QUESTIONS, ANSWERED.
Most parents have questions before getting started. You’ll find answers to the ones I’m asked most often below.
Do you offer leucovorin (folinic acid) for children with autism?
Yes. Folinic acid is an intervention I use frequently in my clinical practice and is considered for some children with autism, particularly where folate metabolism or transport may be relevant. Where appropriate, I can arrange compounded folinic acid through a pharmacist and provide an individualised plan for its introduction and use. Folinic acid recommendations are made according to each child’s individual history, presentation and relevant testing.
Do you offer Folate Receptor Autoantibody (FRAT®) testing?
Brain Kids can arrange Folate Receptor Autoantibody Testing (FRAT®) for children in Australia. Samples are sent overseas for analysis and the test is privately billed. Currently, it is charged at AUD$750. FRAT® testing is not required for every child and a clinical trial of folinic acid may be more suitable.
What is FRAT® testing?
FRAT® (Folate Receptor Autoantibody Test) is a specialised blood test that detects antibodies against the folate receptor alpha (FRα). These antibodies can interfere with the transport of folate into the brain, potentially resulting in low levels of folate within the central nervous system even when blood folate levels appear normal. Folate receptor autoantibodies have been identified in about 70% of children with autism, which is why FRAT® testing may be considered as part of a broader clinical assessment. Brain Kids can arrange FRAT® testing for children in Australia. Samples are sent to a specialised laboratory in the United States for analysis.
Do you recommend FRAT® testing for children with autism?
Actually, no. Not routinely. FRAT® testing can provide useful information about folate receptor autoantibodies, and I can arrange testing when there is a good clinical reason to do so. However, it is an expensive test, particularly for Australian families, as samples need to be sent overseas for analysis. This is further compounded by needing to get a viable sample of blood there in a very timely manner. In most cases, I prefer to consider the child's clinical history and presentation and, where appropriate, use a carefully monitored trial of folinic acid. A child's response can provide useful clinical information without automatically adding the considerable expense of FRAT® testing. My approach to testing is simple: if the result isn't going to meaningfully change what we do, I don't want you spending money on it.
Does my child need to have an autism diagnosis to see you?
Not at all. I work with children who have an autism diagnosis, children who are currently undergoing assessment, and children whose parents have concerns about their development, behaviour, learning, communication, sensory processing or overall health. If you feel that something isn’t quite right, you don’t need to wait for a diagnosis before seeking support. You don’t need to wait for a diagnosis to seek support. Early intervention matters, and the earlier we identify and address factors that may be affecting your child’s health and development, the better.
Do you work with teenagers with autism?
Absolutely! I work with children and young people of all ages, including teenagers. While early intervention is incredibly valuable, there is no age at which it becomes “too late” to investigate factors that may be affecting your child’s health and wellbeing. Teenagers may have very different needs and priorities from younger children, and their care is always tailored accordingly.
Do you offer functional testing?
Yes. Functional testing can provide valuable information about what may be happening beneath the surface and can help guide a more individualised approach to your child’s care. Depending on your child’s history and presentation, testing may include assessment of gut and microbiome health, nutritional status, metabolism and mitochondrial function, environmental exposures, genetics, immune function and folate receptor autoantibodies (FRAT®). Testing is recommended individually. Not every child needs every test, and you will never be expected to undertake testing that is not financially achievable for your family. Some testing can be arranged through standard pathology laboratories, while specialised functional tests are frequently completed through laboratories in Australia or USA.
What tests do you use for gut health?
For comprehensive gut and microbiome assessment, I currently use the Gut Zoomer by Vibrant Wellness, a specialised laboratory in the United States. The Gut Zoomer provides an extensive assessment of the gut microbiome, including beneficial and potentially problematic bacteria, gastrointestinal pathogens, microbial diversity, digestive function, intestinal inflammation, gut immune function, intestinal permeability and important microbial metabolites. It also provides valuable information about the gut–brain connection, which is particularly relevant to the children I work with. The test is completed at home using stool and urine samples, which are then sent to the United States for analysis. Gut testing is not required for every child and will only be recommended where I believe it may provide useful information to guide your child’s care.
Do you have a favourite test?
Yes. Yes I do! The Organic Acids Test (OAT) is my favourite functional test because of the enormous amount of information we can obtain from a simple urine sample. It gives me a window into how your child’s biochemistry is actually functioning, with markers that can provide information about mitochondrial energy production, nutrient requirements, neurotransmitter metabolism, oxidative stress, detoxification pathways, oxalates, and possible bacterial or yeast overgrowth. Rather than looking at one isolated part of the body, the OAT allows me to start connecting the dots between different biochemical pathways and your child’s individual presentation. And there is another BIG advantage: it’s urine. For children who find blood tests extremely difficult or simply impossible, being able to gather this much information without a blood draw can be incredibly valuable. When it is appropriate, the OAT can give us a remarkable amount of information from one little sample of wee!
Does my child need to take supplements?
Almost always, yes. Children with autism can have significant differences in nutritional status, metabolism, mitochondrial function, oxidative stress, methylation and other biochemical pathways. Where these factors are identified, targeted nutritional supplementation can be an important part of addressing them. However, there is no standard supplement protocol for autism. Recommendations are individualised according to your child’s history, symptoms, diet, testing and individual needs. I am very selective about the supplements I recommend for children and prioritise quality, purity and safety. I also understand that cost, taste, texture and simply getting a supplement into your child can be challenging! We will always work together to develop a plan that is both clinically appropriate and realistic for your family.
What if my child refuses supplements?
Join the club, I've been there too. Taste, texture, smell, colour, or simply knowing that you’ve put something different in their food or drink can be enough for some children to refuse a supplement. For those with significant food restrictions, this is a HUGE deal. For many children though, there are plenty of ways we can work around this. Sometimes we need to get creative. Very creative. Different formulations, powders, liquids, favourite foods, clever disguises and the occasional bit of parental trickery are all fair game! Sometimes we need to introduce things very slowly, and sometimes we simply need to change the plan.
Are Functional Medicine consults covered by Medicare or private health insurance?
No. Brain Kids is a privately billed service, and consultations are not eligible for Medicare or private health insurance rebates. All functional laboratory tests are privately billed (no matter how much we wish they weren't).
Why are there so few Functional Medicine practitioners specialising in autism?
Because it’s taken me 27 years, MASSIVE dedication and passion, and approximately the price of a house to get here! There isn't one qualification that teaches you how to do this work. It requires knowledge across multiple areas including child health, nutrition, biochemistry, genetics, immunology, gut health, functional medicine, and brain development and, importantly, the ability to bring all of those pieces together for one individual child. That takes serious skill in critical thinking, problem-solving, and pattern-recognition. My knowledge has been built over decades of clinical practice, university and postgraduate education, specialist training, conferences, mentoring, research, many thousands of hours of study, and a fairly relentless determination to understand more. Autism is extraordinarily complex. Understanding the biological factors that may be influencing an individual child's health and development requires looking across multiple systems and connecting dots that are often considered separately. I absolutely love this work. I’m enormously passionate about these children and their families, and I'll never stop learning for them.