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cbd oil for autism 2 yrs old girl

Cannabis for Treating Core and Comorbid Autism Symptoms – Where are we at?

Several new studies published in recent months (first half of 2019) investigated the effects of various cannabis-based medical products (CBMPs) for reducing symptoms of autism. Although all of the studies were open-label and relatively small in scale, the overall results were overwhelmingly positive and encouraging, with statistically significant improvements observed across all measured domains, including social communication, language, and restrictive and repetitive behaviours and interests, the core symptoms of autism.

The biggest positive changes in most of the studies were measured in the domain of so-called ‘challenging behaviours’ and comorbid disorders that are frequently present in autism and that severely affect quality of life of individuals with autism and their families. These included behaviours and difficulties such as aggression and self-harming, anxiety, hyperactivity, lethargy, irritability, stereotypy and inappropriate speech, sensory difficulties, food acceptance, feeding and sleep disorders and seizures.

As all the studies were limited in scope, possible mechanisms were not investigated in most cases. One notable exception was a preliminary investigation by a team at King’s College London, which noted clear effects of cannabidiol (CBD) on brain functional connectivity and brain excitation and inhibition systems in individuals with autism by magnetic resonance spectroscopy and magnetic resonance imaging (Pretzsch et al., 2019, 2019).

This article contains the following chapters:

Cannabis as medicine – a brief overview

The two main species of cannabis genus of plants are Cannabis sativa and Cannabis indica. A cannabis plant contains more than 500 known active compounds–cannabinoids, flavonoids and terpenes, fatty acids and others. The most well-known cannabinoids are cannabidiol (CBD) and tetrahydrocannabinol (THC), of which only the latter has psychoactive properties. Different strains of the plant are cultivated to contain varying amounts of THC and CBD. Cannabis indica species usually has higher levels of CBD compared to THC, and Cannabis Sativa on average has lower levels of CBD to THC, but there are hundreds of different strains being cultivated of each, and countless hybrid variations. The word ‘hemp’ relates to cannabis plants with in which the levels of THC are very low, usually up to 1%. (At present time the legal limit of THC in hemp oils is 0.2% in the UK and most European countries), while ‘marijuana’ is an unofficial term for strains with high THC content that were originally cultivated primarily for recreational use.

Cannabis has been cultivated in many parts of the world and used as medicine since ancient times. In ancient China it was used to target malaria, rheumatism, constipation, gout and menstrual cramps, and used as a remedy for earache, edema, and inflammation by the ancient Greeks. Since the medieval times practitioners in the West have used cannabis for pain, depression, epilepsy, nausea and vomiting. Around the beginning of the twentieth century over 100 scientific papers had been published in Western medical journals, and medical cannabis preparations were widely used by clinicians and available in local pharmacies.

Recent years have seen renewed research interest and further evidence has accumulated on the therapeutic potential of cannabis—the whole plant extract (sometimes called CBD oil extract, or hemp extract), as well as some of its individual active constituents and their synthetic mimics—in many different conditions.

A growing number of studies points to a major role of the endocannabinoid system (ECS) in human biology. The ECS developed early in evolutionary history and is found in many diverse species. The system comprises of endocannabinoids (natively produced cannabinoids), mediators responsible for their synthesis and metabolism, and the cannabinoid receptors (CRs) that serve as their molecular targets. Endocannabinoids are derivatives of integral components of cellular membranes and act as hydrophobic lipid messengers.

Since CRs are richly expressed throughout the body in various types of tissue and since ECS plays an important regulatory role in many processes, ranging from the regulation of cellular energy metabolism to the modulation of complex cognitive functions, modulating ECS has a great potential for treating a wide range of pathologies, including neurological and neurodegenerative disorders, movement disorders, depression and stress-related disorders, epilepsy, pain, glaucoma, stroke, cancer, inflammation, cardiovascular and metabolic disorders and many others.

