The Doctor is IN with Drs. Bock, Cantor, Rossignol, Yasko and Julie Matthews, CNC
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BIOMEDICAL
Dr. Dan Rossignol
Dr. Jeff Cantor
Julie Matthews, CNC
Dr. Amy Yasko
Dr. Kenneth Bock
Please email your questions to: info@autismfile.com
Question 1 How do you deal with children with autism who have self-limiting diets? How can you introduce new foods if they simply won’t eat them? Response fRom Julie matthews, CnC: There are many reasons for self-limiting diets. Addictions to foods such as gluten and casein can create self-restricting diets, because the child wants to eat nothing but the foods that create opiates that they are addicted to. Carbohydrate craving can be due to yeast overgrowth and other imbalances that can cause picky eating. Nutrient deficiencies such as zinc deficiency and yeast and microbial overgrowth are other common causes of poor appetite and restricted eating. Determining what a child is self-limiting to can be helpful in addressing the underlying cause. The good news is that once the offending, addictive foods are removed, their diet very often expands. I have heard countless stories from clients that have removed the addictive foods Disclaimer
Information is not provided as medical advice. Parents / patients should research all information given. Every person’s physiology is unique. All information provided as a reply should be discussed with the patient’s personal physician and / or autism or other specialist appropriate to the symptom(s) or body system(s) involved in their individual situation, who provides the patient with regular medical oversight, monitoring, and lab testing, and who keeps up-to-date on the most recent research and interventions. Beginning any significant biomedical or other interventions that may impact physiology or making changes to an established regimen should be discussed with the patient’s physician in advance.
128 THE AUTISM FILE | www.autismfile.com | info@autismfile.com
REPRINTED WITH PERMISSION © THE AUTISM FILE ISSUE 29 2009
and their child began eating vegetables, meat, or other restricted foods for the first time. Question 2 Autistic children are exposed to no more heavy metals than typical children. Why do autistic children “hold onto” heavy metals? Response fRom DR. amy yasko: I think that the question as to why autistic children seem to hold onto metals more so than other children is an excellent point and relates to why we need to look at all of the pieces of the puzzle in terms of what creates the condition of autism rather than simply looking at a single point. I have felt for some time that any analysis of autism needs to account for the fact that ... yes, many children are exposed to the same metal load and do not develop autism, as well as the fact that many children are vaccinated and do not develop autism. This is not to say that metals and / or vaccines are
not contributing factors to autism, I feel that they are, but I also believe that you cannot say that metals or vaccines cause autism per se, in most cases. I believe it is a combination of events or factors that all come together to create the condition of autism. When I spoke at ACAM several years ago, I showed a graphic with a revolving door in a building that also had a side door. I described the revolving door as representing our methylation cycle that helps us to naturally detoxify on a continual basis. When the revolving door did not function it caused an increase in toxins within the “building,” such that the graphic showed a building filled with a dark gray cloud. Those who had a functional revolving door (i.e. functional methylation cycle) might accumulate a very small amount of toxins represented by a gray cloud, but not to the extent that those with no revolving door accumulated. This building also had a side door that would allow toxins or the gray cloud to exit by. This side door represented chelation. While the side door
email: info@autismfile.com
on Autism One Radio with Polly Tommey, I was really excited that you are working with adolescents and upwards. No one has ever said there was hope for my son who is 22 now. Is it worth getting my hopes up, energy and time to help my son? I couldn’t put him or myself through something with no benefits. Response fRom DR. kenneth BoCk: From my perspective, there is hope for your 22-year-old son, but it is important to have realistic hope and expectations. There is no question that younger children generally respond more rapidly and fully, i.e., have more chance of marked improvement and even “recovery.” However, I have seen improvements in older children, adolescents and young adults by adding targeted biomedical interventions, and, therefore, I would encourage you to pursue this path. I must reiterate the importance of realism regarding hope and possibility with the knowledge that a positive response to biomedical intervention is not guaranteed. I in no way mean to imply pessimism in my answer to your question, but rather realism and balance. Question 4 My son is 17, severely disabled with autism since 18 months of age, diagnosed at 22 months. He lost all speech at age 3 after a tetanus shot. He has no academic, personal care or social skills. His communication skills are extremely limited. He has recently (in the past year?) developed some disturbing new tic-like behaviors. He opens his mouth as wide as he possibly can with lips stretched over his teeth and bugs his eyes out ... and wants me to close his mouth. He also turns his head in a twitching motion, flexing the muscles in his neck and upper torso, bugs his eyes and purses his lips, then throws his hands down by his side forcefully with his fingers outstretched forcibly, and jumps. He also throws his hands behind him and then