Nutrition for Special Needs Children

Dr. Thiel runs a clinic in Arroyo Grande, County of San Luis Obispo, California.

A recently published study found that he was able to help 929 of 945 Who Saw Dr. Thiel Reported Improvement.
He has had multiple papers published on nutrition for special needs, including autism, Down Syndrome, Epilepsy, and even rarer conditions. He has one of the highest known rates for helping those with special needs.

He can help you or a loved one. Call 1-805-489-7188 to schedule an appointment.

When you have a child with special needs, trying to make sense of your options can often be frustrating. However, whether the child has attention-deficit disorder (ADD), attention-deficit hyperactive disorder (ADHD), autism, cerebral palsy, CHARGE syndrome, Down's (trisomy 21), epilepsy, muscular dystrophy, or other conditions (including undiagnosed ones), nutrition probably deserves your involvement as it specifically may play an important role that you can help support.

Of the special needs conditions, nutrition for those associated with various behavioral disorders may have received the greatest attention, with Feingold considered to be a major pioneer in this area [1]. More recent research also gives clues that nutrition can be helpful for special needs children with a variety of conditions.

A preliminary pretest-posttest study I performed involving diet and supplementation for those with ADD and/or ADHD found nutrition to be highly effective [2]. The study involved 36 subjects, most of whom were children. 3 subjects dropped out. Of the 33 who remained, all 33 reported (or, in the case of minors, had their parents or teachers, report) improvement. In this particular study, the specific nutritional protocols varied based upon individual assessment. The types of substances used included flaxseeds, vitamin B6 (and other B vitamins), l-tyrosine, bovine glandulars, calcium, magnesium, chromium GTF, GABA (gamma-amino butyric acid, an important inhibitory neurotransmitter), proanthocyanidins, alfalfa, enzymes, and other substances--some of the nutrients in these substances appear to be deficient in some with this disorder [3]. Food intolerances were found in 28 (90.3%) of the participants. Those foods by occurrence were bovine dairy products 41.9%, food colors/preservatives 22.6%, refined carbohydrates (sucrose, white sugar, white flour, white rice) 19.4%, wheat (whole and white) 19.4%, and caffeine-containing products 9.7%. One participant each appeared to be bothered by apricots, black pepper, brown rice, chocolate, citrus, millet, and oats.

Food intolerances reportedly can cause a variety of behavioral problems including specific learning disability, perceptual-motor deficits, hyperactivity, coordination issues, impulsivity, emotional instability, short attention span, and abnormal electroencephalograms [3,4]. It has been reported that foods high in salicylates (almonds, apples, apricots, blackberries, cherries, cloves, cucumbers, gooseberries, grapes, mint, nectarines, peaches, plums, raspberries, strawberries, tomatoes, etc.) should be avoided by some of the hyperactive [3]. It is my opinion that the specific protocol to improve such children varies considerably and that all children with ADD or ADHD do not need to avoid all those foods or those previously mentioned in this article (though since artificial preservatives and artificial colors are not foods and are of no value nutritionally, it does not make sense for anyone to consume them unnecessarily).

The effects of various sugars on attention-disorders remains controversial. Essentially, some believe white sugar (sucrose) negatively affects many with this problem [1]; some believe it plays no role [5], while some research this investigator has seen (including his own [2]) [4,6] concludes that it does sometimes play a negative role.

On the other hand, an interesting study found that the consumption of essential monosaccharides seemed to improve the behavior of children with ADHD (the eight monosaccharides essential for the formation of glycoproteins are galactose, glucose, mannose, N-acetylneuraminic acid, fucose, N-acetylglucosamine, and xylose [7,8]) [9]. Glycoproteins are responsible for proper cell to cell communication [7,8,10]. Glycoproteins are found on the surface of all cells. They are known to be necessary for collagen, mucin (a lubricating and protective agent), transferrin & ceruloplasma (transport molecules), TSH (thyroid stimulating hormone), chorionic gonadotrophin hormone, enzymes (such as alkaline phosphatase), proteins in cell-cell interactions, and some lectins [7]. Modern food processing techniques appear to reduce the natural diversity of monosaccharides in the diet (most people only consume glucose and galactose in any quantity). Although the mechanisms of how saccharides affect attention-disorders remains unclear, it does appear that for some at least some saccharides (such as high quantities of sucrose) may play a negative role and that others (such as some of the essential monosaccharides) may play a positive role.

