The Power of One Change at a Time: A Functional Medicine Approach for Families

I think we can all agree as parents — especially those of us with more sensitive children — that any change in routine can feel overwhelming. Most of you, if you’ve found this blog, are likely searching for answers. You want to help your child heal, but you’re not entirely sure where to start.

Maybe you’ve heard that you “should” remove gluten, dairy, sugar, corn, and soy. And maybe you’ve wondered: What on earth is my child supposed to eat if I take ALL of those things away? Your child is already so picky, barely sits at the table, and the idea of removing everything at once feels unrealistic. And honestly? You’re not convinced it will help enough to justify the battle.

Maybe you’ve already tried removing gluten. You gave it your best shot, but couldn’t find replacement foods your child would accept — especially when the rest of the family was still enjoying their usual meals. Or maybe you managed a few days, and then a holiday or birthday party derailed everything before you saw any change.

You may wonder:
Is this just not for us?
Is there an easier, more sustainable way to help my child feel better?

The truth is, healing often begins in the gut. As Hippocrates famously said, “All disease begins in the gut” — a belief functional medicine continues to explore. And if disease begins there, then healing must begin there as well.

While functional testing can give us deeper answers, we don’t have to wait for expensive labs to start supporting the body. One of functional medicine’s foundational models is the 5R approach, a simple framework that helps us organize where to focus. We begin by Removing irritants and triggers, then Replacing what’s missing, followed by Reinoculating with beneficial microbes, Repairing the gut lining, and finally Rebalancing daily rhythms and routines. It’s not meant to be overwhelming — just a way to understand the order of operations so we can take one step at a time.

And that one step doesn’t have to be dramatic.
A single shift — like exploring a gluten-free or casein-free diet for autism — can have profound impacts when done consistently. These changes help calm inflammation, support digestion, stabilize behavior, and improve the body’s ability to heal. Small, steady steps often create ripple effects that build upon each other in ways parents don’t expect.

For many families, the first step is removing gluten or dairy — not both at once. It’s reasonable, doable, and often creates enough change that parents feel encouraged to continue. This is the heart of functional nutrition and dietary changes for autism: beginning with what’s manageable, not with what’s perfect.

And here’s something many parents don’t know: gluten and dairy break down into opiate-like compounds. Sensitive or inflamed children can feel chemically “hooked” on these foods, which explains why so many of our kids are intensely picky and gravitate toward the same items over and over. Once you understand that this is biochemical — not behavioral — everything makes more sense.

This is also why making changes as a family unit matters. Our kiddos are smart. It’s hard to expect them to try something new while watching siblings eat the very foods they’re being asked to avoid. When everyone participates, resistance decreases and success increases.


🌿 Why Support Matters

Implementing dietary and lifestyle changes — for yourself or your child — can feel complicated, even when you understand why the changes might help. Many families know that steps like trying a gluten-free or casein-free diet for autism may reduce inflammation or improve mood, digestion, or behavior. But knowing something might help isn’t the same as knowing how to begin, what to prioritize, or how to monitor progress without taking on too much at once.

This is where steady, organized guidance becomes clinically helpful.

One of functional medicine’s foundational models is the 5R approach — a framework that helps us understand where we’re headed and why sequence matters. But translating that into day-to-day life requires clarity:
Which change should come first?
How long should it be tried?
What signs suggest improvement or sensitivity?
When is it appropriate to advance to the next step?

To make changes realistic, we break them down into SMART goals, a simple behavior-change framework used across all aspects of functional medicine. It means choosing steps that are Specific enough to be clear, Measurable so you can track them, Action-focused rather than theoretical, Realistic for your family’s bandwidth, and Time-bound so we know when to reassess. This keeps progress organized and prevents families from taking on more than they can sustain.

When changes are introduced gradually and evaluated thoughtfully, you gain clearer insight, reduce unnecessary trial-and-error, and build confidence through each small success.


Functional medicine isn’t about perfection. It’s about progress.
And progress often begins with the smallest, simplest shifts — especially when they’re made with clarity, consistency, and compassion.

If you’re unsure where to start, overwhelmed by dietary changes for autism, or unsure how to implement a gluten-free or casein-free diet in a realistic way, you’re not alone.

One change at a time is enough — and those changes add up.

If you’d like guidance on where to begin, or you want help mapping out the first few steps in a way that feels realistic for your family, you can schedule a discovery call here. It’s a simple way for us to talk through your goals, your child’s needs, and whether a functional medicine approach might be a good fit.

Infographic showing how gluten and dairy peptides act like opioids in the body and affect behavior and gut health.

