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Functional Medicine for Behavioral and Developmental Disorders

WHAT IS A FUNCTIONAL MEDICINE APPROACH TO BEHAVIORAL OR DEVELOPMENTAL DISORDERS?

Pamela J. Compart, M.D.

Functional medicine is an approach to the treatment of a disease or disorder which involves looking at the underlying causes or contributing factors to a condition, not just treating the symptoms. For children with autism spectrum disorders, ADHD, or other behavioral or developmental challenges, the approach we generally use is to first ask the following two questions:

1. Is this child’s body and brain getting what they need to function optimally?

2. Is something getting into this child’s body and brain which is interfering with their ability to function optimally?

A functional medicine approach to treatment involves giving the body and brain what they need and eliminating those things which may be interfering. This is a simple organizing framework from which very complex and elegant treatment options flow. The goal of treatment is to optimize function. This means that even if it is not possible to be sure what the name/label of a child’s condition is, this approach can still be helpful. Optimizing function does not require that the symptoms have a name.

Nutrients/factors which the body and brain may need to function optimally include:

  • Vitamins (e.g. vitamins A, C, D, E, B vitamins)
  • Minerals (e.g., zinc, magnesium, iron)
  • Essential fatty acids (particularly omega-3 fatty acids)

Optimal levels of nutrients are also needed for various chemical pathways and for optimal functioning of mitochondria, the energy-generating machinery in the cells.

Factors which may be interfering with optimal function include:

  • Food sensitivities or intolerances
  • Intestinal dysbiosis (imbalanced bacteria, yeast overgrowth)
  • Poor detoxification (of internally or externally derived toxins)
  • Oxidative stress
  • Inflammation (of gut, brain)
  • Poor mitochondrial function (poor energy generation)
  • Poor absorption of nutrients
  • Excessive histamine (from allergies or inflammation)

Children with autism spectrum disorders, as a group, have a host of nutritional deficiencies and biochemical disorders or dysfunctions. Children with ADHD or other behavioral/developmental challenges can have many similar issues, though generally not to the same breadth or depth as those seen in individuals with autism. The clinician’s goal is to determine, for each child, the specific deficiencies and imbalances present in order to individualize treatment.

A functional medicine evaluation involves:

  • A comprehensive, detailed history. This is the most important “test.” The history includes detailed information regarding birth history, medical history, diet and nutrition, medications and supplements, developmental milestones, behavioral issues, educational and therapy history, and family/social history.
  • A detailed physical examination. This includes traditional general and neurological examinations as well as a focus on physical findings which might indicate nutritional deficiencies.
  • Laboratory testing. This is guided by the history and physical examination. Tests may include blood, urine, stool or saliva testing to look for the deficiencies and dysfunctions described above.

Functional medicine treatments are then directed at correcting the underlying deficiencies and dysfunctions with the goal of restoring optimal body and brain functioning. The goals are both to support optimal health as well as to improve the problematic behavioral or developmental symptoms, in order to help the child reach his/her potential and have the best quality of life possible.

This approach allows us to individualize care and move from a more “generic” approach to treatment to one focused on the particular child’s needs. We have yet to see a “generic” child and we strive to create treatment approaches which are tailored to the individual child and family.