wiggles his fingers. He also throws his head back and forth very fast and forcefully while snapping his jaws quickly ... this one he does mainly while riding in the back of my van. He seems to do these things more when in a stressful situation. GABA, Vitamin E, EFAs, B-6 and magnesium seem to help. I have never seen these movements before this year and, except for this, he is a perfectly normal (good) looking 17-year-old boy. Any insight would be greatly appreciated. He has also regressed by many years since he had a tooth surgically removed in 2005. I felt that he was slipping away again as he had in 1992-93. He stopped smiling again for several months, as well. He was sedated with IV Versed for the procedure. I have reason to believe that he woke during the procedure, chipping his front teeth and was possibly given a “push” of Versed to put him back under ... any comments appreciated. Response fRom DR. Dan Rossignol: First, let me address the loss of speech. Parents have noted for years that some children develop normally and then regress and develop autism. Recent studies have validated this parental observation in some children (Werner and Dawson 2005; Goldberg, Thorsen et al. 2008). Several studies in the literature tie regression in children with autism to increased oxidative stress (Chauhan, Chauhan et al. 2004; James, Cutler et al. 2004), brain inflammation (Connolly, Chez et al. 1999), and mitochondrial dysfunction (Poling, Frye et al. 2006). In some children with autism, regression may also be associated with seizure onset (Tuchman and Rapin 1997), although this is controversial. Some parents feel that thimerosal in vaccinations may have contributed to autism in their child, and thimerosal exposure may be linked to the development of tics (Verstraeten, Davis et al. 2003). The recent symptoms that you describe sound suspicious for PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections). Typically with PANDAS there is worsening of the condition
info@autismfile.com | www.autismfile.com | THE AUTISM FILE 129
might not be as effective as the revolving door, it would help to eventually clear the building of the gray cloud. While having the side door open would not be enough to prevent the accumulation of toxins in the first place, it would help to lower the toxin load. So... I feel that underlying genetic susceptibility, which affects methylation cycle function (the revolving door), is what separates autistic individuals from those without autism who are exposed to the same toxins. For this reason, I feel that it is important to get that revolving door moving again, by working to bypass mutations in the methylation cycle. Also, the use of other types of support that aid in chelation of metals and open that side door can help. Finally, as I have discussed in the past, I feel that chronic microbial issues in the body can allow metals to remain “stuck” in the system. Again, underlying genetic susceptibility can allow for increased microbial loads in the body. So, addressing the genetic weakness, as well as the actual microbes, can make a difference in getting those metals and toxins out of the system. Question 3 (this question was aDDResseD speCifiCally to DR. kenneth BoCk) Having listened to your radio interview
ISSUE 29 2009
REPRINTED WITH PERMISSION © THE AUTISM FILE
BIOMEDICAL
after streptococcal infections (“strep throat”). The supplements you are using (GABA, magnesium, etc.) may have a calming effect in some children, so continued use of these would be fine. Certain medication may also be helpful in controlling these behaviors. I suggest seeing a neurologist or a physician who specializes in treating children with autism for further evaluation of these symptoms. Response to the Dental poRtion of question 4 aBove fRom DR. Jeff CantoR: Since children on the spectrum may have different receptors in their nervous systems than neurotypical children, there is the theoretical possibility that they would have long term deficits after IV Versed rather than the short term deficits seen in typical children. There is also the possibility that if nitrous oxide was used that this could, in theory, cause regression in that nitrous oxide has been found to
email: info@autismfile.com
have some untoward affects on the DNA. There are several other possible sequelae to anesthesia that can cause lasting negative post-anesthesia effects. Question 5 What has been the most successful type of therapy you have seen on a consistent basis when treating children with autism? Response fRom DR. Dan Rossignol: If you are asking about behavior therapy for autism, Applied Behavioral Analysis (ABA) is the best studied and published therapy (Eikeseth, Smith et al. 2002; Eikeseth, Smith et al. 2007). If you are asking about medical therapy (besides medication), the answer, in my opinion, would be anti-oxidant supplements and omega-3 fatty acids. There are 5 double-blind, placebo-controlled studies in the medical literature demonstrating that treatment with these supplements improves behaviors in some children with autism including Vitamin C (Dolske, Spollen et al. 1993), L-carnosine (Chez, Buchanan et al. 2002), tetrahydrobiopterin (Danfors, von Knorring et al. 2005), omega-3 fatty acids (Amminger, Berger et al. 2007), and a multivitamin containing antioxidants (Adams and Holloway 2004). Oxidative stress (caused, in part, by a lack of antioxidants) is very common in individuals with autism (Chauhan and Chauhan 2006; James, Melnyk et al. 2006) and is treatable with antioxidant supplementation. For a list of what parents feel is the most helpful in treating their child with autism, you can check out the Autism Research Institute’s “Biomedical Survey Analysis” of more than 26,000 parents at http://www.autism. com/treatable/form34qr.htm.