How the Gut and Brain Communicate

Parents often recognize when their child’s symptoms are connected to something beneath the surface—especially when it comes to digestion, picky eating, or changes in behavior after consuming certain foods. In functional medicine, these clues are never ignored. The gut plays a central role in how the brain functions, how inflammation is regulated, and how a child feels day to day.

By understanding the gut–brain connection, we can begin to uncover why certain symptoms appear and take small, practical steps toward balance and healing.


The Gut–Brain Connection and the Role of the Vagus Nerve

The vagus nerve acts as the main communication pathway between the gut and the brain. It sends signals back and forth, constantly updating each system on how the other is doing.

When digestion is impaired or the gut microbiome is imbalanced, inflammatory signals travel along this nerve and can influence mood, energy, and cognition. In the case of autism, this sometimes means worsening irritability, brain fog, fatigue, increased stimming, aggressive behaviors, or even eloping.

Likewise, when the body or mind is under stress, vagal tone (the strength of this communication) weakens. This can lead to slower digestion, increased inflammation, and shifts in gut bacteria—all of which can make a child feel more dysregulated or uncomfortable in their own body.

In my practice, I see how calming the nervous system and supporting digestion often go hand in hand. When we reduce inflammation in the gut, the vagus nerve can send clearer, calmer messages to the brain. This shift often brings noticeable improvements in mood, focus, and overall function.


Common Signs of Gut Imbalance

  • Picky eating and limited food acceptance
  • Constipation, diarrhea, or alternating patterns
  • Abdominal pain, bloating, or gas
  • Irritability or discomfort after meals
  • Fatigue, poor sleep, or “foggy” behavior
  • Food cravings, especially for carbohydrates or dairy

Some of these patterns have been present for so long that they start to feel “normal” to the whole family—even though they may be quietly impacting a child’s comfort, focus, and development.


My Approach to Gut Healing

In my work with families, I look closely at patterns that might be contributing to ongoing imbalance. For many children, food sensitivities—not the same as food allergies—are part of the picture.

Allergies typically trigger an immediate immune reaction. Sensitivities, on the other hand, can create a delayed response—sometimes hours or even days later—showing up as irritability, fatigue, anxiety, congestion, digestive discomfort, changes in mood or focus, skin rashes, and occasionally respiratory symptoms.

Some children have had digestive symptoms for as long as their parents can remember—so much so that what’s “normal” in the household may actually be a sign of imbalance.

Along with exploring food sensitivities, I often look at whether bacterial or fungal overgrowth might be creating an environment in the gut that’s not favorable to a healthy microbiome. These patterns are explored through functional testing:

  • A comprehensive stool analysis helps identify bacterial imbalances and evaluates overall microbiome health.
  • An organic acids test can reveal signs of yeast or fungal overgrowth.

A thorough stool analysis is especially valuable, as it gives us a clearer understanding of whether dysbiosis may be contributing to behavioral, cognitive, or neurodevelopmental symptoms.

These microbial imbalances are addressed through dietary changes, botanical remedies, and, at times, pharmaceuticals. We use the lab results to make diet and environmental adjustments and then collaborate with a functional medicine doctor for more involved interventions or anything involving medication. It’s especially important to be under the care of the right practitioner—and I help families find one who best fits their needs and collaborate closely with them so the plan is clear, manageable, and aligned.


Moving Forward

As we work through digestion, sensitivities, and any imbalances in the microbiome, parents begin to understand what’s been contributing to their child’s symptoms and what can help things improve.

Every child is different. By supporting gut health through shifts in nutrition and guidance based on lab results, we can begin to gently nudge the body back toward homeostasis. I use labs as an educational tool—helping families see what may be driving symptoms and how to make meaningful, step-by-step changes based on those findings.

Depending on what the labs reveal, the plan may include dietary changes, botanical remedies, or—when appropriate—pharmaceutical agents to help eliminate unfavorable microbes. When medication or more advanced interventions are needed, I help families find the right functional medicine doctor and collaborate with them so everything feels coordinated, thoughtful, and manageable in daily life.

If you’re ready to explore this work for your child, you can learn more on the
Work With Me page or start with a free discovery call to see whether this approach feels like the right fit.

Illustration of the gut–brain connection representing how functional medicine addresses gut health in autism and related conditions.

Understanding Apraxia and Speech Delay: A Functional Medicine View of Motor Planning and Healing

As a parent, you’ve probably asked yourself: Why doesn’t my child say what they mean? Or why can they understand something, but not reliably do it?
These are often the questions that lead to the concept of apraxia—a challenge of motor planning and speech coordination rather than a lack of understanding.