At the present time, CBMPs have been approved in several countries for epilepsy, pain management, nausea and spasticity. In many countries clinicians are able to prescribe medical cannabis products off label for numerous conditions including for example Crohn’s disease, ulcerative colitis, Tourette’s Syndrome, post-traumatic stress disorder, glaucoma, migraine and psoriasis, to name a few.

Autism is a qualifying condition for medical cannabis in several US states .

“The cannabis treatment appears to be safe and side effects reported by the patients and parents were moderate and relatively easy to cope with.”
(Bar-Lev Schleider et al. 2019)

A short history of medical cannabis research for autism

One of the first studies on the potential efficacy of medical cannabis for the treatment of autism was a study on 10 patients published in 2006. A cannabis-based medication dronabinol (delta-9-THC) was administered to adolescent patients with autism and intellectual disabilities and self-injurious behaviours (SIB). A significant and lasting improvement in the SIB and overall mood and wellbeing was achieved in 7 out of 10 patients (Kruger and Christophersen 2006). Another case report published in 2010 described significant and lasting improvements in hyperactivity, lethargy, irritability, stereotypy and inappropriate speech in a child with autism after administration of dronabinol (Kurz and Blaas 2010).

Several years later a mixture of CBD:THC was trialled as treatment for autism by a group of Chilean investigators. Several CBD:TCH formulations were given to 20 children over a course of several months, resulting in significant improvements in core symptoms of autism in two thirds of participants. In addition to improving social communication, language, and/or repetitive behaviours, the treatment had a positive effect on sensory difficulties, food acceptance, feeding and sleep disorders, and seizures (Kuester et al. 2017).

In 2018, a brief report on canabidiol-rich cannabis treatment in 60 children with autism, aged between 5-18 years, was published in the Journal of Autism and Developmental Disorders. The formulation used had 20:1 CBD:THC ratio, taken sublingually over 2-4 weeks, with doses up-titrated to effect and tolerability. The treatment led to improvements in behaviour (61%), anxiety (39%) and communication (47%) (Aran et al. 2019).

In 2019, a larger scale retrospective study was published in Nature which analysed data that was collected between 2015 and 2017 as part of the treatment program of 188 ASD patients aged between 5 to 19 years. The treatment was in most cases based on cannabis oil containing 30% CBD and 1.5% THC. After six months of treatment 82.4% of patients (155) were in active treatment and 60.0% (93) had been assessed; 28 patients (30.1%) reported a significant improvement, 50 (53.7%) moderate, 6 (6.4%) slight and only 8 (8.6%) had no change in their condition (Bar-Lev Schleider et al. 2019).

Another study published in 2019 assessed effects of cannabis oil on behaviours, quality of life and comorbidities in 53 children with autism. Cannabinoid oil solution at a concentration of 30% and 1:20 CBD:THC ratio was administered for a median duration of 66 days. The study was open label and used parental reports to assess treatment effects. Improvements were noted in self-injury and rage attacks (67.6%), hyperactivity (68.4%), sleep problems (71.4%) and anxiety (47.1%) (Barchel et al. 2018).

“66,7% of patients had significant improvement according to CGI-I and APSI. Most cases improved at least one of the core symptoms of ASD, including social communication, language, or repetitive behaviors. Additionally, sensory difficulties, food acceptance, feeding and sleep disorders, and/or seizures were improved in most cases. 71,5% of patients received balanced CBD:THC extracts; 19,0%high-CBD; and 9,5% high-THC extracts.”
(Kuester et al. 2017)

Multi-systemic effects of cannabinoids in autism – possible mechanisms of action

The exact mechanisms of effects of CBMPs in patients with autism are not yet fully understood. Findings from various animal models of autism as well as human studies and clinical experience point to dysregulation of ECS in autism, and dysregulated ECS has been proposed a unifying pathophysiology of autism regardless of individual etiology (Debra S Karhson et al. 2018; Brigida et al. 2017; Siniscalco et al. 2013; Zou et al. 2019; Krueger and Brose 2013).

