THERAPEUTIC USE OF FISH OIL FOR APRAXIA, AUTISM AND OTHER COMMUNICATION IMPAIRMENTS
The following is basic information about fish oil supplementation for children with speech delays, impairments or multifaceted communication impairments:
What is the best fish oil for my baby or child?
My son Tanner didn't like fish oils but they helped him greatly
The confusion is more the brand names than the formulas. In actuality there really is no such thing as a “children’s fish oil” as fish oil is fish oil. However fish oils can be marketed to appear to be just for children by making cuter bottles, fun flavorings, smaller capsules. In general you will find the “Jr” marketed fish oils to be about twice as expensive because they are typically half dosage for around the same cost.
Most parents squeeze the oil out of the capsule anyway -so if anything a larger capsule would be easier for a child as I don’t know of any preschool children that swallow capsules. The one time you may want to consider paying twice as much for fish oil with the “Jr” marketed fish oil capsules is when you want to teach your older child to swallow the fish oils capsules. In my opinion there never is a reason to pay twice as much for the “Jr” marketed oil in a bottle -cuter bottle or not.
In addition to expense, you probably want to provide your child with at least one regular sized capsule of oil. To put that in perspective if we take the brand ProEFA, one capsule of the regular not the Jr sized capsule is about equivalent to the dosage the FDA approved for infant formula. And as the ProEFA Jr. is an exact half dosage, you would need two capsules of ProEFA Jr. to what would be about equivalent to the dosage of essential fatty acids approved for infant formula. One regular sized capsule of ProEFA is about 1/4 of a teaspoon of fish oil.
Fish oils are also known by the following names
Essential Fatty Acids or EFAs
Polyunsaturated Fatty Acids or PUFAs
Long-Chain Polyunsaturated Fatty Acids or LCPs
Omega 3s or O3
EFAs are naturally in mother’s milk, are added to infant formula and food; today find DHA enriched eggs, milk, butter…even ice cream! In our nonprofit Cherab Foundation we use an essential fatty acid (or EFA) combination that combines the Omega 3s (EPA and DHA) with a small amount of Omega 6 (or GLA)
EFAs are added or used by all ages for health reasons due to extensive research. Mainly we hear about the importance of EFAs for healthy brain and eye development in regards to children but Omega 3 and 6 are essential fatty acids that are essential to the whole body. An essential nutrients means they are essential to/needed by our bodies, but our bodies can’t produce them so we need to consume them, and yet they are virtually lacking in our diets today.
“A simple fish oil supplement may be the key to dramatically unlock the voices of children with speech and language disorders.
That’s the conclusion of a group of scientists who reviewed a study of nineteen youngsters suffering from various speech problems. The children, ranging in age from two years to eight years, were given a fish oil supplement containing a mixture of omega-3 and omega-6 essential fatty acids (EFAs). Speech-language pathologists who monitored the children reported significant improvements within just a few weeks. The improvements were noted not only in the children’s ability to talk, but also in their behavior, ability to focus, and in maintaining eye contact.
Now the scientists, brought together by the Cherab Foundation, a major nonprofit group for children with speech disorders, are calling for a large-scale clinical trial to validate these initial findings.The panel of experts who reviewed the study included scientists from the NIH, Johns Hopkins University, Kennedy Krieger Institute, University of Kansas, and Oxford University, England. They join a growing group of researchers who are heralding the benefits of essential fatty acid supplementation for a wide range of brain-related problems including depression, bipolar disorder, schizophrenia, attention deficit hyperactivity disorder, dyslexia, and even Alzheimer’s disease and autism.”
What dosage has been used in the Cherab Foundation for the past decade with thousands of families?
I will use the following examples with the brand name ProEFA since that’s the formula/dosage that seems to work the best for most of us (Efalex and EyeQ are similar Omega 3/6 formulas that also have good reports) For any brand name of Omega 3/6 formula -you could make the same formula by mixing together fish oil (EPA, DHA) and just a few drops of either primrose or borage seed oil (GLA). Keep in mind in anecdotal feedback done by parents from all over through CHERAB -that pure Omega 3 (including cod liver oil) or pure Omega 6 either showed no results -or very little results in almost all cases. If wanting to use a pure Omega 3 the best reports were from higher EPA formulas like Coromega -but again with the small amount of GLA better results were reported.
