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Thursday, December 30, 2010

Gluten-Free Diet

What is Gluten intolerance or celiac disease?

Celiac disease, is also known as gluten intolerance. The disease mostly affects people of European (especially Northern European) descent, but recent studies show that it also affects Hispanic, Black and Asian populations as well. Those affected suffer damage to the villi (shortening and villous flattening) in the lamina propria and crypt regions of their intestines when they eat specific food-grain antigens (toxic amino acid sequences) that are found in wheat, rye, and barley. Oats have traditionally been considered to be toxic to celiacs, but recent scientific studies have shown otherwise.

Because of the broad range of symptoms celiac disease presents, it can be difficult to diagnose. The symptoms can range from "mild weakness, bone pain, and aphthous stomatitis to chronic diarrhea, abdominal bloating, and progressive weight loss." If a person with the disorder continues to eat gluten, studies have shown that he or she will increase their chances of gastrointestinal cancer by a factor of 40 to 100 times that of the normal population. Further, "gastrointestinal carcinoma or lymphoma develops in up to 15 percent of patients with untreated or refractory celiac disease." It is therefore imperative that the disease is quickly and properly diagnosed so it can be treated as soon as possible.

Testing is fairly simple and involves screening the patient's blood for antigliadin (AGA) and endomysium antibodies (EmA), and/or doing a biopsy on the areas of the intestines mentioned above, which is still the standard for a formal diagnosis.

Coeliac disease leads to severe damage of the gut surface, which can be completely reversed by following a gluten-free diet. Shortly after the diagnosis of coeliac disease, you need to be extra careful to ensure you have a nutritionally adequate diet, as you may have been suffering from malabsorption of nutrients.

The only acceptable treatment for celiac disease is strict adherence to a 100% gluten-free diet for life. A gluten-free diet means avoiding all products that contain wheat, rye and barley, or any of their derivatives. This is a difficult task as there are many hidden sources of gluten found in the ingredients of many processed foods.

What is gluten? What is gliadin?

Traditionally, gluten is defined as a cohesive, elastic protein that is left behind after starch is washed away from a wheat flour dough. Only wheat is considered to have true gluten. Gluten is actually made up of many different proteins.
There are two main groups of proteins in gluten, called the gliadins and the glutenins. Upon digestion, the gluten proteins break down into smaller units, called peptides (also, polypeptides or peptide chains) that are made up of strings of amino acids--almost like beads on a string. The parent proteins have polypeptide chains that include hundreds of amino acids. One particular peptide has been shown to be harmful to celiac patients when instilled directly into the small intestine of several patients. This peptide includes 19 amino acids strung together in a specific sequence. Although the likelihood that this particular peptide is harmful is strong, other peptides may be harmful, as well, including some derived from the glutenin fraction.

It is certain that there are polypeptide chains in rye and barley proteins that are similar to the ones found in wheat. Oat proteins have similar, but slightly different polypeptide chains and may or may not be harmful to celiac patients. There is scientific evidence supporting both possibilities.

When celiac patients talk about "gluten-free" or a "gluten-free diet," they are actually talking about food or a diet free of the harmful peptides from wheat, rye, barley, and (possibly) oats. This means eliminating virtually all foods made from these grains (e. g., food starch when it is prepared from wheat, and malt when it comes from barley) regardless of whether these foods contain gluten in the very strict sense. Thus, "gluten-free" has become shorthand for "foods that don't harm celiacs."

In recent years, especially among non-celiacs, the term gluten has been stretched to include corn proteins (corn gluten) and there is a glutinous rice, although in the latter case, glutinous refers to the stickiness of the rice rather than to its containing gluten. As far as we know, neither corn nor glutinous rice cause any harm to celiacs.

What are the symptoms of celiac disease?

There is no typical celiac. Individuals range from having no symptoms (asymptomatic or "latent" forms of the disease) to extreme cases where patients present to their physicians with gas, bloating, diarrhea, and weight loss due to malabsorption.

