METABOLIC DISORDERS IN AUTISM: A BEHAVIORAL EVALUATION OF TREATMENT (URIC ACID, PERVASIVE DEVELOPMENTAL DISORDER, LOW CALCIUM, ALLOPURINOL, NON-SPECIFIC)
ROSENTHAL, DAVID ERIC
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This study evaluated reports by Mary Coleman, M.D., that many autistic individuals have one of three neurologically related non-specific metabolic disorders low blood serotonin (hyposerotonemia); excess urinary uric acid (hyperuricosuria); or low urinary calcium (hypocalcinuria) ; and that significant behavioral improvements can occur (in terms of hyperactivity, attention span, expressive language, self stimulatory or stereotyped behaviors, and sleeping patterns), in some but not all autistics corrected metabolically through diet, vitamin and mineral supplements, and (for some hyperuricosurics) medication (allopurinol). This study, then, was one of applied physiological psychology in this area of childhood psychopathology. Dr. Coleman supervised this Project medically.;Prevalence was evaluated by testing 41 (mostly residential) autistic students (33 males, 8 females, aged 8 to 21; 32 autistics and 9 developmentally disordered nonautistics). Students received office neurologicals, blood and 24 hour urine tests to establish their physical and metabolic status.;Two hyposerotonemic, 16 hyperuricosuric, and 7 hypocalcinuric students were identified in the screening (4.9%, 40.0%, and 17.9% of the sample, respectively), supporting previous findings of prevalence (with somewhat different percentages), and extending them by identifying these metabolic disorders in autistics with organicity, and in developmentally disordered nonautistics.;Sixteen metabolically disordered students identified in the screening participated in the treatment evaluation phase (12 hyperuricosuric; 4 hypocalcinuric). Period 1 (3 1/2 months) was a double blind, treatment vs. placebo study. All students were intended for metabolic correction in Period 2 (3 1/2 months).;Three urine testings established metabolic condition. The restricted purine diet was not as effective as expected in this setting, resulting in fewer metabolically corrected hyperuricosurics in Period 1, and more hyperuricosurics receiving allopurinol in Period 2. Two hypocalcinurics were never corrected, despite increases in supplements. Behavioral testing with several rating scales was largely pre-, mid-, and post-, with school and residential informants.;Hyperuricosuric and hypocalcinuric students were found to be similar on baseline behavioral measures. Hypotheses of general positive behavioral effects of the School Program and of metabolic correction were largely not supported, with the exception of 1 and perhaps 2 hypocalcinurics. Importantly, 3 hyperuricosurics became significantly worse on allopurinol, despite metabolic correction.