The rise in Autism and Autistic SpectrumDisorders (ASD) is approaching epidemicproportions, in comparison to other devel-opmental disorders in recent years accord-ing toDr. Jepson [1], Directorof the Thought-ful House Center for Children in Austin,USA, equating it to an approaching tsunami,and we are collectively unaware of thepending consequences. The cumulative in-cidence rise [2] cannot be explained bybroadening diagnostic criteria, greaterawareness and earlier diagnosis, migratoryfactors or genetics as ASD does not fit thepattern for “classic” genetic [3] diseases forit is a heterogeneous [4], multi-factorialdisorder, and the exact mechanisms arestill unclear at this stage.

However, it is recognized that there areseveral genetic diseases that carry a highrate of autism including fragile X, tuberoussclerosis and neurofibromatosis. Also, asubset of ASD children have a higher rateof chromosomal abnormalities (mostlychromosomes 7 and 15) in the form of de-novomutations such as inversions, duplica-tions, deletions and single nucleotide poly-morphisms (SNP). These changes in geneticcode expression [5] have the possibility tocode for metabolic alterations, giving riseto impairment in various biochemical pro-cesses such as methylation (even of DNA),detoxification and immune deregulation,resulting in a vicious circle as the subse-quent toxicity, oxidation and malnutritionin itself can give rise to these SNP changes.

The “Multiple Hit” hypothesis suggests thatwe cannot ignore the role of the ever in-creasing toxic environment we live in as itmay be the most likely contributory factorin the autism expression. Consider the vari-ous potential hazards for the fœtus [6],being exposed in utero to various maternaltoxins such as drugs (even “gene-nutrient”interactions involving excess folic acid),mercury in amalgam [7,8], and processedfoods “contaminated” with a multitude of

chemicals. In infancy, the exposure contin-ues potentially to formula milks, antibiot-ics, heavy metals [9–12], air pollution fromsolvents [13] and toxic car fumes as well asthe controversial issue of vaccinations [14–16] etc. – the list is endless. It was suggestedthat ASD children may act as the canariesused in mines in days gone by, warning theminers when the environment has becomehazardous and life-threatening – thus, hasour planet become unsustainable?

The average prevalence rate is estimated at1:100 children and rising [17], alarmingly(57%) according to Geraldine Dawson, chiefscience officer from the organization “Au-tism Speaks!. Collectively, we need to takethis distressing trend very seriously as ASDis a lifelong disorder, up to 65% have inspe-cific EGG abnormalities [18] and 25% haveconvulsions. Associated conditions includeAttention Deficit Hyperactive Disorder(ADHD), anxiety, depression and develop-mental delay. If untreated, the prognosis ispoor as only 9–31% will be able to live in-dependently, and only 11–50% able to at-tend college.

Infantile autismwas originally described byLeo Kanner [19] (1943), and theM:F ratio is4 :1. Onset is usually after the age of twofollowing an initial “normal” development.However, the individual variation in pre-sentation and severity is enormous.

The Diagnostic Statistical Manual (DSM‑IV1994 – USA), describes ASD as a group ofneurological disorders including:l Autistic Disorderl Asperger!s syndrome – high function-

ing autisml Rett syndrome (poor prognosis)l Childhood Disintegrative Disorder (re-

gressive autism) – low functioning au-tism

l Pervasive Developmental Disorder(atypical autism).

A. Children diagnosedwith an ASD cruciallyhave delays or abnormal functioning in:1. Social interaction

– No nonverbal behaviour (eye-con-tact/facial expression/body posture/gestures)

– Failure to develop peer relationships/sharing with others (interests/achievements)

– Lack spontaneous seeking of sharingwith others (solitary)

– Lack of social or emotional reci-procity (play/games/aloofness/em-pathy)

2. Language and Social communication– Delayed or lacking development of

spoken language (often shrieks)– Impairment in ability to initiate or

sustain conversation (if adequatespeech)

– Stereotyped and repetitive use oflanguage (echolalia/idiosyncraticlanguage)

– Lack varied, spontaneous play(make-believe/pretend or imagina-tive play)

B. ASD children often have impairments inthe following areas:1. Display restricted, repetitive and ste-

reotyped patterns of behaviour and ac-tivities:– Preoccupation with or special, nar-

row interest in one or more re-stricted activities

S U M M A R Y

This is an article about the complex issues involved in treating autistic chil-dren holistically. It covers a synopsis of the basic biochemistry going askewand suggests simplified dietary and nutritional interventions. Two case ex-amples follow to illustrate completion of the treatment with well-chosenhomeopathic remedies to stimulate the body!s healing mechanisms finallyout of the autistic expression.

