Ann-Mari Knivsberg

A Randomised, Controlled Study of Dietary Intervention in Autistic Syndromes

Abstract Impaired social interaction, communication and imaginative skills characterize autistic syndromes. In these syndromes urinary peptide abnormalities, derived from gluten, gliadin, and casein, are reported. They reflect processes with opioid effect. The aim of this single blind study was to evaluate effect of gluten and casein-free diet for children with autistic syndromes and urinary peptide abnormalities. A randomly selected diet and control group with 10 children in each group participated. Observations and tests were done before and after a period of 1 year. The development for the group of children on diet was significantly better than for the controls.

Autistic Syndromes and Diet: A Follow-Up Study.

Abstract Dietary intervention was applied to 15 subjects with autistic syndromes, with pathological urine patterns, and increased levels of peptides found in their twenty‐four‐hour urine samples. The peptides, some of which are probably derived from gluten and casein, are thought to have a negative pharmacological effect on attention, brain maturation, social interaction and learning. Our hypothesis was that a diet without these proteins would facilitate learning. Social behaviour, as well as cognitive and communicative skills, were assessed before diet. The subjects were closely followed for a year, after which their urine was retested blind, and the assessment of behaviors and skills was repeated. Further retesting was made four years after the onset of dietary intervention. Normalization of urine patterns and peptide levels was found after one year. Likewise, a decrease in odd behaviour and an improvement in the use of social, cognitive and communicative skills were registered. This positive developmen...

Can the Pathophysiology of Autism be Explained by the Nature of the Discovered Urine Peptides

Abstract Opioid peptides derived from food proteins (exorphins) have been found in urine of autistic patients. Based on the work of several groups, we try to show that exorphins and serotonin uptake stimulating factors may explain many of the signs and symptoms seen in autistic disorders. The individual symptoms ought to be explainable by the properties and behavioural effects of the found peptides. The data presented form the basis of an autism model, where we suggest that exorphins and serotonin uptake modulators are key mediators for the development of autism. This may be due to a genetically based peptidase deficiency in at least two or more peptidases and, or of peptidase regulating proteins made manifest by a dietary overload of exorphin precursors such as by increased gut uptake.

Gluten- and casein-free dietary intervention for autism spectrum conditions

Dietary intervention as a tool for maintaining and improving physical health and wellbeing is a widely researched and discussed topic. Speculation that diet may similarly affect mental health and wellbeing particularly in cases of psychiatric and behavioral symptomatology opens up various avenues for potentially improving quality of life. We examine evidence suggestive that a gluten-free (GF), casein-free (CF), or gluten- and casein-free diet (GFCF) can ameliorate core and peripheral symptoms and improve developmental outcome in some cases of autism spectrum conditions. Although not wholly affirmative, the majority of published studies indicate statistically significant positive changes to symptom presentation following dietary intervention. In particular, changes to areas of communication, attention, and hyperactivity are detailed, despite the presence of various methodological shortcomings. Specific characteristics of best- and non-responders to intervention have not been fully elucidated; neither has the precise mode of action for any universal effect outside of known individual cases of food-related co-morbidity. With the publication of controlled medium- and long-term group studies of a gluten- and casein-free diet alongside more consolidated biological findings potentially linked to intervention, the appearance of a possible diet-related autism phenotype seems to be emerging supportive of a positive dietary effect in some cases. Further debate on whether such dietary intervention should form part of best practice guidelines for autism spectrum conditions (ASCs) and onward representative of an autism dietary-sensitive enteropathy is warranted.

Effect of a Dietary Intervention on Autistic Behavior

Autistic syndromes are characterized by impaired social, communicative, and imaginative skills. Urinary peptide abnormalities, in part due to gluten and casein, have been detected in some individuals With autism. These abnormalities reflect processes With opioid effect, Which may explain the behavioral abnormalities seen in autism. The aim of this single-blind, controlled study Was to evaluate the effect of a gluten-free and casein-free diet for children With autism and urinary peptide abnormalities. Observations and tests Were carried out With the 20 participanting children before they Were randomly assigned to either the diet or the control group. The experimental period Was 1 year, after Which observations and tests Were repeated. Significant reduction of autistic behavior Was registered for participants in the diet group, but not for those in the control group.