Docosahexaenoic acid (DHA) which is found in human breast milk and fatty fish (salmon, mackerel, tuna) is required for the maintenance of normal brain function in adults and neural development in infants [11,12]. Deficiencies of DHA are associated with deficits in learning [11]. DHA may be helpful for many children with special needs. As it is not found in standard infant formulas [12], it is likely that many today received too little DHA as infants--some believe that this may partially account for an increase in learning and other developmental disorders [11] (it is also true that the amino acid concentrations in infant formulas is quite different from that found in human milk--human milk normally has more alanine, aspartic acid, glutamic acid, glutamine, leucine, lysine, methionine, proline, serine, and threonine [13]). It has also been reported that DHA helps facilitate the transport of calcium and magnesium through the cell membrane [14] and perhaps this has a calming effect (my clinical experience suggests that those who are deficient in calcium and/or magnesium frequently cannot calm down).

Various reports support the concept that certain nutrients are helpful for autistic children. Specifically folate, vitamin B6, magnesium, vitamin C, and probably vitamin B12 [15-18].

Folate may help some young autistic males reduce ADD-like symptoms [19]. It is reported that the combination of supplemental vitamin B6 and magnesium often results in improvements in days [17,20]--this may be because supplemental magnesium has been shown to help those under extreme physical stress, such as athletes, by increasing venous oxygen [21] and because vitamin B6 is a coenzyme for many reactions that lead to the production of several neurotransmitters [22]. I have found that the combination of vitamin B6 and magnesium in moderate amounts to result in reports of behavioral improvement by parents of autistic children. Vitamin C itself is believed by some to be helpful for the prevention and treatment of autism basically because it is highly concentrated in the brain, is protective against heavy metals, and seems to help with the socialization of some autistic individuals [18]. Tryptophan depletion has been found to increase negative behaviors such as flapping, banging, and hitting, as well as to increase calmness and happiness in autistic adults [23].

N,n-dimethylglycine (DMG), an amino acid derivative, is naturally found in the human body and supports transmethylation processes [24]. There is a report of a Korean study which used DMG for autistic children which found that it improved verbal communications and behavior, while a report of a Taiwanese study suggests that DMG reduced lethargy in autistic children, but did not improve speech [25]. It, as well as the related TMG (trimethylglycine) [26], is sometimes used for children with Down syndrome as well--this investigator has received reports from various sources (including our clientele) that these substances seem to improve verbal abilities of autistic and Down's children. Dr. Bernard Rimland has reported that the digestive hormone secretin is also believed to help some autistic children improve verbal communications [27]. This may be consistent with reports that avoidance of dairy and wheat sometimes helps those with autism [28]. It has been reported elsewhere that a high percentage of autistic children have a 'mutant' protein that is created by the consumption of gluten and/or casein containing foods and which negatively affected behavior [29].

Clinically, I have found that dietary restrictions, combined with mineral, brain, thyroid, and enzymatic support normally does result in improved behavior, as well as performance in school, for those with various forms of autism (including Asperger syndrome).

Children with cerebral palsy (CP) can benefit from nutrition. If nothing else, I have found that nutrition can help with behavioral, bone development, energy, and digestive issues that this population faces.

One study found abnormalities of calcium metabolism in nearly 30% of CP adults [30]. It also appears that long-term use of anticonvulsant medications contribute to low bone density for those with CP [30]. Furthermore, “[c]hildren with severe CP develop over the course of their lives clinically significant osteopenia” [31].

In terms of gait and spasticity issues, proper calcium, magnesium, and parathyroid support can be indicated for these individuals. As, “[m]otor disturbances commonly observed in postnatal-onset hypothyroidism are similar to those of cerebral palsy” [32], my clinical experience is that the converse is basically true and that nutritional support for the thyroid gland (bovine glandulars, l-tyrosine, kelp [33]) can be of benefit to those with CP.

In addition, some of the nutrition that tends to help those with Down syndrome would be expected to help those individuals who have cerebral palsy combined with mental injury.

