PDD / Asperger's/ Autism Spectrum Conditions and Enzymes
last updated 8.25.05
What is it?
PDD = Pervasive Developmental Disorders. This is an umbrella term for an array of complex neurological conditions (disorders) characterized by severe and pervasive impairment in several areas of development, including social interaction and communications skills. There are five sub-categories and Autism is one of them. Asperger's Syndrome is also included although it does not have a designated category.
PDD /autism are considered 'spectrum disorders' because of the wide variety of symptoms and characteristics exhibited, as well as possibly underlying medical conditions and individual makeup. No one method alone is usually effective in treating these conditions. Professionals and families have found a number of different combinations of treatments which may be effective in helping the person to improve their quality of life and ability to function. These may include combinations of medications, nutrition, behaviorial, sensory, and educational therapies.
see National Alliance for Autism Research (US research site)
see Autism Society of America (US general information)
see National Autistic Society (UK general information)
see Dana's View (parent site with many specific resources)
A 'diagnosis' of a PDD condition is often given if the individual meets a certain number of observable behaviorial criteria. This can be a subjective call and can vary widely. This contributes to the wide diversity of symptoms included. Because the underlying causes of these symptoms can be very different, the appropriate 'treatments' for each person can be quite different and may take some trial and error, or detective work, to find. Usually, several types of therapies most appropriate for the person is used together in a total program approach. Finding this set and appropriate ways to implement each becomes the trick.
There is no cure for certain aspects of autism spectrum conditions (like different ways of thinking). However, there are a wide variety of therapies or treatment that may help alleviate some of the unpleasant or problematic symptoms of spectrum conditions (like gastrointestinal problems, bacteria infections, sensory input integration, motor skills, visual problems, etc.). A spectrum person may have pain or discomfort from gut problems just as well as a non-spectrum person. This site focuses on the gastrointestinal aspects and areas that digestive enzymes may assist with (which are many). Information on behavioral, educational, sensory, and other therapies are the focus of other sites. These all work together just as any person needs education, physical fitness, good nutrition and special attention to their individual needs.
see List of Abbreviations Often Used with Special Needs
Nutrition for Spectrum Conditions
Good nutrition and digestion is important for everyone. Someone, especially a young child or person with communication difficulties, may have a harder time relaying what they are feeling. So if something is upsetting them, you may not know exactly what is the problem. Children with neurological difficulties often have eating and digestive problems. This may be due to a real unidentified biological issue which is manifesting in problematic behavior. There is a nerve system that is tightly interconnected with the digestive tract. Things that affect digestion also affect the nervous system. The book 'Enzymes for Autism and other Neurological Conditions' focuses extensively on explaining this and how digestive enzymes fit into the picture (whether you want to supplement them or just understand how the gut and nutrition work). This book includes extensive scientific references.
Prevalence of chronic gastrointestinal symptoms in children with autism and autistic spectrum disorders.
Center for Epidemiology and Biostatistics, Cincinnati Children's Hospital Medical Center, OH 45229-3039, USA.
Molloy CA, Manning-Courtney P. 2003 June 7(2):165-71. PMID: 12846385
The purpose of this study was to estimate the prevalence of chronic gastrointestinal symptoms in a general population of children with autism or autistic spectrum disorder (ASD). The study site was a clinic specializing in ASD in a large pediatric medical center serving a 10 county area in the midwestern USA. In a sample of 137 children, age 24-96 months, classified as having autism or ASD by the Autism Diagnostic Observation Schedule-Generic, 24 percent had a history of at least one chronic gastrointestinal symptom. The
most common symptom was diarrhea, which occurred in 17 percent. There was no
association between chronic gastrointestinal symptoms and a history of developmental regression. The potential phenotypic association between autism and gastrointestinal symptoms is discussed.
