Sunday, July 11, 2010

The Principle of Perspective part two

Joining me for this post is Dr Bob Sears. In addition to being a husband, father, and an incredible pediatrician, He is the Author of “The Autism Book” and the Director of TACA’s Medical Advisory Board. He is also on Facebook. :)

Hi Dr Bob, Thanks so much for joining me for the beginning of this series! I am very thankful for your book and how you present the Bio-medical information for our families…and for the fact that we can then take the information in the book to our own doctors! With that, I am curious on what made you decide to get more involved with *Autism* within your practice?

Dr Bob- Ten years ago a parent brought her daughter into my office and asked me to help her with some treatments for her child with autism. Her ideas sounded “crazy” to me at the time, but I’m open minded and like to help. So I started investigating what she wanted to do for her child and it made sense. I trained with some open pediatricians who were already treating autism, and the rest is history.

KD- On page 61, you wrote “I believe that parents should not wait around for the mainstream scientific world to tell them what to do for their child. Yes Science will give them the answer someday, but that day will come too late for those reading this” I love this statement Dr Bob, because it shows how there is a bridge that needs to happen between evidence based medicine and validating what parents and physicians see with their children and patients. Can you briefly talk about Leaky Gut and Vitamin, Mineral, and nutritional deficiency?

Dr Bob- Leaky gut occurs because the intestinal lining is so irritated by inflammation from allergies and bacterial/yeast overgrowth that it acts like a net with holes in it. The net is normally only supposed to let digested food into the body. Instead, larger particles of undigested food (which are more allergenic) and toxins (that normally should pass out in the stools) are absorbed into the body. Vitamin and mineral absorption is poor and the child can because deficient in various nutrients.

KD- Great, and I know you go into detail about Leaky gut in your book. I also wanted to ask questions about the first five supplements to start as you mention in your book.

Dr Bob- The five primary supplements that help replace what most kids with autism are deficient in (or that are designed to help improve the neurologic and metabolic deficits that exist in most kids with autism) are digestive enzymes (to help calm down the leaky gut), taurine (an essential amino acid needed for a variety of metabolic functions), omega-3 oils (which help with inflammation, gut function, and neurologic function), multivitamins/minerals (to replenish deficiencies), and probiotics (to help make the gut a healthier environment).

KD- I can really relate to your recommendations. Enzymes and Probiotics made a huge difference in my younger sons body chemistry! My younger son who is now 9, was also Diagnosed with Low muscle tone like so many of our kids. Can you review some of what is in your book concerning this?

Dr Bob– Many kids with autism have low muscle tone. This is hypothesized to be due, in part, to dysfunctional mitochondria (the “batteries” in each cell that generate the energy molecules each cell needs to function). Less cellular energy results in lower muscular function. Taking various supplements that help improve mitochondrial function may help with muscle tone and coordination. Supplements include various B vitamins, Co-Q 10, and L-acetyl-Carnitine.

KD-I do know many families struggle with ADHD too. What are your recommendations for supplements that improve cognitive abilities and attention.

Dr Bob – Antioxidants are the basic approach here. I like pycnogenol and quercetin, two plant-based compounds that are very potent anti-oxidants. These help improve the function of various brain chemicals that are needed for attention and focus.

Methyl B12 (most effective when given as shots) along with glycine (an amino acid) and folinic acid (the active form of folic acid) can also help.

KD- Thank you again for giving us a preview of the Bio-medical information in your new book. “The Autism Book”. You have a heart of Gold when it comes to helping families! I can only hope that more mainstream doctors are able to be open minded and listen to the research…and include the parents as part of the team like you do! You strike a balance of mainstream medicine and a natural approach for all children!

Speaking of balance, I was also able to listen to the Autism One conference on Ustream last month. I loved the different speakers and their perspectives. One quote that I loved was from Dr Kartzinel “We don’t treat Autism, we treat the underlying medication conditions associated with Autism”

Here is another doctor who *gets it.* With our children, there was a tipping point in their neurology that halted development. With each child, that point is unique.

We cannot just address the behaviors that our kids exhibit, we need to start building the foundations of that which was halted…typical development. Like a one -two punch. Another quote from Dr Kartzinel at the Autism one conference is “Nothing is a cure all, we need to build a foundation”

Just as important to our children’s biochemistry is our children’s developmental function. That foundation will be talked about in detail as we continue. We, as parents, want our kids to have a foundations for theory of mind! We want our kids bodies healed, and their minds!

RDI is a program that restores a child’s natural development path before Autism affected their neurology. Just as Bio medical treatments are effective for the underlying medication conditions associated with Autism, RDI is effective in treating the developmental core deficits that were halted in Autism. The goal of RDI is to go back to the precise point where the child stopped developing typically and systemically allow the opportunities for a second chance at these developmental milestones. RDI uses the model of typical development with the parent or caregiver guiding the child with intruistic motivation to improve self awareness, co regulation and experience sharing so they are no longer obstacles to the child. These theory of mind functions are extremely difficult for children on the spectrum. RDI has simply taken the research on the development of typical children and applied that research to help our children revisit what they could not get the first time because of Autism.

