This interview between Donna Williams and Dr. Ed Danczak is a 'must read' for parents of children on the Spectrum, and who are interested in or wondering about heavy metals, biomedical treatments, invasive procedures and so on - all considered in the 'light' of 'treating' Autism.
I first met Dr Danczak when I was working as an autism consultant in the UK. When I saw kids who had physical symptoms I’d send them up to him and I was pleased to find most would end up in a healthier state and more switched on and together once their health issues were addressed. Here’s our interview DONNA WILLIAMS
Hi Ed. Tell us a bit about Dr Ed Danczak. How did you get into biomedical treatment of those with autism? DR ED DANCZAK
I had been using acupuncture and later a variety of complementary medicines with the encouragement of George Lewith and Julian Kenyon in Southampton, UK. I was asked to open a partner clinic in Manchester. I attended a lecture by Len McEwan who was using a novel immune technique called EPD to treat autistic children, and he claimed that their functional capacity could be substantially improved, and quoted cases where this had happened. I did some research, and found that there were a number of physicians with similar experiences, and decided to find out what was being done. There were a number of different approaches, no specific programme and very sketchy evidence of efficacy. Very soon afterwards, out of the blue, you called me up in 1996 and asked me to see a child with autism and I started to apply some basic therapies to evaluate their effects. DONNA WILLIAMS
When people use the term ‘biomed’ in the context of autism, it pretty much conjures up words like ‘chelation’, ‘mercury’ etc. What’s your take on that?
DR ED DANCZAK
In 1996, the chelation theories had not been proposed, and there was no controversy over vaccine. The treatments that we started to use involved fixing basic building block deficiencies such as Magnesium, Zinc and managing the gut and immune system function. All the ingredients that we chose were based on papers published in the mainstream, journals such as the Lancet, BMJ and new England Journal of Medicine. We relied on peer reviewed papers, and evidence that was repeatable by third parties when experiments or trials were quoted. Later on I was asked to submit evidence to the Scottish Parliament on mercury and autism together with the use of chelation, which at the time had no evidence to support either an association or a possible treatment route. Subsequent population studies using fine-tooth epidemiological research has shown no association between mercury containing vaccines and autism, and there is no toxicological reason why the sticky heavy metal atom of mercury should be easily removed by chelating agents.
As an occupational physician, when heavy metal exposure occurs the first rule is to consider very carefully whether chelation should be used at all. It can lead to toxicity from the very metal that you are trying to remove. For example in lead poisoning, use of chelation is associated with an outpouring of lead from sequestered (and safe) bone stores which increases the likelihood of toxic lead symptoms occurring. indeed the risks of chelation causing epileptic fits due to removal of “good” minerals such as zinc and magnesium is very real. Chelating not a treatment option for an office or unsupervised setting.
Mercury is present everywhere on planet earth, and the human body is actually quite tolerant to low levels of exposure. There is no evidence to support the assertion that autistic children as a group have any specific intolerance, although there is always anecdote.
In 1996, the chelation theories had not been proposed, and there was no controversy over vaccine. The treatments that we started to use involved fixing basic building block deficiencies such as Magnesium, Zinc and managing the gut and immune system function.
As an interesting side issue, lead poisoning causes cognitive impairment, and this is part of the differential diagnosis of developmental delay in children. The US has shown lead poisoning to be a significant feature, but this is reversible and responds well to removal from exposure. Chelating is unnecessary, as the body usually deals with lead quite well. Other heavy metals such as cadmium which used to appear in plastics and also from contaminated vegetables and earth, also causes a reversible cognitive impairment, but this too responds very well to removal from exposure. Indeed in he cadmium smelting industry proposals were made to use cognitive tests as a way of assessing cadmium effects as there is not a linear correlation between exposure and impairment of function. DONNA WILLIAMS
What are the range of improvements you’ve seen in people with autism who have used biomedical treatments?
