<<Disclaimer: Verify this information before applying it to your situation.>> Many parents around the world have been experimenting with gluten and/or casein free diets for their children with autism and the vast majority have claimed benefits which are often substantial. Practical experience and theoretical considerations both suggest that the earlier the offending products are removed from the diet the better. Our group continues to be coy about promulgating information on this topic until the evidenceof effectiveness is conclusive. Also, I would hate to be sued. In spite of this, we are contacted on a daily basis by parents for advice on this matter. We have learned to insist (OK strongly recommend) that parents discuss their plans with their GP and, where appropriate, a nutritionalist of dietician to ensure adequate replacement of cereal and dairy produce. Diagnosis of autism does not usually occur until the child is at least 2 years old and more likely 4. It is unusual, therefore, for us to be contacted by a parent whose child is only 20 months old. She had heard about dietary intervention and wnted to give it a go. We warned her that this is not a game and to be prepared for "withdrawal symptoms". The boy had existed largely on "Weetabix" and milk and this was withdrawn from his diet. The results were, by all accounts dramatic. Normally we experience anxiety and clinginess and a few tears but this boy was absolutely distraught and cried and screemed almost solidly for a couple of days. At this point, the mother decided to give him back his Weetabix. The results were disastrous in that the screeming was hugely intensified and the child arched his back and generally went berserk. At this point he was hospitalised for a couple of days and is now back at home (eating his Weetabix). Naturally, we were alarmed at this tale and there are a number of plausible explanations ranging from pure coincidence to the fact that the child was very young and so did not have any of the biologically active, gluten derived, peptides stored in his tissue. Thus removal of the gluten led to a "Cold Turkey" type response which would not be seen in older children or adolescents. We are unaware of any other experiences with children as young as this but wondered if others on the list would like to comment. I appreciate that although there are links between coeliac and autistic conditions they are not the same. It may be, however, that others may have comments. In the meantime, we have decided that when dealing with very young children, we will suggest that the gluten be withdrawn in two stages about a week apart. I would welcome any comment on this. Paul Shattock