DEVELOPMENTAL DELAY AND THE ALLERGY CONNECTION

Parents are perplexed and concerned when their child has shown normal development during the early years of his or her life but suddenly stops progressing as expected or even regresses at 18-30 months of age. Children who experience cessation or regression of speech and developmental problems are often diagnosed as having Pervasive Developmental Disorder (PDD) or even Autism. Unfortunately, children who fall into this classification typically receive speech and occupational therapy because a majority of health care practitioners are not aware of other treatments. Thus, many parents are not aware of the causes of their child's problems and do not have much hope for future improvement. Some physicians regard the terms Autism and PPD as classifications rather than diagnoses--convenient terms for children with similar symptoms and behaviors but different underlying causes. In the developmentally-delayed child it is important to look beyond the symptoms to understand the causes of the problem. Interestingly, food allergies often are found to play a key role, and when dietary restrictions are added to other treatments including supplemental vitamins and minerals, dramatic improvement in a child's condition often results. Johnny seemed to be a normal child until age two and a half when his speech and behavior showed marked deterioration. His problems included decreased eye contact difficulty with loud sounds, no expressive speech, chronic bloody noses and recurrent ear infections. He became easily fatigued and displayed aggressive behavior. His medical diagnosis included allergies, fatigue, severe expressive speech delay and pervasive developmental disorder. He appropriately had been receiving speech and occupational therapy.

What Can Cause a Developmental Delay?
Often allergies are the link which connects behavior problems, developmental delays and recurrent infections. Allergies are most commonly thought of as adverse reactions to inhalants such as molds, pollens (trees, grass, weeds) and animal danders (cat, dog). Allergies are much broader in scope, however, and are caused not only by inhalants but by the food we eat and the chemicals present in our air, food and water. Allergies can produce readily identifiable symptoms like hayfever and asthma, but their effect can also be more subtle as well. Allergies can affect any part of the human body, but most importantly, the central nervous system. Children who exhibit the following problems may benefit greatly from allergy tests and treatment: frequent ear infections and developmental problems The focus of initial allergy tests could include tests for pollens, molds and any food ingested twice per week on a regular basis.

How Are Food Allergies Tested?
Under the controlled supervision of a family physician, a single food elimination diet is a simple approach which a parent can employ at home. Often a food which a child particularly craves is the one to which he is allergic. In a single food elimination diet, the craved food is eliminated from the child's diet for 10 days and then reintroduced. If symptoms arise, it is a good sign to parents that this food is causing the child's medical problems. A more comprehensive approach to allergy testing is a multiple elimination diet. In a multiple elimination diet, the following are eliminated from the child's diet for approximately 14 days: milk, chocolate, wheat, corn, eggs, craved foods, citrus, preservatives sugar, additives, peanuts. During the two weeks of the test, the child is prescribed a diet of fresh fruit, vegetables, chicken, turkey, fish and grains (oat, rice, barley and rye). Then eliminated foods are reintroduced into the diet, one day at a time, as a food challenge. If symptoms such as headaches, rashes or abdominal pain develop, that particular food is a likely culprit and should be eliminated or restricted from the child's diet. Johnny was tested for food allergies at age 3. Once the foods he was allergic to had been identified, food immunotherapy was added to his treatment. Two days after starting the food immunotherapy, the results were so dramatic that his teachers were astonished. Within two days, Johnny was reading, counting from 1 to 10, saying the alphabet and speaking in four to five word sentences rather than uttering just one or two words at a time. His difficulties with eye contact, fatigue, aggressive behavior and attention span all significantly improved once he began allergy treatment. While all success stories may not be as compelling as Johnny's, his illustrates the impact of identifying the underlying cause of a medical problem on a child's life. If a food allergy is discovered, changes in diet are relatively easy to implement and can make an enormous difference in the well-being of a child.

What Can Parents Do?
If your child suffers from developmental delays, contact a pediatric allergist or your family physician to investigate the possibility of food allergies. With all that is now known about the links between allergies, chronic infection, developmental disorders and undesirable behavior, parents are advised to consider food allergies as a cause of these interrelated problems. Physicians can derive great benefit by listening to parents talk about their children and interpreting the parent's comments medically. By supplementing medical expertise with clinical judgment and old-fashioned common sense, doctors can practice the art of medicine as well as the science of medicine and thereby provide children with the best of care. Richard E. Layton, M.D., practices specialized pediatrics, allergy, and preventive medicine and maintains a private practice in Towson. He has over 29 years experience in pediatrics and is president of the Maryland Association of Innovative Health Care Practitioners.