The Autism File

Do-it-yourself creativity can turn your home into an effective therapy center, saving you money and strengthening bonds with your ASD child…

My ten-year-old son has been in some form of therapy weekly for the last eight years.  From physical therapy to speech, occupational, behavioral and social skills, Ronan has logged thousands of hours of therapy.  It’s been a way of life for him and will likely continue to be that way for some time.

Here, There, And Everywhere

Ronan has four typical siblings, and I was somewhat taken aback when his six-year-old sister was recently referred for vision therapy.  As Ronan’s needs have taken over much of our family’s time and energy, I was unprepared to carve more time in our full calendar to shuttle Izzy to and from therapy three days a week.  However, therapy would reduce her vision issues and academic struggles that crept up last year, so getting her where she needed to be was exactly what I’d do.

Taking two kids several days a week here, there and everywhere is taxing not only on the kids but on our schedule, finances and emotions.  We juggle so much already, so finding supplemental, inexpensive therapy ideas that we could do at home to benefit both Ronan and Izzy was my goal.  As I don’t have the professional background our therapists do, I asked them for advice before starting home-based activities.  I didn’t want to hinder or interrupt any skills my children were developing.

To follow through with the kids’ therapy “homework” and to work within a reasonable budget, I borrowed books and supplies from our therapists and borrowed college library books because of the wide selection and current titles.  I got ideas from therapy-specific magazines and catalogs, and looked up websites with “For Parent” sections that described therapies, target skills, and areas to be developed in simple terms.  There was a great deal of information on setting up a home environment and applying therapeutic goals to foster effective, successful learning moments.

Home Sweet Home

Activities that we’ve been able to replicate were just a few household items away!  Izzy’s vision therapy hones in on eye-hand coordination, focusing close up, and following directions.  Much of it is very similar to Ronan’s occupational therapy.  We’ve had fun popping bubble wrap (office supply stores have this in large rolls) and using tweezers to transfer dried beans into small containers.

Anytime we can get food involved is also fun:  skewering grapes on shish-kabob sticks, stringing popcorn on string (or fishing line if you need something sturdier), and picking up marshmallows with toothpicks.  Use an ice cube tray to serve snacks so your child practices fine-motor and eye-hand coordination.  Most of those activities can be quickly set up, are readily available and easily cleaned up.

I usually tell my children that they can’t throw their toys unless they’re outside playing with balls.  Playing a bean bag toss game with their small stuffed animals (if you don’t have an actual bean bag) is fun because it bends a regular rule and can add an element of competition.  Your target can be a large mixing bowl or a hula hoop.  Depending on the child’s ability, you can place the hula hoop right at their feet or scoot it farther away with each toss.  Then hold the hula hoop in the air so your child focuses their toss at a different angle, speed and trajectory.  Take a step back with each successful toss.  If your child loves a challenge, keep score!

Set up a therapy corner with shelves that house separate bins full of manipulatives which you can rotate out after several weeks to maintain interest:

• small chalkboards and chalk
• play dough and cookie cutters
• scissors and paper of varying thickness
• tracing and lacing cards
• therapy dough (great for hiding small LEGOs in!)
• beads for stringing
• stamps and stamp pads
• dominoes
• picture cards for matching
• clothes pins
• pipe cleaners
• magnetic board and magnets
• dress-up bin to practice donning and doffing clothes.

Expand Your Options

To maximize the potential benefits of in-home therapy, consider alterations to accommodate various activities.  We’ve done this several times over the years having installed swings and a pull up bar, and created space for a home-made wooden balance beam.  We’ve also brought in a small blow-up wading pool and filled it with plastic balls, and found a used mini trampoline for sensory input.  An in-home obstacle course is one of the most exciting activities we do inside after rearranging some of the furniture.  We then bring out tunnels, a small plastic slide, a pop-up house and sometimes even use the pillows from the couch!

The entire house—including the walls—have therapeutic potential.  Chalkboard paint and shower board (found at home improvement stores) foster creativity and a host of ideas:  play Tic Tac Toe or Pictionary.  Practice how to make the basic lines of the letters (horizontal, vertical, circular, slash), numbers and shapes.  Or just enjoy drawing together.

Real Help—Without Breaking The Bank

Therapy on a budget is quite doable.  Many items found in several rooms in your home can serve a different purpose.  Think about how they are typically used, then look at the objects again and ask, “What else can I do with these?”  If it can be lifted, squeezed, dropped into, counted, or sorted, then you have already cut your costs.  If you find that you don’t have anything useful for therapy, make a list of what you’d like to have.  Then, go to thrift stores or the clearance rack of department stores and start hunting for deals.

