Therapeutic Use Of Fish Oil for Apraxia, Autism and Other Communication Impairments


“Every so often, scientists really do discover a substance of transformative power, one with the ability to cure the previously incurable and improve the quality of life for the rest of us. Omega-3 fatty acids — a component of simple fish oil, once so prevalent in our diet but now largely absent — could be such a substance.”~ Harvard Medical School doctor, Andrew Stoll, MD

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 outside of teaching a child to swallow capsules, or wanting to use an exact half dosage, I can’t think of any other 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 NNProEFA 3.6.9., 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 NNProEFA 3.6.9. Jr. is an exact half dosage, you would need two capsules of NNProEFA 3.6.9. Jr. to what would be about equivalent to the dosage of essential fatty acids approved for infant formula. One regular sized capsule of NNProEFA 3.6.9. is about 1/4 of a teaspoon of fish oil. (Note- The professional line of the Jr is no longer available but the commercial line Complete Omega Jr still is as of now)

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.”

Pilot Study using NNProEFA 3.6.9. for autism inspired by one of the parent members of Cherab who has a child with apraxia.

Due to the anecdotal feedback through the Cherab Foundation one of the parent members, Nancy, who has a child with apraxia started using NNProEFA 3.6.9.. Her SLP in Arizona was shocked about the sudden and dramatic positive changes in her son, and shared NNProEFA 3.6.9. with her caseload of around 18 children. One of the parents in this SLP’s caseload was a doctor who wanted to conduct a pilot study for just autism (not apraxia even though that it was a combination of apraxia and autism in the SLP’s caseload) using NNProEFA 3.6.9. Below are the results of that study:

EFA Benefits on Language and Learning Skills in Children with Autism and Asperger’s Syndrome
Patrick L, Salik R. The Effect Of Essential Fatty Acid Supplementation on Language Development and Learning Skills in Autism and Aspergers Syndrome. 2005. Tucson Medical Center, Tucson, AZ.
Fish oil provides essential fatty acids which are critical for brain health.Methods
Children aged 3–10 years who had been professionally diagnosed with autism or Asperger’s syndrome were each given one gram of Nordic Naturals NNProEFA 3.6.9.™ [Complete Omega™ (formally Complete Omega-3.6.9™)] day for 90 days. NNProEFA 3.6.9. provides 135 mg EPA (eicosapentaenoic acid) and 90 mg DHA (docosahexaenoic acid) from fish oil along with 33 mg GLA (gamma linolenic acid) from borage oil and 15 IU of natural vitamin E. The children readily accepted the lemon-flavored oil; capsules were chosen for consistent dosing and parental convenience.On days 0, 45, and 90 of supplementation, 49 developmental items from the Assessment of Basic Language and Learning Skills (ABLLS), a criterion-referenced tool, were used to measure eight primary areas of language and learning: receptive language, requesting, labeling, intraverbals, imitation, play skills, social interaction, and generalization.Results
Eighteen (18) of the initial 22 children completed the 90-day trial. All of the children displayed significant increases in their language and learning skills based upon the ABLLS. A t-test analysis of the data showed high statistical significance in all areas: receptive language, requesting, play skills, intraverbals and social interaction resulted in a p-value < 0.0001. A p-value of <0.001 was obtained in the areas of labeling and generalization. In addition, a p-value of <0.01 was obtained for vocal imitation. No adverse effects were noted.Conclusion
The highly significant results of this small, open label pilot trial shows promise for children with autism spectrum disorder.This study was conducted using Nordic Naturals NNProEFA 3.6.9. one capsule a day

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 NNProEFA 3.6.9. 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 NNProEFA 3.6.9. by Nordic Naturals manufactured in the US and Eye Q by Equazen manufactured in the UK. Nordic Naturals makes a number of oils and they have a number of lines including a health care professional and a commercial line. The Omega 369 is the commercial line sold in stores which is the exact same formula as the professional line called NNProEFA 3.6.9. sold by health care professionals. NNProEFA 3.6.9. in the professional line is slighly cheaper as you get 90 capsules per bottle vs. 60 for around the same price of the Omega 369 in the commercial line.

Formula of one (regular not Jr.) capsule a day NNProEFA 3.6.9. 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 NNProEFA 3.6.9. (regular not Jr.) which is the formula listed above is about the dosage of EFAs the FDA approved for infant formula.

Through the years the formula that has worked discovered by Lisa Geng in 2001 is combining NNProEFA 3.6.9. with another formula by Nordic called NNProEPA to raise the EPA even more. For apraxia the ratio is 2 capsules of NNProEFA 3.6.9. to one capsule of NNProEPA. This has been the formula that has worked best for thousands in over a decade. Please read on to see research on reasons for a specific Omega 3 AND Omega 6 formula. You can look at the amounts of EPA, DHA and GLA and recreate the same or similar formula just about anywhere.

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.

A sampling of the numerous research studies to support the use of fish oils in infants and children

Nutrition important in healing brain injuries

In 2011 the Department of Defense together with the Institute of Medicine published ‘Nutrition and Traumatic Brain Injury: Improving Acute and Subacute Health Outcomes in Military Personnel (2011)’

This report is solid clinical validation for the importance of further exploration of nutritional therapy to treat various neurological conditions including traumatic brain injury and stroke. In the report, there were a number of essential nutrients found to be effective including the omega 3 fats DHA, EPA from fish oils, and the proteins that contain the branched chain amino acids (BCAAs), such as Alanine, Arginine, Aspartic Acid, Cystin, Glutamic Acid, Glycine, Histidine, Isoleucine, Leucine, Lysine, Methionine, Phenylalanine, Proline, Serine, Thereonine, Trytophan, Tyrosine, Valine found naturally in whey protein.

