CASE STUDY: Functional Medicine for Regressive Autism

Regressive autism presents unique challenges for families as they witness their child losing previously acquired skills and developmental milestones. For parents navigating this difficult journey, functional medicine offers a comprehensive, whole-body approach that explores underlying physiological imbalances that may contribute to autistic behaviours and regression. This case study examines how we address regressive autism in young children aged 2-9 years at Barefoot Medicine using our trademarked D.A.R.I.N.G. Approach to Autism.

Understanding Regressive Autism in Children

Regressive autism, also known as late-onset autism or autism with regression, affects approximately 20-30% of children diagnosed with autism spectrum disorder (ASD). Unlike classic autism, which presents signs from early infancy, regressive autism involves a period of typical development followed by a noticeable loss of previously acquired skills, typically occurring between 15-30 months of age.

Common Signs of Regression

• Loss of previously used words and language skills
• Diminished eye contact and social engagement
• Decreased interest in play and interaction
• Development of repetitive behaviours or restricted interests
• Changes in sleep patterns and digestive function
• Increased sensory sensitivities

Parents often describe this regression as watching their child “slip away” or feeling as though “a light switched off.” These experiences can be devastating and often prompt families to seek answers beyond conventional treatment approaches.

Conventional vs. Functional Medicine Approaches

Conventional medical approaches to autism typically focus on behavioural interventions, speech therapy, occupational therapy and sometimes medication to manage specific symptoms. While these interventions are valuable, they may not address potential underlying physiological imbalances.

Functional medicine takes a different approach by:

• Investigating root causes rather than just managing symptoms
• Treating the whole child, not just the diagnosis
• Personalising treatment based on individual biochemistry
• Addressing environmental factors and triggers
• Focusing on nutrition, gut health, and immune function

The D.A.R.I.N.G. ApproachTM

Trademarked by Barefoot Medicine Ltd, this is the methodology we use in all personalied health programmes, whether it is for health optimization for peak performance, or to address long-term chronic health problems.  This acronym stands for Discover, Analyze, Report, Integrate, Nourish, Guide.

Discover

Getting to the root cause is done not just using detailed questionnaires of the ‘facts’ such as dates and previous interventions, but also by extensive 1:1 conversations via telephone or video call.  This is so that I can learn more about the mental, emotional and spiritual impact of events on you and things that have shaped the trajectory of your health. 

Analyze

Test, don’t Guess is our motto here.  Non-invasive functional tests give us a great insight into what is happening behind-the-scenes in your gut microbiome, your neurotransmitter function, your oxidative stress levels (the ageing process) and much more  Whilst this is generally a snapshot, we also know that certain processes and body systems change over time, so if your gut bacteria is out of balance, that has not happened overnight.  Equally, if there are certain opportunistic bacteria present in the gut then we also know that they may be crossing the blood-brain barrier and interfering with neurotransmitter function that affects mood and behaviour.

Report

The detailed lab reports we receive give a clear indication of what needs to be addressed as a priority.  In the case of a metabolic report, for example, the lab uses a traffic light system so you can see which nutrients are severely lacking (in red), which could benefit from supplementation (in orange) and which are at a good level (green).   With regard to the environmental toxins, this is either indicated in a percentile compared with other people of your age, or on a sliding scale from what is regarded as a ‘healthy cohort’ through to outside of the norm.

Integrate

Once we have brought all the information together from the 1:1 discussions, the questionnaires and the lab results, we need to prioritize the findings and develop a Health Strategy document, which will be your point of reference.  This is a working document that can be added to if you continue to have further tests. The important part of the ‘integrate’ phase is that while it can be alarming to see how much needs to shift in some cases, gradual change is more lasting and less of a shock to the system.  This is why we plan to integrate change into your existing schedule, allow time to adjust until it becomes the norm, then we make the next change.  This is especially true of any dietary changes that need to be made.

Nourish

We need to nourish your body and your mind.  This is done in various ways that are tailored to you as an individual.  Dietary changes may involve eliminating something such as gluten, or adding supplements to support systems first.  Nourishing your mind may involve a ‘digital detox’ or being encouraged to engage in community activities or hobbies.  Every family is different and this area is probably the most ‘bespoke’ of all becasue we adopt a whole-family approach to health, not just making changes for an individual.  Often people do not like to be singled out or to feel different, and equally, catering to different needs would be more likely to make the parents of an autistic child burn out even faster than they already are! So nourishing your health is a very personal and individualized strategy.

Guide

Once we have finished the process, you will be able to use the Health Strategy to guide you, but for many families, they want a regular point of contact or way to stay in touch.  I have set up the Barefoot Biohackers Community for this purpose, with virtual meetup opportunities for parents of autistic children, online courses to give you deeper insights into natural healthcare, a community chat where parents are encouraged to post their success stories.  Please note that this forum is for parents to share positive and uplifting experiences and tips.  Most of the people I have worked with have shyed away from facebook groups because they found it too damaging to their own mental health when they saw som of the posts that seemed to be more of a place to vent.  Whilst I understand the need for an emotional outlet, it is fundamentally important in our community that we respect the mental health of other parents so that this community can be a ‘haven’, especially on rainy days and long nights!

