Speech and language delays in autism:
Why do children with autism have delayed expressive and receptive speech?
Children and adults with autism often have delayed speech and language and there is no consensus on which underlying medical concerns contribute to impaired communication but the clues may lie in which biomedical treatments are most likely to improve language.
Expressive language is dependent on praxis which is dependent on the proper balance of brain chemicals and energy production by the mitochondria. Improving regulation of serotonin, dopamine and GABA while reducing the brain chemical glutamate (which causes high levels of excitability in the brain) has shown to improve expressive and receptive language.
While is doesn’t take a lot of energy to understand language, it takes tremendous energy to support optimal speech. Age level communication relies sensory motor integration to show someone that you understand by pointing, speaking or leading.
When people with autism report what is happening in their brains, there is a consistent message of:
- It is difficult to control my body
- Organizing my words is very hard
- I can’t figure out how to move my mouth
- My brain makes me do things I can’t stop
- Pointing is overwhelming
- I understand EVERYTHING!
Why is echolalia and scripting so common in autism?
Echolalia – when a child repeats the words that you are saying in a repetitive way.
Scripting – Reciting lines from movies, commercials, books is when autistics are stressed, excited or bored.
Echolalia and scripting most likely have their origins in the imbalance in serotonin and other neurotransmitters in the brain. This is a proposed theory based on some children having more serotonin receptors in the right side of the brain. Changes in serotonin levels contribute to immunoexcitotoxicity. Over activity in the brain results in compromised function. In practice, it is almost as if the ability to memorize for people with autism is so exceptional, that they attempt to use this strength to communicate. When given a task, people with autism tend to use their right brain to solve the task, leading to repetitive types of communication.
It is more difficult for autistics to mimic others or learn from others. Some researchers postulate this has to do with mirror neurons. It may very well but if we distill the information down to usable form. There isn’t the right balance of neurotransmission and not enough energy. In biomedical treatment, we support both and see language changes in the majority of our patients. Brain chemicals require a healthy microbiome, working methylation cycles and energy production from the mitochondria that isn’t hampered by the cell danger response.
Biomedical treatment of speech, language delays in autism:
Regardless of cause, biomedical treatment can improve expressive, receptive and spontaneous language by improving methylation. Methyl B12 injections are the most important treatment for improving speech. The methylation cycle produces and regulates serotonin, which is a brain chemical crucial to optimal speech and language. Other important methylation supports are DMG, TMG, SAme, 5-MTHF (methyltetrahydrafolate) and methionine.
The other biomedical treatment central to supporting optimal speech and language for children with autism is dietary intervention. A diet that removes grains and dairy, while increasing healthy fats helps mitochondria produce more energy in the form of ATP. More energy production translates to more language. All speech delay has its roots in mitochondrial weakness.
A grain free, dairy free diet plays a critical role in improving the gut health in autism. Often called a “paleo” diet but more appropriately termed “modified ketogenic”. Research from the Human Microbiome Project has identified that post-natal development relies 100% on the ecosystem that lives in the gastrointestinal tract, the microbiome. Overgrowth of harmful microbes like yeast and clostridia lead to alterations in the microbiome. The NIH microbiome research shows that whoever is in charge of the gut, governs brain function.
Dr. Derrick MacFabe’s research on clostridia explores an animal model of autism, whereby typical rats begin to show “autistic” behaviors. In addition to the physiological and biochemical changes mimicking what is seen in the brains of autistics, these animals experience decreased communication and social interaction.
Biomedical Treatment of echolalia and scripting:
The origins of echolalia and scripting in autism are poorly understand. Once again the biomedical treatments that help certainly indicate that excess glutamate is involved. Glutamate is the brain’s most plentiful neurotransmitter. Too much, however, can be a problem. For this reason, it is strictly regulated by the body’s master antioxidant, glutathione, which is a product of the methylation cycle.
Research by Dr. Jill James at the Arkansas Children’s Research Institute identified that methyl B12 injections improve glutathione levels. Glutathione is the body’s primary intracellular antioxidant and is responsible for detoxifying harmful heavy metals, microbes and chemicals. Lower levels of glutathione, will result in higher levels of glutamate, thereby triggering a cascade of changes called immunoexcitotoxicity.
Elevated toxic load inside cells contributes to repetitive symptoms seen in autism by depletion of glutathione. Glutathione is part of phase II detoxification in the liver and is responsible for many detoxification reactions. Studies on methyl B12 and a precursor to glutathione, n-acetyl-cysteine (NAC) reduce repetitive behaviours in autism. Adequate glutathione decreases toxic load, most notably leading to the removal of heavy metals and a reduction in glutamate.
Vitamin B6 and magnesium is another biomedical treatment strategy used to reduce repetitive behaviours such as echolalia and scripting. The mechanism is probably the same as B12 injections, NAC and diet which work to improve glutathione status.
Biomedical treatment improves communication:
In summary, biomedical treatment improves expressive, receptive and spontaneous speech in autism while also reducing repetitive types of communication. These benefits almost certainly come from the biomedical interventions that address the cell danger response and immunoexcitotoxcity.
Biomedical intervention changes lives by improving children’s ability to communicate, while reducing excitability in the brain.