KEYWORDS Autistic spectrum disorder, Immune system, Dysbacterio-sis, Holistic, Individualization, Nutrition, Hyoscyamus, Theridion

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Autism – A ThreeStage ApproachAnton van Rhijn, United Kingdom

Anton van Rhijn, Autism – A Three Stage Approach – Homœopathic Links Spring 2011, Vol. 24: 97–105 © Thieme Medical and Scientific Publishers Private Ltd. 97

– Inflexible adherence to specific rou-tines or rituals (obsessional – hatechanges)

– Stereotyped and repetitive manner-isms (stimming = flapping, rockingor spinning)

– Persistent preoccupation with partsof objects (zooming in on detail)

– Perseveration traits (alone, indepen-dent, “own world”, line up objects inrows)

2. Various sensory integration difficulties:– Sensory hypersensitivity (sound,

touch) or hyposensitivity (pain)– Motor skills (awkwardness and poor

motor development (accident prone)– Poor body awareness– Easily distracted or very active (bor-

dering on ADHD)3. Limited comprehension:

– Theory of mind (don!t understandperspective or the mental states ofothers) [20,21]

– Learning difficulties

In other words, typical behaviours in au-tism include:l Stares into open areas – don!t focus on

anything specificl Appears to be deaf at times – tunes oth-

er people outl Don!t respond to their namel Don!t smile when smiled atl Cannot explain what they wantl Language skills are slow to develop or

speech is delayedl Used to say a few words or babble, but

now he/she doesn!tl Don!t follow directionsl Don!t wave good-byel Don!t understand the concept of point-

ing at objectsl Throws intense or violent tantrumsl Has odd movement patterns – spin

around in a circle/flapping handsl Prefers being in a well-known placel Hands cover the ears oftenl Can be overly active, uncooperative, or

resistantl Don!t know how to play with toys or to

role play

Parents who suspect their child sufferingfrom autism can use the Checklist for Au-tism in Toddlers (CHAT) to identify autisticfeatures. Professionals use a battery of as-sessments to confirm the diagnosis.

Considering the expression of autism, it iseasy to understand the distress and devas-tation in a family when a child is being di-agnosed as suffering from ASD. The conse-

quences for the individual, family and soci-ety at large are enormous in every aspect oflife and the medical profession is at a loss asto what to offer. This is unfortunately stilldue to their limited and very out-datedview and approach, based on the under-standing that it is a neuro-developmentaldisorder for which there is no cure, despitethe abundance of research evidence indi-cating that it might actually be a biomedicaldisorder that is treatable. Fortunately, vari-ous leading organizations outside of theconventional medical world, such as DefeatAutism Now (DAN), the groups from Dr.Jepson, and Dr. Bradstreet, director of theInternational Child Development ResourceCenter (ICDRC) in Florida, to name a few,have contributed to this knowledge andhave a much better understanding of thecondition and are developing ever increas-ing, effective treatment strategies.

Autism and Biochemistry

In order to intervene rationally, we need tohave a clearer understanding as to what isgoing on in the biochemistry of these chil-dren where numerous systems involvedare malfunctioning, leading to disruptingneuro-regulatory processes. It has becomea very complex and extensive science andit is impossible to cover all the intricate de-tails in an article such as this. Best to give avery simplified overview of the main, inter-twined, systems involved such as:

1. Compromised, weakened immunesystemChildren with ASD are prone to recurrentinfections, commonly accepted and treatedones such as upper respiratory infections(tonsillitis/otitis). Research have found de-creased number of lymphocytes includingnaïve T-cells [22], T-helper cells [23,24],skewing Th1/Th2 response, cytotoxic T-cells and B-cells, low levels and decreasedactivity of natural killer cells and macro-phages, abnormal levels of monocytes, eo-sinophils and immunoglobulins (elevatedIgA, IgG & IgM to gliadin & casein) and ele-vated pro-inflammatory cytokines [25–27](TNF-α & IL-12) and platelets as well as dys-regulated immune cell apoptosis (celldeath). Many processes are being main-tained by glutathion depletion. The guthowever is commonly overlooked andoften shows clinically undiagnosed inflam-matory changes in the small [28] and largeintestines [29,30] (Ileo-colonic lymphoidnodular hyperplasia [31], Lymphocytic en-terocolitis and granulations), leading to:

