1) Developmental delay is on the rise. The prevalence and trends of childhood developmental disabilities in the U.S. from 2009-2017 were analyzed by Dr. Zablotsky and colleagues in the journal Pediatrics last month. Autism Spectrum Disorder rose from 1.1% to 2.5%.
Attention Deficit Disorder increased from 8.5 to 9.5%.
General intellectual disability changed from 0.9 to 1.2%.
The authors believe that the increase is related to better screening criteria and improved survival of at risk populations.
In my opinion, the authors’ opinions do not jibe with what we are seeing in the clinic. The three diseases stated above are definitively on the rise, but the stated reasons are unlikely to account for what we are seeing.
I am of the belief that there are other epigenetic [resulting from external rather than genetic influences] factors at play — including maternal nutrition and chemical exposure — that will likely prove to be a significant factor in these trends.

2) Celiac disease and mood issues. Dr. Wahab and colleagues looked at the autoimmune disease against the protein gluten called Celiac disease and the secondary effects it has on mood and behavior. The authors showed that patients with unknown celiac disease had significantly more anxiety problems and defiant behaviors.
My thoughts on this study are as follows:
1) If a patient suffers from a mood disorder, I recommend that all patients try a gluten-free diet for a month and then reassess the mood symptom complex.
2) If you have a first degree family relative with celiac disease, I recommend all family members try a gluten-free diet and reassess how they feel.
3) “In 3.5-year-old children, Celiac disease autoimmunity is associated with increased reports of child depression and anxiety, aggressive behavior, and sleep problems when mothers are unaware of their child’s CDA status. Mothers’ knowledge of their child’s CDA status is associated with fewer reports of psychological symptoms, suggesting that awareness of the child’s tTGA test results affects reporting of symptoms.”

Dr. Chris Magryta is a physician at Salisbury Pediatric Associates. Contact him at newsletter@salisburypediatrics.com