The term neuro-immune dysfunction refers to a group of complex multi-symptom diseases characterized by acquired dysregulation of both the immune system and the nervous system. These diseases most often follow an infectious or flu-like illness and may result in lifelong disease and disability. Included in this definition are similarly presenting conditions such as Attention Deficit Hyperactivity Disorder (ADHD), Obsessive Compulsive Disorder (OCD), Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME), Chronic Fatigue Immune Dysfunction Syndrome (CFIDS), fibromyalgia, post-Lyme disease, Gulf War illness and some cases of Autism Spectrum Disorder.
Immune dysfunction is the result of an imbalance of gut microflora in the microbiome. If the microbiome isn’t supported by a healthy diet there will be an eventual breakdown of the protective mucosal lining of the gastrointestinal tract and this allows food particles, allergens, toxins and pathogens to travel directly to the brain through a series of recently discovered meningeal lymphatic vessels. When faced with the onslaught, the neuro-immune system becomes activated to protect the neurons from damage. This neuro-protective inflammatory response shuts down blood flow to critical areas of the brain and is the same response that occurs during an illness, such as the flu. Under normal circumstances, this mechanism becomes deactivated when the illness is over but in neuro-immune dysfunction it continues on a dysfunctional, autoimmune course.
The human microbiome is comprised of trillions of diverse microbes, or microbiota, that regulate almost every function of our body. The microbiome regulates the immune system and the food we eat shapes our microbiome right after we are born. Dietary patterns have the largest impact on our microbiome but the 1960’s marked the beginning of microbiome depletion, a situation that has worsened with each passing generation. The use of oral contraceptives, the over-use and increased use of antibiotics, the increased use of prescription and over-the-counter medications, endocrine disruptors, glyphosate and the proliferation of the genetically modified, chemical-laden, nutrient-poor and high-carb/sugar Standard American Diet (SAD) have all resulted in the decimation of the healthy microbes that keep our immune systems functioning optimally. A lack of healthy microbes allows the bad ones to increase and thrive and this imbalance renders the immune system dysfunctional. This phenomenon is proposed to account for some of the dramatic rise in autoimmune and inflammatory disorders in parts of the world where the symbiotic relationship between the immune system and microbiota has been the most affected.
Autism and many other psychiatric “labels” are in fact symptoms of neuro-immune dysfunction, which is caused by an environmental assault on a genetically susceptible population during a critical period. In children who develop neuro-immune dysfunction, the environmental insults occur during the early years when the immune system is still developing and in adults the illness is often triggered during times of stress or similar periods of immune system overwhelm.
The theory of neuro-immune dysfunction in CFS and chronic brain disorders in children was postulated by Dr. Michael J. Goldberg more than 25 years ago. There are many medical doctors who now follow Dr. Goldberg’s treatment protocol but there are many reasons why the theory of immune dysfunction has not reached mainstream practice.
First, neuro-immune dysfunctions have largely been ignored by the majority of our medical community because they are misunderstood and essentially not in their scope of practice. Many dysfunctions, such as autism and ADHD for example, are currently classified as developmental disorders in the Diagnostic & Statistical Manual of Mental Illness, Fifth Edition, or the DSM-V. In the case of Gulf War Illness, Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and related conditions, we have witnessed these patients being treated with skepticism, uncertainty, apprehension and labeled as deconditioned or having a primary psychological disorder so the published research to support the theory of neuro-immune dysfunction is essentially non-existent.
Second, available funding has consistently been directed into the wrong areas. In the case of autism, society has spent over 1 billion dollars on genetic research even though it is scientifically impossible for a genetic condition to reach epidemic numbers. Equally disastrous is the fact that, as a collective group, the autism community has yet to establish an organization that understands neuro-immune dysfunction’s role in chronic brain disorders. Many organizations that have been established to help repeatedly waste excessive amounts of donated funds on useless and ineffective studies that do absolutely nothing to improve our quality of life or waste exorbitant amounts of money on marketing and public relations to advance their own agendas. Prevention has never been a consideration.
Third, infighting within the autism community about what autism is, what causes it and how to treat it remains the most significant obstacle to advancements in the understanding, treatment and prevention of the condition and the vaccine debate has divided our community on a profound level. The lack of a “voice” and unity has been the most challenging and detrimental factor for the community itself and is at the core of poor and ineffective advocacy efforts on all fronts.