Key Physiological Systems in Functional Medicine for Autism

The Gut-Brain Connection

Research increasingly supports the connection between gut health and brain function, often referred to as the “gut-brain axis.” Children with autism frequently experience gastrointestinal issues, with studies suggesting that 30-70% of children with ASD have concurrent digestive problems.

As you will see from the Case Studies below, when I address gut inflammation and dysbiosis in children with regressive autism, we often see improvements not just in digestive symptoms but also in behaviour, sleep, and sometimes even language and social engagement.

Common Gut-Related Interventions

• Comprehensive stool testing to identify pathogens, dysbiosis, maldigestion, toxins and inflammation
• Metabolic testing: are you getting the right nutrients from your diet?
• Food sensitivity testing
• Targeted nutritional supplementation

Immune Dysfunction and Inflammation

Many children with regressive autism show signs of immune dysregulation and chronic inflammation. Research has identified abnormal immune markers in some children with ASD, suggesting that immune function plays a role in autism pathophysiology.

Functional medicine assessments done via a urine test often include:

• Evaluation of inflammatory markers
• Examination of oxidative stress markers
• Assessment of neurotransmitter pathways

Detoxification and Environmental Factors

In my experience, children with autism always have compromised detoxification pathways, making them more vulnerable to environmental toxins. It is not yet clear which came first, the toxins in the environment, or the genetic alterations, but research is available for you to make your own mind up if you as Simone to share it.

Whilst I am able to offer non-invasive genetic testing to measure detoxification pathways, this is particulary expensive and the results from several other tests give us a clear indication of assumptions that can be made and addressed without this added expense.

The environmental tests I tend to focus on are:-

• Glyphosate
• Heavy metal testing
• Mycotoxins
• Toxic and Essential Elements

Metabolic and Nutritional Status

Nutritional deficiencies and metabolic imbalances can significantly impact brain development and function. Comprehensive nutritional testing might reveal deficiencies in:

• Essential fatty acids
• Minerals
• Vitamins that are vital for reducing oxidative stress
• B vitamins, particularly B6, B12, and folate
• Amino acids necessary for neurotransmitter production

Case Study: Matthew Age 5

Matthew was a typically developing 2-year-old who had reached all his milestones on time. He had a vocabulary of about 50 words, engaged socially with his family, and showed interest in imaginative play.

At 26 months, his parents noticed gradual changes: Matthew stopped using words altogether, began avoiding eye contact and he developed repetitive behaviours like hand-flapping and spinning and eventually he seemed to retreat into his own world. 

At the time of the initial consultation, he had just moved to primary school but recently he has become increasingly aggressive, he has hit other children in school and he bit a teaching assistant, drawing blood. The GP has not been able to help and most professionals have told the parents this is common with autism and that behavioural therapy is the only option.

Matthew’s parents approached Barefoot Medicine with the hope of improving his communication skills and reducing his anger and frustration. They believed that his diet has a lot to do with his behaviour but it has become so restrictive that they cannot get him to eat anything other than chicken nuggets and cheese.  He dislikes drinking anything, even water. He often has a tendency towards constipation, but can go to the other extreme with very loose stools.

Laboratory Testing

We did a comprehensive range of tests including:

• 3-day Comprehensive Gut Function stool analysis
• Organic Acid Test
• Toxic and Essential Elements
• Food Sensitivities
• Environmental Toxins
• Mycotoxins
• Glyphosate

Comprehensive testing revealed several imbalances:

• Significant dysbiosis (imbalance of gut microbes) and presence of candida albicans
• Elevated inflammatory markers
• Extensive Nutritional deficiencies
• Evidence of intestinal permeability (“leaky gut”)
• IgG food sensitivities to gluten, dairy and casein
• Glyphosate contamination in the 100th percentile
• Significant mycotoxin presence of fungi that are known to interfere with the nervous system, kidneys and liver (key detoxification pathways).

Personalised Treatment Strategy

the goal of treatment is to reduce sytemic inflammation. To achieve this, we needed to identify what was triggering the inflammation in the first place.

The cycle of events, based on the test results, are that gut dysbiosis, poor detoxification pathways and opportunistic bacteria were triggering systemic inflammation, which in turn triggered neuroinflammation that affected neurotransmitters.  His love of cheese and simultaneous sensitivity to casein was causing the metabolite casomorphin to be acting like ‘morphine’ and triggering behaviour changes whilst also increasing an addiction to cheese and thereby triggering the vicious cycle again. Environmental toxins such as glyphosate exposure and heavy metal exposure were also triggering inflammation.  The gut dysbiosis was likely causing stomach ache that Matthew was not able to verbalize, but it made him less inclined to want to eat, especially anything unfamiliar. The pain in his gut and the frustration of not being able to express his needs was leading to angry outbursts. He would not go to the toilet in school and preferred to ‘hold on’ until he was at home, which may also have contributed to physical pain that was making him lash out at those around him.

