimen, but it must be done after the proper nutritional adjustments have been made. It allows the patient to be more open to all aspects of his/her surroundings. Auditory Enhancement Training (AET) is a process for correcting sensory input anomalies like those found in individuals with: (The pathognomonic clinical sign is hyperacusis.)
- Pervasive Developmental Disorders
- Attention Deficit Disorder
- Learning Disabilities
- Hyperacusis (hyper-sensitivity to sound)
Studies conducted across the U.S., Australia and England have revealed statistically significant changes in children with autism that underwent AET as compared with matched children who did not receive AET. The changes noted were:
- Improved attention to auditory stimuli
- Improved memory for routine information
- Improved ability to understand what is said to him/her
- Improved ability to reason
- Improved articulation (speech)
- Improved social skill, affection toward family and friends
- Reduced echolalia
- Reduced impulsivity, restlessness, distractibility
- Reduced irritability
The AET (Auditory Enhancement Training) program offered through our center consists of:
- The Berard approach, utilizing the BGC (brand) Audio Tone Enhancer/Trainer
- Twenty sessions of one-half hour, twice a day, for ten consecutive days
- These treatments are done in the clinic
Gross and Fine Motor
All aspects of the sensory system are important. Our clinic gives special exercises to parents to do with their children. Some children have a hypersensitivity to touch, while others love to be wrapped tightly and hugged. These home exercises help make adjustments to the proprioceptive centers.
Many patients have an under-active thyroid. At this point, when there is a deficiency, the hormone is added to the treatment plan. In some cases, other adjustments in diet may help re-balance the thyroid function thus lessening dependence on thyroid medication. Hypothyroidism often responds to supplementation with iodine, fish oil, zinc, vitamin C and vitamin D3. If this does not correct it, then thyroid hormone replacement and close follow-up are indicated.
ELECTROCHEMICAL & pH-DRIVEN THERAPIES
Infrared Laser Treatments
This treatment is used to bring down pain and inflammation and lymphatic dysfunction, which is a major characteristic of this population.
Homeopathy is used with many patients. It can be very helpful when dealing with fragile patients, since it is always a gentle and non-invasive treatment, which is also easy to deliver (usually sublingual drops or pellets). Most commonly homeopathy is helpful in dealing with the viral load and with heavy metal detoxification.
Buffers are also tools in our arsenal. They are oral and act to change the pH inside the tissues of the body.
Stem Cell Therapy
Dr. Kotsanis has been doing research on the use of stem cells to treat many different disorders. We believe that stem cell therapy will be more widely available in the very near future and will have a great positive impact in the ASD population.
While we do not currently offer Hyperbaric Oxygen Therapy in our clinic, it is highly recommended. It is a medical treatment that uses high pressure oxygen as a drug. The patient is seated in an enclosure and pressurized oxygen is put into the cabin. By then adjusting the dose of the oxygen, the timing and the number of treatments, the oxygen treats the inflammation by forcing oxygen into the tissues of the body.