Language – expressive, receptive, echolalia, scripting
Children and adults with autism often have delayed speech and language. There is no consensus on which underlying medical concerns contribute to impaired communication but the clues may lie in which biomedical treatments are most likely to improve language.
Expressive language is dependent on praxis which is dependent on the proper balance of brain chemicals and energy production. Improving regulation of serotonin, dopamine and GABA while reducing the brain chemical glutamate (which causes high levels of excitability in the brain) have shown to improve expressive and receptive language. While is doesn’t take a lot of energy to understand, it takes tremendous energy to support sensory motor integration to show someone that you understand by pointing, speaking or leading. When people with autism report what is happening in their brains, there is a consistent message of:
- I understand everything
- I can’t always control my body and it takes tremendous effort to do so
- I can’t organize my words to communicate and sometimes can’t figure out how to make my mouth move to make words
- My brain makes me do things that I can’t control
Echolalia and scripting most likely have their origins in the imbalance in serotonin in the brain. This is a proposed theory based on some children having more serotonin receptors in the right side of the brain. Over activity in the brain results in compromised function. In practice, it is almost as if the ability to memorize for people with autism is so exceptional, that they attempt to use this strength to communicate. When given a task, people with autism tend to use their right brain to solve the task. It is more difficult for them to mimic others or learn from others. Some researchers postulate this has to do with mirror neurons and it may very well but if we distill the information down to usable form; there isn’t the right balance of neurotransmission and not enough energy. In biomedical treatment, we support both and see language changes in the majority of our patients. Brain chemicals require a healthy microbiome, working methylation cycles and energy production from the mitochondria that isn’t hampered by the cell danger response.
Social Interaction in Autism Spectrum Disorder
As the puzzle of the medical aspects of autism unfold, it is becoming more and more apparent that there is altered visual processing involved impacting delayed social development. The first step to being social is being able to process the visual information of the people you are interacting with. Our combined clinical experience reveals that the core medical issues are linked to changes in the cell membrane (potentially by the cell danger response or immunoexcitotoxicity)and, in particular, the G proteins. Dr. Meg Megson published an article about G proteins and her use of the cis form of vitamin A in cod liver oil used to repair them. Take a look at the picture below. Imagine that the cell membrane has become stiff and rigid due to a microbe, chemical or heavy metal causing damage. The G protein (seen in the picture below) needs to be healed along with the rest of the cell membrane and Dr. Megson’s ground breaking discover is the key.
Carnitine is another important transport molecule on the cell membrane. It is uniquely sensitive to toxic insults as well. Once supported, the G proteins and the carnitine shuttle together with the cell membrane begin to function resulting in dramatic changes in eye contact , social interest and interaction and even focus and attention. Carnitine and the cell membrane are produced by the methylation cycle and nourished by fat soluble vitamins (like vitamin E) essential fatty acids, carnitine in supplement form and phospholipids like phosphatidylcholine.
Fine and Gross Motor
Motor delays in autism are certainly linked to the decreased energy produced by the mitochondria under conditions of oxidative stress (induced by chronic cell danger response and immunoexcitotoxicity). The intricacies of alterations in the brain, in the case of fine and gross motor skills may also help explain why some children have delayed gross and fine motor skills. People diagnosed with autism have impaired “pruning” of the brain. Imagine a beautiful vegetable garden (the neurons in the brain) that become overrun with weeds. As the number of weeds grow, the garden is less able to support the goal of producing vegetables. Altered function, decreases optimal development. Impaired “pruning”, according to researcher Guomei Tang, who analyzed brain tissue of children and adults diagnosed with ASD, is due to brain immune cells (glia) being engorged with “damaged parts”. Dr. Tang also discovered that signals required to cause programmed cell death were deficient. Under normal physiological conditions, a damaged or engorged immune cell can trigger “autophagy” which disconnects it from other cells. This is akin to removing dead or dying plants in the garden to make room for other plants that are thriving. Mitochondria send out a signal to program cell death. Impaired mitochondrial impairs the brain’s ability to “clean up” and remove debris from damaged cells. The majority of the brain is made up of immune or glial cells. They migrate towards damage and attempt to “scavenge” damaged parts of cells to prevent disrupted connectivity. In autism, these immune cells do not function properly, decreasing the ability for the brain to process and integrate information and perform complicated motor planning (praxis).
Cognitive function often appears to be impaired in autism but mounting research and individual reporting is shifting our perspective on cognitive capabilities for children and adults diagnosed with autism. Children and adult who are able to communicate, both verbally and non-verbally, report that they are able to understand and learn but lack the ability to coordinate movements to respond.
According to a 2016 study by Vanessa Bal, assistant professor of psychiatry at the University of California, San Francisco, “nearly half of children with autism who speak few or no words have cognitive skills that far exceed their verbal abilities”
The study evaluated 1470 children and showed that 43 to 52 percent of minimally verbal children have significantly higher nonverbal than verbal intelligence scores. Part of the problem is in the evaluation of children with developmental delays because cognitive evaluation depends heavily on motor planning which is impaired for at least have of the people diagnosed with autism spectrum disorder.
Methylation is essential to support executive functioning in the brain. Methyl B12 injection have been shown to support focus, attention, working memory and starting and finishing tasks because it helps to product serotonin, dopamine and GABA. Methylation is also required to produce components of the cell membrane including carnitine and phosphatidylcholine. Impaired methylation will impact a child’s ability to perform cognitively but is not a direct marker of capabilities. Biomedical treatment results in dramatic changes in cognitive performance, providing much needed fuel (made in the mitochondria) to support motor planning and methylation support that enhances executive functioning.