Behaviour, attention and cognition in severe dyslexia

Information about coexisting problems in dyslexia may be vital for diagnostic and remedial procedures. There are few studies in this area, and to our knowledge none for the students in focus in this study. They all have phonological deficits and severely impaired reading abilities, in spite of prolonged educational remediation. The aim was to assess if these students have more behavioural/emotional problems than normal reading students. A clinical sample of 70 students, 59 males and 11 females, were compared to a normal reading control group. The groups were pair-wise matched on age, gender, cognitive level, and whether they lived in rural or urban areas. Mean age for the two groups was 150 months, and mean IQ scores approximately 100. Information on behaviour/emotions was obtained from parents, teachers and participants by means of the Child Behavior Checklist, Teachers Report Form and Youth Self Report. The dyslexia group showed significantly more problems in all areas than the controls. This was reported from all three groups of informants. Parents reported most problems, internalizing behaviour for more than 50% of the participants and total problem behaviour for nearly 45%. Significantly more attention problems were also reported for the dyslexia group from all informants. Parents reported that nearly half the group demonstrated attention problems. Both groups of participants had more problems reported for those with IQ scores of 100 or lower. Further research is needed in this area, but the results clearly indicate that identifying additional behavioural/emotional problems may be imperative for students with severe reading problems.

Dietary Intervention for a Seven Year Old Girl with Autistic Behaviour

Abnormal urinary peptide patterns and peptide levels are reported in autism. These abnormalities are in part peptides from gluten, gliadin and casein, and some of them are opioids. These opioids cross the blood-brain barrier and effect the central nervous system. A seven year old girl with autistic behaviour who benefited from a diet without gluten and casein is described in this case report. The young girls behaviour and skills were registered before diet, after one year and after two. Over the period of two years the girl changed from being severely withdrawn to a normally communicating child who enjoys the company of others. The childs linguistic and cognitive skills also increased simultaneously more than could be expected. Furthermore her urine patterns and peptide levels were normalised.

Internalizing, externalizing and attention problems in dyslexia

The aim of this study was to investigate if children with dyslexia displayed more behavioural/emotional problems than normal readers did. Twenty-six children with dyslexia and a control of 26 children without reading problems participated in the study. The mean age in the dyslexia group was 9 years and 8 months and in the control group 9 years and 10 months. The estimated mean intelligence quotient score was 94 in the dyslexia and 100 in the control group. Parents and teachers provided information on behaviour through Child Behavior Checklist and Teachers Report Form. Only teachers reported significant group differences. Ratings from both groups showed, however, higher mean values of internalizing, externalizing and total problem behaviour in the dyslexia group compared to controls. Parents informed on a higher number of participants with dyslexia to have internalizing behaviour above the clinical cut-off point, while teachers reported a higher number with externalizing behaviour. Both parents and teache...

Developing a participatory multidisciplinary team approach to enhance the quality of school start

The article discusses how participatory action research was applied during a three-year project at 27 schools in Norway in order to enhance the quality of school start. A multidisciplinary on-site team approach was developed, supported by workshops and dialogue seminars. External professionals from the supportive municipal health care system and special education/school psychology services assisted children and teachers in the first grade, focusing on early health promotion and support to children at risk of developing problems. The project was reported to improve multidisciplinary teamwork and relationships, to increase focus on developmental and health care issues, to develop professional knowledge and practical skills, to increase support to local educational staff, and to provide a better school-start for all and particularly vulnerable children. Local creativity and ownership within supportive administrative structures were reported as promoting factors, while available time and external professional resources were the main constraints. The building of learning partnerships based on face-to-face interaction appeared to be a particular strength of the approach.

Motor coordination difficulties in 5–6‐year‐old children with severe behavioural and emotional problems

Incidence, severity and types of motor difficulties in children with severe behavioural and emotional problems were evaluated. A group of 6‐year‐olds (n = 29) with such problems and controls (n = 29) were compared on the Movement Assessment Battery for Children (M‐ABC). The groups were compared on total scores as well as manual dexterity, ball skills and balance. Individual M‐ABC profiles were compared with Teachers Report Form profiles. It was found that 62.1% in the high‐risk group and 20.7% in the control group showed motor coordination difficulties. In the high‐risk group 55.2% fulfilled the criteria of the DSM‐IV for developmental coordination disorder, compared to 3.4% controls. The high‐risk group showed significant difficulties within all sub‐areas of the M‐ABC. There was a significant relationship between attention problems and manual dexterity difficulties. The combination of problems identified makes these children vulnerable with regard to school inclusion and in need of proper assessment and intervention.