Q:  So I should be giving my child a vitamin supplement?

A:  Absolutely. Poly-vi-sol with Iron is probably okay to start with, or order a gluten-free multivitamin & mineral formula from your natural foods store, or from Kirkman Labs (800-245-8282). Kal Dinosaur Chewables and “I Love Schiff” liquid and chewables are tolerated by many food-sensitive children, and are available with or without minerals. Because many autistic children have been reported to improve on a regimen of vitamin B6 and magnesium, you may want to order a supplement rich in these nutrients from a lab such as Kirkman. For a 40 pound child, Dr. Bernard Rimland of the Autism Research Institute recommends 300 mgs. of B6 and 100 mgs. of magnesium per day. It is likely that absorption of B6 (which aids in nervous system function) could be greatly diminished.in people with a leaky gut.

Q:  What else does my child need?

A:  There are six basic things a person needs from food: water, protein (and amino acids,) carbohydrates, fats, vitamins, minerals (including iron & calcium.)  In addition, food contains certain phytochemical substances that seem to help with functions like disease prevention. It is helpful to consult a knowledgeable nutritionist about the use of supplements such as pycnogenol for any child on a limited diet.

Children who have gone for one year eating only chicken, canola oil, potato, rice, calcium-enriched beverages, and a liquid multivitamin supplement with minerals have had excellent results on nutritional blood tests. You'd be surprised to learn just how unnecessarily varied an American diet is, compared with the diets of other cultures.

Q:  So how do I know if my child will respond to this diet?

A:  The biggest clue is when a child self-limits his diet - especially to milk and wheat. This is no longer seen as a "need for sameness" but as a biological addiction. Children who don't necessarily "self-limit" but who also respond are those who eat an unusually large or small amount of food. Although the former may not recognize the source of the opiates, he knows that eating makes him feel good. The latter may realize that many foods make him feel ill, and tries to avoid eating whenever possible. These "failure to thrive" autistic children are very hard to put on this diet because of their parents' fears, but will usually respond when acceptable substitutes to the non-tolerated foods can be provided.

Other symptoms of food intolerance or vitamin deficiency are dermatitis or extremely dry skin, migraines, bouts of screaming, red cheeks, red ears, abnormal bowel movements, abnormal sleep patterns or seizures.

Q:  What's all this I hear about yeast?

A:  Candida and other yeasts live in our bodies in small amounts. It was speculated that in individuals with improperly-functioning immune systems, they could flourish in the gut and lead to a host of problems, including fatigue, sugar cravings, headaches, and behavioral problems.

Q:  How do we know if this is really true?

A:  We didn't, until recently. Dr. William Shaw in Kansas found unusually high levels of "fungal metabolites" (yeast waste products) in the urine of several groups of abnormally functioning individuals (including people with autism.)  His first paper describing this phenomenon was published in the Journal of Clinical Chemistry in 1995 (Vol. 41, No. 8.)  His urinary organic acids test is performed by the Great Plains Laboratory (913-341-8949)

Q:  So does yeast cause autism?

A:  This finding may be just another consequence of the abnormally functioning autistic immune system. However, early antibiotic use may actually be the triggering factor for children predisposed to autism. It has been hypothesized that the candida might aggravate a condition of gut permeability (the "leaky gut" syndrome), which might let the gluten and casein proteins into the bloodstream before they are broken down, so it may in part be responsible for autistic behaviors. Many parents of children with ADD or ADHD as well as those with autism report that treatment for candida does improve their children's behavior and concentration.

Q:  How do I treat for candida?

A:  One approach is to ask your pediatrician for a course of Nystatin, which is a non-systemic (not absorbed into the bloodstream) anti-fungal. Taken orally, it works locally in the gut to fight candida. This medication is considered to be quite safe, even when taken for several months. For a 25-35 lb. child, ask the doctor for a prescription for Nystatin powder (125,000 units per cc) in a stevia base, starting with 1 cc 4x/day. Your local pharmacy probably carries a commercial preparation in a sugar base - this feeds yeast!  Try a compounding pharmacy such as Pathway (800-869-9160)

"Probiotics" such as acidophilus, the natural bacteria found in yogurt, are other candida-fighters, and are available at the natural foods store in powdered form in the refrigerated section, or from Kirkman Labs. Some acidophilus preparations are milk-based - be sure to get one that is not!  Bifidus works in the large intestine and can be of great benefit. "FOS" is desirable in these supplements, as it feeds the probiotics.

Q:  Aren't probiotics the "healthy flora" I've heard about?

A:  Yes, they compete with candida for the sugars you eat. It's the "good bacteria."  You may be aware that acidophilus is eradicated from your gut when you take antibiotics.

Q:  That's why you're supposed to eat yogurt when you are on antibiotics.

A:  Exactly. As a matter of fact, in the 1950's, when oral antibiotics were first prepared for general use, scientists knew about this candida problem and coated the tablets with Nystatin. After a few years, the FDA decided that the two drugs should be prescribed separately (which they never were) and made them stop.

Q:  My friend's child tried Nystatin and it made him vomit. If Nystatin is so safe, why did he react to it?

A:  The child may have experienced a "die-off reaction" to the candida. As it dies, candida releases toxins into the bloodstream and can cause nausea, vomiting, or diarrhea. It is likely that candida was indeed a problem for this child. Your friend should discuss a dosage change (starting with a low dose and working up to a "normal dose") with the prescribing doctor.

Q:  My doctor has never heard of any of this and she is extremely skeptical. I'm embarrassed to tell her I'm considering this approach?

A:  Skepticism is a good thing in a medical doctor or scientist. However, since there is preliminary evidence to support this safe, non-invasive intervention, it is up to you to educate her, state your wishes, and ask for her support. For a doctor, it is better to wait until all of the data is published in peer-reviewed journals before advocating a treatment. For a parent, it is reasonable to want to help one's child without waiting for all of the results of the "double-blind placebo" studies. Because this approach does not include any unusual supplements, invasive drugs, or expensive treatments, your pediatrician should be supportive. Explain that you would like to try this for a few weeks, and agree that you will be objective about recording your child's progress while on the diet.

Q:  Where can I find support?

A:  It is likely that other parents in your area are already aware of this intervention. Look at the PASS list at www.autismndi.com for local contacts, or form a group yourself. There are also several support groups for the biological treatment of autism on the Internet (such as the one at www.gfcfdiet.com). I have included a great deal of information in my book, Unraveling the Mystery of Autism and Pervasive Developmental Disorder: A Mother's Story of Research and Recovery (Simon & Schuster 2000, Broadway Books 2002). Other valuable resources are Lisa Lewis’s books, Special Diets for Special Kids, and Special Diets for Special Kids Two, which include lots of information and hundreds of terrific recipes. Both are available from ANDI or from www.amazon.com. For a copy of our catalog, please visit our website: www.AutismNDI.com or fax us at 609-737-8453. To subscribe to the ANDI News, send $24 ($28 for subscriptions outside of the U.S.) and your name & address to ANDI, PO Box 335, Pennington, NJ  08534-0335. Good luck!