Carly, a sweet 3 1/2 year-old girl, was first brought to my office in March of 2013. Her mother reported that she had some concerns about Carly from birth, including very abnormal bowel function with only one stool every 7-10 days. She was also late to walk at 19 months.
She started to regress in her language and social skills around 18 months. After her second birthday, she could no longer clap her hands which she had done since she was 6 months old and could no longer say 'Daddy'.
Fussy eating and holding food in her mouth
Eating is a big challenge. She is a fussy eater and will hold food in her mouth instead of chewing and swallowing it, sometimes for 10 minutes or more. It can take 20 minutes to get three bites of food into her at dinnertime.
Sleep is another challenge. She is up for hours during the night, often between 1-4 am, disrupting the whole family. Melatonin is helping with this. She grinds her teeth and rubs her face into the pillow and sleeps in the knee-chest position.
She walks in a stiff way.
Ultrasounds and autism link?
Prenatal history: There were concerns about the pregnancy which caused repeated ultrasounds to be done. The mother was put on bed rest at 6 months and labour was induced at 38 weeks.
All of this is important in CEASE therapy, as new research shows that ultrasounds during pregnancy may also increase the risk of autism.
As an infant Carly was happy other than the colic, but as mentioned she only had one bowel movement every 7-10 days which the doctors said was normal in breast-fed infants. Of course neither the mother nor I agreed.
Her digestion is still not normal and she alternates between hard and loose stools and only has one bowel movement every three days. The family tried a gluten and casein-free diet for 6 months, which helped a bit with her constipation.
Fish oil seems to help with language, from no sounds she went to making some sounds. If the mother forgets to give the fish oil Carly gets quieter.
She can have staring episodes several times a day during which she is quite unresponsive.
It is hard for her to wait for some things and she can have a melt-down if her mother is too slow to put her into the car.
She is stimming with head-banging, chewing things, licking the furniture or rubbing her mouth on her brother. She will also bite herself.
Ascorbyl palmitate, vitamin C, zinc and fish-oil supplementation for one week to prepare for detoxification.
Then Pentacel 30CH Mondays and Thursdays for two weeks followed by Pentacel 200CH twice a week. This is a homeopathic preparation of the vaccine Pentacel containing DTap-P-Hib.
She actually had Infanrix which also contains Hep-B, but I did not have it in the office at the time.
She also received Tuberculinum 30CH on Saturdays as a constitutional remedy and Saccharum officinale 6DH daily for her digestive issues.
Follow-up May 8/13
"She is more engaged and interactive. She now walks up to people and asks them to sing to her."
She is still waking up at night, last night she was up for four hours. Her stools are more firm and she has a bowel movement every other day now.
She is not holding food in her mouth any more! Now she only holds the last bite, previously every bite was a challenge. She will try all kinds of different foods now, before she was very fussy.
She is not grinding her teeth anymore and chewing on things a little bit less, she uses her chew tube for her pre-school about 1/3rd less.
A dangerous climbing issue
"And no more dangerous climbing!" the mother tells me. "Before she would climb every day, up an armchair through the window into the backyard, or up to the window and sitting in it, up bookcases, climbing onto barstools at the counter and leaning back with her toes on the counter, dangling." Yikes, she didn't even tell me that before!
"Now she is no longer seeking out this dangerous type of climbibing. She has had a few falls in the past and this was a real concern to us."
She sleeps on her side now rather than in the knee-chest position.
The staring is a little bit better. She has more patience when it comes to getting into the car. Now if the mother suggests going for a walk she wants to go instead of not responding as before.
She is not licking the couch as much. She is trying to get the mother's attention by holding her mother's face, a new development.
Assessment: Good response, especially in regards to the eating and climbing.
Continue Pentacel clearing with 1M and 10M.
Follow-up June 13/16:
She is chewing a bit more again and is putting things in her mouth and sucking her fingers, especially when she started the 1M Pentacel. Still licking the furniture. Her use of sign language and attempts to communicate are better, she seems to be more aware and understanding things better. With the 1M Pentacel she was constipated for 4-5 days, now it is better again.
She is now engaging in some spontaneous dancing, having fun doing it. Now she is laughing when her brother tries to hug her, before she would push him out of the way.
Dinnertime is still much better, barely holding food in her mouth at all. She is trying to say 'La', sticking out her tongue. Today she said the 'Sh' sound for the first time.
She is more cuddly and affectionate, even with the therapists. This is a new development.