“CHARGE syndrome, or Hall-Hitner syndrome (HHS), has been delineated as a common syndrome that includes coloboma, choanal atresia, cranial nerve dysfunction (particularly asymmetric facial palsy and neurogenic swallowing problems), characteristic ear abnormalities, deafness with hypoplasia of the cochlea and semicircular canals, genital hypoplasia, and variable heart defects, orofacial clefting, tracheo-esophageal fistula, renal anomalies, thymic/parathyroid hypoplasia, spine anomalies, short broad neck with sloping shoulders, and characteristic facial features” [34].

It also has been called CHARGE association and has been somewhat associated with autism [35].

My limited clinical experience has suggested that digestive issues, mental abilities, weight, and other concerns associated with CHARGE can, in fact, respond positively to nutritional interventions. Specifically by utilizing enzymes and bovine/ovine glandulars related to digestion, the thyroid, and the brain, as well as calcium and magnesium and other nutrients.

Although it is a fairly rare disorder, I wanted to mention it in this article to let parents of children with rare disabilities know that proper nutrition is likely to be helpful for their child. For example, although the medical literature says almost nothing about nutritional supplements for CHARGE syndrome or various other disabilities (and I personally am working on changing that), I have found that nutritional support definitely can change outcomes.

Although the use of nutrition for persons with Down syndrome (and other conditions) has been repeatedly challenged [30-32], even some mainstream researchers have recommended vitamin and mineral supplementation for those with Down syndrome [33,34]. Early work done by Turkel [35] and , more recent work by Warner [36], Lawrence-Tafoya [30], and Leichtman [37], as well as an earlier study by Harrell et al [38] concluded that nutritional interventions did raise intelligence of persons with Down syndrome. Many have criticized these researchers and have concluded that nutritional interventions are not effective [30,32,39]. Since one study found that zinc reduced TSH by 34% for hypothyroid Down syndrome patients [40], it is possible that the supplemental zinc may also positively affect some symptoms. It has been speculated that zinc deficiency may be a cause of subclinical hypothyroidism in Down's syndrome children [40]. Down syndrome patients may have below normal plasma levels of selenium and zinc and some have benefited from zinc supplementation [41-44]. Antioxidant nutrients have been reported to help Down's children [35-37], but other reports have disagreed [30,32,39].

A study involving Dutch children with Down syndrome concluded that those children were more prone to have celiac disease than other Dutch children, but not more likely to have a cow's milk intolerance [45]. Celiac disease seems to increase IgA and IgG in Down's patients and cause digestive problems [46]. A German study concluded that children with Down syndrome had higher bovine serum albumin antibody levels than others [47]. Warner (until his death) and some others involved in nutritional interventions for trisomy 21, often advise against the consumption of cow's milk.

Ira Loft, M.D. has recently stated, “it is estimated that as many as 10 percent of children with Down syndrome also have autism” [54]. Thus, some of the nutritional interventions related to autism can be applicable for these children.

In the studies I have performed regarding those with Down syndrome, I have found that nutritional interventions can improve growth [55] and facial features [56] for children. I also have conducted research that suggests that the cognitive deterioration associated with Down syndrome can be reduced through proper food vitamins, food minerals, and other substances [57].

Although not normally considered to be a nutritional disorder, nutritional approaches are often effective for children with various forms of epilepsy.

Vitamin B6 is considered by some to be a “first-line” therapy for intractable forms of epilepsy such as Lennox Gastaut Syndrome [58].

Many doctors and parents have noticed improvement with a ketogenic diet [59]. A ketogenic diet minimizes carbohydrates and emphasizes fat. Some parents have reported seizure reductions using a high protein, “Atkins-like” diet.

Some of the most recent research that I have done suggests that for myoclonic forms of epilepsy, doctors should consider calcium and related nutrients as a first line therapy [60].

Years back I noticed that those with Down syndrome are about 10 times as likely as those without it to develop some type of seizure disorder [61]. And because of that, concluded that oftentimes, those with Down syndrome or some form of epilepsy tended to have very similar nutritional needs.

People with muscular dystrophy often have nutritional deficiencies [62], and thus can be helped by nutrition. Although my clinical experience with this disorder is quite limited, I have found that weight, digestive concerns, and energy levels can all improve with nutritional support.

Another reason to consider nutrition is that even the Merck Index admits from a medical standpoint, “No specific treatment exists” [63] for muscular dystrophy (though some forms of exercise are often advised [63]).

