| Page 3 Q: Removing both foods at once seems overwhelming. I'm afraid of my child's reaction. Can I start slowly? A: Many parents strongly suggest that you try removing dairy first, and then work on planning for a completely gluten-free diet. Gluten can take more effort and some education on your part, and preparation may take a bit longer. Some physicians recommend doing this diet one step at a time to accurately record the child's response, and to reduce withdrawal reactions. The experts seem to agree that the milk and wheat proteins are so similar to each other that if one is a problem, the other should be removed as soon as possible. Q: How do I know if this applies to my child? A: Although there is some peptide testing available, there are many reports of false negatives and false positives. Widespread use of a reliable test is not yet available. DAN! doctors and researchers agree that this is a very common problem in the autistic population, so a trial period on the diet may be your child's best bet. Although a lab result is more convincing to a doctor, the noticeable improvement many children exhibit will usually persuade even a reluctant spouse to support the diet. Many affected children who eat a great deal of dairy and/or wheat-based foods will show changes within a few days of their elimination. For some, it can take up to three months. Some children don’t appear to benefit significantly, yet when the proteins are re-introduced a regression is noted. The diet must be strict. Many parents have found that their child did not improve until they discovered and removed a hidden source of gluten or dairy. Noticeable changes in eye contact, sociability, and language are one sign that diet is an important issue. Another thing to look for are changes in the child's bowel movements or sleep patterns. Q: When my child was taken just off dairy he improved greatly, but then he started eating a lot of wheat, perhaps to make up the opiates he was missing. Will I see the same kind of noticeable improvement when I remove gluten? A: Children who eat a lot of gluten should show an improvement when it is removed. Some parents say that their child's response was more obvious with dairy, and some with gluten. Unfortunately, gluten seems to take longer to disappear from the system than casein does. Urine tests show that casein probably leaves the system in about three days, but it can take up to eight months on a gluten-free diet for all peptide levels to drop. If this intervention is followed by a deterioration or regression (a withdrawal-type response), stay the course! It almost certainly means that your child will benefit. This may seem like a lot of work for an uncertain payoff, but in the lifetime of your child it may be the most important step you take. Q: The only non-dairy, non-wheat foods my child will eat are french fries and chicken nuggets. Are these okay? A: Chicken nuggets are coated with wheat. Some french fries are dusted with wheat flour to keep them from sticking together. It is a very good idea to get used to checking with your supplier or the manufacturer. Keeping a stack of blank, pre-stamped postcards in the kitchen is a handy way to check. The biggest problem with french fries eaten out of the house is contamination of the frying oil with gluten from onion rings and other breaded products. Making homemade fries is a good option. If your child refuses them at first, it may be because of what they're missing! Some parents report that their kids have an uncanny ability to detect gluten in foods. Since many of the children enjoy salt, salting the fries might make them more acceptable. Q: What else contains gluten? A: Wheat, oats, rye, barley, kamut, spelt, semolina, malt, food starch, grain alcohol, and most packaged foods - even those that do not label as such. There is a lot of information on gluten intolerance because of a related disorder called Celiac Disease. Q: After I removed gluten and casein, I discovered that other foods seemed to be causing a problem, like apples, soy, corn, tomatoes, and bananas. I see irritability, red cheeks and ears, and sometimes diarrhea or a diaper rash. I thought you said that these kids don't have allergies. A: Many do have allergies, or allergy-related symptoms such as hay fever, asthma or eczema. Sometimes they have problems with foods which are not "classical" allergies, and which won't show up on skin tests. In this case, a different type of immune response seems to be involved. Q: So if these foods are not contributing to his autism, they're okay? A: Not really. Current research indicates that in a great many cases, autism seems to be an immune system dysfunction. This can lead to a problem breaking down casein & gluten, but may also result in a problem breaking down phenolic foods (phenol sulfur transferase deficiency,) and an over-reactive response to other allergens. Often, once gluten is removed, this effect becomes more noticeable, perhaps because the allergens were "masked" by the effect of the gluten. It is also possible that a "leaky gut syndrome," caused by the gluten intolerance, is now permitting other foods to pass through the intestinal screen and into the bloodstream. For children who respond to this diet, allergens do seem to place further stress on the immune system, and have often been shown to worsen behavior and development. Q: But my child's immune system seems to be working unusually well - he is rarely sick. A: What we're describing is not an immune deficiency, but rather an immune dysfunction. Many (although not all) seem to share a history of ear infections and spitting up as babies (possibly milk-related,) or of chronic diarrhea, constipation, or loose stools (possibly wheat-related.) Other parents note that their autistic children seem to be the healthiest members of the family. In this case, it has been hypothesized that the immune system is too aggressive and ends up turning on the nervous system. This may explain the presence of anti-myelin antibodies in some children, and may also explain why some have immune issues like multiple allergies but do not respond well to dietary intervention. Q: What causes this problem? Autism seems to be so much more common than it used to be. A: Researchers are not sure, but it seems likely at this time that many cases are caused by a genetic predisposition or by environmental toxicity, combined with some kind of triggering event that stresses the immune system, such as a vaccination or virus. In several cases, prolonged use of antibiotics seems to have contributed to the onset of the disorder. Q: So, if I can't give him milk or wheat, and if he has some other food allergies, what do I feed my child? A: Most kids are okay with chicken, lamb, pork, fish, potato, rice, and egg whites. Parsnips, tapioca, arrowroot, honey, and maple syrup are usually okay too. French fries from McDonalds are currently gluten free (but may contain soy or corn.) Certain white nuts, like macadamia and hazelnuts, are also usually tolerated. Others kids may be okay with white corn, bacon, fruits such as white grapes or pears, beans, sesame seeds, or grains such as amaranth and teff (available at natural foods stores.) There's always something to feed them - even the most finicky kids seem to like sticky white chinese rice or french fries. Q: How do I know which foods he's allergic to? A: Try an allergy elimination diet. For example, keep common allergens out of his diet for a few days and then re-introduce them, one-by-one. If you see symptoms, either physical or behavioral, try again in a few days. Try to be systematic, to be certain before ruling out a food. Two excellent resources, probably available at your library, are Doris Rapp's book, Is This Your Child, and William Crook's Solving the Puzzle of Your Hard to Raise Child. Q: I'm already worried about my child's nutrition, and his "allergies" are causing me to further reduce his choices. If apple juice and bananas are the only fruits he will eat and he's reacting to them, how is he supposed to get by. A: Fruit contains water, sugar, fiber, and vitamins. He needs to get these things from other sources Q: I thought the "five food groups" were so important A: They are, to an individual without food intolerances. But, just as a person who eats a balanced diet might not need to take vitamins, a person with poor nutrition can make up for a lot with a good vitamin and mineral supplement Page 4 | 