Activation of ECS has been shown to attenuate autism-related symptoms and behaviours and improve cognitive function in both genetic and environmental animal models of autism (Zamberletti, Gabaglio, and Parolaro 2017). Regulating ECS in diverse monogenetic models such as Fmr1, neuroligin and BTBR improves social and cognitive impairments in affected animals (Gomis-González et al. 2016; Speed et al. 2015; Wei et al. 2016). Similarly, cannabidiol treatment reverses neurochemical deficits and abnormal neurodevelopment in environmentally-induced valproic acid (Servadio et al. 2016; Melancia et al. 2018; Zamberletti et al. 2019), immune activation and early inflammation models of autism (Osborne et al. 2019; Doenni et al. 2016).

In addition to the findings from divergent animal models, evidence is emerging of ECS playing an important role in several human disorders with strong links to autism. Improvements in autism-related symptoms following cannabidiol (CBD) administration have been reported in patients with Fragile X Syndrome (FXS) (Tartaglia, Bonn-Miller, and Hagerman 2019). In a recent study a novel transdermal CBD gel formulation produced clinically meaningful reductions in social avoidance, irritability and anxiety symptoms in children and adolescents with FXS (Heussler et al. 2019). In children with tuberous sclerosis complex (TSC), another disorder with extremely high prevalence of autism, treatment with CBD leads to improvements in autism-related symptoms and behaviours. In a recent study on TSC significant positive effects were observed in verbal communication, vocalizations, cognitive availability, and initiation of emotional and physical connections in a large majority of participants irrespective of reduction in seizure activity (Hess et al. 2016).

Observations from clinical settings and parental accounts mirror the results of small trials of CBMPs for autism. Positive clinical results are being reported by clinicians for cases of idiopathic autism with widely different presentation and severity of symptoms.

It is of relevance in this context that a genetic mutation has recently been identified for the first time in a patient presenting with anxiety, mild cognitive dysfunction and early onset autism, which links functional impairments in ECS-linked FAAH2 gene activity with patient’s neurologic and psychiatric symptoms (Sirrs et al. 2015).

ECS is a major regulator of brain development, synaptic plasticity, sensory processing and sensory integration, stress regulation and neuromodulation. It modulates social interactions, including social anxiety and social reward, aggressive behaviours, cognition and memory.

Cannabinoid receptors are present in many organs and types of tissue, including brain and peripheral neurons, the vagus nerve (the central ‘line of communication’ between the gut and the brain), gastrointestinal lining, immune cells, skin, and others. ECS is involved in the modulation of many of the molecular pathways that are altered in autism, such as GABAergic and glutamatergic transmission, immune dysregulation and inflammation, oxidative stress, and altered energy metabolism.

Autism is frequently accompanied by multiple factors that influence severity of symptoms and level of disability of affected individuals such as anxiety, impulsivity and lack of control, agitation and irritability, aggression and self-harming behaviours, depression, cognitive dysfunction, heightened stress response, attention and processing issues, sleep disturbances, immunological and metabolic disturbances, abnormal sensory processing, tics and motor dysfunction.

Rates of nearly all physical health conditions are much higher in autism than in the general population and include gastrointestinal disorders (constipation, reflux, IBD), epilepsy and seizures, migraines, asthma, cancer, immune conditions, obesity, dyslipidemia, hypertension, and diabetes. Rarer conditions, such as movement disorders and Parkinson’s disease are also significantly more common among adults with autism (Alabaf et al. 2019; Croen et al. 2015; Bell, Wittkowski, and Hare 2019).

ECS is known to be affected in many of the conditions that are frequently encountered in autism, and numerous studies have demonstrated the promising effects of various cannabinoids for many of those conditions.

Mechanism of action for the effect of cannabinoids on ASD may possibly involve their effects on: brain signalling and neuronal connectivity; modulation of oxytocin, vasopressin and dopamine signalling; modulation of HPA and stress response; sensory processing; motor functioning; seizures; immunity and inflammation; gastrointestinal function and gut-brain signalling .