Food or Drugs For Toddlers?

Recently the AAP has approved ADHD diagnosis and ADHD drugs for a child as young as 4 years old even though food has been found to be more effective than drugs for ADHD. The AAP has also just stated that all children between 9 and 11 years old will 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?

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. Speakers from that conference

Official Statement

The First Scientific Conference Dedicated to the Therapy of Verbal Apraxia/Dyspraxia. Professional anecdotal overseen by CAPT Joseph Hibbeln, M.D.

Post conference Statement

The First Scientific Conference on Therapy for Verbal Apraxia/Dyspraxia, held on July 23-24, 2001 at the Headquarters Plaza Hotel, Morristown, New Jersey under the auspices of the Cherab Foundation, focused on “Essential Fatty Acids (EFAs) and Verbal Apraxia: A New Potential Therapeutic Intervention.” A panel of scientific experts discussed the evidence presented at the conference in the form of professional anecdotal case reports on improvement of verbal communication ability with EFA supplementation in this population. The panel unanimously agreed that the existing scientific evidence justifies planning and implementing a comprehensive clinical trial to convincingly validate this new potential therapeutic intervention.
The panel discussed various clinical research alternatives including the following:
  • A controlled case series trial using currently available standardized speech assessment measures or developing new clinical assessment profiles for baseline and post-EFA testing
  • A randomized, placebo-controlled multicenter clinical trial of EFA and placebo supplementation to be undertaken as soon as possible. For example, if a randomized, placebo-controlled clinical trial would be undertaken, all diagnosed verbal apraxic children, including those with hypotonia and sensory integration disorder, who have not been supplemented with EFAs, would be eligible for randomization. The panel suggested that all randomized children would be supplemented with EFA or placebo in addition to appropriate speech therapy. This took into consideration the potential cooperative or possibly synergistic effect of the combined therapies in the treatment group. The length of the trial is proposed to be 3 months. Improvement in verbal communication skills, or the lack thereof using an assessment protocol as described above, would be the major therapeutic outcome measured, and plasma, as well as erythrocyte membrane EFA levels would be monitored periodically. The two groups would consist of about 20-30 age-matched subjects. NNProEFA 3.6.9. would be the therapeutic supplement used in the trial based on preliminary successes attained.
In addition the panel noted the potential availability of electrophysiological measuring instruments that could serve as assessment tools of developmental-behavioral characteristics of a verbal apraxic child, and recommended the exploration of such techniques. While the panel refrained from discussing the etiology and pathophysiology of verbal apraxia, it also expressed great interest in what appears to be a presence of verbal apraxia in a percentage of children on the autistic spectrum and a possible association in other disorders and syndromes, such as: hypotonia, sensory integration disorder, dysarthria, attention deficit hyperactivity disorder, Kabuki Syndrome and cerebral palsy. The panel recommended further exploration of these phenomena.
Although no final decision was reached on the nature of the clinical trial/trials to be undertaken, the workshop ended with a commitment from all members to continue debating this issue in close collaboration with the organizers, and to reach a decision within the shortest timeframe possible.
The organizers thank all panel members for their tireless dedication and enthusiastic participation in the Workshop’s deliberations, and thank all parents who contributed to the success of the workshop, by requesting the professionals supervising and treating their children to complete a professional anecdotal case report questionnaire on the outcomes of EFA supplementation. This workshop could not have taken place without their assistance.
The organizers also wish to acknowledge with thanks the assistance of many dedicated parents in helping with the logistic aspects of the workshop.
Last but not least, the organizers are thankful to the Cherab Foundation’spresident, Ms. Lisa Geng, for her support of this workshop, and her boundless energy and enthusiasm in the service of verbal apraxic children and their parents.

Scientific Panel Members From Cherab’s First Apraxia Conference 2001:

CAPT Joseph Hibbeln, M.D.

Chief Outpatient Clinic National Institute of Alcoholism and Alcohol Abuse, NIH LMBB – Section of Nutritional Neuroscience (NN) Bethesda, Maryland, Non-affilited Collaborator, CFBFA

Video by Dr. Hibbeln

Susan E. Carlson, Ph.D.

Professor, University of Kansas, Kansas City, Kansas, Member Consortium for Brain Fatty Acids (CFBFA)

Ann Moser,B.S.

Manager, Peroxisomal Diseases and Fatty Acid Profiles Clinical Laboratory,Kennedy Krieger Institute, Baltimore, Maryland. (Also a component laboratory of the CFBFA)

Jennifer Hill-Karrer, Ph.D.

Associate Professor, University of Kansas Medical Centre, Kansas City, Kansas, and Collaborator CFBFA

Andrew Zimmerman, M.D.

Professor, Johns Hopkins University and Kennedy Krieger Institute, Baltimore, Maryland, and Collaborator, CFBFA.

Alexandra J. Richardson, MA, DPhil

Senior Research Fellow in Neuroscience, Imperial College School of Medicine, MRI Unit, Hammersmith Hospital, London; and University Lab. of Physiology, Oxford.

Hugo W. Moser, M.D.

University Professor, Johns Hopkins University School of Medicine Baltimore, MD Director of Neurogenics Department, Kennedy Krieger Research Institute Baltimore, MD


Lori Roth M.A., CCC/SLP, Speech Pathologist, Cherab Foundation

Nancy Kaufman, M.A., CCC/SLP Kaufman Children’s Center Michigan

Look Who’s Talking Now: Fish oil capsules help children with speech disorders find their voices

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 results were dramatic,” says developmental pediatrician Marilyn C. Agin, M.D., medical director of the New Jersey-based foundation, who also reported similar results in ten anecdotal cases. “They strongly suggest that EFA supplementation combined with speech and occupational therapy could become the treatment of choice in multifaceted communication disorders.”

