The following guest
column was written for First Signs by Mitzi Waltz,
©2001. Mitzi is the author of
several Patient Centered Guides that provide comprehensive coverage
on a variety of developmental and behavioral disorders, including
Autism Spectrum Disorders: Understanding the Diagnosis and Getting
Usually, a medical diagnosis automatically
leads to treatment. Unfortunately, thatís often not the case for
autistic spectrum disorders. As of this writing, the FDA has
approved no medications to treat ASDs. Your insurance company or
HMO will probably tell you no treatments are covered. Books and
Web sites do present options, but how can you make wise
decisions when every day counts?
Start with the basics.
Some doctors still deliver the diagnosis of autism as if it were
an incurable cancer. True, we donít have a cure, but we do have
therapies that can help most children with ASDs. Like epilepsy,
asthma, and other “incurable” medical conditions, ASDs are
eminently treatable. Begin with your childís basic physical
health. Many children with ASDs have health problems, such as
severe diarrhea or constipation, allergies or food intolerances,
or immune-system dysfunction. These may be clues about the
actual cause of ASDs, but that’s a question for the researchers.
Right now, your job is to ensure that your child is not
suffering from pain, illness, or poor nutrition. A healthy,
comfortable child can benefit most from the other kinds of help
that are available.
Next, make sure your child gets a complete multidisciplinary
Find out about his strengths and weaknesses and how he learns.
Autism is a group of symptoms, not a single medical condition.
Just as there may be several reasons for these symptoms to
occur, there may be several roads to improvement.
When facing treatment decisions:
- Make sure the interventions you choose are as safe as possible.
- Check the credentials of all healthcare providers, and make sure they are knowledgeable about the latest research.
- Tell your childís primary healthcare provider about everything you try.
- Keep good notes.
I strongly believe, based on both evidence from clinical studies
and from talking to many experienced parents, that all young
children with ASDs can benefit from a program of intensive,
daily, structured, one-to-one interaction. The best-known system
is Applied Behavior Analysis (ABA), originally developed at UCLA
by Dr. Ivar Lovaas. Floor-time play therapy, an approach
developed by Dr. Stanley Greenspan, is also effective for many
children. These methods can be tailored to meet each childĻs
Speech therapy, occupational therapy for children with fine
motor problems, sensory integration for those under- or
over-sensitive to sensory information, and physical therapy for
delayed gross motor development are also well-tested.
Medication for specific symptoms, such as obsessive-compulsive
behavior, severe anxiety, or self-injurious behavior, may be
helpful. At this time, the most important role for medication is
reducing symptoms that prevent the use of interventions like
ABA, floor-time play therapy, and speech therapy. Some children
also need anti-epilepsy medication, as up to one-fourth of
children with autism also have a seizure disorder. A few doctors
are experimenting with medications that target the immune or
gastrointestinal systems. Always start with the lowest dose
possible, make any increases gradually, and communicate
regularly with your doctor.
Biological interventions seek to address metabolic or
immune-system problems. They include special diets, vitamins,
and dietary supplements. Eliminating the proteins gluten and
casein may help with digestive and bowel problems, and may also
prevent opiate-like peptides from reaching the brain. Many
parents have reported positive benefits from putting their
autistic-spectrum child on a gluten-free, casein-free diet. If
youíre interested, work with a licensed dietitian, and join a
diet-focused support group in your area or online.
Supplementation with B vitamins and magnesium has been
extensively researched. Itís not universally effective, but it
does seem to help some. If you want to try vitamins, familiarize
yourself with their effects and side effects.
Research on essential fatty acids in autism has just begun. They
have shown promise in clinical trials targeting other brain
disorders. Other supplements may also be valuable.
Check out alternative healthcare practitioners carefully. Sadly,
some are untrained or use false credentials, and some make
potentially harmful suggestions. Be especially wary of anyone
who both recommends and sells supplements.
Evaluating new therapies.
The history of autism has been marked by a series of failed
“breakthroughs,” including dangerous drugs like fenfluramine and
even LSD. It seems like every year thereís something new, and
plenty of families desperate enough to pay thousands for it.
Autism is a complex condition, so miracle cures are unlikely.
Like diabetes and asthma, it involves both genetics and
environment, and affects multiple systems within the body.
Treatment plans must address that complexity. Comprehensive
treatment should start as early as possible to help each child
achieve her greatest potential.
So donít wait for a cure. Get going right away with therapies
that have scientific backing, and evaluate other options based
on your childís individual needs and symptoms. This generation
of children will be the first to benefit from time-tested
treatments. There may even be some real breakthroughs! With wise
choices and hard work, the chance of a good outcome is
© First Signs, Inc., May 2001
Mitzi Waltz Ä http://www.mitziwaltz.com/
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