Tara Skye Goldin, ND

Many of us are treating children with Asperger syndrome, otherwise known as autism spectrum disorder (ASD). The most recent statistic that I read is that 1 in 54 boys is now considered to have ASD.¹ This is a significant increase over the past few decades. Whether this is due to vaccines, environmental pollutants, better diagnostic interventions, or more frequent evaluations of socially awkward children requires further investigation and will not be addressed in this article because many excellent pieces have been written on this, and hopefully that will continue.

According to the new fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), Asperger syndrome is going to be lumped together in ASD as a higher-functioning form of autism.² Asperger syndrome in the DSM-5 is diagnosed by a “‘qualitative impairment in social interaction,’ such as problems with eye contact, facial expression, body language and posture; a failure to develop friendships; an inability to share common interests or to reciprocate socially or emotionally.”³ A second diagnostic criterion is “restricted repetitive and stereotyped patterns of behavior, interests and activities.”³

Everett was referred to me by his therapist. When I first met with him, he was 11 years old and in fifth grade. His mother was a bit skeptical of naturopathic medicine but was willing to try whatever was necessary to help her son.

Case Study

Everett was born via C-section at 35 weeks, had delayed motor and speech development, and had seen numerous specialists, as do many children who have concerned and conscientious parents. He had seen a psychiatrist and did not respond well to the medications prescribed. At the time of the initial visit, he was still taking atomoxetine hydrochloride and fluoxetine. At the initial meeting, his mother presented me with a thick file containing all the past neuropsychological evaluations and the details of Everett’s individualized educational program, which he had had some version of since age 2 years. His feet would meet each other while going upstairs at age 2 years, he had echolalia, and he was obsessed with the moon. The family never used the words autism or Asperger syndrome in front of him. He repeated kindergarten. When excited he would “stim,” “a jargon term for a particular form of stereotypy, a repetitive body movement (often done unconsciously) that self-stimulates one or more senses in a regulated manner” (http://www.wikidoc.org/index.php/Stimming).

In first grade, Everett was behind in reading, had attention issues, and was disruptive. In second grade, he still had attention issues, and medications were started. He had many adverse effects to the different medications, including paranoia, hallucinations, hair pulling, and weight gain. His parents took him off all medications over the summer. He was diagnosed as having Asperger syndrome at National Jewish Hospital, Denver, Colorado.

Initial Visit on February 18, 2008
Everett has trouble concentrating, remaining on task, making eye contact, and conducting social relationships. His parents reported that he does not pick up on body language or facial cues and is generally unhappy:

He seems angry and says that no one likes him. He does not make eye contact. He has oppositional tantrums with anger and tears. His reaction is way out of proportion to the event. He’s unhappy because he feels different from the other kids. He has low self-esteem. He gets along better with adults. He has intense friendships and will glom onto one friend and cling to that friendship. He needs to sleep with a fan on or he has nightmares. He is a picky eater. He only eats 6 things: bread, peanut butter and jelly sandwiches, fish sticks, French fries, canned peas, and ice cream. He is an anxiety-ridden kid. There are many random fears. His fifth grade teacher is concerned. He is argumentative and has trouble with friendships. He has obsessive tendencies.

Included in the medical history and physical examination are the findings that Everett has occasional sinus problems and headaches, and his legs hurt and swell. He experienced bed-wetting when the weight gain occurred. He was fully vaccinated. I prescribed Baryta carbonica LM4 daily, fish oil, and a kids multivitamin.

Visit on March 19, 2008
Everett’s mother reports: “People who know him well have seen improvement. His general demeanor has changed. He’s happier now, there is less stimming, and he has a better ability to stay on task. He is calmer and less oppositional. Friendship dramas are not as big a deal. We saw the effects within a week. His moods are more steady, and we are seeing progressive improvements. He is eating a little more variety.”

Visit on April 17, 2008
Everett is doing well. He is much more engaged, calm, and interactive. His therapist notices this as well. His teachers are seeing a dramatic difference. He is not as clingy with his friends and is not as volatile emotionally. The occurrence of stimming is rare.

2008-2009 School Year
Everett continued to improve, attaining peer level in sixth grade and winning an award for the “most improved.” His weight gain has leveled off, and he is making new friends. He now makes eye contact with people, he tries new foods, and his emotions are more on an even keel. He never stims in public.

