Autism Spectrum Disorder - Diagnosis

The diagnosis of Autism Spectrum Disorder is essentially delays in communication and socialization. There are also issues with eye contact, self-stimulatory behaviors, delayed pointing, and sensory integration. Children with ASD lack spontaneity. The best way to define this syndrome is the word "spectrum" in Autism Spectrum Disorder. Over the past thirteen years I have seen hundreds of children with a diagnosis of Autism Spectrum Disorder who typically vary in degrees of involvement and often have very different histories. The key to helping is to review that child's medical history and recommend interventions to fit the patient's individual needs.

For example, there are children who typically are doing well and are often advanced at 15-18 months and then show marked regressions in language, socialization and behavior. Conversely, a number of children who have been diagnosed with Autism have problems with social interaction and eye contact in early infancy. Other children may receive this diagnosis after the age of age 4 as Autism can be at times difficult to diagnose.

Typically, therapies that benefit one child are poorly tolerated by another child. A number of interventions can benefit 20-40% of children. Some respond best to ABA and/or play therapy and there is a subset that responds best to medications. Indeed, this is a spectrum disorder; the key is obtaining a comprehensive medical history from parents.

The interventions with the highest rate of success include dietary restriction, Methyl B12 injections, treating the gut, appropriate supplements and allergy treatment. As long as I have been involved in dealing with Autism, there has been a great deal of disagreement with the mainstream world of medicine consisting of pediatricians, developmental pediatricians, neurologists, child psychiatrists and physicians representing NIH, CDC and the American Academy of Pediatrics. This "conventional" group believes that all children with Autism have a genetic disorder. Most of the research money being utilized currently is aimed at finding a genetic cause for Autism. The conventional group believes that the primary reason for the staggering increase in the rate of Autism is that "we are better at making the diagnosis."

In contrast, believers in a biomedical basis for Autism include a number of physicians who have a child with Autism, parents of autistic children, as well as speech and occupational therapists who are exposed to autistic children on a regular basis. This group believes that most children with Autism have had an autoimmune insult, which may include number of immunizations given the first two years of life, ingestion of casein (milk, yogurt, cheese, ice cream) and/or gluten (wheat, oat, barley, rye and spelt), increased antibiotic use (especially the first two years of life), viral infections, and an inability to detoxify environmental pollutants. Autistic children may be genetically "vulnerable," but do not necessarily have a genetic defect. This would explain why most developmentally normal children can be immunized, eat casein and gluten and have antibiotic after antibiotic and do fine.

It is my opinion that Autism is truly a "mixed bag." There is a certain percentage, let's say 50% who eventually will be found to have a genetic marker. However, to account for the staggering increased rate of Autism over the past 20 years, I would agree with the biomedical theorists that many children are genetically at risk and are affected by various environmental insults. For this growing number of children, biomedical interventions should be strongly considered.