自閉症兒童必須要先到醫院進行專業測查，對於先天性自閉症，目前全世界還沒有更好的方法來對孩子進行有效治療。對於不是先天性的自閉症患兒，透過遊戲、專業的訓練，如果孩子自身接受能力強的話，那孩子的語言發展、認知水平都會有很好的提升，但需要時間，同時結合家庭教育，父母與孩子要建立良好的親子關係，多有效陪伴，這樣效果會更好。

先要分清是器質性症變還是功能性障礙。如是器質性的，先就器質性病變進行治療，比如腦瘤。然後訓練恢復。如為功能性則直接進行訓練。但每個人情況不同，不能用一種方法適用所有患者，我是祖傳中醫傳承且學過西醫。

首先，孩子是否由權威的具有自閉症診斷能力的醫院確診為自閉症，或者是否被診斷為疑似或自閉症傾向。如果確診為自閉症或者經診斷有自閉症傾向或者疑似，這樣的孩子需要專業的特殊教育康復訓練機構來幫助孩子完成語言，社交，行為的系統訓練，以達到功能無限接近正常孩子。因為自閉症是一種先天的精神殘疾，無法根治，最有效的手段就是康復干預，因此普通的生活撫養方式的改善或者針對大多數孩子的普通教育手段都無法對自閉症患兒起到康復的作用。有些孩子由於後天撫養方式不當，關注和交流很少，造成孩子語言，認知，社交發育落後，症狀表現與自閉症的核心症狀非常相似，容易使部分自閉症患兒家長對孩子抱有發育遲緩的幻想，拖延就診，拒絕干預，錯過孩子最黃金的康復年齡，造成終身遺憾。實際上，發育遲緩或者自閉症都需要專業康復干預來啟用孩子的相關功能，如果只是發育遲緩，孩子在康復過程中是可以摘帽，也就是排除自閉症的可能的。那麼對於確診是自閉症的兒童儘早干預也不會耽誤孩子。

首先肯定要透過對孩子的評估來確定孩子已經達到了什麼程度，又有哪些方面是欠缺的，然後進行針對性的訓練。

自閉症兒童的訓練，包括認知訓練都是一個由易到難、由簡到繁的漸進過程。

兒童認知能力訓練包括：注意力、觀察力、記憶力、數字認知、圖形認知、序列認知、異類鑑別、同類匹配等八項內容。

日常的開展內容的有以下幾項：

（1）模仿與指令：這是兒童學習的基礎，兒童的動作、語言、技能以及行為習慣、品質等的形成和發展都離不開模仿；

（2）配對與分類：區別物體的異同是學習能力的基礎，而對兒童進行配對能力的訓練，目的就在於提高他們區別物體異同的能力和對事物進行分類的能力。如物物配對、物圖配對、圖圖配對、書面泛化、形狀分類、顏色分類、大小分類等；

（3）物品和功能：讓孩子瞭解的就是孩子經常使用或者經常見到的物品，在明白“是什麼”之後，我們要知道“做什麼用”“怎麼用”，為進一步發展生活技能奠定基礎。如認識—模仿使用—生活應用（衣、食、住、行類物品）；

（4）物品歸類：類別概念是兒童邏輯思維和概括能力的集中體現，分類操作是兒童思維發展的重要促進手段。特別要注意的是兒童的分類訓練必須從兒童所熟知的物品開始。如食品類、服裝類、動物類、日常用品 類、交通工具類等；

（5）命名：進行理解物體名稱的訓練，有助於他們懂得關於物體和動作的名稱，並進而為進行表達物體名稱的訓練打下基礎。在理解物體名稱的訓練中，應該首先選擇孩子熟悉的物體來開始訓練。如常見物品的指認—名稱仿說—命名錶達（水果蔬菜、日常用品、動物、交通工具等）；

（6）認識顏色：大部分時候兒童是透過顏色、形狀、大小來區分周圍的物品的，顏色是三種屬性中最容易辨認的一種，兒童很容易就能學會利用顏色來對物體進行分類。如紅、黃、藍、綠、黑、白等；