In between these two extremes lie a wide variety of symptoms that include:

Steatorrhea (fatty stools that float rather than sink)
Abdominal pain
Excessive gas
Any problem associated with vitamin deficiencies
Iron deficiency (anemia)
Chronic fatigue
Weight loss
Bone pain
Easily fractured bones
Abnormal or impaired skin sensation (paresthesia), including burning, prickling, itching or tingling
Peripheral Neuropathy* (tingling in fingers and toes)

Individuals have reported such varied symptoms as:
White flecks on the fingernails
Fuzzy-mindedness after gluten ingestion
Burning sensations in the throat

In children, the symptoms may include:
Failure to thrive
Querulousness, irritability
Inability to concentrate
Wasted buttocks
Pot belly with or without painful bloating
Pale, malodorous, bulky stools
Requent, foamy diarrhea
In addition to all of these, dermatitis herpetiformis, a disease in which severe rashes appear (often on the head, elbows, knees and buttocks) is related to celiac disease.
Reactions to ingestion of gluten can be immediate, or delayed for weeks or even months.

The amazing thing about celiac disease is that no two individuals who have it seem to have the same set of symptoms or reactions. A person might have several of the symptoms listed above, a few of them, one, or none. There are even cases in which obesity turned out to be a symptom of celiac disease.

The Gluten-Free Diet

A gluten-free diet is essential for people who have coeliac disease or dermatitis herpetiformis (a gluten induced skin sensitivity). Some people may choose to follow a gluten-free diet for other reasons, although these two diseases are the only ones where a gluten-free diet is considered medically imperative.
Gluten is a mixture of proteins found in some cereals, particularly wheat. It is the gliadin component of gluten which is responsible for coeliac disease. A gluten-free diet is not the same as a wheat-free diet, and some gluten-free foods are not wheat free. Despite a good deal of research, it is unknown how or exactly why gluten harms the gut. It is now considered likely that coeliac disease involves an abnormal immunologic response, rather than an enzyme deficiency as was suggested in the past.

It is possible to follow a gluten-free vegan diet, although you must be extra careful to ensure that your diet is nutritionally adequate. It is essential that you seek the advice of a sympathetic dietician if you want to follow a vegan gluten-free diet.

Vegetarians may initially find it difficult to establish what foods they can and cannot have.

A gluten-free diet involves the complete avoidance of all foods made from or containing wheat, rye, barley and usually, oats. Some doctors say oats may be permitted, although The Coeliac Society advise against the inclusion of oats in a gluten-free diet.

The Coeliac Society publishes a list of gluten-free manufactured products in a booklet which is updated every year. You can check with The Vegetarian Society if you are unsure whether any particular foods on this list are suitable for vegetarians or vegans. Some manufacturers use the gluten-free symbol on their label.

A wide range of specially manufactured gluten-free foods such as, bread, bread mix, pasta, biscuits, cakes, crispbread and flour are prescribable under the NHS.

Some gluten-free flours are low in protein, because they have had the gluten removed, which is itself a protein. Specially manufactured, prescribed gluten-free flours usually have milk protein added. Vegetarians can get protein from nuts & seeds, pulses, the non-gluten containing cereals, soya products, milk, cheese and free range eggs. Make sure some protein is included in each meal, and practice protein complementation with the vegetable proteins, for example, combine a nut or pulse dish with a suitable cereal

Gluten is a protein found in wheat, rye, barley, triticale and oats. The component of gluten that causes problems for people with coeliac disease is the prolamine fraction. The prolamine fraction in wheat is called gliadin; in rye, it is called secalin; in barley, it is hordein; and in oats, it is avenin.