It has, however, medically been suggested that those with Duchenne muscular dystrophy or similar situations would benefit from proper amounts calcium and vitamin D [64].

While research suggests that selected amino acids, such as arginine [65], may be of benefit to those with muscular dystrophy, I have found that more complete proteins (such as found in ovine/bovine glandulars) are more likely to provide quicker and more sustainable results.

In addition to the dietary factors and nutrients listed earlier, many other substances such as vitamin E, ginkgo biloba, co-enzyme Q10, and phosphatidylserine are believed by some to increase intelligence and improve some aspects of behavior [66].

This article has barely touched on the substances that may have value for special needs children. There is no one nutritional approach that works for everybody. Good nutritional health professionals strive to keep up with research and how it can be applied in real life (such as with your child).

It is important to note that many of the problems that disabled children face cross over many disabilities and therefore, some of what helps children with one disability can sometimes help with a disability that seems totally unrelated. On the other hand, some nutritional substances that can help some disabilities, can worsen others. Parents are advised to seek advice from well-trained doctors and other experts before trying something on their own. Specifying nutrition, based not just on the medical condition, but also based on the individual, is a hard concept for many to accept, but I have found it to be the most effective way to get real results for disabled children.

It may take several decades before all the primary controversies surrounding the use of nutrition for special needs children are resolved to the satisfaction of some scientists. As for this scientist and father of a special needs child, the research of others and the results of my clinical practice clearly demonstrate that various aspects of nutrition (including diet and appropriate supplementation) can be helpful for special needs children. This is an area all parents of special needs children should look into, as well as to discuss any applications with a properly trained nutritional health care professional.