Until now children with severe speech disorders such as apraxia, a neurologically-based condition, have required years of intensive one-on-one therapy-often with painfully slow progress. “But now, with EFA supplementation, the future for these children may be much brighter-and sooner rather than later,” says Lori L. Roth, M.S., CCC/SLP, a speech pathologist with the Cherab Foundation.

The amazing potential of EFA supplementation came to light when the nonprofit group’s president, Lisa Geng, used it with her three-year-old son, Tanner. After just three weeks his vocabulary exploded. “It was the breakthrough we had been praying for. It was incredible,” says Lisa.

Why does this supplementation work? The experts believe that the speech disorders are the result of a breakdown in communication between the brain and the muscles in the mouth, tongue and jaw that have to work together to produce speech. Essential fatty acids, especially the omega-3 DHA and the omega-6 fatty ARA, are highly necessary for brain development. Most children obtain them-during the most critical times of brain development-directly from their mothers while they are still in the womb and subsequently while being breast-fed. Any deficiency can result in permanent neurodevelopmental deficits in the growing infant.

“Therefore, essential fatty acid supplementation in neurodevelopmental speech disorders could correct a specific deficit in the speech center of the central nervous system,” says Robert Katz, Ph.D., Cherab’s director of EFA research.

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.

How Do You Serve 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.

Keep A Paper Towel Handy

Right after the fish oils go into their mouth, blot their lips right away with the paper towel to make sure you remove the chance of any fish oil going anywhere but in their body. After you blot their mouth give them something to drink and blot their lips again to make sure you have every bit of fish oil cleaned off. If you don’t blot their mouth, many will wipe their mouth with the back of their hand, and then onto their clothes, hair, or God forbid furniture!

Mother Tested Tips For Serving Fish Oil To a Toddler

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!

Tanner had tremendous surges on fish oils

My 5 year old apraxic son Tanner is a trooper and takes the NNProEFA 3.6.9. 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 NNProEFA 3.6.9. bottle, and put a pin in the part that is left. When it’s time to give Tanner his NNProEFA 3.6.9., 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 NNProEFA 3.6.9., 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 NNProEFA 3.6.9. – 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 NNProEFA 3.6.9. 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!

Syringe Method: How to

Wyatt serving himself NV original but you can serve fish oils the same way

Wyatt serving himself a protein shake mixed with botanicals but you can serve fish oils the same way

Some and found serving protein shakes or fish oils in a syringe or shovel to be easiest.

Use the proper implement for liquid medicines. Don’t use a spoon–too much chance for spillage (and, unless you use a measuring spoon, too much chance of giving the wrong amount). My personal preference is a medication syringe (most pharmacies carry them). If you have a preschooler or older who freaks a bit at getting stuff squirted in his mouth and will cooperate, use the medication spoons that have a cylinder for measuring as a handle (also available in pharmacies)–it allows you to pour out a little at a time.

When squirting into a mouth, remember:

  • Aim back (but not too far back) and to the side. If you go too close to the front it’s easier to spit out, but if you go straight back the child may gag.
  • Don’t squirt all at once. As tempting as it is to get it over with, if you don’t want to be wearing it, wait until they swallow each bit before giving more.
  • If you’ve got a squirmer: hold your child so that they are leaning back. Put the arm closest to you behind your back, and hold the other one down with the hand of the arm that’s cradling them. If you’ve got a kicker, you can put their legs between yours.

A chaser may help. Something strongly sweet is often effective–I’ve had good luck with chocolate syrup. Honey is good too–but never use in a baby less than a year old, because of the risk of botulism. With really nasty-tasting ones, I’ve sometimes filled a syringe with chocolate syrup and alternated medicine with chocolate. Eating some crackers can help kill the taste too, or brushing teeth (which is good to do after giving iron or iron-containing vitamins).” ~ Dr. Claire McCarthy

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!

Picky Eater Tips

Any fish oil that tastes like candy?

Omega3Fishies_36YES there is an answer and it’s a new one!

The Nordic Naturals Omega 3 Fishies are great for extremely picky eaters because they taste just like candy and unlike most other Omega 3 gummies on the market -they actually have a rich source of EPA and DHA!

In fact the dosage of EPA and DHA in the Nordic Naturals New Fishies is comparable to NNProEFA 3.6.9., what our group has used for years. NNProEFA 3.6.9. had positive dramatic results for children with autism and apraxia of speech in CHERAB’s professional anecdotal feedback study as mentioned as well in The Late Talker book.

bul250 mg combined EPA+DHA in each serving(150 mg EPA 100 mg DHA about the same as one regular sized capsule of NNProEFA 3.6.9.!)

bul No artificial flavoring, coloring, or preservatives

bul Gluten FREE

bul Yeast FREE

bul Milk-derivative FREE

There is no GLA in the Nordic Natural Fishies -but again the formula of EPA and DHA is about the same as one regular sized capsule of NNProEFA 3.6.9.. One could always add a drop of primrose oil to their child’s diet!

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 age, the health of the body, certain disease states, as well as over consumption of omega-6 fatty acids from most vegetable oils. 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.

An alternative to fish oils is algae

Algae is a fantastic alternative to fish oils for those that can’t get liquid fish oils into their children no matter what, or who have children that are allergic to fish, or for vegetarians. Nordic Naturals has a brand new product called Algae Omega (formally ProAlgen).

Taste test…virtually no smell. The slightest scent of lemon. I’ve had my family taste it. No taste, no after taste. I’m convinced based on my own picky teens who has no idea they ate algae that you can mix this in anything and a child wouldn’t know there was something healthy hiding in there!

