BIOMEDICAL BIOMEDICAL TREATMENT OF THE TREATMENT OF THE YOUNG ADULT WITH YOUNG ADULT WITH AUTISM SPECTRUM AUTISM SPECTRUM DISCORDERDISCORDER

Presented by Presented by Michael W. Elice, M.D. andMichael W. Elice, M.D. andBarbara FischkinBarbara Fischkin

AutismOne, May 2009, Chicago, ILAutismOne, May 2009, Chicago, IL

What is ASD?What is ASD?

SOCIAL

LANGUAGEBEHAVIORAL

Asperger’s

Pervasive Developmental Delay

Attention Deficit Disorders

AutismAutism

DSM IV Diagnostic Criteriafor Autistic Disorder Impairment in Social Interaction

-Impairment in the use of nonverbal behavior-Lack of spontaneous sharing-Lack of social/emotional reciprocity-Failure to develop peer relationships

Impairment in Communication-Delay in or lack of development of spoken language &

gestures-Impairment in the ability to initiate or maintain

conversation-Repetitive and idiosyncratic use of language-Lack of pretend play

Restricted Repertoire of Activity and Interests-Preoccupation with restricted patterns of interest-Inflexible adherence to routines-Repetitive movements-Preoccupation with parts of objects

Increase in Autism Incidence

05

1015202530354045

1950 1965 1980 1994

Year of Birth

Inci

denc

e per

10,

000

AutismEpilepsyMental Retardation

Autism ---- rising incidence

1/2000 prior to 1970

1/500 1996 1/166 2005

1/150 2007And increasing…………….now thought to be 1/80 – 1/100 children!!

What is Autism?What is Autism?

A complex array of gene-environment A complex array of gene-environment interactionsinteractions

This demands a rigorous evaluation to search for This demands a rigorous evaluation to search for the unique disease markers that help us the unique disease markers that help us understand each child’s individual needsunderstand each child’s individual needs

There is NO usual autism treatmentThere is NO usual autism treatment Only one FDA approved intervention for the Only one FDA approved intervention for the

agitative, aggressive affects of autism – agitative, aggressive affects of autism – RisperadoneRisperadone

Beyond this, NOTHING ELSE!Beyond this, NOTHING ELSE! Resources of mainstream medicine are oriented Resources of mainstream medicine are oriented

to behavioral therapy, NOT BIOMEDICALto behavioral therapy, NOT BIOMEDICAL

Disorders Associated Disorders Associated with ASDwith ASD Obsessive Compulsive DisorderObsessive Compulsive Disorder Oppositional Defiant DisorderOppositional Defiant Disorder Tourette’s Syndrome – Tic DisorderTourette’s Syndrome – Tic Disorder PANDASPANDAS Bi-Polar DisorderBi-Polar Disorder Metabolic DisordersMetabolic Disorders Mitochondrial DisordersMitochondrial Disorders

Find the SourceFind the Source

Assess the Underlying CausesAssess the Underlying Causes Maldigestion/MalabsorptionMaldigestion/Malabsorption DysbiosisDysbiosis InfectionInfection InflammationInflammation Intestinal Permeability (leaky gut)Intestinal Permeability (leaky gut) Immune dysfunctionImmune dysfunction Food Intolerance/ AllergiesFood Intolerance/ Allergies ToxicityToxicity

Albert Einstein:Albert Einstein:

““If we knew If we knew what we were what we were doing, it doing, it wouldn’t be wouldn’t be called research.”called research.”

BIOMEDICAL THERAPIES

1. ELIMINATION DIET

2. ALLERGY TESTING

3. ESSENTIAL FATTY ACID/COD LIVER OIL 4. VITAMINS/MINERALS

5. DIGESTIVE ENZYMES

6. METHYL COBALAMIN, FOLINIC ACID, TMG, NAC 7. AUTOIMMUNE THERAPY

8. CHELATION 9. ANTIFUNGALS AND ANTIANEROBICS 10. INTRAVENOUS GAMMA GLOBULIN 11. HYPERBARIC OXYGEN

Daniel Mulvaney, age Daniel Mulvaney, age 21 years21 years

Lived in Mexico City and Hong Kong Lived in Mexico City and Hong Kong with parents, Barbara and Jim, with parents, Barbara and Jim, journalistsjournalists