“…this study suggests that abnormalities in anandamide activity may underlie the deleterious impact of environmental risk factors on ASD-relevant behaviors, and that the endocannabinoid system may be a therapeutic target for the core and associated symptoms displayed by autistic patients.”
(Servadio et al. 2016)

Cbd oil for autism 2 yrs old girl

Autism spectrum disorder (ASD) is a heterogeneous neurodevelopmental disorder affecting over 1% of the general population. While it is well established that ASD stems from a combination of genetic and environmental factors, there are no defined mechanisms of pathogenesis, rendering curative therapy very difficult to establish. No effective therapy exists for ASD, presenting an urgent clinical need for better control of common core pathologies of ASD regardless of its etiology. Cannabidiol (CBD), a major phytocannabinoid constituent of the cannabis plant, is gaining significant attention in both the media and in medicine for its antiepileptic, anxiolytic, and antipsychotic properties. Recent anecdotal reports, accumulating preclinical and clinical data, and mechanistic insights suggest that CBD provides a viable treatment opportunity for patients with ASD.

Key words

pathogenesis, Cannabidiol, Autism spectrum disorder (ASD)

Introduction

Autism spectrum disorder (ASD), often characterized by impaired social interaction and communication, as well as repetitive and stereotypic behaviors, is one of the most common (∼1/64 at births in US) and fastest-growing neurodevelopmental disabilities. The basic symptoms of ASD are often accompanied by other neurological deficits including, but not limited to, anxiety, mood disorder, sleep disturbance, as well as seizures. These medical conditions associated with ASD interact with each other and result in difficulty of any single symptomatic relief of ASD. Many patients must undergo a series of therapies, medications, and clinical visits in an attempt to alleviate some of the symptoms, which often causes economic and personal stress on the patient and their family. For this reason there is urgent clinical need to better manage multiple neurological pathologies of ASD simultaneously, and in so doing improve the quality of life of ASD individuals and their caregivers.

Cannabis has demonstrated its potential for the therapeutic treatment of a variety of ailments and diseases. The naturally grown plant contains over 80 different biochemical compounds called cannabinoids, many of which share very similar chemical structures and active properties [1]. Cannabinoids are often classified into three sub-groups: Phytocannabinoids, endocannabinoids, and synthetic cannabinoids. Phytocannabinoids are the cannabinoids that are found naturally in the cannabis plant, of which cannabidiol (CBD) is the 2 nd most naturally abundant in the plant. CBD has been gaining increasing worldwide attention because of its broad therapeutic potential for providing neuroprotective, anti-inflammatory, antipsychotic, anxiolytic, and anticonvulsant effects in both clinical and preclinical studies [2-8]. Recent anecdotal reports, accumulating animal and human research suggest that CBD provides a viable treatment opportunity for diverse developmental disorders, including ASD. Therefore, CBD holds the potential to simultaneously ameliorate seizures, anxiety, and motor and behavioral deficits that are prevalent in ASD (Figure 1). In an open-label FDA expanded access study, Anderson et al. [9] showed that CBD was not only effective in treating seizures, but also had positive effects on measures of behavior, in a cohort of children with ASD [9].

Figure 1. The beneficial spectrum of CBD provides a strategy for treating ASD pathologies.
Mechanism of action of CBD