Vincent and Lily both have profound special needs. There mom, Dawn, has never been able to get Vincent to consume any fish oil, even the “child friendly” fish oils. Here’s a video of the Algae Omega (formally ProAlgen) being secretly hidden in his protein shake. Both teens have make remarkable progress, and at the end of the video you can hear Lily say “Turn Off” as she is pointing to the video camera! She had never said that before!

Each 1.5 ml (less than half a teaspoon) has 200 mg of EPA and 350 mg of DHA…but the fact there is that much EPA in an algae formula is BRILLIANT! Once you open the bottle store it in the refrigerator. As it’s higher in DHA than EPA and with no GLA -this is not the formula of Omega 3s we have found best in the group over the years -however if your child is also on protein shake you’ll easily be getting in the healthy essential fats from an incredible source! And because this is a brand new formula from a unique source that most have not tried -it could in theory even be superior.

It’s for sure worth exploring and I give Algae Omega (formally ProAlgen) TWO thumbs up!

100% vegetarian source of omega-3s EPA and DHA

Unique formulation provides significant amounts of
both EPA and DHA

Made from microalgae, nature’s original source of marine omega-3

Supports normal vision, heart health, positive mood, immunity, and the body’s natural anti-inflammatory response*

Absolutely no unpleasant smell, taste or aftertaste

Great lemon taste

Nordic Naturals Algae Omega (formally ProAlgen)® is the ideal vegetarian alternative to fish oil. Made from microalgae, it offers a plant-based source of beneficial marine omega-3s EPA and DHA without the use of fish. While most algae oils are short on EPA, Algae Omega’s unique combination of EPA and DHA is a pure, safe, and effective source of both of these essential fatty acids. ” Capsules will be coming out shortly -but again the liquid is super easy to hide in virtually any food or drink. I wouldn’t put it into anything that is boiling or steaming hot however as that could compromise the algae’s nutrients.

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 NNProEFA 3.6.9.. 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 NNProEFA 3.6.9. and 1 NNProEPA –you can buy Nordic Naturals NNProEFA 3.6.9 And NNProEPA combo)

Efalex which is a fish oil formula developed by Dr. Jacky Stordy and which has been used in research -the dosage is “Two capsule two to four times daily with food or drink. Taking this product for the first time: Adults and children older than five years, 8 capsules daily with food or drink for the first 12 weeks.” My son Tanner started on Efalex but as it’s low in EPA, we as a group found the NNProEFA 3.6.9. to be a better formula. You can however read my son Tanner’s initial updates when first on Efalex here as published in the book The LCP Solution written by Dr. J. Stordy. My son’s section is called “The Lellow Breakthrough

In addition to what I shared about our nonprofit experience, researched Efalex and the dosage used on that label, as you can see from this page which was written with an interview with Dr. AJ Richardson (one of the doctors who presented at our First Apraxia Conference as you’ll see below) who looks at fish oil brands marketed to children, in just about every case the dosage Dr. Richardson recommends is about three times higher than what is on the product label.

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 NNProEFA 3.6.9. (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 NNProEFA 3.6.9. 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.

The fish oil comes in a liquid or a capsule. My child can’t swallow capsules so shouldn’t I buy the liquid?

It depends on the age of the child. Most children prior to seven or eight years old are not swallowing capsules. So most of us pierce the capsule with a pin and squeeze it out. Because new parents have no idea how many capsules one teaspoon is equal to there are mistakes made. For example one parent emailed that she started her 3 year old on 3 teaspoons a day of fish oil, which is equal to about 12 capsules. Most would never dream of starting their child or even themselves on 12 capsules of fish oil capsules a day. More is not always better. If you have the right formula you will find it will work even at lower dosages.

Fish oils are very unstable in oxygen as you can imagine. While the capsule keeps that same fish oil inside it fresh for up to 4 years and without being refrigerated, the oil in the bottle lasts only around 4 months and needs be be refrigerated once opened.

So if you have the liquid use it quick. Some here may like the liquid because they think it’s easier to use -but the capsules are better in my opinion for various reasons including:

  1. Longer shelf life
  2. No need for refrigeration
  3. Easy to control dosage
  4. Easy to travel with
  5. Not a big deal if you spill the bottle over
  6. You can just use a pin and turn the capsule into liquid, but can’t turn the liquid into a capsule

Many start with one capsule of NNProEFA 3.6.9. which would be approximately equivalent to a 1/4 a teaspoon of the liquid NNProEFA 3.6.9.. 1/2 teaspoon of NNProEFA 3.6.9. oil is close to the equivalent of about 2 capsules of NNProEFA 3.6.9..

If you are experienced and decide you want to use the liquid knowing all you do now, you can proceed how you see best. But even still, if you travel I suggest you purchase the capsules for during that time.

What is the best way to increase EFAs in my child and where do I get them?

There are many ways to increase the amount of essential fatty acids in you or your child’s diet. You can for one increase the amount of fish. Today in addition to fish, again you can also serve your child algae with the new formula by Nordic Naturals called Algae Omega (formally ProAlgen) which contains both EPA and DHA and has no smell or taste. If you are going to give your child fish oils, make sure it’s a reputable brand that verify their product’s purity in writing. 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 NNProEFA 3.6.9. by Nordic Naturals manufactured in the US and Eye Q by Equazen manufactured in the UK. Nordic Naturals makes a number of oils and they have a number of lines including a health care professional and a commercial line. The Omega 369 is the commercial line sold in stores which is the exact same formula as the professional line called NNProEFA 3.6.9. sold by health care professionals . NNProEFA 3.6.9. in the professional line is slightly cheaper as you get 90 capsules per bottle vs. 60 for around the same price of the Omega 369 in the commercial line. Even if you do purchase a formula that doesn’t contain any GLA from primrose or borage seed oil, seek one that is higher in EPA to DHA such as Coromega -but again with the small amount of GLA better results were reported in the majority of our group for over a decade now.