When it comes to fish oils brand name isn’t important, all that matters are formula, dosage and quality of the oils. For the person that says they are using or tried using “fish oil” that may or may not be the right formula. What has worked best in our nonprofit for thousands now over a decade is a formula higher in EPA than DHA with a small amount of GLA. Two brands that fit this criteria would be ProEFA by Nordic Naturals manufactured in the US and Eye Q by Equazen manufactured in the UK. Nordic Naturals makes a number of oils…the Omega 369 is the commercial line sold in stores of the same professional line sold by health care professionals (or online fromSpeech411.com ) called ProEFA. ProEFA is slighly cheaper as you get 90 capsules per bottle vs. 60 for around the same price.
Dosage of one (regular not Jr.) capsule a day ProEFA using US testing standards which has worked well for the majority as a basic formula for children of all ages.
- 148 mg EPA
- 99 mg DHA
- 40 mg GLA
Tanner Geng who's been on fish oils since 2 year's old
One capsule of ProEFA (regular not Jr.) which is the dosage listed above is about the dosage of EFAs the FDA approved for infant formula.
Dr. Stordy and Malcolm Nicholl co authored The LCP Solution and my son Tanner’s story is the first one in the book under apraxia “The Lellow Breakthrough“
Malcolm was one of my co authors of the book The Late Talker as well. The LCP Solution or the Omega 3 Connection are both excellent books for general info about why EFAs (or LCPs/PUFAs/…stinky fish oils) are essential to our bodies, have to be consumed, but are virtually lacking in our diets today.
Side effects:
I knew you would be looking for this one!!! Now french fry or doughnut oil, no fear! Honestly when is the last time you looked up side effects for french fry or doughnut oil? Many parents may find it cute to feed their baby that first french fry….but shudder to think of giving their child fish oils. Fish oils have been used for generations by our grandparents and their grandparents for health reasons.
Side effects reported in our group (thousands now over a decade) for Omega 3/6 oils if any would be for the most part temporary mild loose stools or change in behavior which may last about a week.
On the other hand what are the side effects of not enough essential fatty acids? As parents we need to push to have the FDA encourage set minimum dosages of fish oils for children from 1to 5 years old, especially in light of recent rulings by the AAP.
Recently the AAP has approved ADHD diagnosis and ADHD drugs for a child as young as 4 years old. The AAP has also just stated that all children between 9 and 11 years oldwill be tested for cholesterol; some children will be put on a statin drug.
With over 18 thousands studies that validate the health benefits of essential fatty acids from fish, why wouldn’t the FDA approve fish oils which are known to help with focus and cardiovascular health before even thinking of approving drugs with side effects for children as young as preschoolers?
Why is there vitamin E added to the fish oils?
There is a small amount of vitamin E added to fish oil capsules for two reasons
1. To stabilize the fish oil
2. Due to the results of a study that found “There is some concern that a diet rich in fish oil taken for many months may induce a deficiency of vitamin E. People who eat a diet high in fish or who take fish oil supplements may want to consider taking vitamin E supplements.”
Do all fish oils contain vitamin A?
Any oil that comes from the liver of the fish, such as Cod Liver Oil/CLO naturally contains vitamin A. Fish oils not made from the liver of the fish do not contain vitamin A. In general in our group we have found that the cod liver oil is not as effective of a formula. Perhaps because it’s higher typically in the DHA than the EPA and there is no GLA.
I heard we get enough Omega 6 in our diets, so why use a fish oils with Omega 6 added?
For some reason we notice more surges when an Omega 3 formula with a ‘small’ amount of GLA from either primrose or borage seed oil (the Omega 6) is added. One theory as to why is that the GLA has very strong anti inflammatory properties that enables the DHA and EPA to cross the blood brain barrier through the tiny vessels it needs to travel into the brain? Right now I can only report what has worked best and as parents we’ve tried all of the formulas.
How do you get a child to take fish oils?
Some children like the taste of fish oil. The parents need to hide the bottle as the kid will chew the capsules like they are gummy candies! But for many of us the child will either hate or not like the taste of fish oil.