It is also important to consider that the only individuals who truly understand this condition are too ill or too overwhelmed taking care of sick children, or both, to advocate for change and the doctors who understand it are too busy taking care of a dramatically increasing number of patients.
In 1911, autism was first coined by Paul Eugen Bleuler to describe a subset of schizophrenic patients who were especially withdrawn and self-absorbed. He stated that autism was “an active turning-away from the external world. The most severe cases withdraw completely and live in a dream world; the milder cases withdraw to a lesser degree.”
In 1943, American child psychiatrist Leo Kanner, M.D., published a paper describing 11 children who were highly intelligent but displayed “a powerful desire for aloneness” and “an obsessive insistence on persistent sameness.” He later named this condition “early infantile autism” and in 1944 German scientist Hans Asperger describes a “milder” form of autism in a group of boys who were highly intelligent but had trouble with social interactions and specific obsessive interests.
In 1980, “Infantile autism” was officially separated from childhood schizophrenia and listed in the DSM for the first time. Over the next several years we then saw the emergence of many more psychiatric labels that were designed to fit the description of symptoms that did not fall into an already established criteria. These include Autistic Disorder, Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS), Asperger’s Disorder, Rett’s Disorder and Childhood Disintegrative Disorder (CDD), which is also known as Heller’s syndrome and disintegrative psychosis. CDD is characterized by late onset of developmental delays or “stunning reversals” in language, social function, and motor skills.
Subtypes of ADD were then presented in DSM-III. These included ADD/H (with hyperactivity) and ADD/WO (without hyperactivity). In the 1987 revised version of the DSM-III (DSM-IIIR) the name of the disorder and its diagnostic criteria was overhauled, once again emphasizing hyperactivity. The authors now called it Attention Deficit Hyperactivity Disorder (ADHD), and consolidated the symptoms into a unidimensional disorder, without any subtypes at all. After the publication of the DSM-IIIR, a variety of studies were published supporting the existence of ADD without hyperactivity, and the definition was changed again in the fourth, and most recent, edition of the manual published in 1994 (DSM-IV). The authors did not change the name ADHD, but the symptoms were divided into two categories-inattentive and hyperactive/impulsive and three subtypes of the disorder were defined: ADHD, Primarily Inattentive; ADHD, Primarily Hyperactive/Impulsive; and ADHD, Combined Type. In the years that followed we saw the addition of Oppositional Defiant Disorder (ODD), Childhood Bipolar Disorder (CBD), Global Developmental Delay (GDD) and many more.
The 1980’s was a period of critical interest in chronic brain disorders as it was in this decade that CFS began destroying the lives of adults. ME/CFS (Myalgic Encephalomyelitis/Chronic Fatigue Syndrome) has been called the “Disease of a Thousand Names” and in 1984 the first documented clusters of CFS-like cases in the U.S. occurred in Lake Tahoe, NV and Lyndonville, NY. In 1985 The National Institute of Allergy and Infectious Diseases held a consensus conference at which the name ‘Chronic Epstein-Barr Virus’ (CEBV) was used, causing CEBV to become the name of choice for a short time. Medical journals began referring to CEBV as a legitimate illness. In 1986, a paper by A. Melvin Ramsay, MD gave a definitive description of ME by declaring that the syndrome known as myalgic encephalomyelitis in the UK is called ‘epidemic neuromyasthenia’ in the USA. In 1987 the CEBV Association was founded by Marc Iverson and Alan Goldberg. In the late ‘80s the group changed its name to the CFIDS Association of America at the suggestion of immunologist Seymour Grufferman who suggested the name ‘Chronic Fatigue Immune Dysfunction Syndrome’ to reflect the immune abnormalities and lessen the emphasis on fatigue. In 1988 the U.S. Centers for Disease Control and Prevention (CDC) chose to name this mysterious illness ‘chronic fatigue syndrome’ and published a case definition (the “Holmes criteria”) to be used for research. Several other more medical-sounding names were considered but dismissed because they lacked definitive proof of a causal agent.