Two of my favorite educators from the MAPS (Medical Academy of Pediatric Special Needs) program, Dr. Dana Johnson and Dr. Anju Usman Singh, have each contributed valuable insight into this area. Their work beautifully illustrates how both body and brain must be supported to help children overcome speech delays and motor planning challenges that may underlie apraxia


What Is Apraxia (and How It Relates to Speech Delay)?

The word praxia comes from the Greek for doing, and “a-” means without. Apraxia describes difficulty planning and executing voluntary movements—even when comprehension and muscle strength are intact.

For many children, this shows up as speech delay or inconsistent verbal output. They may know what they want to say but can’t consistently get the words out. Others experience broader body-movement challenges that affect coordination, imitation, and daily tasks.

Apraxia is not simply a speech disorder—it’s a motor coordination issue that can influence every part of how a child expresses themselves and engages with the worl


Insights from Dr. Dana Johnson

Dr. Dana Johnson, PhD, MS, OTR/L is an occupational therapist and researcher based in Tampa, Florida. She specializes in motor planning, apraxia, and sensory-motor integration in children and adults who are non-speaking, minimally speaking, or inconsistently verbal.

Dr. Johnson’s work highlights that communication is not only cognitive—it’s motor-based. For many children with speech delay or limited expressive language, the challenge lies in the brain-body connection needed to initiate and sequence speech movements.

By supporting that connection through sensory integration, intentional movement, and motor-reliability work, she helps children build consistency and confidence in communication.

Her educational contributions through Documenting Hope and the MAPS community have helped countless clinicians and parents better understand how body-based support can unlock communication potential.


Insights from Dr. Anju Usman Singh

Dr. Anju Usman Singh, MD, FAAFP, ABIHM, FMAPS is the director of True Health Medical Center in Naperville, Illinois. A board-certified family and integrative medicine physician, she has been a pioneer in biomedical and functional approaches to autism, ADHD, apraxia, and speech delay.

Dr. Usman Singh’s work focuses on how underlying toxic load and nutritional deficiencies can interfere with neurological and motor development. Imbalances in zinc and copper, mitochondrial function, chronic infections, and environmental exposures can all impact how efficiently the brain and nervous system coordinate movement and speech.

Her research supports the idea that when the body’s detoxification, immune, and metabolic systems are overwhelmed—or when it lacks key nutrients—motor control and speech production can both be affected.


A Functional Medicine Framework for Speech and Motor Development

Through a functional medicine lens, we look at the underlying “terrain” of the body that influences brain-body communication. When speech delay or apraxia is present, there are often contributing factors that make it harder for the nervous system to function efficiently.

That exploration may include reducing toxic load from environmental chemicals, heavy metals, or infections that stress the nervous system; replenishing nutrients like zinc, magnesium, B vitamins, iron, and essential fats that support neurotransmission and motor coordination; and supporting gut health, mitochondrial energy, and detox pathways so the body can process and recover more effectively.

When the body’s foundation is strengthened, therapies that target speech and movement often become more effective—because the system they’re working on is more responsive.


What Progress Can Look Like

Progress often starts subtly. Parents might notice that transitions become smoother, gestures or attempts at speech appear more often, or their child seems more organized in movement. Over time, as toxic burden is reduced and deficiencies are corrected, speech and communication can begin to emerge or strengthen.

This isn’t about quick fixes—it’s about allowing the body’s natural capacity for healing to unfold. When we support the body and remove obstacles, the brain and nervous system often respond with new levels of clarity and coordination.


Bodies have a natural propensity toward healing. When we remove obstacles and offer the right kind of support, that built-in wisdom has room to do its work. This process isn’t about changing who your child is—it’s about creating the conditions where their strengths can shine.


Supporting speech and motor development through a functional, root-cause approach—helping parents understand the ‘whys’ behind apraxia and speech delay

References

Take the next small step toward your child’s healing.
Together, we can explore the whys behind your child’s speech and motor challenges, uncover possible contributing factors, and create a clear, supportive roadmap—visit-ready labs, smart questions for your clinician, and simple actions that fit real family life.

Leucovorin and Folate Pathways in Autism

(Why this therapy may help — and why it’s only one part of the whole picture)

Why Folate Matters for the Brain

Folate—also known as vitamin B9—is essential for brain development, neurotransmitter production, and detoxification. It supports processes like methylation and DNA repair that help the brain grow and function well.

But in some children on the autism spectrum, folate has trouble getting into the brain where it’s needed most. Even when blood tests show normal folate levels, the transport mechanism that moves folate across the blood–brain barrier can be blocked.