Age 3 years – febrile illness with Age 3 years – febrile illness with temp of 106 degrees, otitis temp of 106 degrees, otitis media. Hospitalized for media. Hospitalized for dehydrationdehydration

Symptoms:Symptoms:

Loss of interest in other childrenLoss of interest in other children Chewing on clothesChewing on clothes ShreddingShredding Loss of expressive languageLoss of expressive language Loss of interest in toysLoss of interest in toys Loss of toileting skillsLoss of toileting skills Increase in temper tantrumsIncrease in temper tantrums

More Symptoms and More Symptoms and Interventions:Interventions: PICA – ate glass in playgroundPICA – ate glass in playground Hearing test – positiveHearing test – positive Starts BOCES early childhood with Starts BOCES early childhood with

ABA, vitamin therapyABA, vitamin therapy Luvox, Risperdal to control Luvox, Risperdal to control

‘violent behavior’‘violent behavior’ 2005 – 2 grand mal seizures, EEG 2005 – 2 grand mal seizures, EEG

inconclusive, MRI - normalinconclusive, MRI - normal

Dan meets Dr. Elice, Dan meets Dr. Elice, November, 2007November, 2007Age 20 yearsAge 20 years Mouthing – pica, bitingMouthing – pica, biting Head pain requiring head compressionHead pain requiring head compression Hands move up and down, flappingHands move up and down, flapping Ear flappingEar flapping Enjoys being upside downEnjoys being upside down Prefers to lie down to compress abdomenPrefers to lie down to compress abdomen AffectionateAffectionate Transitions wellTransitions well Gets very close to peopleGets very close to people Clomps feetClomps feet Lateral gazeLateral gaze Occasional crooked smileOccasional crooked smile Obsesses on rope – uses as a lariatObsesses on rope – uses as a lariat

Dan’s Medical HistoryDan’s Medical History

Product of Barbara’s first Product of Barbara’s first pregnancypregnancy

Pitocin induced labor – failure to Pitocin induced labor – failure to progressprogress

Born in Mexico CityBorn in Mexico City Developmental milestones all on Developmental milestones all on

targettarget Fully immunized without reactionsFully immunized without reactions

Dan’s Medical HistoryDan’s Medical History

Diet – craved vegetables, lettuce, Diet – craved vegetables, lettuce, sushi and fishsushi and fish

BM’s – loose, frequent, foul smelling,BM’s – loose, frequent, foul smelling,

greenish/brown color, 4-5 times/daygreenish/brown color, 4-5 times/day- Respiratory: frequent coughingRespiratory: frequent coughing- Skin – “chicken skin” red facedSkin – “chicken skin” red faced- Sleep – terrible!Sleep – terrible!

Family HistoryFamily History

RosaceaRosacea UrticariaUrticaria GoutGout ADDADD ArthritisArthritis AlcoholismAlcoholism Cardiovascular Cardiovascular

diseasedisease ADMADM MSMS Alzheimers DiseaseAlzheimers Disease

Asperger’s Asperger’s SyndromeSyndrome

ADDADD ThyroiditisThyroiditis Colitis, ulcersColitis, ulcers Seasonal allergiesSeasonal allergies Colon cancerColon cancer Breast cancerBreast cancer

Lab InvestigationLab Investigation

Complete Blood Count w/ differential and platelet count, ESRSerum Metabolic Assay (Complete)Thyroid Profile (T3, T4 and TSH), AutoAntibodiesAmino Acid Profile, PlasmaMethylenetetrahydrofolate Reductase (MTHFR)Organic Acid Profile, UrineAmmonia LevelLactic Acid Level (Lactate)Pyruvic Acid Level (Pyruvate)Folic Acid, Homocysteine, Vit B1, B6, B12, D3 levelsHeavy Metal Profile (Lead, Mercury, Arsenic and Cadmium), BloodAntigliadin Antibodies and Transglutaminase (Celiac Panel)Measles, Mumps and Rubella, all vaccine antibody titersChromosome Analysis (include Fragile X), genomic array analysisIgG, IgA, IgM, IgE levelsIGG SubclassesB and T cell function testsMyelin basic protein and neural axon filament antibodiesASLO and Anti Dnase Antibodies