Though the mechanism underlying the beneficial effects of CBD is still largely unknown, converging lines of evidence suggest dysregulated cannabinoid signaling likely could play a critical role in the pathophysiology of social functioning deficits in ASD [10]. Unlike psychoactive phytocannabinoid delta-9-tetrahydrocannabinol (THC), CBD displays low affinity but unexpectedly high potency as an antagonist of cannabinoid receptor 1/2 (CB1/CB2) in vitro, which likely accounts for its lack of psychotropic activity [11,12]. Contradictorily, CBD can exhibit an indirect effect on the CB1 receptors by inhibiting the degradation of the endocannabinoid anandamide [13]. However, the broad CNS benefits of CBD are likely a result of its complex pharmacological mechanisms. Besides cannabinoid receptors, CBD also interacts with many other, non-endocannabinoid signaling systems, including the equilibrative nucleoside transporter, the orphan G-protein-coupled receptor GPR55, the transient receptor potential of melastatin type 8 channels, the 5-HT1a receptor, the α3 and α1 glycine receptors, and the transient receptor potential of ankyrin type 1 channel [14]. The multiple mechanistic-targets of CBD make it a unique candidate for treating complex symptoms associated with a number of disorders, including ASD [15].

Anticonvulsant effect of CBD

Epilepsy is common (20-30%) in ASD and is more prevalent in individuals with autistic-like behavior resulting from particular genetic predisposition (e.g. Angelman syndrome, Rett syndrome, Dup15q syndrome, etc.). Animals possessing such genetic modifications also exhibit CNS hyperexcitability, enhanced seizure susceptibility and/or spontaneous recurrent seizures. CBD exhibits potent anti-epileptic features in both clinical and preclinical studies [8,16-21]. Notably, CBD significantly reduced the frequency of total seizures of all types in a recent clinical trial for the treatment of drug-resistant seizures in Dravet syndrome [8]. The antiepileptic mechanisms of CBD are still unclear, but may involve multiple targets [14], which renders it an appealing candidate for complex and refractory epilepsy in ASD. Importantly, the anticonvulsive effects of CBD may be useful in suppressing explosive rage and calming severe anxiety. It is hypothesized that unrecognized partial complex seizures, which cause changes in consciousness but not muscular convulsions, are one source of autistic behavior disturbances [22].

Anxiolytic effect of CBD

Of children with ASD, 40% had at least one comorbid diagnosed anxiety disorder [23], which interacts with and exacerbates the other symptoms of ASD. Anxiety negatively impact quality of life of ASD individuals and is associated with higher health care usage and other social costs [24]. Studies using a wide range of animal models of anxiety suggest an anxiolytic-like effect of CBD [2,4]. Interestingly, CBD reduced general anxiety in a bell-shaped dose-response curve, with anxiolytic effects observed at moderate but not higher doses [25-27]. CBD also alleviated stress-induced anxieties in mice. Acute administration of CBD reduces anxiety induced by restraint, re-exposure to a context that previously paired with foot shocks or predator stress [28-31]. Evidence from human studies also strongly supports the potential for CBD as a treatment for anxiety disorders. CBD reduced anxiety in a group of social anxiety disorder patients and was shown to regulate cerebral blood flow in limbic and paralimbic brain areas [4]. CBD also reduced anxiety induced by simulated public speaking in both healthy volunteers and patients with social anxiety disorders [32,33]. Consistent with animal studies, acute administration of CBD induced anxiolytic effects in healthy subjects with moderate (300 mg), but not lower (100 mg) or higher (900 mg) doses [34]. CBD can also attenuate anxiety related sleep problems. Animal studies revealed microinjection of CBD into the central nucleus of the amygdala blocks repeated combination tests-induced rapid eye movement sleep suppression, probably through its anxiolytic effect [35]. A case study reported CBD decreased anxiety and improved the quality and quantity of sleep of a ten-year-old girl diagnosed with post-traumatic stress disorder (PTSD) [36]. The broad anxiolytic effects of CBD provide a unique treatment opportunity for the diverse anxiety phenotypes in ASD.