References for Questions 4 & 5:
References for Questions 4 & 5: Adams, J. B. and C. Holloway (2004). “Pilot study of a moderate dose multivitamin / mineral supplement for children with autistic spectrum disorder.” J Altern Complement Med 10(6): 1033-9. Amminger, G. P., G. E. Berger, et al. (2007). “Omega-3 fatty acids supplementation in children with autism: a double-blind randomized, placebocontrolled pilot study.” Biol Psychiatry 61(4): 551-3. Chauhan, A. and V. Chauhan (2006). “Oxidative stress in autism.” Pathophysiology 13(3): 171-81. Chauhan, A., V. Chauhan, et al. (2004). “Oxidative stress in autism: increased lipid peroxidation and reduced serum levels of ceruloplasmin and transferrin--the antioxidant proteins.” Life Sci 75(21): 2539-49. Chez, M. G., C. P. Buchanan, et al. (2002). “Double-blind, placebo-controlled study of L-carnosine supplementation in children with autistic spectrum disorders.” J Child Neurol 17(11): 833-7. Connolly, A. M., M. G. Chez, et al. (1999). “Serum autoantibodies to brain in Landau-Kleffner variant, autism, and other neurologic disorders.” J Pediatr 134(5): 607-13. Danfors, T., A. L. von Knorring, et al. (2005). “Tetrahydrobiopterin in the treatment of children with autistic disorder: a double-blind placebo-controlled crossover study.” J Clin Psychopharmacol 25(5): 485-9. Dolske, M. C., J. Spollen, et al. (1993). “A preliminary trial of ascorbic acid as supplemental therapy for autism.” Prog Neuropsychopharmacol Biol Psychiatry 17(5): 765-74. Eikeseth, S., T. Smith, et al. (2002). “Intensive behavioral treatment at school for 4- to 7-yearold children with autism. A 1-year comparison controlled study.” Behav Modif 26(1): 49-68. Eikeseth, S., T. Smith, et al. (2007). “Outcome for children with autism who began intensive behavioral treatment between ages 4 and 7: a comparison controlled study.” Behav Modif 31(3): 264-78. Goldberg, W. A., K. L. Thorsen, et al. (2008). “Use of home videotapes to confirm parental reports of regression in autism.” J Autism Dev Disord 38(6): 1136-46. James, S. J., P. Cutler, et al. (2004). “Metabolic biomarkers of increased oxidative stress and impaired methylation capacity in children with autism.” Am J Clin Nutr 80(6): 1611-7. James, S. J., S. Melnyk, et al. (2006). “Metabolic endophenotype and related genotypes are associated with oxidative stress in children with autism.” Am J Med Genet B Neuropsychiatr Genet 141(8): 947-56. Poling, J. S., R. E. Frye, et al. (2006). “Developmental regression and mitochondrial dysfunction in a child with autism.” J Child Neurol 21(2): 170-2. Tuchman, R. F. and I. Rapin (1997). “Regression in pervasive developmental disorders: seizures and epileptiform electroencephalogram correlates.” Pediatrics 99(4): 560-6. Verstraeten, T., R. L. Davis, et al. (2003). “Safety of thimerosal-containing vaccines: a two-phased study of computerized health maintenance organization databases.” Pediatrics 112(5): 103948. Werner, E. and G. Dawson (2005). “Validation of the phenomenon of autistic regression using home videotapes.” Arch Gen Psychiatry 62(8): 889-95.
