Are you ready? …School Tips
It should come as no surprise that success — or failure — at school starts at home. Studies have linked poor academic performance to factors such as a lack of sleep, poor nutrition, obesity, and a lack of parental support.

Making the First Day Easier

Remind your child that she is not the only student who is a bit uneasy about the first day of school. Teachers know that students are anxious and will make an extra effort to make sure everyone feels as comfortable as possible. Point out the positive aspects of starting school: It will be fun. She’ll see old friends and meet new ones. Refresh her positive memories about previous years, when she may have returned home after the first day with high spirits because she had a good time. Find another child in the neighborhood with whom your youngster can walk to school or ride with on the bus. If you feel it is appropriate, drive your child (or walk with her) to school and pick her up on the first day.

Eating During the School Day
Most schools regularly send schedules of cafeteria menus home. With this advance information, you can plan on packing lunch on the days when the main course is one your child prefers not to eat. Try to get your child’s school to stock healthy choices such as fresh fruit, low-fat dairy products, water and 100 percent fruit juice in the vending machines. Each 12-ounce soft drink contains approximately 10 teaspoons of sugar and 150 calories. Drinking just one can of soda a day increases a child’s risk of obesity by 60%. Restrict your child’s soft drink consumption.

Before and After School Child Care
During middle childhood, youngsters need supervision. A responsible adult should be available to get them ready and off to school in the morning and watch over them after school until you return home from work. Children approaching adolescence (11- and 12-year-olds) should not come home to an empty house in the afternoon unless they show unusual maturity for their age.
If alternate adult supervision is not available, parents should make special efforts to supervise their children from a distance. Children should have a set time when they are expected to arrive at home and should check in with a neighbor or with a parent by telephone. If you choose a commercial after-school program, inquire about the training of the staff. There should be a high
staff-to-child ratio, and the rooms and the playground should be safe.

Developing Good Study and Homework Habits
Create an environment that is conducive to doing homework. Youngsters need a permanent workspace in their bedroom or another part of the home that offers privacy.
Students should set aside ample time for homework. Establish a household rule that the TV set stays off during homework time. Supervise computer and Internet use. Be available to answer questions and offer assistance, but never do a child’s homework for her. Take steps to help alleviate eye fatigue, neck fatigue and brain fatigue while studying. It may be helpful to close the books for a few minutes, stretch, and take a break periodically when it will not be too disruptive.
If your child is struggling with a particular subject, and you aren’t able to help her yourself, a tutor can be a good solution. Talk it over with your child’s teacher first.
So in summary…
1) Enforce Healthy Habits of eating, sleeping, snacking and playing (computer games.)
2) Stick to a Routine
3) Create a “Launch Pad”- have a single place to put backpacks, jackets, etc.
4) Designate a study space
5) Read, Again and Again
6) Learn Always – There’s only so much teachers can do. Parents have to fill in with good support at home. Look for ways to teach your child throughout the day. For example, cooking combines elements of math and science. Use the time when you make dinner as an opportunity to read and follow directions, to discuss fractions, to make hypotheses (“What will happen when
I beat the egg whites?”), and to examine results.
7) Take the Lead -Children learn by example. Let your kids “catch” you reading. Take time to learn a new skill and discuss the experience with them. Sit down and pay bills or do other “homework” while your kids do their schoolwork. If you display a strong work ethic and continually seek out learning opportunities for yourself, your kids will begin to model that same behavior in their own lives.
Talk Often – Do you know how your child feels about her classroom, her teacher, and her classmates? If not, ask her. Talk with her about what she likes and doesn’t like at school. Give her a chance to express her anxieties, excitements, or disappointments about each day, and continue to support and encourage her by praising her achievements and efforts.
9) Show Interest – Don’t limit your support to your child; extend it to her teachers as well. Meet the teachers and stay in regular contact by phone or e-mail so that you can discuss any concerns as they arise. Not only will it pave the way for you to ask questions, but it will also make the teachers more comfortable with calling you if they have concerns about your child.
10) Expect Success – Perhaps the most important way you can support your child’s efforts at school is to expect him to succeed. That doesn’t mean that you demand he be the best student or the best athlete or the best artist. Rather, let him know that you expect him to do “his best” so that he’ll be proud of what he can accomplish. If you make that expectation clear and provide a home environment that promotes learning, then your child will have a greater chance of becoming the best student he can be.

