Choline and Complex Language Development
by Kelly Dorfman, M.S., Nutritionist and DDR Co-founder
Recently when I began recommending choline to improve motor planning, many parents reported spontaneous improvement in the complexity of expressive language in their children. I want to share my thoughts about this very exciting and unexpected outcome with our readers.
What is Choline?
Choline is essential for brain development. In 1998 the National Academy of Science recognized it and established a daily requirement of 425–550mg. Research shows that lack of choline in a mother’s diet during pregnancy and lactation can permanently limit brain capacity later in life. Individuals must ingest choline. Since primary dietary sources are liver, eggs, wheat germ, lecithin and soy, it is unlikely that many kids, especially those on elimination diets, get enough of this critical nutrient.
What is Complex Language?
Developmentally, children progress from labeling items, to asking for what they want, a form of "demand" language. The next step, the most difficult for many children on the autism spectrum, is conversing and answering "why" "where" or "what" questions, all components of "complex" language. Clinically, many children get stuck at the level of "demand" language, transitioning to the next level slowly or not at all. Making conversation requires a specific type of motor planning in the language area of the brain that allows finding, prioritizing and sequencing words, rather than simply memorizing or scripting. The part of the brain that labels objects is different from the section that generates conversation or answers questions such as "What happened at school today?"
What are the Functions of Choline?
Choline has several important purposes. It is needed to:
- assure structural integrity and signaling ability of the cell membrane, the "gate-keeper" that surrounds and protects every cell. Material can enter a cell and neurotransmitters can signal a cell only as the membrane allows. A healthy cell membrane contains phosphatidylcholine (PC) to regulate its permeability. Insufficient PC compromises this regulatory function.
- contribute small chemical structures called methyl groups that enable methylation, a key phase of detoxification. Methylation is also important for gene expression, nutrient activation (especially for vitamin B-12), and cell membrane stabilization. Research by Dr. Jill James and others suggests that autism can result from a faulty methylation system.
- build acetylcholine, a neurotransmitter that regulates memory, motor planning, and executive functions such as sorting and prioritizing. How Does Choline Enhance Complex Language? Nobody knows for sure, but I have a theory, based on my professional training, review of the research and clinical observations. I believe that the part of the brain where motor planning for language takes place is under the influence of acetylcholine. The combination of copious amounts of acetylcholine along with permeable membranes composed of sufficient PC appears to be the magic formula for improving complex language in many children.
- Adam, age three, had multiple developmental delays, for which he was receiving speech, occupational and FloorTime therapies. Despite this aggressive intervention, progress was slow. Adam used many single words, but few phrases or sentences. Within a month of starting choline as PC, he was conversing.
- A six-year-old boy shocked his parents by using a whole sentence for the first time just a few weeks into taking PC.
Research supports choline supplementation. Rat pups who took choline showed enhanced memory and attention lasting throughout their lifetimes. Researchers could even identify those animals that took choline supplements in infancy from their behavior as aging rats.
Because foods alone cannot provide sufficient amounts, extra choline must be added to obtain therapeutic benefit. Choline as a dietary supplement comes in several different versions. Choline bitartrate is found in most multiple vitamins, but rarely used as a separate supplement. Alpha glyceryl phosphatidylcholine (GPC) and DMAE (see 7:2) are two other forms available. GPC is thought to slow brain aging by increasing motoric response time. DMAE may improve symptoms of attention deficit disorder, with irritability as a side effect. For complex language development, I prefer phosphatidylcholine (PC).
For children who cannot swallow capsules, try liquid PC, Xymogen Phosphaline, available from The Village Green (800.869.9159). Dosage is ½ to 1 tsp. per day. Xymogen Phosphaline is strong- tasting and thick; mix it with apple or pear sauce, spread it on a pancake, or camouflage it with maple syrup.
The only side effect of PC may be loose stools because it is fatty. PC is derived from soy, but because it contains no soy protein, it is safe for most children on gluten-, casein- and soy- free diets. Children with serious soy reactions should avoid this product, however.
Bottom line: choline is safe and effective as a brain membrane builder. It may be the secret weapon for taking language to the next level.[Initially published in New Developments: Volume 11, Number 2 - Winter, 2005-2006]