Check out websites like Freecycle or Craig’s List for specific items for which you won’t pay full price.  Don’t forget about the library!  Some libraries will have puzzles, themed kits, videos and games to loan. Swap therapy ideas and supplies with a friend.  Look on Pinterest for ideas on how to make your own games and projects.  Not only will you save money that might have been spent on formal therapy, but you and your child will have fun interacting as he learns important new skills.

Take It Outside

Anytime you can transfer activities outside is great.  A change in scenery, being able to use gross-motor movement and getting some natural sunshine are great benefits of being outdoors.  Blow bubbles, chase them and pop them.  Use a jump rope the traditional way or pretend it’s a tightrope walking on it as it lays flat on the ground.  Pull or push a wagon filled with different objects to give it some weight.  Play hopscotch, Simon Says, Mother May I, Red Rover and Hide and Seek.  You’ll surely share some giggles and can foster basic back-and-forth play while creating good memories.

Fine motor skills activities can even be brought outside.  Set up a water table in the yard with different objects and test if they sink or float.  If you can’t afford a water table that the pricey toy catalogs sell, take a plastic storage bin and fill it with water. Use different-sized measuring cups to transfer water using the dominant hand to pour at the beginning of the activity, and then switch to the non-dominant hand at the end.  Add sponges to the game.  Soak the sponge and then ask your child to squeeze it—use only the fingertips at first.  Switch hands to work on strengthening both.

When the water play is done, keep the water in the tub and use paintbrushes to “paint” the house, the fence, the driveway or sidewalk.  Use up and down, left to right movement always trying to cross the midline.  “Paint” letters, numbers, sight words, and shapes.  Keep a spray bottle close by when playing with the water table, too.  You can spray “paint” trees, flowers, and bushes as your child strengthens his hand muscles.  Have him aim for certain parts of objects, use sweeping motions left to right and up and down; make vertical and horizontal lines and again, try to cross the midline.  When dry, put other sensory-type items in the tub:  noodles, rice, beach sand, cotton balls or beads.  Use different-sized plastic containers and ladles, stirring or measuring spoons, tongs and strainers that you probably already have in the kitchen.

While still outside, plan for a picnic.  If your child has a poor memory recall, hand him the items one at a time after playing a labeling game, saying “I’m going to give you something that we put the juice in.”  Once he guesses “cup” correctly, hand it to him and ask him to grab it with his non-dominant hand.  Have your child set the items in a pattern:  cup, plate, napkin and repeat.  If he needs help putting things in the right spot, use direction words:  next to, in front of, to the left of, or to the right of.  Take turns passing the snack items out to practice social skills and good manners.

After eating and cleaning up, take some confetti (either store-bought or keep it simple and use hole-punched paper) and toss it into a small section of grass.  Ask your child to find 10 pieces before you count (jazz it up and count backwards from a certain number).  They can use their fingers, tweezers or tongs to find the pieces.  Have a small lidded plastic butter tub (cut the lid so it has a slit like a piggy bank).  As your child collects the small bits of confetti, he transfers the confetti into the tub.  You can also use a tennis ball, making a slit about 2 inches long.  The ball will have to be squeezed (start with the fingertips) in order to open the slit to deposit the confetti inside.  If your child likes a challenge, set a timer and ask him to collect a certain amount of confetti in under one minute.

If formal therapy isn’t an option for parents of children 0-3 years of age, investigate services through the local Early Intervention program.  School-age homeschooled children may qualify for funding for therapy through the local school district.  Call your district’s special education or related services department to find out more.  If you live near a university, ask the department head of the psychology, speech and language, physical therapy, occupational therapy services or education departments if they offer reduced cost therapy session opportunities.  Keep in mind that students in training would be paired with your child so make sure you are comfortable with working with an unlicensed (yet supervised) student.  Parents can also learn from observing a trained therapist in the clinical setting.  I’ve often been invited into the therapy room, or observed through a two-way mirrored window, in order to keep up-to-date with my children’s therapy progress.

Biomedical Treatments On A Budget

By Holly Bortfeld 

Many treatments that are effective and safe for people with ASD are often not covered by insurance, but please don’t let that stop you from trying treatments that can help your children down the path to health and wellness.

1. Educate yourself.  Learn how to research treatments and determine if the chances are good that your child will respond.