Asthma Management at School
Children spend a significant part of their day at school. That is why it is so important that asthma symptoms are well managed while they are there. It is also important that you are aware of your child’s symptoms and any problems with how your child’s asthma is managed in school.

Effective Communication
Good communication is essential to asthma care and management in school. The school needs to know about your child’s asthma, how severe it is, what medications your child takes, and what to do in an emergency. This communication can be helped by having your health care provider complete an asthma action plan for the school, as well as a medication permission form that includes whether your child should be allowed to carry and use her own inhaler. You should also sign a release at school and at your health care provider’s office to allow the exchange of medical information between you, the school, and your health care provider.
Your child’s school needs to communicate to you its policies on how your child will get access to her medications and how they deal with emergencies, field trips, and after-school activities.
The school should also inform you about any changes or problems with your child’s symptoms while she is at school.

Peak Flow Meter
Peak flow meters can be helpful for school staff in determining the severity of an asthma attack.
If your child’s health care provider has recommended a peak flow meter, determine your child’s best peak flow (your health care provider should tell you how to do this). Then keep a peak flow meter at school. ***Also important to make sure your child sees his or her health care provider every 3 months to check his/her asthma. At these visits they can assess your child’s pulmonary lung functions with a PFT machine or a peak flow meter to make sure their medications are working properly.

Coping With Asthma at School
Students with asthma face a number of problems related to school. Talk to your child about how well his asthma is being managed in school. Also talk to your child’s teachers, school nurse, coaches, and other school personnel to get their opinions on how well your child is coping with asthma in school and to see if asthma symptoms are causing any of the following problems:
-Missing school due to asthma symptoms or doctor visits.
-Avoiding school or school activities. Work with your health care provider and school personnel to encourage your child to participate in school activities.
-Not taking medication before exercise. Your child may avoid going to the school office or nurse’s office to use his inhaler before exercise. Schools that allow children to carry their inhalers with them can help avoid this problem.
-Side effects from medication. Some asthma medications may alter your child’s ability to perform in school. Teachers need to know if and when your child takes asthma medication so that you can be notified if there are any problems.
-Physical activity is important for your child’s physical and mental health. Children with asthma should be able, and encouraged, to participate completely in physical education, sports, and other activities in school. All students should have some knowledge of asthma basics and management. Encourage your school to offer asthma awareness education as part of the health education curriculum.

Know Your Rights
Learn about the federal laws that can help you with asthma management concerns at school.
These include the following:
Section 504 of the Civil Rights Act of 1973
Americans with Disabilities Act (ADA)
Individuals with Disabilities Education Act (IDEA)

He has a slow-to-warm temperament with atypical social interactions. There is expressive language delay but he seems to understand everything. He is an attractive little boy who seems bright to his primary care physician. His mother brings him to her physician and wonders if he is normal because he struggles and attains skills later than normal. The primary care physician (PCP) refers him to the infants and toddlers community program for speech and language evaluation. He qualifies for speech services. The speech and language pathologist (SLP) refers him to occupational therapy (OT) because he is clumsy and has sensory dysfunction. The OT recognizes developmental dyspraxia, balance issues and graphomotor dysfunction and treats him accordingly. She wonders about the etiology of all these subtle but important differences as well.

At five years of age, he is struggling in kindergarten and his mother returns to the PCP. The PCP considers a psychological evaluation but decides to give the youngster another year since “he is a boy”. Tommy struggles in first grade but by the second grade, he seems to have settled down. However, by the end of third grade, he has behavioral problems, is failing in school, and is acting out at home. Tommy is sent to a pediatric neurologist to determine if medication should be considered for his attention problems.

What does he have?

