Thursday, July 30, 2009

Clinic Notes: IPods and Asperger's

I love my IPod. Only the music that I want downloaded at a cheap price. I listen to my IPod when I run, want to relax, work outside, on planes, anywhere that boredom might sit in. I've even thought about doing ABA podcast, but haven't got around to it yet. And I tell mothers who bring their children to my clinic to listen to their IPod when their kids are tantruming. I wasn't surprised to read that IPods are being used to teach social skills to children with Asperger's. Kids with Asperger's have problems deciding what is appropriate and inappropriate social behavior. At a Minneapolis Center for children with Asperger's social stories depicting how to behave in different situations are placed on short videos and slide shows. The kids with Asperger's can watch the relevant videos or slide show before they are in the actual situation and then adapt their behavior. I plan to try this in my clinic with some of my Asperger's kids.

Friday, July 24, 2009

Clinic Notes: When the Baby Boomers Develop Alzheimer's and Today's Kids with Autism Grow Up Who Will Care for Them?

My mother has Alzheimer's and is in an Alzheimer's unit at a local nursing home. She doesn't know us anymore, but she is receiving the best care possible. And she should. It is costing $5000 per month to keep her there and she doesn't get her hair fixed for free anymore. Now that's extra.
In my clinic the parents of the children with autism that I see are worried about what will happen to their children when they grow up. In most states there is a long waiting list for sheltered workshops and group homes and many adults with autism are vegetating in their parents' homes.
My mother's Alzheimer's and the autism epidemic got me to thinking about the future. Could moderate to high functioning children with autism be taught to care for Alzheimer's patients, at least, Alzheimer's patients who were mild to moderate? Children with autism like schedules and with a visual schedule should be able to attend to many of the Alzheimer's patients' needs. Of course, some nursing care would still have to be provided. And children with autism seem to have an affinity for other people who have neurological disorders. It could be done and would save a lot of money. I think the Alzheimer's patients and the adults with autism would enjoy each other. I'm not sure to go about implementing this though. And surely someone would object.

Saturday, July 18, 2009

Clinic Notes: Stem Cells and Autism

Several years ago I read an article about a small stem cell company (StemCelInc.) who was trying to develop a cure for Batten Disease, a neurodegenerative disease of childhood. Children with Batten disease progressively loose function at an early age and eventually die. It is a horrible disease. I read all I could find about the company and its efforts and was so impressed that I bought stock, hoping that my small investment would help fund their research efforts. Since then I have bought other stem cells companies and closely followed their research efforts. Several companies, one of which is StemCells Inc., have received approval by the FDA to proceed with Phase 1 studies. In Phase 1 studies the safety of the drug, or procedure, is evaluated. Phase 1 is followed by other Phases to assess the success of the drug, or procedure, and potential side effects. Several companies, including StemCells Inc have now completed Phase 1 trials and the FDA is reviewing the results before allowing clinical trials. With mixed emotion I read in a recent Schafer report that a child with Autism from Maine was receiving stem cell therapy for his autism. Since stem cell therapies have not been permitted beyond Phase 1 trials in the US this child went to Costa Rica for his "therapy." The report mentioned that the treatment was expensive, that's no surprise, and they are starting a support group for parents who are interested. Of course, as a clinician I am very much against this for safety reasons and I feel like the expensive treatment is primarily motivated by greed. But then, if I were a parent of a child with autism I wonder how I would feel.

Friday, July 10, 2009

Clinic Notes: Autism and Gluten

Several years ago a pediatrician contacted me regarding her two-year old child who had just been diagnosed with autism. She worked in a large university hospital and took her child to the Neurology Department for an evaluation and they told her that autism was a neurological disorder. The followed up with an appointment with the Immunology Department and they told her that autism was an immune disorder. Similarly, in the Gastroenterology Department she was told that autism was a gastric disorder. In desperation she contacted me and asked what kind of disorder was autism. I told her in the end autism is a neurological disorder although gastric and immune factors may be involved in the etiology of autism. Previous studies have found a link between autoimmune disorders such as type 1 diabetes, rheumatoid arthritis and celiac disease. Celiac disease is a gastric disorder, which is treated by a gluten free diet. Gluten is found in wheat products and is in a variety of foods. Many parents have reported improvement in behavior in their children with autism on a gluten free diet. Unfortunately, this claim has not been confirmed in a double-blind study. In a double blind study the person giving the substance, in this case gluten or the absence of gluten, and the person receiving the substance do not know which they are giving or receiving. This is the standard for controlling placebo effects. I would like to see this study done, but I would like to see children in the study restricted to children with autism who also have gastric problems. This still wouldn't be a perfectly controlled study because the children not receiving gluten may simply feel better and therefore act better.

Thursday, July 02, 2009

Clinic Notes: Recovering From Autism with ABA

We have been telling parents for years that ABA is the best treatment for autism. But then we quickly add that there is no cure for autism and it is a life long condition. Well, maybe we were wrong. We have had data for some time suggesting that it may be possible to prevent autism in high-risk toddlers by using intensive ABA (See Now a recent study finds that one in ten children given intense ABA at an early age recover from autism. (See WebMD Health News for details). The results of this study do not surprise me. Many of the kids who started ABA early in my clinic seem to be "normal" by age six or seven. I think the problem now is finding affordable and competent ABA for all of the kids with autism who are out there.