Based on these findings, Matthew’s treatment plan was based around stopping exposure to toxins from the environment and food that he was unable to digest, detoxifying his body from the accumulations that have developed, but only once the pathways are strong enough. Then focus on the gut and creating an environment that is inhospitable to opportunistic bacteria that are causing inflammation.

• Nourish and strengthen detoxification pathways, promote the bowel.
• Reduc exposure to environmental pathogens
• Eliminate opportunistic infection from the gut to reduce systemic inflammation
• Gradually eliminate triggers in food to reduce systemic inflammation
• Introduce nutrient-dense wholefood supplements

Nutritional Intervention

• Gradual Implementation of a gluten-free, casein-free diet
• Targeted supplements addressing specific deficiencies as per lab results
• Goal: removal of artificial additives, colours and preservatives.

Gut Healing Protocol

• Antimicrobial herbs to address pathogenic bacteria
• Specific prebiotics and probiotics to restore beneficial microbes
• Specific nutrients to support gut lining repair
• Digestive enzymes to improve nutrient absorption

Detoxification Support

Integration with Conventional Therapies

• Continued speech therapy.  therapist noticed a significant improvement in his ability to focus and concentrate, which led to him learning how to use a PECS board.
• Tracking of Mood and Food Journal and fortnightly consultations with the parents to modify Health Strategy.

Six-Month Progress

After six months of this integrated approach, Matthew showed significant improvements:

• Much calmer and happier in himself, no more aggressive outbursts.
• Began forming words and attempting to speak. Can now use several words appropriately. Eager to learn.
• Has learned how to communicate using a PECS board, so is much less angry and frustrated now he can get his needs met.
• Improved eye contact and social engagement
• Resolution of chronic constipation that had not previously been addressed
• Better sleep patterns and reduced night waking
• Decreased stimming behaviours
• Improved attention span during therapy sessions, according to his Speech and Language therapist

While Matthew still meets criteria for autism spectrum disorder, his quality of life and functional abilities have significantly improved. His parents are now also getting a full nights’ sleep and there is less tension around the family home.   Matthew has begun to engage in play and even tickling with his brother where previouly he did not like to be touched.

Challenges and Considerations

While functional medicine offers promising approaches for children with regressive autism, several challenges and considerations exist:

Time Commitment

The functional medicine approach requires significant time and energy from families, including dietary changes which may involve an extensive slow process of food reintroduction, supplement administration and of course the ability to get the stool and urine samples in the first place.  This can be challenging for already overwhelmed parents, but the results can be life-changing for the whole family.

Access to Functional Medicine for Autism

While evidence supporting various aspects of functional medicine for autism is growing, it is not yet recognized by NICE and is therefore not available through your GP or on the NHS.  This means that private treatment is the only option. The laboratories do not sell these extensive tests to the public directly due to the extensive training needed to interpret them.

Individual Variability

Not all children respond to the same interventions. What works dramatically for one child may produce minimal results in another, underscoring the need for personalised approaches and the need to track interventions using the Mood and Food Journal regularly.  This will help us to adjust the Health Strategy as we go along.

The Future of Functional Medicine for Regressive Autism

The field of functional medicine for autism continues to evolve as research advances our understanding of the underlying mechanisms involved in autism spectrum disorders:

Emerging Research Areas

• The role of the microbiome in neurodevelopment
• Mitochondrial dysfunction in autism
• Neuroinflammation and immune dysregulation
• Precision nutrition based on metabolomics
• Environmental epigenetics

Growing Acceptance

Increasing numbers of conventional medical practitioners are recognizing the value of functional medicine approaches, particularly for complex conditions like regressive autism. This is leading to more integrated care models and collaborative research.

Dr. Michael Chen, a paediatric neurologist who incorporates functional medicine principles, notes: “We’re seeing a paradigm shift in how we approach autism. The old model of purely behavioural interventions is giving way to a more comprehensive understanding that includes underlying physiological factors. This is especially important in cases of regression, where something has clearly changed in the child’s system.”

Conclusion: A Personalised Path Forward

Functional medicine offers a promising complementary approach for children with regressive autism, focusing on identifying and addressing potential underlying physiological imbalances that may contribute to symptoms.

By examining the interconnected systems of the body, particularly the gut-brain axis, immune function, detoxification capacity and nutritional status, we can develop personalised care plans that support whole-body health.

For parents of children who have experienced regression, this approach offers both hope and practical strategies. While not every child will respond the same way, it provides additional tools that may improve outcomes and quality of life.

As one parent whose child benefited from this approach shared: “Functional medicine gave us back our power when we felt helpless. Instead of just accepting regression as inevitable, we found ways to support our child’s body and brain. The journey hasn’t been easy, but seeing our child reconnect with us has made every effort worthwhile.”

By combining the best of conventional therapies with the personalised, root-cause approach of functional medicine, families and practitioners can work together to optimize each child’s potential for development, health and happiness.