I know you mention RDI in your book Dr Bob. How did you first hear about Relationship Development Intervention?

Dr Bob- I originally heard about it from other pediatricians involved in treating autism as an adjunctive therapy for children with autism to help them improve their social abilities. I have since learned that it is much more than that.

KD- What do you generally tell your patients regarding RDI?

Dr Bob- I have started to recommend it more and more as a primary developmental therapy (just as OT is a primary therapy) for my patients with autism.

KD- That is great! This is so important because we want our kids to understand what we understand… the very core of what makes us *care* about why we act the way we do. We want to fill in those developmental milestones which will prevent gaps and regression as our children get older. Relationship Development Intervention is the remediation program that accomplishes this goal by allowing our children with Autism to have a second chance to make those discoveries they missed the first time. This gets them back on the track of typical development, where their continued growth then flows naturally. Biomedical intervention can be needed to treat the underlying causes of the initial tipping point. Simultaneously, RDI ® follows the cognitive developmental sequence from the effects of the halted functioning, and builds a strong neurological foundation.

This foundation, the ability to “think” will be our first chapter in “the Cradle of though”
Once again, thank you so much Dr Bob Sears. You are invaluable to all of us in the Autism Community!
For all who are reading- Please feel free to ask any questions during this series as we explore *thinking.*

Friday, July 2, 2010

The Principle of Perspective Part One

Thought, desire and feelings. How do they integrate? I never dreamed this would be something I would give a second thought too. My world changed after my son was Dx with Autism. Like many, I was told my children ( I have two with ASD) would never lead a normal life, and need to be placed in an institution, This was my first sense that convention wisdom when it came to Autism had a long way to go in understanding what Autism * is*. I also discovered that while mainstream medicine needed an update, there were many cutting edge developmental scientists and Doctors that were leading the way to greater understanding. I am finally at a point where I see that we are ALL trying to unravel Autism and how to effectively help children live a quality of life that they want!

This is what is leading me to concentrate the next month or so in reviewing the Book * The Cradle of thought* by Peter Hobson. I read this book a few years ago, and I found this book helped me to understand what I needed to focus on with my children, as this book is one of the dozen that Dr Steven Gutstein used to help all children on the spectrum through Relationship Development Intervention ® .

Fast forward a few years later, both my children are doing fabulous and they have effectively returned to their own developmental tracks in development. My youngest is not with his peers yet, but he will be…. And they both are able to share perspective and understand social cues ( theory of mind)

Back to thought, desire and feelings. These are the foundations to subjective perspective in infancy. In turn, this subjective perspective matures into taking on another’s perspective.

Taken from a book by Peter Walsh PhD- “No, and ways parents can say it”

A fascinating experiment helped map this change. A group of toddlers at fourteen months and then eighteen months were presented with raw broccoli and Goldfish crackers and then asked to share. As the author Malcolm Gladwell explained in a January 10, 2000 article in The NewYorker:

Some years ago, the Berkeley psychology professor Alison Gopnik and one of her students, Betty Repacholi, conducted an experiment with fourteen-month-old toddlers. Repacholi showed the babies two bowls of food, one filled with Gold¬fish crackers and one filled with raw broccoli. All the babies, naturally, preferred the crackers. Repacholi then tasted the two foods, saying "yuck" and making a disgusted face at one and saying "yum" and making a delighted face at the other. Then she pushed both bowls toward the babies, stretched out her hand, and said, "Could you give me some?"

When she liked the crackers, the babies gave her crack¬ers. No surprise there. But when Repacholi liked the broccoli and hated the crackers, the babies were presented with a diffi¬cult philosophical issue—that different people may have dif¬ferent, even conflicting, desires. The fourteen-month-olds couldn't grasp that. They thought that if they liked crackers everyone liked crackers, and so they gave Repacholi the crackers, despite her expressed preferences. Four months later, the babies had, by and large, figured this principle out, and when Repacholi made a face at the crackers they knew enough to give her the broccoli.

Toddlers are not doing things parents don't want them to do JUST to be contrary. They are exploring this newly discovered difference between themselves and others.

Now that we see when theory of mind starts to emerge….we can look at Autism, and that lack of emergence, and ask… What happened? What was the cause of how the brain was deprived from this typical growth of thinking?

We know genetics could play a role. We know that our environment and the toxins a child is exposed to could play a role. We also know that it could be a combination of both and that each child’s tipping point that lead to the brain deprivation in development is unique. We know that there is regressive Autism and Infantile Autism. We will be exploring all these possibilities, going over Peter Hobson’s “The cradle of thought” and talking about effective interventions and why they are effective. I hope that you find this series in my blog helpful.

Since I am not a medical Doctor, Dr. Bob Sears will join me in part two to discuss some Bio-medical information regarding Autism.