A person with coeliac disease should avoid any foods that contain gluten. It is important to read the labels of all packaged or prepared foods. Some foods that may contain gluten include:

Meat products - any products prepared with breadcrumbs or batter, most sausages and other processed meats (including smallgoods), thickened soups, meat pies and frozen meals.
Dairy products - malted milk, some flavoured milks, cheese spreads, icecream in a cone, many custards and many soymilks.
Fruits and vegetables - canned and sauced vegetables, textured vegetable protein (found in some vegetarian products) and fruit-pie filling.
Cereal and baking products - wheat, wheaten or unspecified corn flour, semolina, couscous, wheat bran, barley, oats, porridge, breakfast cereals containing wheat, rye, oats or barley, corn or rice cereals containing malt extract, icing sugar mixtures and baking powder.
Pasta and noodles - spaghetti, pasta, lasagne, gnocchi, hokkein noodles, soba noodles and two-minute noodles.
Bread, cakes and biscuits - all bread, cakes and biscuits prepared with flours that contain gluten. This also includes communion hosts.
Condiments - malt vinegar, many mustards, relishes, pickles, salad dressings, sauces, gravy and yeast extracts.
Snacks - liquorice, some lollies and chocolates, packet savoury snacks, and some flavoured potato and corn chips.
Drinks - cereal coffee substitutes, milk drink powders, beer, stout, ale, guinness and lager.
Food labelling caution
Packaged foods have ingredient labels stamped on the box, package or bottle, but products are not always labelled if they are 'gluten free'. Also, the ingredient label may not list 'gluten' as a component, but it can be present within other ingredients such as thickeners, which could be wheat based. Effective from December 2002, new Australian food labelling laws will ensure that any ingredient (for example starches, thickeners, maltodextrin etc) derived from gluten-containing grains will need to have the source indicated. Also, processing aids derived from gluten-containing grains used to assist in the manufacture of foods will have to be declared.

There is an Australian Food Standard for processed foods labelled 'gluten free'. When foods are tested using the prescribed test, there must be 'no detectable gluten'. Currently (June 2001) this test is sensitive to 0.003% (3 parts per million).

Naturally gluten free foods

Despite the restrictions, a person with coeliac disease can still enjoy a wide and varied diet if they take an open-minded approach.

Corn (maize), rice, soy, potato, buckwheat, millet, quinoa, lentils and amaranth are all gluten free. It is important to read the labels of all packaged or prepared foods. Some gluten free foods that people with coeliac disease can enjoy include:

Meat products - plain meat, fish, chicken, bacon, ham off the bone and meats that are frozen or canned but with no sauce.
Dairy products - eggs, full cream milk, low fat milk, evaporated milk, condensed milk, fresh cream, processed or block cheese and some soymilks.
Fruits and vegetables - fresh, canned or frozen but not sauced; fruit juices, nuts and peanut butter.
Cereal and baking products - corn (maize) flour, soya flour, lentil flour, rice (all types), rice flour, rice bran, potato flour, buckwheat, millet, amaranth, breakfast cereals made from corn and rice without malt extract, polenta and psyllium.
Bread, cakes and biscuits - most rice crackers, corn cakes, rice crispbreads, corn tortillas and corn taco shells.
Pasta and noodles - gluten free pasta, rice noodles, bean vermicelli and 100% buckwheat noodles.
Condiments - tomato paste, tahini, jam, honey, maple syrup, cocoa, all kinds of vinegars (except malt), some sauces and some salad dressings.
Snacks - plain chips and corn chips, popcorn and plain chocolate.
Drinks - tea, coffee, mineral water, wine, sports drinks, spirits and liqueurs (check these for gluten-containing ingredients first).

Gluten free cereal products
Naturally gluten free cereal products that can be enjoyed include:

Corn tortillas
Lentil flour
Malt-free rice and corn breakfast cereals
Millet meal
Most pappadums
Potato flour
Rice (any kind)
Rice bran
Most rice crackers
Rice flour
Rice vermicelli
Soya flour
Soy-based lecithin
Taco shells

Making the switch to gluten free baking

In some cases, you can modify existing recipes for cakes and biscuits to make them gluten free. Gluten is the ingredient in wheat that helps the cooked produce to hold together, so you will need to use some other types of 'binding' agents.

