Fish oils, omega 3 fatty acids
Children with autism may be deficient in the fatty acids EPA and / or DHA found in fish oils, hence a role for diet. Childhood autism may be linked to a deficiency of fatty acids found in oily fish. A pilot study at the University of Stirling found that children with autism had cells that broke down fatty acids more rapidly than normal cells. Autism rates in Scotland have risen dramatically in the past ten years, a trend mirrored across the developed world. In Scotland, an estimated 50,000 people, nearly 7,000 of them children, suffer from autism. Brain cell membranes are composed primarily of omega-3 and omega-6 fatty acids, substances found in oily fish such as mackerel and salmon. A study of about 20 autistic children last year revealed that cell membranes in their blood metabolized, or processed, fatty acids at a faster rate than other children. The discovery led to speculation that a fatty acid deficiency may be partially responsible for the onset of autism. "We have already seen a connection between omega levels and schizophrenia and dyslexia," said Dr Gordon Bell of the university. If cell function in the brain is changed, the behavior of the brain will change as well. Dr Bell compared cell membranes to a "brick wall" of fatty acids. Bricks fall out, but as long as they are replaced, then the wall holds strong. Problems occur when bricks fall out faster than they can be replaced. If the scientists confirm this is what causes autism, they may conclude that the answer is to replenish "bricks" of fatty acids at a greater rate; in short, eat more fish.

Behavioral effects of omega-3 Fatty Acid supplementation in young adults with severe autism: an open label study.
Arch Med Res. 2008.
Nineteen young adults with severe autism, aged 18-40 years, received two fish oil capsules per day [0.93g of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) plus 5mg of vitamin E to avoid lipid peroxidation] for 6 weeks. Subjects were assessed with an ad hoc caregiver questionnaire, the Rossago Behavioral Checklist, for the assessment of behavioral anomalies. No significant improvements were observed with regard to the severity and frequency of problematic behaviors either during the active treatment period or during the post-treatment 6-week observation period. Our negative findings do not point toward a major effect of omega-3 FA supplementation on behavioral abnormalities in adults with severe autism.

Omega-3 fatty acids supplementation in children with autism: a double-blind randomized, placebo-controlled pilot study.
Biol Psychiatry. 2007.
We conducted a randomized, double-blind, placebo-controlled 6-week pilot trial investigating the effects of 1.5 g/d of omega-3 fatty acids (.84 g/d eicosapentaenoic acid, .7 g/d docosahexaenoic acid) supplementation in 13 children (aged 5 to 17 years) with autism disorders accompanied by severe tantrums, aggression, or self-injurious behavior. We observed an advantage of omega-3 fatty acids compared with placebo for hyperactivity and stereotypy, each with a large effect size.

Plasma fatty acid levels in children with autism.
Prostaglandins Leukot Essent Fatty Acids. 2001.
Phospholipid fatty acids are major structural components of neuronal cell membranes, which modulate membrane fluidity and hence function. Evidence from clinical and biochemical sources have indicated changes in the metabolism of fatty acids in several psychiatric disorders. We examined the phospholipid fatty acids in the plasma of a population of autism subjects compared to mentally retarded controls. Our results showed a marked reduction in the levels of 22: 6n-3 (23%) in the autism subjects, resulting in significantly lower levels of total (n-3) polyunsaturated fatty acids (PUFA) (20%), without significant reduction in the (n-6) PUFA series, and consequently a significant increase in the (n-6)/(n-3) ratio (25%).

Kava root testimonial
I just wanted to let you know that kava has saved our family. We have a 17 year old son with autism. With puberty and the teenage years presenting challenges of size, rages and inability to control some emotional behaviors we were desperate. When we see our son beginning to become agitated we give him kava kava and he completely calms down and is able to focus and maintain at school, home and in the community. Not wanting to medicate our son, we are thankful for the discovery of the effects of kava on the behaviors of autism.
   A. Kava should not be used more than 2 days a week due to potential liver harm.

Probiotics, friendly bacteria
Bacteria living in the intestines and colon may affect symptoms of autism by releasing substances in the gut that cross into the blood and make it to brain tissue and influence the health of nerve cells or influence the release of brain chemicals. A small study found that some children with autism have different types of intestinal germs compared to children without autism. Bacteria, fungi and yeast living in our bodies are important to health. They can affect the body’s susceptibility to infection, they can affect body weight and may even play a role in cancer. There’s also some evidence they play a role in mental health. "Most gut bacteria are beneficial, aiding food digestion, producing vitamins, and protecting against harmful bacteria,” says Dae-Wook Kang of the Biodesign Institute of Arizona State University, an author on the 2014 study. “If left unchecked, however, harmful bacteria can excrete dangerous metabolites or disturb a balance in metabolites that can affect the gut and the rest of the body, including the brain." Children with autism tend to have abnormal and less-diverse communities of gut bacteria.
   My comments:  It is still not clear whether supplementation with probiotics or changes in dietary intake of fermented foods can make a difference in children with autism. Makes one ponder whether perhaps certain forms of mental conditions, for instance chronic anxiety, mood disorders, and others, may be, at least slightly or partially, influenced by manipulation of the intestinal microflora.