Why is there vitamin E added to the fish oils?

There is a very small amount of vitamin E (around 15 IU per capsule) 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.

Why EPA, DHA…AND GLA? (Eicosapentaenoic acid, Docosahexaenoic acid, Gammal Linolenic acid)

Our body needs omega-3 and -6 fatty acids to protect the cells in our body and to help them to function properly. The adult human brain is composed of about 60% fat (dry weight). Our body can produce some of this fat (fatty acids), however, the body is unable to synthesize omega-3 and omega-6 fatty acids, which make up 35% of the brain fat 1. This is why omega-3 and omega-6 are called essential fatty acids and have to be provided through the diet.

Not all Omega-6 is the same. Gamma-Linoleic Acid (18:3n-6) is a specific type of Omega 6. Food sources would be from evening primrose, borage, blackcurrant and hemp seed oils. Borage Seed Oil is the richest source of GLA (up to 24%), followed by blackcurrant seed oil (up to 18%). Evening primrose oil contains 9% GLA. Gamma Linolenic Acid (GLA). GLA is made from linoleic acid in the body and is an intermediate in the production of DGLA and AA GLA can act in much the same way as Omega-3 fatty acids and enhance their effects by exerting an anti-inflammatory action and reducing excess incorporation of inappropriate Omega-6 in the brain, while still promoting the functional and structural influences from Omega-3.

Deficiencies of these essential omega-3 and omega-6 fatty acids can contribute to a host of symptoms and disorders, such as cognitive impairment like attention deficit hyperactivity disorder (ADHD) 2-5 and depression 6.

A specific formulation of polyunsaturated fatty acids EPA:DHA:GLA (Eicosapentaenoic acid, Docosahexaenoic acid, Gammal Linolenic acid) at the ratio of 9:3:1 proved effective in various clinical trials 2,3,5. In this specific ratio, these three essential fatty acids work most effectively to provide both structural and functional support for the central nervous system.

Research shows that DHA or GLA alone, or DHA in combination with low EPA levels had no positive effects on ADD/ADHD-related symptoms 4,7,8

EPA protects and enhances nervous function

  • EPA is known to ameliorate different cognitive diseases 2,3,5
  • EPA has anti-inflammatory properties by
    reducing production of pro-inflammatory mediators (cytokines) 1.
  • EPA plays a role in maintaining the integrity
    of mitochondrial membranes in brain regions important for memory and cognitive function (hippocampus and cortex) 1.
DHA supports brain development

  • DHA is important during prenatal human brain development
  • Deficiency can have marked consequences, including cognitive impairment 23, cerebellar dysfunction 24, retarded visuael acuity25, and ­various other neurological disorders 26

GLA and anti-inflammation

  • GLA reduces pro-inflammatory prostaglandin production in the brain cells 21
  • GLA normalizes the level of some neurotransmitters at the synapse 21


