Case Study Part II

A young african american boy in a black shirt

Kofi’s mother returns for a follow-up visit. She is awaiting her consultation with the developmental-behavioral pediatrician.You ask her how things are going.

She gets teary-eyed. “I’m so frustrated with Kofi’s behaviors,” she cries. “He used to be such a nice child!”

Kofi’s mother then tells you that she has been reading up on complementary and alternative medicine (CAM) therapies on the Internet. She has also spoken with several parents whose children with ASD are on CAM therapies.

“I couldn’t just sit at home and do nothing while I wait for this appointment,” she explains. “Besides, many parents in the parent support group I go to have told me how well these therapies work.” Kofi’s mother is now planning to start Kofi on a CAM therapy, but was hesitant to tell you before because she didn’t think you would approve.

You ask Kofi’s mother what she is considering.

She mentions chelation therapy, antifungal medication to treat yeast overgrowth in his GI tract, and vitamin supplements. She says, “I was hoping you wouldn’t laugh at me, but I really would like your opinion – there is so much information on the Internet and it’s hard to know whom to trust.” She then looks away sheepishly. “Actually, I’ve been giving Kofi vitamin supplements I learned about on a website for the past month. I didn’t tell you before because I thought you would tell me to stop giving them to him.”

Kofi’s mother then pulls out a folder full of advertisements and articles printed from prominent parent advocacy websites and blogs. She would like your opinion on which treatments are safe for Kofi.


 

A young african american boy in an orange shirt

After discussing these issues with Kofi’s mother and assuring her you understand, you say, “Let’s talk about vitamin supplements first. Kofi has no chronic illness that might affect his ability to process vitamins, so I don’t think we would do any harm by giving him supplements in moderation. Let’s just make sure his kidneys and liver are healthy with a few lab tests. I will add these to my records of medications that Kofi is taking.”

You continue, “Although I feel that supplements will not harm Kofi, I don’t feel the same way about chelation therapy. As we already discussed, chelation therapy hasn’t been shown to be effective at helping with the symptoms of ASD in a way that I find convincing. Given the risks, high costs, and potential disruption for Kofi and your family’s quality of life, I strongly recommend against starting chelation therapy.”

“On the other hand, one over-the-counter therapy many people use to help children with trouble sleeping is melatonin. Melatonin is one of the most proven of all the CAM therapies used for children with ASD, with improvements in sleep duration and decrease in the amount of time it takes to fall asleep, with no proven risks. It might really improve everyone’s quality of life. Have you looked at it?”

His mother nods her head and tells you that she was meaning to ask you about melatonin. Kofi’s mother agrees to see the specialist before making any decisions on treatment. She agrees to keep you informed of any additional practitioners or treatments she decides to enlist. You thank her for that and ask her to call you once she has seen the developmental-behavioral pediatrician.

You remind her it’s a good idea to add only one new treatment at a time, so you can see if the treatment results in any change.


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