Suggestions include:

Be prepared to experiment, and accept that a few of your first attempts may be unsuccessful.
Replace the role of gluten with xanthan gum or guar gum powders. These products are available from some coeliac societies and some supermarkets.
Try adding more baking powder to cakes.
Add an additional egg to pancake batters.
Make your own flours
The following mixtures may be used to make adequate flour substitutes:

Self-raising flour - two tablespoons potato flour, sufficient white rice flour to make it up to one cup, half a teaspoon of bicarbonate soda, half a teaspoon of cream of tartar, one teaspoon of xanthan gum (or guar gum).
Plain flour - combinations include: two cups rice flour, two thirds cup potato flour and one third cup tapioca flour; equal portions of soya flour and cornstarch; equal portions of soya flour and potato flour; equal portions of soya flour and rice flour.
Sweet pastry - 60g cornstarch, three quarters cup milk powder, one and a half cups coconut, 120g melted butter.
Baking powder - one quarter cup bicarbonate soda and half cup cream of tartar.


Wednesday, December 29, 2010

We Cured Our Son's Autism
By Karyn Seroussi
Copyright © 2000 Karyn Seroussi

berdasarkan artikel di bawah, beberapa perkara perlu diberi perhatian, iaitu kaedah penyembuhan alternatif dengan cara mengelakkan diet berasaskan susu, gluten dan kafein, serta kebarangkalian autisme tercetus akibat suntikan pelalian cacar-beguk-rubella pada usia masih bayi.

When the doctors said our son would be severely disabled for life, we set out to prove them wrong.

When the psychologist examining our 18-month-old son told me that she thought Miles had autism, my heart began to pound. I didn't know exactly what the word meant, but I knew it was bad. Wasn't autism some type of mental illness -- perhaps juvenile schizophrenia? Even worse, I vaguely remembered hearing that this disorder was caused by emotional trauma during childhood. In an instant, every illusion of safety in my world seemed to vanish.

Our pediatrician had referred us to the psychologist in August 1995 because Miles didn't seem to understand anything we said. He'd developed perfectly normally until he was 15 months old, but then he stopped saying the words he'd learned -- cow, cat, dance -- and started disappearing into himself. We figured his chronic ear infections were responsible for his silence, but within three months, he was truly in his own world.

Suddenly, our happy little boy hardly seemed to recognize us or his 3-year-old sister. Miles wouldn't make eye contact or even try to communicate by pointing or gesturing. His behavior became increasingly strange: He'd drag his head across the floor, walk on his toes (very common in autistic children), make odd gurgling sounds, and spend long periods of time repeating an action, such as opening and closing doors or filling and emptying a cup of sand in the sandbox. He often screamed inconsolably, refusing to be held or comforted. And he developed chronic diarrhea.

As I later learned, autism -- or autistic spectrum disorder, as doctors now call it -- is not a mental illness. It is a developmental disability thought to be caused by an anomaly in the brain. The National Institutes of Health estimates that as many as 1 in 500 children are affected. But according to several recent studies, the incidence is rapidly rising: In Florida, for example, the number of autistic children has increased nearly 600 percent in the last ten years. Nevertheless, even though it is more common than Down syndrome, autism remains one of the least understood developmental disorders.

We were told that Miles would almost definitely grow up to be severely impaired. He would never be able to make friends, have a meaningful conversation, learn in a regular classroom without special help, or live independently. We could only hope that with behavioral therapy, we might be able to teach him some of the social skills he'd never grasp on his own.

I had always thought that the worst thing that could happen to anyone was to lose a child. Now it was happening to me but in a perverse, inexplicable way. Instead of condolences, I got uncomfortable glances, inappropriately cheerful reassurances, and the sense that some of my friends didn't want to return my calls.

