Thinking Autism International Conference 2019

17 - 19 May 2019, London UK

'New Frontiers in Autism Research: Evidence-based Treatment of Medical Comorbidities'

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Featured speakers & presentation abstracts

Adi Aran MD
Shaare Zedek Medical Center, Israel

‘The endocannabinoid system in autism spectrum disorder – implications for treatment’

Adi Aran, MD – Director of pediatric neurology at Shaare Zedek Medical Center in Jerusalem.  Dr. Aran specializes in the diagnosis and treatment of Autism Spectrum Disorder (ASD) and related genetic disorders. His research is focused on the endocannabinoid system involvement in ASD and related disorders and the evaluation of new therapies for the treatment of these disorders. Dr. Aran serves as a board member on the Israeli Society for Pediatric Neurology, and is a member of the International Society for Autism Research. He completed his Medial Studies in the Hebrew University and continued to Postdoctoral research fellowship in Stanford, CA. Dr. Aran is a pioneer in the research of medical cannabis in Autism, a subject that is currently receiving public attention worldwide.

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.

Federico Balzola MD
Division of Gastroenterology, University of Turin, Italy

‘Autism and gastrointestinal symptoms’

Federico Balzola, MD, holds board certification in Gastroenterology and Digestive Endoscopy. He attended Turin University School of Medicine, where he completed his gastroenterological residency. He was awarded a training from 1994 to 1995 at the Royal Free Hospital in London, and 1995 to 1998 at the Molinette Hospital of Turin. Following his fellowship in Gastroenterology and Clinical Nutrition at that hospital, he has been a consultant on the Gastroenterology and Hepatology Department since 1998, where he oversaw the gastrointestinal clinic and consultation service with a special interest in inflammatory bowel disease and liver/bowel transplantation. He is currently working in the Gastroenterology and Hepatology Intensive Care Unit.

Dr Balzola has published results of his research in international medical journals and has presented at numerous scientific meetings. At present, he maintains his practice in gastroenterological fields with a special research interest in autism. He is driving several clinical research in Italy on the identification and treatment of the autistic enteropathy with dietetic and pharmacological approaches. He lives in Turin with his wife, Paola, and two daughters, Beatrice and Margherita.

The major prevalence of gastrointestinal symptoms in patients with autism compared to healthy controls has been extensively proved, with a potential secondary impact on children’s behaviours. From a physiopathological point of view, dysbiosis associated to impaired gastrointestinal permeability has been suggested as a potential trigger thus altering the normal nervous system functions. Dietary or pharmacological interventions are often utilized, however, results are still debated. In this uncertain context, the existence of a possible link between gastrointestinal inflammation and neuropsychiatric disorders needs to be clarified in the way to find the right dietetic and pharmacological tools to obtain the best effects on bowel and neurological inflammatory process and for this improvement of gastrointestinal and autistic symptoms.

Dr Ioná Bramati

PhD BSc (Hons) Ost Med DO ND

‘Evaluation of behavioural and gastrointestinal symptoms in autistic children after visceral osteopathic treatment & possible faecal calprotectin correlation’

Dr Ioná Bramati graduated from the British College of Osteopathic Medicine (BCOM) in 2001 and for the past 18 years has been practicing in London at IBCcare. Dr Bramati is a specialist with a doctorate on the effects of visceral osteopathy in autistic children suffering from gastrointestinal dysfunction. She was awarded a PhD by the University of Westminster, London, a project that was approved for collaboration with King’s College Hospital, London, endorsed by the National Autistic Society and sponsored by BCOM via a grant from the British Naturopathic and Osteopathic Association. Dr Bramati is committed to helping improve the quality of life and wellbeing of children on the autism spectrum using a non-invasive form of therapy, Visceral Osteopathy.

After graduating from BCOM, Dr Bramati attended numerous post-graduate courses in visceral, cranial, and structural osteopathy. She is a former BCOM Clinic Tutor and Paediatric Lecturer, has worked at the specialist Osteopathic Centre for Children, London and has been a practitioner on call at St John and St Elizabeth’s Birth Unit, treating new-born babies and mothers post-labour. She currently lecturers Visceral Osteopathy at the University College of Osteopathy (UCO) in London.

Dr Bramati is also an international speaker at a large number of osteopathic colleges and conferences in the UK and Europe and was awarded the Elsevier/International Conference on Advances in Osteopathic Research New Researcher Prize at ICAOR 10 in Brazil for her research in treating autistic children with visceral osteopathic techniques.

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 with ASD suffering from gastrointestinal issues.

Stella Chadwick

BSc (hons) mBANT CNHC

‘Autism, nutrition and gut health’

Stella Chadwick is a CNHC Registered Nutritionist qualified in Nutritional Genomics (the science of the relationship between genetics, nutrition and health). Her professional training includes a 1st Class BSC Honours (Nutritional Therapy) degree as well as a specific training focus on the principles of Functional Medicine, which assesses and addresses the underlying causes of conditions. She has a special interest in brain-gut connection, food and chemical sensitivities and the impact of autoimmune conditions.