see Selected Studies on Digestive Enzymes influencing Neurological Conditions
Diets/Eating Plans sometimes used:
see Feingold or Failsafe Programs
see Specific Carbohydrate Diet
see GFCF diet
see Keto diet
yeast control diets
Here is an outline or organization scheme for all the possible therapies:
1. Some type of one-on-one interacting with child, such as the following
(this would include academics and socializing skills)
- ABA, VBA, DTT
- RDI (Relationship Development Intervention)
- Faciliated Communication
2. Some type of Sensory Integration Therapy, as needed
- Sensory Integration (SI) therapy/Occupational Therapy
- Physical therapy/hippotherapy/sports
- Hearing therapy/AIT/Listening program
- Irlen lenses/special glasses
- Speech therapy/language training
- PECS - picture exchange system/sign language
3. Some type of biological measures, if needed
(this order is what I think is most efficient as a guide)
- Enzymes (primary)
- Probiotics (primary, in yogurt or supplements)
- Medications, if necessary or helpful
- Extra measures to heal gut (zinc, oatmeal, aloe, essential fatty acids)
- Reduce toxins (Feingold /Failsafe program, general detox, reduce chemical load)
- Extra supplements, if necessary (magnesium, selenium, calcium, multivitamin, essential fatty acids)
- Remove problematic foods, if necessary
- Yeast/bacteria treatment, if necessary
- Viral treatment, if necessary
- Special detox or chelation, if necessary
Digestive enzymes up front. The reason is that they are efficient, often eliminate the need for special diets and bucketfuls of supplements. You may still want to take a few selected supplements or remove a few foods, but not the exasperating and expensive amounts sometimes given. Good results often come quickly and inexpensively with enzymes and most people see improvement of some kind within the first 3-4 weeks, which is very encouraging. Enzymes help your body absorb and use other supplements or diet foods, so it is good to have enzymes in place when pursuing these other avenues. Enzymes also facilitate and work on the other items named: yeast, bacteria, viruses, and detoxification/chelation.
Probiotics are very good is assisting healing a gut and proper intestinal function.
Check for yeast/bacteria problems, or even viruses. Treat those up front if you have one because that may be at the root of many of the other problems and often you can see rapid improvement.
Remove artificial chemicals/additives/colorings and consider epsoms salts (cheap). This seems to improve behavior relatively quickly for the majority of those sensitive to it, and it is something you can do right away.
see Epsom salts
see Feingold Program
After all this, if you need to still remove some foods or add some supplements, do that, trying one at a time allowing several days between them to see if they are tolerated, if there are any delayed reactions, and allowing the body to adjust to any improvements.
Then any additional special detoxification protocols. Some of these can be done concurrently and some not, so they should be researched very thoroughly. This is one area where some detoxification or chelation methods have the potential to cause significant setbacks or permanent harm.
Too B or Not Too B
discussion on excessive B vitamins
Sometimes parents are advised to give very excessively high doses of B6 for their children with autism spectrum conditions. However, experience shows that many children have very terrible reactions to supplements with excessively high doses of B6. The ARI information from over several decades also shows that the majority of people with autism do not benefit from high B6 vitamin supplements although some do. A high does is about 50 mg, a very high dose 100 mg, and excessively high often way over that. While some B6 as well as other basic vitamins are beneficial, excessive amounts may be too much neuro- stimulant particularly for neurologically sensitive people. It is important to check with a qualified medical doctor for your situation when taking anything over the Recommended Daily Allowance of anything.
Why so many negative reactions and why might some do okay with it? For one thing, most all sources agree that B vitamins work as a team together and should be taken in the proper ratios - a balance of B vitamins. Taking an excessive amount of just one or two individual vitamins in the B family can cause deficiencies in other B vitamins. So you might just be trading one problem for another.
