Autismus Anhang 2


Asperger syndrom

Begabung und Herausforderung

Kinder mit der milderen Form des Asperger-Syndroms können reflektieren und sind meist nicht weniger intelligent als der Durchschnitt. In vielen Fällen sind sie sogar hochbegabt und haben ein Spezialgebiet. Weil sich auch ihre Sprache normal entwickelt und sie sich manchmal sehr gewählt ausdrücken, wird das Asperger-Syndrom oft

erst nach der Grundschule diagnostiziert. Asperger-Kindern fällt der Kontakt mit anderen schwer, sie können sich nicht in sie hineinversetzen und Blicke, Gesten und

Ironie deuten. Sie benötigen Routinen und eindeutige Ansagen. Informationen müssen sie logisch verarbeiten.

Über die Ursache des Syndroms streitet die Wissenschaft, sie liegt wohl in einer zu schwachen oder zu starken Verbindung zwischen Gehirnregionen.

Nicht nur in IT-Unternehmen wie Auticon und SAP werden Autisten mit dem Asperger-Syndrom wegen ihrer Akribie und ihres oft phänomenalen Gedächtnisses sehr geschätzt. Jeder 55 Erwachsene mit dem Asperger-Syndrom findet eine Anstellung - als Techniker, Informatiker, einige auch als Professor. Unbekannt hingegen ist, wie

viele "unentdeckte Autisten" längst fest im Berufsleben stehen.


[Jean Lacombe]

Many cases of children suffering autism can be greatly improved through homeopathy. In fact, some of the patients can have a complete recovery.

In this article I will share my experience with five cases of autism that had been successfully treated in the past few years. There are two different protocols offered for

dealing with autistic disorders as well as principal homeopathic characteristics that are often found in cases of autism. A short list of certain specific remedies which are

more effective in treating autism and recommendations of their proper dilution will also be included. At the end of this article I will include the level of general improvement achieved for every child.

Two homeopathic approaches in treating autism

In the last years I have developed two protocols that resulted in significant improvement of young patients. The first is prescribing a remedy according to the principle of “totality of symptoms” recommended by Hahnemann. While treating my autistic patients I have noticed that in many cases the prescription generally groups around ten homeopathic remedies.

The second approach is to “desensitize” the children from the possible side effects of vaccines they received by prescribing the homeopathic remedy made from the vaccine itself. This method can be recommended as an experimental approach when parents have clearly noticed that the child’s character and behavior changed during the days following vaccination. In many cases it appears that MMR vaccine -measles, mumps and rubella- sometimes produces large energetic disturbances as well as major disruptions of the defense system. When this occurs, MMR itself in dilutions of 30C to 10M would be prescribed. Recommendations about the potency of the remedy will be discussed later in this article.

Characteristic Autism Symptoms in 5 Cases:

The cases of Noah (5 year old), Igor (5 year old), Sebastien (7 year old), Raphael (4 year old), and Misma (6 year old), have a lot in common. Aside from the fact that all

of these children had been diagnosed with autism, they also had a number of characteristic symptoms. I have divided their symptoms into three categories:

1st category combines symptoms that I have found in all children;

2nd category includes the symptoms present in at least three children;

3rd category contains symptoms that affected only one child, but they are essential in confirming the prescription.


Group 1: Symptoms Found In All 5 Children

  Psychic hypersensitivity

  Although each of the children appears as “in a closed shell”, paradoxically, they exhibit extreme sensitivity and often very strong reactions to the atmosphere, people (sometimes even spontaneous aversions to a particular individual) or changes in schedule/order.

< Admonition

In circumstances when the parents have to go against their child`s will or desire, it is necessary to approach the situation with patience. The simple word “No” often leads to excessive crying or violent anger. With one of the children, scolding led him to hit his head against floor or walls.

Some additional rubrics of repertory to consider are:

Crying for nothing among children

Irritability among children

            Language Delay Not surprisingly, the speech of each child is poorly developed. Two of them don`t demonstrate any desire to communicate.

Certain delays in physical growth

The physical development of four of the children is significantly below the average. For the younger kids it is close to normal, but still, they are feeble.

• Concentration difficult

The concentration of these children seems pretty normal when they are doing activities they like, such as watching TV, playing video games, etc. However, the concentration is totally inadequate when

they have to face necessities, for example, while doing their homework in preschool, or trying to remember directions, etc.


After putting together the symptoms of the first group, we find the best remedies are: Carc. (10), Bar-c. Sil. Tub. (8), Calc-p. Med. and Nux-v. (7).


Group 2: symptoms presented in at least 3 children:

  Aversion to talking, reserved, doesn’t play with other children (mute, do not want to play with others)

  Except for one child, the children have problems with or have no interest in playing or sharing activities with other children (or sometimes even with parents).

  • Avoid eye contact

  With the exception of one child, these children do not seek eye contact with others and try to flee it. When confronted with this type of interaction, they feel irritable.

  • Compulsive or obsessive behavior

These types of behaviors often expressed by one or another child … jumping up, standing on a chair or a table and jumping to the floor, or always keeping toys in their hands (teddy bears or small cars)

• Agitation in children

None of these children could calmly attend the consultation.

• Sensitivity to music

Most parents reported that their child vividly reacts to certain musical tunes. Some music can make their child hum or dance.

• Autism, after vaccination

All these children had been vaccinated. In 3 cases, the parents noticed an immediate change of character or behavior the day after or the following week after their vaccination. Parents of the other two kids cannot remember anything particular (Fever? Sleep disorder? Eczema or pulmonary problem? First symptoms of autism?)


The results of repertorising the symptoms of the second group are: Carc. (9); Cham. Merc. Nat-m. (6).

