Biomedical Treatment now in the Philippines

(Published in the Philippines Graphic Magazine, April 2008)

Every 20 minutes, a child with autism is born. In the Philippines and around the world, cutting across cultural and socio-economic lines, autism numbers continue to rise, confounding health professionals, overwhelming educators, and crushing the hearts of parents and family members.

As with all diseases with no known cure, autism – a lifelong condition -- continues to vex all who have to deal with it on a daily basis, without as much as a glimmer of hope. Management of autism traits – ranging from the inability to communicate meaningfully to unexplained tantrums, learning disabilities, and repetitive movements like hand flapping or twirling – entails a multidisciplinary approach. This often consists of behavioral management, physical, occupational and speech therapy, and special education, among others. But while helpful, none directly address that which causes the disorder itself.
Thus, when the first accounts of autism recoveries were recorded and brought to the fore, the autism community lost no time in embracing that which allowed children to break free of their socio-emotional cages, prisons that do not allow them to communicate meaningfully, even with the people who love them the most. The astonishing recoveries, according to the parents, happened when milk and wheat were completely eliminated from the autistic children’s diets. Children who were previously non-verbal went on to outtalk their siblings, began playing like children should, and finally connected with the people who, in the past, they regarded just as they would a blank wall. The unexplained screaming and tantrums disappeared and in their wake emerged happy, healthy children – something their parents could only dream of in the past.
Today, the ranks of recovered children includes some Filipinos who were able to climb out of the dark on account of their parents’ relentless efforts to experiment with what is today known as the biomedical approach to treating autism.

To explain the recoveries, it was shown that autism symptoms and behaviors are caused by opiates – substances found in drugs like heroin and morphine – that the body produces upon the ingestion of gluten and casein, proteins found in wheat and milk. In a healthy body, the digestive track takes in these proteins easily, and breaks them down into peptides that the body can utilize. Casein is broken down into large peptides like caseomorphine, which should be broken down further into smaller amino acids for eventual digestion.

In children with autism, gluten and casein are not digested properly to become simple amino acids, but remain in peptide form. In its peptide form, casein has opiate properties similar to morphine, and may plug into the same opiate receptor sites in the brain. Gluteomorphin, which also resembles morphine, is derived from gluten, found in wheat, barley, rye and oats and has been verified by mass spectrometry techniques to be present in unusual quantities in urine samples of children with autism.

Most autistic children were also found to have leaky guts, allowing relatively large molecules to enter the bloodstream from the intestine in abnormal quantities. As a result, these opiates leak from the intestine into the bloodstream, and eventually cross the blood-brain barrier to affect the brain and bring about the bizarre behaviors observed among children with autism. These behaviors disappear when the opiates are removed from the bloodstream, which will only happen when gluten and casein are no longer available in the body.
Hungry for a miracle, the autism community embraced the wheat-free, milk-free diet (better known as the gluten-free, casein-free diet for the specific proteins found in them) to amazing results for some, and a measure of improvement for others. Specific vitamins and nutrients – zinc, vitamin C, vitamin B12 with magnesium, among others -- were also noted to cause improvements in the behavior of autistic children. The biomedical approach eventually snowballed through the years to become the lifeline of many an autistic child.
Underpinned by the GFCF diet, the biomedical approach is also the cornerstone of the Defeat Autism Now! (DAN) movement. DAN is the fruit of the efforts of professionals committed to aiding recovery from autism. In 1995, the Autism Research Institute convened a group of about 30 carefully selected physicians and scientists in Dallas for the express purpose of sharing information and ideas toward defeating autism as quickly as possible. The participants represented the most advanced thinking by some of the best minds in the autism world, including Dr. Bernard Rimland, whose work has contributed much to the modern world’s understanding of autism. They shared a common dissatisfaction with the way physicians treated autism, mainly through drugs, which are believed to cause devastating side effects without addressing the root of the problem itself. They also believed that the right diet and nutritional supplements could be used to alleviate autistic symptoms.
DAN would also become the beacon of hope of thousands of families all over the world struggling with autism. In the United States, the autism community has openly embraced the DAN protocol, noting how it complements other therapies such as occupational therapy, speech therapy and applied behavior analysis (ABA). Several physicians began taking part in conference-trainings that would certify them as DAN doctors. In the Philippines, just as many parents are taking up the DAN protocol, paying little regard to the staggering costs and the logistical nightmares involved.

Until last year, Filipinos who wanted to follow the DAN protocol for their autistic children had to go to Singapore or Hong Kong where the nearest DAN doctors held office. Urine, stool and blood specimens were drawn there and then sent by courier to the United States, where these were analyzed to determine the presence and levels of allergens, metals (including lead and mercury), yeast, bacteria and viruses. After a two to three-week wait, the results are sent back to the DAN doctors for analysis and the appropriate nutritional supplements, as well as other adjunct therapies are prescribed.

