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Technical report: The pediatrician's role in the diagnosis and management of autistic spectrum disorder in children (Pediatrics. 2001)

Therefore, there is a need to understand, Biology including Anatomy and cell biology Immunology and Biochemistry so that some of the biological approaches currently available for the treatment of the medical condition described as autism, can be understood, and people can make educated choices about applying them responsibly.

Define what a gluten-free casein-free diet is. Discuss why to consider using supplements and why to consider additional laboratory testing, Review alternative biomedical treatments. Discuss why consider a Gluten-free/Casein-free diet because you can try it on your own and there is research that suggests the diet can help many children.

Explain what gluten is. Gluten and gluten-like proteins are found in wheat and other grains, including oats, rye, barley, bulgar, durum, kamut and spelt, and foods made from those grains. It is also found in food starches, semolina, couscous, malt, some vinegars, soy sauce, flavorings, artificial colors and hydrolyzed vegetable proteins

Explain what is casein is. Casein is a protein found in milk and products containing milk, found in such as cheese, butter, yogurt, ice cream, whey and most brands of margarine, and some non-milk products such as soy cheese, hot dogs, and tuna fish, in the form of caseinate.

Explain about proteins and peptides proteins are made up of peptides. When foods are eaten, proteins from the foods are broken down by enzymes into peptides. Peptides are made up of amino acids. Amino acids are the building blocks of life. Amino acid is an organic compound (meaning it contains carbon). Amino acids have an amino group: 1 nitrogen and 2 hydrogens, at one end an organic acid or carboxyl group at other end.

There are two theories as to why autistic children cannot eat milk or wheat products. In on theory, dietary peptides are improperly broken-down. There is evidence that some people with autistic spectrum disorders cannot properly digest gluten and casein, which break down into substances that act like opiates in their bodies. According to this theory, these "drug-like" substance alters the person's behavior, perceptions, and responses to his environment.

The other theory is considered the immune dysregulation theory. In this case, abnormal immune responses occur. The immune system looses the ability to respond appropriately and when this happens, it is possible that the body develops abnormal responses to things it might not normally react to, like foods.

Review, anatomy of the “gut” or the digestive track, including mouth, esophagus, stomach, small intestine, large intestine, and colon, from gross anatomical perspective to and microscopic perspective

“Leaky Gut” which is an abnormal or unfavorable increase in intestinal permeability is defined. The intestinal lining is supposed to be barrier between the gut and the bloodstream. If the intestinal lining becomes damaged, it is possible for incompletely digested proteins and/or other by-products to “leak” through the intestinal lining. They can be recognized as foreign by the immune system, and/or “leak” into bloodstream.

Explain how to treat “Leaky Gut”. The gut needs to be cleansed of toxins., Avoid the following non-food foods: sugars, refined carbohydrates, and fatty foods. Enhance the flow of digestive secretions /enzymes. Provide proper nutrition to the body via supplements and proper nutrition/diet, and consider incorporating vitamins, anti-oxidants, and probiotics.

Explain what is Intestinal dysbiosis? Intestinal flora, including yeast and bacteria , are ubiquitous and are an integral part of the gastroinestinal track. Intestinal dysbiosis occurs when there is an overgrowth/imbalance of natural intestinal flora(s).

Explain how do your treat intestinal dysbiosis? Try laboratory testing to determine pathogen: like Yeast, clostridia, or unfavorable bacteria. Discuss prescriptive medications that could be used or over the counter treatments available.

Review Basic Immunology. Normal immune system function, depends upon proper immune systems responses. Cellular response produces T (matured in thymus) and B (produced in bone marrow) cells or lymphocytes. Humoral response involves the production of antibodies. When there is a Cellular response invading cells/bacteria are attacked and killed. This is called a TH 1 response. When there is a humoral response, antibodies are produces. This is called Th2 response. Humoral response produces antibodies: IgG-blood stream immune response, IgE-allergy, IgM-quick response, IgA-mucosa

Review Basic Biochemistry. Detoxification involved methylation and sulfation which are two of the healthy body's natural means of ridding itself of toxic substances: ASD children often need supplements to provide them with the raw materials their bodies need to carry out methylation and sulfation. Important chemical events in the body are made possible by methylation.

Review information about early intervention resources as well as provide and overview of behavioral therapies that are available. Discuss the significance of introducing some type of biomedical intervention in conjunction with behavioral and education therapies, and explain that in many cases the overall progress of a therapy program can be facilitated and accelerated because essentially, biomedical and behavioral therapies need to go “hand-in-hand”. This is because, as the body heals, it becomes more receptive and responsive to the various behavioral and educational interventions.

Take home lessons, are listed as follows. An understanding of a little bit of biology and biochemistry, and in turn why nutritional supplements may be important and how the GF/CF diet could help. An understanding of basic immunology and how things can go wrong. What to look for and laboratory testing that may be discussed. An understanding of the biochemistry of detoxification, and the importance of methylation and sulfation, and their relationship to supplements. Understand that biochemical and behavioral interventions need to be implemented together to enable more successful treatment results and outcomes