2. Gastrointestinal dysfunctionOur gut is the major barrier between ourbody and the foods we ingest. The chronicinflammatory changes and frequent use ofantibiotics often leads to a bacterial dysbio-sis [32] and an increased gut permeability[33] (leaky gut). This is reinforced by ab-normal sulphation [34] and lacking sul-phate, a main feature in ASD, contributesto a leaky gut as sulphation is essential inproducing glycoproteins or glycosamino-glycans (GAGs) for the protective mucinlayer in the gut. The “unfriendly colonisa-tion” of pathogens (candida, pseudomonas,clostridium [35] etc.) exposes the gut tobacterial toxins which passes readily intothe circulation, as well as partly metabo-lised food particles, challenging the poorlyadapted immune system even more, andaffecting behaviour adversely. ASD childrenthrive on carbohydrates which should beavoided as they typically present with the“Gap syndrome” [36] features, such as colic,crying, posturing, tantrums and physicallywith bloating, flatulence, diarrhoea, consti-pation with over-spilling and various feed-ing difficulties and malabsorption. Theinflammation also contributes to compro-mised gut integrity due to atrophy of themucosa and intestinal villi resulting in adiminished absorption surface and inad-equate absorption of nutrients, leading to:

3. MalnutritionIt is well known that childrenwith ASD lacknumerous nutrients, partly due to beingfussy eaters but mainly due to malabsorp-tion, and are basically malnourished [37],requiring supplementation with some-times mega doses. The problem also al-ready starts in the stomach due to hypo-chloria, which in turn fails to stimulate ap-propriate amounts of pancreatic enzymes(peptidase) required for digestion. Dysbac-teriosis also contributes to lack of vitaminsdue to diminished endogenous productionand conversion.

4. Opiate elevationPoor digestion and a lack of sulphur, an es-sential co-factor for other essential enzy-matic processes, result in unmetabolisedpeptides (exorphins, with opiate activity)[38] from wheat (gliadomorphins) anddairy (casomorphins) which enter the cir-culation via the leaky gut and pass easilythrough the blood brain barrier (BBB), tolatch on to the opiate receptors, renderingthe ASD patient into an opiate state, oftenthe typical presentation of the children.This gluten [39] and casein enteropathyand intolerance (increased IgA to gluten &

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casein) creates an addiction to wheat (glu-ten molecule has 15 opioid sequences) anddairy products, akin to an opiate addict, inorder to maintain the state and to avoid un-pleasant withdrawal symptoms. Theymim-ic the effects of β-endorphins (encephalins)[40,41], resulting in typical ASD traits suchas reduced pain sensitivity, increased inci-dence of epileptic-type seizures, modifica-tion of sleep patterns,memory and learningdifficulties, reduced sociability, continuoushunger (no satiety sensation), body tem-perature deregulation, constipation andstool abnormalities. Early pioneers such asPanksepp (1979) and Reichelt (1981) haveclearly established a link between our diet,especially wheat and dairy products andthe autistic expression, confirmed by morerecent researchers [42–45].

5. Poor metabolic detoxificationpathwaysOne of themain systems involved is the sul-phur and Phenol-sulphotransferase-P (PST-P) system, the same malfunctioning systeminvolved in migraine sufferers (often infirst-degree relatives of ASD children) inwhom exposure to chocolate or cheese willprovoke a migraine attack. Themain reasonis sulphate deficiency, due to poor conver-sion (sulphate oxidase) from dietary cys-teine, which is also a molybdenum-depen-dent step [46], resulting in insufficient me-tabolism (inactivation) of neurotransmit-ters such as catecholamines (dopamine)and neurotransmitter amines (serotonine,tyramine and phenylethylamine). ASD chil-dren are known to have low sulphate [47]levels and a low sulphate/cysteine ratio.This gut-brain axis is very involved here asit is now understood that there are as manyneurotransmitters in the gut as there are inthe brain, making sense of the suggestionthat ASD is almost like having “coeliac dis-ease” in the brain, affecting our gut andbrain function adversely.

6. Insufficient methylation processesand impaired mitochondrial functionMethylation [48] is crucial to our cellularhealth, mainly to enhance and maintainvarious biochemical processes, but also toenhance antioxidant and detoxificationpathways. Poor detoxification pathways re-sult in an accumulation of environmentaltoxins (heavy metals, pesticides and vari-ous chemicals), consequently affecting be-haviour in the sensitive developing brainthrough cellular injury. Mitochondrial[49,50] function, essential for ATP produc-tion, is also compromised.

7. Oxidative stress – insufficientglutathione productionASD children are constantly in a state of in-flammation and thus prone to severe oxi-dative stress. Glutathione, one of the majoranti-oxidant agents, deficiency (partly dueto low cysteine levels) contributes to a de-creased capacity to control oxidative stressand exposes the body to increased amountsof destructive free radical compounds. Oxi-dative stress [51–56] is strongly associatedwith modification in the metabolism of lip-ids, proteins and DNA that can lead to struc-tural modifications in cell membranes, en-zyme inhibition, genetic mutations andbiochemical abnormalities in numerousneurological processes contributing toautonomic dysfunction, neurotransmitterderegulation, neuro-degenerative and neu-ro-behavioural abnormalities.