Below are helpful tips on how to get yucky magic fish oil into kids that worked for me when my son was younger. Trust me totally worth the drama! From our one Cherab website
Tanner had tremendous surges on fish oils
My 5 year old apraxic son Tanner is a trooper and takes the ProEFA from a spoon every day. I hold his nose for him, but he doesn’t mind the taste. We started the holding the nose thing when Tanner used to take the efalex, which is very fishy smelling and tasting, and it’s kind of our ritual now.
I rip only half of the protective waxy seal off the top of the ProEFA bottle, and put a pin in the part that is left. When it’s time to give Tanner his ProEFA, I open the top of the bottle, pull out the pin, put a hole in the capsule, put back the pin, and squeeze the oil onto a spoon.
Here are some other things we used to have to do when Tanner took the efalex which he hated. (Efalex is fishier tasting and smelling)
1. We would put just put a drop of fish oil in the middle of the bread for a sandwich and cover with peanut butter, a drop in the middle of a pancake, a drop in the middle of a bowl of spaghetti, etc. if we put too much fish oil, Tanner would not eat the food.
2. Glenn and Tanner and Dakota would each hold a cup filled with a dash of juice. Tanner’s juice was always “spiked” with efalex. Tanner is very competitive and would love a good race. “Ready set Go!” and Glenn would hold the cup to his mouth without drinking and then stop and have all three compare who drank the most. Of course, Tanner was winning! They would keep doing this until Tanner won (which meant he finished the efalex fish oil spiked juice)
3. I used to bribe Tanner with gummy bears that he could have after. Didn’t work as good as the first two. But for a long time we did a combination of number one and number three.
4. Tanner’s older brother started taking the fish oil, and Tanner wants to do what Dakota does.
5. As Tanner got older, at about four, we started calling the fish oil “yucky magic fish oil which helps you talk” and we really made a big deal about how yucky it was, and would “show off” to people how Tanner could take this yucky stuff and eat it right off the spoon. It worked for Tanner!
It was lots of work, but well worth the results. If your child will not take ProEFA, maybe buy some efalex and try that. Compared to efalex, a sock would probably be a treat!
Again, some EFAs are liked by some children-hated by others. With ProEFA – many kids from the Cherab group will just eat it from a spoon, or chew the capsule since borage oil is naturally sweet. I can say that ProEFA does not smell like some of the other EFAs we’ve used. After a year and a half of Tanner hiding behind the couch when it was time to take other fish oils, this was amazing even without all the great breakthroughs he’s had!
And sometimes as Colton demonstrates, it’s “Sooooo easy” to give a child fish oil!
Share this video with your child as Colton could inspire your child to take his fish oil this way too!
Should I put fish oil in my child’s reusable plastic cup?
You don’t want to put fish oil into any type of reusable plastic no matter what type of liquid or food it’s mixed with because the oil will bind to the plastic and you will find it difficult if not impossible to get the smell of fish out of the cup no matter how much you wash it. Think of when you put spaghetti sauce into a plastic Tupperware like container and the container turns orange from the plastic absorbing the pigments from the spaghetti sauce during the wash. While one can deal with an orange container, try to deal with fish oil steam when you open your dishwasher! Most likely you’ll throw any plastic cups away that you put fish oil in. You preferably want to serve fish oil in glass, ceramic, metal (such as on a spoon) and if you use plastic -disposable plastic.
What about flax seed oil?
Flax seed oil or freshly ground flax seeds are an excellent source of the essential omega-3 alpha-linolenic acid (ALA or LNA) which is the quintessential parent member of the omega-3 family of essential fatty acids (EFAs). The body transforms it into EPA and the EPA into DHA.
This transformation is very inefficient (the yield is only about 5%) and is further inhibited by over consumption of omega-6 fatty acids from most vegetable oils or certain disease states. Therefore, it is advisable to independently consume also ready made EPA and DHA from good quality fish of from high quality fish oil supplements. The only other recommended source outside of fish oil would be algae. Some recommended intakes are listed on the introductory lecture on EFAs from the First Conference on Therapy of Verbal Apraxia, July 23-24, 2001, Morristown, NJ.
What is the difference between fish oil in the bottle vs fish oil capsules?
