Treating autism: A primer on interventions

At Boston.com's Child Caring blog, I'm wrapping up my series for Autism Awareness Month with a primer on different treatments and therapies.

No one really knows what causes autism. A recent article in Science Direct indicates that children living near toxic waste seem more likely to have autism. Though the thimerosal/MMR vaccine theory has been debunked, many parents feel that the mercury-laced preservative is linked to their children's autism by triggering a toxic tipping point or otherwise damaging the immune system.

Last year, some studies showed a possible link between autism and certain metabolic dieases can be sensitive to vaccine toxicity, leading to some autism-like symptoms. And of course, there's the genetic link: “Autism is probably caused by many, many things, most of them genetic, and this is one of them,” mitochondrial expert Salvatore DiMauro of Columbia University and the author of a study of autistic individuals with mitochondrial disease, tells the Simons Foundation Autism Research Initiative.

With the autism rate on the rise, parents are turning to a number of different resources and interventions in the hope of finding a way to manage their children's autistic behaviors, improve their lives, and maybe find a way to help them heal. There's a great discussion about various methods going on in the comments section of the first post I wrote for Autism Awareness Month.
As with any medical condition, treating autism is not a do-it-yourself proposition, so please talk to your child's doctor(s) for more infomation and guidance. There are many options to look into when it comes to helping your child and alleviating some of the traditional symptoms.

Applied Behavior Analysis: ABA focuses on understanding how an individual's actions and skills are related to and affected by their environment, including social settings. The goal is to use various techniques, such as positive reinforcement, to encourage useful or desired behaviors while minizing harmful or negative behaviors. According to the Cambridge Center for Behavioral Studies, "ABA has been effective for teaching a vast range of skills to people with disabilities as well as to many other people in every setting in which people live, study and work."

There have been hundreds of published studies showing that certain ABA techniques can help individuals with autism learn specific skills, such as how to communicate, develop relationships, play, care for themselves, learn in school, succeed at work, and participate fully and productively in family and community activities, regardless of their age.

For more information on ABA, or on choosing a well-trained specialist, visit the New England Center for Children's resource page or the Cambridge Center for Behavioral Studies autism page.

The GFCF Diet and the SCD: Our 10-year-old son, who has Asperger's Syndrome, has been on a gluten-free and casein-free diet for about five years now (as recommended by several doctors, who still follow his treatment). It turns out he may have a genetic predisposition to gluten sensitivity, and instead of processing gluten properly, his gut leaks it out into his bloodstream, where it eventually acts like an opiate, plugging receptors in his brain and making him act loopy, spacy, and distant. Even now, five years later, it's easy to tell if he's ingested gluten -- the spaciness sets in within a day or two and he often ends up with stomach pain, which gradually disappears over the course of several weeks of being back on the diet.

Another option some doctors suggest is the Specific Carbohydrate Diet, or SCD. Based on chemistry, biology, and clinical studies, the diet allows or prohibits certain foods based on their molecular structure. Complex sugars and starches are not allowed, but simple ones -- think bananas, peas, and nuts -- are, because they do not need to be broken down by the digestive organs and, as such, do not tax the patient's already-damaged digestive system.

According to Pecanbread.com, a site devoted to the SCD: "The diet of early man is one of meat, fish, eggs, vegetables, nuts, low-sugar fruits, and certain oils. Starches, grains, pasta, legumes, and breads have only been consumed for a mere 10,000 years. Many people are not adapted to these types of foods yet."

There is a case to be made for a link between dietary intervention and a change in the severity of symptoms of autism. "If I were to put a gallon of milk in my car's gas tank, people would think that I was nuts," says nutritionist and autism advocate Mika Bradford, whose youngest son was diagnosed with autism about 10 years ago. "But when I suggested that what my son was eating affected his moods and behavior, I was belittled. We know that what we eat can affect our weight, blood-sugar levels, and how we feel. Dietary intake is directly related to medical conditions like Celiac disease and diabetes. Why would we diminish its role in other states of disease or behavioral diagnosis?"

Dr. Tim Buie, a pediatric gastroenterologist at Massachusetts General Hospital, has studied the connection between gastrointestinal issues and children with autism. On the Autism Network for Dietary Intervention website and at several conferences he's stated that he believes that many of the symptoms of autism are actually indicators that the child is in physical pain and unable to communicate about it. His study of more than 500 gastrointestinal endoscopies with biopsies on autistic children show that "more than half of these children had treatable gastrointestinal problems that ranged from moderate to severe including esophagitis, gastritis and enterocolitis along with the presence of lymphoid nodular hyperplasia."

Biomedical Invervention and Dietary Supplementation: There are a host of controversial interventions that hinge on removing toxins like heavy metals or supplementing the patient with things vitamins, minerals, or enzymes that the patient may not be producing on his own. The DAN (Defeat Autism Now) method combines biomedical, nutritional, and behavioral therapies to "recover" children with autism. The majority of mainstream doctors, however, do not recommend the DAN protocol, pointing out that "certain biomedical interventions, like chelation, are considered to be potentially dangerous," though the link between environmental factors, like toxins, and autism is becoming more accepted. Discover Magazine ran an article recently on biomedical intervention, in which Jill Neimark writes, "A vivid analogy is that the genes load the gun, but environment pulls the trigger," leading to an array of symptoms that need to be treated in the body as a whole, not just neurologically.

In Healing and Preventing Autism, Jenny McCarthy and Dr. Jerry Kartzinel detail several of the most popular supplements -- vitamin B12, digestive enzymes, fatty acids, Zinc, selenium, calcium, and probiotics, among many others -- in an easy-to-follow, conversational way (though the book seems more geared toward reassuring like-minded readers, rather than presenting the pros and cons of different interventions and theories).

I'm a mom and a journalist, not a doctor -- whatever methods people decide to explore in treating autism, it's imperative that treatment take place under the supervision of a qualified doctor or, in the case of ABA, a qualified, trained therapist. As with any medical condition, autism treatment is not a do-it-yourself project.

You can read the other posts in my series on Autism Awareness here

Inside the mind of a child with autism

Autism awareness: Resources that can help

Does my child have autism?