DR ED DANCZAK
Autism is a behavioural description, and therefore comes in many aspects.All children were fully investigated in a non invasive way to establish deficiencies of co-factor minerals such as zinc, magnesium and manganese. In my book I have described children who had epilepsy, no control over their bowels and an absence of speech who, over the course of approximately 2 years gained control over their fits using supplements of zinc magnesium and manganese, together with bowel support, and anti-convulsant medication. The development of speech is always associated with a change in behaviour, and this improves as speech becomes more articulate. Other children have used similar regimens from a much higher functioning level gaining significant improvements in interaction and educational achievement. An relative deficiency of zinc alone may lead to low growth with children slipping into the lower percentiles of the growth chart. This was a concern with one parent whose child should have been tall, his parents were both over 6 feet high, but when given zinc, he rapidly started to grow and catch up to where he should have been on the predictive chart. The concurrent ADHD showed improvement as well.
DONNA WILLIAMS
Taking ‘autistic’ as an adjective, do you feel there are aspects of ‘autism’ which are about personality or neurological difference which are not related to gut, immune issues? DR ED DANCZAK
Autism is a behavioural description quoted in DSM IV and the ICD 10. Underlying illness should always be addressed. For example, in my book I describe autism responding favourably to the use of anti-convulsant therapy. Ear infections and persistent glue ear are higher than expected in children with ASD. There is good evidence to support the claim that clearing up glue ear improves hearing, and therefore communication, as speech is heard clearly. Some children presenting to the clinic had clear speech impairment with a strong nasal component and very flat in tone consistent with hearing through a thick tube of mucus in the inner ear. Once the ear condition had been addressed the child became responsive and the features of behaviour which pointed to an ASD diagnosis gradually began to resolve. The inability to deal with infection properly is an important feature in the genesis of symptoms picked up during early childhood. In the gut, problems seen in the clinic usually related to persistent diarrhoea, poor toilet training, associated with mineral deficiencies of zinc magnesium and often manganese. The use of replacement minerals, probiotics and gut support medication from complex homeopathic preparations is only a little different to that used in African children with the consequences of malnutrition. The persistent diarrhoea in ASD leads to a biochemical profile in the hair similar to malnutrition seen in the developing world. Managing basic building blocks is the essential tool and not overly complex therapies with a base only in hypothesis.
There is a clear genetic link between the occurrence of the broader autistic spectrum in families and the occurrence of specific autism in children. The genetic link is not straight forward. Genes affected seem to be involved in brain and gut development together with those related to allergy. The objective of many researches has been to identify and manage the genetic components to reduce degrees of autism, but so far this goal has proved elusive.
Personality is as much a feature of the environment in which the developing child is brought up and the evolution of the brain through the first 25 years of life or so. Much has been invested in comparison between the Burt model of identical twins separated at birth, brought in different environments particularly related to material wealth. The achievement of the child in the comfortable background was claimed to be different and possibly better than the child who was brought up in the deprived community. Certainly family disturbance is a common feature in ASD where ADHD has been diagnosed. It was established in Liverpool that children, form disturbed homes, who were offered a bed to sleep in the day and an area of the school where they could be insulated from disturbance was highly beneficial in behaviour and educational terms. When this was used the need for Ritalin and other similar drugs was dramatically reduced.
DONNA WILLIAMS
In the culture-cure debate biomed is seen as part of society’s fixation on demonising or eradicating autism. Do you feel the two can be reconciled?
DR ED DANCZAK
Autism is not a demon condition, nor is eradication a rational response to a behavioural disorder diagnosed by description only and with no signature biochemistry or genetic tests.
Many of the symptoms attributed to autistic behaviour can be produced from a range of social and clinical conditions. Some have no inter current illness, many children do.
The pharmacological effects of cytokines, the short proteins released in the immune system are very powerful. They have effects on sleep, and brain circulation. resolving a low grade immune system upset with night sweats, can lead to a significant improvement in the child’s cognitive function when these are addressed.