8. Autoimmune processes, allergies andfood intoleranceThere is rising evidence that the centralnervous system is not immune to the sys-temic inflammatory processes [57] eitherand that neuronal inflammation and auto-immune [58] processes may be the laststraw in the chain of events, overwhelmingthe system resulting in autism regression.Auto-antibodies have been detected againstPurkinje cells, myelin basic protein, seroto-nin receptors, caudate nucleus, neuron ax-on filament protein, cerebellar neurofila-ments and nerve growth factor. It is notpossible to cover all the neuronal compo-nents involved in the scope of this article.

Treatment Interventions

So, with all these processes involved, wheredo we begin to intervene therapeutically?Individualization remains important asthere are so many different presentationsin ASD and no two are alike. Many practi-tioners use various biomedical tests to as-sess the nutritional and biochemical “state”of the patient as tests provide reliable pa-rameters and objective biomarkers [59](oxidation, methylation, sulphation) to actas a guide and also to measure the effectsof various interventions. One can test forjust about anything, ranging from measur-ing urinary peptides and organic acids &IAG [60], porphyrin [61] concentrations,neopterin [62] & isoprostane levels, DNA &RNA markers, comprehensive metabolicpanel and stool analysis, intracellular andhair analysis for heavy metals levels toname but a few. The downside is that theyare complex, a science in itself, requiring a

degree in biochemistry to understand themand very expensive, putting an enormousfinancial burden on the already stretchedfamily [63,64].

There are a few treatment centres and pro-tocols around, such as the DAN [65] andSunderland [66] protocol. Some interven-tions can be very complex, driven by theresults from the multitude of biochemicaltests available to “correct all the imbal-ances”. The suggested supplement regimescan be very elaborate and again extremelyexpensive and demanding in compliance.They help these children considerably, butonly to a new equilibrium where they tendto plateau. The major disadvantage of theseprotocols is that they do not offer a homeo-pathic treatment, which is essential tomake the child progress even further to-wards full recovery.

My approach is a much more simplifiedone, without doing all the expensive testsand supplement regimes as I take it forgranted that most ASD children have in-flammation, a leaky gut with dysbacterio-sis, severe oxidative stress, biochemical im-balances, methylation and sulphation prob-lems, limited diets, food intolerances andnutritional deficiencies. It was opted for aminimalistic approach with well-selectedsupplements. Again, it is not possible inthe scope of this article to go into detailsabout the rationale for all the selected sup-plements. I chose not to include the com-monly used detoxification programs forheavy metals, such as the various availablechelation protocols, as they have risks in-volved if not well conducted. Certain par-ents may however insist on it and also askfor some of the tests such as the compre-hensive stool analysis or urinary organicacids panel. It is much safer to recommendgreen algae, Chlorella and Spirulina, to de-toxify the body, with the added bonus thatthey also are very nutritious, providingamino acids, minerals and vitamins inabundance, whilst getting rid of heavy met-als.

I opted for a 3 stage approach, preferablydoing them in the right sequence, one at atime to evaluate the effects of each inter-vention on its own. At the initial consulta-tion, obtain a thorough history of the ASDchild, including medical, dietary and nutri-tional details and a homeopathic history.Rating scales and video footage remain op-tional. Ask about past and current interven-tions and other professional input. Then as-sess and draw up a treatment plan. It can be

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very time-consuming to treat these chil-dren as their parents require a lot of expla-nation about ASD in order to achieve goodcompliance.

1. “Clean the environment” bychanging the diet regime to al Wheat, gluten and most grains/dairy/

yeast free diet (WF/DF/YF) [67,68]l Low glycaemic index (LGI) = no sugar

foods/specific carbohydrate diet (SCD)[69]

l Avoid also corn and soya productsl Eliminate additives, phenols, salicylates

and e-numbers (Feingold diet)l Consider individual food challenges as

other foods may be involvedl Anti-oxidant rich food (Acai/Goji/Noni/

Pomegranate/Raspberry/Blueberry)

It is suggested to do this alone for threemonths and assess the effects of the dietalone.