Read books, websites and use the medical libraries free at your local hospitals. Read about treatments, lab tests, and information you wish to discuss prior to your doctor appointments.

2. Know your child. Keep copies of all medical records. Learn what the external signs of conditions look like in your child so you can report and treat them properly.

Create a profile for your child through his/her test results and responses to treatments.  Keep a journal when trying new treatments of any kind. Keep copies of every lab test, doctor appointment, therapist report, school report, IEP, etc.

3. Use your insurance for all doctors and labs possible. Code treatments for the actual condition, not the autism umbrella.

Unfortunately, not all doctors accept insurance, especially in autism. Explain to the doctor that you need to use insurance-covered labs whenever possible, not the boutique/specialty labs unless there is a really good reason and then they need to limit those to fit your budget. If the doctor is not willing to work with you on this, you might need to consider finding another physician.

4. Use your state’s Medicaid or waiver programs to cover what the insurance company doesn’t.

Medicaid programs usually will not cover any autism “specialists,” tests or treatments, but they will generally pick up co-pays for visits and prescriptions and lab tests performed at hospitals.

5. Find out if your insurance will cover compounded vitamins and supplements. Start with trial-sized bottles of vitamins first to see if your child will tolerate them before you spend a lot of money.

Some insurance companies will cover vitamins and supplements if you have them compounded into liquids or powders to fit a prescription from a physician. Ask about trial sizes too.

6. Cook your own special diet foods. Cook from scratch, or like people used to cook before stuff came in boxes.

Do you remember seeing your grandma cook dinner when you came to visit?  There were no boxes.  Just real, whole foods.  Cook a meat, a vegetable, and a starch per meal.  It’s much cheaper than anything pre-made or partially prepared.

7. Never start more than one treatment, of any kind, within a two to three week period.

If there’s a problem, you need to know what is causing it. By trying one treatment at a time, you’ll know exactly if that one new treatment is causing the reaction (good or bad) rather than stopping everything and starting all over again if there are too many treatments and responses/reactions in your child to track.

8. Get your local insurance-covered pediatrician to rewrite the MAPS (see Find Out More, right) doctor scripts so that your insurance will cover them.

If you must use a specialty doctor that isn’t on your insurance plan, or a specialty lab, find out if your insurance covered physician is willing to rewrite the prescriptions so that your insurance will cover the tests and/or treatments.

9. Don’t keep wasting time and money on any doctor or treatment if you are not seeing results.

Just because a doctor says, “Ninety percent of my kids do well with this,” doesn’t mean your child will be one of that 90%. If you feel like your child is doing poorly with a treatment, don’t be afraid to tell your doctor you want to discontinue the treatment.

10. Find creative ways to pay for your biomedical program

Hold bake sales, use bartering, grants, family gifts, etc. and write it all off on your taxes.

Many children lose the language they have gained as autism takes hold—but that doesn’t mean they don’t want to communicate.

During my son’s toddler and preschool years I read everything I could get my hands on—but it wasn’t bestselling novels or fashion magazines that caught my eye. My afternoons were spent taking notes and making copies of pages to reference later. I squeezed in as much reading as I could while my children napped, spending my nights looking up terms and studies in the medical books I borrowed from the college library down the street. I wasn’t a student registered in any university courses—I was a parent of a child who had started to regress.

Having a typical child turn into a special needs child wasn’t something I’d prepared for or could have predicted. I had a good bit of knowledge about typical childhood development because of my career for nearly a decade as an educator. I knew when my son Ronan started to regress, something was different from what I’d seen in my own classroom although I couldn’t pinpoint exactly what. Sadly, neither could the professionals we were beginning to visit.

Searching For Answers

Thinking I might be able to use some of my old college textbooks wasn’t proving useful. I ended up scanning the bookshelves at a nearby college in my quest for answers, checking out everything from nursing care to psychological phenomena, but nothing fit my son’s issues. Having exhausted the local libraries, I turned to the internet. Soon I was settled at my desk in my own home, searching for answers one webpage at a time.

I continued a general search of childhood diseases, hoping something would pop out at me. I searched rare disorders, medical miracles and more, and became curious about speech and language development. It interested me because Ronan had gained some typical toddler vocabulary but had recently started to lose that speech. He was vocal and excited to say his words—but over time, I was crushed to hear garbled utterances. Ronan eventually fell silent. My quest for answers hastened.

Losing Speech

One thing that left me puzzled as Ronan was losing his skills was that through the silence he ached to communicate. The articles I read on severe expressive speech delays scared me. How could children be able to be a part of the world if they couldn’t talk? I’d never heard of children losing their speech in the way Ronan and other children I was reading about were.

