Thinking Autism International Conference 2019
17 - 19 May 2019, London UK
'New Frontiers in Autism Research: Evidence-based Treatment of Medical Comorbidities'
Opening Evening – Friday 17 May
6:10pm - 6:30pm
6:30pm – 7:10pm
Abnormal breathing patterns in autism
7:10pm – 7:50pm
Autism, nutrition and gut health
Stella will discuss the connection between the health of the gut and the health of the brain with a specific focus on exploring the role the gut microbiome plays in that connection. In her
7:50pm – 8:10pm
Our son’s progress
8:10pm – 9:00pm
Autism case study – 6 years of translating science into treatment to help a child with classic severe autism
The case study follows the treatment of Monty, a nine-year-old boy with classic (severe) autism and subject of the Epiphany ASD blog, from December 2012 for six years, mainly by re-purposing cheap generic drugs. He was treated based on translating the published autism research into therapy; he was not treated by a DAN-type doctor, any alternative practitioner, or anyone’s “protocol”. From the age of four Monty had followed an intensive ABA programme at home and attended school only in the mornings and with a 1:1 assistant. At the age of nine he was about five years developmentally delayed.
From being completely unable to learn anything at mainstream Primary school to the age of 8, to a teenager who can keep up academically in secondary school, albeit with support. Today Monty can ride a bike, ski, skate, swim and play the piano very well. He is still autistic, just less so.
Stereotypy, anxiety, self-injury were all sucessfully treated using novel methods.
A PANS/PANDAS-like episode with sudden onset tics was fully resolved by immediately applying drug therapy from the existing literature.
8:30pm – 10:00pm
Social event – reception drinks & nibbles
Saturday 18 May
8:15am - 8:50am
8:50am - 9:00am
Welcome and about Thinking Autism
9:00am – 9:45am
Evidence-based medical diagnostics in autism: developing a clinical practice algorithm
Agnieszka Wroczyńska MD PhD
Recent scientific evidence shows that many medical conditions are not only highly prevalent in individuals with autism and contribute to lower quality of life and premature deaths, but can often contribute to the overall severity of autism symptoms and executive and cognitive dysfunction of the affected person. When identified, many of these conditions can be treated with existing evidence-based treatments.
The existing clinical guidelines for autism focus on behavioural interventions and current interdisciplinary approach recommendations with regard to autism and comorbidities do not sufficiently address the medical needs of many persons with autism.
This talk will focus on identifying those underlying or comorbid medical conditions in autism, such as inborn errors of metabolism, epilepsy and subclinical epileptiform discharges; mitochondrial dysfunction, gastrointestinal disorders with high prevalence in autism such as celiac disease, reflux disorders and eosinophilic esophagitis; immune and allergic disorders, including mast cell activation disorders, autoimmune encephalitis, PANDAS/PANS and others.
The talk will also discuss possible atypical, behavioural presentations of medical conditions in persons with impaired or minimal communication skills and provide an overview of existing evidence-based treatments. The conception of a research-based diagnostic algorithm to improve the screening and identification of medical comorbidities in autism will be presented.
9:45am – 10:30am
Addressing autism comorbidities in the UK – experiences from inside the NHS
Ben Marlow MD MBiochem
Dr Marlow is passionate about improving care for autistic individuals and their families and bringing a better understanding about the neurobiology of autism. In his talk he will be making a case for this speciality to modernise and use the tools and approaches available to diseases such as cancer, and to start phenotyping different ‘autisms’ into clinical subtypes. The presentation will highlight the need for the UK to move away from the rigid ‘behavioural approach’ and acknowledge that different autisms have different underlying biology that need to be approached in different ways. His talk will be directed at comorbidities within different types of autism, the importance of trying to phenotype and subtype patient groups, the development of clinical networks and a passionate plea for the NHS to evolve and recognise that autistic children need far better medical care. He will also outline his vision for are modern clinic that will better investigate and manage medical comorbidities.
10:30am – 11:00am
Parent’s experience and perspectives on immunology
11:00am – 11:30am
11:30am – 12:10pm
Sensory processing in Autism Spectrum Disorders
It is well understood that many on the autism spectrum experience a range of sensory processing challenges. A wide variety of research shows differences in processing in all areas of auditory, tactile, visual and other sensory stimuli. Many common behaviours such as spinning and flapping can have a sensory basis.
Alan will discuss how to recognise and understand typical behaviours in terms of sensory processing. We will also cover the impact upon communication, behaviour and learning that is possible from improvements in these areas.
12:10pm – 12:50pm
Behavioural & gastrointestinal symptoms in autistic children after visceral osteopathic treatment
Ioná Bramati-Castellarin PhD BSc (Hons) Ost Med DO ND
Dr Bramati will be sharing information on her published research – Repeat-measures longitudinal study evaluating behavioural and gastrointestinal symptoms in children with autism before, during and after visceral osteopathic technique (VOT) which demonstrated a positive, overall significant, symptomatic improvement in ‘social behaviour and communication’ and ‘digestive signs’ subscales comparing before and after VOT. She will also share the results of the correlation between the Faecal Calprotectin and a Twenty-Four-Parameter Questionnaire in Autistic Children with gastrointestinal symptoms. Finally, she will give her insight on the challenges and practicalities of using osteopathic techniques in patients suffering from ASD and gastrointestinal problems.
