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Treating the Cause Instead of the Symptom
CHORI Scientist Characterizes Novel Syndrome

"We need to start asking why these kids are having these problems in the first place so that we can actually treat the cause instead of the symptom."

Pediatriac emergency medicine physician and CHORI clinical scientist Claudia R. Morris, MD, has just published an exciting study in the July/August issue of Alternative Therapies, which characterizes a new syndrome in children of allergy, apraxia and malabsorption.

Verbal apraxia (VA) is a neurological speech disorder with no known cause. Consisting of motor, verbal and behavioral disabilities, VA occurs early in childhood development, but persists into adulthood as a lifelong disability and is found in about 50 percent of patients diagnosed with autism spectrum disorders (ASD). The only treatments for VA to date have included speech and physical therapy to try and curb the symptoms.

"Verbal apraxia is a very misunderstood condition that isn't a diagnosis but a symptom," says Dr. Morris.

By distributing a questionnaire through a web-based support group and resource center for families with children suffering from VA, Dr. Morris was able to gather data on 187 different children with VA symptoms. The data yielded two critical pieces of information. One, that there is a subset of children with the VA diagnosis who present with the same symptom constellation of food allergies, apraxia, and malaborption, and two, that this syndrome is representative of a larger set of neurological dysfunctions that suggest a common underlying mechanism of disease that overlaps symptoms of vitamin E deficiency.

"Nutritional deficiencies have significant consequences on the developing brain," explains Dr. Morris. "Vitamin E deficiency in particular causes severe neurologic dysfunctions that parallel exactly the symptoms of apraxia. It is those very symptoms that improved with vitamin E supplementation."

A majority of the children with verbal apraxia responded positivity with vitamin E and omega 3 fatty acid supplementation, suggesting that this disorder is amendable to nutritional interventions.

"Why these kids have symptoms similar to those caused by vitamin E deficiency is unknown and needs further explanation. Regardless of the explanation, a nutritional vitamin E intervention does seem to help," says Dr. Morris. However Dr. Morris does advise families to work closely with a physician rather than trying promising but unproven interventions on their own.

In addition, the study underscores the importance of providing children with VA with a more comprehensive metabolic workup than is currently undertaken in clinical practice.

"We were able to get lab data on 26 of these kids," says Dr. Morris.
"What we found was high levels of carnitine deficiency, gluten sensitivity or food allergy and fat malabsorption, all of which suggest the need for these kids to be thoroughly tested so we can find out what is going on."
Even more importantly, the identification of this new VA syndrome provides physicians with a specific set of characteristics that they can use to provide intervention for these children as soon as possible.

"While 75 percent of the time kids identified as late bloomers really are just that, 25 percent of the time there is a true pathologic condition and to miss it is to miss critically valuable time," Dr. Morris says. "If a child has all these symptoms, chances are they are going to fall into the 25 percent who have a condition that needs treatment and the sooner we can identify them and get them help, the better."

While the evidence in the Alternative Therapies in Health and Medician issue is far from conclusive, Dr. Morris's study provides a strong foundation for future placebo-controlled clinical studies on vitamin E and omega 3 fatty acid supplementation in this population, as well as a more rigorous investigation of the connection between apraxia and ASD.

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Tuesday, May 17, 2011 8:19 AM

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