The numbers of children being silenced by their regressions gave me new determination to find out more, and quickly. I knew that traumatic brain injury could cause speech issues, but that didn’t apply to my son. Previously typical children were being coupled with intense and disabling issues. Ronan struggled to produce words he’d clearly gained already. It didn’t make sense that he’d lost what I thought was such a simple skill. One of my internet searches brought me to a diagnosis known as apraxia of speech which I researched further. What I discovered was intriguing because I felt that Ronan displayed several of the traits of an apraxic child.

Ronan had just been enrolled in the early intervention program to address some of his delays with bare minimum allotted therapy time. Despite many attempts to increase instruction time, more speech was never granted. I knew that early identification and intense speech therapy with a highly trained speech and language pathologist (SLP) was proving successful for some children. They were able to gain skills allowing them to communicate through speech again. I wanted that for my son, too.

Wasted Time

Knowing Ronan would greatly benefit from the intense therapy suggested for apraxic children, I continued to request more school-based speech therapy. We didn’t have the means to go to a therapist privately and I foolishly thought the school system would provide the therapy he needed. I remember bringing up apraxia at Individualized Education Plan (IEP) meetings, requesting that Ronan be screened. The final response after all my attempts was, “When Ronan is six, maybe he’ll have enough speech skill to be properly evaluated, so let’s just wait until then.” Being the new special needs mom that I was, I recorded that information in my IEP binder and made a mental note to ask again for this testing when Ronan turned six.

So much time was wasted waiting for Ronan to “catch up” and for providers to clue in. During those next three years, Ronan received the cookie-cutter speech therapy typical in our area: 30 minutes twice a week with someone not experienced with apraxia. During this time, I discovered that while in kindergarten, not only was his school therapy grossly inadequate, but his entire schooling experience was causing regression and anxiety. With careful consideration, to secure his safety and preserve what little educational base he had, we transferred Ronan to private speech therapy and a private school. Once settled into his new routine and placements, he finally began to make steady progress. The decision to go private with better trained professionals proved positive.

Hopeful Signs

Our private SLP had been working for five years in the speech therapy field when she met Ronan. Erin Maher, who had completed her clinical work in a hospital rehabilitation setting for adults, realized the hospital was not for her. She wanted more than ever to work with children in a private setting. Settling down in the Raleigh area after graduation, Erin’s dream came true. She took a CFY-SLP position at Let’s Talk and has been there ever since.

Erin worked directly under the clinic’s “autism guru” while also gaining knowledge and skills working with the practice’s autism population. Her Clinical Fellowship—although very intense—would prove to be rewarding. Erin got to learn from the best and was immersed further into speech and language development, and how it related to those on the autism spectrum.

After meeting her a few times, I knew Erin was going to be the perfect fit for Ronan. The day we switched over to her services, Erin and our former SLP, and Ronan and I were sitting in the therapy room. Ronan had just started to make gains with some difficult motor planning exercises usually hampered by his low tone. He knew many words and occasionally one would tumble out. But, expressive output continued to be very rare.

On this partciular morning, Ronan had just finished some lip exercises with a lollipop. He was normally very distracted which, in this moment, helped us have a conversation without interruptions, but Ronan had something to say. He leaned forward into our circle and said, “Yum.” It was a deliberate, satisfied response to a tasty treat. Ronan said “Yum” twice more and had us sitting there in awe—and also filled with hope.

Time And Effort

Erin knew she had years of speech therapy ahead to give Ronan a chance to communicate better. Ronan of course had the most work to do. He had to learn how to shape his lips, have enough energy and memory to remember how to make sounds, and then put everything together to produce those sounds and be understood by others.

Ronan worked hard while Erin stayed as determined as ever. What proved to be the biggest component of Ronan’s journey was his sheer determination coupled with Erin’s dedication. After completing a series of exercises, sometimes Ronan would put his head down to rest. The second the next activity was laid out, he would pick his head up, scoot his little body up to the table, and try his hardest. Erin tapped into Ronan’s initiative and got right to work.