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  2. Johnson, M., Ostlund, S., Fransson, G., Kadesjo, B. & Gillberg, C. Omega-3/omega-6 fatty acids for attention deficit hyperactivity disorder: a randomized placebo-controlled trial in children and adolescents. J Atten Disord 12, 394-401, doi:1087054708316261 [pii] 10.1177/1087054708316261 (2009).
  3. Richardson, A. J. & Montgomery, P. The Oxford-Durham study: a randomized, controlled trial of dietary supplementation with fatty acids in children with developmental coordination disorder. Pediatrics 115, 1360-1366, doi:115/5/1360 [pii] 10.1542/peds.2004-2164 (2005).
  4. Schuchardt, J. P., Huss, M., Stauss-Grabo, M. & Hahn, A. Significance of long-chain polyunsaturated fatty acids (PUFAs) for the development and behaviour of children. Eur J Pediatr 169, 149-164, doi:10.1007/s00431-009-1035-8 (2010).
  5. Sinn, N., Bryan, J. & Wilson, C. Cognitive effects of polyunsaturated fatty acids in children with attention deficit hyperactivity disorder symptoms: a randomised controlled trial. Prostaglandins Leukot Essent Fatty Acids 78, 311-326, doi:S0952-3278(08)00050-1 [pii]10.1016/j.plefa.2008.04.004 (2008).
  6. Omega-3 fatty acids and depression: new data. Harv Ment Health Lett 19, 7, doi:M0603d [pii] (2003).
  7. Hirayama, S., Hamazaki, T. & Terasawa, K. Effect of docosahexaenoic acid-containing food administration on symptoms of attention-deficit/hyperactivity disorder – a placebo-controlled double-blind study. Eur J Clin Nutr 58, 467-473, doi:10.1038/sj.ejcn.16018301601830 [pii] (2004).
  8. Voigt, R. G. et al. A randomized, double-blind, placebo-controlled trial of docosahexaenoic acid supplementation in children with attention-deficit/hyperactivity disorder. J Pediatr 139, 189-196, doi:S0022-3476(01)66292-9 [pii] 10.1067/mpd.2001.116050 (2001).
  9. Stevens, L. J., Zentall, S. S., Abate, M. L., Kuczek, T. & Burgess, J. R. Omega-3 fatty acids in boys with behavior, learning, and health problems. Physiol Behav 59, 915-920 (1996).
  10. Antalis, C. J. et al. Omega-3 fatty acid status in attention-deficit/hyperactivity disorder. Prostaglandins Leukot Essent Fatty Acids 75, 299-308, doi:S0952-3278(06)00118-9 [pii] 10.1016/j.plefa.2006.07.004 (2006).
  11. Kavraal, S. et al. Maternal intake of Omega-3 essential fatty acids improves long term potentiation in the dentate gyrus and Morris water maze performance in rats. Brain Res 1482, 32-39, doi:10.1016/j.brainres.2012.09.002 S0006-8993(12)01463-1 [pii] (2012).
  12. Hajjar, T. et al. Omega 3 polyunsaturated fatty acid improves spatial learning and hippocampal Peroxisome Proliferator Activated Receptors (PPARalpha and PPARgamma) gene expression in rats. BMC Neurosci 13, 109, doi:10.1186/1471-2202-13-109 1471-2202-13-109 [pii] (2012).
  13. Mazereeuw, G., Lanctot, K. L., Chau, S. A., Swardfager, W. & Herrmann, N. Effects of omega-3 fatty acids on cognitive performance: a meta-analysis. Neurobiol Aging 33, 1482 e1417-1429, doi:S0197-4580(11)00546-X [pii] 10.1016/j.neurobiolaging.2011.12.014 (2012).
  14. Chiu, C. C. et al. Associations between n-3 PUFA concentrations and cognitive function after recovery from late-life depression. Am J Clin Nutr 95, 420-427, doi:ajcn.111.015784 [pii] 10.3945/ajcn.111.015784 (2012).
  15. Hennebelle, M. et al. Influence of omega-3 fatty acid status on the way rats adapt to chronic restraint stress. PLoS One 7, e42142, doi:10.1371/journal.pone.0042142 PONE-D-12-07752 [pii] (2012).
  16. Kiecolt-Glaser, J. K., Belury, M. A., Andridge, R., Malarkey, W. B. & Glaser, R. Omega-3 supplementation lowers inflammation and anxiety in medical students: a randomized controlled trial. Brain Behav Immun 25, 1725-1734, doi:S0889-1591(11)00468-5 [pii] 10.1016/j.bbi.2011.07.229 (2011).
  17. Ross, B. M. Omega-3 polyunsaturated fatty acids and anxiety disorders. Prostaglandins Leukot Essent Fatty Acids 81, 309-312, doi:S0952-3278(09)00174-4 [pii] 10.1016/j.plefa.2009.10.004 (2009).
  18. McKenney, J. M. & Sica, D. Prescription omega-3 fatty acids for the treatment of hypertriglyceridemia. Am J Health Syst Pharm 64, 595-605, doi:64/6/595 [pii] 10.2146/ajhp060164 (2007).
  19. Morris, M. C., Sacks, F. & Rosner, B. Does fish oil lower blood pressure? A meta-analysis of controlled trials. Circulation 88, 523-533 (1993).
  20. Shimizu, T. Lipid mediators in health and disease: enzymes and receptors as therapeutic targets for the regulation of immunity and inflammation. Annu Rev Pharmacol Toxicol 49, 123-150, doi:10.1146/annurev.pharmtox.011008.145616 (2009).
  21. Song, C., Manku, M. S. & Horrobin, D. F. Long-chain polyunsaturated fatty acids modulate interleukin-1beta-induced changes in behavior, monoaminergic neurotransmitters, and brain inflammation in rats. J Nutr 138, 954-963, doi:138/5/954 [pii] (2008).
  22. Boelsma, E., Hendriks, H. F. & Roza, L. Nutritional skin care: health effects of micronutrients and fatty acids. Am J Clin Nutr 73, 853-864 (2001).
  23. Birch, E. E., Garfield, S., Hoffman, D. R., Uauy, R. & Birch, D. G. A randomized controlled trial of early dietary supply of long-chain polyunsaturated fatty acids and mental development in term infants. Dev Med Child Neurol 42, 174-181 (2000).
  24. Jamieson, E. C. et al. Infant cerebellar gray and white matter fatty acids in relation to age and diet. Lipids 34, 1065-1071 (1999).
  25. Neuringer, M. Cerebral cortex docosahexaenoic acid is lower in formula-fed than in breast-fed infants. Nutr Rev 51, 238-241 (1993).
  26. Salem, N., Jr. & Ward, G. R. Are omega 3 fatty acids essential nutrients for mammals? World Rev Nutr Diet 72, 128-147 (1993).

What is Omega 9?

Omega-9 fatty acids are from a family of unsaturated fats that commonly are found in vegetable and animal fats. This monounsaturated fat is described as omega-9 because the double bond is in the ninth position from the omega end. These fatty acids also are known as oleic acids or monounsaturated fats and can often be found in canola, sunflower, olive and nut oils. Unlike omega-3 and omega-6 fatty acids, omega-9 fatty acids are produced by the body, but also are beneficial when they are obtained in food.

What are the types and sources of omega-9 fatty acids?

  • Oleic acid – Oleic acid is a main component of canola oil, sunflower oil, olive oil, and other monounsaturated fats, many of which are used as a solution for reducing bad fats in cooking oils. Other sources are peanuts, pistachios, almonds, and avocados.

Omega-9 is necessary yet “non-essential” because the body can manufacture a modest amount on its own, provided essential EFAs are present.

How do all the Omegas add up?

Although omega-3, omega-6, and omega-9 fatty acids all serve different functions within the body, the evidence is clear that incorporating balanced proportions of both essential and non-essential fatty acids are necessary for maintaining overall heart health and general wellness. According to a joint position paper between the Academy of Nutrition and Dietetics and the Dietitians of Canada.

Does omega 3 or omega 6 or GLA cause seizures in those prone to seizures?

Answer from Dr. Richardson (one of the doctors who presented at our First Apraxia Conference)

“Re your enquiry – I have to say that I have become extremely bored with this issue, although I can fully understand people’s concerns.

First – let me say that re fish oil, this story seems quite ridiculous to me. What appears to have happened is that a myth that started with evening primrose now appears to have spread – as myths and rumours do – to fish oil.