Dan’s Lab ResultsDan’s Lab Results

NEGATIVE RESULTSNEGATIVE RESULTSFolic acid: elevatedFolic acid: elevatedMTHFR: + mutation, A and MTHFR: + mutation, A and

C sitesC sitesAmmonia: elevatedAmmonia: elevatedHerpes Simplex I: + Herpes Simplex I: +

antibodiesantibodiesStrep B: + antibodies; ASO Strep B: + antibodies; ASO

and antiDNAse Band antiDNAse BSerologic immunity to Serologic immunity to

mumps and rubella BUT mumps and rubella BUT NOT measlesNOT measles

Epstein Barr Virus: + Epstein Barr Virus: + antibodiesantibodies

POSITIVE RESULTS POSITIVE RESULTS LFT’s: within normal LFT’s: within normal

limitslimits B12, B6, B1: within B12, B6, B1: within

normal limitsnormal limits Amino acids: within Amino acids: within

normal limits normal limits Plasma catecholamines: Plasma catecholamines:

normal normal Pyruvate, lactate, insulin, Pyruvate, lactate, insulin,

homocysteine: normal homocysteine: normal Antigliadin Antibodies: Antigliadin Antibodies:

negativenegative

Laboratory InvestigationLaboratory InvestigationHair analysis for metals Hair analysis for metals 8 years old8 years oldElevated:Elevated:

- aluminum- aluminum

- cadmium- cadmium

- lead- lead

- mercury- mercury

- silver- silver

- uranium- uranium

- titanium- titanium

““Association of MTHFR Association of MTHFR Gene Variants with Gene Variants with Autism”Autism”

Marvin Boris, M.D., Allan Goldblatt, Marvin Boris, M.D., Allan Goldblatt, P.A.,P.A.,

Joseph Galanko, PhD., S. Jill James, Joseph Galanko, PhD., S. Jill James, PhD.PhD.

J. Of Physicians and Surgeons. 9:4.J. Of Physicians and Surgeons. 9:4.

Winter Edition, 2004Winter Edition, 2004

MTHFR

Methyl Cobalamin (B12)Methyl Cobalamin (B12)

Alterations in this pathway can induce chronic metabolic Alterations in this pathway can induce chronic metabolic imbalances. Data indicates that these alterations occur imbalances. Data indicates that these alterations occur frequently in ASD children.frequently in ASD children.

Vitamin B12 is an essential cofactor for this pathway. B12 Vitamin B12 is an essential cofactor for this pathway. B12 deficiency is well known to have neuropsychiatric deficiency is well known to have neuropsychiatric consequences in adults and adversely affect consequences in adults and adversely affect neurodevelopment during infancy. Therefore, the abnormal neurodevelopment during infancy. Therefore, the abnormal metabolic profile observed in a significant proportion of metabolic profile observed in a significant proportion of autistic children suggests the possibility that the behavioral autistic children suggests the possibility that the behavioral features characteristic of these children could be a features characteristic of these children could be a manifestation of a genetically based systemic metabolic manifestation of a genetically based systemic metabolic derangement.derangement.

Methyl cobalamin inhibits the toxic effect of mercury on the Methyl cobalamin inhibits the toxic effect of mercury on the development of nerve fibers and glial cells. This explains development of nerve fibers and glial cells. This explains why the administration of injectible methyl cobalamin has why the administration of injectible methyl cobalamin has resulted in many of these children becoming more aware of resulted in many of these children becoming more aware of the environment, starting to speak and acting like other the environment, starting to speak and acting like other childrenchildren

MTHFR ASSOCIATED MTHFR ASSOCIATED DISEASESDISEASES

NEURAL TUBE DEFECTSNEURAL TUBE DEFECTS CARDIOVASCULARCARDIOVASCULAR CEREBRAL VASCULARCEREBRAL VASCULAR INFLAMMATORY BOWEL DISEASEINFLAMMATORY BOWEL DISEASE CANCER- COLORECTAL, GICANCER- COLORECTAL, GI LEUKEMIALEUKEMIA MULTIPLE PSYCHIATRIC DISORDERSMULTIPLE PSYCHIATRIC DISORDERS