130 THE AUTISM FILE | www.autismfile.com | info@autismfile.com
REPRINTED WITH PERMISSION © THE AUTISM FILE
ISSUE 29 2009
BIOMEDICAL
Dr. Dan Rossignol
Dr. Jeff Cantor
Julie Matthews, CNC
Dr. Amy Yasko
Dr. Kenneth Bock
Please email your questions to: info@autismfile.com
Question 1 How do you deal with children with autism who have self-limiting diets? How can you introduce new foods if they simply won’t eat them? Response fRom Julie matthews, CnC: There are many reasons for self-limiting diets. Addictions to foods such as gluten and casein can create self-restricting diets, because the child wants to eat nothing but the foods that create opiates that they are addicted to. Carbohydrate craving can be due to yeast overgrowth and other imbalances that can cause picky eating. Nutrient deficiencies such as zinc deficiency and yeast and microbial overgrowth are other common causes of poor appetite and restricted eating. Determining what a child is self-limiting to can be helpful in addressing the underlying cause. The good news is that once the offending, addictive foods are removed, their diet very often expands. I have heard countless stories from clients that have removed the addictive foods Disclaimer
Information is not provided as medical advice. Parents / patients should research all information given. Every person’s physiology is unique. All information provided as a reply should be discussed with the patient’s personal physician and / or autism or other specialist appropriate to the symptom(s) or body system(s) involved in their individual situation, who provides the patient with regular medical oversight, monitoring, and lab testing, and who keeps up-to-date on the most recent research and interventions. Beginning any significant biomedical or other interventions that may impact physiology or making changes to an established regimen should be discussed with the patient’s physician in advance.
128 THE AUTISM FILE | www.autismfile.com | info@autismfile.com
REPRINTED WITH PERMISSION © THE AUTISM FILE ISSUE 29 2009
and their child began eating vegetables, meat, or other restricted foods for the first time. Question 2 Autistic children are exposed to no more heavy metals than typical children. Why do autistic children “hold onto” heavy metals? Response fRom DR. amy yasko: I think that the question as to why autistic children seem to hold onto metals more so than other children is an excellent point and relates to why we need to look at all of the pieces of the puzzle in terms of what creates the condition of autism rather than simply looking at a single point. I have felt for some time that any analysis of autism needs to account for the fact that ... yes, many children are exposed to the same metal load and do not develop autism, as well as the fact that many children are vaccinated and do not develop autism. This is not to say that metals and / or vaccines are
not contributing factors to autism, I feel that they are, but I also believe that you cannot say that metals or vaccines cause autism per se, in most cases. I believe it is a combination of events or factors that all come together to create the condition of autism. When I spoke at ACAM several years ago, I showed a graphic with a revolving door in a building that also had a side door. I described the revolving door as representing our methylation cycle that helps us to naturally detoxify on a continual basis. When the revolving door did not function it caused an increase in toxins within the “building,” such that the graphic showed a building filled with a dark gray cloud. Those who had a functional revolving door (i.e. functional methylation cycle) might accumulate a very small amount of toxins represented by a gray cloud, but not to the extent that those with no revolving door accumulated. This building also had a side door that would allow toxins or the gray cloud to exit by. This side door represented chelation. While the side door
email: info@autismfile.com
on Autism One Radio with Polly Tommey, I was really excited that you are working with adolescents and upwards. No one has ever said there was hope for my son who is 22 now. Is it worth getting my hopes up, energy and time to help my son? I couldn’t put him or myself through something with no benefits. Response fRom DR. kenneth BoCk: From my perspective, there is hope for your 22-year-old son, but it is important to have realistic hope and expectations. There is no question that younger children generally respond more rapidly and fully, i.e., have more chance of marked improvement and even “recovery.” However, I have seen improvements in older children, adolescents and young adults by adding targeted biomedical interventions, and, therefore, I would encourage you to pursue this path. I must reiterate the importance of realism regarding hope and possibility with the knowledge that a positive response to biomedical intervention is not guaranteed. I in no way mean to imply pessimism in my answer to your question, but rather realism and balance. Question 4 My son is 17, severely disabled with autism since 18 months of age, diagnosed at 22 months. He lost all speech at age 3 after a tetanus shot. He has no academic, personal care or social skills. His communication skills are extremely limited. He has recently (in the past year?) developed some disturbing new tic-like behaviors. He opens his mouth as wide as he possibly can with lips stretched over his teeth and bugs his eyes out ... and wants me to close his mouth. He also turns his head in a twitching motion, flexing the muscles in his neck and upper torso, bugs his eyes and purses his lips, then throws his hands down by his side forcefully with his fingers outstretched forcibly, and jumps. He also throws his hands behind him and then wiggles