The climbing and food holding was clearly improved with the Pentacel remedy. Mouthing issues have not changed that much, likely because they are related to the Hep-B vaccine which we have not cleared yet.
Repeat Pentacel clearing and add Hep-B as I'm still waiting to receive the Infanrix-Hexa vaccine. The intense mouthing and chewing points to the Hep-B vaccine, this connection has been observed in clinical practice.
I also changed the Saturday remedy to Medorrhinum to further addess the chewing issue.
In the meantime I checked back with the mother regarding the number of ultrasounds she had during the pregnancy. I just found out that there is a homeopathic remedy made from ultrasound, so this may also help this child.
It is unusual to see autistic girls, only 1 in 244 girls are diagnosed as autistic compared to 1 in 54 boys, so I'm wondering if the number of ultrasounds this child had predisposed her.
She also showed some concerns from birth which may also point into this direction.
Follow-up July 26/13:
Carly's chewing and mouthing behaviours did not change with the Medorrhinum or added Hep-B, she is still licking the couch and now chewing her hair.
She has had a lot of diarrhea over the past two weeks, with mucousy, loose stools, this is a new symptom as she has had a history of constipation. A good sign for progress.
All her gains are still present and have continued to improve, she is sleeping really well, not climbing anymore and not holding any food in her mouth any more. The other day she even ate Pizza and chewed it which was a huge improvement as she was so averse to chewing her food before. The mother reported that before the treatment Carly just lived on noodles and anything she could swallow without chewing.
Still is still dancing and more engaged and is continuing to make more noises and sounds.
Her toileting is improving, three weks ago she went on the potty three times a day for a week, it's been more sporadic again since.
Infanrix-Hexa, 30CH twice a week for two weeks, then 200CH for two weeks.
Follow-up August 29/13:
The speech therapist noticed a lot more sounds this month, called it 'an explosion of awesomeness'.
She has no diarrhea now, but is a bit more constipated. Still chewing, mostly her hair. The eating is still getting better. Falling asleep is a bit worse again lately.
She is more interested in the matching programs with the interventionist. She is playing well with her brother, they are wresting together and laughing. Lately she is a bit yeasty in her diaper area.
Continued improvement, esp in speech.
Infanrix Hexa 1 M twice a week for two weeks, followed by 10M for two weeks. Saturdays: Candida, 30CH.
Follow-up September 26/13:
Carly is continuing to make more sounds, ooh, oh, g, k, but no words.
Eating is still improving, she does not need as much ketchup, before she wanted it on everything - something else the parents had not told me yet - but not for the past two weeks now. Starting to feed herself more.
Chewing a little less on the furniture, but still on her hair.
Falling asleep is an issue off and on.
She seems to be understanding a bit more in general. Started to grit teeth over the past two weeks. She stopped touching fences and hedges a lot, used to do that a lot, but not this week. Has been humming a lot.
Good progress, less ketchup, less chewing, humming. New symptom of grinding teeth.
Repeat Infanrix Hexa 1M and 10 M. Tuberculinum one dose for the grinding.
Follow-up November 7/13
She is doing great. No more griding of the teeth. Eating is still improving, now she actually picked up food from the counter, took rice and chicken, she never did that before.
Climbing is okay. Regarding speech - she seems to be watching people's mouths more. Biting herself a bit more over past 2-3 weeks.
Parents are often told that she had a really good day at preschool.
Still walks with a bit of a hitch but is getting faster and better with stairs. Humming a lot, new tune. The licking of the furniture is about half of when we started treatment.
Follow-up Mach 17/2014
Carly had a febrile seizure in December and was followed up by an EEG. There was a break in treatment as the family went through some other issues with a new pregnancy.
Mom reports via email: "Carly is doing really well, everyone seems to be commenting on how great her eye contact has been the last few weeks. We have been really enjoying her! Her sleep has become worse again and we have her on medication for that now.
Otherwise all is well, Carly's EEG showed no other seizure activity, and she is the beautiful, happy girl we love. She has become much more interested in books lately. It is such as joy to sit and read with her. Honestly, it was one of the things I was looking forward to so much as a parent, sharing a love for books."
Plan: We will have a phone consultation and restart Carly on clearing remedies, she has made great progress on CEASE Therapy over the past year and there is still more room for improvement.
Dr. Anke Zimmermann, ND, Victoria, BC. Naturopath
Dr. Anke Zimmermann, ND, FCAH, Naturopathic Pediatrics
209-1061 Fort Street, Victoria, BC, V8V 5A1