Biomedical Biomedical InterventionsInterventions Dan starts on vitamin, mineral, antioxidants, Dan starts on vitamin, mineral, antioxidants,

probiotics and essential fatty acidsprobiotics and essential fatty acids Methyl cobalamin (B12) injectionsMethyl cobalamin (B12) injections Dan is allowed gluten, caseinDan is allowed gluten, casein Dan is told to avoid corn syrup, Dan is told to avoid corn syrup,

preservatives, dyes and fast food, where preservatives, dyes and fast food, where ingredients/preparation is unknowningredients/preparation is unknown

Prescription medications:Prescription medications:– HaldolHaldol– LuvoxLuvox– TenexTenex– ZonisamideZonisamide

Clinical ObservationsClinical Observations

Enuresis – decreasesEnuresis – decreases Bowel movements decrease in Bowel movements decrease in

frequency from 8 to 2 per dayfrequency from 8 to 2 per day Attention – increases – Dan goes Attention – increases – Dan goes

to the movies and sits for 1 hour to the movies and sits for 1 hour 45 minutes45 minutes

Dan plays ice hockey with Dan plays ice hockey with increased concentrationincreased concentration

Next: more biomedicalNext: more biomedical

Addition of folinic acid and N-acetyl Addition of folinic acid and N-acetyl cysteine to methyl cobalamin injectionscysteine to methyl cobalamin injections

PANDAS protocol, per NIMH studies – PANDAS protocol, per NIMH studies – induction with 5 days of prednisone induction with 5 days of prednisone followed by penicillin, 1 gram dailyfollowed by penicillin, 1 gram daily

Actos (PPAR gamma agonist)Actos (PPAR gamma agonist) Celebrex (COX-2 enzyme inhibitor)Celebrex (COX-2 enzyme inhibitor) Diamox (carbonic anhydrase inhibitor)Diamox (carbonic anhydrase inhibitor)

Clinical ObservationsClinical Observations

Increased concentrationIncreased concentration Prompted use of words, says “Hi” without Prompted use of words, says “Hi” without

promptprompt GI – now 1-2 bowel movements/day, formed GI – now 1-2 bowel movements/day, formed

and normal appearanceand normal appearance Increased interaction with other adultsIncreased interaction with other adults Sleep is uninterrupted by urination; he is dry Sleep is uninterrupted by urination; he is dry

at nightat night No longer appearing to have headachesNo longer appearing to have headaches Summer camp – Dan gets “raves” – staff Summer camp – Dan gets “raves” – staff

cannot believe how his behavior has changedcannot believe how his behavior has changed

Who is Dan?Who is Dan?

After 6 months of biomedical After 6 months of biomedical intervention, his primary care intervention, his primary care pediatrician says “he looks like a pediatrician says “he looks like a different person!”different person!”

One year later………One year later………

Increased concentration, now on Face Book Increased concentration, now on Face Book communicating with 130 “friends”communicating with 130 “friends”

Health is excellentHealth is excellent GI and GU all functioning normallyGI and GU all functioning normally Haldol is discontinued without psychotic Haldol is discontinued without psychotic

behavior or sleep disruptionbehavior or sleep disruption Nemenda (glutamate receptor antagonist) is Nemenda (glutamate receptor antagonist) is

added due to increase in bizarre motor added due to increase in bizarre motor behavior, e.g. hands in mouth, walking with a behavior, e.g. hands in mouth, walking with a list to one side, strange finger movements and list to one side, strange finger movements and inability to perform tasks previously masteredinability to perform tasks previously mastered

Plan for DanPlan for Dan

Continue the immune supportContinue the immune support Heavy metal detoxification Heavy metal detoxification

(chelation)(chelation) Hyperbaric Oxygen TherapyHyperbaric Oxygen Therapy Intravenous Gamma Globulin Intravenous Gamma Globulin

(IVIG)(IVIG)

WHY CHELATE?WHY CHELATE?

