Biomedical Treatments and Autism…

You might be scratching your head and asking “what is biomedical treatment?”  Biomedical treatment is a term referenced often in the autism community to describe the process of thorough medical testing and treatments that assess both the biological and psychological processes of a child with autism. It’s an in-depth evaluation, a process that takes more time than the typical well baby visit.  Makes sense right?  Babies with autism are not well.

Why is the term unique to autism?  Dr. Sidney Baker describes biomedical as the following approach:

 The word biomedical means that the fundamental principle of biology – the individuality of each living creature –  is the first consideration in the medical treatment options for each patient. (1)

I learned about biomedical treatments after my son began experiencing some serious medical issues.  At first the term confused me.  It’s not used for other medical conditions like cancer, diabetes or cystic fibrosis.  These diseases are diagnosed in patients, who then receive medical treatment based on the lab results and the unique needs of the patient.

An autism diagnosis seldom leads to that same logical treatment path.  Because autism is considered a psychological diagnosis, many physicians don’t see the value in looking for medically caused issues that might be contributing to a child’s symptoms.  What many TACA families have found is that a psychological diagnosis does not mean that you cannot have legitimate physical ailments (also called co-morbid issues) as well.  Some recent research studies released in 2011 (2) support what parents have been saying for years.

The American Academy of Pediatrics recognizes some of the most prominent co-morbid issues common with autism, which include but are not limited to: gastrointestinal distress, seizures, mitochondrial disease and dysfunction, immune dysregulation, food allergies, sleep disturbances and autoimmune issues. Other issues include persistent bacterial or viral infections. (3)

Additionally, autism can also come with mood disorders, extreme behaviors, attention deficit, self stimulatory behaviors, obsessive compulsive behaviors, cognitive problems, learning differences and speech delays.  These issues vary greatly as the child ages and health status changes.

One thing we know about autism is the diagnosis is complex and very unique to the individual.  There is a common saying in our community: when you see one child with autism, you’ve seen one child with autism.  Rarely do these individuals look similar.  Their health needs are also unique to their individual needs.

Behaviors that accompany autism often get explained away by the label.  “Of course he shows signs of obsessive compulsive disorder.  He has autism.”  But what if in reality these behaviors were clues to treatable underlying medical issues.  The biomedical approach asks the question: could some of these issues be caused by poor health?

And that’s a tough question to answer for many reasons:

• One characteristic of the autism disability is difficulties in communication, including a percentage of people that are completely non-verbal.  Doctor’s examinations tend to rely at least in part on dialogue between the physician and the patient.  How much potentially vital information does the physician miss if the patient can’t tell you how he feels?  Where she hurts?
• Let’s face it – many of us are not particularly comfortable during a medical exam.  Additionally, people living with autism often have sensory issues – to light, to sound, to being touched, to cold or heat.  Now remember every medical appointment you have ever had…..a bright light in your eye, a steel object in your ear, funny little hammer banging against your knee, stranger probing your back, stomach, etc.  ………You get the idea.
• Our kids also often exhibit an inability to adapt well to strange settings or strangers.  All that sensory overload discussed in #2 can lead to patient overload.  Or as parents of children with autism call it:  Total Meltdown.  Overwhelmed, kids with autism may use self-stimulatory or obsessive compulsive behaviors in an attempt to calm themselves.  Those adaptive behaviors can further interfere with the medical exam.
• Finally, there are still so many unanswered questions about the causes of autism that our physicians and pediatricians continue to get confusing and conflicting information about what to look for and how to treat it.

These four issues can make it close to impossible for a person with autism to receive a thorough and meaningful exam.

After the picture I just painted, no wonder doctors unfamiliar with autism are often reticent to treat our kids.  Imagine examining an individual that can’t tell you what’s wrong.  Or a patient who exhibits unusual and sometimes highly disruptive behavior while you are trying to do your job. I get it.  Then their office gets destroyed by said patient.

But as parents we depend on, no we NEED medical professionals who have experience with autism and the patience of Job to investigate ALL the clues (behavioral and medical).   The willingness to run all the necessary lab work to uncover what is making our kids sick.

That’s why the term biomedical intervention provides an important distinction over conventional medicine. It takes time, patience, labs, multiple exams and long appointments to sleuth through the clues to effective treatments.

Nutrition plays a huge role in the solution. Garbage in garbage out right? Food choices make a big difference in every kid’s life – especially kids with autism.  Many kids have sensitivity issues involving taste, texture and smell which can lead to a very limited diet.  Treatment plans need a complete nutrition plan and allergy avoidance strategy to be successful.

For many families biomedical treatment means a professional will take the time to meet with the family, exam, test and figure out what is going on. This can take months or even years to find, diagnose and treat.  Once diagnosed with autism, biomedical treatments can be partnered with traditional therapies, such as applied behavior analysis, speech and occupational therapies.

We all know if you feel better you can actually learn and acquire skills.

The Autism Treatment Evaluation Checklist (ATEC) is a great tool for clinicians and parents to evaluate treatments based on autistic symptoms. ATEC scores collected from thousands of families yield important clues to common treatments for ASD. (4)

What parents can do today:

• Find a professional willing to take the time with your child to look beyond the autism label
• Obtain a TACA mentor and get connected to parent education. (5)(6)
• Run labs based on an extensive exam and patient history review.
• Normalize labs by treating co-morbid conditions unique to the individual.

Maybe we are using the wrong terminology.  The term we could be using is functional medicine.  Functional medicine is primarily used for to convey the idea of prevention while dealing with chronic conditions AND treating them.

After all, biomedical intervention or functional medicine is really just another way to say “proper health care.”  It involves handling individuals with dignity and respect to help ensure good health.  It’s about taking time with a patient and not dismissing symptoms of physical illness because of a psychologically defined diagnosis.  It takes knowledge and persistent efforts to find the answers that can lead to treatments and change a life for the better.

The 1 in 91 living with autism deserve the best we have to offer.

Resources:

1)     What is Biomedical intervention? http://www.autism.com/pro_article_baker_01.asp

2)     New Studies

1. Williams, B. L., Hornig, M., Buie, T., Bauman, M. L., Cho Paik, M., Wick, I., Bennett, A., et al. (2011). Impaired Carbohydrate Digestion and Transport and Mucosal Dysbiosis in the Intestines of Children with Autism and Gastrointestinal Disturbances. (S. Jacobson, Ed.) PLoS ONE, 6(9), e24585. doi:10.1371/journal.pone.0024585.t008
2.  Nutritional and metabolic status of children with autism vs. neurotypical children, and the association with autism severity.

Findings: The autism group had many statistically significant differences in their nutritional and metabolic status, including biomarkers indicative of vitamin insufficiency, increased oxidative stress, reduced capacity for energy transport, sulfation and detoxification.

3)     American Academy of Pediatrics Standards of Care for Autism:
http://www.tacanow.org/family-resources/aap-standards-of-care/

4)      ATEC: http://www.autism.com/ind_atec.asp

5)     TACA Mentor program:  http://www.tacanow.org/about-taca/parent-mentors-guidelines/

6)     TACA Chapter info : http://www.tacanow.org/local-chapters/