“Gut treatment should be part of every ASD treatment protocol to some degree.” Anju I. Usman, MD, cited respected mainline published findings as support for her professional view when she spoke to parents of children with special needs recently. Dr. Usman, the director of the True Health Medical Center in Naperville, Illinois, self-reports that she has treated more than 10,000 children over the last fifteen years. She believes that her clinical experience comports with recent evidence-based research on gastrointestinal (GI) problems in children with autism spectrum disorder (ASD).
Dr. Usman identified published support for her view in a presentation, “GI Biology, Pathology, and Treatment Strategies,” sponsored by local Maryland chapters of TACA (Talk About Curing Autism) on October 27th at Ann Arundel Community College. She provided highlights of research and expert panel consensus opinion published both in The Lancet and Pediatrics, the official journal for the American Academy of Pediatrics which support investigation of and treatment for the dietary causes of behaviors associated with the autism/ADHD continuum.
Here (below) are three of many key diagnostic/treatment takeaways for why evaluating GI issues is crucial to treating children on the ASD/ADHD continuum. These takeaways are followed by links and references to the supporting published research and/or expert recommendations:
ASD/ADHD GI Diagnostic/Treatment Takeaway #1 – Behavioral symptoms may be the only signs of a gastrointestinal disorder: This especially true for children who have communication challenges. For these reasons, gastrointestinal causes should be evaluated as part of the standard of care for patients with ASD. Dr. Usman recommended that parents show this published expert opinion to their children’s medical practitioners. One goal of the expert panel’s published recommendations is to remind physicians that “bad behavior” should not be discounted but rather treated as a potential indicator of an underlying medical problem.
Publication Source and Link: Pediatrics, the Official Journal of the American Academy of Pediatrics http://pediatrics.aappublications.org/content/125/Supplement_1/S1.abstract
Expert Panel Quote: “Care providers should be aware that problem behavior in patients with ASDs may be the primary or sole symptom of the underlying medical condition, including some gastrointestinal disorders.” (Timothy Buie, MD et al., “Evaluation, Diagnosis, and Treatment of Gastrointestinal Disorders in Individuals With ASDs: A Consensus Report,” Pediatrics Vol. 125, No. Supplement 1, January 1, 2010, doi:10.1542/peds.2009-1878C.)
ASD/ADHD GI Diagnostic/Treatment Takeaway #2 – ADHD symptoms can be caused by food. Elimination of the trigger foods can result in elimination of the ADHD symptoms: A simple elimination diet which included only “rice, meat, vegetables, pears and water” eliminated ADHD symptoms in a significant portion of the study group. Discontinuance of the diet caused a recurrence of ADHD symptoms.
Publication Source and Link: The Lancet http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(10)62227-1/abstract
Researcher Quote: “A strictly supervised restricted elimination diet is a valuable instrument to assess whether ADHD is induced by food.” (Donna McCann, PhD et al., “Food additives and hyperactive behaviour in 3-year-old and 8/9-year-old children in the community: a randomised, double-blinded, placebo-controlled trial,” The Lancet, Vol. 370, Issue 9598, November 3, 2007, doi:10.1016/S0140-6736(07)61306-3.)
ASD GI Diagnostic/Treatment Takeaway #3 – Celiac disease and other GI tract abnormalities and can cause “autistic” symptoms : Dietary deficiencies and related nutritional absorption problems can impair a child’s nervous system function and cause developmental problems. Treating these can alleviate symptoms which appear behavioral in nature.
Publication Source and Link: Journal of Child Neurology http://jcn.sagepub.com/content/25/1/114
Researcher Quote: “This case is an example of a common malabsorption syndrome associated with central nervous system dysfunction and suggests that in some contexts, nutritional deficiency may be a determinant of developmental delay. It is recommended that all children with neurodevelopmental problems be assessed for nutritional deficiency and malabsorption syndromes. (Stephen J. Genuis, MD, and Thomas P. Bouchard, BSc, “Celiac Disease Presenting as Autism,” Journal of Child Neurology, Vol. 25, No. 1, January 2010, doi: 10.1177/0883073809336127.)
CONCLUSION: Dr. Usman’s clinical findings and the published research/opinion which she cites expand upon the diet/behavior link identified by Benjamin F. Feingold, MD, decades ago. http://www.feingold.org/theory.html
As evidence-based research and clinical findings continue to prove, the expression “You are what you eat” is so profoundly true for the child on the ASD/ADHD continuum that it can affect basic health, well-being, and cognitive/social-emotional functioning. What can the parent of a special needs child do? Work with medical professionals to: (1) Identify and avoid foods and additives which harm the gut, (2) Treat GI disorders in the digestion and nutritional absorption processes. By doing so, parents can improve a child’s health, his ability to relate to the world around him, and optimize the benefit of other therapeutic and pharmacological interventions as a result.