1/2 tsp of fish oil is about the same as 2 capsules of ProEFA. If you use oil from a bottle the shelf life will be around 4 months once opened vs. up to 4 years as with the capsules. Also the oil needs to be refrigerated, the capsules do not. Even if you typically prefer using the oil from the bottle I highly recommend getting some capsules as well for when you travel.
My bottle of fish oil says just one capsule a day. Isn’t that the dosage?
Many -including me -were not aware that only those fish oil formulas used in research are allowed to recommend higher dosages than the standard “one to two capsules” But check out the old Efalex bottles -or if you are from the UK the Eye Q bottles -both of which are used in research…much higher dosages anywhere from 4 to 9 capsules a day are recommended. In our nonprofit most even with preschool children use on average 3 capsules a day. (2 ProEFA and 1 ProEPA which you can get online )
What improvements should I look for when I start my child on fish oils?
Since I receive lots of calls about this -I wanted to list the most common changes in an apraxic or other speech disordered child on EFAs from what I’ve read and heard and seen. Most of the following are for children that were essentially nonverbal previous to supplementation.
1. Increase in babbling or attempts at sounds.
2. Increase in imitation.
Changes also can be looked for in (what you see as positive or negative)
- sleep
- attention
- appetite
- focus
- behavior
- stools
Next will come a breakthrough of something you were probably working on for a bit -so you will be excited but will think “Well -I don’t want to get my hopes up we were working on that for awhile now -maybe it’s just a coincidence” However after the second or third surge in a short period of time -and then another – you are pretty sure things are different and it’s at this point the professionals and the rest of the family and your friends are noticing it too – maybe about two to three weeks now.
OK -the next stage is pure elation and hope -you see the light and no longer feel as desperate and want to share this new information with everyone and anyone. As the months go by and your child continues to progress at a much more rapid rate -you may even start to doubt the original diagnosis -especially if you started EFA supplementation at two -and perhaps the SLP that diagnosed the apraxia who also was at first excited is starting to second guess if the original diagnosis was correct as well.
Unless you have to stop the ProEFA (or other Essential Fatty Acids) and literally have the chance to see the regression of acquired speech and language skills, attempts, and changes in behavior like we did with Tanner (and/or have a chance to again witness the second surge when your child is put back on the EFAs) -that doubt will probably remain somewhere in your mind and in others around your child. So the “I told you that he would start talking when he was ready” comments should be expected of course.
The child on ProEFA or some other EFA formula’s like it no longer fits the criteria of the classic definition of apraxia -and yet doesn’t fit the classic perception of what a late talker is either. The brain responds to multiple stimuli and even if children on fish oil no longer present with the original diagnosis, they will still require appropriate speech therapy. And while most of this information is focused on speech and communication impairments, fish oils are beneficial for numerous conditions from cardiovascular to psychological conditions as they contain the essential fatty acids. With a slightly different formula of fish oils containing high EPA to DHA and an even smaller amount of GLA, the fish oils are also extremely beneficial for those diagnosed with ADHD. There are numerous cases of children that due to the effectiveness of fish oils, were kept off prescribed drugs for ADHD with known serious side effects.
I just started feeding my child essential nutrients (essential fatty acids, essential amino acids and other essential nutrients) and in addition to increase in speech and other improvements, I noticed he is sucking his fingers and chewing on his clothes. Is this a side effect?
There are two main temporary changes changes sometimes reported in the first week or two of supplementation of essential nutrients. The most common temporary change reported is increased “hyperness” While some may view this increase in hyper activity as a negative, some theories are that it’s a sign that neurons that were previously dormant starting firing. It could due to changes in production of neurotransmitters as well. Regardless the reason, this stage typically lasts only about a week or two. Your options during this stage are to wait it out, or lower the dosage a bit and trade improvements for a more docile child. Most choose to wait it out.
Like the “hyper” stage another less frequently reported temporary “side effect” is the child’s sudden interest in chewing or sucking on toys, clothes, fingers etc. When you notice your child all of a sudden chewing on their clothing or sucking their fingers, this could be a late oral exploration stage for some with speech impairments that didn’t go through this important developmental stage fully or at all. We first heard about some speech impaired children going through normal developmental stages such as oral exploration or the “terrible twos” later with essential fatty acids (fish oils. ) , and now we are hearing about this in some cases with essential amino acids and nutrients from food (Nutriiveda ) as well. Based on the parallels reported between fish oils and NV it’s not surprising. Going through developmental stages later rather than never is good. And going through the oral exploration developmental stage is a great as again oral exploration is a normal developmental stage or the “teething” stage is important for developing speech.
