National Association of Residential Providers for Adults with Autism

NARPAA ECLASS Autism Education for Direct Care Staff

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MODULE TWELVE BIOMEDICAL

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MODULE TWELVE
As a result of completion of this module, the participant will be able to:
Evaluate the validity of different biomedical approaches to mitigate the affects of Autism.

INTRODUCTION
Biomedical intervention for Autism consists of a wide range of therapeutic approaches for treating some of the symptoms. There are some individuals and groups who talk of curing Autism, however this is still in a theoretical stage.

INTRODUCTION
The biomedical approach to intervention has largely been based around dietary changes including gluten- and casein-restricted diets, pigment-restricted diets, use of nutritional supplementation, use of specially formulated digestive enzymes, or a combination of the above. These dietary changes allow for improved digestion and metabolism, improved absorption of nutrients, and a reduction in immune system reactivity.

INTRODUCTION
In addition, a number of accompanying therapies have also been popular. Opponents to these therapies, among them many people with Autism, do not believe they actually treat Autism but rather the conditions that are often comorbid to Autism.

HISTORY
Bernard Rimland, a psychologist and parent of a son who had Autism, speculated early on that his son's Autism was the result of the DPT vaccine. Dr. Rimlands strong anti-vaccine stance and denouncement of the DPT vaccine was a significant factor in the redesign of the vaccine in 1990.

HISTORY
Dr. Rimland experimented with eliminating certain kinds of food and found that when casein and gluten were eliminated from his sons diet, Autism symptoms appeared to be reduced. This gave rise to the notion of the "leaky gut" cause of Autism, in which the gastrointestinal walls have been compromised, leading to the incomplete breakdown of food, and thereby allowing toxic protein chains to be absorbed into the bloodstream.

HISTORY
Sidney Baker, MD, Maureen McDonnell, and other healthcare practitioners used Dr. Rimland's observations to develop the DAN (Defeat Autism Now) protocol. While the DAN doctors operate outside the mainstream medical community, they have attracted a growing number of pediatricians, neurologists, allergists, nutritionists, and others help to develop and refine their approaches. In addition, parents are increasingly active in assessing a wide range of approaches to help their family members who have Autism. A large and growing number of online communities are constantly exchanging information and ideas to further the state of biomedical intervention as treatment for Autism.

CONCEPTUAL FOUNDATIONS
The premise for biomedical intervention is that at least some people with Autism have been made sick in a way that prevents their nervous system from functioning properly. They allegedly have great difficulties sorting out sensory impressions and are prone to hyper- or hyposensitivity to impressions from their sense of sight, hearing, smell, touch, propreoception, or balance.

CONCEPTUAL FOUNDATIONS
Proponents of biomedical intervention believe that environmental shocks have caused a syndrome that includes some autistic traits and other health problems, ranging from gastrointestinal problems to allergies.

PROPONENTS OF BIOMEDICAL INTERVENTION

Proponents claim that people with Autism: Are consistently compromised in three essential systems: Gastrointestinal tend toward constipation or diarrhea and often have abnormal cravings or abhorrence for certain kinds of food. Immunological are prone to allergies, migraines, and react abnormally to infectious diseases. Neurological are consistently hypo- or hypersensitive to sensory impressions.

PROPONENTS OF BIOMEDICAL INTERVENTION

Proponents claim that people with Autism: Generally improve in all three systems with an adapted or 'special' diet or with the addition to their diet of certain dietary supplements, nutrients, and enzyme supplements. Will present with regression if there is an infraction against the adapted diet

ORIGINAL HYPOTHESIS
The original hypothesis behind this type of intervention is that many people who have Autism have a damaged or "leaky gut" that allows certain compounds into the bloodstream which are not completely broken down. These compounds include morphine-like substances or mu-opioids supposedly derived from gluten and casein proteins, which have not been broken down properly in the stomach and intestines. These proteins have been detected in patients by researchers such as Kalle Reichelt of Norway and by the Autism Research Unit of Sunderland University in the UK.

ORIGINAL HYPOTHESIS
A major problem with the model is that the above problems do not appear in the Autism diagnostic criteria but are rather comorbid conditions.

RESTRICTIVE DIET
Biomedical intervention usually starts with a restrictive diet, such as the gluten-free, casein-free diet. Typically, foods will be restricted in a particular sequence, for example by eliminating: Dairy products - casein and/or lactose Gluten, found in grains such as wheat, barley, rye, oats, spelt, etc.