Tactile Therapy

Because of the thorough Let’s Talk evaluation, Ronan was granted the highest level of therapy time possible. Erin began to use a speech-language treatment technique called PROMPT (Prompts for Restructuring Oral Muscular Phonetic Targets). PROMPT involves the physical manipulation of a child’s jaw, face and mouth during communicative exchanges to show patients how speech sounds are produced. 
Ronan had consistently struggled with oral motor skills. He was able to imitate minimal oral motor movements but was not able to produce any sounds in imitation, so this became a focus of his therapy. Initially, Ronan’s attempts to imitate oral motor movement were done using a lollipop in front of a mirror so he could see himself. He was later able to transfer the movements he learned to pure imitation. Eventually the prompting techniques Erin used with these exercises were decreased as Ronan gained sounds.

Ronan was able to imitate more sounds than with other programs while using this tactile cueing system. Erin not only provided intense therapy and genuine care for Ronan, but also taught his school instructors and me. She guided us in providing tactile input for current targeted sounds Ronan was working on in order to draw out his speech gains and skills to other natural settings.

Speech Tools Crucial

Erin’s arsenal of speech tools included straws and bubbles to practice breath output and strengthen Ronan’s ability to control how sound was made. Ronan’s sessions were chock-a-block full, and he thrived thoroughly from it.

He learned how to blow bubbles, blow up a balloon, toot a horn to produce sound, and how to make specific sounds. Word approximations were confirmed by Ronan himself as he used his sign language simultaneously to express a thought. Erin pushed Ronan to the next level, using her technical knowledge and genuine desire to help children succeed.

Ronan trusted Erin and followed through with her demands. He also built confidence in his attempts to always try, try again. I appreciated every bit of encouragement Ronan got and the cheering Erin sent my way, too. Our whole family got involved with Ronan’s therapy: we were constantly amazed at his progress.

Tell-All Child…

Aiding Ronan with his communication has been a big task and has taken years to perfect. It’s something I never imagined having to do.

Thankfully I didn’t give up on searching for answers, and to this day Ronan has a great desire to tell us what he wants or needs. He can now call out to his Daddy with the sweetest sounding “Da da.” Ronan is silent no more! He has yet to regain all of the words he lost and still relies heavily on sign language, but his desire to speak remains very strong. Finding the right people with the right tools for such a monumental task is paying off, one sound and one word at a time.

Addressing digestive issues can lead to improved health for ASD kids… and you.

One can judge the efficacy of a given supplement by the length of time it survives in the market. Parents of children on the autism spectrum are adept at quickly deducing what works for their kids—and if the product does not produce results, it rapidly disappears. Many supplements have come and gone in the dozen or so years since enzymes first hit the autism scene, but enzyme supplements are more popular than ever. The increased use of enzymes as part of dietary programs to support the GI tract indicates they do work, but many parents still do not understand how enzymes help digestion.

The Lactose Factor

Replacing or altering metabolic enzymes is difficult and usually requires genetic manipulation. But digestive enzymes (see Enzymes 101), which make up a very tiny fraction of the body’s enzyme load, are different. Enzymes involved in digestion function outside of cells but within the GI tract to break down food proteins, carbohydrates, starches and triglyceride fats. As such, these enzymes can be replaced or supplemented orally with great effectiveness.

One example of enzyme supplementation is the use of lactase, an enzyme that breaks down the carbohydrate disaccharide lactose to glucose and galactose, which are simple sugars. Many of us become lactose intolerant after the age of 30, and eating dairy products can be a painful experience if lactase is not available to break down lactose. Symptoms include bloating, gas, cramping, and watery stools—but taking a capsule of lactase enzyme can easily allow one to enjoy cheese and ice cream without the unpleasant side effects of lactose intolerance.

Digestion And ASD

So how do enzymes help the digestion of those with autism spectrum disorders? Food intolerance is a condition widely found in those with autism, though it is by no means restricted to autism. The causes of food intolerance are not always known, but in many cases intolerance occurs due to incomplete breakdown of foods during the digestive process. This is most notable with food proteins, which are composed of amino acids.

Think of amino acids as letters, and proteins as words. Just as specific sequences of letters form specific words, specific sequences of amino acids produce different proteins. If you change the “letter,” you change the meaning of the “word.” Digestion is supposed to completely break down proteins to amino acids. However, some proteins are only partially broken down while in the small intestine. The small protein fragments produced from incomplete digestion are called peptides. Peptide production during digestion is actually quite normal, and eventually even peptides are broken down completely way downstream in the gut.

However, in some individuals these peptides can produce biological effects, some of which are helpful, while others are problematic. With certain individuals, the effects are observed in both digestive functions and behavioral responses. Loose stools or constipation may occur, and certain behaviors may be exhibited—for example, lack of attention, hyperactivity, or sleep issues. If a pattern of eating certain foods is associated with certain repeatable behaviors, then it may be possible to address these problems through dietary intervention. By understanding how certain foods are processed in the gut during digestion we can then address the underlying problems of food intolerance with the use of appropriate enzyme supplements.