（7）認識形狀：形狀知覺是視覺、動覺和觸覺協同活動的結果，在形狀知覺方面，特殊兒童的視覺經驗和視覺辨別能力不足是其不能準確認知形狀的關鍵，在進行形狀認識訓練時要透過多種感官共同完成。如圓形、方形、三角形等；

（8）數學：兒童處在邏輯思維和數字概念初步形成和發展的時期。數學知識的邏輯性和抽象性對發展幼兒的抽象邏輯思維具有特殊的作用。如口頭數數、給物說數、按數取物、掌握數概念、數的簡單運算。

在進行了一段時間的認知訓練後應再評估看孩子是否有進步，並且及時給與調整方案，制定新的訓練計劃。

Patient Report: Autism Spectrum Disorder Treated With Camel Milk

使用駱駝奶治療自閉症譜系障礙

Christina M. Adams, MFAcorresponding author

克里斯蒂娜·M·亞當斯，MFA通訊作家

Abstract

This patient report is about my son, who was diagnosed with autism spectrum disorder (ASD) at 3 years of age, and the effects I observed when he began drinking camel milk daily. Beginning at age 9, he drank one half cup of raw camel milk a day and experienced overnight an improvement in his symptoms. His continued regular consumption of camel milk was associated with sustained symptom improvements for 6 consecutive years (2007-2013). This patient report is a road map of my navigations, consultations with experts and autism care providers, and the apparent effect of camel milk on autism spectrum disorder (ASD).

Key Words: Camel milk, autism spectrum disorder, patient report

摘要

這份病人報告是關於我的兒子的，他在3歲時被診斷為自閉症譜系障礙(ASD)，以及我觀察到的他開始每天喝駱駝奶的影響。從9歲開始，他每天喝半杯生駱駝奶，一夜之間症狀有所改善。他連續6年(2007-2013)持續飲用駱駝奶與症狀改善相關。這份病人報告是我的導航圖，是我與專家和自閉症護理提供者的諮詢，以及駱駝奶對自閉症譜系障礙(ASD)的明顯影響。

關鍵詞:駱駝奶，自閉症譜系障礙，患者報告

INTRODUCTION

As an infant, my son appeared normal and met the generally accepted growth and development milestones. He was calm and attentive, smiled at 6 weeks, laughed, and could focus on books and toys. He was affectionate and bonded with his parents and always showed appropriate separation anxiety. He spoke two clear words at 9 months and walked on his first birthday. However, beginning at 6 months, he started biting people and never pointed to objects. He also had very red cheeks, constipation, prolonged startle reflex, and infant torticollis.

介紹

我的兒子嬰兒期間看起來很正常，符合人們普遍接受的生長髮育階段。他平靜而專注，在6周時微笑，大笑，可以專注於書本和玩具。他和父母感情深厚，關係密切，表現出適當的分離焦慮。九個月大的時候，他就能清晰地說出兩個字，一歲生日的時候，他還能走路。然而，從6個月大開始，他就開始咬人，而且從不指向物體。他也有非常紅的臉頰，便秘，長期驚嚇反射，嬰兒斜頸。

EARLY AUTISM

Just before he turned 3 years old, my son was diagnosed with autism. He had loss of language and attention at 15 to 18 months, the appearance of hyperactivity, sensitivity to noise, and fixation on objects and water. He had difficulty interacting with others, was still biting and engaging in aggressive behavior, and had been dismissed from two preschools. Like many ASD children, he was found to have food intolerances and allergies, skin conditions, auditory processing delay, expressive/receptive language delay, constipation, and an intermittent tic disorder.

早期自閉症

就在我兒子3歲之前，他被診斷出患有自閉症。他在15到18個月的時候失去了語言能力和注意力，表現為極度活躍，對噪音敏感，對物體和水很執著。他很難與他人交流，仍然愛咬人，並有攻擊性行為，曾被兩所幼兒園開除。和許多自閉症兒童一樣，他被發現有食物不耐受和過敏、面板狀況、聽覺處理延遲、表達/接受語言延遲、便秘和間歇性抽動障礙。

After the diagnosis and continuing for years, he received a battery of tests including complete physical exams, electroencephalograms, neurological and sensory evaluations, auditory testing, and stool and urine testing for heavy metals, amino acids, organic acids, intestinal parasites, and Candida. Laboratory tests were ordered, including complete blood counts, metabolic profiles, and tests for immune-globulins and inflammatory markers. He also received regular vaccination through 15 months.