RESTRICTIVE DIET
Eggs, nuts, and berries that are known provoke allergic reactions Fruits and vegetables that contain lutein, salicylates, phenols, and other substances that may cause a reaction All artificially colored food, i.e., the Feingold Diet All bi- and poly-saccharides, such as lactose, fructose, starch, etc. (the Specific Carbohydrate Diet)

RESTRICTIVE DIET
Parents report varying success with these diets, and combinations of them. Some have seen a complete recovery simply from eliminating milk; others need to eliminate pigments, salicylates or phenols to reach a tipping point; others have found a workable, effective diet in the Specific Carbohydrate Diet. Others report no benefit from a restrictive diet at all.

NUTRITIONAL SUPPLEMENTS
Since the gastrointestinal system is presumed to have been compromised in people who have Autism, many parents and medical professionals find it necessary to give their family member or patient nutritional supplements. The range of supplements given to people with Autism undergoing biomedical intervention is wide, but can be categorized as follows:

NUTRITIONAL SUPPLEMENTS
Vitamins - in particular: B-complex vitamins, such as B12, B6, etc.

This also includes Vitamin B derivatives, such as TMG, P5P, etc.

Vitamin C Vitamin A

Others, in RDA doses

NUTRITIONAL SUPPLEMENTS
Essentially Fatty Acids Provided in Supplements Such AS:
Fish Liver Oiol Barage Oil

Flax Seed Oil

NUTRITIONAL SUPPLEMENTS
Probiotics - there is some controversy about the benefits and potential harm of some bacteria strains versus others, but most agree that acidophilus is required.

NUTRITIONAL SUPPLEMENTS
Anti-yeast supplements - parents report mixed success with antifungal medication, but are more enthusiastic about natural remedies such as:
Garlic Caprylic acid Grapefruit seed extract Products such as Biocidin

ALTERNATE THERAPIES
While some people seem to benefit from a restrictive diet and careful use of nutritional supplements, there is more variation in other, so-called "alternative" medical approaches. Some of the most common ones are:

ALTERNATE THERAPIES
Applied Kinesiology. Combining acupressure and chiropractic, kinesiologists de-sensitize people to substances to which they are sensitive. Applied kinesiology also activates organs and systems through touch and pressure, strengthening the body's systems.

ALTERNATE THERAPIES
Chelation. By introducing agents that help remove heavy metals from the persons body, it is hoped that the underlying cause for their disorder is remedied. Chelation may also remove essential minerals and must be administered with great care.

MEDICATIONS AND AUTISM

Medications have a limited role in improving symptoms in people who have Autism. However, some may help with self-injurious and other behaviors that are causing difficulty. Medications may also take a person to a functional level at which they can benefit from other treatments.

MEDICATIONS AND AUTISM

There is no standard medication for treatment of Autism. The American Academy of Pediatrics (AAP) suggests targeting the main one or two dominating problem behaviors when considering medications.

MEDICATIONS AND AUTISM

Neuroleptics, such as:
haloperidol (Haldol); thioridazine (Mellaril); and risperidone (Risperdal). These are known as antipsychotic medications that work by changing the effects of brain chemicals. Neuroleptics may help decrease unusual behaviors that can occur with Autism.

MEDICATIONS AND AUTISM

Selective serotonin reuptake inhibitors (SSRIs), such as: fluoxetine (Prozac); or sertraline (Zoloft, Lustral).
The high rate of effectiveness for helping with depression, anxiety, and obsessive, stereotypical behaviors has made these medications a popular choice for helping to manage Autism. They may also improve general behavior, language, learning, and socialization. In addition, SSRIs have fewer side effects than neuroleptics.

MEDICATIONS AND AUTISM

Other problems medications can be used: Medications to help lower blood pressure and are sometimes used to help manage over activity, such as:
clonidine hydrochloride (Clorpres, Combipres); and guanfacine hydrochloride (Tenex).

MEDICATIONS AND AUTISM

People who are occasionally aggressive may become more stable when using the following medications, although monitoring the level of the drug in the body through regularly scheduled blood tests is required. lithium (Eskalith, Eskalith-CR, Lithobid, Lithonate, Lithotabs); and anticonvulsants (carbamazepine [Carbatrol, Epitol, Tegretol], valproic acid [Depakene]).

MEDICATIONS AND AUTISM

The effectiveness of these medications varies by individual. Side effects are also possible and should be discussed with the doctor. Some doctors may advise going off a medication temporarily, in order to identify whether it is having a positive or negative effect.

MEDICATIONS AND AUTISM

The effectiveness of these medications varies by individual. Side effects are also possible and should be discussed with the doctor. Some doctors may advise going off a medication temporarily, in order to identify whether it is having a positive or negative effect.