A Biomedical Approach to Autism: Clinical Assessment Options for Children with Autism and Related Disorders;

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A Biomedical Approach to Autism: Clinical Assessment Options for Children with Autism and Related Disorders; A Biomedical Approach

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by Sidney M. Baker, MD & Jon Pangborn, PhD

Autism Research Institute, 4182 Adams Avenue, San Diego, California 92116 USA

Softbound, 41 pp., 1996, $25 or more tax-deductible contribution to Autism Research Institute.

Children with autism are isolated in a private world. They show little or no response to other people or to their environment. Doctors and parents alike have long been frustrated in their efforts to find successful treatments for these children. In January 1995, the Autism Research Institute sponsored the Defeat Autism Now! (DAN!) Conference. The Autism Research Institute has sought out and researched effective treatments for autism since its inception in 1967. About 30 researchers and clinicians assembled at the conference to discuss promising biomedical treatments. A report of the participants' best ideas and clinical practices has been published in a consensus report Clinical Assessment Options for Children with Autism and Related Disorders: A Biomedical Approach by Sidney M. Baker, MD and Jon Pangborn, PhD.

The 41-page document focuses on diagnostic tests and other methods by which practicing doctors can identify underlying biological conditions that contribute to autistic behavior. Over a dozen diagnostic tests are explained. Reliable laboratories and costs are included for each test. Autistic children tend to exhibit central nervous system abnormalities and immune system weaknesses, some of which are inherited. Most autistic children have metabolic disturbances that can be identified with urine tests. An elevation of anserine and carnosine (dietary peptides) with low levels of certain amino acids and a disturbance of the methionine metabolism sequence are the two most common metabolic abnormalities. Digestive malfunction and bowel flora imbalance often play profound, and largely unrecognized roles in autism. Which contributing factors affect an individual child is up to the doctor to determine and then treat. Diet, supplements, chelating agents -- in other words, the tools of alternative-minded physicians -- are among the treatments for ameliorating these conditions.

The DAN! document provides an outline for tracking down the biomedical conditions that affect an autistic child. The outline presupposes that the child has already undergone routine preliminary tests -- a complete bloodcount, a urinalysis, a blood chemistry screen with thyroid profile -- to rule out anemia, liver, kidney, or thyroid malfunction. These tests are usually normal in autistic children; but as the authors point out, "they are the first step in evaluating anyone with a serious medical problem." Testing for lead and other heavy metals, which should be standard in pediatric care, is particularly necessary for individuals with neurological problems. Autistic children tend to have difficulty removing toxins from the body, making it more likely than for normal children that toxic metals will accumulate in their bodies. Conference participants find that hair mineral analysis is particularly useful for identifying toxic metal overload. The consensus is that while "hair is a relatively weak measure of nutritional status . . . it can be a good indicator of imbalances that can be corrected by nutritional intervention." 24-hour urinary mineral profiles and whole blood mineral profiles, if they can be obtained, in combination with hair mineral analysis provide the most thorough picture of nutritional status.

Food-related disorders, such as poor digestion and assimilation and food allergies or intolerances, are common factors in autism. The document recommends stool analysis for assessing digestive and metabolic function and microbiology, mycology, and parasitology. Urinary peptide tests for casein and gluten can show whether a child is sensitive to milk or grams before going through the hassle of eliminating these foods from the diet. Food allergies, although certainly not a cause of autism, can cause certain symptoms. Pathological growth of yeast, fungi, and/or bacteria in the bowel also contribute to behavior problems. Dr. William Shaw has developed an assay that detects abnormal microbial organic acids patterns. The authors note that "[a]voidance of sugars and artificial additives in food, diagnostic avoidance of gluten and casein, yeast-free diet and a diagnostic trial of antifungal medication, supplements of vitamins and minerals are relatively inexpensive, if sometimes inconvenient approaches, that often yield dramatic results."

The authors recognize that using all of the tests in this document is expensive; they do not intend that this outline be followed blindly. Dr. Baker says, "In my own practice, the most important diagnostic test is listening and my most important guide is intuition." The authors recommend that parents consult The American Academy of Environmental Medicine or the American College of Advancement in Medicine to find a doctor who is familiar with the practices outlined in the Protocol, which will be updated periodically and eventually include treatments for biochemical and immunological problems. Clinical Assessment Options for Children with Autism and Related Disorders: A Biomedical Approach contains no guarantees, but it does shed light on underlying, and treatable, factors that contribute to autism.

Townsend Letter for Doctors & Patients.

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By Jule Klotter

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