Did you know more than 500,000 people in the United States are believed to have a Sex Chromosome Anomaly? Research reveals that every day 20 children will be born with XXY, XXX or XYY chromosomal disorders and only 5 of those 20 will be diagnosed in their lifetime and receive appropriate treatment. Ten to twenty percent of these disorders are identified from amniocentesis completed because of advanced maternal age. Although these disorders are associated with language-based learning disabilities, children remain largely undiagnosed because their neurodevelopmental problems are often perceived as “just a speech or motor delay” or, as children become older, “merely a learning disability.” Goal is to…

• Identify children with neurodevelopmental disorders as early as possible.
• Prevent language-based learning disorders
• Provide children with appropriate, targeted treatment and intervention
• Promote recovery and normalization as well as address the neurodevelopmental issues involved through syndrome-specific goals.

As a neurogenetic disorder, X & Y Variations are known by many names, among them: Sex Chromosome Disorders, X & Y Chromosomal Variations, Sex Chromosome Anomaly and Sex Chromosome Aneuploidy Variations.

Within the disorder are many sub-categories, which are identified by names including Klinefelter’s Syndrome, 49 XXXXY, Tetrasomy X,49 XXXXXX, Pentasomy X, 48 XXY and 47 XXY.

X & Y Variations are common but frequently undiagnosed genetic conditions that differ from the normal sex chromosome pairings of XX for females and XY for males. Due to a chromosomal mistake that produces additional X or Y chromosome to the normal complement of 46, the resulting total of 47 chromosomes (or more) may impact a child’s developing central nervous system and his or her body condition.

• XXY occurs in 1 out of 650 live births
• XXX occurs in 1 out of 900 live births
• XYY occurs in 1 out of 1,000 live births

Information on these disorders is often outdated and incorrect. New research has been done on populations with these disorders and there is now more information than ever. Widespread misinformation about these conditions cause unnecessary distress to families dealing with such a diagnosis:

• Contrary to common belief, people with X & Y Variations are often bright and exceptionally talented in perceptual tasks (such as design and computers).
• They can play a variety of sports.
• They typically do not have Autistic Spectrum Disorder.
• They generally are not hermaphrodites, asexual or sexually confused, and they do not have an increased incidence of homosexual or transgender behavior based on current published scientific literature.
• They are not always infertile (although they can have low fertility).
• They are not characteristically prone to violence or criminal activity.
• And they do not have an increased incidence of mental retardation, provided that their chromosomal variant is identified early and they are given appropriate targeted treatment and syndrome specific goals.

Unfortunately, because most ‘ practitioners often receive insufficient information about sex chromosome disorders, they don’t even consider testing for X & Y Variations when caring for a child who presents with developmental concerns.

I want health care providers, educators and parents to know:

• 1 in 500 children have X & Y Variations that cause complex learning disabilities.
• 20 babies born each day have an X & Y Chromosomal Variation, and only 5 will be diagnosed in their lifetime.
• Developmental Dyspraxia is often mistaken as being “only a minor speech delay” when, in fact, multiple developmental domains are affected and require targeted treatment.
• Symptoms of Dyslexia often present in preschool years and early identification and treatment is highly effective.
• 10 percent of children with X & Y Variations are identified prior to birth and they usually develop Dyspraxia and Dyslexia. The knowledge gained from caring for these infants and toddlers benefits all children who have reading, speech and motor planning dysfunction.
• With the proper diagnosis and intervention, children who have these neurogenetic disorders can be transformed from vulnerable to powerful, from school failure to academic success, from disabled to able!

If you have a child who has recently been diagnosed with an X and Y Chromosomal Variation and you need more information contact The Focus Foundation.

This schedule indicates the recommended ages for routine administration
of currently licensed vaccines, as of December 1, 2008, for children aged
0 through 6 years. Any dose not administered at the recommended age
should be administered at a subsequent visit, when indicated and feasible.
Licensed combination vaccines may be used whenever any component
of the combination is indicated and other components are not contraindicated
and if approved by the Food and Drug Administration for that dose of the series.

