Parents of children living on the autism spectrum should be excited about MAPS. In 2012, the MAPS physicians training and certification group is the next generation in physician leadership for chronic conditions including autism. I am very excited about assisting with this important project and know this will provide great assistance to families looking for answers and positive treatments for their children.
I want to thank Dr Rossignol for leading this effort along with Dr David Berger to help families and build community for these much needed physicians.
This entry gives parents some insight of the history and next steps for this important effort. Enjoy.
Lisa Ackerman, TACA Founder & Executive Director.
By Dr. Dan Rossignol
We have all heard the statistic that 1 in 91 children in the United States has some form of Autism Spectrum Disorder (ASD). This means, on average, 1 in 40 households is somehow impacted by this disorder. On my street alone, there are 7 children with ASD! In many cases, the child who develops ASD had a period of time of normal development followed by a regression and then the development of ASD. This period of normal development, where parents observe their child functioning typically, propels parents of children with ASD to seek treatments to return their child to that level of functioning.
I first met Dr Bernard Rimland founder of Autism Research Institute in 2005. After a short period of time, I started calling him Bernie. At the time, I was searching for answers to the reasons why my two children had developed ASD. I was trained in evidence-based medicine at the University of Virginia and worked there with one of the pioneers of evidence-based medicine. For 3 years prior to meeting Bernie, I had trusted other physicians who informed me that there were no effective treatments for children with ASD. I was told the gluten-free and casein-free diet did not work and that nutritional supplements could not help. However, my wife was undeterred by these grim pronouncements and she began pursuing treatments for our children while I sat on the sidelines. When I met Bernie, one of the things that amazed me about him was that he viewed ASD not as a psychiatric disorder, but rather as a disorder characterized by biochemical and physiological abnormalities that could be tested, identified and treated. At the time, I was just beginning to understand these concepts, and a paradigm shift was occurring in my approach to not only ASD, but to disease in general. What I realized was that the type of medicine Bernie was talking about was what medicine used to be all about. Medicine was built upon the foundation of observation and identification of underlying mechanisms of disease processes. This identification of mechanisms is rooted firmly in identifying biochemical abnormalities that may be contributing to the features of disease. What Bernie taught me was to focus on the child and his/her biochemistry that may be contributing to the behavioral features of autism. In that sense, each child is a puzzle to sort out and identify what is functioning normally and what is functioning abnormally. I then began to search the medical literature for tests and treatments that could help improve the biochemistry and features of ASD. I no longer relied on other physicians or researchers to do this searching.
Over time, what emerged was a complicated amalgam of metabolic abnormalities, including mitochondrial dysfunction, immune dysregulation, inflammation, oxidative stress, methylation problems, transsulfuration issues and toxicity in ASD. For example, Dr. Richard Frye and I recently published a review article where we searched the world’s literature to identify how many studies implicated these biochemical abnormalities in ASD . Here’s what we found:
- 437 publications examined immune dysregulation or inflammation in ASD; 416 (95%) found an association
- 115 publications examined oxidative stress in ASD; all 115 found an association
- 153 publications examined mitochondrial dysfunction in ASD; 145 (95%) reported an association
- 190 publications examined environmental toxicant exposures in ASD; 170 (89%) found an association
- 62% of the publications in these 4 areas were published in the last 5 years (2006-2010)
- Genetic studies were the most common type of study in the medical literature concerning ASD; these studies accounted for more studies (1,576) than these 4 areas combined
Over the last several years, the emergence of multiple biomarkers has now given physicians the tools to identify these physiological abnormalities in children with ASD and other related disorders and to monitor the effects of treatments . Fortunately, the medical literature is now ripe with studies identifying these biomarkers in children with ASD as well as treatments that target these biochemical abnormalities. These treatments often include dietary changes, nutritional supplements and medications.
As the medical literature has grown, keeping up with new studies becomes more and more challenging. For example, a recent search of Pubmed reveals 19,414 articles concerning ASD. Of note, 55% of these articles (10,634) have been published since 2005, the year I first met Bernie.
Given the complexity of medical comorbidities and physiological abnormalities found in some children with ASD and other related disorders, and the emerging number of biomarkers and available treatments, many physicians have been searching for a way to integrate these findings into scientifically proven testing and treatments. That is where MAPS, the Medical Academy of Pediatrics Special Needs, comes in. This forward thinking organization is dedicated to establishing, teaching, and supporting the testing and treatment of children with ASD and related disorders.
MAPS is recruiting medical and scientific experts in the fields of ASD and environmental medicine to develop an in-depth, CME approved curriculum, as well as developing one of the largest care-focused treatment databases dedicated to this area of practice.
The timely development of this standard of care for testing and treatment becomes even more critical when so many parents are turning to the internet for self-education. Many desperate, well-intentioned parents are seeking information to get help for their child. Yet, with so many potential treatments being offered to these vulnerable families, they turn to their physicians with questions, concerns, and hopes for a better life. MAPS will ensure that physicians meet a certain standard, so parents can be assured they are receiving evidence-based information for their child.
MAPS has developed from the vision first laid down by Bernie. It is a continuation of his life’s work and passion for helping children with ASD and other related disorders to live a better life and to have their chronic medical problems properly identified and addressed. For more information about MAPS, please visit www.medmaps.org.
Dan Rossignol MD FAFFP
1. Rossignol DA, Frye RE: A review of research trends in physiological abnormalities in autism spectrum disorders: immune dysregulation, inflammation, oxidative stress, mitochondrial dysfunction and environmental toxicant exposures. Mol Psychiatry 2011.
2. Bradstreet JJ, Smith S, Baral M, Rossignol DA: Biomarker-guided interventions of clinically relevant conditions associated with autism spectrum disorders and attention deficit hyperactivity disorder. Altern Med Rev 2010, 15(1):15-32.
Read more about Dr Bernard Rimland’s efforts here: http://autism.com/all_rimland_tribune.asp
MAPS info http://www.medmaps.org