2. Provide supplements to aid gutrecovery, halt inflammation & correctnutritional status. This consists of twocomponentsA. Gut Supportl L-Glutamine (amino acid) – gut repair,

immune support and anti-oxidant [70]l MSM (methyl sulfonyl methane) – sul-

phation issues, detoxification – or ex-ternally, Epsom salts (MgSo4) in thebath to provide sulphur

l Digestive enzymes [71] – Promote di-gestion

l Probiotic (Lactobacillus – Acidophilus/Rhamnosus)

B. Nutritionall Vitamins (Vit C/Vit B6 and B12 [72]/Vit

E/Vit D3)l Minerals (Zinc/Magnesium/Molybde-

num/Selenium/Iron)l N-Acetyl-Cysteine – anti-oxidant/de-

toxification of heavy metalsl α-Lipoic acid – anti-oxidantl Ω-3 EFAs (Essential Fatty Acids espe-

cially EPA and DHA – ratio of 3:1)

Although I have not included methyl do-nors (help with methylation issues) in myprotocol, many practitioners are keen toprescribe them such as trimethylglycine(TMG) and S-adenosylmethionine (SAM!e).Dimethylglycine (DMG) has shown to cor-rect all five components of the Aberrant Be-haviour Checklist Scale (communication/social interaction/affection and eye contact,seizure control and hyperactivity).

Continue these two interventions for an-other three months to assess the combinedeffects of the diet and the supplements.Then add a homeopathic remedy on thethird consultation at six months.

3. Homeopathic remedyFinding an individualized remedy can bequite a challenge because they are unableto provide you with symptoms due to theircommunication difficulties. Also, thestrange, rare and peculiar symptoms theydisplay are quite common and often path-ognomic for ASD. I often use “visualization”to communicate with the patient on a spir-itual level, in order to find a suitable similli-mum. I call it spiritual homeopathy, match-ing the picture with my own database from“visualizations” on various substances fromthe three major kingdoms. It is exciting tomerge spirituality with mainstream medi-cine as they do tend to complement oneother.

Two, quite similar cases will follow to illus-trate how effective homeopathy can be inhelping to restore these children to health.In both cases however, parents opted forthe commencement of diet and some sup-plements simultaneously and the homeo-pathic remedy later.

Case One – Autism/Insomnia/Constipation

A 6-year-old boy was referred by his familydoctor, following a request from his moth-er, who was very unhappy about the out-come of the consultation she had with thepsychiatrist regarding treatment optionsfor her son. He was diagnosed with an au-tistic spectrum disorder, and the suggestedtreatment was Ritalin, which the motherdeclined in favour of another therapeuticapproach.

His emotional presentation was insomniadue to the fact that he was very anxious,with fear of the dark and being left alonein his room. Initiating sleep was very diffi-cult and he would end up in his mother!sbed, but woke frequently during the nightand was fully awake by 5.00 am. Needlessto say, nobody got any sleep at all whichdid not help the moods in the household.Hewas also autistic with obsessive compul-sive traits. He insisted on sameness, andwas very upset if there were any changesto his routines. He would respond with ex-treme disruptive and aggressive behaviour

if obstructed in any way. He was particu-larly obsessed with electrical appliancesand time – constantly asking what time itwas. He also had speech and language de-lay, with associated communication diffi-culties. His general comprehensionwas im-paired, and on par with a three-year-old.His socialization skills were poor and hefound it difficult to give appropriate emo-tional responses. Also, he had poor abilityfor independent and imaginative play andneeded guidance because he was veryeasily distracted by noise, to which he wasvery sensitive too.

Physically he suffered from constipationwith irregular bowel movements withoverflow and soiling of intermittent loose,offensive stools, even during sleep. He alsohad enuresis nocturna and suffered from avery dry and itchy skin, with flexural ery-thema, and recurrent ear infections. He re-acted with fever to DTP vaccinations buthas not received his MMR as yet. He hashad many courses of antibiotics for his in-fections which did not do his gut any fa-vours.

Although pregnancy was unremarkable, hewas a small baby at birth and not breast feddue to lack of milk, so was put on formulamilk. He had abdominal cramps and criedconstantly for months, and could not be pa-cified, most likely due to intolerance ofmilk. His language development was fastinitially, then suddenly stagnated at theage of 17 months, despite normal hearingtests. His motor development was slow,being clumsy, tripping over things, withpoor spatial awareness and eye-hand coor-dination. He found it also difficult to cycleunaided. The family history revealed mi-graine, asthma as well as hay fever fromvarious members. He has a healthy youngerbrother who is much more developed thanhim on all levels. He requires remedialteaching at school and speech therapy.

On taking a further homeopathic history, itbecame clear that he had a good appetite,being quite thirsty for fruit juices or coldwater, with a strong aversion to eggs andvegetables. Hewas upset by dairy products;colourings, additives, flavourings and fruitsmade his behaviour worse. On further en-quiry, the mother informed that his verystubborn routines were dictating the life ofthe entire family, and impaired social inter-action. He would line up everything (espe-cially toys) orderly in neat straight lines,and did not allow any alteration to this. Hewas also fond of loud music (monotonous

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rhythms), which only held his attentionvery briefly. He showed no interest andwas unable to entertain himself indepen-dently, or play constructively. He neededconstant stimulation, but tended to throwobjects away and got bored quickly. It be-came difficult to manage his extreme vio-lent and aggressive temper tantrums whenhe tried to strike or strangle others, yet henever displayed self harm, or breaking ofobjects. He was very selfish, refusing toshare with others, showed no empathy andwas unable to consider other people!s pointof view. He was not affectionate and dis-liked being touched. He gave very poor eyecontact during the consultation, as if hewaslocked in his own world, making only sniff-ing noises, with very limited communica-tion kills, responding with an oddmonosyl-labic grunt. Physical examinationwas unre-markable and hewas on the 50th centile forheight & weight. Mother rated his generalhealth as three out of ten before a treat-ment plan was suggested.

