CHANGE IN CHILD'S BEHAVIOR OR FITNESS MAY BE CAUSED BY FOOD ALLERGIES

Move over Sherlock Holmes. Today, late in the 20th Century, Richard E. Layton, M.D., is following in your footprints. Not to solve crimes, but rather to ascertain exactly what is causing allergic reactions in children. Aside from hives and wheezing spells, some of these allergies are responsible for learning and behavior problems, such as Attention Deficit Hyperactivity Disorder (ADHD). Dr. Layton has found allergies behind migraine headaches, usually believed to have a psychosomatic origin. One of his patients--a seven year-old girl with severe migraines--was allergic to peanut butter. Once she began avoiding peanut products, the headaches disappeared. Perhaps one of Dr. Layton's most dramatic successes was that of a child who had been diagnosed with autism. "My child had a variety of incorrect diagnoses from autism to sensory integration dysfunction," says Silver Spring's Cathy Conway, the five year-old boy's mother. "He wasn't sleeping, wasn't developing, had stopped talking, and was generally sick and miserable." It turned out that the boy was allergic to several foods and to molds, pollen, and dust--in short, his immune system was completely out of whack and the allergies were affecting the behavior of his central nervous system. Once the allergies were identified, they were treated with immunotherapy, or drops of antigens that are placed under the tongue. The results were virtually immediate. "My husband wondered if the doctor had switched kids on us." says Ms. Conway. The child has since been determined not to be autistic. In many ways, Dr. Layton is contributing to, if not building, a new branch of science, patient by patient. While most of us are used to thinking of allergies--essentially, the adverse effects resulting from contact with an irritant--the result from pollen and animal dander, allergies also result from the foods we eat and the chemicals present in the environment. We may also think of the reactions as runny eyes, breathing difficulties and stuffy noses, and that's about all. Most food allergies result from sugar, chocolate, citrus fruits, coffee, soybeans, eggs, milk, peanuts, shellfish, and wheat. And the results can include ADHD and migraine headaches, as well as bedwetting and abdominal pains, for starters. Because there are few pediatricians locally who are working as frequently with allergies, Dr. Layton often finds his patients traveling from Northern Virginia to Towson for assistance. Where then do these very few allergy specialists begin looking for the clues to the cause of allergies? Doris J. Rapp, M.D., of Buffalo, New York, and author of Is This Your Child? has a list of "The Big Five" behavior signs to be alert to. "Is there a change in your child's ability to write or draw after eating a certain substance?" she asks, "If the child wakes up having a hard time breathing, it may be due to an allergy to the bedding materials." Dr. Rapp advises parents to be alert to changes in pulse rate; the change may really be indicating an allergic reaction. Other reactions to watch are circles under a child's eyes, red ears, and red patches on cheeks.

Finally, pay attention, she notes, to changes in the way the child feels, behaves, or acts; behavior may be affected by contact with an allergic substance. Not surprisingly, doctors such as Richard Layton and Doris Rapp often find themselves the doctor of last resort. Parents usually have tried everything before finally turning to pediatric allergists. "I usually have a pretty good idea about what a child may need after the first two hours." says Dr. Layton, who takes a very precise medical history of each patient. "I go over each child from head to toe." If he suspects a mold to be the cause, he will frequently test 20 different molds. If he suspects food, the most frequent offenders are soybeans, corn, wheat, egg, milk, sugar, and baker's yeast. The least offensive foods are carrots, barley, grapes, lamb, oats, peaches, pears, rice, squash and sweet potatoes. Interesting enough, a child may crave the very food that is causing the problem. These "masked" or hidden allergies, cause adverse reactions that are less noticeable, and milder, precisely because they are ingested so frequently. Dr. Rapp frequently videotapes her patients, when she is testing for allergies, to observe the differences in the child's behavior. These videos then are often used in her medical school pediatric class at the State University of New York (SUNY) at Buffalo. While the physicians have many successes, there is one group of children that is particularly difficult to treat--those with autism. "Very little is known about this medical condition to begin with," says Dr. Layton, who emphasizes that, in addition to his "experimental" allergy work, he frequently relies on the knowledge and practices of the 15 years he spent practicing "conventional" medicine. By whatever means--be the high technology or old-fashioned observation--Dr. Layton uses to put the clues together, when a diagnosis is made there are usually three methods of treatment. "One is avoidance," he notes. While it is the ideal way to conquer an allergy, this frequently is not practical. For example, it may be easy enough to avoid perfumes in individual homes, but this is impossible to control in offices or churches, on public transportation, or in a myriad of other situations. Avoidance may also be practiced at home with allergies to glycerine (in certain soaps or shampoos) or formaldehyde (in many things, such as formica). But since the energy- conscious 1970's, many buildings have been built with considerable amounts of formaldehyde, which was used as insulation. Fortunately, there is, as previously mentioned, immunotherapy, which can come to the rescue. Here the antigen effectively neutralizes the irritant; treatment may be as long as two years with a life-long cure resulting or it may be necessary to use immunotherapy for life. There is much left to understand about allergies, and Dr. Layton believes in keeping an open mind. "I'm bitterly opposed to rigid thinking, be it on the part of mainstream, or alternative, medical practitioners." "Listening is the key, as is the use of clinical judgment and common sense," he notes.