Until recently, the Philippines did not have its own DAN doctor, but a mother’s concern for her son prompted pediatrician Rhodora Ibasco to work towards a DAN certification. Today, Dr. Ibasco is the only DAN physician in the Philippines, and more than a hundred Filipino families have sought her services since her certification in late 2007. Many are comforted by the fact that she charges a very reasonable P750 per session, as opposed to the minimum $200 or so charged by her foreign counterparts.

Today, Dr. Ibasco holds fort at the Comprehensive Clinic for Autism and Related Disorders in Quezon City, a center funded by another parent with an autistic child, Carlina Roa. The clinic also has a hyperbaric oxygen chamber and an infrared sauna.
It offers the same services offered by the Hong Kong and Singapore clinics through its tie-up with the Great Plains Laboratory in Kansas City, where the analysis of urine, stool and blood samples are done.

Because Roa is based in Cebu, a similar clinic has been opened in Cebu in February 2008. Tests to determine levels of toxins in the child’s body are offered by the clinic. Comprehensive tests, such as the complete autism panel, or individual ones, such as the Organic Acid Test, the hair metals test, the Ig test, are done in the clinic. Supplements, such as MB12 injections, cod liver oil and probiotics may be ordered through the clinic.

The clinic, painted a cheerful yellow, has rubber decals of its patient’s names adorning its walls, with small animals and flowers added to take out the gloom that have so marked the lives of these children. Patients, aged from 1 to 22, and their families march into the clinic brimming with optimism, hoping that biomedical treatment is the missing piece in the autism puzzle.

Dr. Ibasco acknowledges that while the biomedical route is expensive, Filipino parents are ready to give it a try. She points out, however, that the GFCF diet is essential for any of the therapies to succeed. “The Filipino diet is essentially GFCF,” she notes, pointing out that rice does not contain gluten and that milk is something children usually outgrow by their toddler years. The only culprits to be eliminated from the diet will be bread, cakes, and chips.

This, of course, is easier said than done. Autistic children have been noted to self-limit their diets to what is usually bad for them, providing clues of a biological addiction. Parent after parent tell of their children’s meal demands: McDonald’s chicken nuggets day in and day out for one; milk and Oreos for three straight years for another; Chuckie chocolate milk in the same box and nothing else for another. (This author’s autistic child, for instance, still throws a major tantrum if he does not get his Jollibee spaghetti or Greenwich ham and cheese pizza daily. It took months of behavior and occupational therapy to finally get him to eat a bowl of rice with soup.) Succeeding at GFCF entails a lot of discipline and sacrifice. Many family members cannot understand how something so good and so loved by the child should be withheld. “It’s really hard to implement at first, but you just have to persevere,” said Dr. Ibasco.

The tests, too, are expensive. The comprehensive autism panel costs P86,500 while the minor autism panel is P49,500. Even individual tests such as the Organic Acid Test go for P11,000, an amount equivalent to 22 OT sessions. Dr. Ibasco urges parents to go for the autism panels if they can afford it as these provide greater information, but in case they cannot, then the individual tests will suffice.

Biomedical treatment, she notes, will be truly effective when done simultaneously with other known therapies (OT, SP and ABA) as well as a good special education program.

Dr. Ibasco takes heart in the fact that there is greater awareness about autism now. Already, the American Academy of Pediatrics has come up with its list of red flags of autistic traits to be used in the early screening of children. More people are also coming to know about the biomedical approach, and embrace it even if many other physicians dismiss it as some sort of voodoo. At the recent autism conference in Manila, a known developmental pediatrician openly attacked biomedical treatment as unproven and without scientific basis. But Dr. Ibasco echoed researchers and parents when she says “why wait for the evidence (that the physicians are asking for) when the results are already there?”

Already, parents are getting more vocal about their experiences and successes, and many have educated themselves to an extent that draws Dr. Ibasco’s admiration. “Some of the parents I meet in the conferences know more than I do,” she smiled. Parents are the strongest advocates of autism, and their efforts have spurred authorities to pour more resources into its understanding. Jenny McCarthy’s appearance in Oprah, wherein she spoke of her son’s recovery after he took the biomedical route, also brought biomedicine within the sphere of understanding of most families with autistic members. In the Philippines, hundreds of parents are part of an online support system (www.autismpinoy.com) where they trade information on biomedical and other treatments, GFCF recipes, among others, and provide the emotional support and understanding that only those who have lived with someone with autism ever can.

Unable to find sources of the needed supplements, some parents have taken matters into their hands, and today are the exclusive distributors of these products. CCARD, for instance, is a distributor of the New Beginnings line of nutritionals. The list of parents who have turned their despair into an enterprise to help their children and other families struggling with autism continues to grow.

As the battle against autism rages, Dr. Ibasco urges families of autistic individuals to “go natural” in their lifestyles. Clean surroundings, she said, would be a good start. She urges families not to use “katol” or insecticides but to opt for natural cleaners like vinegar instead. “Genetics is the trigger of autism, but it is the environment that pulls that trigger,” she concluded. //