Combining all the symptoms of group 1 and 2 gives the following: Carc. (18); Nux-v. (12) Tub. (12). Cham. Med. Nat-m. (11)


Group 3: characteristic symptoms affecting only one child:

  Grinding teeth at night

  • Sleepwalking

  • Nightmares

  • Intolerance to milk and dairy products

  • Bad breath

  Smelly stool

  • Nail biting

  • Warts on hands and fingers

  The result of repertorising the group 3 symptoms is: Sulph.; Ars. and Tub.; Calc.; Nat-m.


Combining all three categories of symptoms (groups 1, 2, 3) revealed a new balance for remedies: Tub.; Sulph.; Nat-m.; Ars. Carc.

Remedy selection.

The first approach (classical homeopathy) based on the rule of totality of symptoms considers 4 points:

  After twenty characteristic symptoms have been observed, some remedies were almost always present at every step: Carc. Tub. Med. Nat-m.

  The point mentioned above is interesting for two reasons:

  A) Carc. Tub. and Med. cover a relatively small number of symptoms. They are present in a limited number of Materia Medica rubrics (unlike Phos. Sulph. Calc. etc.) and yet… being the characteristic symptoms of autism … these remedies are in the first places!

  B) These three remedies belong to the category of rather rare remedies, the nosodes.

  Reflecting on the rubrics relating to the etiology “Following vaccination”, we have found these 4 remedies (Carc. Tub. Med. Nat-m.) not only in this category but also in the section “Autism, result of vaccination” in the repertory of Murphy (3rd edition).

  In 5 cases, the 1st approach led to prescribe Carc., the remedy that covers best the totality of symptoms of groups 1 and 2. In 4 of 5 cases, the treatment after Carc. was completed by Tub. +/o. Nat-m.


Remedy selection (Approach 2).

In two of five cases, I have also tried to use another method, the sequential therapy of Dr. Elmiger. This second approach doesn`t require any repertorising. You just need to be sure that the child has been affected by the vaccination and help “desensitize” the patient. The prescription should be the remedy diluted and energized from the vaccine that caused the problems. In one case the dose of MMR 30, 200, 1M and 10M K has been prescribed. In the second case, we started from the last immunization at the age of 4 years and have gone backward to childbirth. The prescribed remedies were MMR and DPT/ Sabin / Meningitis, Hepatitis. Both vaccines in doses of 30, 200, 1M and 10M K.

Observations about the second approach:

1. The prescription is not done according to the law of similarity but the principle of identity.

2. Despite the simplicity of this approach, results of the prescription can be spectacular.

3. The main idea of this approach, is that a vaccine created an energy barrier leading to appearance of the symptoms, and the remedy in potentized form will remove that barrier.

This approach is done by prescribing the potentized vaccines in a certain order, corresponding to the successive layers of appearance of symptoms. If a child had been vaccinated by X vaccine, then by Y vaccine, and finally

by Z vaccine, the order of prescription should be reversed, starting with the vaccine Z, then give the Y, and end with the prescription of X vaccine in proper dilution.



After a year of treatment, the diagnosis of autism was reversed for one of the boys. The first prescribed remedy was Nat-m. 30CH. Immediately the mother noticed that her son’s speech improved and that he had a greater desire to communicate. Tub. and particularly Carc. in doses of 30, 200, 1M and 10M K alleviated the symptoms of groups

1 and 2 by over 80%. The child has since been accepted into a regular classroom.

The second patient responded very quickly to the prescription of 200K and 1M of Carcinosinum. Most symptoms of groups 1 and 2 were improved by about 50%. The child continues to take Carc. 1M once a month.

For the 3rd patient, the symptoms of groups 1 and 2 were reduced by more than 80% after doses of Nat-m. (30C to 10M). His treatment lasted for 18 months.

Over a period of 8 months, the 4th child had extraordinary results with Carc. 30, 200, 1M and 10M. Considering that we had the situation under control with Carc we decided to continue treatment with MMR. It was clear for the mother that the child’s personality had changed in the days following the MMR vaccination. After administering the MMR 10M, the parents saw that their child had become normal again! A strong desire to communicate at home and at school, laughing, humor in the classroom. The boy refused to sit down when his teacher asked, but looked at the teacher with open eyes and

a wide smile! He is able to sleep alone, wakes up happy now and dresses himself. A new symptom of a bad breath appeared. Over the last three months MMR 10M was prescribed once monthly.

The boy is speaking more all the time. He looks obviously “happy.”

A last child had no reaction to the prescription of the second approach. The successive doses of DTP vaccine (diphtheria, tetanus, pertussis), then a dose of Sabin/Hepatiti/Meningitis/influenza vaccine, and subsequently a dose of MMR were taken with no results, but increasing amount of stool. I then chose the first approach and gave the boy Carc. 30, 200, 1M and 10M. There was no significant reaction, except a new tendency to bite. Troubled by the total ineffectiveness of these two prescriptions

I reviewed the case and prescribed a single dose of Stram. 10 M (hyperactivity following vaccination, autism, desire to bite). The treatment is ongoing. What a helpless feeling it was when a normally effective approach led to a minimum of overall improvement!

The choice of the potency

The treatment of these 5 cases during the last three years was a relatively recent experiment. Four of the five patients are still in the process of recovery. I would like to confirm that high dilutions (1M, 10M) of the remedies used are more effectives and provide better results. For many years I taught my students at Quebec Homeopathic Centre the principle that “totality of symptoms leads to the choice of remedy, as the nature of the symptoms leads to the choice of potency.” In the case of autism the symptoms are very characteristic and particularly intense. It looks like the vital energy is very powerful and therefore, it would require high dilutions of the prescribed remedies to restore balance.