Providers should consult the relevant Advisory Committee on Immunization practices statement for detailed recommendations, including high-risk conditions: http://www.cdc.gov/vaccines/pubs/acip-list.htm. Clinically significant adverse events that follow immunization should be reported to the Vaccine Adverse Event Reporting System (VAERS). Guidance about how to obtain and complete a VAERS form is available at http://www.vaers.hhs.gov or by telephone, 800-822-7967.

2. If you are worried, call Dr. O first. Don’t take your child in to the ER without calling. Two reasons: Your child may not have H1N1 but could become exposed by being around sick children. And after several hours of waiting, you are still likely to be told the basics-plenty of fluids, rest and dose-appropriate acetaminophen for a fever. After all, it is still the flu we are talking about.

3. Remove the term H1N1 from the equation. If your child had the regular flu, would you take him/her to the hospital? If the answer is no, then don’t take him/her to the hospital now.

4. Yes, hearing between 30,000 and 90,000 people could die from H1N1 is scary, but keep in mind-around 40,000 people die from the regular or seasonal flu every year. The numbers may not be that much different, yet there is not panic about the regular flu. As things look now, H1N1 is causing only mild to moderate illness, not the widespread deaths people are worried about.

5. There are some children who should be seen by their pediatrician right away. Call Dr. O if:

A baby younger than 12 weeks has a fever greater than 100.4 degrees Fahrenheit
A child older than 12 weeks has a fever for three days or any fever over 103 degrees Fahrenheit or higher
A child’s fever returns after a 12-24 hour time period

A child is not passing urine or making tears for more than six hours
A child does not smile or show interest in playing for several hours

As the school year shifts into high gear, many children are out sick with the FLU! According to the CDC records, Georgia is one of the hardest hit states. Jacksonville also has had its fair share with the Influenza H1N1 strain “The Swine Flu”. But don’t panic! Stay calm and just follow the universal precautions of infection control, such as frequent hand washing, not touching your mouth, eyes or nose, and avoiding crowded public places with infants under age 3 months. Of course do not forget your fruits and vegetables, which will provide your daily boost of vitamin C and a well balanced diet.

Initial symptoms of swine influenza (Swine Flu) include high fever, body aches, runny nose, and sore throat. Nausea, diarrhea, and vomiting have also been reported. Infection control precautions (i.e., hand washing, covering mouth with tissue when sneezing or coughing) are encouraged. If your child is diagnosed with Swine Flu, isolation is recommended for infected individuals and household contacts.

The US Centers for Disease Control and Prevention guidelines indicate that flu patients should stay at home for only 1 day after their fever resolves. People with H1N1 can probably be contagious for at least a week, according to Dr. De Serres from CDC. Although people are tempted to diminish the time a sick patient stays at home, that’s probably not wise. To find out more about flu symptoms and prevention, see updated information from the CDC.

The new virus is resistant to the antiviral agents amantadine and rimantadine but sensitive to oseltamivir (Tamiflu) and zanamivir (Relenza). It’s imperative to get your child to a doctor immediately when symptoms occur, and to start treatment within 48 hours of symptom onset to ensure the most efficiency in treatment against influenza virus. The usual vaccine for influenza administered at the beginning of the influenza season is not effective for this viral strain. But on September 15, 2009, The US Food and Drug Administration (FDA) announced that it has approved 4 vaccines against the 2009 influenza A (H1N1) virus, or Swine Flu. The vaccine lots are expected to be available and distributed within the next 4 weeks.

The FDA said that the vaccines, based on early data, effectively elicit an immune response in most healthy adults about 8 to10 days after vaccination. Clinical studies are still underway to produce an optimal dose for children, with results expected in the near future. As with the seasonal influenza vaccine, some lots of the H1N1 vaccine will contain the preservative thimerosal and others will not. The FDA has been continuing its efforts toward reducing thimerosal used in vaccines.

The FDA is working with different organizations regarding adverse event monitoring, information sharing, and an overall analysis during and after the 2009 H1N1 vaccination program, according to the news release. “As with any medical product, unexpected or rare serious adverse events may occur,” the FDA notes.