[1] Feingold BF. Hyperkinesis and learning disabilities linked to the ingestion of artificial foods and fats. J Learn Disabil 1976;9(9):551-559
[2] Thiel RJ. Nutrition-based interventions for attention-deficit disorder and attention-deficit hyperactive disorder. Townsend Letter for Doctors and Patients 2000;201:93-96
[3] Werbach MR. Attention-deficit hyperactive disorder. In Textbook of Nutritional Medicine. Third Line Press, Tarzana (CA), 1999:153-162
[4] Pfeiffer CC. Mental and Elemental Nutrients: A Physician's Guide to Nutrition and Health Care. Keats, New Canaan (CT), 1975
[5] Kanarek RB. Does sucrose or aspartame cause hyperactivity in children. Nutr Rev 1994;52(5):173-175
[6] Kaplan BJ, McNicol J, Conte RA, Moghadam PK. Overall nutrient intake of preschool hyperactive and normal boys. J Abnorm Pyschol 1989;17(2):127-132
[7] McAnalley B. A solid scientific foundation. Breakthrough 2(1):5-7, 1997
[8] Murray RK, Granner DK, Mayes PA, Rodwell VW. Harper's Biochemistry. Appleton and Lange, Stamford (CN), 1996
[9] Dykman KD, Dykman RA. Effect of nutritional supplementation on attention-deficit hyperactivity disorder. Integr Physiol Behav Sci 1998;33(1):49-60
[10] Axford J. Glycobiology and medicine: an introduction. J R Soc Med,1997;90:260-264
[11] Horrocks LA, Yeo YK. Health benefits of docosahexaenoic acid. Pharmacol Res 1999;40(3):211-225
[12] Wood J, et al. Is docosahexaenoic acid necessary in infant formula? Pediat Res 1996;40(5):687-693
[13] Agostoni C, Carratu B, Boniglia C, Riva E, Sanzini E. Free amino acid content in standard infant formula: comparison with human milk. J Am Coll Nutr, 2000;19(4):434-438
[14] Null G. Complete Encyclopedia of Natural Healing. Kensington Books, New York, 1998
[15] Werbach MR. Autism. In Textbook of Nutritional Medicine. Third Line Press, Tarzana (CA), 1999:163-166
[16] Ratner RS. Vitamin B6, Magnesium, DMG. Autism Res Rev Intl 1998;12(2):6-7
[17] Rimland B. What is the right 'dosage' for vitamin B6, DMG, and other nutrients useful in autism? Autism Res Rev Intl 1997;11(4):3
[18] Rimland B. Vitamin C in the prevention and treatment of Autism. Autism Res Rev Intl 1998;12(2):3
[19] Bregman JD, et al. Fragile X syndrome: variability of phenotypic expression. J Am Acad Child Adoles Psychiat 1987;26:463-471
[20] Lelord G, et al. Clinical and biological effects of high dosage vitamin B6 and magnesium in autistic children. Acta Vitaminol Enzymol 1982;4(1-2):27-44
[21] Golf SW, et al. On the significance of magnesium under extreme physical stress. Cardiovasc Drugs Ther 1998;12:197-202
[22] Leklem JE. Vitamin B6. In Modern Nutrition in Health and Disease, 9th ed. Williams & Wilkins, Balt., 1999:413-421
[23] McDougle CJ, et al. Effects of tyrptophan depletion in drug-free adults with autistic disorder. Arch Gen Psychiat 1996;53:993-1000
[24] Laryea MD, Steinhagen F, Pawliczek S, Wendel U. Simple method for the routine determination of betaine and N,N-dimethylglycine in blood and urine. Clin Chem,1998;44(9):1937-1941
[25] Kendall RV, Lawson JW. Recent findings on N,N-dimethylglycine (DMG): a nutrient for the new millenium. Townsend Letter,2000;202:75-85
[26] Pugaczewski RM. TMG Announcement. International Nutrition, Inc., Owings Mills (MD), May 2000
[27] Rimland B. The use of secretin in Autism: some preliminary answers. Autism Res Rev Intl 1998;12(4):3
[28] Lewis LS. Special diets for special kids: understanding and implementing a gluten and casein free diet to aid in the treatment of autism and related developmental disorders. Future Horizons, Arlington (TX), 1998
[29] Dorfman K. Exploring the casein-free, gluten-free diet. New Developments;1(2):4
[30] Nakano H, Aoyagi K, Ohgi S, Akiyama T. Factors influencing metacarpal bone mineral density in adults with cerebral palsy. J Bone Miner Metab. 2003;21(6):409-414
[31] Henderson RC, Kairalla JA, Barrington JW, Abbas A, Stevenson RD. Longitudinal changes in bone density in children and adolescents with moderate to severe cerebral palsy. J Pediatr. 2005;146(6):769-775
[32] Arii J, Tanabe Y, Makino M, Sato H, Kohno Y. Children with irreversible brain damage associated with hypothyroidism and multiple intracranial calcifications. J Child Neurol. 2002;17(4):309-313
[33] Thiel R.J. Suspected hypothyroidism: treat, ignore, or feed? International Journal of Naturopathic Medicine, 2002; 1(1): 12-22
[34] Graham JM Jr, Rosner B, Dykens E, Visootsak J. Behavioral features of CHARGE syndrome (Hall-Hittner syndrome) comparison with Down syndrome, Prader-Willi syndrome, and Williams syndrome. Am J Med Genet A. 2005;133(3):240-247
[35] Artigas-Pallares J, Gabau-Vila E, Guitart-Feliubadalo M Syndromic autism: II. Genetic syndromes associated with autism.] Rev Neurol. 2005;40 Suppl 1:S151-162
