Neurodevelopmental and Behavioral Pediatrics

Neurodevelopmental and Behavioral Pediatrics

Dietary Treatment of Young Children with Autism and Behavioral Effects on the Gluten Free and Casein Free Diet

As part of the University of Rochester STAART Center we completed a double blind placebo controlled challenged study of the gluten and casein free diet in preschool children with Autism who were in behavioral programs. Data was collected on physiologic symptoms (e.g., stool characteristics and nutritional status); behaviors not unique to Autism (e.g., sleep activity) and behaviors characteristic of Autism (e.g., social approach). Data on these symptoms were taken at entry to the study, after at least 4 weeks on diet, after completion of the challenges and at 30 weeks. Data was also taken before and after each challenged snack. After 4 weeks on a carefully monitored GFCF diet, the children received 3 trials of each of 4 challenge snacks containing gluten, casein, gluten and casein or placebo. Data on physiologic behaviors (stool, nutritional status), behaviors not limited to Autism (sleep, activity) and behaviors characteristic of Autism prior to introduction of the diet then before and after each challenge snack. No statistical differences were detected in length of sleep, night waking's, stool frequency, activity (observed by parent, teacher, or research staff or by actigraphy), or core symptoms of Autism as measured by an operationalized Ritvo Freeman Real Life Rating Scale.

This is the first study to examine the behavioral effects of a nutritionally monitored GFCF diet on behavior in young children with Autism. While no statistically significant effects were identified in group analysis, such effects might be possible in individuals or for subgroups of children not included in this carefully controlled study (e.g., children with GI disease). Future studies need to address the potential effects of nutrition on behavior in children with Autism and need to be large enough to evaluate subtle changes in core symptoms.

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