Long term antibiotic therapy may be an effective treatment for children co-morbid with Lyme disease and Autism Spectrum Disorder

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Long term antibiotic therapy may be an effective treatment for children co-morbid with Lyme disease and Autism Spectrum Disorder

Mason Kuhn - a,
Shannon Grave - a,
Robert Bransfield - b,
Steven Harris - c,

a - University of North Dakota, 231 Centenial Drive Stop 7189, Grand Forks, ND 58202-7189, USA
b - Robert Wood Johnson University of Medicine and Dentistry Medical School, Education and Research Building, 401 Haddon Avenue, Camden, NJ 08103, USA
c - Stanford University, School of Medicine, Stanford University Medical Center, Stanford, CA, USA

Received 10 October 2011. Accepted 19 January 2012. Available online 21 February 2012.
http://dx.doi.org/10.1016/j.mehy.2012.01.037, How to Cite or Link Using DOI

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Abstract

Patients diagnosed with Lyme disease share many of the same physical manifestations as those diagnosed with an Autism Spectrum Disorder (ASD). In this study four male children (ages 26–55 months) who have an ASD diagnosis and one male child (age 18 months) who displayed behaviors consistent with an ASD, were assessed using the SCERTS Assessment Process Observation (SAP-O) form. The SAP-O meets state and federal requirements for providing a comprehensive, ongoing assessment of a child with an ASD [33]. The SAP-O form measures children’s abilities using observational, authentic assessment procedures in the domains of joint attention, symbol use, mutual regulation, and self regulation via observations of specific behaviors in familiar settings [33]. The five children tested positive for Lyme disease and their SAP-O score was evaluated before and after 6 months of antibiotic therapy. Each child was prescribed 200 mg of amoxicillin three times per day and three of the five children were prescribed an additional 50 mg of Azithromycin once per day. All of the children’s scores on the SAP-O assessment improved after 6 months of antibiotic therapy. The assessors also reported anecdotal data of improved speech, eye contact, sleep behaviors, and a reduction of repetitive behaviors.


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Figures and tables from this article:



Fig. 1. Bottom twenty-five states for prevalence of Autism Disorder and prevalence of Lyme disease in those states in 2009 and .
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Fig. 2. Top twenty-five states for prevalence of Autism Disorder and prevalence of Lyme disease in those states in 2009 and .
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Fig. 3. Examples of behaviors included, by not limited to, in the SCERTS SAO form. Parents and teachers gave a score of 2, 1, or 0 on 214 behaviors. Scoring Key: 2 = criterion met consistently 1 = criterion met inconsistently 0 = criterion not met based on observed or reported information or would not be expected.
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Fig. 4. Parents and teachers collected data of the number of times Child A verbally identified a picture vocabulary card. The data point for each month represents the average for each work session (total correct responses for the month / the number of work sessions). The vertical dotted line represents when antibiotic therapy began.
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Fig. 5. SCERTS profile summary scores for Child A before antibiotic therapy began and 6 months into antibiotic therapy.
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Fig. 6. Teachers pointed to items in the classroom and asked Child B to “look” at the item. When Child B’s eye gaze followed the point it was recorded as a correct response. During each work session Child B was asked to follow the teacher’s point five times. The data points are the average correct responses per work session per month (total correct responses/number of work sessions). The vertical dotted line represents when antibiotic therapy began.
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Fig. 7. SCERTS profile summary scores for Child B before antibiotic therapy began and 6 months into antibiotic therapy.
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Fig. 8. Number of times Child C gave his teacher eye contact when he responded verbally to a question in his classroom. Twenty trials were collected during the baseline period so for consistency twenty trials were collected during the following months. The vertical dotted line represents when antibiotic therapy began.
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Fig. 9. SCERTS profile summary scores for Child C before antibiotic therapy began and 6 months into antibiotic therapy.
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Fig. 10. SCERTS profile summary scores for Child D before antibiotic therapy began and 6 months into antibiotic therapy.
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Fig. 11. SCERTS profile summary scores for Child E before antibiotic therapy began and after antibiotic therapy concluded.
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Fig. 12. The average SCERTS profile summary score for Child A–D before they started antibiotics and 6 months later. Child E’s scores were not included because his pre-antibiotic score was compared to his score 4 years later after he completed antibiotic therapy.
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Fig. 13. Age of diagnosis of ASD and LD, physical symptoms, positive WB IgM and IgG bands, co-infections, prescribed antibiotic(s), and physical improvements of the five children in the study.

Corresponding author.
Published by Elsevier Ltd.