MercuryMercury Epidemic trends in ASD in the 1990’sEpidemic trends in ASD in the 1990’s Thimerosal – an ethylmercury Thimerosal – an ethylmercury

compoundcompound added to vaccinesadded to vaccines Increase in the number of vaccines Increase in the number of vaccines

given to infants and toddlersgiven to infants and toddlers All these vaccines add up to as much as All these vaccines add up to as much as

200 micrograms in the first 6 months!200 micrograms in the first 6 months! In 1999 AAP requires thimerosal to be In 1999 AAP requires thimerosal to be

removed from all pediatric vaccines removed from all pediatric vaccines ASAPASAP

Remaining thimerosal containing Remaining thimerosal containing vaccines expired by 2003vaccines expired by 2003

Thimerosal still present, in very small Thimerosal still present, in very small amount in DT, Tetanus Toxoid, amount in DT, Tetanus Toxoid, Menomune and certain Flu vaccinesMenomune and certain Flu vaccines

Mercury: What can it Mercury: What can it do?do?

Increases oxidative stressIncreases oxidative stress Decreases glutathione productionDecreases glutathione production Increases inflammatory cytokinesIncreases inflammatory cytokines Causes cell deathCauses cell death Accumulates in brain, liver, and Accumulates in brain, liver, and

other organsother organs

What about Lead?What about Lead?

Lead is ubiquitous in our environment – 4-5 Lead is ubiquitous in our environment – 4-5 million tons have been deposited in the million tons have been deposited in the environment from car exhaust aloneenvironment from car exhaust alone

It can be found in the water, air, soil and dustIt can be found in the water, air, soil and dust Ingestion occurs by hand to mouth transmissionIngestion occurs by hand to mouth transmission 80% of lead poisoned children can be 80% of lead poisoned children can be

asymptomaticasymptomatic Lead has a half life in the body of 20 years!Lead has a half life in the body of 20 years! Lead exposure can result in neurological damage, Lead exposure can result in neurological damage,

learning and behavioral problems and lowered learning and behavioral problems and lowered intelligenceintelligence

Fetal exposure to lead affects neurodevelopmentFetal exposure to lead affects neurodevelopment

Symptoms of Metal Symptoms of Metal PoisoningPoisoning Emotional lability, irritability, behavioral changesEmotional lability, irritability, behavioral changes Poor focus and attentionPoor focus and attention HyperactivityHyperactivity Loss of developmental milestones, language delayLoss of developmental milestones, language delay Learning delaysLearning delays Criminal, delinquent behaviorCriminal, delinquent behavior Abdominal pain, loss of appetite, vomiting, constipationAbdominal pain, loss of appetite, vomiting, constipation Headache, ataxia,Headache, ataxia, Lethargy, somnolence, seizures, stupor, comaLethargy, somnolence, seizures, stupor, coma Muscle weaknessMuscle weakness Impaired fine motor coordinationImpaired fine motor coordination Visual-spatial impairmentVisual-spatial impairment Hearing defects, auditory processing problemsHearing defects, auditory processing problems Delayed growthDelayed growth

Other Toxins: Other Toxins: AluminumAluminum

- no physiologic need- no physiologic need- ability to cross blood brain barrier - ability to cross blood brain barrier

enhanced by fluorideenhanced by fluoride- found in vaccines- found in vaccines- inhibitor of Magnesium, calcium and iron- inhibitor of Magnesium, calcium and iron- increases oxidative stress- increases oxidative stress- decreased glutathione- decreased glutathione- increases lipid peroxidation- increases lipid peroxidation- synergistic with mercury to increase toxicity - synergistic with mercury to increase toxicity exponentiallyexponentially- deposited in brain, bone, muscle, kidney and liver- deposited in brain, bone, muscle, kidney and liver