Treatment and follow-upBefore even considering a homeopathicremedy, it is important to address his gutissues. He is clearly suffering from a gutdysbiosis and probably a leaky gut, result-ing in a poor gut barrier, and compromisedabsorption of nutrients. Also, inflammatorychanges cannot be excluded. At this stageone can consider doing a gut permeabilitytest, and to exclude coeliac disease, butthese were not done. His initial treatmentwas to commence him on wheat and dairyfree diet (WFDF), and supplements of L-Glutamine 500mg, MSM 500mg daily,omega 3 essential fatty acids (EPA & DHA)1 g daily and a multi-mineral and multi-vi-tamin preparations daily as well as probiot-ics. Do remember that the effects of dairyproducts clear after about two weeks, butto clear the system from the effects ofwheat and gluten products may take sixmonths.

Follow-up appointment after two monthsshowed a marked improvement in his be-haviour. He coped for the first timewith go-ing on holiday, where he was challenged todeal with totally new routines. He was stillfearful of being left in his room, but sleep-ing better now. There was an improved eyecontact and ability to interact more appro-priately with others. He hardly showed anyaggression and his obsessional tendencies,by lining his toys up, eased off considerably.His writing skills improved as well as didhis ability to comprehend his environment.He had no eczema and his stool pattern re-

turned to normal, indicating clearly whenhe wanted to go to the toilet. Occasionallystill enuretic, but no infections though.Mother stated his general health improvedto five out of ten and I rated him + 1 on theGlasgow Homeopathic Outcome Scale(GHOS).

The treatment was continued without aremedy at this time.

Follow-up another two months later was abit disappointing unfortunately, as he didnot stick to his diet, which was breeched atschool. This is why parents need to have fullcooperation at school for adhering to diets.He became thirstier, developed mild ecze-ma and the constipation returned. He alsohad two ear infections for which he wasprescribed antibiotics by his family doctor.Sleeping was still better, but his autistic be-haviour regressed a bit. He refused to comeinto the consulting room initially, then set-tled eventually. His mother rated his gener-al health at four out of ten and I still ratedhim as + 1 on the GHOS. The treatment asoutlined above was continued and a ho-meopathic remedy introduced in the formof Hyoscyamus 12C one dose three times aweek. This is a cautious approach as thesechildren are very sensitive to remedies.

He was followed-up at three months andthe treatment was continued as he gener-ally improved. Follow-up after anotherthree months showed that he was muchmore settled, calmer, less tantrums or out-bursts and less fear. He was sleeping well,even alone in the dark throughout thenight. He still displayed some obsessionaltraits with aversion to change, with a preoc-cupation with time, asking over and overhow late it was. Hewasmore social, playingappropriately, showing empathy and al-lowed himself to be touched and started togive hugs. He had much better eye contactand started to speak a fewwords now. Con-stipation was better and he only had a milditch with eczema on his shoulder. Hismother rated his general health at six outof ten and I still rated him as + 1 on theGHOS. The treatment was continued as faras the supplements were concerned, butthe remedy potency was changed to Hyo-scyamus LM1, two drops diluted in 50mlof water, and one teaspoon as a dose threetimes a week.

He was followed-up at six months, and heimproved to such an extent that his mothernow rated his general health as seven out often and I rated him + 2 on the GHOS. Hewas

so much better! Hardly any routines or ob-sessive behaviour, and he became patientand calm, without any anger towardsothers. He started horse riding, is in main-stream school with remedial help. His con-centration and reading skills improved con-siderably. He is now able to converse verywell, even told me a joke, with jesting andlaughing! This is a very big improvementas autistic children are not able to do thisgenerally. He does get bullied at school andalthough he is not able to defend himself,he is dealing with it. He started karate les-sons to help his confidence. Everything isso much easier at home and his constipa-tion and enuresis are not an issue anymore.The treatment planwas continued as abovebut the Hyoscyamus potency was increasedto LM2, one dose three times a week.