I know of no evidence whatsoever that could possibily link the consumption of fish oil (omega-3 fatty acids) to an increased risk of epilepsy. In fact, one would expect exactly the opposite!

Re evening primrose oil (omega-6 fatty acids), again there appears to be no reliable evidence of any link to epilepsy – although there are plenty of anecdotes and rumours, fuelled by the fact that some manufacturers have chosen to put a warning on their products to this effect.

This story arose from some very early trials of the use of EPO in schizophrenia. The drugs used to treat schizophrenia have numerous side-effects, one of which is to reduce the threshold for epileptic fits quite substantially. Thus when a few schizophrenia patients suffered fits while taking this medication (and evening primrose oil), it was duly noted down. This was interpreted by some as a possible negative effect of EPO – rather than the more obvious explanation that the neuroleptic drugs were to blame.

Since then, no evidence has been forthcoming to suggest that EPO carries this risk – in fact the balance of evidence appears to suggest the opposite.

However, like all ‘scare stories’ – this one does not seem to go away…”
Dr A J Richardson
University Lab of Physiology
Parks Road
Oxford OX1 3PT

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.

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. There are numerous studies linking good nutrition to better cognition.

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 or two. Below are a few other, but for a full list, see this page.

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 from whey together with nutrients from foods like turmeric, amalaki, haritaki, gymnema, green tea, cocoa, cinnamon, and cayenne pepper as well. Based on the parallels reported between essential fats and other essential nutrients 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. Typically infants match adult displays of mouth opening (MO) and tongue protrusion. Here is a wonderful PDF on this from Indian University, ‘ Imitation or exploration? Young infants matching of adults’ oral gestures’

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 amount of essential nutrients your child is getting from foods 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

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 more healthy foods 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.

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 six month- 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.

I just started my child on fish oils and he’s smelling fishy- is that from the fish oils?

I just started my child on fish oils and he’s waking up in the middle of the night crying -is that from the fish oils?

More common questions and answers can be found on our “Getting Started” page.

The Worst Side Effects May Be From…

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.”

My child is allergic to fish. Can I still give him fish oil?

Nordic Naturals states “In theory, fish proteins should be effectively removed in processing. However, it is certainly possible for fish oils to have small traces of protein. The fish gelatin that is used in our fish gelatin Omega-3 formula, however, is derived from fish protein, and could be considered allergenic.” You could use the oil that is not in a capsule in that case, but again check with your child’s doctor.

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)

A report by, which conducts independent tests of supplements, examined 41 common fish oil products and found none contaminated with mercury or PCBs.

Another report, by researchers at Harvard Medical School and at Massachusetts General Hospital, studied five popular brands of fish oil and found that the brands had “negligible amounts of mercury, suggesting either that mercury is removed during the manufacturing of purified fish oil or that the fish sources used in these commercial preparations are relatively mercury-free.”

Test results for various fish oils can also be found on the International Fish Oil Standards Web site.

Q. Should I worry about mercury in fish-oil capsules?

A. No. “Most studies on fish products have been very reassuring,” says Brent Bauer, MD, director of the complementary and integrative medicine program at the Mayo Clinic in Rochester, Minnesota. When researchers at, an independent testing company in White Plains, New York, examined more than 50 different fish oils, they found that none were contaminated — probably because toxins tend to accumulate in the muscles of fish, not the oil. Plus, supplements are generally made from species that are lower in mercury, like sardines and anchovies Fitness Magazine


Studies suggest that fish oil products contain little or no contaminants, such as mercury, dioxins or PCBs. For one thing, most companies use species of fish that are lower on the food chain, like cod and sardines, which accumulate less mercury. And many companies distill their oils to help remove contaminants.

Also 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.”

Nutrition Cognition Research Articles


EFA information

EFA tips and sources

EFA resources

EFA tips

Article from EngleMed

“Look Who’s Talking Now: Fish oil capsules help children with speech disorders find their voices “

The Late Talker book Chapter on fish oils.

First Apraxia Conference

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 doctor essential 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!

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

Martha Herbert M.D. PhD, Pediatric Neurologist at Harvard is one of the doctors that I respect greatly, and as a medical doctor she has always been ahead of the game in regards to nutrition/cognition links. She’s one of the doctors that reviewed my book The Late Talker. In this segment she explains that autism is “not a life sentence” and why diet is big.

Why is nutrition important? A talk by Dr. Martha Herbert

25 Responses to “Therapeutic Use Of Fish Oil for Apraxia, Autism and Other Communication Impairments”
  1. Lopcoessy says:

    Finally, an issue that I am passionate about. I have looked for information of this caliber for the last several hours. Your site is greatly appreciated.

  2. Maria Lopez says:

    Thank you so much wish us luck we are going to start taking it and we hope we have positive results. thank you for all your advice and help. we appreciate it. Maria

  3. Megan Monica says:

    Hi there, Just wanted to show my appreciation for your time and hard work

  4. Joycelyn Wahlstrom says:

    What i find difficult is to find a blog that can capture me for a minute but your blog is different. Bravo.

  5. Claire Dunnell says:

    I just got your book the late talker as my son was just diagnosed with apraxia, I just found this website and wanted to thank you for being there for parents like me.

  6. Paul Night says:

    Wow, what great info! Found this link from

  7. Rachel McDonald says:

    You are so cool! So nice to find this site with unique thoughts about fish oils and nutrition and the links to our children with special needs. Really thanks for getting this topic out in the open. Outside of drugs these are things we as parents need to know about, and you present them with originality. Again thanks!

  8. Charlotte's Mom says:

    Great information! I’ve been looking for something like this for a while now. Thanks!