In early 1990, CFS was coined “The Yuppie Flu,” implying that it was a form of malingering or burnout and contributing to the public perception of CFS as a psychosomatic condition. While officials spent the coming years arguing about what to call this mysterious illness, adults suffered greatly while autism cases began to rise to epidemic proportions.
Also in 1990, a military conflict to expel Iraqi troops from Kuwait began. Led by the United States, the Gulf War in the Persian Gulf was launched in response to Iraq’s invasion and annexation of Kuwait. Civilian workers and military veterans returned to their home countries with a mysterious and multi-symptomatic disorder. Gulf War Syndrome (GWS), also known as Gulf War illnesses(GWI) and Chronic Multi-symptom Illness (CMI), caused acute and chronic symptoms including fatigue, muscle pain, cognitive problems, rashes and diarrhea in approximately 250,000 of the 697,000 U.S. veterans who served in the 1990-1991 Gulf War.
Aside from the many physical and psychological issues involved in any war zone deployment, Gulf War veterans were exposed to a unique mix of hazards not previously experienced. These included pyridostigmine bromide pills (given to protect troops from the effects of nerve agents), depleted uranium munitions, anthrax and botulinum vaccines and high-powered microwaves used to disrupt Iraqi communications. The oil and smoke that spewed for months from hundreds of burning oil wells presented another exposure hazard not previously encountered in a war zone. Military personnel also had to cope with swarms of insects, requiring the widespread use of pesticides. According to a report by the Iraq and Afghanistan Veterans of America, veterans of Iraq and Afghanistan may also suffer from this syndrome.
The DSM-V is the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. It is the American Psychiatric Association’s (APA) classification and diagnostic tool for mental illness. The DSM serves as a universal authority for psychiatric diagnoses. Treatment recommendations, as well as payment by health care providers, are often determined by DSM classifications.
A diagnosis under the DSM-V means that the only treatments available to individuals with autism are therapy or mind-altering drugs, neither of which of address the core problem. There is a clear distinction between true mental illness and those who are suffering with immune dysfunction but unfortunately, society has not recognized this. Many children suffer with food intolerances/allergies, viral markers, encephalopathy-like symptoms, frequent ear infections, GI issues, eczema or hives, sensory and auditory processing difficulties, and abnormalities with fine and gross motor skills and many more symptoms of a medical illness but those symptoms are not treated.
Treating autism as a psychiatric condition is in effect causing more harm to our children than not treating them at all. A diagnosis under the DSM carries with it a high rate of inaccuracy, the potential to stigmatize children and young people, a lack of any effective treatment and the risk of children and adolescents being prescribed dangerous antipsychotic medications. Dr. Allen Frances, who chaired the DSM-IV task force, noticed an alarming trend between the time of that Fourth Edition in 1994 and the publication of the Fifth Edition in 2013. He noticed that Attention Deficit Disorder had tripled, Autism had increased almost 40 times, Childhood Bipolar Disorder had also increased by 40 times and Adult Bipolar Disorder had doubled during that 19-year period. Dr. Frances recognized the alarming implications of this diagnostic inflation and now warns about prescribing antipsychotic medications to children that are posing immediate harms and have negative long-term consequences. Hippocrates, the father of medicine, said, “First do no harm”. This is the “Hippocratic Oath”, a moral code for ethical conduct and practice in medicine, yet antipsychotic medications cause excessive weight gain, thereby increasing the risk of diabetes and a later risk of heart disease, and possibly a shortened life expectancy. Dr. Frances also points out that these medications are stunting our children’s emotional growth, since these children lack coping skills and once they reach adulthood they believe that they simply need to take medication in order to cope with stress. Another reason antipsychotic medications should NEVER be prescribed to children is because they have not been tested to ensure that they are not hazardous to the microbiome, and although this has not been done, the side effects we see in children indicate that the risk of harm to the microbiome, which regulates the immune system, would be quite high.
Immune dysfunction strongly resembles what practitioners are seeing emerge across the lifespan: an individual experiences a regression or loss of functional skills. In adults, this is called a disease process but in children it has erroneously been labelled a developmental disorder. These children were not born this way and, as with any disease, when the underlying illness is treated medically the debilitating physical and psychiatric symptoms can be dramatically reduced or eradicated completely.
