Sunday, July 26, 2009

Syndrome of Allergy, Apraxia, Malabsorption

Phenomenal! I love it as more and more science can support the fact that biomedical interventions for children with Autism are more effective than just traditional therapy alone. Here is a new research study supporting the use of a gluten free diet as well as supplementation for greater success in speech therapy. As many moms of children with Autism know, there are medical conditions that are underlying, you treat those and you have a reduction or in some cases, extinction of Autism related symptoms. This came from Dr. Jacqueline McCandless from her LDN Yahoo! group. Sorry for any formatting issues, I copied and pasted.
SCIENTIST FIRST TO CHARACTERIZE NOVEL SYNDOME OF ALLERGY, APRAXIA, MALABSORPTIONNewswise — A landmark study conducted by Children's Hospital & Research CenterOakland is the first to reveal a new syndrome in children that presents with acombination of allergy, apraxia and malabsorption. Autism spectrum disorderswere variably present. Verbal apraxia has until now been understood to be aneurologically based speech disorder, although hints of other neurological softsigns have been described. The new study, led by Children's Hospital & ResearchCenter Oakland scientist and pediatric emergency medicine physician, ClaudiaMorris, MD, and Marilyn C. Agin, MD, a neurodevelopmental pediatrician at SaintVincent Medical Center in New York, however, suggests that the symptoms ofverbal apraxia are, at least for a sub-group of children, part of a larger,multifactorial, neurologic syndrome involving food allergies/gluten-sensitivityand nutritional malabsorption."While it is critical to treat verbal apraxia symptoms that often include severedelays in expressive speech production with speech therapy, we need to startasking why these kids are having these problems in the first place so that wecan identify mechanisms we can actually target to treat the cause of thesymptoms," says Dr. Morris.Published in the July/August issue of Alternative Therapies in Health andMedicine, the new study takes a major step toward identifying the potentialmechanisms that may contribute to apraxia symptoms. In the study, Dr. Morriscollected information from nearly 200 families with children who suffered fromverbal apraxia in order to better characterize the symptoms and metabolicanomalies of a subset of children. The data clearly demonstrated a commoncluster of allergy, apraxia and malabsorption, along with low muscle tone, poorcoordination and sensory integration abnormalities. In addition, Dr. Morris wasable to gather laboratory analyses in 26 of the children, which revealed lowcarnitine levels, abnormal celiac panels, gluten sensitivity, and vitamin Ddeficiency among others.All children genetically screened carried an HLA gene associated with glutensensitivity and celiac disease. "The sample size is still small and should beinterpreted with caution," says Dr. Morris. "However this is of particularinterest given the recent publication by Eaton and colleagues in the July 6online edition of Pediatrics demonstrating a greater than 3-fold risk of autismin children born to mothers diagnosed with celiac disease. This brings somecredibility to the anecdotal reports of gastrointestinal and behavioralimprovements in children with autism spectrum disorders and/or verbal apraxiawhen eliminating gluten from their diets. Although the implications of theseobservations remain to be determined, this association and the utility ofdietary modifications warrant further investigation, particularly if we canidentify a genetically vulnerable group".Most significantly, the data indicate that the neurologic dysfunctionrepresented in the syndrome overlaps the symptoms of vitamin E deficiency. Whilelow vitamin E bioavailability may occur due to a variety of different causes,neurological consequences are similar, regardless of the initiating trigger. Thestudy suggests that vitamin E could be used as a safe nutritional interventionthat may benefit some children. Growing evidence support the benefits of omega 3fatty acid supplementation in a number of neurodevelopmental disorders.Anecdotally children with verbal apraxia will often demonstrate leaps in theirspeech production when taking high-quality fish oil. The addition of vitamin Eto omega 3 fatty acid supplementation in this cohort of children inducedbenefits that exceeded those expected from just speech therapy alone, accordingto parental report."While data from a case series is by no means conclusive, the results clearlypoint to the need for further attention to this poorly understood disorder, anda placebo-controlled study to investigate the potential role of vitamin E andomega 3 supplementation in this group of children," says Dr. Morris.She points out that it is equally important for children given an apraxiadiagnosis to receive a more comprehensive metabolic evaluation than what iscurrent practice. Many of the nutritional deficiencies like low carnitine, zincand vitamin D are easily treated. By not addressing the nutritionaldeficiencies, the child will continue to suffer from significant medicalconsequences of those deficiencies. The first step is to identify and treat thedeficiencies. The next step is to try to figure out why they have thesedeficiencies and a fat malabsorption syndrome in the first place. However, Dr.Morris does advise families to work closely with a physician rather than tryingpromising but unproven interventions on their own.In the mean time, however, Dr. Morris's study provides the essential foundationfor identifying the children who may need these treatments."By identifying these early red flags of the syndrome, we've provided a way toget these kids treatment at the earliest possible moment. While 75 percent ofthe time kids identified as late bloomers really are just that, 25 percent ofthe time there is a true pathologic condition. To miss it is to miss criticallyvaluable time for early intervention. If a child has all these symptoms, chancesare they are going to fall into the 25 percent who have a condition that needsfurther evaluation and treatment."


Kristy Treible said...

Thank you so much for sharing this! I might have to copy and paste this on my blog!

Mer (Lulu's Mommy) said...

Hi my daughter age 25 mo was just dx with apraxia