Other Toxins: Other Toxins: Organic PollutantsOrganic Pollutants

– Phthalates, pesticides, herbicides, PCB’s, BisphenolsPhthalates, pesticides, herbicides, PCB’s, Bisphenols– Difficult to detox, stored in fat, cord blood, breast Difficult to detox, stored in fat, cord blood, breast

milkmilk– Tiny doses may interfere with hormonal signals that Tiny doses may interfere with hormonal signals that

regulate human organs, development and regulate human organs, development and metabolismmetabolism

– NO SAFE LEVELS!NO SAFE LEVELS!– DNA damageDNA damage– CarcinogenicCarcinogenic– NeurotoxicNeurotoxic– Damage spermDamage sperm– Allergies, asthma, diabetes, heart disease, thyroid Allergies, asthma, diabetes, heart disease, thyroid

diseasedisease

Vicious cycle of Vicious cycle of toxicitytoxicity

EnvironmentalToxins

Impaired Detoxification

Increased damage from toxins

Heavy Metal Heavy Metal Detoxification Detoxification ((the politically correct the politically correct term for term for Chelation)Chelation) Testing for toxic metal exposureTesting for toxic metal exposure Chelation agentsChelation agents

- DMSA - DMSA - DMPS- DMPS- EDTA- EDTA- D-penicillamine- D-penicillamine

Maintain adequate levels of glutathioneMaintain adequate levels of glutathione Maintain adequate levels of vitamins and minerals Maintain adequate levels of vitamins and minerals Continue checking urine for metals until excretion Continue checking urine for metals until excretion

levels are significantly reducedlevels are significantly reduced

Clinical Response to Clinical Response to Chelation of LeadChelation of Lead

Improved eye contactImproved eye contact Decreased hyperactivityDecreased hyperactivity Emerging language; words and sentencesEmerging language; words and sentences Decreased scripted language, echolaliaDecreased scripted language, echolalia Improved GI functionImproved GI function Improved skin, hair, nailsImproved skin, hair, nails Markedly improved learning abilities in Markedly improved learning abilities in

schoolschool Increased social skillsIncreased social skills

HYPERBARIC HYPERBARIC OXYGEN THERAPYOXYGEN THERAPY

Hyperbaric Oxygen TherapyHyperbaric Oxygen Therapy Dates back to 1662Dates back to 1662 Therapeutic uses:Therapeutic uses:

- wound healing- wound healing- GI disease- GI disease- Infectious diseases- Infectious diseases- Migraine syndromes- Migraine syndromes- Sleep disorders- Sleep disorders- Peripheral vascular disease - Peripheral vascular disease - Stroke- Stroke- Brain injury- Brain injury- Rheumatoid Arthritis- Rheumatoid Arthritis- Chronic fatigue syndrome- Chronic fatigue syndrome- Multiple sclerosis- Multiple sclerosis- Parkinson’s Disease- Parkinson’s Disease

And……………………………………………………………And……………………………………………………………

Hyperbaric Oxygen Hyperbaric Oxygen TherapyTherapy Autism Autism Autistic Spectrum DisordersAutistic Spectrum Disorders

Hyperbaric oxygen therapy may improve symptoms in autistic children. Med Hypotheses.  2006; 67(2):216-28 (ISSN: 0306-9877) Rossignol DA; Rossignol LW

• neuroinflammation and increased oxidative stress• decreased cerebral perfusion confirmed by SPECT and PET scans• temporal regions of the brain related to speech, language and auditory processing• HBOT is successful in known hypoperfusion syndromes

- cerebral palsy- fetal alcohol syndrome- closed head injury- stroke

• HBOT can normalize oxygen concentration in ischemic tissues• HBOT has potent anti-inflammatory effects by reducing oxidative stress

Hyperbaric Oxygen Hyperbaric Oxygen TherapyTherapy Oxygen is our primary source of energyOxygen is our primary source of energy Oxygen:Oxygen:

- promotes immune support- promotes immune support- destruction of toxins- destruction of toxins- promotes new cell growth- promotes new cell growth- displaces harmful free radicals- displaces harmful free radicals- destroys harmful bacteria, parasites- destroys harmful bacteria, parasites

and other microbesand other microbes- enhances absorption of vitamins, - enhances absorption of vitamins, minerals, amino acids, and other minerals, amino acids, and other

nutrients nutrients

Hyperbaric Oxygen Hyperbaric Oxygen TherapyTherapy

RESULTSRESULTS Statistically significant changes in autistic Statistically significant changes in autistic

symptoms, such as:symptoms, such as:- language- language- eye contact- eye contact- interactive play- interactive play- cognition- cognition- improved GI function - improved GI function - improved health and physical - improved health and physical

behaviorbehavior

Intravenous Gamma Intravenous Gamma Globulin (IVIG) Globulin (IVIG) TherapyTherapy

Improvement in children with autism treated with intravenous Improvement in children with autism treated with intravenous gamma globulin gamma globulin Marvin Boris MD;  Allan Goldblatt PA-C; Stephen M. Edelson PhD Marvin Boris MD;  Allan Goldblatt PA-C; Stephen M. Edelson PhD Journal of Nutritional & Environmental MedicineJournal of Nutritional & Environmental Medicine , Volume , Volume 15, Issue 4 December 2005 , pages 169 - 176 15, Issue 4 December 2005 , pages 169 - 176

Purpose.Purpose. Immune dysfunction has been associated with children Immune dysfunction has been associated with children with autism. One study found a beneficial response of intravenous with autism. One study found a beneficial response of intravenous gamma globulin (IVIG) therapy in autistic children. The present gamma globulin (IVIG) therapy in autistic children. The present study further evaluated the administration of IVIG to these children. study further evaluated the administration of IVIG to these children.

Results.Results. The participants' overall aberrant behaviors decreased The participants' overall aberrant behaviors decreased substantially soon after receiving their first dose of IVIG. Further substantially soon after receiving their first dose of IVIG. Further analysis of the total scores revealed decreases in hyperactivity, analysis of the total scores revealed decreases in hyperactivity, inappropriate speech, irritability, lethargy and stereotypy. However, inappropriate speech, irritability, lethargy and stereotypy. However, 22 of the 26 children regressed to their pre-IVIG status within 2-4 22 of the 26 children regressed to their pre-IVIG status within 2-4 months of discontinuing the IVIG. months of discontinuing the IVIG.

IVIGIVIG

Conclusions.Conclusions. Significant Significant improvement occurred in autistic improvement occurred in autistic children receiving monthly IVIG. children receiving monthly IVIG. There is a reasonable rationale There is a reasonable rationale considering the risk/reward ratio to considering the risk/reward ratio to utilize IVIG therapy in children with utilize IVIG therapy in children with autism. A well-controlled placebo autism. A well-controlled placebo double-blind study would be double-blind study would be important to further clarify the use important to further clarify the use of IVIG in autism and its duration of of IVIG in autism and its duration of benefitsbenefits

It’s not a sprint… it’s a It’s not a sprint… it’s a MARATHON!MARATHON! Do NOT sprint! Pace yourselves Do NOT sprint! Pace yourselves Pace your bodies, your spirits, your financesPace your bodies, your spirits, your finances There will be hills and valleysThere will be hills and valleys Never be complacent with what you achieveNever be complacent with what you achieve Always celebrate the milestones achievedAlways celebrate the milestones achieved As hard as it is for us, it is harder work for our As hard as it is for us, it is harder work for our

children.children.

ConclusionsConclusions

Autistic Spectrum Disorders are being Autistic Spectrum Disorders are being diagnosed in epidemic ratesdiagnosed in epidemic rates

They are not genetic disordersThey are not genetic disorders They are medical disorders of the They are medical disorders of the

immune system with genetic immune system with genetic predispositionpredisposition

There are environmental triggers that There are environmental triggers that may initiate the symptomsmay initiate the symptoms

Biomedical intervention does help in Biomedical intervention does help in many casesmany cases

Why Bother Doing This Why Bother Doing This With a 20 Year Old??With a 20 Year Old?? Why not??Why not?? You may have tried everything else!You may have tried everything else! Your child will enjoy lifeYour child will enjoy life You will enjoy life moreYou will enjoy life more They may live up to their full potentialThey may live up to their full potential Less burden on support staffLess burden on support staff Better residential placementBetter residential placement They may attain an independent lifestyle!They may attain an independent lifestyle!