When considering all of this, the most important thing to remember is that vaccines save lives and prevent complications from illnesses. The Flu vaccine will help protect individuals from serious illness and prevent death from influenza.

I strongly urge people to receive their seasonal influenza virus vaccine as soon as possible. Individuals with diabetes, asthma, congenital heart disease and patients with chronic illnesses should consult their physician for the Swine Flu vaccine.

Call our offices at (904) 273-6533 or (904) 743-2100 for preservative-free (no thimerosal) flu vaccines for your children.

Autism spectrum disorders are not rare; many primary care pediatricians care for several children with autism spectrum disorders. Pediatricians play an important role in early recognition of autism spectrum disorders, because they usually are the first point of contact for parents. Parents are now much more aware of the early signs of autism spectrum disorders because of frequent coverage in the media; if their child demonstrates any of the published signs. Parents please raise your concerns to your child’s pediatrician. It is important that pediatricians be able to recognize the signs and symptoms of autism spectrum disorders and have a strategy for assessing them systematically. Pediatricians also must be aware of local resources that can assist in making a definitive diagnosis of, and in managing, autism spectrum disorders. The pediatrician must be familiar with developmental, educational, and community resources as well as medical subspecialty clinics.

• The “Autism A.L.A.R.M.“12: a flyer that highlights the prevalence of autism, the importance of screening and listening to parents’ concerns, and the urgency of making simultaneous referrals to specialists in ASDs and early intervention programs to promote improved outcomes.
• “Is Your One-Year-Old Communicating With You?”13: a brochure that focuses on early identification of social communication deficits and behavior problems that may be associated with developmental disorders, primarily ASDs. This brochure is intended for distribution to all parents of infants at the 9- or 12-month well-child visit. It encourages parents to share any concerns they have about their infant’s language development and social skills with the pediatrician as early as possible.
• “Understanding Autism Spectrum Disorders”14: a 48-page introductory booklet for parents of children in whom an ASD has been diagnosed recently or is suspected strongly.
• Firstsign.org: resource web site for concerned parents.

I will highlight today the pre-speech deficits often exist that, if detected, could facilitate earlier diagnosis.
* These deficits include:

• lack of appropriate gaze;
• lack of warm, joyful expressions with gaze;
• lack of the alternating to-and-fro pattern of vocalizations between infant and parent that usually occurs at approximately 6 months of age (i.e., infants with ASDs usually continue vocalizing without regard for the parent’s speech);
• lack of recognition of mother’s (or father’s or consistent caregiver’s) voice;
• disregard for vocalizations (i.e., lack of response to name), yet keen awareness for environmental sounds;
• delayed onset of babbling past 9 months of age;
• decreased or absent use of pre-speech gestures (waving, pointing, showing);
• lack of expressions such as “oh oh” or “huh”;
• lack of interest or response of any kind to neutral statements (e.g., “Oh no, it’s raining again!”)

Please do not hesitate to call me at (904) 273-6533 or (904) 743-2100 if you have any questions. We love your children to grow healthy!

Dr. O

I have been reading the latest information on the seasonal flu and the swine or H1N1 flu every day. This has been the first stressful flu season for me in my 16 years of being in practice. It has been quite confusing to health care providers because of what has been reported in the media in terms of when and how much of the H1N1 vaccine will be distributed by the government and who will get it first. I can only imagine what the general public is thinking about all this.

I have also been following various clinical trials closely on the H1N1 vaccine’s final outcome. I stopped worrying about the H1N1 flu vaccine after I read an article published in The New York Times on October 11, 2009 by my former professor Dr. Paul Offit, the chief of the infectious diseases division of the Children’s Hospital of Philadelphia.

He explained that in one clinical trial the H1N1 vaccine has already been given to thousands of volunteers to determine whether it could protect them from the H1N1 virus and not cause adverse reactions. Following the success of this clinical trial, the Food and Drug Administration licensed the H1N1 vaccine to make it available to the general public. Dr. Offit commented on the vaccine in his article titled “Nothing to Fear but the Flu Itself.” Anyone who would like to read the full article can click here.