Ribose?
Email November 2011 - A study came out last June which suggested that d-Ribose could be helpful for autism. My son tried it, and the results were remarkable: increased sociability, increased social cognition, mood stabilization, etc.

Vitamin B6 and multivitamins
Pilot study of a moderate dose multivitamin / mineral supplement for children with autistic spectrum disorder.
J Altern Complement Med. 2004. Arizona State University, Tempe, AZ, USA.
Determine the effect of a moderate dose multivitamin / mineral supplement on children with autistic spectrum disorder. Twenty children with autistic spectrum disorder, ages 3-8 years. A Global Impressions parental questionnaire found that the supplement group reported statistically significant improvements in sleep and gastrointestinal problems compared to the placebo group. An evaluation of vitamin B(6) levels prior to the study found that the autistic children had substantially elevated levels of B6 compared to a control group of typical children. Vitamin C levels were measured at the end of the study, and the placebo group had levels that were significantly below average for typical children, whereas the supplement group had near-average levels. The finding of high vitamin B6 levels is consistent with recent reports of low levels of pyridoxal-5-phosphate and low activity of pyridoxal kinase (i.e., pyridoxal is only poorly converted to pyridoxal-5-phosphate, the enzymatically active form). This may explain the functional need for high-dose vitamin B6 supplementation in many children and adults with autism.

Vitamin D
Pediatrics. 2015. Core symptoms of autism improved after vitamin d supplementation. This report is one case study of a 3 year old boy who improved after vitamn D supplementation.

Melatonin for sleep
Dr. Beth L. Goodlin-Jones, of the Medical Investigation of Neurodevelopmental Disorders (M.I.N.D.) Institute at the University of California Davis Health System in Sacramento, and her team report, "Melatonin can be considered a safe and effective pharmacologic treatment in addition to behavior therapies and sleep hygiene practices for the management of sleep problems in children with autistic spectrum disorder and fragile X syndrome." In a 4-week study, 18 children, ranging in age from 2 to 15 years, with autistic spectrum disorder and/or fragile X syndrome were given either 3 mg melatonin or placebo each night for 2 weeks. The children then "crossed over" to the other treatment group for 2 weeks. Reports from 12 children who completed the study showed that use of this natural hormone led to improvements in total night sleep durations, sleep latency times and sleep-onset times. Journal of Clinical Sleep Medicine, 2009.
   Comments: For long term use, I suggest no more than 1 mg of melatonin a few nights a week. I am concerned that if parents give 3 mg nightly for many weeks or months tolerance could develop or side effects could occur. It is possible that even a third of a mg or half a mg could also be effective.

Symptom
The main feature of autism is impaired social interaction. Children with autism may fail to respond to their names and often avoid looking at other people. They often have difficulty interpreting tone of voice or facial expressions and do not respond to others' emotions or watch other people's faces for cues about appropriate behavior. Another autism symptom is being unaware of others' feelings toward them and of the negative impact of their behavior on other people.
   Sleep problems are reported in the vast majority of children with autism and fragile X syndrome. Fragile X syndrome is an inherited form of mental impairment resulting from a "fragile," or broken site, on the X chromosome. The syndrome affects 2 to 4 percent of those with autism spectrum disorder, and symptoms of autism are common in children with fragile X. Some people consider autism to be part of the obsessive compulsive disorder spectrum.

Sign
Many children with autism engage in repetitive movements such as rocking and hair twirling, or in self-injurious behavior such as biting or head-banging. They also tend to start speaking later than other children and may refer to themselves by name instead of "I" or "me." Some speak in a sing-song voice about a narrow range of favorite topics, with little regard for the interests of the person to whom they are speaking.

Those with autism rarely look people in the eye. While avoiding eye contact is often regarded as a sign of social or personal indifference, many people with autism say eye contact causes them discomfort or stress.