He was followed up at six months, andagain after six months, with a rating in hisgeneral health as eight out of ten and I ratedhim + 3 on the GHOS. His improvementcontinues and everybody noticed it. Thepsychiatrist stated that he is not autisticanymore. His speech is normal and he ismanaging well in school with improvedconcentration and reading skills to the ex-tent that he needs much less help. He hasbecome a gentle and cooperative boy, muchmore flexible without obsessions. He isvery humorous and enjoys his karate andhorse riding. He enjoys socialising, by beingvery interactive and affectionate, with nor-mal eye contact. His sleep pattern remainswell with normal stools, no enuresis nor ec-zema. Parents very happy with their “to-tally changed boy” as they put it, a com-ment often heard as parents express theimprovement in their children as “havingtheir child back”. He was discharged with areduction in supplements, and to phasethem out over six months, and his remedy,Hyoscyamus LM3, one dose twice a weekfor three months and once a week for an-other three months. It was advised to con-tinue the wheat and dairy free diet for an-other two years.

HyoscyamusHyoscyamus has proven to be a very goodremedy for autism, especially with the as-sociated violence and the theme of “keep-ing others out of their space with a clearboundary”. It can be justified by repertoris-ing on the following symptoms, ignoringpathognomic symptoms of autism, such asthe aversion to being touched (see Fig. 1).

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Case Two –ASD/Hyperactivity

An 8-year-old boy was referred by the fam-ily practitioner following a request from hismother. He has an autistic spectrum disor-der with hyperactivity, diagnosed when hewas three years old. His mother was also in-terested in a nutritional therapeutic ap-proach, and not willing to put her child onthe suggested Ritalin.

He presents with delayed speech with lan-guage and communication problems,which had already became apparent at theage of two. Testing puts his speech level onpar with a five-year-old. He has semanticand pragmatic language difficulties, andproblems with social timing and dialogueflow with difficulty comprehending per-sonal meaning. It comes to no surprise thathe also had learning difficulties and beingextremely hyperactive, unable to remainstill at any time, did not help matters. Hewas over-excitable, with very fast move-ments, always moving, either running, tip-toeing, spinning and finger flipping, collec-tively called stimming. He was constantlyputting objects in his mouth, biting onthem. He could be aggressive, striking outat others. He had obsessional ruminations,repeatedly asking the same questions, withvery rigid routines, re-enacting film scenesover and over. It was very difficult relating

to him, as he lived in his own world, thussocially he was a loner without friends.

His past medical history revealed that hewas prone to frequent upper respiratory in-fections and tonsillitis, and he had red earson eating bread, which makes him consti-pated as well, with stools like rabbit drop-pings. Mother had a viral infection duringpregnancy, and his birth was traumatic, re-quiring a forceps delivery due to bradycar-dia. This resulted in a trauma with a left fa-cial paralysis and swallowing difficulties.Fortunately he fully recovered from this,but he was unable to breast-feed due toswallowing problems and was commencedon formula milk from the beginning. He isan only child but he has two uncles withautism.

Homeopathic history revealed that he had apoor appetite, with a desire to eat pizza,sugar, sweets, banana and indigestiblefoods such as sand and flowers. He wasclearly aggravated by wheat and sugar.Emotionally, he had high levels of anxiety,with a fear of monsters, big dogs, spidersand fast moving animals. He was obsessedwith train sets, and kept counting stationson the underground lines. He was very re-luctant to have any changes to his environ-ment or routines. He hated school classes,despite having a remedial teacher on aone-to-one basis. Computers were his fa-vourite and seemed to hold his attention a

bit. He had an interest in music, especiallydrums, but he was not successful in playingan instrument. His favourite movie was “ABugs Life”, especially interested in the grasshoppers and he identified himself with theants. He stated that he dreamt that he wasin a big bubble, and as his communicationskills and vocabulary were limited, hetended to confabulate. Hewas very restless,with sudden, jerky movements, twiddlingwith a toy, gave little to no eye contact dur-ing consultation. He was small for his age,with dark rings under his eyes, which isoften a sign of food intolerance.

Investigations showed a normal EEG, andhis mother supplemented him with highdoses of vitamin B6 & dimethylglycine(DMG). The only other medical input con-sisted of many courses of antibiotics andspeech therapy. His mother rated his gener-al health as three out of ten.

Treatment and follow-upThe initial treatment consisted of a wheat,gluten and dairy free diet. The above sup-plements were stopped, and he was com-menced on Ω-3 EFAs, L-glutamine 500mgand zinc 15mg daily.