In all cases of autism it is possible to reduce or eliminate many of the distressing symptoms in autistic children. In many cases it is possible to achieve complete recovery in these patients! At this stage of my experience I have found that the treatment of autism does not seem to be very difficult as long as the appropriate remedy has been chosen. The symptoms presented in the cases are very characteristic (see groups 1 and 2) and they lead to a rather limited number of homeopathic remedies. Additionally, when considering that the vaccination is the trigger of the disease, the prescription of remedies such as Carc., Tub., Nat-m. and Med. appears to be almost inevitable.

The less “classic” sequential approach can be equally effective in treating autism. This relatively easy to use method can also give surprising results. I hope that sharing these experiences will stimulate discussion of these methods and lead to many more successful healings.


[Prof. Dr. Karoly Horvath] arbeitet seit 1990 an der Universitätsklinik Maryland in Baltimore, Pädiatrie - Abteilung für Kinder - Gastroenterologie.

Er ist gebürtiger Ungar, sein Forschungsschwerpunkt an der Semmelweisklinik in Budapest war Zöliakie.

Im Vortrag erläuterte er seine Doppelblindstudie über die Wirkung von Sekretin bei autistischen Kindern im Alter von ca. 2 - 6 Jahren. Sie wird voraussichtlich im Herbst 1999 fertig gestellt sein.

Er zeigte folgende Hypothesen als mögliche Ursachen von Autismus auf:

Opioid Theorie: Abbauprodukte von Gluten und Casein (Peptide) haben

Veränderungen bei Vorgängen im Gehirn zur Folge und führen zu autistischen Verhaltensweisen.

Umwelteinflüsse: Einwirkungen von Toxinen

Antibiotische Therapie: Überwachsung der Darmflora [Pilze (Candida)]

Impfungen: Mumps-Masern-Röteln-Impfung

Autoimmunerkrankung: ein Forscher in Amerika fand Auto-Antikörper gegen Gehirngewebe bei autistischen Menschen

Keine dieser Hypothesen ist jedoch wissenschaftlich fundiert nachgewiesen und er führte diesbezüglich folgende Therapien an:

Gluten- bzw. (und) caseinfreie Diät


Substitutionstherapie mit Darmbakterien

Antikörper - intravenös: Gammaglobuin

psychiatrisch wirksame Medikamente


Letztere Behandlungsart wird von ihm angewendet und im Rahmen einer Gastroskopie konnten positive Veränderungen im Verdauungsvorgang und in Folge davon bei der Mehrzahl der Kinder Verbesserungen im Verhalten festgestellt werden. (Sozialverhalten, Sprache, Stereotypien)

Eine vermehrte Bildung von Verdauungssäften wurde beobachtet.


Wie bereits in der Zeitschrift der "Österreichischen Autistenhilfe" März 99, S.11 angeführt wurde, erläuterte er einen Zusammenhang des Sekretins mit den Gehirnaktivitäten, indem es die Produktion und Verwertung von Neurotransmittern anregt.

Im Zentralnervensystem gibt es verschiedene Stellen, wo Sekretinrezeptoren angesiedelt sind.

19 Gewebshormone könnten möglicherweise auch Auswirkungen auf Gehirnfunktionen haben, eines davon ist Sekretin.

Durch Tierversuche kam man zur Annahme, dass es Hormone gibt, die Nervenzellen vergrößern und die Zahl der Nervenverbindungen im Gehirn vermehren können.

Diese Beobachtungen können in eine neue Richtung bei der Forschung über Autismus weisen und möglicherweise eine Ursache für Autismus finden helfen.


[Karoly Horvath MD. PhD.* and Jay A. Perman. MD†]

Autistic disorder and gastrointestinal disease

Autistic disorder is a pervasive developmental disorder manifested in the first 3 years of life by dysfunction in social interaction and communication. Many efforts have been made to explore the biologic basis of this disorder, but the etiology remains unknown. Recent publications describing upper gastrointestinal abnormalities and ileocolitis have focused attention on gastrointestinal function and morphology in these children.

High prevalence of histologic abnormalities in the esophagus, stomach, small intestine and colon, and dysfunction of liver conjugation capacity and intestinal permeability were reported.

3 surveys conducted in the U.S. described high prevalence of gastrointestinal symptoms in children with autistic disorder. Treatment of the digestive problems may have positive effects on their behavior.

Recent epidemiologic data indicate that autistic disorder (AD), as defined by the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) criteria, affects as many as 1of 250 children.

This represents significant change since the early 1990s when autism was diagnosed in 1of 1000 to 2000 children. A gender difference is seen in AD; approximately 80% of the children are boys. Most of the recently diagnosed cases belong to the “late onset” group: normal development in the first year of life followed by regression in social and communication skills.

The focus in autism research has expanded from psychological studies to exploration of the biologic basis of this pervasive developmental disorder. Although the number of published metabolic, genetic, immunologic, and neuroimaging studies has significantly increased, we are still far from understanding the etiology of autistic disorder.

It is likely that no single cause exists. A generally accepted consensus regarding the brain areas responsible for autism does not exist.

The gastrointestinal (GI) tract was a relatively neglected part of autism research until the late 1990s, although two studies published almost three decades ago suggested GI problems in children with AD. In 1971, a report of 15 randomly selected autistic cases described six children who had bulky, odorous, or loose stools, or intermittent diarrhea; one patient had celiac disease.

The other study described low serum concentrations of -1 antitrypsin.

Two studies were published in 1998, which drew significant attention and initiated a new period in the investigation of the GI tract of children with AD. Wakefield et al. described ileal-lymphoid-nodular hyperplasia and nonspecific colitis in 12 children with developmental disorders; for 9 of them the diagnosis was AD. The other study, which was a case report of three children with AD, reported the results of upper GI endoscopies.