Cause
Current research links autism to biological or neurological differences in the brain. MRI ( Magnetic Resonance Imaging) and PET (Positron Emission Tomography) scans show abnormalities in the structure of the brain, with significant differences within the cerebellum, including the size and number of Purkinje cells. In some families there appears to be a pattern of autism or related disabilities, which suggests there may be a genetic basis to the disorder, although at this time no one gene has been directly linked to autism. Men who become fathers in their 40s or older are much more likely to have autistic children than younger dads, bolstering evidence that genetics contributes to autism.
    A 2015 study shows that women who take antidepressants in the later stages of pregnancy are more likely to have a child with autism. The study specifies one particular group of antidepressants in particular — the SSRIs, or selective serotonin reuptake inhibitors, such as Prozac, Zoloft or Paxil.
   Disturbances in the serotonin system is another cause of autism, see study below.
   Having a parent or a mother with psychiatric problems such as schizophrenia increases a child's risk of having autism.
   Low birth weight and preterm delivery are a cause. These children are more likely to exhibit autistic symptoms.
   Advanced parental age appears to increase  autism risk in children, and the risk is seen with both mothers and fathers.
   Newborn babies who develop jaundice, a common liver problem that turns their skin and eyes yellow, are at greater risk. Pediatrics, 2010.
   Expectant mothers suffering from asthma, allergies or a type of skin disease have a higher risk of giving birth to an autistic child. Asthma, allergies and psoriasis symptoms during pregnancy — especially if diagnosed in the second trimester — doubled the risk of autism in children compared to children who were not afflicted. Obese mothers are more likely to have autistic children.
   Having a mother who lived within 1,000 feet of a freeway while pregnant doubles a child's odds, according to Southern California researcher Heather E. Volk, PhD, MPH.
   Women who used prescription antidepressants of the SSRI type before or during pregnancy have an increased risk of having a child with this condition.
   Women who have the flu while pregnant or have a fever lasting several days are more likely to have a child later diagnosed with this condition.
   Children exposed to higher levels of traffic-related pollutants during pregnancy or during the first year of life are more likely.
   Environmental pollutants, in addition to genetics, play a role in autism development.
   Children whose mothers took certain asthma drugs during pregnancy may have a slightly increased risk of autism. The study, published online Jan. 6 2016 in Pediatrics, found a connection between autism risk and prenatal exposure to drugs called beta-agonists. They are most often used to control asthma, and include inhaled medications such as albuterol, salmeterol (Serevent) and formoterol (Foradil).
   Children living in an area of New York state that uses aerial pesticides to control mosquitoes have a higher rate of autism than children in neighboring areas.

Pregnancy, pregnant women
Exposure to antidepressant medications in the womb raises a child's risk of autism; July 19, 2017, BMJ, online.

Vaccine controversy
Is it possible that children given too many vaccines could develop signs of autism?
   There is a debate in the medical community regarding the role of vaccines in causing or precipitating autism. I am not sure at this time but I am not ruling out the possibility that there could be a link. Over the past two decades so many new vaccines have been added to a child's vaccination list that the medical community has little idea how all of these interact with each other and how they influence the immune system and neural tissue.

A study of specially bred mice suggests that a mercury preservative in vaccines could potentially cause some of the brain changes in autism. Mercury released primarily from coal-fired power plants may be contributing to an increase in the number of cases. However, a 2013 study indicates children exposed to low levels of mercury in the womb because their mothers ate large amounts of fish during pregnancy don't appear to be at increased risk. University of Rochester Medical Center, news release, July 23, 2013

What does not cause it
There does not appear to be a link between the season or month a child is born and the subsequent risk. There does not seem to be a link between mercury levels (as determined by analyzing hair samples for mercury) and the risk. I have not seen any evidence that autism is a result of toxins or toxic metals.

Autism treatment
There are three large categories of autism treatment: Behavioral modification and communication approaches, dietary and nutritional approaches, complementary approaches. Despite anecdotal evidence suggesting that secretin is a useful treatment, the results of a new review do not support a therapeutic role for this gastrointestinal hormone.

Growth hormone
Boys with autism have higher levels of growth hormones than other boys, which may explain why children with the condition often have larger heads. Boys with autism spectrum disorders are also heavier than boys without these conditions.

Research study
Tests on the brain tissue of 11 patients with autism who had died and spinal fluid from six living children with autism showed the activation of immune system responses. In a study published in the online edition of the Annals of Neurology, researchers said they found abnormal activity by immune system signaling chemicals called chemokines in the autistic patients. This ongoing inflammatory process was present in different areas of the brain and produced by cells known as microglia and astroglia.

Emails
We have an 8-year old son that has autism and we've been working with him for the last 4-years with therapy. We didn't see as big of a change in him until the last 3 months when we put him on a GFCF diet ( flucose free casein free ) and had a local allergy doctor, Dr. Baptist recommend a bunch of supplements and B-12 injections. He still has some behavior issues but his vocabulary has increased. Any opinions about chelation therapy? Does it work for Asperger syndrome?
   We are glad your child has improved. I am not familiar with the use of chelation therapy for autism but I would be cautious.