One of her underlying focuses is on restoring a healthy link between the gut and the brain by combining carefully planned nutritional and lifestyle changes, utilising her specialised functional medicine-led approach. She founded the Brainstorm Health Clinic in 2014 with a passion to serve patients and families who are dealing with co-morbidities associated with ASD.

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 presentation she will provide a guide through evidence-based strategies which are practical, sustainable and achievable in helping rebuild the gut microbiome in order to optimize the gut/brain connection.  

Richard Frye MD PhD
Director of Autism Research at Arkansas Children’s Hospital

‘Metabolic disorders associated with autism’

‘Seizures in Autism Spectrum Disorder’

Dr Richard Frye is a Child Neurologist with expertise in neurodevelopmental and neurometabolic disorders. He received an MD and PhD in Physiology and Biophysics from Georgetown University and completed his Child Neurology Residency and Fellowship in Behavioral Neurology and Learning Disabilities at Harvard University/ Children’s Hospital Boston. He has authored over 150 peer-reviewed publications and book chapters, and serves on several editorial boards. He has conducted several clinical trials demonstrating the efficacy of safe and novel treatments that target underlying physiological abnormalities in children with ASD. He is the Chief of Neurodevelopmental Disorders and Developmental Medicine at the Barrow Neurological Institute at Phoenix Children’s Hospital.

Title: ‘Metabolic Disorders Associated with Autism’

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.

Title: ‘Seizure in Autism Spectrum Disorder’

Description: 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.

Alan R Heath

BSc (Hons) Psych

‘Sensory processing in Autism Spectrum Disorders’

Alan is a Director and Founder of Learning Solutions, an organisation based in Yorkshire that since 1996 has been dedicated to helping children and adults maximise their learning potential. His work brings together the underlying sensory challenges experienced by many children on the spectrum. He works extensively in schools in the UK and internationally. He is a dedicated speaker for NASEN (National Association for Special Educational Needs). He has trained teachers and presented at conferences across Europe, the Middle East and the USA. Alan runs a private consultancy for children combining assessment and remediation programmes using sound stimulation and movement work and is the author of ‘Beating Dyslexia A Natural Way’ published in 1997.
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.

Dr Amy Herlihy

Special Kids Medical Clinic

‘Next steps for families – making decisions based on available evidence’

Dr Amy Herlihy is a 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 improving gastrointestinal function nutritional deficits.

When your child receives a diagnosis of Autism the available therapy options can quickly become overwhelming. During her talk Dr Herlihy will guide you through safe, practical steps that you can implement at home to begin your child’s healing journey. Using the scientific evidence available she will discuss helpful dietary adjustments, help match symptoms with nutritional supplements and discuss how to optimise your child’s gut health. Leaving the talk you should be equipped with a framework of where to begin and what to do.

Mr David Horn
Medical Lead, The Centre for Medicinal Cannabis

‘Changing the legislative and clinical landscape of cannabis-based medicine in the UK’

David Horn is formerly a UK surgeon, now for 15 years a senior Business Management Consultant operating within the medical sector. David has wide experience within both clinical and management settings across the UK NHS, including NHS Acute Trusts and NHS Commissioners (CCG). His expertise spans medical business start-ups, business case development, Transformational Change, Clinical Process Redesign, and performance management within the NHS.

coming soon

Dr Annabelle Manalo
Scientific Director, Tikun Olam

‘Real life experience of medical cannabis treatment in autism’

Dr Manalo is a cell and developmental biologist from Vanderbilt University in Nashville, Tennessee. She has a background in neuroscience at Georgetown University and has recently studied genetic mutations that mimic the offset effects of chemotherapies on cardiotoxicity. 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. To further her mission to heal the world through cannabis, she recently signed with Tikun Olam, a mission-driven organization at the forefront of global cannabis research.
Dr Manalo gives a brief introduction to phytocannabinoids and the differences between cannabidiol derived from hemp versus marijuana, followed by an overview of the 188 patient study on autistic children prescribed the high CBD, low THC strain Avidekel. 90.2% of patients reported an improvement in their quality of life. With very few side effects, patients were able to tolerate the cannabis, confirming safety and efficacy of Avidekel amongst a large population of pediatric patients.

Ben Marlow MD
Consultant Paediatrician MBiochem

‘Addressing autism comorbidities in the UK – experiences from inside the NHS’

Dr Marlow is a Consultant Paediatrician specialised in Neurodisability. He trained at UCL London and spent the majority of is career in Luton which has the second largest population of children with additional needs in the UK. He also has a background in Biochemistry through a previous degree that saw him work in the pharmaceutical industry for GSK and at research institutions within the US. His oldest child Freddie 5 has a diagnosis of severe Autism, providing Dr Marlow with an experience and perspective of a parent trying to navigate through the obstacles and challenges in place within the NHS and the education system.