This paper described increased pancreaticobiliary secretory response following intravenous secretin administration, coinciding with a significant amelioration of the GI symptoms and improvement in eye contact, alertness, And expansion of expressive language. This review summarizes the GI symptoms, and histologic and functional abnormalities reported in children with AD.

ISSN 1040–8703 ©2002 Lippincott Williams & Wilkins, Inc. DOI: 10.1097/01.MOP.0000030221.71203.46 583

Gastrointestinal symptoms in children with autistic disorder Population surveys can provide a picture of the magnitude of GI problems in children with AD.

Three surveys (a total of 1280 subjects with AD) have been reported from Arizona, California, and the middle Atlantic region.

Agreement was found among the surveys that close to 20% of these children had chronic diarrhea. Our detailed survey in which children with AD were compared with their siblings found the following GI symptoms:

diarrhea (three or more loose or watery stools per day, persisting longer than 2 weeks);

constipation (two or fewer bowel movements per week hard in consistency; foul smelling stools; gaseousness (two to three times per week);

abdominal bloating (at least one time per week);

abdominal discomfort (at least one time per week);

food regurgitation (more than once a week).

Table 1shows the prevalence of GI symptoms in

112 consecutively examined children with AD and their nonautistic, age-matched siblings living in the same household. Overall, 76% of the autistic patients had at least one GI symptom as compared with 30% of the healthy siblings. Most the children with AD (64%) had two or more symptoms. A high%age of children more than 4 years of age with autism (48%) were not yet toilet trained, compared with 2% of their siblings.

Nongastrointestinal symptoms suggestive of digestive disease

Children with AD frequently have reflux esophagitis.

Infants and children with gastroesophageal reflux disease more frequently have sleep disturbance than the normal population.

Nighttime wake-up with pain, abdominal discomfort, or both is common feature of gastroesophageal reflux and reflux esophagitis in children. We found a higher prevalence of sleep disturbances and sudden irritability in children with AD who had GI symptoms.

Sleep disturbances

Children with neurologic, neuropsychiatric, and developmental disabilities are predisposed to sleep disturbances.

Sleep problems (interrupted sleep and limited hours of sleep) were reported in one third of handicapped children.

Another study of children with autistic disorder reported a 64% prevalence of sleep problems.

The most common problem was difficulty falling sleep (41%),

frequent awakening (34%)

early morning awakening (20%).

Our study found disturbed sleep with nighttime wake up in 52% of the patients with autism versus only 7% of the healthy siblings (P < 0.001). Children with AD and GI symptoms had a higher prevalence of sleep disturbances (55%) compared with those who did not have GI symptoms (14%). In our series of 36 children with autistic spectrum disorder, 61% of those with AD and reflux esophagitis had nighttime wake-ups compared with 13% of those without reflux esophagitis.

Sudden irritability or aggressive behavior

It is difficult to assess the cause of sudden irritability manifested as unexplained crying and aggressiveness in these nonverbal children with AD. More than 1/3 of the parents reported these symptoms in their children.

Although these features are not part of the DSM-IV criteria of autistic disorder, many experts consider them as autistic symptoms. We found that 43% of 28 children with esophagitis had daytime unexplained irritability versus 13% of those who had normal esophageal histology.

Whereas 24-hour pH probe measurements are necessary to establish a close correlation between acidic refluxes and irritability, it is technically not feasible to perform this procedure in most of these children.

Functional gastrointestinal abnormalities

Disaccharidase activities

Low activities of disaccharidase enzymes (lactase, maltase, sucrase, palatinase, and glucoamylase) were present in 21of the 36 children (58%) with AD. The most frequent finding was a low lactase level, which was present in 14 of 36 patients. Ten children had decreased enzyme activities in two or more enzymes. Children with low enzyme activities had loose stools, gaseousness, or both. Functional studies of carbohydrate malabsorption to prove the clinical significance of the disaccharidase findings would require that these children cooperate for breath hydrogen testing, which is not feasible in this population.

Pancreatic enzyme activities

Astroenterology and nutrition dases) consistent with pancreatic insufficiency. This patient’s sweat chloride test result was normal. For the remaining children, no difference was seen in the fasting

pH of the duodenal fluid nor in the prestimulatory and poststimulatory enzyme activities between those who were autistic and those who were not.

Pancreaticobiliary fluid secretion

Because secretin has a secretory effect on both pancreatic duct cells and the biliary epithelium, the fluid response (mL/min) represents a combination of these two fluids. We observed increased volume of secreted fluid following secretin administration (2 cu/kg body weight [BW], intravenous, during endoscopy). Average pancreaticobiliary fluid output was significantly higher (3.8 ± 2.2 mL/min) for the autistic group compared with controls (1.46 ± 0.57 mL/min; P < 0.05). Of the 36 children studied, 75% had a fluid output 1SD above the values of the patients who were not autistic. Typically, the children with AD with chronic diarrhea had a higher fluid output compared with those without diarrhea (4.8 ± 2.3 vs 2.4 ± 1.3 mL/min; P < 0.05).Increased response to administration of a hormone is suggestive of the upregulation of the receptors for that hormone. The reason for the increased response warrants further investigation.

Intestinal permeability

D’Eufemia et al. reported that 43% of the children with AD without evident GI symptoms had increased intestinal permeability (lactulose/mannitol [L/M] test) as compared with none of the 40 controls. We performed permeability studies by using L/M tests in 25 children with AD and GI symptoms. Of the children, 76% (19/25) had a LM ratio above the cutoff value (0.03).

