Dr. green

Frequently Asked Questions

Is there a cure for autism?

As autism is not a disease, but a diagnostic category or concept, the autism itself is not curable. However, the symptoms by which autism is diagnosed can be alleviated through healing, rebalancing and repair of the body, so that a child is may no longer diagnosable with autism. The symptoms of autism are a result of injuries and imbalances and the child’s adaptive and maladaptive responses in his attempt to cope. We focus more on healing rather than curing, aiming to treat the child rather than the diagnosis.

What causes autism?

Autism is caused by injuries and metabolic disruptions in the body, and a child’s attempts to cope with the resultant stresses and challenges. There are many theories as to the causes of, one might say “autisms” instead of “autism,” as there are considerable differences between affected children. We believe that best explanation of the cause of autisms and their dramatic increase in the past generation is environmental toxins. While genetic susceptibility is a contributing factor, this susceptibility frequently manifests as an impaired detoxification or immune system. The toxins of greatest relevance are those which are widely distributed and commonly found in children (even newborn infants). These include metals (especially mercury, lead and aluminum), PCB’s and dioxins), persistent pesticides (DDT, then chlordane, then chlorpyrifos were eventually phased out, though decades later, residues and metabolites are still found in children), hormone disrupters (such as those found in plastics, Styrofoam, Teflon, Scotchguard, flame retardants in children’spajamas and mattresses, herbicides, and other household products), antibiotics (yes, they are toxins, whether ingested on prescription or as byproducts of animal feed), vaccines (these contain many toxics; only the thimerosal has been mostly removed), fluoride, smog—the list gets overwhelming and numbing. All of these substances may contribute to autism through neurotoxicity, or damage to immune, intestinal, endocrine, or metabolic functions, all of which are central aspects of the injuries encountered in autism. In addition, many of these substances can cause direct injury to DNA, leading to mutations or epigenetic disruptions (epigenetic means alteration of gene expression). While this list is indeed overwhelming to consider (even though it is not comprehensive), your awareness of this huge problem can be very helpful to your children.

What are the priorities in medical treatment for children on the autism spectrum?

The first priority is to help a child to become comfortable in his or her own body and in the world. This includes addressing pain, sleep, self-injury, anxiety, seizures, aggression, digestive issues and any active infections. Problems in these areas may have a variety of causes, and so it is important to search for causes and contributing factors while at the onset, working to decrease the suffering and stress associated with these problems. So it is appropriate to aim to alleviate these symptoms as well as possible, sometimes temporarily using prescription medications, even while looking deeper for the underlying causes.

The second priority is to help the child to become truly, vigorously healthy. This includes removing artificial food chemicals, empty calories, and processed foods from his or her diet, and replacing them with whole foods. It also includes removing foods which are not tolerated. It may include supplementing deficient nutrients such as vitamins D and C and B’s; amino acids and essential oils; minerals such as magnesium and zinc and iron. Hormone problems such as low thyroid or low adrenal function are also concerns which need to be explored in the journey toward vigorous health.

The third priority is to help him/her eliminate toxins, allergens and infectious agents. This may include targeted therapies such as chelation, antimicrobial treatments such as antifungals and antivirals and sometimes antibiotics. It also may include natural or pharmaceutical agents to help reduce inflammation and oxidative stress. Sauna treatments, colon cleansing, hyperbaric oxygen and intravenous therapies may be included in this aspect of treatment.

How long does medical treatment take?

Parenting goes on for a life time, and many of the concepts involved in treatment may also be life long—teaching children good eating habits, learning to say “no” to temptations such as foods they don’t tolerate, obtaining optimal school and supportive care, raising happy and supportive siblings, supporting inherited weaknesses (such as folic acid metabolic problems or celiac conditions), etc. The intense medical therapies generally are continued for a matter of years—through early and middle childhood. Older children with autism often need special supports through puberty and into adulthood. Progress continues in understanding and developing new remedies for children and adults with autistic traits, and so we are often able to find more help for those who have not recovered, based on new findings from clinical research. The impacts of autism are so severe that we expect that many affected children will need ongoing support for many years, even if they have shed their diagnosis of autism.

Will my child have to follow a restricted diet?

We find diet to be extremely helpful in improving health and decreasing symptoms, as most children with autism have dietary sensitivities, poor nutrition, intestinal and immune disorders. We aim to establish a diet of whole foods, and find that the majority of autistic children improve on a diet free of gluten, casein, corn, and soy. Some children need to follow other regimes such as disaccharide free (SCD or GAPS), low oxalate, phenol free, specific allergen free, or low glycemic diet, and we will vigorously explore the dietary needs of each child we see. Children with self restricted diets can learn to change and eat well, though they may seem impossibly stuck in their limited choices. Providing your child with a new diet can be economical, though often requires more food preparation and learning new options.