12:50pm – 2:10pm
2:10pm – 2:55pm
Use of cannabis extract for the treatment of children with autism: the Israeli experience
Orit E Stolar MD
2:55pm – 3:40pm
Neural development, cerebral folate metabolism and autism
Dr Jaleel Miyan
Cerebral folate issues during development of the brain can result in inefficient drainage of cerebrospinal fluid. This is associated with change in metabolic profile in the fluid that effectively blocks entry of available folate into the developing cerebral cortex. Recent studies show a potential fluid drainage problem in autism with increased extra-axial fluid accumulation. Although this is different to the ventricular enlargement seen in hydrocephalus it does indicate a drainage issue and thus a cerebral folate problem that is likely to respond to the same folate treatment that prevents and/or treats hydrocephalus, a condition of severe fluid drainage obstruction. This presentation will review work on cortical development, hydrocephalus and cerebral folate and how this can be resolved with a simple supplement that may be applied to autism.
3:40pm – 4:00pm
4:00pm – 4:45pm
Metabolic disorders associated with autism
Richard Frye MD PhD
Recent research has demonstrated that autism spectrum disorder is associated with several metabolic disorders, including disorders of redox, methylation, folate, purine, tetrahydrobiopterin, carnitine, amino acid and mitochondrial metabolism. The association with metabolic disorders is important as such disorders may be amenable to treatment if the disruption in the metabolic pathway is detected and understood. Although it is important to better understand the appropriate treatments that could theoretically improve function of these pathways, empirical evidence for such treatments is much more helpful in guiding clinical therapy. Studies have documented improvement in autism symptoms with many of these treatments in clinical studies which range from case reports to well-controlled randomized trials. This presentation will review the metabolic disorders associated with autism that could be amendable to treatment and the evidence for the potential treatments.
6:00pm – 10:00pm
Saturday evening BBQ social event
Sunday 19 May
8:30am - 8:55am
9:00am – 9:45am
Seizures in Autism Spectrum Disorder
Richard Frye MD PhD
A growing literature has demonstrated that seizures and epilepsy are prevalent in children with autism spectrum disorder. In addition, many children have epileptic activity in their brain despite not having any obvious seizures. Epilepsy and seizure-like activity in the brain appears to be associated with more severe autism and are associated with other medical abnormalities. Research studies suggest that specific treatments may be effective for the treatment of seizures and seizure-like activity in children with autism and some studies suggest that such treatments may improve autism symptoms. This talk will discuss these points with an emphasis on treatment.
Application of ketogenic diet in epilepsy and autism
Iwona Zarnowska MD and Prof Tomasz Żarnowski
The endocannabinoid system in autism spectrum disorder – implications for treatment
Adi Aran MD
The endocannabinoid system is a major regulator of synaptic plasticity. Studies in animal models suggest substantial involvement of the endocannabinoid system in the regulation of learning and memory processes, social and emotional reactivity, motivation, epilepsy and other processes that are often altered in neuropsychiatric disorders including autism spectrum disorder. Reduced endocannabinoid ‘tone’ was suggested as a possible cause of ASD in several animal models of ASD. In some of these models, activating the endocannabinoid system or administrating cannabidiol rescued the social deficits. In my lecture I will describe the potential of cannabinoid treatment in treating core- and comorbid- symptoms of ASD and will present the results of pioneering clinical studies of artisanal CBD-rich cannabis strains as well as pure cannabinoids solution in children with ASD.
Real life experience of medical cannabis treatment in autism
Dr Annabelle Manalo
Dr Manalo is a cell and developmental biologist from Vanderbilt University in Nashville, Tennessee. She has a background in neuroscience at Georgetown University. During her studies in the new Cardio-Oncology industry, Annabelle gave birth to her son Macario. As a newborn baby, Macario suffered from a stroke and uncontrollable seizures. Their journey towards recovery has filled Annabelle with a passion and commitment to the cannabis industry, including an interest in specific cannabinoid therapeutic benefits to disease. In her talk Dr. Manalo will give a brief introduction to phytocannabinoids and the differences between cannabidiol derived from hemp versus marijuana, followed by an overview of a study on autistic children prescribed the high CBD, low THC strain Avidekel.
Changing the legislative and clinical landscape of cannabis-based medicine in the UK
David Horn, Medical Lead, The Centre for Medicinal Cannabis
Autism and gastrointestinal symptoms
Federico Balzola MD
Translating autism science into therapy – a case for personalized medicine
Many parents of those with severe autism await the day when medicine will be available to treat the core symptoms of their autism, including raising IQ. There are thousands of research papers on autism and more published every day, and yet still there are still no approved medicines for treating core autism symptoms.
This talk will argue that a great deal is actually possible today using personalized medicine to improve the lives and executive functioning of many people with autism. The presentation looks at ways to maximise chances of achieving the potential benefits from what science already knows about the specific types of autism. There are no easy answers and no guarantees of success, but existing research can inform personalised multi-drug therapies that have proven clinically successful.
The presentation highlights issues that will have to be understood to narrow down the specific sub-type of autism that might be amenable to treatment. For a small minority of cases a single gene is the key, but most autism is idiopathic and is likely caused by scores of genes being over/under-expressed as the result of multiple hits, both genetic and environmental.
Next steps for families – making decisions based on available evidence
Amy Herlihy MD
Dr Amy Herlihy is a leading specialist in Autism and Nutritional Medicine based in Cork, Ireland. Dr Herlihy graduated with Honours from UCC and obtained her MRCS and MRCGP with Distinction in Edinburgh thereafter. In 2014 she set up Special Kids Medical Clinic. With her background as a GP, Fellow of the Medical Academy of Paediatric Special Needs (MAPs), GAPs practitioner and having a Diploma in Nutritional Medicine from the University of Surrey Dr Herlihy aims to help those with ASD and other developmental delays reach their full potential. The clinic focuses on healing the gut and improving underlying nutritional deficits.
Next steps for families – moving on, gathering information, creating support networks