The Carolina Center’s Approach to Autism & ASDs

Overview

Many children with autism and Autism Spectrum Disorers (ASDs) show an array of biological problems that may contribute to the behaviors associated with this disease.  Among the “core” problems are detoxification weaknesses, nutritional deficiencies, and intestinal imbalances such as yeast overgrowth.  The Autism Research Institute (ARI) has introduced an integrative biological treatment program for treating these and other conditions associated with autism, and this program is at the core of the Carolina Center’s approach to autism.  The program can be used in conjunction with Advanced Behavioral Analysis and other behavioral approaches, and there is increasing evidence of its efficacy, as reported in a systematic review of the evidence published in the December 2009 Annals of Clinical Psychiatry.

Individualized Biological Testing

Individualized, in-depth clinical and laboratory assessments are central to the success of ASD management.   Testing can be used to determine the presence of nutritional deficiencies, pathogenic intestinal bacteria, yeast overgrowth, toxic metals and chemicals, immune dysfunction, food allergies or intolerances, intestinal malabsorption and “leaky gut”.  We will also perodically retest laboratory values and adjust management as indicated.

Diet & Supplementation

Specific dietary strategies (e.g., emphasizing whole, natural foods and avoiding dietary casein and gluten,  as well as sugar and additives) are often helpful and make other strategies more effective.   Supplementation can help correct deficiencies or imbalances that have been identified through testing.  Redressing these imbalances can ultimately have a major therapeutic impact on children with autism. 

Digestive Health Support

Many individuals with autism have poor digestion and intestinal inflammatory conditions that limit nutrient absorption and contribute to brain inflammation and dysfunction.   Strategies for healing the digestive tract and minimizing digestive stress may include the following: a nutritional program that supports the intestinal mucosa; addressing food sensitivities; controlling the overgrowth of intestinal pathogens; and using digestive enzymes when needed.

Innovative Biological Therapies

Biological therapies may include heavy metal removal, hyperbaric therapy, Naltrexone, and intravenous nutrition strategies (e.g., IV iron for anemic children with yeast overgrowth).   The rationale for using these approaches has been continually strengthened in recent years.  For example, a 2009 report in the Journal of Toxicology demonstrated a strong relationship between the severity of autism and the relative body burden of toxic metals.   Heavy metal removal is carried out in conjunction with an intensive nutritional program and can result in major behavioral improvements.  In addition, children undergoing hyperbaric oxygen therapy often show rapid progression in language skills and the expansion of their vocabulary.   A recent review of the evidence in the June 2008 Annals of Pharmacotherapy found that Naltrexone improved attention and eye contact while also decreasing self-injurious behavior, hyperactivity, agitation, irritability, temper tantrums, social withdrawal, and stereotyped behaviors.  Supplements such as melatonin and 5-HTP (activated tryptophan) may help reverse many of the sleep problems commonly seen in children with autism.  Biologically based treatments guided by appropriate testing, along with improved understanding of the environmental causes of autism,  may offer the best hope for overcoming this profound disorder.

Scientific References

Rossignol DA.  Novel and emerging treatments for autism spectrum disorders: a systematic review. Ann Clin Psychiatry. 2009; 21(4):213-36

Kidd PM.  Autism, an extreme challenge to integrative medicine. Part 2: medical management. Altern Med Rev. 2002; 7(6):472-99

Elder JH. The gluten-free, casein-free diet in autism: an overview with clinical implications. Nutr Clin Pract. 2008-2009;23(6):583-8;  Goin-Kochel RP, Mackintosh VH, Myers BJ. Parental reports on the efficacy of treatments and therapies for their children with autism spectrum disorders. Research in Autism Spectrum Disorders 2009;  Lucero M, Stang J, Goldberg D.  Nutrition practices of children with autism.  J Am Diet Assoc. 2003; 103 (Suppl 9): 67

Kidd PM.  An approach to the nutritional management of autism. Altern Ther Health Med. 2003; 9(5):22-31

Horvath K, Perman JA.  Autistic disorder and gastrointestinal disease. Curr Opin Pediatr. 2002 Oct;14(5):583-7; Erickson CA, Stigler KA, Corkins MR, Posey DJ, Fitzgerald JF, McDougle CJ.  Gastrointestinal factors in autistic disorder: a critical review.  J Autism Dev Disord. 2005 Dec;35(6):713-27

Weber W, Newmark S. Complementary and alternative medical therapies for attention-deficit/hyperactivity disorder and autism. Pediatr Clin North Am. 2007; 54(6):983-1006

Adams JB, Baral M, Geis E, Mitchell J, et al. The severity of autism is associated with toxic metal body burden and red blood cell glutathione levels. Journal of Toxicology; 8/26/09; published online ahead of print

Rossignol DA, Rossignol LW, James SJ, Melnyk S, Mumper E.  The effects of hyperbaric oxygen therapy on oxidative stress, inflammation, and symptoms in children with autism: an open-label pilot study. BMC Pediatr. 2007 Nov 16;7:36

Elchaar GM, Maisch NM, Augusto LM, Wehring HJ.  Efficacy and safety of naltrexone use in pediatric patients with autistic disorder. Ann Pharmacother. 2006; 40(6):1086-95

Landrigan PJ.  What causes autism? Exploring the environmental contribution. Curr Opin Pediatr. 2010; 22(2):219-25.

Bradstreet JJ, Smith S, Baral M, Rossignol DA. Biomarker-guided interventions of clinically relevant conditions associated with autism spectrum disorders and attention deficit hyperactivity disorder. Altern Med Rev. 2010; 15(1):15-32