My child can’t swallow pills and won’t take vitamins…

Some children can learn to swallow pills by age 4 or so. Generally they have to be able to respond to rewards and able to follow simple commands. With a strong reward or prize, have them take a bite of food (banana works best), chew it and then put a small pill in with the chewed food and ask them to swallow all together. In some cases it is better to start with a tiny object such as a grain of uncooked millet. Then progress to a grain of uncooked rice, then to a lentil, and then to a pill. Reward each success. Sometimes it is best to do only one step per day. This method, using chewed food to help lubricate and combine the pill with other lumps, has been most often successful. Some children will succeed using a pill cup, which helps wash the pill down. And some children simply aren’t ready. For the children who can’t swallow pills, parents have found many different techniques successful (and you may need to try many). The most important ingredient is your determination to succeed. When Bernie Rimland, father of Autism Research Institute, was asked about getting medicine into resistant children, his simple response was “Who’s bigger?”. Remember, you are fighting for your child’s health, and a little patient, recovering from autism, said to me yesterday, “Vitamins help my brain.” So, using tough love and ingenuity, try some of the following methods. If giving a capsule, add a tsp or so of flavorful liquid to the powder emptied from capsule and mix thoroughly. Draw the mix into a medicine syringe and squirt it in. Often this is a two person job, rather like medicating an unwilling pet, but with repetition and determination you can succeed. If she spits it out, reload and give another dose (this is usual at first). When you are teaching the syringe technique, give a tiny bit of the mix the first dose, to ease her into it, and to reserve more for the probable repeat when (if) she spits it out. Again, be patient, and don’t try to win completely in one day. Many parents succeed by using food or liquids to conceal the vitamins. We’ve heard successes using rice milk, juice, coke (yuk, corn syrup often contains mercury), sorbet, peanut butter, raspberry vinaigrette, smoothies, spaghetti sauce, apple sauce with extra cinnamon, maple syrup, dairy free yogurt. Minerals can be cooked in foods such as muffins. This partial list reflects the ingenuity (and desperation) of parents. Once your child realizes that you are really serious about succeeding, you will.

How can I protect my autistic child from further injuries by environmental toxins?

There are many simple choices you can make which will reduce your children’s body burden of toxic chemicals. These include avoiding home use of pesticides (National Coalition for Alternatives to Pesticides at www.pesticides.org provides extensive guidance on safe alternatives to pesticides), and a shoes off in the house policy. Avoid cooking with Teflon or other coated pans, and avoid aluminum pans (instead use cast iron, steel, glass, ceramic or baked enamel pans). Filter your drinking water and your bathing water. Use glass instead of plastic for food storage, and use bisphenol A- and phthalate-free drinking water bottles (stainless steel is good choice). Consult the dirty dozen list for guidance on which foods are most likely to contain pesticide residues (and should thus be avoided or purchased as organically grown), and which foods are most likely to be pesticide free even when grown organically (www.ewg.org, many other sites). Make sure your child’s mattress is free of flame retardants (unless he smokes in bed!). Use green products around your house , avoid fluoride toothpaste (kids eat their toothpaste, and fluoride is neurotoxic), and use nontoxic cosmetics (kids “eat” their moms). Choose a less toxic dentist (absolutely avoid amalgam fillings). Keep dietary fish to a minimum, and choose the lowest mercury species (www.fda.gov for methylmercury levels in fish—a 4 ounce serving of fish with .020 ppm mercury will exceed the EPA daily limit dose for a 40 pound child, and children on the autistic spectrum are generally weak in detoxification defenses). When fish is consumed, mercury uptake may be reduced by giving 100 mcg of selenium orally at the same time, as selenium may bind with mercury (this makes sense, but is has not been proven effective). Consider replacing your carpeting (starting with child’s play area) with wood or tile or nontoxic linoleum (e.g. marmoleum). If your house is located near a toxin emitter (such as a golf course, a conventional farm, a polluting industry, a freeway or very busy street, consider relocating. Check out your child’s toys (so many Chinese made toys have been contaminated with lead and other neurotoxins), as many children more or less eat their toys. Research suggested vaccines, be aware of their multiple ingredients, and be willing to use your discretionary veto (we recommend children with autism forego further immunizations). If your child has an ear infection or other common infection, consider using ear drops, homeopathy, herbs or “TOT” (tincture of time, or supportive patient observation) rather than antibiotics. Also, consult with your pediatrician about how strong is the need for antibiotics, and whether the narrowest spectrum medication has been prescribed if you decide to give it to your child. Beware of the hazards of over the counter medications. For example; ibuprofen is generally a safer choice than acetaminophen. Iron, copper, and folic acid may not be well utilized by children with autism. Artificial food additives (dyes, flavorings, preservatives) may cause agitation and behavioral problems in children on the autistic spectrum. Some of these suggestions are simple and inexpensive, and some are complex and expensive. It is important to inform yourself and do what you can to protect your child, at the same time respecting your financial and emotional resources as you make gradual changes

What are Dr. Green’s success statistics in treating autistic children?