You can try other things for him to suck on during this stage. For example when you see him sucking his fingers -you can offer him a natural lollipop..
Essential nutrients such as essential fatty acids. and essential amino acids and nutrients from food are reported to create surges in many areas -receptive, expressive, focus, attention, motor planning, academic etc. In the rare case there is no noticeable benefits essential nutrients still need to be consumed daily for good health as the body is unable to produce essential nutrients.
If the teething really bothers you again can lower the dosage of fish oils or NV a bit and trade improvements. You can also provide more appropriate teething material for your child to chew or suck on. Here are some suggestions. But again these stages don’t tend to last more than a week or two.
Here are two examples of the late oral exploration stage after essential nutrient supplementation
Not even 2 days on NV!!
Hello, All!! My son, Cale, is 2 1/2 and just started Nutriiveda on Wednesday night, so not even 3 days, and we are already seeing results, as early as late Wednesday night/early Thursday morning (seriously, after it only being in him for a few hours!)!!!! I’m impressed, to say the least!!! While we haven’t noticed the possible extra “hyperness” that some see in the first week,
we have noticed that he’s been sucking on his finger a few times and he’s never done that before (not a big deal since he’s improved in so many other areas).
Anyway, he has been able to repeat a three word sentence (never able to do that before), even though the words still follow his normal pattern on dropping off the beginning sound (So, the sentence, “Mommy, jump please” came out “Mommy, ump eez”)…but still amazing! We’ve been trying to get him to repeat TWO word sentences/phrases with no luck up until now, and he repeated a THREE word sentence! Awesome! He was also able to put the “B” sound on “bear” the other day with his therapist, which he’s never been able to put a B on any word except ball, even though we’ve been working on it for ages. He is also trying to say more words and when we correct how he’s saying it (since he’s dropping off the beginning sounds, as usual), he’s much more able to produce a word that sounds more like it should! He also, on his own, said “mommy car” and pointed at my van….a two word phrase on HIS OWN!!! Okay, obviously I’m ecstatic and just wanted to share! I’m so glad we were able to find a way to fit NV into our budget–best thing I’ve ever done for my son!!!
fish oil side effect??
My son started chewing his toys last summer after we started fish oil, he also started drooling for the first time. It didn’t last too long, maybe 2 weeks?? He also started saying some words at the same time!
To me it seemed like his chewing was because he could feel what his mouth was doing. He started trying to lick things too and he always looked surprised.. like he could feel the texture or taste and that it was new to him. With my son it didn’t last long but it was the beginning of he having some words that he could use.
Here is one article on Oral Exploration from Carolina Pediatric Dysphagia
Oral Exploration: The Window to Their World Introduction to Infant Mouthing
Did you ever wonder why babies mouth so much? They are learning about their world! Babies experience the world through their mouths – their mouth is their primary learning tool. Through this a baby will experience size, shape, texture, taste, and temperature; and at the same time will be preparing their mouth for more complicated oral tasks involved with feeding and speech development. Babies also use oral play and exploration as a source of comfort and organization. Whether it is a newborn sucking a nipple or a teething sixmonth- old biting a finger, oral experiences are relaxing and comforting. Babies begin to explore with their mouths even before they are born. Thumb sucking has been noted in utero as early as 16 weeks gestation. At birth the sensation in and around the mouth is the most highly developed. Most children are eager to suck and should enjoy oral and facial touches from caregivers, soft blankets and warm hands. By 4-6 months most babies have now developed greater body control and strength. They are learning to sit without support, reach for and hold toys, and bring toys to their mouths. Now the learning really begins! Everything must be taste-tested and explored, licked and drooled on! It is at this point where concerns about germs or choking are high. But don’t worry, as long as you keep a fairly clean house and monitor what objects are available, there should be no problem. Remember, keeping babies from mouthing and drooling on objects and toys will keep them from learning and being comforted.
