Supplements, enzymes and diets are used as part of the treatment program by most parents of autistic children. Often it becomes hard to tell what works and what doesnt. The approach we have used is to try any approach that works for a significant number of kids and observe results ourselves. Lab results and blood/urine tests in most cases are only a guideline. What matters is whether we see any improvement in a behavior or any skill acquisition. For diets, the methodology is to slowly introduce the diet, but be 100% compliant. (For example, gluten-free means no playdough etc.). After a few weeks of 100% compliance we look for any improvement. To confirm we do a challenge test. That is, on a weekend day, introduce a large quantity of the substance and see if there is any regression to confirm the positive effect of the exclusion. If the challenge test does not cause any noticeable regression, assume that it is ok to re-introduce the food. The reverse experiment works for supplements. Stop the supplement and note any regression.

However, there are many reasons why it is difficult to see accurate cause and effect relationships for every intervention. For example

1. In some cases, a group of foods may cause inflammation and resulting problematic behaviors. In that case, the positive effect may be seen only after removing all such foods.
2. Similarly some supplements might act in conjunction to cause improvement in some area, example, methylation support. Again, in that case, unless all the pathways are supplemented, the desired effect may not be seen.
3. Some improvements may be masked by pathogens (yeast/bacteria) and a desired outcome may not be visible. On another day, the same intervention may have a desired outcome.

So in most cases, figuring out an optimal diet or supplementation program for the child is a very long term part of the overall treatment plan. It requires patience, very keen observation of subtle behavioral changes, and requires the discipline to implement the restriction or addition 100%.

Some tools to help are:

1. Keep a food diary to accurately record all foods consumed
2. Prepare foods at home to avoid confusion due to unknown ingredients
3. Keep a diary to note any behavioral changes. If the child is on an ABA program this becomes easy since ABA records usually keep very accurate statistics of behaviors.
4. Watch for input from other caregivers/school/therapists about positives/negatives, any new skill acquisition.

Here is the procedure we have had to experiment with from a diet perspective

1. Completely eliminate gluten and casein (improved bladder control, potty training, sleeping at night)
2. Eliminate highly problematic foods from a IgG food allergy test, rotate less problematic foods (only repeat foods in a 4 day cycle)
3. SCD trial (Specific Carbohydrate Diet) reduced hilarity, giggling but cannot implement strictly, compromising with a low carbohydrate SCD-like diet.
4. Lo-oxalate diet improved bowel movement (eliminated certain nut-flours, increased pumpkin seed, coconut)
5. Yeast diet (eliminated problematic fruits, dry fruits, yeast bread etc) apart from low carbohydrate
6. Eliminate phenolic foods (banana, apple, etc, and introduce enzyme to address phenols)

The diet is a hard one to be perfect on, so its a constant exercise in experimentation and improvisation.

An important aspect of the experimentation is to come up with a table, for the particular individual, of foods/supplements and effects. For our case this is the chart we have. Ofcourse every child is different, so this table perhaps only applies to our case. Anyway, here is our current table based on experimentation and observation

In general, many kids with autism benefit significantly as a result of a suitable diet and supplement strategy. Often, finding the best diet for a child is like solving a dynamic optimisation problem, but seems to help.  It goes beyond organic or gluten-free for most kids, and we are still trying to figure it out. Ofcourse beyond all this, kids are kids and some problematic behavior and diet infraction is part of growing!

Resources

• Dietary Information: http://www.autismndi.com
• SCD Diet: http://www.breakingtheviciouscycle.info
• Lo Oxalate Diet: Yahoo Group: Trying_low_oxalates
• Enzymes: http://www.enzymestuff.com
• Supplements/Enzymes: http://www.kirkmanlabs.com http://www.asdmarket.com