He was followed-up two months later andmay bemore alert and interactive. Commu-nicationwas still limited with difficulties inlearning. He remained very energetic, withspinning, flicking with the rope on his jack-et. His movements were intensely jerky,shaking both arms, as if flying and jumpingup and down. He still had rigid routines. Hestill thought that cartoons were real andthat he was an ant (from “A Bugs Life”). Helacked the ability to grasp the concept ofpretend or what was real, with added con-crete thinking. However, his appetite wasbetter, eating healthy foods, including ap-ples and banana and his bowel movementsimproved considerably. His ratings im-proved to four out of ten according to hismother and I rated him + 1 on the GHOS.However, it was time to introduce a ho-meopathic remedy to complement his dietand supplements. He was issued with The-ridion (Latrodectus curassavicus) 30C oncea week.

His next follow-up was after three months.There was no change for the first threeweeks, after which he became noticeablyso much better. He became much calmer,less hyperactive and more aware of his en-vironment. His attention span improvedand he managed a social skills program atschool. He started to interact well with

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Fig. 1 Repertorisation case 1 (RADAR).

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others, communicating clearly and appro-priately. His obsessional traits were alsomuch reduced. He managed to sit still dur-ing thewhole interviewaswell. He had losestools during the first three weeks and re-covered spontaneously from a tonsillitis.The treatment regime was continued untilhis next appointment after three months,when his mother rated his general healthas six out of ten, and I rated him + 2 on theGHOS. He was emotionally so much im-proved and more mature. He was able tocry when upset rather than respondingwith anger or striking. There were less ru-minations and obsessions. He was so muchcalmer, but still had the occasional twitch-ing. His communication skills improvedand he was able to talk appropriately inshort sentences, grasping concepts betterand making connections between themes.He was able to express “his feeling beinghurt” and he became sensitive to music,even crying from some pieces. He reflectedon his pending birthday and asked if hecould break his diet by having a cake madeof wheat. His treatment was continued andthe potency of Theridion increased to 200C,one dose every 14 days.

He was followed up for three years at sixmonthly intervals. He was doing extremelywell. His moods were stable and he re-sponded and interacted normally, age ap-propriate, with others, giving proper eyecontact and mixing well with his peers. Hestarted to enjoy school, especially poemsand showed clear speech and comprehen-sion. He even made jokes, stating that hedid not eat his birthday cake and was stillavoiding wheat, clearly indicating that he

was able to see things from another per-spective. He dreamt about being repri-manded after he dropped a picture, statinghe was sorry and “didn!t mean to makemistakes”. He was coping with changesnow and had no more obsessive routinesor compulsive repetitions of speech. Thestimming ceased and his constipation andinfection tendencies resolved. His motherrated him nine out of ten and I rated him+ 3 on the GHOS. During the past two years,he gradually reduced the dose of Theridionand only took a 200C monthly and latertwo monthly, thereafter an infrequent doseas required. He was discharged, able to tol-erate wheat on a rotational base, but re-main dairy free.

It was clear, from the hyperactivity anddyskinesia, that he needed a spider remedy.Although Tarantula came to mind, the de-sire for fruit and especially banana, madeTheridion the right choice as the two rem-edies have many symptoms in commonand the repertory does not reflect this fact(see Fig. 2).

Conclusion

These cases illustrate how two very similarcases can be helped considerably with twodifferent remedies. In my experience, othereffective remedies for ASD include Vera-trum album, the bowel nosode Proteus andCuprum, Phosphorus, Opium and the noblegasses Helium and Hydrogen. It is also im-portant to consider eliminating the effectsof vaccination, if there is a clear history of“never well since” that we all hear about.

The late Tinus Smits has devised his CEASEprogram to deal with these issues and alsoto neutralize the effects of toxins andchemical drugs (even medicines) the fœtuswas exposed to during pregnancy.

Finally, every childwith ASD requires speci-alized, individualized interventions, oftenintensely on a one-to-one basis, includingoccupational, educational and psychologi-cal input and communication enhancingprogrammes such as speech therapy, theSon-Rise program and Applied BehaviourAnalysis (ABA), which has shown to be veryeffective in improving communication, so-cialization and comprehension. It is essen-tial to raise awareness in teachers in schools,to be educated in the complexities of theirASD students so that they can becomemoresupportive for the child and their families.There is scope for numerous specialized au-tistic centres, where the whole therapeuticpackage can be provided from one centre,under supervision fromwell-trained thera-pists. This is certainly a condition, due to itscomplexity and severity, which requires anintensive holistic approach. The ASD threatis real, considered a public health crisis bysome, as the consequences for our societymay be severely detrimental if not ad-dressed urgently. It requires an enormousamount of recourses and dedicated fundingto establish centres to provide treatmentand to conduct research. You!re invited tosee a video about my cases at www.saving-alostgeneration.com.

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Fig. 2 Repertorisation case 2 (RADAR).

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Dr. Anton van Rhijn MSc, MD, FFHomHeggeli HelhetsmedisinHeggelibakken 20375 OsloNorwayE-mail: anton.rhijn@gmail.com

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