[36] Sacks BI, Buckley RF. Multi-nutrient formulas and other substances as therapies for Down syndrome: an overview. Down Syndrome News and Update 1(2):70-83, 1998
[37] Dwyer J. Fertile fields for fads and frauds: questionable nutritional therapies. NY State J Med, 1993:105-108
[38] Pruess JB, Fewell RR, Bennett FC. Vitamin therapy and children with Down syndrome: a review of research. Except Child,1989;55(4):336-341
[39] Luke A, Sutton M, Schoeller DA, Roizen NJ. Nutrient intake and obesity in prepubescent children with Down syndrome. J Am Diet Assoc,1996;96(12):1262-1267
[40] Reading CM. Down's syndrome: nutritional interventions. Nutr Health,1984;3(1-2):91-111
[41] Turkel H, Nusbaum I. Medical Treatment of Down Syndrome and Genetic Diseases, 4th ed. Ubiotica, Southfield (MI), 1985
[42] Warner FJ, Stephens C. Metabolic supplementation for correction of raging free radicals in trisomy 21. Presentation at the International Down's Conference. Madrid, Spain
[43] Leichtman LG. Targeted nutritional intervention in the treatment of children and adults with Down syndrome. Presentation at the 1998 National Down Syndrome Congress, Meeting, Dallas, Texas, August 17, 1998
[44] Harrell RF, Capp RH, Davis DR, Peerless J, Ravitz LR. Can nutritional supplementation help mentally retarded children? an exploratory study. Proc Natl Acad Sci U S A,1981;78(1):574-578
[45] Weathers C. Effects of nutritional supplementation on IQ and certain other variables associated with Down syndrome. Am J Ment Defic,1983;88(2):214-217
[46] Bucci I, et al. Zinc sulfate supplementation improves thyroid function in hypozincemic Down children. Biol Trace Elem Res 1999;67(3):257-268
[47] Chandra RK, McBean LD. Zinc and immunity. Nutr, 1994;10(1)
[48] Kadrabova J, et al. Changed serum trace element profile in Down's syndrome. Biol Trace Elem Res 1996;64(3):201-206
[49] Anneren G, et al. Increase in serum concentrations of IgG2 and IgG4 by selenium supplementation in children with Down's syndrome. Arch Dis Children, 1990;65:1353-1355
[50] Sherman AR. Zinc, copper and iron nutriture and immunity. J Nutr,1992;122:604-609
[51] Hopman E, et al. Nutritional aspects of children with Down syndrome. In Clinical Pearls 1999. ITServices, Sacramento, 1999:256
[52] Storm W. Prevalence and diagnostic significance of gliaden antibodies in children with Down's syndrome. Eur J Ped, 1990;149:833-834
[53] Fuchtenbusch M, Karges W, Standl E, Dosch HM, Ziegler AG. Antibodies to bovine serum albumin in type 1 diabetes and other autoimmune disorders. Exp Clin Endocrinol Diabetes,1997;105(2):86-91
[54] National Down Syndrome Society. Understanding DS and Autism. Down syndrome Update, 2005;XXI,3:1,4-5
[55] Thiel R.J. Growth effects of the Warner protocol for children with Down syndrome, Journal of Orthomolecular Medicine, 2002;17(1):42-48
[56] Thiel R.J. Facial effects of the Warner protocol for children with Down syndrome. Journal of Orthomolecular Medicine, 2002;17(2):111-116
[57] Thiel R.J, Fowkes S.W. Can cognitive deterioration associated with Down syndrome be reduced? Medical Hypotheses, 2005; 64(3):524-532
[58] Glauser TA, Morita DA. Encephalotopic epilepsy after infancy. In: Pediatric Epilepsy, 2 nd ed. Demos, New York, 2001: 201-218
[59] Freeman JM, Vining EPG, Pillas DJ. Seizures and Epilepsy in Childhood: A Guide for Parents, 2nd ed. John Hopkins University Press, Balt., 1997
[60] Thiel R. Might disorders of calcium cause or contribute to myoclonic seizures? Accepted for publication by Medical Hypotheses, November 16, 2005
[61] Thiel R.J., Fowkes S.W. Down syndrome and epilepsy: A nutritional connection? Medical Hypotheses, 2004; 62(1): 35-44
[62] Motlagh B, MacDonald JR, Tarnopolsky MA. Nutritional inadequacy in adults with muscular dystrophy. Muscle Nerve. 2005;31(6):713-8
[63] Beers MH, Berkow R, eds. The Merck Manual of Diagnosis and Therapy. Merck Research Laboratories, Whitehouse Station (NJ), 1999
[64] Bianchi ML. How to manage osteoporosis in children. Best Pract Res Clin Rheumatol. 2005;19(6):991-1005
[65] Barton ER, Morris L, Kawana M, Bish LT, Toursel T. Systemic administration of L-arginine benefits mdx skeletal muscle function. Muscle Nerve. 2005;32(6):751-60
[66] Khalsa DS. Brain nutrients. Townsend Letter for Doctors and Patients, 2000; 205/206:132-133

The Center for Natural Health Research supplies research and other items for health care professionals interested in natural interventions.

For additional information check out http://www.healthresearch.com. This research is for doctors and other health care professionals. Thiel is not a medical doctor. None of this research is medical advice, nor should it be construed as medical advice; nor is any of this information specific for any individual.