在確診並持續數年之後，他接受了一系列測試，包括完整的體檢、腦電圖、神經和感覺評估、聽覺測試，以及糞便和尿液中重金屬、氨基酸、有機酸、腸道寄生蟲和念珠菌的測試。要求進行實驗室檢測，包括全血計數、代謝情況、免疫球蛋白和炎症標誌物檢測。他還接受了15個月的定期疫苗接種。

My son was enrolled in 35 to 40 hours per week of intensive one-on-one therapy at our home in a clinically supervised program of applied behavioral analysis (ABA). He also had 3 hours per week of individual speech therapy and 2 hours per week of occupational therapy. His diet was gluten- and casein-free for 2 years with limited intake of sugar, yeast, and nuts. His medications included various antiviral (famciclovir, valaciclovir) and antifungal medications (nystatin, ketoconazole, amphotericin-B), selective serotonin reuptake inhibitors (SSRIs; citalopram, escitalopram) and blood pressure–reducing medication (guanfacine) to decrease hyperactivity and aggression. These medications, used daily and mostly added one at a time for careful observation, seemed to be beneficial. The combination of his treatments produced positive benefits that were confirmed in twice-monthly ABA clinic meetings, daily ABA data gathering, and pediatric ASD specialist office visits. As many children make limited gains with similar treatments, this progress earned my son a reputation as a “responder” in autism parlance.

我的兒子參加了一個應用行為分析(ABA)的臨床監督專案，每週在家接受35到40個小時的強化一對一治療。他每週還有3小時的個別語言治療和2小時的職業治療。他的飲食中有兩年不含麩質和酪蛋白，糖、酵母和堅果的攝入量有限。他的藥物包括各種抗病毒藥物(泛昔洛韋，伐昔洛韋)和抗真菌藥物(尼司他汀，酮康唑，兩性黴素b)，選擇性血清素再吸收抑制劑(SSRIs;西酞普蘭，艾司西酞普蘭)和降壓藥(胍法辛)來減少多動症和攻擊性。這些藥物，每天使用，大多一次增加一個仔細觀察，似乎是有益的。他的治療組合產生了積極的益處，這在每月兩次的ABA臨床會議、每天ABA資料收集和兒科ASD專家辦公室訪問中得到了證實。由於許多孩子透過類似的治療只能獲得有限的效果，這一進步為我的兒子贏得了孤獨症術語中“反應者”的名聲。

By age 5, this hard-working child had demonstrated significant improvement, passed the kindergarten readiness test, and began attending a public school with a shadow aide. ABA therapy dropped to 3 hours per week. He later attended a school for children with attention deficit/hyperactivity disorder with weekly social skill sessions and participated in lessons and activities outside our home with and without an aide. His schoolwork was at or above grade level with the anticipated exception of handwriting. Although he needed intermittent supervision to stay on task, his cognitive scores were all above average. He continued to struggle with prolonged eye contact, and his conversations, while inquisitive and mutually engaging, were sometimes inattentive and monologue-style. Nevertheless, he was bright and friendly and enjoyed social contact and outings with peers and friends. Interestingly, when he ate dairy products around age 7, even pizza with the cheese removed at a baseball game, he would develop many symptoms. Hand-flapping, circle and toe walking, inattention, and constipation would result within hours, and he once complained, “It feels like there"s dirt in my brain.” Though he had returned to gluten 2 years after his ASD diagnosis with no outward effects, he avoided dairy products and kept his sugar intake low.