Wide-spectrum behavioral benefits of CBD

Animal studies suggest that CBD has a broad spectrum of behavioral benefits. CBD administration was found to rescue reserpine-induced motor and cognitive impairments, normalize MK-801-induced social deficits and hyperactivity, and attenuate THC-induced reduction in social interaction in rats [37-40]. Acute CBD treatment also protected against hippocampal cell death and improved cognition in mouse models of ischemia and cerebral malaria [41,42]. CBD can also reduce learned fear by decreasing fear expression, disrupting memory reconsolidation, and enhancing extinction in contextual fear memory paradigm as shown in a study involving mice [43]. These findings suggest CBD holds therapeutic potentials for ASD-related behavioral abnormalities.

Concluding remarks

Individuals with ASD typically face many challenges that worsen their quality of life, create a host of social and behavioral problems, can force their families into a reduced socioeconomic lifestyle, and potentially increase their risk of death. These individuals and their families currently have no available options to alleviate the devastating toll that this experience can have on them. It is for these reasons that there is a great need to find effective treatment options and explore the safety, efficacy and tolerability, of this promising drug, CBD, for these desperate patients. Establishing, in a preclinical and clinical setting, the quality of life and other daily function changes that CBD could be causing in social behavior, cognition, or motor skills is important. Introduction of CBD into a regular treatment regimen could lead to significant reductions in their otherwise untreatable symptoms. The evaluation of changes examined in sophisticated studies while participants are receiving CBD treatment is an important step in therapeutic testing of the drug and in understanding its potential.

Collectively, the pharmacologically broad-spectrum of CBD covers diverse neurological pathologies of ASD, thereby providing a unique and viable therapeutic opportunity to alleviate multiple core ASD symptoms simultaneously. The increasing interest and attention of its beneficial effects in controlling seizures, behavioral and mood abnormalities in ASD call for systematic preclinical and clinical studies to reveal the mechanisms, efficacy, therapeutic spectrum and safety of CBD in ASD.

Acknowledgement

I thank Christopher L. Anderson (Department of Biomedical Engineering, University of Florida, United States) for critical discussions and reading of the manuscript.

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Editor-in-Chief
Article Type
Publication history

Received date: June 20, 2017
Accepted date: July 19, 2017
Published date: July 21, 2017

Copyright

© 2017 Gu B. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Citation

Gu B (2017) Cannabidiol provides viable treatment opportunity formultipleneurological pathologies of autism spectrum disorder. Glob Drugs Therap 2: DOI: 10.15761/GDT.1000134

Corresponding author
Bin Gu

Department of Cell Biology and Physiology, University of North Carolina, Chapel Hill, NC 27599, USA

Controversial Cannabis Treatment Helps 9-Year-Old Boy Speak His First Words

Though Kalel Santiago of Puerto Rico is only 9 years old, he’s already endured some adult-level struggles. At just 10 months, he was diagnosed with the rare childhood cancer neuroblastoma, and spent more than two years undergoing surgery, chemotherapy, and radiation treatments. Then came the next diagnosis: severe, non-verbal autism.

“While he was in the hospital, we noticed he didn’t speak at all and had some behavior that wasn’t right, like hand flapping, and walking on his toes,” his father, Abiel Gomez Santiago, tells Yahoo Parenting from the family’s home in Aguada. “But we waited until he was 3 and cancer-free to look at his behavior.”

He and his wife Gladys — also parents to two older boys, now 18 and 20 — did a cram course in educating themselves on autism. They tried various schools and therapies, and eventually found impressive success with a unique surf-therapy school near their home. Then, through an April fundraising event for that program, the Santiagos happened upon a treatment that would quickly change their lives: hemp oil, rich in the compound cannabidiol (CBD), which has been shown, at least anecdotally, to dramatically ease symptoms of both epilepsy and autism.

They took home the tiny sample bottle of spray and began giving their son twice daily doses, as directed on the label, right into his mouth. And the results, they say, were startling: Kalel started talking — in just two days.

“He surprised us in school by saying the vowels, A-E-I-O-U. It was the first time ever,” Abiel says. “You can’t imagine the emotion we had, hearing Kalel’s voice for the first time. It was amazing. The teacher recorded him and sent it to my wife and me and we said well, the only different thing we have been doing is using the CBD.” Soon thereafter, he adds, Kalel started using consonants to connect his sounds. “He said, ‘amo mi mama,’ ‘I love my mom,’” Abiel says. “I don’t know how to thank [the CBD oil makers].”

