Developmental Disorders: Early Identification is the Key

Developmental Disorders are becoming more common. Medical Scientist and Naturopath Annalies Corse has some sound advice.

“Sometimes, real superheroes live in the hearts of small children fighting big battles”- Autism Spectrum Disorder, Through My Eyes.

A specific subset of neurological conditions is known as developmental disorders. These are increasingly prevalent, yet inadequately understood behavioural, psychological and psychiatric disorders that present in childhood.

Due to the very early age of onset and the increasing links between developmental disorders with maternal transfer, genetics, nutrition and lifestyle choices, the MinddFoundation regards many of these disorders as preventable and manageable through the practice of integrative health and the functional medicine approach.

Developmental Disorders May Lead to Longlasting Problems

Developmental disorders lead to impairment and challenges in learning, language, behaviour and physical health. A phenomenal amount of learning and skill acquisition occurs during infancy and early childhood; it is often a time when parents are rather vigilant with the development of their children.

First smiles, visual fixing and following, crawling, walking, pincer-grasping, pointing, waving, responding to affection and self-feeding are some of the hundreds of milestones families enjoy observing in their babies and children. It is a massive concern for many parents when the simple joys of childhood may not be progressing as expected.

Don’t Wait and See, Get The Right Help Straight Away

Parents know their child best. Always share your concerns with your child’s health care provider. In these situations, it is best not to ‘wait and see’. A Paediatrician can carry out full neurological/developmental assessments. Developmental paediatricians and Integrative paediatricians specialise in these areas. Integrative/Functional Medicine GP’s and some Naturopaths/Nutritionists may have a special interest and work with these children. Many allied health professionals, such as physiotherapists, speech therapists, behavioural therapists and child psychologists, offer valuable support to these children and their families.

What is a Developmental Disorder?

The following list comprises some of the well-known developmental conditions of childhood. Many persist into adulthood, though this should not be a reason to avoid seeking help. Depending on the unique individual situation, children recover some, many or all of their functions. Some conditions are genetic, with specific DNA mutations established through medical research. Other conditions have vague causes which might be a combination of genetics and environment:

• Attention-Deficit Disorder (ADD) and Attention-Deficit Hyperactivity Disorder (ADHD)
• Autism Spectrum Disorder
• Auditory Processing Disorders
• Dyscalculia
• Dysgraphia
• Dyslexia
• Dyspraxia/Apraxia
• Gross Motor Skill Delays
• Expressive Language Disorder
• Visual Processing Disorders
• Learning Disabilities
• Sensory Processing Disorders (Other)
• Other conditions described as being developmental in nature but with known and specific genetic abnormalities include Angelman Syndrome (chromosome 15 single gene defect), Down Syndrome (trisomy of chromosome 21), Fragile X Syndrome (X chromosome single gene defect), Prader-Willi Syndrome (paternal chromosome 15 deletion, or double inheritance of maternal chromosome 15), William’s Syndrome (chromosome 7 gene deletions)

What Causes Developmental Disorders?

While existing research behind the cause of developmental disorders remains scant, Integrative and Functional Medicine has identified three critical areas of concern:

1. Toxicological Health:
   Exposure to toxins in utero or neonatal life is increasingly linked to developmental delay. Pregnant women should avoid exposure to toxic heavy metals (including lead, mercury, arsenic) in the same way they are advised to avoid smoking and consuming alcohol. Many toxic chemicals are released into the environment and bios accumulate in the food chain. Pesticides are just one example together with weedkillers like Roundup (i.e. Glyphosate). Developing brains of young babies and children are particularly sensitive. Additionally, children being far smaller than adults in surface area means that a toxic dose that may be less significant in adults can be disastrous in children.
2. Quality of Diet:
   Mothers need to eat well during pregnancy, ensuring ample intake of micronutrients and antioxidants. The diet of the affected child is critical to support their natural endogenous detoxification pathways, reduce inflammation, support gut health (particularly concerning gut-brain health), and nourish and support healthy nerve impulse transmission. Chemical-free diets can work wonders for these children.
3. Prenatal and Neonatal Life:
   Prematurity and infections (including Rubella, Zika virus, Herpes Simplex virus, Varicella virus, Cytomegalovirus and Group B Streptococcus bacteria) during the in utero period or early neonatal life are well-established causes of developmental disorders. However, the apparently more subtle problems of nutritional deficiencies actually have a powerful effect on both maternal genes and the health of the embryo and growing foetus. Zinc, copper, selenium, iron, vitamins B9, B12, A and D are all critical to DNA transcription, translation and gene expression. The importance of maternal AND paternal prenatal nutrition, for at least 6 months before conception cannot be stressed enough. This is the time for doing all you can to safeguard the genome of your offspring.

Testing for Developmental Disorders

Diagnosis of a developmental disorder can be challenging. Screening tests observe if children are learning/have mastered essential milestones at the expected age. Talking and playing with children is a significant part of screening tests. Tests are always age-appropriate. There are no specific blood or pathology tests to determine causes of developmental delay, apart from testing for specific genetic syndromes. However, should you consult with an integrative practitioner, they will often use functional pathology testing. These are non-specific and non-diagnostic of developmental disorders, but they do provide valuable information regarding micronutrient deficiencies, gut health, possible toxin exposure/accumulation. All are increasingly linked to learning delay and neurodevelopmental disorders.

If concerns are apparent after screening, then children will undergo a full developmental evaluation. This is often performed by developmental paediatricians, developmental psychologists or a paediatric neurologist.

Getting Support for the Whole Family

Supporting children with neurodevelopmental delays or disorders can be extremely challenging, often affecting the balance and well being of not only parents but also entire families. In many ways, each family member will require extra nutritional and lifestyle support. This ensures other health issues can be easily managed, preventing them from being added to the family’s health burden. The Functional Medicine approach is ideal for all families experiencing the challenges of developmental disorders.

“Parents who have children with special needs- also have special needs. They need to know more than the average parent. They need to do more than the average parent. They need more patience than the average parent… and so much more”. – S.Zajicek, Parents Supporting Parents.

The MINDD Foundation offers information and support to help achieve optimal outcomes for an individual dealing with a developmental condition.  It begins with a strong team of Integrative practitioners who can guide the patient on an individualised path best suited to their unique combination of genetic and environmental factors.  Whether you are a parent, practitioner or carer, you are not alone in your quest for information and support.

Written by Annalies Corse BMedSc, BHSc

References

1. Centres for Disease Control (CDC) (2016). Act Early Checklist. Available at: http://www.cdc.gov/ncbddd/actearly/pdf/checklists/all_checklists.pdf
2. Centres for Disease Control (CDC) (2016). Developmental Milestones: Learn the Signs. Act Early. Available at: http://www.cdc.gov/ncbddd/actearly/milestones/index.html
3. Grandjean, P. and Landrigan, P. (2006). Developmental neurotoxicity of industrial chemicals: A Review. The Lancet. 368, (9553): 2167-2178.
4. Kerstjens, J. M., Bocca-Tjeertes, I. F., de Winter, A. F., Reijneveld, S. A., & Bos, A. F. (2012). Neonatal morbidities and developmental delay in moderately preterm-born children. Pediatrics, 130(2), e265-e272.
5. Shevell, M. I., Ashwal, S., Donley, D., Flint, J., Gingold, M., Hirtz, D., … & Sheth, R. D. (2003). Practice parameter: Evaluation of the child with global developmental delay Report of the Quality Standards Subcommittee of the American Academy of Neurology and The Practice Committee of the Child Neurology Society. Neurology, 60(3), 367-380.