Another problem is that many synthetically made B6 vitamins may be made from coal-tar. Coal-tar derived synthetics include artificial colorings and flavorings. So if someone has a sulfate processing problem, or is sensitive to artificial additives of this nature, or doesn't tolerate phenolic compounds or artificial additives, then they may very likely not tolerate B6 vitamins if they are synthetically derived. If you are not tolerating B vitamins, you might want to look at a non- synthetic source of nutrients. More information and several non-synthetic formulations are at the link below. In the middle of this page are some links that go to research showing why taking lots of synthetic supplements is not always the most healthful, and you might want to try getting as much nutrition from natural sources as possible.
Nutrition and enzymes (general diet strategies)
This may be one good reason that many seem to do better with enzymes with regular diet (as much as possible) than super-restrictive diets and lots of synthetic supplements. And a reason why Peptizyde enzymes with casein/gluten foods in the diet bring much more improvement that staying on a GFCF diet for some spectrum individuals.
Another reason may have something to do with yeast. Dr. Semon (the author of 'Feast without Yeast' and autism doctor) said that if you have yeast you should NOT take B vitamins as these feed yeast...or the yeast intercept it so you don't benefit, etc. Something else to look into exactly if you have yeast and are considering B vitamins above the RDA level.
So who might benefit from extra B vitamins? Well, if you have a genetic condition called pyroluria. Pyroluria is none to cause deficiencies in B6 and zinc. The following link shows that pyroluria runs about 20% in autism and 30% in schizophrenia (although some doctors speculate this might be a bit higher). These numbers are roughly about the same number of people who seem to benefit from extra doses of B6 vitamins (extra zinc and evening primrose. So it might be that those benefitting from extra B6 are really correcting something brought on by pyroluria which brings the total body amount of B6 up to a typical level. The extra B6 is necessary to override the deficiency so the person is actually metabolizing something closer to an RDA or needed amount. Something to consider. There is a test that can be done through most commercial labs that checks for pyroluria. You can ask about having this done if you are considering extra high B6 amounts. This link also lists the symptoms/characteristics of pyroluria.
There is evidence that viruses can cause dysfunction in the brain and damage the protective coating, called myelin, around the nerves. This leaves the nerves exposed and susceptible to damage. A discussion on why autism has an autoimmune basis and why this most likely involves a virus. You can read ‘Autism, Autoimmunity and Immunotherapy’ at: http://libnt2.lib.tcu.edu/staff/lruede/singhfeature.html, or contact the Autism Autoimmunity Project.
for more information on these conditions
Magazines and Resources
Advocate magazine from Autism Society of America
Autism-Aspergers Digest magazine from Future Horizons
Abbreviations often used
Primary Behavioral Therapy Techniques
Floortime - Greenspan web site
Differences between the gut microflora of children with autistic spectrum disorders and that of healthy children.
J Med Microbiol. 2005 Oct;54(Pt 10):987-91. PMID: 16157555 [PubMed - indexed for MEDLINE]
Parracho HM, Bingham MO, Gibson GR, McCartney AL.
Food Microbial Sciences Unit, School of Food Biosciences, The University of Reading, Whiteknights, PO Box 226, Reading RG6 6AP, UK.
Children with autistic spectrum disorders (ASDs) tend to suffer from severe gastrointestinal problems. Such symptoms may be due to a disruption of the indigenous gut flora promoting the overgrowth of potentially pathogenic micro-organisms. The faecal flora of patients with ASDs was studied and compared with those of two control groups (healthy siblings and unrelated healthy children). Faecal bacterial populations were assessed through the use of a culture-independent technique, fluorescence in situ hybridization, using oligonucleotide probes targeting predominant components of the gut flora. The faecal flora of ASD patients contained a higher incidence of the Clostridium histolyticum group (Clostridium clusters I and II) of bacteria than that of healthy children. However, the non-autistic sibling group had an intermediate level of the C. histolyticum group, which was not significantly different from either of the other subject groups. Members of the C. histolyticum group are recognized toxin-producers and may contribute towards gut dysfunction, with their metabolic products also exerting systemic effects. Strategies to reduce clostridial population levels harboured by ASD patients or to improve their gut microflora profile through dietary modulation may help to alleviate gut disorders common in such patients.