After Miles' initial diagnosis, I spent hours in the library, searching for the reason he'd changed so dramatically. Then I came across a book that mentioned an autistic child whose mother believed that his symptoms had been caused by a "cerebral allergy" to milk. I'd never heard of this, but the thought lingered in my mind because Miles drank an inordinate amount of milk -- at least half a gallon a day.

I also remembered that a few months earlier, my mother had read that many kids with chronic ear infections are allergic to milk and wheat. "You should take Miles off those foods and see if his ears clear up," she said. "Milk, cheese, pasta, and Cheerios are the only foods he'll eat," I insisted. "If I took them away, he'd starve."

Then I realized that Miles' ear infections had begun when he was 11 months old, just after we had switched him from soy formula to cow's milk. He'd been on soy formula because my family was prone to allergies, and I'd read that soy might be better for him. I had breast-fed until he was 3 months old, but he didn't tolerate breast milk very well -- possibly because I was drinking lots of milk. There was nothing to lose, so I decided to eliminate all the dairy products from his diet.

What happened next was nothing short of miraculous. Miles stopped screaming, he didn't spend as much time repeating actions, and by the end of the first week, he pulled on my hand when he wanted to go downstairs. For the first time in months, he let his sister hold his hands to sing "Ring Around a Rosy."

Two weeks later, a month after we'd seen the psychologist, my husband and I kept our appointment with a well-known developmental pediatrician to confirm the diagnosis of autism. Dr. Susan Hyman gave Miles a variety of tests and asked a lot of questions. We described the changes in his behavior since he'd stopped eating dairy products. Finally, Dr. Hyman looked at us sadly. "I'm sorry," the specialist said. "Your son is autistic. I admit the milk allergy issue is interesting, but I just don't think it could be responsible for Miles' autism or his recent improvement."

We were terribly disheartened, but as each day passed, Miles continued to get better. A week later, when I pulled him up to sit on my lap, we made eye contact and he smiled. I started to cry -- at last he seemed to know who I was. He had been oblivious to his sister, but now he watched her play and even got angry when she took things away from him. Miles slept more soundly, but his diarrhea persisted. Although he wasn't even 2 yet, we put him in a special-ed nursery school three mornings a week and started an intensive one-on-one behavioral and language program that Dr. Hyman approved of.

I'm a natural skeptic and my husband is a research scientist, so we decided to test the hypothesis that milk affected Miles' behavior. We gave him a couple of glasses one morning, and by the end of the day, he was walking on his toes, dragging his forehead across the floor, making strange sounds, and exhibiting the other bizarre behaviors we had almost forgotten. A few weeks later, the behaviors briefly returned, and we found out that Miles had eaten some cheese at nursery school. We became completely convinced that dairy products were somehow related to his autism.

I wanted Dr. Hyman to see how well Miles was doing, so I sent her a video of him playing with his father and sister. She called right away. "I'm simply floored," she told me. "Miles has improved remarkably. Karyn, if I hadn't diagnosed him myself, I wouldn't have believed that he was the same child."

I had to find out whether other kids had had similar experiences. I bought a modem for my -- not standard in 1995 -- and discovered an autism support group on the Internet. A bit embarrassed, I asked, "Could my child's autism be related to milk?"

The response was overwhelming. Where had I been? Didn't I know about Karl Reichelt in Norway? Didn't I know about Paul Shattock in England? These researchers had preliminary evidence to validate what parents had been reporting for almost 20 years: Dairy products exacerbated the symptoms of autism.

My husband, who has a Ph.D. in chemistry, got copies of the journal articles that the parents had mentioned on-line and went through them all carefully. As he explained it to me, it was theorized that a subtype of children with autism break down milk protein (casein) into peptides that affect the brain in the same way that hallucinogenic drugs do. A handful of scientists, some of whom were parents of kids with autism, had discovered compounds containing opiates -- a class of substances including opium and heroin -- in the urine of autistic children. The researchers theorized that either these children were missing an enzyme that normally breaks down the peptides into a digestible form, or the peptides were somehow leaking into the bloodstream before they could be digested.