到5歲的時候，這個勤奮的孩子表現出了顯著的進步，通過了幼兒園預備考試，並開始在一個影子助手的幫助下進入公立學校。ABA療法減少到每週3小時。後來，他參加了一所針對注意力缺陷/多動障礙兒童的學校，參加了每週一次的社交技能課程，並在有或沒有助手的情況下參加課外課程和活動。他的學業成績在年級或以上，除了預料中的書法以外。雖然他需要間歇性的監督才能完成任務，但他的認知成績都高於平均水平。他繼續與長時間的目光接觸作鬥爭，他的談話雖然好奇而又相互吸引，但有時是漫不經心的、獨白式的。儘管如此，他還是很開朗、友好，喜歡與同齡人和朋友進行社交和郊遊。有趣的是，當他在7歲左右吃乳製品時，即使是在棒球比賽中去掉乳酪的披薩，他也會出現許多症狀。拍手、繞圈、用腳趾走路、注意力不集中，幾小時內就會便秘。雖然他在被診斷為自閉症譜系障礙兩年後又開始食用麩質，但他沒有食用奶製品，也沒有攝入過多的糖。

Editors" Remarks

編輯備註

In this patient report, a mother shares her observations and assessment of the effectiveness and safety of camel"s milk for her autistic son. We believe this patient report helps to communicate her experience of the care her family received. It will also inform clinicians about how patients experience the care they provide. We support reporting the patient"s perspective.

在這份病人報告中，一位母親分享了她對駱駝奶對她患有自閉症的兒子的有效性和安全性的觀察和評估。我們相信這個病人的報告有助於傳達她的經驗，她的家人得到的照顧。它也將告知臨床醫生病人如何體驗他們所提供的護理。我們支援報告病人的觀點。

Despite this remarkable progress, at age 9, my son began to have significant behavioral issues: sudden hyperactivity, loss of attention, distracted language, and loss of self-regulation. These symptoms were exacerbated when he had not eaten for 2 to 3 hours. Visits to his treating ASD physicians, titration of existing medications, and additional dietary measures did not seem to help. A trial of SSRI (fluoxetine) made him dazed and anxious and seemed to worsen the behavioral issues. It was becoming difficult to prompt and cope with his actions as discipline and safety techniques were no longer effective. As his mother, I was increasingly taxed and my outlook was becoming ominous.

儘管有了這些顯著的進步，在9歲的時候，我的兒子開始出現嚴重的行為問題:突然的多動症、注意力不集中、語言不集中、自我調節能力下降。當他2到3小時沒有進食時，這些症狀會加重。他去看治療自閉症譜系障礙的醫生，對現有藥物進行滴定，並採取額外的飲食措施，似乎都沒有效果。一次SSRI(氟西汀)的試驗使他頭昏眼花，焦慮不安，似乎使行為問題惡化。由於紀律和安全措施不再有效，他的行動越來越難以及時處理。作為他的母親，我的稅負越來越重，我的前景也變得不妙。

TREATMENT WITH CAMEL MILK

駱駝奶治療

On October 10, 2007, 2 weeks before my son"s tenth birthday, he drank his first half cup (4 oz) of thawed raw unheated camel milk. I chose this course because I had spent the previous 2 years studying camel milk and consulting people familiar with its use. In fall 2005, a camel farmer spoke to me about the use of camel milk in Middle Eastern hospitals for premature babies due to its reputed nonallergenic and nutrient-rich qualities. That information led me to theorize the milk might strengthen my son"s immune system and thus improve his functioning and also serve as an alternative dairy product. I reviewed the scant literature that evening and over the next few months. In 2006, I found Dr Reuven Yagil"s brief 2005 report on several children with ASD responding positively to camel milk. I then consulted Israeli-American scientist Amnon Gonenne, PhD, on his theory that camel milk may act as an anti-inflammatory agent and might help my son. Reassured by anecdotal reports and conversations with healthcare providers and camel milk producers, I concluded the risk of trying camel milk was minimal. One of my son"s physicians signed a letter authorizing his need to consume camel milk. I then arranged to receive bottles of raw frozen camel milk from Israel. The camel milk was tested for the presence of bacteria prior to freezing, stored at −20° C, and then shipped by air to me.