his fingers. He also throws his head back and forth very fast and forcefully while snapping his jaws quickly ... this one he does mainly while riding in the back of my van. He seems to do these things more when in a stressful situation. GABA, Vitamin E, EFAs, B-6 and magnesium seem to help. I have never seen these movements before this year and, except for this, he is a perfectly normal (good) looking 17-year-old boy. Any insight would be greatly appreciated. He has also regressed by many years since he had a tooth surgically removed in 2005. I felt that he was slipping away again as he had in 1992-93. He stopped smiling again for several months, as well. He was sedated with IV Versed for the procedure. I have reason to believe that he woke during the procedure, chipping his front teeth and was possibly given a “push” of Versed to put him back under ... any comments appreciated. Response fRom DR. Dan Rossignol: First, let me address the loss of speech. Parents have noted for years that some children develop normally and then regress and develop autism. Recent studies have validated this parental observation in some children (Werner and Dawson 2005; Goldberg, Thorsen et al. 2008). Several studies in the literature tie regression in children with autism to increased oxidative stress (Chauhan, Chauhan et al. 2004; James, Cutler et al. 2004), brain inflammation (Connolly, Chez et al. 1999), and mitochondrial dysfunction (Poling, Frye et al. 2006). In some children with autism, regression may also be associated with seizure onset (Tuchman and Rapin 1997), although this is controversial. Some parents feel that thimerosal in vaccinations may have contributed to autism in their child, and thimerosal exposure may be linked to the development of tics (Verstraeten, Davis et al. 2003). The recent symptoms that you describe sound suspicious for PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections). Typically with PANDAS there is worsening of the condition
info@autismfile.com | www.autismfile.com | THE AUTISM FILE 129
might not be as effective as the revolving door, it would help to eventually clear the building of the gray cloud. While having the side door open would not be enough to prevent the accumulation of toxins in the first place, it would help to lower the toxin load. So... I feel that underlying genetic susceptibility, which affects methylation cycle function (the revolving door), is what separates autistic individuals from those without autism who are exposed to the same toxins. For this reason, I feel that it is important to get that revolving door moving again, by working to bypass mutations in the methylation cycle. Also, the use of other types of support that aid in chelation of metals and open that side door can help. Finally, as I have discussed in the past, I feel that chronic microbial issues in the body can allow metals to remain “stuck” in the system. Again, underlying genetic susceptibility can allow for increased microbial loads in the body. So, addressing the genetic weakness, as well as the actual microbes, can make a difference in getting those metals and toxins out of the system. Question 3 (this question was aDDResseD speCifiCally to DR. kenneth BoCk) Having listened to your radio interview
ISSUE 29 2009
REPRINTED WITH PERMISSION © THE AUTISM FILE
BIOMEDICAL
after streptococcal infections (“strep throat”). The supplements you are using (GABA, magnesium, etc.) may have a calming effect in some children, so continued use of these would be fine. Certain medication may also be helpful in controlling these behaviors. I suggest seeing a neurologist or a physician who specializes in treating children with autism for further evaluation of these symptoms. Response to the Dental poRtion of question 4 aBove fRom DR. Jeff CantoR: Since children on the spectrum may have different receptors in their nervous systems than neurotypical children, there is the theoretical possibility that they would have long term deficits after IV Versed rather than the short term deficits seen in typical children. There is also the possibility that if nitrous oxide was used that this could, in theory, cause regression in that nitrous oxide has been found to
email: info@autismfile.com
have some untoward affects on the DNA. There are several other possible sequelae to anesthesia that can cause lasting negative post-anesthesia effects. Question 5 What has been the most successful type of therapy you have seen on a consistent basis when treating children with autism? Response fRom DR. Dan Rossignol: If you are asking about behavior therapy for autism, Applied Behavioral Analysis (ABA) is the best studied and published therapy (Eikeseth, Smith et al. 2002; Eikeseth, Smith et al. 2007). If you are asking about medical therapy (besides medication), the answer, in my opinion, would be anti-oxidant supplements and omega-3 fatty acids. There are 5 double-blind, placebo-controlled studies in the medical literature demonstrating that treatment with these supplements improves behaviors in some children with autism including Vitamin C (Dolske, Spollen et al. 1993), L-carnosine (Chez, Buchanan et al. 2002), tetrahydrobiopterin (Danfors, von Knorring et al. 2005), omega-3 fatty acids (Amminger, Berger et al. 2007), and a multivitamin containing antioxidants (Adams and Holloway 2004). Oxidative stress (caused, in part, by a lack of antioxidants) is very common in individuals with autism (Chauhan and Chauhan 2006; James, Melnyk et al. 2006) and is treatable with antioxidant supplementation. For a list of what parents feel is the most helpful in treating their child with autism, you can check out the Autism Research Institute’s “Biomedical Survey Analysis” of more than 26,000 parents at http://www.autism. com/treatable/form34qr.htm.