  9. Izzy A says:

    Thanks so much for all the info you put out there for parents..helping to keep the hope alive!

    • Lisa Geng says:

      You are so welcome! I do what I do because I remember what it was like when my son Tanner was diagnosed with apraxia and there was so little information. I want to make sure all of our children, no matter what age or diagnosis, are provided the best opportunity for a voice and a chance for a verbal future. There really is so much hope! Lisa Geng

  10. A ong says:

    Thank you so much for the info and the book! Amazing! My child has improved lots since taking pro efa 6 months ago. Should I add on pro EPA as well? He has made tremendous progress but seemed to have plataeud in the past month.

    • Lisa Geng says:

      You don’t mention how much ProEFA you are using. One or two capsules- or are you using the liquid? And if so how much. Also is your child on NV as well because that would make a difference too -but I’m suspecting not if your child has plateaued.

  11. A ong says:

    He’s taking 5ml of pro efa daily (liquid form) what is NV?

  12. Christine Horvath, MS, OTR/L says:

    OMG… This article was just posted to FB and I am SO glad to see it! It has been a LONG time since we have spoken Lisa, but to this day I reference the ProEFA/Omega 3&6 information I learned from you during our work together with the Cherab Foundation while you were in NJ. In fact just shared it with a family after an IEP meeting on Friday as I see the changes kids make once they start taking it! I am so happy to see your advocacy efforts are still going strong! You were missed once you left NJ! Hope you and your family are doing well. If you need any SI OT support for any of the families you work with let me know. Would be glad to help out again where I can!

  13. Kathy says:

    Hi Lisa! I enthusiastically went searching for proEFA and I’m seeing that the amounts of EPA/DHA and GLA have changed with their latest product. They are now 135 EPA, 90 mg DHA and 33 mg GLA. Will that make a big difference? And how many capsules a day should my 5 yr old be taking. He’s small for his age at just under 40 pounds. Thanks – we’re hoping this works!

  14. Sylvia says:

    HI, Thanks for such elaborate description on fish oil. I’m not sure if you are still answering questions on this blog… but one quick question. My son is 19 months. I have been giving him 2 capsule of ProEFA and half capsule of Nordic Naturals Cod liver Oil and half capsule of ProEPA every day now for the past 2 months. I have seen some improvement in his speech. But few days ago I have come across an article that states that children under 2 should be getting more DHA than EFA.. And only children over 2 should receive more EFA to DHA.. Am concerned that I have been giving him the wrong dosage.. Do you have any information on this matter?

  15. leng says:

    hi, can a baby of 3 months old safe to consume efalex?

  16. daryl hartley says:

    Appreciation to my father who shared this website with me, it’s actually remarkable.

  17. Ursula says:

    Hi Lisa, I am hoping you are checking this great site. I have a 26 month old daughter who may have motor and speech apraxia. Althought it has not been confirmed, they believe her delay is due to the apraxia…this has been said to us by two different doctors (neurodevelopmental and autism research doctor). They also mentioned that Apraxia cannot be diagnosed at an early age. However, I have made the decision to not wait, and purchased the ProEFA and the ProEPA from the site you reccomended above. I see on different comments something about NV. Is this something I should also be adding to her food as well.

    I purchased both ProEFA and ProEPA capsules, and I believe the dosage to give is two ProEFA capsules, and one ProEPA capsule. I will be extracting the liquid and mixing this with her bottle. Is this ok, and is this the correct dosage to give to her.

    I also would like to know what is the benefit of giving this to a child with no speech issues? Can this be given to a child that does not have apraxia and no speech issues? I am thinking of giving this to my 3 year old child as well.

    Any information you can provide, I greatly appreciate it. Is your son still taking the ProEFA and ProEPA? I would love to hear more about your experience with a child with Apraxia, as we dont really know where to start.
    We are confused as to what to do or not to do. One one side the two doctors mentioned there is a chance she has apraxia and on the other hand the two therapists she has been seeing for about a year say they do not see her as having apraxia. We are also trying to determine if these therapies should be cancelled, as they really have not helped our daughter much. The neurologist says the best treatment is at home and daycare, and therapies dont help much since its only 45 minutes a week. Any help is greatly appreciated it. THANK YOU SO MUCH!

  18. Johnd982 says:

    Just wanna input on few general things, The website pattern is perfect, the subject material is real excellent. Believe those who are seeking the truth. Doubt those who find it. by Andre Gide.

  19. John says:

    I appreciate, cause I found just what I was looking for. You have ended my 4 day long hunt! God Bless you man. Have a nice day. Bye

  20. Johne800 says:

    I need to input, I hadn’t the benefit of examining everything, but you have an excellent grasp on the subject

    • Lisa Geng says:

      Hi Cyndi,

      I don’t recommend the NNgummies -I recommend the NNNordic fishies which have 300mg of Omega 3s per ONE fishie according to the NN website
      The gummie you shared has in comparison 90 mg of Omega 3 per FOUR gummies according to their website (so 20 something mg a gummie?)

      In general I don’t even recommend the NN Nordic fishies either unless you can’t get fish oils into your child as they are so expensive in comparison to fish oil like NNProEFA and NNProEPA.

      As far as a gummie vitamin….I’m the mom behind IQed by the way and prefer food sources for vitaqmins like my IQed which is all natural and replaces the need for a vitamin and can be used as a full meal replacement even for picky eaters

  21. Cecile Noe says:

    Thank you for sharing this information. I’ve bookmarked this page and have found this to be incredibly useful as every time I have a question I come here and search for it and find the answer I’m looking for.

    If I may offer some constructive criticism, uou may want to think about splitting up this page into a few different pages as there is so much to take in I don’t believe the average person will be able to grasp all of it.

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