In a burst of excitement, I realized how much sense this made. It explained why Miles developed normally for his first year, when he drank only soy formula. It would also explain why he had later craved milk: Opiates are highly addictive. What's more, the odd behavior of autistic children has often been compared to that of someone hallucinating on LSD.

My husband also told me that the other type of protein being broken down into a toxic form was gluten -- found in wheat, oats, rye, and barley, and commonly added to thousands of packaged foods. The theory would have sounded farfetched to my scientific husband if he hadn't seen the dramatic changes in Miles himself and remembered how Miles had self-limited his diet to foods containing wheat and dairy. As far as I was concerned, there was no question that the gluten in his diet would have to go. Busy as I was, I would learn to cook gluten-free meals. People with celiac disease are also gluten-intolerant, and I spent hours on-line gathering information.

Within 48 hours of being gluten-free, 22-month-old Miles had his first solid stool, and his balance and coordination noticeably improved. A month or two later, he started speaking -- "zawaff" for giraffe, for example, and "ayashoo" for elephant. He still didn't call me Mommy, but he had a special smile for me when I picked him up from nursery school. However, Miles' local doctors -- his pediatrician, neurologist, geneticist, and gastroenterologist -- still scoffed at the connection between autism and diet. Even though dietary intervention was a safe, noninvasive approach to treating autism, until large controlled studies could prove that it worked, most of the medical community would have nothing to do with it.

So my husband and I decided to become experts ourselves. We began attending autism conferences and phoning and e-mailing the European researchers. I also organized a support group for other parents of autistic children in my community. Although some parents weren't interested in exploring dietary intervention at first, they often changed their mind after they met Miles. Not every child with autism responded to the diet, but eventually there were about 50 local families whose children were gluten- and casein-free with exciting results. And judging by the number of people on Internet support lists, there were thousands of children around the world responding well to this diet.

Fortunately, we found a new local pediatrician who was very supportive, and Miles was doing so well that I nearly sprang out of bed each morning to see the changes in him. One day, when Miles was 2 1/2, he held up a toy dinosaur for me to see. "Wook, Mommy, issa Tywannosauwus Wex!" Astonished, I held out my trembling hands. "You called me Mommy!" I said. He smiled and gave me a long hug.

By the time Miles turned 3, all his doctors agreed that his autism had been completely cured. He tested at eight months above his age level in social, language, self-help, and motor skills, and he entered a regular preschool with no special-ed supports. His teacher told me that he was one of the most delightful, verbal, participatory children in the class. Today, at almost 6, Miles is among the most popular children in his first-grade class. He's reading at a fourth-grade level, has good friends, and recently acted out his part in the class play with flair. He is deeply attached to his older sister, and they spend hours engaged in the type of imaginative play that is never seen in kids with autism.

My worst fears were never realized. We are terribly lucky.

But I imagined all the other parents who might not be fortunate enough to learn about the diet. So in 1997, I started a newsletter and international support organization called Autism Network for Dietary Intervention (ANDI), along with another parent, Lisa Lewis, author of Special Diets for Special Kids (Future Horizons, 1998). We've gotten hundreds of letters and e-mails from parents worldwide whose kids use the diet successfully. Although it's best to have professional guidance when implementing the diet, sadly, most doctors are still skeptical.

As I continue to study the emerging research, it has become increasingly clear to me that autism is a disorder related to the immune system. Most autistic children I know have several food allergies in addition to milk and wheat, and nearly all the parents in our group have or had at least one immune-related problem: thyroid disease, Crohn's disease, celiac disease, rheumatoid arthritis, chronic fatigue syndrome, fibromyalgia, or allergies. Autistic children are probably genetically predisposed to immune-system abnormalities, but what triggers the actual disease?