References for Questions 4 & 5:
References for Questions 4 & 5: Adams, J. B. and C. Holloway (2004). “Pilot study of a moderate dose multivitamin / mineral supplement for children with autistic spectrum disorder.” J Altern Complement Med 10(6): 1033-9. Amminger, G. P., G. E. Berger, et al. (2007). “Omega-3 fatty acids supplementation in children with autism: a double-blind randomized, placebocontrolled pilot study.” Biol Psychiatry 61(4): 551-3. Chauhan, A. and V. Chauhan (2006). “Oxidative stress in autism.” Pathophysiology 13(3): 171-81. Chauhan, A., V. Chauhan, et al. (2004). “Oxidative stress in autism: increased lipid peroxidation and reduced serum levels of ceruloplasmin and transferrin--the antioxidant proteins.” Life Sci 75(21): 2539-49. Chez, M. G., C. P. Buchanan, et al. (2002). “Double-blind, placebo-controlled study of L-carnosine supplementation in children with autistic spectrum disorders.” J Child Neurol 17(11): 833-7. Connolly, A. M., M. G. Chez, et al. (1999). “Serum autoantibodies to brain in Landau-Kleffner variant, autism, and other neurologic disorders.” J Pediatr 134(5): 607-13. Danfors, T., A. L. von Knorring, et al. (2005). “Tetrahydrobiopterin in the treatment of children with autistic disorder: a double-blind placebo-controlled crossover study.” J Clin Psychopharmacol 25(5): 485-9. Dolske, M. C., J. Spollen, et al. (1993). “A preliminary trial of ascorbic acid as supplemental therapy for autism.” Prog Neuropsychopharmacol Biol Psychiatry 17(5): 765-74. Eikeseth, S., T. Smith, et al. (2002). “Intensive behavioral treatment at school for 4- to 7-yearold children with autism. A 1-year comparison controlled study.” Behav Modif 26(1): 49-68. Eikeseth, S., T. Smith, et al. (2007). “Outcome for children with autism who began intensive behavioral treatment between ages 4 and 7: a comparison controlled study.” Behav Modif 31(3): 264-78. Goldberg, W. A., K. L. Thorsen, et al. (2008). “Use of home videotapes to confirm parental reports of regression in autism.” J Autism Dev Disord 38(6): 1136-46. James, S. J., P. Cutler, et al. (2004). “Metabolic biomarkers of increased oxidative stress and impaired methylation capacity in children with autism.” Am J Clin Nutr 80(6): 1611-7. James, S. J., S. Melnyk, et al. (2006). “Metabolic endophenotype and related genotypes are associated with oxidative stress in children with autism.” Am J Med Genet B Neuropsychiatr Genet 141(8): 947-56. Poling, J. S., R. E. Frye, et al. (2006). “Developmental regression and mitochondrial dysfunction in a child with autism.” J Child Neurol 21(2): 170-2. Tuchman, R. F. and I. Rapin (1997). “Regression in pervasive developmental disorders: seizures and epileptiform electroencephalogram correlates.” Pediatrics 99(4): 560-6. Verstraeten, T., R. L. Davis, et al. (2003). “Safety of thimerosal-containing vaccines: a two-phased study of computerized health maintenance organization databases.” Pediatrics 112(5): 103948. Werner, E. and G. Dawson (2005). “Validation of the phenomenon of autistic regression using home videotapes.” Arch Gen Psychiatry 62(8): 889-95.
130 THE AUTISM FILE | www.autismfile.com | info@autismfile.com
REPRINTED WITH PERMISSION © THE AUTISM FILE
ISSUE 29 2009