Sulfation deficit in the liver

Abnormal serum liver function tests have not been described in children with AD. Waring et al. studied the conjugation (sulfation and glucuronidation) process in the liver by using acetaminophen as substrate, and reported that the sulfate conjugation of acetaminophen was diminished in children with AD compared with those of age-matched children. We performed three acetaminophen tests on the same 26 children with AD.

Of the 26 children, 22 (85%) had basal acetaminophen sulfate: glucuronide ratio less than 1. Although slight fluctuations were seen, the individual ratios stayed in the same range in the two repeat tests performed at 6-week intervals. These measurements suggest a persisting defect in the sulfation capacity of the liver (unpublished data). This decrease in the sulfation, if present in the brain and small intestine, may influence the activation and catabolism of certain hormones and neurotransmitters.

Histopathology of the gastrointestinal tract

Gross upper GI endoscopic findings (ulcers, erosions) are rarely found in these children. On routine histologic examination, reflux esophagitis (25/36; 69%) was the most frequent finding in 36 consecutive children with AD who had upper GI endoscopy. The clinical symptoms correlated well with the histologic findings. Of the children with reflux esophagitis, 93% had at least one of the following symptoms: signs of abdominal pain, nighttime

wake-up, and sudden daytime irritability.

Chronic gastritis was reported in 15 of 36 children. Of the 36 children, 24 had chronic duodenitis. Although increased numbers of lymphoid aggregates and lymphocytic infiltrate in the mucosa with mild distortion of the surrounding glands were present in the stomach, none of the children had Helicobacter pylori infection. Only 2 of the 36 children had mild villous blunting in the duodenum, but the histologic features were inconsistent with celiac disease. We have tested the sera of more then 400 children with AD, and none of them had serologic evidence of celiac disease (unpublished data).

A gluten- and casein-free diet is generally used in patients with AD.

This practice is based on two hypotheses. The first is that autistic behavior can be partially caused by a dysfunction in the brain opioid system. The second is based on the fact that both gluten and casein have potentially opioid segments called “gliadorphins” and -casomorphins, respectively. It is presumed that because of the “leakiness” of the intestine these peptides pass the intestine and reach the brain.

However, scientific confirmation of these two hypotheses is warranted.

Routine histology showed increased staining at the base of crypts where Paneth cells are localized. Paneth cells produce many factors (eg, lysozyme, lactoferrin, defensin), which may play a role in local immune defense.

A morphometric analysis of Paneth cells was performed on the biopsies of all the 36 children with AD and 22 agematched controls who were not autistic. An elevated number of Paneth cells per crypt were found compared with the control group (3.09 ± 0.46 vs 2.07 ± 0.32; P < 0.05). Our recent immunohistochemical studies combined with digital image analysis revealed that the lysozyme content was much higher in the Paneth cells of autistic subjects than in controls (unpublished data). No clear explanation exists for the changes in the Paneth cells in children with AD. It may be the consequence of either

a dysfunction in local immune defense or in the digestive system.

Wakefield et al. obtained ileocolonic biopsies from 60 consecutive children with developmental disorders, 83% of whom had AD. 59% had one or more GI symptoms (eg, abdominal pain, constipation, diarrhea, changing stool consistency [constipation # diarrhea], or bloating. All were well nourished with height and weight within the normal range. Colonic endoscopic findings included segmental swelling, hyperemia, superficial erosions, and nodularity. On histologic Autistic disorder and gastrointestinal disease Horvath and Perman 585 examination, mild to moderate ileal lymphoid nodular hyperplasia (LNH) was described in 93% of the developmentally delayed and autistic children examined. In the colon, 30% had LNH. Histologic signs of chronic colitis were identified in 53 of 60 children (88%). An increase in the number of intraepithelial lymphocytes was present in 13% of the children. None of these findings was compatible with an inflammatory bowel disease.

The same research group performed immunohistochemical staining on transverse colonic biopsies of 21children with AD and in four control groups: normal controls (n = 8), patients with LNH (n = 10), ulcerative colitis (n = 14), and Crohn disease (n = 15). The main findings in children with AD were (1) a significant increase in the basement membrane thickness; (2) increase in the mucosal gamma/delta cell density; (3) increased number of CD8+ (suppressor cell) cells; and (4) intraepithelial lymphocytes.

In addition, the density of CD3+ cells and plasma cells and the crypt proliferation ratio were higher in children with AD than in normal controls.

Disruption of epithelial glycosaminoglycans was detected with special staining. The epithelium in children with autism was HLA-DR negative, which is suggestive of a predominantly type 2 T-helper response. These two studies concluded that a new variant of inflammatory bowel disease is present in children with autism and other developmental delays.

Torrente et al. reported IgG deposition on the basolateral surface of the intestinal epithelial cells in 23 of 25 autistic children. The IgG deposits were colocalized with complement C1q, which was not seen in patients with celiac disease or in normal controls. The IgG-C1q colocalization was accompanied by increases in mucosal lymphocyte density and crypt cell proliferation, which, together with the epithelial IgG deposition, are suggestive of an autoimmune process.

Histologic and immunohistochemistry studies performed on the intestinal biopsies of children with AD, thus, demonstrate the presence of chronic inflammation in the GI tract. As mentioned, a recent immunohistochemical study raised the possibility of an autoimmune pathomechanism in the autistic gut. Also, serologic data indicate a possible autoimmune pathogenesis. Cell-mediated immune response of peripheral lymphocytes to the brain myelin basic protein was reported in 13 of the 17 patients with autism. Antibodies to myelin basic and neuronaxon filament proteins were present in the sera of autistic patients, and patients with positive measles and herpes virus 6 antibody titers more likely had autoantibodies to these brain proteins. If the autoimmune process is proved, the described GI inflammation may be the consequence of a multiorgan inflammatory process.