Autism is not a disease, but a diagnostic category or concept. The autism itself is not curable, but the co-morbid conditions associated with autism are often treatable. Your child is not a statistic, but an individual, and so it is most difficult to extract comparative response rates. We find a wide range of responses to treatment in different children with autism, ranging from early, dramatic improvements, to slow gradual improvements, to ups and downs but ongoing progress. Recovery or virtually complete recovery occurs in many children, though not in the majority. We very rarely see children fail to improve over time. While it is difficult to generalize, the prevailing experience is that untreated children with autism rarely recover, while treated children are much more likely to make good progress or recover. Also, children have the best prognosis when treatments are started early, and when they have less severe injuries (or are less severely impacted), or have regressive autism vs. autism from birth.

Do you only treat children?

We work with children with autism and related disorders, as well as parents wishing to become pregnant or who are already pregnant and would like to decrease their risk of having a child who later develops autism. It is often helpful to work with parents or siblings of our autistic patients, as we may learn new things about the autistic child through evaluating other family members.

Can we become patients of Dr. Green if we live outside of  Oregon, Washington or Hawaii?

Yes, a substantial number of our patients live out-of-state, and many live in Europe and other countries outside of the United States. We require our  first-time patients who are residents of the United States to be seen in person for the first visit.  After this, appointments can be done via video conference.  For this, a stable internet connection and the ability to speak English is a must.

Do you work with insurance companies?

We do not directly bill or contract with insurance companies, but we do provide you with full diagnostic and procedure codes for you to bill your insurance company. We also do our best to utilize laboratories which contract with the standard insurance companies. In addition, we are always open to discuss the costs of tests or office procedures and treatments, with the aim of helping families get the most benefit from their healthcare dollars. We recently started a pilot project to develop and demonstrate the effectiveness and economic efficiency of a small group treatment approach for families with autism. We are most enthusiastic about offering this approach, facilitating inter-family networking and support, and ensuring that economic obstacles do not prevent children receiving care. Please ask our staff for more information if you’re interested in participating in future small group offerings.

Should we do biomedical treatment or speech, ABA and occupational therapy?

We find that children make the most progress if they are involved in both medical and rehabilitative therapies. If, for financial or logistical reasons, you have to make a choice, it is generally most effective to start with medical therapies. After salient medical issues are addressed, the rehabilitative therapies will be much more efficient and your child may be better able to learn.

How much can we expect to spend on supplements?

While there are always new, and often expensive remedies being discovered, a basic support regimen will cost between $75 and $200 per month. Prescription medications may also be involved and are generally well covered by most insurance companies. When we start new supplements, are able to provide small trial dose packets, to allow you to test them for tolerance, palatability and effectiveness. We also use bulk formulations which are often much less expensive.

How do you do chelation?

First of all, chelation is not appropriate or necessary for every child with autism or related disorders. We have seen many children make huge progress without chelation, and others make huge progress through chelation. Chelation is a detoxification therapy which we use when we find evidence of heavy metal toxicity, and in some cases to help with severe oxidative stress. There are a number of lab tests which may be used to help decide whether a child needs chelation treatment. When we do prescribe chelation, we use one of four remedies (DMPS,DMSA, EDTA, or D-Penicillamine) as the primary agent, with supports of intestinal function and nutrients also involved. We use the medications by injection, by suppository, orally, and as skin lotion, depending on the toxins involved, and on the age and cooperation of the child. The majority of our chelation treatments are administered at home under our guidance, with periodic checks on progress and tolerance.

How do you use email at the EverGreen Center?

If you are a prospective patient and have questions, please write us at info@childrenandautism.com.  Existing patients are asked to use the Patient Portal to communicate with Dr. Green and our staff. We ask you to be concise, and understand that complex questions and problems generally require a consultation. We welcome your secure Patient Portal messages to help us keep close contact and follow-up with your family. You may also send photos and videos to help us get a better view of what you may be trying to describe. As this form of communication is a large part of our practice, we generally charge for them based on the length and complexity of our response.

What are your telephone policies at the EverGreen Center?

Our Patient Portal gives patients the ability to view their lab results, schedule their own appointments and send secure messages to Dr. Green. We ask that you use the phone for making appointments or for new patient inquiries. Otherwise, please use the Patient Portal for questions, supplement orders or other dialogue.  We require that all of our patients have a primary care provider and do not have after hours on-call coverage.

How do I get my Lab Results?

Your lab results will be posted to the Patient Portal when we receive them and they have been reviewed by Dr. Green.

Many labs take 4-6 weeks to send reports back to the clinic. Once we receive your lab results they go to Dr Green for review. We cannot send them out or discuss them until the doctor has reviewed them. Once they are reviewed, we will either contact you with supplement suggestions, contact you for an appointment, or file them for review at your next appointment if no review is needed at that time. If you haven’t heard from our office, the results are most likely not available to us yet. If you are wondering whether or not your lab has been completed, please contact the lab directly. The lab phone numbers are below.
Please do not call the office for lab results.

Doctors Data800-323-2784
Entero Lab972-686-6869
Genvoa Lab800-522-4762
Great Plains Lab913-341-8949
Health Diagnostics732-721-1234
Lab Corp800-762-4344
Neuro Immuno866-651-0250
Quest Diagnostics800-222-7941