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 a modern clinic that will better investigate and manage medical comorbidities.

Dr Jaleel Miyan
Senior Lecturer in Neuroscience, University of Manchester

‘Neural development, cerebral folate metabolism and autism’

Dr Jaleel Miyan is a Senior Lecturer in Neuroscience at The University of Manchester where he has been since 1990. He completed his Bachelors in Neurobiology at the University of Sussex and a PhD in Neurobiology at the University of Glasgow. After working at Edinburgh and Sheffield Universities he was awarded a Royal Society University Research Fellowship which he held for 10 years initially at Edinburgh and then transferred to Manchester. His research interests are in neurodevelopment, particularly of the cerebral cortex, and in bidirectional neural control and coordination of the host defence and immune system. These two research areas have recently come together in a novel view of developmental disorders, specifically ASD. His lab has produced a supplement based on an understanding of cerebral folate metabolism and how this can go wrong in developmental disorders. In preclinical studies this supplement has been able to prevent hydrocephalus (the target condition) but also maximises normal brain development indicating its potential for a range of conditions.

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.

Orit E Stolar MD
Assaf Harofeh Medical Center, Israel

‘Use of cannabis extract for the treatment of children with autism: the Israeli experience’

Dr Stolar received her medical degree at The Chicago Medical School, North Chicago, IL, and her B.S. in Biochemistry at UCLA, Los Angeles, CA. She is board certified in Pediatric Neurology and Developmental Behavioral Pediatrics after successfully completing the fellowship program at Dana-Dwek Children’s Hospital – Sourasky Medical Center (Ichilov), Tel Aviv, Israel. She completed her pediatric residency at Meir Medical Center, Kefar Saba, Israel.

Dr Stolar has been working as a clinical director of the Early Childhood Services at the Autism Center of Assaf Harofeh Medical Center, Israel, since 2009. The Autism Center is a national center undertaking diagnosis, treatment and research of autism spectrum disorders, which is a combined project of Assaf Harofeh Medical Center and ALUT (The Israeli National Association for Children with Autism). Dr. Stolar is the Medical Director of “Alutaf”, the Early Intervention Program that consists of eleven daycare centers for treating toddlers with ASD. She established and directed a multi-disciplinary eating disorder clinic for children with ASD (active until 2015) and a pharmacological clinic at the Autism Center.

Coming soon.

Agnieszka Wroczyńska MD PhD

Medical University of Gdansk

‘Evidence-based Medical Diagnostics in Autism: developing a clinical practice algorithm’

Dr Wroczyńska is a board certified internal medicine specialist. She works as a physician and academic teacher in a National Centre of Tropical Medicine, Medical University of Gdansk and is a member of Polish Institute of Evidence Based Medicine.

Dr Wroczyńska has published over 50 articles in peer reviewed journals, conference presentations and book chapters. Since 2014 she has been the physician in charge of her 11 years old son with autism and complex medical issues.

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 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 overview of existing evidence-based treatments. The conception of research-based diagnostic algorithm to improve screening and identification of medical comorbidities in autism will be presented.

Iwona Zarnowska MD PhD and Prof Tomasz Żarnowski

Medical University, Lublin

‘Application of ketogenic diet in epilepsy and autism’

Dr Iwona Żarnowska is an experienced paediatrician and child neurologists. She received an MD and PhD on the application of ketone bodies in experimental epilepsy. She specializes in the diagnosis and treatment of epilepsy and autism. Her current expertise is concentrated mainly on the application of ketogenic diet in epilepsy and autism. She investigates the mechanisms of ketogenic diet activity especially in the context of kynurenine pathway metabolites.

Prof Tomasz Żarnowski is a professor and chairman at the Chair of Ophthalmology, Medical University, Lublin, Poland (Professor title in 2012). He specializes in glaucoma and neuro-ophthalmology. His research is focused on neuroprotection in glaucoma and neurological diseases. He is also interested in epilepsy and autism. In numerous studies he investigated tempol, lithium, citicoline, ketone bodies, ketogenic diet, kynurenine pathway metabolites. He published over 150 peer-reviewed publications including Nature (cumulated IF over 200) and is active in several editorial boards. He received two British Council Fellowships: in Norwich (UEA) and Oxford (St. John’s College).

A high-fat, low-carbohydrate, low-protein diet, also called the ketogenic diet, was introduced to clinical practice as an alternative method to treat epilepsy, based on observations that starvation often leads to fewer seizures in epileptic patients. Since then, the ketogenic diet has been used to manage patients suffering from intractable epilepsy for nearly a century, especially in the US and Western Europe. Recently, there is accumulating evidence of possible efficacy of the ketogenic diet in the treatment of autism spectrum disorders. The talk will focus on the medical and dietary principles of ketogenic diet (part 1) and will present a history of children with autism successfully treated with ketogenic diet (part 2).

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