This is called Cerebral Folate Deficiency (CFD). Often, it’s linked to folate receptor alpha autoantibodies (FRAAs)—immune proteins that block the receptor responsible for carrying folate into the brain.

When this happens, kids may experience language delays, irritability, fatigue, or developmental plateaus that don’t improve with diet or therapy alone. In a functional medicine framework, this is one of many possible “root causes” we explore when progress feels stuck.


What Leucovorin Is—and How It Works

Leucovorin (folinic acid) is an active form of folate that can bypass the blocked receptor and still reach the brain.

While standard folic acid depends on the folate receptor α (FRα) to cross into the central nervous system, leucovorin uses an alternate pathway—the reduced folate carrier (RFC)—to deliver active folate directly to where it’s needed.

Once in the brain, leucovorin supports the same vital processes as natural folate: methylation, neurotransmitter balance, and mitochondrial function.

This is what makes it different from over-the-counter folic acid supplements. For children with FRAAs or other transport problems, leucovorin can sometimes “open a different door” and restore function that was otherwise blocked.


What Dr. Richard Frye’s Research Shows

Dr. Richard E. Frye, a pediatric neurologist and researcher, has published multiple studies exploring folate metabolism in autism. His work shows:

  • High rates of FRAA positivity (around 70 %) in children with autism.
  • Improved verbal communication and language development in FRAA-positive children treated with folinic acid.
  • Better social engagement and reduced irritability in several studies.
  • Dose-dependent effects: those with higher antibody levels often show stronger responses.
  • Good safety profile: side effects are generally mild and temporary (agitation, sleep changes, or headaches).

In other words, leucovorin appears to help when a clear folate-transport issue is identified—and when it’s introduced thoughtfully, as part of a broader plan.


Why It’s Not the Whole Picture

Folinic acid can make a big difference—but only if the rest of the system can support that change.

Folate metabolism is connected to everything from gut health to mitochondrial energy, detox pathways, and sleep. If those areas are still under strain, leucovorin alone may only move things partway.

Functional medicine focuses on strengthening these foundations so that targeted therapies like leucovorin can work more effectively.
That means also looking at:

  • A nutrient-dense, anti-inflammatory diet
  • A healthy gut and balanced microbiome
  • Adequate mitochondrial and detox support
  • Quality sleep and stress regulation
  • Coordinated supplement and medication routines

When these systems are supported, we tend to see steadier, longer-lasting improvements—speech that continues to build, behavior that stabilizes, and energy that feels more consistent.


Testing and Clinical Considerations

If a child’s history or symptoms suggest a possible folate-transport issue, a physician can order FRAA testing (and sometimes tests for soluble folate-binding proteins).

When results confirm an issue, leucovorin may be prescribed under medical supervision. Doses vary, but all studies emphasize close monitoring and gradual introduction.

Families should never start this on their own. It’s best used as part of a coordinated plan with a clinician who understands neurometabolic or functional medicine approaches.


A Functional Medicine Lens

In functional medicine, we rarely look for a single “answer.”
We look for patterns—nutrient pathways that need support, inflammation that needs calming, and systems that need connection.

Leucovorin can be a powerful tool for some children, especially those with confirmed folate receptor antibodies, but it’s one piece of a much larger puzzle. When we zoom out and build a foundation that supports methylation, detox, sleep, and digestion, the body can finally use these targeted interventions the way they’re intended.


Your Family’s Roadmap to Healing

If you’ve heard about leucovorin or FRAA testing and aren’t sure if it fits your child’s picture, I can help you sort through it.
Together, we can:

  • Understand what testing might be appropriate
  • Prepare visit-ready labs and questions for your clinician
  • Translate complex recommendations into clear, doable steps
  • Build the foundations that make biomedical interventions more effective

You don’t have to figure this out alone.
Step by step, we can build a roadmap that helps your child’s body work better—so therapies like leucovorin can make the difference they’re meant to.

Leucovorin (folinic acid) can bypass a blocked folate receptor to support folate transport into the brain — an important step in addressing cerebral folate deficiency seen in some children with autism.

References:

  1. Frye R.E. et al. Folinic acid improves verbal communication in children with autism spectrum disorder and language impairment: a randomized double-blind placebo-controlled trial. Mol Psychiatry (2016)
  2. Rossignol D.A., Frye R.E. Folinic acid in autism spectrum disorder: a systematic review and meta-analysis. Prog Neuropsychopharmacol Biol Psychiatry (2021)
  3. Frye R.E. et al. Biomarker associations and clinical response to folinic acid in autism spectrum disorder. Front Neurosci (2024)