Many parents want their child to conform to the coffee morning expectation of normal development. This is entirely natural and in fact seems to have been the indicator that led some parents to seek advice on delayed development. However, children do not all develop at the same rate, even on the physical aspect of walking. Language acquisition can be slower with some children, and a premature diagnosis of autistic behaviour can be very difficult to establish. Demonising particular behaviour has always been part of society as the herd seeks to exclude those it believes are different in some way. The common example of bullying in the school playground occurs because the group does not like one aspect of a child’s personality or clothing.
Although my clinic was always about managing the physiological aspects to try to get the body to work as well as it could, support for the parents, steering them towards social support and expert parent programmes substantially reduced their anxiety, which reflected in the child’s response. Pre-school management of development and inter current illness is very important. Equally, the desire to start education early, as low as three years old, will probably lead to an industry of investigators trying hard to identify children whose development is part of the normal range but who may only be a little slower than their peer group.
DONNA WILLIAMS
You present yourself as working holistically. Could you explain this in the context of biomedical treatment.
DR ED DANCZAK
I have summed up the difference between holistic medicine and the conventional approach as that between reductionism, that is to say, treating the most specialised niche of illness such as the localised lung infection compared to dealing with the person as whole. This would involve attention to the individual and their needs, management of any infection, or poorly functioning area such as the gut, the use of physiotherapy, and avoiding the use of take this and go away type medication.
This view is an interaction between the physician and the patient. This is extended in the management of ASD to a doctor, parents and child relationship. The development of the child is critically dependent upon the parents, but will also require a team of others including Educational and child psychologists, teachers, therapists, medicines, and supplements to help make the child’s body work properly. From this list it is evident that the physician cannot be the sole purveyor of therapy.
DONNA WILLIAMS
As a holistic doctor supporting biomedical interventions for those with autism who have gut, immune issues, which other types of issues do you see as relevant to the adjustment and development of a person with autism?
DR ED DANCZAK
Understanding is probably the most important issue. Parents attending the clinic wanted someone to advise them on a range of topics from support through to medication and supplementation. Many had no-one to talk to and had ideas that were based on erroneous conclusions in the grey literature, or the daily printed media and had been convinced about specific treatments which were not necessary or were only realistically useful in the otherwise stable and well child.
The complexity of issues raised in recent years from the vaccine campaigners alone has kept large numbers of people occupied in contested debate. The outflow from this has caused substantial worry and confusion amongst parents who have been alarmed and frightened by a behavioural diagnosis which has become demonised in the media. The most important thing that a physician can do is sit and listen, and address concerns. A busy hospital or GP department with a short appointment time is no way to deal with this. As the the physician is often the lead member of the team what seems like a ten minute interview is never enough
DONNA WILLIAMS
Tell us about your online E-book.
DR ED DANCZAK
The book is a collection of informative essays intended to be taken a small amount at a time. The chapters go through the use of complementary medicine and shows evidence for the use of my approach in the management of children.
Chapter Six is the distillation of the interaction between different body systems that can have an effect on the developing child and commentary related to this. The Chapter can be seen on www.autismmanagement.net which apart from a flow diagram has indicators to where to go in the book to read it up. There are case studies where we have varying degrees of responses from different therapeutic directions. The essential is that there is a marriage between complementary and conventional medicine, with each having something to offer, and improved outcomes when done together.
DONNA WILLIAMS
You’ve retired from practice now. What’s that like? How does a doctor hang up the white coat?
DR ED DANCZAK
When my dad was 83, I asked him what it was like to retire. He looked at me and said he thought he might consider it soon! He was still very active in the community and whenever someone asked him for help, he didn’t turn them down. I am similar. Although I don’t have the white coat on anymore, some of my old patients keep in touch if they have difficulties and when any parent shouts help, I will try to if I can.
Treating people in the clinic required intense concentration, and for every day in the hospital I needed a day to organise paper, treatments and medication. It was never confined to the 30-60 minutes of clinic time. I do miss the patient contact and the evolution of a child’s behaviour as interaction develops between parents and an awakening child doing toilet training, communication acquisition both verbal and non verbal.