Children with medical or developmental difficulties
Children with medical or developmental difficulties may lack these early oral experiences. Children with motor difficulties may not have the motor ability to hold toys or bring them to their mouths, and therefore have limited opportunities for oral exploration. Children who have experienced hospital procedures such as intubation, suctioning, etc. can often develop the idea that the mouth and throat hurts and should be avoided. Similarly, children with reflux who experience discomfort during and after feeding may also associate oral experiences as painful and unpleasant. As parents and caregivers, we need to identify situations or difficulties that may interfere with a child’s abilities to experience their world through oral exploration. By providing pleasurable oral and facial input, oral development can begin to re-shape early learning experiences and set the stage for more positive and earlier experiences with food.
More common questions and answers can be found on our “Getting Started” page.
I’m thinking of also using Nutriiveda/ NV with fish oils. Should I stop fish oils when I first start NV?
If your child has been on fish oils and you are starting NV for therapeutic reasons as well do not stop the fish oils. Fish oils contain the essential fatty acids, NV contains all of the essential amino acids and nutrients from whole foods and as both are essential nutrients they compliment each other. If you have not yet started either, it is recommended to start one and then start the next a month later so you can get a better idea which is doing what. Fish oil surges are in a day to three days -typically a week for first surges. NV surges are typically in a day to three days and results are reported to be a bit more dramatic and in more areas for some reason.
My child is allergic to shellfish. Can I still give him fish oil?
Use high quality fish oils and call the company to verify the source of the DHA and EPA. Here’s a quick answer from Dr. Weil “A shellfish allergy shouldn’t prevent you from safely taking fish oil supplements.”
I’m concerned about mercury from fish consumption for my child. Also I’m pregnant now so should I avoid consuming fish?
There is a two part answer to this. In regard to fish oil supplements the population at large does not know that MeHg (mercury) binds to proteins and therefore it is not of concern in highly purified fish oils. (you can read more in letters I and other members of the Cherab Foundation sent out to the FDA and IOM here) And recent research has found that pregnant mothers who consume fish twice a week have babies that are just “smarter”. This is the conclusion of a recent large study as you can read on the USDA’s Nutrition Evidence Library here “Moderate evidence indicates that increased maternal dietary intake of long chain n-3 polyunsaturated fatty acids (PUFA), in particular docosahexaenoic acid (DHA) from at least two servings of seafood per week, during pregnancy and lactation is associated with increased DHA levels in breast milk and improved infant health outcomes, such as visual acuity and cognitive development.”
Also read “Can Fatty Acids in Breast Milk or Formula Make Kids Smarter?” Two new studies find benefits at 14 months and about 10 years.
“Whether they’re fed by bottle or breast, babies seem to turn out smarter when nourished with healthy fatty acids found in breast milk and some formulas, two new studies indicate.
The studies, done in the United Kingdom and Spain and published online Sept. 19 in the journal Pediatrics, found that higher levels of long-chain polyunsaturated fatty acids (such as DHA, EPA and ALA) were linked to greater mental development in both young and older children.”
One Year Later; A Possible Cure Through Essential Nutrition For Autism, Apraxia Etc.
Links:
“Look Who’s Talking Now: Fish oil capsules help children with speech disorders find their voices ”
The Late Talker book Chapter on fish oils.
History of how our First Apraxia Conference came about
Me and my son Tanner when he was younger
We hope to raise monies for clinical research to validate the importance of Omega 3 and 6 fatty acids Until there is research, share all with your child’s ped -many neurologists today are more knowledgeable about the importance of EFAs even if your pediatrician still has little to share in this area.
While looking into fish oils which contain essential fatty acids, you may also want to explore with your child’s doctoressential amino acids and nutrients through diet as well.We have had incredible success with essential nutrients and there is extensive and growing research on the importance of these essential nutrients. Essential nutrients are needed daily but the body can’t produce them so they need to be consumed in the diet. The problem is many diets today are poor, and add to that compromised metabolic systems. The purest form of supplementation is through food.
Essential fatty acids, essential amino acids and essential nutrients may be confusing…but good news is that we don’t have to understand everything about good nutrition to see it have positive effects!
Email us or provide feedback below if you have any questions or comments!
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Written by Lisa Geng, mother to two boys that were both “late talkers” who are doing great today. President and Founder of the Cherab Foundation, and Co Author of The Late Talker book St Martin’s Press