Changing The Digestive Landscape

The problem for those with food intolerance is that the bulk of protein and carbohydrate digestion is in the same part of the gut where nutrient absorption occurs. Peptides and disaccharides are formed, absorbed, and may enter the systemic circulation through active or passive transport mechanisms found in the gut wall. If gut inflammation is present, these compounds can enter the circulation more easily. Once in the bloodstream, these compounds can produce effects in other parts of the body.

Taking supplemental enzymes can greatly change the digestive landscape—however, the enzymes taken orally must be from non-pancreatic sources, as these are not stable to stomach acid. Plant-based enzymes derived from fungal sources are the most common over-the-counter enzyme supplements and are active even in stomach acid. When taken with a meal, the enzymes start the breakdown of foods while the food is still in the stomach. Any food eaten will remain in the stomach from 90 to 180 minutes depending on the type and quantity of food. More importantly, foods and their nutrients are not absorbed from the stomach. This means that a food peptide can be tolerated while it is in the stomach but once it moves into the small intestine the peptide can be absorbed and become active. Therefore, one has a window of opportunity to address a potential food infraction before the infraction produces a resultant behavioral response.

Wheat and dairy proteins can be safely broken down while those foods are still in the stomach using the correct combination of proteolytic enzymes. Sufficient enzyme must be dosed such that the enzymes have time to work on the food before the stomach empties. Contrary to popular belief, very little food breakdown occurs in the stomach. Pepsin is the major enzyme in the stomach and its primary purpose is to activate pancreatic enzymes once the food mass empties into the duodenum. So, by adding additional acid-stable enzymes (by oral administration) to the food mass in the stomach, we jump-start the digestive process.

Enzymes in Autism Treatment

In the case of ingesting a food that is not tolerated, taking enzymes specific for the breakdown of that food may alleviate the intolerance. This function has received quite a bit of notice in the research community. Several research institutions have presented protease enzyme combinations as possible treatments for severe food intolerance such as celiac disease. Using protease enzymes that specifically address the structure of gliadin, a gluten peptide, researchers have demonstrated that gliadin production from gluten is inhibited. Since gliadin is the culprit that causes gut damage and immune problems in those with celiac disease, the effects of eating wheat are negated when these enzymes are used appropriately. While FDA approval is quite some time away, it is still gratifying to see the traditional research community emphasize the importance of plant-based enzymes in dietary problems.

As stated earlier, the great majority of enzyme supplements are derived from fungal sources. Aspergillus niger, grown under controlled conditions, is the primary source of enzymes. Varying the growth conditions of the fungi produces different enzymes. Japan is the primary source of enzyme production. The combination of art and science used for centuries in Japanese enzyme production results in purified enzyme proteins without any fungal contamination. Enzymes are most likely the safest dietary supplement available. Studies conducted with humans taking large amounts (up to 10 grams or more) of various enzymes over a period of time showed no ill effects. Enzymes are proteins and any protein has the potential to be allergenic, so one should insure that no sensitivity to enzyme protein exists prior to taking standard doses.

Optimizing The Dose

Dosing of enzyme products is based on the amount of food eaten, not body weight or age. There are many factors to consider for determining optimal dosing: diet, gut health, environment, etc. Since the safety factor for enzyme dosing is so large, we recommend experimenting with different dosing. You can use the enzyme supplier’s dosing recommendations as a guideline but keep in mind that individuals are different. It is best to start with low amounts and work up to a dose that produces the desired result.

One other indication that enzymes are providing help in the autism community is the proliferation of supplement companies now offering enzyme products. Unfortunately, many of these companies have no real experience or expertise in the use of enzymes. Anybody can contact an enzyme manufacturer and become a supplier of enzyme products. However, that does not guarantee a product that will produce results.

Base your choice of enzyme product on the knowledge and expertise shown by the company. Look for a company with actual hands-on experience in characterizing and purifying enzymes. Ideally, the staff should include a doctoral-level scientist with actual laboratory research experience and publications in enzyme biochemistry. They should do their own formulation and relay the information to a reputable, GMP-compliant enzyme manufacturer. Different enzyme combinations can produce very different results so an understanding of how each enzyme works is essential to producing an effective product. Finally, the company should be responsive to any questions you may have concerning their products. A company should want to build a relationship with its customer so providing answers is paramount to establishing trust.