Autism is a dysfunction of the brain areas responsible for communication, language, and social interaction. It is apparent that the children with AD have a high prevalence of various GI symptoms and dysfunctions.

Future research should clarify whether digestive inflammation is part of a unique multiorgan, probably autoimmune, process.

Pending answers, clinicians can treat most GI symptoms in children with autism by using conventional GI treatment options. In our experience, treatment of the GI problems (eg, reflux, colitis) often has beneficial effects on the behavior of children with autistic disorder.


A Pediatrician's Insight on Autism

LILIPOH (= an acronym for Life Liberty and the Pursuit of Happiness through Health) Please give us a short introduction to your practice.

Dr. Allen: I have been a pediatrician for 21 years, and I am board certified in anthroposophic medicine, holistic medicine, and traditional pediatrics. In 2008, my wife and I set up an anthroposophic healing center near Fair Oaks, California, The Center for Living Health. We work with Susan Johnson, MD, and William Bento, PhD, as well as eurythmy, craniosacral, art, and extra lesson therapists.


LILIPOH: Do you see an increasing number of autistic children in your practice?

Dr. Allen: Yes, I have seen a significant increase in the number of children with autism in my practice and in the world at large since the late 1990s.


LILIPOH: Could you please outline the basic characteristics of autism, or the spectrum that is currently described with this word. How has it changed over the last few years?

[Dr. Allen]

Autism spectrum disorders (ASD) are characterized by:

1. Social-interaction difficulties such as: failure to respond to their names, reduced interest in people, and delayed babbling. By toddlerhood, many children with autism have difficulty playing social games, don’t imitate the actions of others, and prefer to play alone. They may fail to seek comfort or to respond to parents' displays of anger or affection in typical ways.

2. Communication challenges. Young children with autism tend to be delayed in babbling and speaking and learning to use gestures, and exhibit an inability to understand body language, tone of voice, and expressions that aren’t meant to be taken literally. For example, even an adult with autism might interpret as sarcastic, “Oh, that's just great!” as meaning it really is great.

3. A tendency to engage in repetitive behaviors. Common repetitive behaviors include hand flapping, rocking, jumping and twirling, arranging and rearranging objects, and repeating sounds, words, or phrases. Sometimes the repetitive behavior is self-stimulating, such as wiggling fingers in front of the eyes.

However, symptoms and their severity vary widely across these three core areas. Taken together, they may result in relatively mild challenges for someone on the high- functioning end of the autism spectrum. For others, symptoms may be more severe, as when repetitive behaviors and lack of spoken language interfere with everyday life.

Historically, according to the American Psychological Association, the term autism was first coined by Swiss psychiatrist, Paul Eugen Bleuler in 1908. He used it to describe a schizophrenic patient who had withdrawn into his own world. The root of the word autism is from the Greek "autos" which means "self." Combine that with the Greek suffix "ismos" which means “action or state of being,” and you get an original root meaning that roughly translates to a state of being absorbed by one's self or withdrawn within oneself. This makes sense today because people with autism often seem to be lost in themselves.

The pioneers in research into autism were Hans Asperger and Leo Kanner, who worked separately in the 1940s. The American child psychiatrist, Leo Kanner, studied children who had features of difficulties in social interactions, difficulty in adapting to changes in routines, good memory, sensitivity to stimuli (especially sound), resistance and allergies to food, good intellectual potential, echolalia or propensity to repeat words of the speaker, and difficulties in spontaneous activity. These were children who were severely affected. Hans Asperger studied a different group of children. His children also resembled those Kanner studied but they differed in one important respect: the children he studied did not have echolalia as a linguistic problem. Rather, they spoke like grownups. He also mentioned that many of the children were clumsy and different from normal children in terms of fine motor skills. These were very able children.

In addition, beginning around the 1940s, parents of autistic children began receiving blame for their child's autism, particularly the mothers, who were called "refrigerator mothers.” The whole idea behind the refrigerator mother concept was that children become autistic because of the mother’s frigidity. The mothers were supposedly "cold" to their child and didn't interact or play with them and didn't cuddle them. Of course, we now know that this is a ridiculous theory and the product of doctors being too quick to jump to a conclusion.

It wasn't until the 1960s that autism was established as a separate disorder, distinguished from others such as schizophrenia and retardation. Up to then, autism was treated very similarly to those disorders. From the 1960s through the 1970s, research into treatments for autism focused on medications such as LSD, electric shock, and behavioral change techniques. The latter relied on pain and punishment. During the 1980s and 1990s, the role of behavioral therapy and the use of highly controlled learning environments emerged as the primary treatments for many forms of autism and related conditions. Other treatments were added as needed. Currently, the cornerstone of autism therapy is behavioral therapy.

The DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, 4th ed, 1994, the current edition of American psychiatry's diagnostic guide) identified a set of separate Pervasive Developmental Disorders that are considered “autism spectrum disorders” (ASDs). These include Autistic Disorder, Asperger’s Disorder, Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS), Rett’s Syndrome, and Childhood Disintegrative Disorder.

However, one of the most significant changes with the new DSM-V, which will be formally unveiled in May 2013, is that the separate diagnostic labels of Autistic Disorder, Asperger’s Disorder, PDD-NOS, and Childhood Disintegrative Disorder, will be replaced by one umbrella term “Autism Spectrum Disorder.” The new Autism Spectrum Disorder will have new criteria to qualify, and Rett’s Syndrome is no longer included. These changes are already sparking quite a controversy in the autism community.


LILIPOH: Is the increase in the number of diagnosed “cases” a function of improved diagnosis, or could it be linked to increased stimulation, changes in the ability of teachers—or is there a basic genetic change?