2009-2010 School Year
Everett had a rocky start to middle school with their higher level of expectation, so we increased his Baryta carbonica to LM6 daily. This seemed to level him off, and the trajectory of improvement continued. He started participating on the swim team. He skied down black diamond hills. His body weight has slimmed. He is driven and goal oriented. There is some oppositional behavior, which his mother believes is age appropriate.

2010-2011 School Year
Overall, Everett is doing pretty well. In the fall, we raised his Baryta carbonica dose to LM8 because his mother had noted a plateau. In the winter and spring, his parents noticed him lying more. Changing his remedy to Tuberculinum bovinum LM4 seemed to help with the lying.

2011-2012 School Year
Everett has started high school. He was beginning to exhibit perfectionism, and at one point he said “I should just put a board in my head” after having trouble mastering skills for his golf team. He is back seeing his counselor. The lying seems to have stopped. He is having trouble making new friends at his new school. His demeanor has become very pessimistic. We put him back on Baryta carbonica and raised the potency to LM10.

After taking Baryta carbonica LM10, Everett began joking about “farts,” “boobies,” and other silly and annoying sexual things that seem immature to his parents and to his old friends. He is starting to alienate some of his friends from middle school. We switch his remedy to Hyoscyamus LM4 daily, and the immature silly sexual comments stop. He is beginning to make friends at his new school and now swims competitively for the high school team and has some upperclassmen friends. He seems more mature, is learning to drive a car, and is more responsible.

Summary

Homeopathy has much to offer children with Asperger syndrome–ASD. The socially awkward behaviors that are often involuntary in many patients clear up when the simillimum is prescribed. I like to use LM potencies in many of these cases because the patients are often taking other medications. Even if they are not, as in this instance, continuing to take the remedy at a gentle level daily keeps them and their parents engaged in the treatment. Also, I do not need to worry so much about the patient antidoting his or her remedy accidentally.

Much progress is being made with children and individuals having ASD who adopt a gluten-free and casein-free diet or even a GAPS (gut and psychology syndrome) diet. We did not pursue that angle with Everett because of his fixation on certain foods and his limited appetite for new foods, but with more recent patients I have made those recommendations. It is notable that dramatic improvements occurred herein with mostly the simillimum and some multivitamins and fish oil. While I think that the fish oil and vitamins helped with overall nutrition, the homeopathy seemed to have the most dramatic effect in this case.

As a child progresses during the latent years of childhood and through puberty and adolescence, it is not uncommon to need to change the homeopathic remedy as these new developmental stages arise. In this case, we had a few really good years on one remedy, and then the picture changed as Everett grew, hormones factored more into the equation, and we needed to change the prescription.

Homeopathic Keynotes

The Table contains some basic keynote excerpts from Morrison’s Desktop Guide to Keynotes and Confirmatory Symptoms.⁴ For more complete remedy pictures, I suggest reading various materia medica to fully comprehend the remedies.

^aI have also noticed that children who lie a lot often will eventually need a Tuberculinum remedy.

Tara Skye Goldin, ND is a naturopathic doctor practicing in Boulder, Colorado. She is a 1990 graduate of Bastyr University. She has also done in depth homeopathic study with Louis Klein, RsHom, Jeremy Scherr, RsHom, and Andrew Lange, ND, all to whom she is eternally grateful for their broad knowledge base and genius. Her practice focuses on homeopathy, botanical medicine, nutrition, women’s health and pediatrics as well as mood disorders. When she is not working, she enjoys time with her family, hiking and nordic skiing in Colorado, practicing Ashtanga Yoga and choral singing. Contact: www.taraskyegoldin.com.

References

Autism and Developmental Disabilities Monitoring Network Surveillance Year 2008 Principal Investigators, Centers for Disease Control and Prevention. Prevalence of autism spectrum disorders: Autism and Developmental Disabilities Monitoring Network, 14 sites, United States, 2008. MMWR Surveill Summ. 2012;61(3):1-19.
American Psychiatric Association. 299.80: Asperger’s disorder. http://www.dsm5.org/ProposedRevisions/Pages/proposedrevision.aspx?rid=97. Accessed April 10, 2012.
Adams HK. DSM-V: Asperger’s syndrome to be eliminated; some Aspies upset: the proposed changes to the DSM will move the category of Asperger’s syndrome in with autism. http://voices.yahoo.com/dsm-v-aspergers-syndrome-eliminated-some-aspies-5463529.html. Accessed July 16, 2012.
Morrison R. Desktop Guide to Keynotes and Confirmatory Symptoms. Albany, CA: Hahnemann Clinic Publishing; 1993.