2007年10月10日，就在我兒子十歲生日的前兩週，他第一次喝下了半杯(4盎司)解凍但未加熱的生駱駝奶。我選擇了這個治療，因為我在過去的兩年裡一直在研究駱駝奶，並諮詢熟悉它用途的人。2005年秋天，一位養駱駝的農民告訴我，中東地區的醫院使用駱駝奶餵養早產兒，因為駱駝奶被認為不會引起過敏，而且營養豐富。這些資訊讓我想到，這種牛奶可能會增強我兒子的免疫系統，從而改善他的功能，還可以作為一種替代奶製品。那天晚上和以後的幾個月裡，我查閱了一些零星的文獻。2006年，我發現Reuven Yagil博士2005年關於幾個ASD患兒對駱駝奶有積極反應的簡短報告。然後我諮詢了以色列-美國科學家Amnon Gonenne博士，他的理論是駱駝奶可能有消炎的作用，可能對我兒子有幫助。我從坊間傳聞以及與醫療服務提供商和駱駝奶生產商的對話中得到了安慰，我得出結論:喝駱駝奶的風險很小。我兒子的一位醫生簽署了一封信，授權他喝駱駝奶。然後我安排從以色列接收了幾瓶生的冷凍駱駝奶。駱駝奶在冷凍前進行了細菌檢測，儲存在- 20°C，然後空運給我

On the morning after my son ingested camel milk, he demonstrated astonishing improvements in behavior including eye contact, communication, emotional expression (“I really love you; you"re awesome; you do so much for me”), and self-organization. He ate breakfast more neatly, noted his schedule, put on his shoes, and got his backpack for school while conversing at the same time.

在我兒子喝下駱駝奶的第二天早上，他的行為表現出了驚人的改善，包括眼神交流、交流、情感表達(“我真的愛你;你太棒了;你為我做了這麼多”)，以及自我組織。他把早餐吃得更乾淨利落了，記下了自己的日程安排，穿上鞋子，背起書包去上學，同時還在說話。

He continued consuming 4 oz of camel milk daily with rapid continued improvement in behavior and motor planning. For example, he started looking both ways when crossing streets and parking lots. His erratic behavior stopped, and my frequent offerings of extra protein, which had only somewhat mitigated the problem, were no longer needed. Within 3 weeks, there was also a marked improvement and smoothing of his skin condition. Increasing the daily amount of camel milk to 8 oz seemed to cause new facial grimaces and jerking in one arm, which disappeared when his intake returned to 4 oz. His pragmatic language and vocabulary skills were improved, and other academic skills tested above average and exceptional in some areas.

他每天繼續喝4盎司的駱駝奶，行為和運動計劃都得到了快速的持續改善。例如，他在過馬路和停車場時開始左顧右盼。他的古怪行為停止了，我經常提供額外的蛋白質，這隻在一定程度上緩解了問題，不再需要了。在3周內，他的面板狀況也有了明顯的改善和平滑。每天增加到8盎司的駱駝奶似乎會導致新的面部表情和一隻手臂的抽搐，但當他的攝入量回到4盎司時，這些症狀就消失了。

Interruption of camel milk consumption on several occasions resulted in behavioral and physiological lapses. Just before he turned 12, while I was away from home for two and a half weeks, he did not take camel milk. His school behavior deteriorated to the point that he was in danger of being moved to a special education classroom. Within 24 hours of resuming the camel milk intake, he returned to prior functioning levels. From age 12 to 16 years (present age), he continued on variable amounts of camel milk from Israel and later from the United States, along with conventional medications.

有幾次中斷食用駱駝奶，導致他行為和生理上的疏失。就在他12歲之前，我離開家兩個半星期，他沒有喝駱駝奶。他在學校的行為惡化到他有被轉移到特殊教育教室的危險的地步。在恢復喝駱駝奶的24小時內，他恢復了之前的功能水平。從12歲到16歲(現在的年齡)，他繼續飲用來自以色列和美國的不同數量的駱駝奶，以及傳統的藥物

Camel milk has offered observable and sustained benefits to my son"s health and functioning. Along with medications and dietary management, I believe camel milk has contributed to the successful management of his symptoms. My son views camel milk positively and is reassured to know he can always access it.