The reported number of children below the age of 18 who have died from the H1N1 flu since April 2009 has reached nearly 80. This number is close to the number of children who die each year from seasonal influenza, according to the U.S. Centers for Disease Control and Prevention (CDC). But the CDC also warned that the H1N1 flu in 2009 has yet to run its course!

Many health care experts say the H1N1 flu does not appear to be more dangerous than other flu strains, but they do warn that children have been catching it more easily than the seasonal flu. The majority of children who have died from the H1N1 flu have had underlying diseases that put them at risk for influenza-related complications. However, between 20% and 30% of these children were healthy.

Anticipating possible shortages of the H1N1 vaccine in the beginning stages of its release, the CDC has recommended that clinicians first immunize patients on a priority basis. The CDC recommends that the vaccine be given to patients in the following order of priority:

• Pregnant women
• People who live with or care for children younger than 6 months of age
• Health care and emergency services personnel
• Persons between the ages of 6 months and 24 years of age
• People from ages 25 through 64 years who are at higher risk for complications from an H1N1 infection

In the event that there may not be enough of the H1N1 vaccine at first, the CDC recommends that these groups receive the vaccination first:

• Pregnant women
• People who live with or care for children younger than 6 months of age
• Health care and emergency services personnel who have direct contact with patients or with infectious substances
• Children 6 months through 4 years of age
• Children ages 5 -18 who are at greater risk for complications of influenza

Anyone who receives the H1N1 vaccine should also still receive the seasonal flu vaccine that is available every year. You may receive both vaccines at the same time. There are no known problems associated with receiving vaccines for both the H1N1 flu and seasonal flu on the same day; however, health officials recommend a three-week waiting period between receiving the nasal versions of the vaccines.

Most health care providers expect to receive the H1N1 flu vaccine by mid-November, if not sooner. Check with your doctor or nurse, local pharmacist, or local health department to see when the vaccine will be available.

As verbal individuals with autism are frequently misdiagnosed, I’d like to take this opportunity to alert you to their display of symptoms. Your child may have received a diagnosis of:

• ADD or ADHD
• Intellectual Disability, Mental Retardation or Learning Disability
• Adjustment Disorder
• Conduct Disorder
• Oppositional Defiant Disorder
• Obsessive Compulsive Disorder
• Bipolar Disorder, Affective Disorder
• Schizophrenia
• Auditory or Sensory Processing Disorder, Dyspraxia

In the early years:

• Development of language and communication is atypical
• Delayed speech or repetitive use of phrases
• Shrink from social contact with peers
• May not have pretend play with toys or imaginative play

By school age:

• Usually talking well and can enter school
• May have stopped avoiding social contact and is at least tolerant of it
• May be socially awkward and socially immature

Over the next few years:

• “Eccentricities” dominate his social interactions
• A “little professor” on topics of special interest to him
• When not talking about his interests, his social interactions are immature or stilted
• The child may interact with peers, although others may perceive him as different

As time passes and social demands increase:

• May become anxious in social situations
• Peers may reject him and he may become depressed
• In school, he may be placed in learning support classes because of social, behavioral or language comprehension problems
• He may be considered to have an attention problem or obsessive compulsive behaviors

My great interest with Asperger’s started after I developed the ability to diagnose children affected by the syndrome from their unique handshake – limp, like a “dead fish”. This unique handshake has proven to be a key factor in the understanding of their social anxiety, difficulty with body language, gestures, etc. that children with various forms of Autism display. The mother of a boy I diagnosed in this way, who we shall call “JC” tells his story:

“Ours is a remarkable example of diagnosing Asperger’s Syndrome and what one doctor is able to detect just by a handshake. JC has always been a very loving child. Though he behaved well in class, all of his teachers agreed that he just did not understand the work. Unfortunately, he was labeled with mild mental retardation with an IQ of 78 over six years ago. Luckily, this proved to not be the case. He was diagnosed with Asperger Syndrome and subsequently retested for a proper school placement. He was also eligible for McKay Scholarship for full tuition coverage since the public school system could not meet his needs at the time. He was then placed in a small private school special learning track program. His self-esteem was totally rebuilt and finally JC started experiencing SUCCESS! He has learned how to play the guitar and is currently teaching himself the piano. He has written several songs and he is an avid reader. His academic strengths are definitely in English with a few struggles in Math. He has been on the medicine Luvox and Zoloft and has been able to focus and continue to keep the GPA at 3.86!”