Dr. Allen: There is a real increase in the number of children with autism. It is true that we are all now better at recognizing them, and even at younger ages, but that is a direct result of the epidemic of new cases. In 1960, the prevalence of autism was 1:4000. In 2000 it was 1:2000. Now it is 1:88 children in the U.S.

When I first started practicing in 1992, I worked in a large, traditional pediatric practice where we would see 250 or more kids every day. In a practice that large, you get an accurate pulse on the health, or lack of it, in the community at large. Trends in health are identifiable, such as the increase in diabetes and other autoimmune disorders in children that we have witnessed in our practice. We were not seeing these children with ASD in the early 1990s—autism was still rare!

Then, in the late 1990s, I started to notice more children who were not incarnating in a typical way. These children lacked sparkle in their eyes, and instead, there was dullness there, as if covered with a veil. These youngsters did not regard the human face with recognition and connection, and smile, but simply looked at me as if I were one of the many inanimate objects in the room. I was deeply moved. It made such an impact on me that 15 years later, I can still remember the first child I saw with what would later be diagnosed as autism. When I first started seeing these children, my colleagues and I were unable to diagnose them, but I would make a note in their chart about their eyes. Shortly thereafter, autism became very familiar to me and to the rest of the world.

The increase in diagnosis of autism is not simply the result of overstimulation (and/or other reactive disorders that might reveal mild symptoms similar to ASD), or the inability of teachers. True, teachers are having a hard time with these children, but it is not because they are any less capable than teachers of the past. It is because there is an epidemic of these children who are not incarnating typically, and we are all still learning about their gifts and challenges.

A genetic component has been identified, as there are more mutations in the genetic make-up of kids later diagnosed with autism versus kids that are not, when testing cord blood samples. However, this is true in some of the kids diagnosed with autism, but not all of them.


LILIPOH: What treatments have been found to be supportive in a child’s life after the diagnosis (therapy, stimulation, art, music, physical activity, medications, etc.)?

Dr. Allen: Each child or adult with autism is unique, so each autism intervention plan should be tailored to address specific needs.Traditional intervention can involve behavioral treatments, medicines or both. Many persons with autism have additional medical conditions such as sleep disturbance, ADD/ADHD, anxiety, seizures and gastrointestinal (GI) distress. Addressing these conditions can improve attention, learning, and related behaviors.

This can be traditionally done as follows: sleep disturbance (healthy sleep training, melatonin, or medications); ADD/ADHD (medication); anxiety (Cognitive Behavioral Therapy CBT and/or medications); seizures (medication) and gastrointestinal (GI) distress (dairy and gluten sensitivity/allergy—food restriction, probiotics). Objective scientific studies have confirmed the benefits of two methods of methods of comprehensive behavioral early intervention. They are the Lovaas Model based on Applied Behavioral Analysis (ABA) and the Early Start Denver Model.

Studies indicate that early intensive behavioral intervention improves learning, communication and social skills in young children with autism. While the outcomes of early intervention vary, all children benefit. Researchers have developed a number of effective early intervention models that work best if the intervention focuses on the core areas affected by autism (social skills, language and communication, imitation, play skills, daily living, and motor skills); if it provides the child with opportunities to interact with typically developing peers; and if the program actively engages parents in the intervention, both in decision making and the delivery of treatment.

Parents and therapists also report success with other commonly used behavioral therapies, including music therapy, floor time, pivotal response therapy, and verbal behavior therapy. Anthroposophic treatments that have been found to be beneficial include anthroposophic remedies, eurythmy, rhythmical massage, art therapy, and speech therapy. Rudolf Steiner said, in Education for Special Needs, that whenever we give treatment to a handicapped child, we are intervening in karma, and that this work of the gods

we must undertake as a benefit to us all.

The basic lessons we learn from our Waldorf kindergarten teachers -the benefits of adequate warmth, sleep, decreased media and overstimulation and good nutrition- are instrumental in helping all children, especially those with autism.

Growing evidence suggests that a small minority of persons with autism progress to the point where they no longer meet the criteria for a diagnosis of autism spectrum disorder (ASD). Various theories exist as to why this happens. They include the possibility of an initial misdiagnosis, the possibility that some children mature out of certain forms of autism and the possibility that successful treatment can, in some instances, produce outcomes that no longer meet the criteria for an autism diagnosis. I believe that when a child has an interruption in their incarnation process, they may reveal symptoms that resemble ASD. If we can meet them and support them anthroposophically, we can intervene in their karma and help them to heal.


LILIPOH: How can an anthroposophic medical outlook help us to understand autism?

Dr. Allen: Autism can be looked at as an atypical incarnation process. This specific “abnormality” reveals itself in the pattern of symptoms we call autism. Yet, one should ask, what is the purpose of autism? In anthroposophy, Steiner said that we prepare for our upcoming incarnation in the time between death and rebirth. The interweaving of the cosmos, the individual soul, and our specific karma come together as we make plans for what we want to work on in our upcoming incarnation.

Is the purpose of autism one of altruism, to serve as a sacrificial mirror (see below) or as a springboard for the individual soul to form a future earthly life, as Steiner indicated in his book, Education for Special Needs?

The essence of autism is a disharmony of the ego function. The ego does not engage the lower organization (metabolism) sufficiently from the periphery inward. This is reflected into the consciousness pole, as the centering of the ego in the upper organization is also deficient. The disturbed relationship of the ego results in a weakened etheric stream from the lower organization, which is too little for a healthy relationship to the soul forces. Thus, thinking, feeling, and willing cannot be brought together. 2 In a mild case, this might manifest as a bright child with autism who is hyper-focused on one topic but has difficulties with others, can’t read social cues, can’t feel love, has delayed speech, and repeatedly engages in hand-flapping. A child may come into this life with autism, or autism may develop from a vaccine or other physical injury, either to the brain or to the gut. If the injury is in the brain, then it causes a reflected injury in the gut, or if the original injury is in the gut, then the reflected dysfunction occurs in the brain.