駱駝奶對我兒子的健康和機能有顯著而持久的益處。除了藥物治療和飲食管理，我相信駱駝奶對成功地控制他的症狀也有貢獻。我的兒子對駱駝奶持肯定的態度，他知道自己隨時都能喝到駱駝奶，這讓他感到安心。

A MOTHER"S PERSPECTIVE

一個母親的觀點

Children with ASD present multiple lifelong challenges. For such a catastrophic and increasingly prevalent disorder, medical treatment and care is debatable, confusing, and expensive. My son"s immune and behavioral responses often correlated to dietary matters. Camel milk, a natural food suitable for premature infants, intrigued me as possibly having inherent value as a health and food substance. Camel milk as a trial treatment seemed less invasive and costly than specialist care, medications, alternative treatments, and behavioral interventions.

ASD患兒存在多種終身挑戰。對於這樣一種災難性的、日益普遍的疾病，醫療和護理是有爭議的、令人困惑的和昂貴的。我兒子的免疫和行為反應通常與飲食有關。駱駝奶是一種適合早產兒食用的天然食品，它作為一種健康食品的內在價值引起了我的興趣。與專家護理、藥物治療、替代治療和行為干預相比，駱駝奶作為一種試驗治療似乎侵入性更小，成本更低。

Just as importantly, camel milk"s history gave me assurance. Camel milk has been used for centuries as a medicine in Middle Eastern, Asian, and African cultures. Nomadic cultures have reported living off camel milk exclusively with no apparent loss of health. The United Nations lauded camel milk"s nutritional content in 2006.1

Although anecdotal information on camel milk exists for a variety of illnesses, documented data related to autism are scarce. Jodie Dashore, a board-certified doctor of occupational therapy in private practice in the United States, has begun documenting behavioral outcomes of ASD children with cormorbidities who are ingesting raw camel milk from the United States.

Global attention on the assessment, causes, and treatment of ASD continues to provide parents of autistic children with hope.

雖然關於駱駝奶的軼事資訊存在於各種疾病中，但與自閉症相關的文獻資料卻很少。Jodie Dashore是美國私人執業的職業治療專業認證醫生，她已經開始記錄患有自閉症譜系障礙的兒童從美國攝取生駱駝奶後的行為結果。

全球對ASD的評估、病因和治療的關注繼續為自閉症兒童的父母帶來希望

My message to parents and physicians would be as follows:

•Intuition of parents and/or patients is critical to pursuing connections between symptoms and potential treatments.

•Communicate all symptoms, even those that seem minute or insignificant, to healthcare providers.

•Affected parents and patients often know when a behavior or symptom is unusual or suspicious.

•Conduct “due diligence” on all therapies, work in partnership with credentialed health providers to assess and ensure safety of new therapies, and always introduce new therapies methodically.

•Document the course of treatment and data from life events with dates and times.

•Camel milk is an available food product with potential therapeutic value. It tastes “just like milk” and can be flavored to preference.

我給家長和醫生的資訊如下:

•對父母和/或患者的直覺是尋求症狀和潛在治療之間聯絡的關鍵。

•向醫療服務人員傳達所有症狀，即使是那些看起來微不足道的症狀。

•受影響的父母和患者通常知道什麼行為或症狀是不尋常的或可疑的。

•對所有治療方法進行“盡職調查”，與有資質的醫療服務提供者合作，評估並確保新療法的安全性，並始終有條不紊地引入新療法。

•記錄治療過程和生活事件的資料，並註明日期和時間。

•駱駝奶是一種有潛在治療價值的可用食品。它嚐起來“就像牛奶”，可以根據個人喜好調味

Acknowledgments

The author would like to acknowledge Amnon Gonenne, PhD, who served as her scientific consultant over the years while generously sharing his advanced knowledge of human immune function and camel milk. The author also acknowledges Jodie Dashore, OTD, MS, OTR/L, for reviewing the author"s son"s test results and sharing her data on recent camel milk usage by children with autism spectrum disorder.

致謝

作者想要感謝Amnon Gonenne博士，她多年來一直擔任她的科學顧問，並慷慨地分享了他在人類免疫功能和駱駝奶方面的先進知識。作者還感謝Jodie Dashore, OTD, MS, OTR/L，感謝她審閱了作者兒子的測試結果，並分享了她關於最近患有自閉症譜系障礙的兒童使用駱駝奶的資料。