Many of the parents swore that their child's autistic behavior began at 15 months, shortly after the child received the MMR (measles, mumps, rubella) vaccine. When I examined such evidence as photos and videotapes to see exactly when Miles started to lose his language and social skills, I had to admit that it had coincided with his MMR -- after which he had gone to the emergency room with a temperature of 106°F and febrile seizures. Recently, a small study was published by British researcher Andrew Wakefield, M.D., linking the measles portion of the vaccine to damage in the small intestine -- which might help explain the mechanism by which the hallucinogenic peptides leak into the bloodstream. If the MMR vaccine is indeed found to play a role in triggering autism, we must find out whether some children are at higher risk and therefore should not be vaccinated or should be vaccinated at a later age.

Another new development is giving us hope: Researchers at Johnson and Johnson's Ortho Clinical Diagnostics division -- my husband among them -- are now studying the abnormal presence of peptides in the urine of autistic children. My hope is that eventually a routine diagnostic test will be developed to identify children with autism at a young age and that when some types of autism are recognized as a metabolic disorder, the gluten and dairy-free diet will move from the realm of alternative medicine into the mainstream.

The word autism, which once meant so little to me, has changed my life profoundly. It came to my house like a monstrous, uninvited guest but eventually brought its own gifts. I've felt twice blessed -- once by the amazing good fortune of reclaiming my child and again by being able to help other autistic children who had been written off by their doctors and mourned by their parents.

Adapted from the book Unraveling the Mystery of Autism and Pervasive Developmental Disorder: A Mother's Story of Research and Recovery by Karyn Seroussi. Published by Simon & Schuster February 2000.

For more info, contact:

The Autism Network for Dietary Intervention (ANDI)
Fax 609-737-8453
Publishes ANDI News, a newsletter containing recipes, research updates, and articles by parents and physicians.

The Autism Research Institute
Fax 619-563-6840
Provides information about autism research and treeatment, including alternative therapies. Organizes the annual DAN! (Defeat Autism Now!) Conference.

Editor's Note: As a retired English teacher with 24 years in the classroom, I've long been concerned about ADHD and the powerful drugs so often prescribed to children and teenagers who have been diagnosed with the condition. Over the years I saw far too many kids turned into zombies by the popular ADHD drugs. Consequently, after I left teaching I wrote a special report entitled How to Get Your ADHD Child Off Mind-Altering Drugs. In this report, I detail 20 different natural alternatives to using Ritalin™ and other prescribed stimulants for attention deficit problems. Click here for details about the report.


Youth with autism is a natural at the piano

Jenny LaCoste-Caputo

Alex Ritter sticks his fingers in his ears as he walks along the crowded corridors of Roosevelt High School on his way to orchestra class.

The noise and chaos grate on Alex and agitate him. A few months ago, he wore big ear mufflers, the ones that look like the headphones that airport workers wear on the flight line, but he decided to shed them last summer to score a few cool points.

When he reaches his classroom, he walks in small, tight circles, holding his hands up by his face, his fingers and lips moving.

Then he sees the piano. He looks for his teacher and, in a staccato tone, asks: "Piano? Yes?"

Not yet, he's told. He goes back to walking in circles.

Alex has autism. At 18, he's a senior at Roosevelt, in the North East Independent School District, but will stay at the school three more years because of his special education status. He's minimally verbal, usually just speaking one or two words at a time. He responds best to Japanese - his mother's native language - but even then, rarely speaks to strangers without being prompted.

But when Alex sits at the piano to play the piece he's working on for an upcoming regional competition, he changes. The nervous ticks are gone. The eyes that have been darting back and forth are focused on the music in front of him. His face is relaxed and his hands rest lightly on the keys. And then, with the skill of a collegiate-level performer, he plays.

"The kids call it 'the zone,'" orchestra teacher Lydia Hurtado-Yanez said. "He gets in the zone and nothing distracts him, nothing bothers him."

