Wednesday, October 31, 2007


A big health story this week relates to new reports of the American Academy of Pediatrics (AAP) calling for vigilance regarding signs of autism. "What's brand-new is that we're asking pediatricians to screen all children for autism at the 18-month and 24-month well-baby visits—not just children with speech delays and children of parents who have a concern. We're also telling pediatricians to ask parents about social and language deficits that may be present in very young children," Chris Plauché Johnson told U.S. News & World Report.

The AAP press release refers to the use of gluten-free diets to help children with autism spectrum disorders (ASDs):
Although use of the gluten-free/casein-free diet for children with ASDs is popular, there is little evidence to support or refute this intervention. More studies are in progress, and it is anticipated that these studies will provide substantially more useful information regarding the efficacy of the gluten-free/casein-free diet.
So what's to be done while the world awaits the result of the studies?

Well, I see some benefit in pediatricians and parents being similarly vigilant for celiac disease and other forms of gluten intolerance. Some reasoning:
  • The frequency of autism is about 1:150; the frequency of celiac disease is higher, about 1:133.

  • Blood screening for celiac disease is a relatively safe procedure that should not jeopardize a child's health (though a pediatrician should make sure that the blood tests are evaluated correctly).

  • Even if tests for celiac disease are negative in children suspected of having autism, there should be some consideration that there could be a neurological gluten intolerance that does not fully register in tests for celiac disease. A recognized example of a neurological gluten intolerance (not to be confused with celiac disease or autism) would be gluten ataxia.

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