JC’s experience is a success story about a 15 year-old boy who received the necessary intervention in order to jump start what was already there. What the researchers are now calling neuronal synapses problems could be the cause of the Autistic Spectrum Disorders. I call this kind of intervention a NEURONAL JUMP START. Asperger Syndrome children often need social skills training, early school intervention and sometimes medications. For more information on the syndrome please link to the web site www.autismgateway.com.

A letter I recently received from the mother of a patient got me thinking about vaccines and the debate over whether certain vaccines somehow play a role in causing autism. The vaccine-autism controversy offers many examples of how our current culture sometimes distorts the scientific approach to medicine in favor of untested holistic approaches. Many researchers, most notably from the University of Pittsburgh, have published an extensive number of articles emphasizing that autism may be traced to genetics not to vaccines. The findings may be found on the University’s web page, http://www.pittautismresearch.org/

Here is an excerpt of the letter I have received from my patient’s mother:

“Dear Dr. Ozdemir,

I want to apologize for letting my emotions get the best of me last week when we were discussing vaccines. You are the professional and I feel it is important for me to respect your knowledge and where you are coming from. I know you desire the best for your patients. Please accept my apology. My journey with autism has been arduous and very painful. Of course, there have been many rewards but not without a lot of hard work physically, emotionally and financially. I have made the greatest gains spiritually. Autism rules my day every second: what we do, what we eat and where we can go as a family. Thank you for treating my son’s bronchitis and putting my mind at ease that he did not have RSV or H1N1. After following your recommendation, his bronchitis cleared up in a few days. I do not want you to think that I am just not vaccinating him (for now) without thought…”

A London researcher was the first to assert that the combination measles-mumps-rubella vaccine, known as MMR, causes autism in children. Following this “discovery,” a handful of parents declared that a mercury-containing preservative in several vaccines was responsible for the disease. If mercury caused autism, they reasoned, eliminating it from a child’s system should treat the disorder. Consequently, a number of untested, alternative therapies arose.

Children with autism have been placed on stringent diets, subjected to high temperature saunas, bathed in magnetic clay, asked to swallow digestive enzymes and activated charcoal, and injected with various combinations of vitamins, minerals, and acids. Instead of helping, these therapies can hurt those who are most vulnerable, and particularly in the case of autism. Some of the adverse outcomes of the alternative therapies are explained in Dr. Paul Offit’s book “Autism’s False Prophets,” published in 2008.

It is important not to undermine childhood vaccination programs that have saved millions of lives. Prime examples of this are the documented success of the vaccines to treat H1N1 (the Swine Flu), polio, small pox and many other illnesses. My heart goes out to the mother who wrote me the touching letter. I acknowledge her pain and deeply sympathize with her since I too have a child with many special needs. But the truth of the matter is vaccines have proven to be highly effective in preventing a host of childhood illnesses such as polio, small pox, measles, mumps, rubella and many more and have not shown to cause autism. For example:

• Ten epidemiological studies have concluded the MMR vaccine doesn’t cause autism;
• Six have shown Thimerosal doesn’t cause autism; and
• Three have determined Thimerosal doesn’t lead to subtle neurological problems.

Further references can be obtained from the University of Pittsburgh’s web site and also from Dr. Paul Offit’s book, “Autism’s False Prophets.”

A growing body of evidence now points to genes that are linked to autism, and despite the removal of Thimerosal from vaccines in 2001, the number of children with autism continues to rise.

My staff at Pediatric Associates of Jacksonville and I wish you a very happy, safe and healthy Holiday Season.