LILIPOH: What are the social/spiritual implications arising from the fact that so many children are being diagnosed with autism?

Dr. Allen: According to educator Eugene Schwartz, if we look at illnesses as mirrors for the age, we see in our current mirror, indifference, social isolation, timidity, and lack of empathy. In autism we find individuals who share these “inbreathing” characteristics, and serve as sacrificial mirrors to reflect our time.

Ours is a time of materialism. This excessive materialism distracts us from our spiritual development. People with autism are handicapped in a way that prevents their spiritual development. This is a sign of our times. The purpose of autism is to balance out this excessive materialism. Thus autism can be seen as both the result of, and the remedy for, excessive materialism. We are suffering from the inability to develop spiritually and deeply connect with our fellow human beings. Autism reveals this to us, and gives us the opportunity to step away from ourselves and our immersion in the materialistic world, and focus on helping our children with autism and the world at large. We have to be sensitive, caring, and loving enough to open ourselves to the gifts that these individuals bring to the world. With healthy empathy and tolerance, we can support them and learn the meaning and balance of their incarnation. In the process, we learn to strive for healthy social connection and continue developing our potential as spiritual human beings.


LILIPOH: Can you explain what Rudolf Steiner and Karl Koenig, MD, said about what these individuals bring to their incarnation?

Dr. Allen: People who are handicapped bring in karmic blessings and karmic work for parents, siblings, caregivers - anyone and everyone who has a relationship with them in any way. This is a real Christ healing impulse to learn social connection, and how to care for our fellow human beings. Each handicap brings a specific lesson for the individual, parents, family and community.

R.S. once said that when we see a child with an “abnormality” and we immediately want to “fix” them, trying to get rid of the “abnormality,” we in fact are both not learning the lesson they bring, and might just be driving out a fragment of genius. I believe this is true, as my own son, Kieran, which means “beam of light,” came into this world as

an angel - a wake-up call to put me and my family back on our spiritual path when we were lost in the sea of materialism.

He was born with cerebral palsy and later developed seizures. Conventional medications failed, so Kieran led me on a holistic journey, including my introduction to anthroposophy, as I searched for things to heal my son. What I discovered in the process is that they helped to heal me.

Kieran’s quality of life improved, and he remained with us long enough to complete our life lessons. Then, two weeks after his seventh birthday, he developed pneumonia and unexpectedly passed. This was the hardest lesson for me as a father, as a pediatrician, and as a human being, to learn. Yet, I was grateful for his teachings and for the awareness of his gift even during his lifetime. It was both the most difficult and the most gratifying experience of my life.

Kieran was a beam of light, an angel on this earth, who deeply touched everyone who was exposed to him. I believe that children with autism, like my son, are here to be our teachers.


LILIPOH: What happens to the parents? I understand that divorce rates are very high in families with children with autism. Are there resources to support the families?

Dr. Allen: Parents of children with autism are generally exhausted, isolated and frustrated. The physical, emotional and financial burdens are enormous, and friends and family shy away. However, the reported 80% divorce rate of parents with autistic children is erroneous. Recent studies have found that 64% of children with an autism spectrum disorder have two married biological or adoptive parents, while 65% of children who do not have an autism spectrum disorder had two parents. Another study revealed a 24% chance of divorce between autistic parents of autistic children versus a 14% chance of divorce between parents of non-autistic kids. Whichever study you believe is more correct, they are both much lower than 80%.

There are many resources available to families of autistic children and adults. These range from advocates to financial, diagnostic, books, diets, caregivers, support groups, social programs, education, parental support, blogs, and attorneys, etc. Some of these can be accessed through the Resource Guide by Autism Speaks (see below), that offers resources available specific to one’s state and zip code.


LILIPOH: What happens when autistic children grow up to be adults?

Dr. Allen: It all depends on their level of function and how well we've been able to help them to integrate with the world. A lot has to do with early intervention, understanding individuals with their specific gifts and challenges, and then putting enough support in place so that these individuals are able to reach outside of themselves, tolerate their surroundings and be able to interact with them.

Things generally improve as children with autism get older, yet nearly seven years after high school, 35% of autistic young adults still had no paid employment or education beyond high school. The statistics are dramatic: within a decade or so, more than 500,000 children diagnosed with autism will enter adulthood.

Some of them will have the less severe variants like Asperger’s syndrome or “high-functioning autism” and may be able to live more independent and fulfilling lives. But even this subgroup will require some support, and the needs of those with lower-functioning varieties of autism will be profound and constant as some will forever live in a supported environment, whether at home or in a group home, and will never hold a job.

There may be others who lead not only normal, but incredible lives, having so much to offer the world in the way of creativity and knowledge, as they share their gifts and passions, making the world a better place for all of us. We just have to be “open” to them, and to give them the opportunity without our traditional “limiting” boundaries.


LILIPOH: What research is happening that will let us project into the future?

Dr. Allen: Research is revealing that the risk of autism increases linearly with BOTH the age of the father AND the age of the mother at conception. Increased risk also happens with low folic acid levels, fever and flu during pregnancy, etc. There are both genetic and environmental factors currently being investigated. In addition, there

is significant research being done on the gut-brain connection (which is supported by Steiner’s view of the interaction or reflection between the upper and lower forces).

An autism tsunami is on the way. With the numbers of children diagnosed with autism skyrocketing, we will soon have over half a million young adults 18 or older in the United States with autism.

This is a global wake-up call!



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