It must be stressed that our treatment is not a cure for autism and related conditions. Our work is designed to highlight an effective medical protocol that addresses the underlying medical condition in order to reduce or eliminate the “symptoms” that we mistakenly believe are mental disorders. It should also be noted that in cases of genetic autism, treating the immune system may significantly reduce or completely eliminate the more debilitating symptoms associated with the condition. In fact, since immune dysfunction is at the root of most chronic illnesses today, our treatment protocol may be helpful for many conditions including allergies, asthma, eczema, bowel disorders, Alzheimer’s and even cancer.
The HNITC will not be staffed by MD’s but every child in our care will have a specialized treatment plan prescribed by a local, qualified medical doctor.
The HNITC will not be offering QEEG, neurofeedback, HBOT or other interventions that do not target the underlying cause of the symptoms seen in autism and related cognitive disorders. Our specialized medical treatment plan targets neurotoxins and the underlying pathogens (viruses, bacteria, yeast, protozoa) that penetrate the blood-brain-barrier and force activation of the brain’s immune system (the neuro-immune system). Our rehabilitative therapy will consist of treatments that address behaviours and Childhood Apraxia of Speech (CAS) and are designed to transition our children back into a formal educational setting. We will only provide therapy and education models that have been clinically proven to address social, communication and behavioural deficits and are recommended by our doctors. QEEG, neurofeedback, HBOT etc. are very expensive interventions that may not produce results if a child’s brain is not healthy enough to learn. Our goal at the HNITC is to return the child’s brain to a healthier state so they can learn and resume normal development. In some cases, non-medical therapies may in fact do further harm.
Immunology is a relatively new field of medicine that is extremely complex and the exact mechanisms of Intravenous immunoglobulin (IVIG) are not completely understood. IVIG has been shown to be helpful with the harmful inflammation caused by autoimmune illnesses but it is not yet indicated for treatment of PANDAS. In a placebo-controlled trial, IVIG has been shown to decrease symptom severity and shorten the course of illness in PANDAS and its benefits have been supported by a small number of published case reports and shared clinical experiences. For most patients, a single course of IVIG is sufficient to produce significant improvements and, in some cases, complete remission of symptoms but multiple monthly or quarterly infusions of IVIG have not been systematically tested for PANDAS. Additionally, since IVIG is made from pooled human donor products, it carries the inherent risk of transmitting undetected infections. IVIG treatment in children with autism has demonstrated transient benefits (initial improvements that are later lost) and this is likely due to the fact that the total toxic load on the immune system has not been addressed. The HNITC believes that PANDAS/PANS and AE are all phenotypes of neuro-immune dysfunction and that our treatment protocol will be effective in ameliorating the symptoms associated with these conditions. Since the HNITC will be operating as a residential care facility, we will not be offering IVIG at our location. We will, however, make the necessary arrangements to ensure all our residents have access to appropriate treatments at our local hospitals or clinics, as directed by the attending physicians.
Fetal Alcohol Spectrum Disorder (FASD) is an umbrella term used to describe the range of disabilities that result from prenatal alcohol exposure. Affected individuals may have facial features that are characteristic of FASD but in the absence of these identifying physical attributes FASD may be misdiagnosed as ADHD. Like autism, ADHD and related neurodevelopmental “labels”, FASD is considered a lifelong condition but the HNITC believes that our treatment protocols, which involve unburdening an overwhelmed and dysfunctional immune system, can effectively alleviate or eliminate the learning, communication and behavioural challenges faced by individuals with FASD.
Since testing for infections is extremely expensive, very invasive and completely unreliable, the HNITC will not test our children for strep, Lyme and co-infections or other types of infectious pathogens. Step 2 of the HNITC treatment protocol involves the use of agents and therapies that target the underlying pathogens, which will be addressed from largest to smallest (beginning with parasites, then fungi, bacteria and lastly viruses). The improvement of symptoms or a Herxheimer reaction following the administration of a pharmaceutical agent are clear indications that the medication is working and more reliable than any testing methods that are available to us at this point in time. If symptoms do not improve or a Herxheimer reaction does not occur the medication will be stopped following a 6-8 week course.
Pandemic refers to an outbreak of a disease that is widespread and prevalent over a very large area, such as a country or the world. Epidemic refers to a disease that affecting many individuals in an area at the same time. Therefore, autism is a pandemic of epidemic proportions.