One or two times per year, the staff at the Child Development Center gets to visit a very busy school for developmentally challenged children in South Florida. Unfortunately, most of the families have pretty limited financial resources. With the assistance of my Spanish-speaking staff, we usually examine 10 or more of the most affected clients. I visit with each family for approximately 1/2 hour, then try to help identify children who might be candidates for biomedical intervention. The purpose of the clinic is to diagnose children in our community who would not otherwise be exposed to complementary and alternative medicine in order to help parents decide whether this is something that they would like to explore. Costs are kept to a minimum and even the small application fee is donated back to the school.I thoroughly enjoy the experience, both because the children are extremely interesting and the families are so appreciative. Plus, I gain a ton of experience with treatment-naive patients, which is rare in our Internet-connected age.
Here is a sample of the incredible children who were seen at our recent clinic:
1. How many neurologists does it take to make the diagnosis of autism? This 6 year-old boy demonstrated significant developmental impediments, including motor delays since the age of 15 months, when he was neither walking nor talking. Neuro #1 said, “Not sure. Let’s wait a while and see.” Wait until when, to see – what? Doc #2, who examined the toddler at 2 years of age, when the child was still not demonstrating speech or language, said that there was developmental delay. Ya think? When pushed for a diagnosis, Neurologist #3 said that “It might be Autism.” Neurologist #4, who saw the child at 3 years, when he was only saying a few random words, prescribed Risperdal, then Intuniv for the behavioral problems. Yep, it’s ASD!
2. All oppositional behavior is not just oppositional behavior. The parents of this 8 year-old female were concerned because of the child’s “lack of focus”, over-activity, and generally “bad moods”. The medical history told a much more important story of a typically developing child, speaking at one year, who had “complete loss of eye contact and speech within the month after her second MMR vaccination.” (I ain’t saying’ anything about the ‘shots’- not in this blog). Anyway, the child has had many bowel problems, multiple sensory issues, and behavioral problems throughout her life. Not surprisingly, Vyvanse and Ritalin have not made her better! I believe that this remarkable child had regressive autism, from which she has mostly recovered, with some residual problems which could very well be amenable to biomedical intervention.
3. This child’s story represents the folly of modern Western medicine. This little girl was born in Nigeria, developing typically, and even ahead of schedule in motor and speech domains. Apparently, in Africa, many children receive a BCG vaccination to prevent tuberculosis, which is endemic. When the child arrived in America, she demonstrated a positive PPD test (a skin test to check for TB), due to the previous intervention. But, the “rules” of the public health department dictated that the child receive 9 months of a medication to “cure the problem”, after which she regressed into severe ASD. When I examined the child who is now 7 years old, she had failed to improve from Risperdal, Adderall, Abilify, or Intuniv. Drugs, drugs, and more drugs.
4. Even alternative medicine therapies don’t always work. This 7 year-old male has demonstrated developmental delays since infancy. When I examined him, he was moderately-to-severely affected by his ASD symptoms, especially in the social domain. The family has spent a great deal of resources on chelation with DMSA, HBOT (soft), multiple supplements, spironolactone (a diuretic that is sometimes used for it’s anti-inflammatory effect) and even Ritalin has not been able to help the hyperactive behaviors. Perhaps it is time to step back, examine what are the major symptoms, and address the medical problems that could be causing his distress.
5. Maybe DAN protocols will work? This 3 year-old boy was diagnosed as autistic since the age of 16 months. However, the medical history consisted of multiple episodes of otitis media which required antibiotic treatment. Instead of pouring more medications into the child, my impression is that there are many children like him, who have acquired their ASD through the increased usage of antibiotics, and they may get a great deal of symptomatic improvement through biomedical intervention.
This is just a sample of the myriad presentations of ASD which are all around us; in our communities, and among our families. As physicians get more experience with the various signs, symptoms and patterns of illness and recovery, we will hopefully get better at making the diagnosis and helping our patients improve.