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Dr. Robert Sears, MD, FAAP, pediatrician, and author has just released his new book, The Autism Book, a comprehensive guide to detecting, treating, and preventing autism. Here we ask him 5 questions regarding his book, his work, and his research on the issue after a decade of hands-on experience.

1. With so many potential causes of autism, what are the key preventive measures a woman who is pregnant or planning on becoming pregnant can take? You outline a thorough list in your book, but can you highlight the top 5 to begin with?

While we don't know what the actual cause of the autism epidemic is, we do know what medical problems tend to co-exist with autism. Identifying and preventing these, even before the autism is apparent, may be a useful form of prevention.

• Avoid Vitamin D deficiency – This is actually a hormone that plays a crucial role in many cellular processes within the body. Talk to a physician who practices integrative medicine about proper dosing in order to build up your levels. It’s best to correct a woman’s deficiency prior to pregnancy. Infants and children should be supplemented to prevent deficiency, and those who are already deficient need to take higher doses for several months under the guidance of a doctor.
• Avoid mercury – Women with mercury fillings should consider having them removed prior to pregnancy. While pregnant and breastfeeding, avoid mercury-containing fish like swordfish and shark, and limit tuna. And most importantly, steer clear of mercury-containing flu shots during pregnancy and childhood. Some companies make mercury-free flu shots every year.
• Identify food allergies as early as possible – Children with chronic rashes or loose stools are likely to have food allergies. Eliminate cow’s milk products and wheat from the diet (the two most common allergies in autism). The irritating effects of these allergens on the gut and the immune system can be a contributor to autism.
• Limit antibiotics – Antibiotic overuse leads to unhealthy gut irritation. Turn to natural treatments for common childhood diseases (such as garlic ear drops for ear infections) and only use antibiotics when absolutely necessary.
• Make wise vaccine choices – Even though the majority of medical research does not support a link between vaccines and autism, many parents are worried and prefer to follow an alternative vaccine schedule that slows the shots down and spreads them out. I believe this is a wiser way to vaccinate.

2. You discuss the many tests parents should consider after a child is diagnosed, but do you think any of these tests would be valuable if done prenatally to identify unique susceptibilities of the mother and potentially develop an individualized prevention plan?

Such tests do exist. One is a genomics test that measures a person’s genetic susceptibility to chemicals and heavy metals and other chronic illnesses. Another is a glutathione level, one of the body’s most important detoxifiers. However, I do not consider such prenatal testing useful yet because no one has yet to do any research to determine if testing these, and other factors, and then acting upon the results, has any effect on autism prevention. Such research is underway, but we won’t have useful results for a few years. Hopefully it will end up panning out as a useful screening tool, but I don’t recommend it at this time. Most adults who have such abnormalities have perfectly healthy and developmentally normal children. The stress over any such abnormal results could cause more harm than good. One possibly useful test would be to screen all women for gluten allergy (the severe form of which is celiac disease) and certain auto-immune disorders, as research has shown women with these conditions are more likely to have a child with autism. But again, these might cause a lot of unnecessary worry.

3. In your recommendations for treating autism, you mention eating organically as much as possible. Why is this important and what kinds of results have you seen?

Most researchers believe that chemicals and heavy metals play a role in autism. These toxicants cause minor changes in a developing infant’s genetics which then translates into minor dysfunction in various aspects of the brain. Avoiding these chemicals as best as you can is a worthwhile preventative effort. I believe eating organic prior to pregnancy, during pregnancy and breastfeeding, and then during at least the first few years of life is important. The Environmental Working Group made an alarming discovery a few years ago – newborn babies have over 200 chemicals and pollutants in their umbilical cord blood. This has to change. Eating organic may not be enough; parents need to “green up” their whole lifestyle to limit the toxins and chemicals in the air they breathe, the water they drink, the household products they use, and the furniture they live on. I believe going green isn’t just “all the rage”; it’s a must! Pick up a book about going green today.

Editor’s Note: Healthy Child Healthy World: Creating a Cleaner, Greener, Safer Home is an excellent resource!

As for visible results from such measures, I can’t comment yet. I haven’t had enough time or performed any specific research yet to see if going green and eating organic makes a measurable difference. Time and study will tell. But I don’t recommend waiting for anyone to prove it’s worth it. By then it will be too late for many children.

4. Do you have any advice for parents dealing with physicians who don't take their chemical/environmental concerns seriously?

Parents should realize that pediatricians don’t receive any formal training in how to treat autism. We are learning how to recognize the signs, but very few pediatricians provide treatment. So, unless a particular doctor has taken a special interest in autism and sought out additional training, it is unlikely that he or she will listen to a parent’s concerns about environmental and chemical concerns. I have joined a growing group of physicians around the world in what is called the Defeat Autism Now approach to autism treatment. We do take such concerns seriously, and we offer many scientifically-based treatments to help improve autism. We investigate each child for various associated medical, nutritional, infectious, gastrointestinal, and hormonal problems and correct those. These kids and families need help, and doctors such as myself are willing to listen and provide that help. Parents can find a Defeat Autism Now doctor near them by checking the doctor’s registry at the Autism Research Institute. Parents can and should also turn to other parents for support. Who better to help a family with a child newly diagnosed with autism than other families living in the same area who have already walked that road? My favorite nationwide support group is Talk About Curing Autism. The parents in these groups are ready and willing to help new families find answers and get started on therapies.

5. What do you believe are the most important areas of research for identifying how to treat autism?

There are two avenues of autism treatment that I believe are the most critical. The first is developmental/behavioral therapy. Applied Behavioral Analysis therapy is the primary method used to teach children with autism how to interact. Kids should spend between 15 and 30 hours each week engaged one-on-one with an ABA therapist. Occupational Therapy is also useful for low muscle tone and motor delays. Sensory Integration OT should also be offered to help children’s overall problems with sensory overload. Speech and language therapy is also a must.

The other avenue of treatment is correcting medical problems that are commonly associated with autism. There are various medical, nutritional, allergic, and infectious problems that can possibly make autistic symptoms and behaviors worse. These vary greatly between children. Here are several of the main medical issues that should be addressed:

• Chronic intestinal problems – Although many children with autism don’t seem to have any symptoms of diarrhea or constipation, those that do can benefit greatly from having their gut healed and returned to normal function, which in turn helps heal the brain. A doctor can test your child for food allergies or intestinal infections that may be contributing to this.
• Allergies – Eczema, nasal allergies, asthma, or food allergies can all interfere with the immune system. It’s important to test for these and eliminate or treat any offending allergens. A healthy immune system helps improve neurological function.
• Thyroid problems – A poorly functioning thyroid gland is somewhat common in autism. This can be easily diagnosed with a blood test.
• Metabolic disorders – There are a host of rare metabolic problems that a child with autism may have. Some are treatable, some are not. A doctor can test for these.
• Genetic disorders – Rarely, a child’s autism will be caused by a major genetic defect, such as Fragile X syndrome. Genetic testing can be done to look for such problems, although there is no specific treatment (yet) if a genetic disorder is found.

Various nutritional supplements, such as high dose B vitamins, minerals, fish oils, and numerous others have been scientifically shown to improve health and neurologic function. Getting started on these right away is very beneficial.

The opinions expressed here are solely those of the author and not necessarily those of Healthy Child Healthy World. You can read Healthy Child Healthy World's full position statement on Autism Spectrum Disorders, here and vaccines, here.

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