Mid-performance, Alex shoots a look at Leslie Philbrick and grins. At that moment, he looks like any other talented kid showing off for a teacher. Philbrick is Alex's case manager, English teacher and occasional orchestra-class chaperone.

Last spring, Alex competed in the University Scholastic League's state solo and ensemble competition and received a gold medal, and a rating of "one," the highest possible score. Of the 85,000 students who competed at the regional UIL competition, 22,000 made it to state. Of those, 7 percent earned a rating of one.

"He is incredible," Philbrick said. "I'm determined to teach this boy how to write. Anybody that can do what he can do, I know we can teach him. It's like it's all locked up inside of him and we just need to find the right key."

Hidden musical talent

Several studies have shown music therapy can help children with autism. A 2004 study by Pamela Heaton, a psychologist at the University of London, found that autistic children may often have outstanding, sometimes hidden, musical skills and benefit from specialized musical training.

About two years ago, Philbrick overheard Hurtado-Yanez, who leads Roosevelt's varsity orchestra, telling someone she needed a pianist talented enough to handle an arrangement she wanted the orchestra to play. Philbrick told her about a boy named Alex who took lessons at the same studio as her son. Alex's piano teacher, Mary Kathryn Archuleta, specializes in teaching students with special needs.

"I brought Alex in to play for the orchestra. He played Bach. It was a breathtaking performance," Philbrick said. "I'm a special ed teacher and I have a child with autism and I feel like I can say, when it comes to Alex, you may meet one child in a million like this."

Sophia Goodin, 17, was a freshman in the orchestra when Alex first played for varsity orchestra.

"We were all just stunned," said Sophia, now a junior. "I remember looking around the room and half the people's jaws were dropped."

From then on, Alex became an official member. At the end of his junior year, he qualified for his letterman's jacket.

Alex's mom, Kazumi Ritter, is proud of him, but she doesn't treat him like a prodigy. She started him with piano lessons when he was 11 because she felt he needed something to do. Alex's dad is in the Army National Guard and is stationed at Fort Hood.

"I wanted him to play sports, but I couldn't find a baseball or soccer coach who was willing to take him," said Kazumi Ritter, who is from Okinawa. "I just let him do what he does. People say, 'Oh my gosh, he's so good.' But to me, he's just capable. He practices hard."

And his practice pays off. Hurtado-Yanez said her husband, a band director at Fox Tech High School in the San Antonio Independent School District, attended the state competition with her. It was the first time he had heard Alex play.

"I looked over at my husband and he had tears in his eyes," she said. "He couldn't believe Alex could play like that."

Other lessons

Right now, Alex is working on a Brahms rhapsody difficult enough to challenge a professional.

"Anything I've ever given him, he's always learned," Hurtado-Yanez said. "That Brahms piece is just crazy."

And music has helped Alex with other skills. Philbrick said he communicates better, especially in writing. She credits the music. For all his talent at the keyboard, however, Alex's participation in orchestra offers his classmates other, even more important lessons, Hurtado-Yanez said.

"It's taught my kids to be compassionate and understanding," she said. "I don't even have to talk to the new kids about how to treat Alex. The older kids teach the new ones."

Maegan Griffith, 17, is in her third year in the orchestra with Alex. She said watching his fascination with music has been inspiring.

"Sometimes he'll just walk around and watch people play their instruments. He even touches them," said Maegan, a senior who plays the double bass.
When he's not playing the piano or sitting, trancelike, listening to the orchestra, Alex goes back to being the autistic boy, distracted by too much stimuli.

"C lunch, yes?" he asks Philbrick over and over, when he's ready to eat. Sometimes he answers her questions. Other times, he stands in the corner, fingers in his ears, looking agitated.

But when Philbrick gives him the chance to play once more before lunch, he doesn't hesitate. His face relaxes as he puts his hands on the keys, then begins to play a difficult arrangement of "America the Beautiful."

He finishes to a smattering of applause and, looking up, says: "Piano, good job."


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