Kalel with his parents, Abiel and Gladys.

But the product they are grateful for — Hemp Health, from California, which sells for $40 per ounce (almost a three-month supply) — is not without controversy. It’s just one of many CBD oils now marketed as legally attainable alternatives to the much sought-after Charlotte’s Web — the most popularized version of the oil, which is low in THC and and rich in CBD. But it’s made from specially cultivated marijuana (the cannabis flowers). And since medical marijuana is not legal in all states, especially for minors, scores of desperate families from all over the country have moved to Charlotte’s Web’s source, Colorado. In response, Hemp Health and other versions derived from industrial hemp — THC-free cannabis stalks and seeds — have popped up on the web, claiming to be cheap and legal alternatives.

But the Food and Drug Administration (FDA) would disagree. The agency maintains that such products are unregulated and therefore not proven safe, and that their sale as dietary supplements is in fact illegal. (Though enforcement of such sales, spokesperson Jeff Ventura tells Yahoo Parenting, would depend on factors including “agency resources and the threat to the public health.”) In February, the FDA sent warning letters to many CBD oil manufacturers, telling them to stop making medical claims — like being cure-alls for everything from glaucoma to Ebola — about their products.

In addition, Project CBD, a nonprofit that promotes and educates on the medical uses of CBD, is wary of hemp-derived oils. “[CBD] oils can be effective,” director Martin Lee tells Yahoo Parenting. “We would suggest, however, that anyone who is seeking such products should try to access CBD oil derived from cannabis rather than industrial hemp, which is not an optimal source for CBD.”

Still, what Abiel and Gladys saw that day in the Hemp Health sample was neither threat nor rip-off, but a tiny glimmer of hope. And so far, they say, the results have been nothing short of startling.

Kalel during surf therapy with Dr. Giovanni Martinez.

“He’s been connecting — like he’s awakening to seeing the world,” Abiel says, noting that they have kept up the treatments for just over a month now, and that Kalel continues to make improvements. “He’s looking you in your eyes, he’s been trying to say different things and imitate what we are saying. He’s saying ‘uncle,’ ‘aunt,’ the names of my two kids. It’s something amazing that I cannot explain.” (Regarding the product’s legality, the dad notes, “If we had to go somewhere else to get it, we would. I’d go anywhere.”)

Kalel’s response has shocked others, as well, including his teachers, and even the CBD oil company. “We were really amazed to hear Kalel’s progress, because what they are using is a lower-concentrate product,” Miguel Feliciano, president of Hemp Health’s Puerto Rico distributor, Antonio & Associates, tells Yahoo Parenting. He adds that word of Kalel’s progress has gotten out locally, through the surf-therapy school, Surf4Dem, and that other parents are now asking to try to product.

Kalel’s surf therapist Dr. Giovanni Martinez, a clinical psychologist who has worked with Kalel since Surf4Dem’s inception, has also been stunned by the boy’s change.

“Like his parents, I am also in shock,” he tells Yahoo Parenting. “I never got him to speak, and it was something that was haunting me. Language was something that was missing.” Martinez, who started his surf-therapy school after being inspired by how surfing helped his brother, who has Down syndrome, said he researched the various uses of CBD oil after Gladys asked him about it for Kalel. He told her it was worth a shot. Now he’s cautiously optimistic about how other children may benefit.

“I’m not going to say let’s give this to every kid, because we have to monitor and study it,” Martinez says. “But I am very impressed with his language development. Imagine a mom who has been waiting almost 9 years to hear her child speak?” Though the use of anything cannabis derived continues to be controversial, he believes it is something worth fighting for, given this kind of a result. “To me,” he says, “the story of Kalel is groundbreaking.”