How Cannabis Fits Into My Work With Families

I'm PJ "Starling" Letourneau, a certified cannabis coach and a PDA parent. I coach families raising autistic and PDA kids, and for some of those families, cannabis is part of the conversation. This page explains how I approach it: where it fits, what I do and don't do, and what the research can and can't tell us yet.

If you're a parent who has heard other families talk about cannabis and you want a calm, honest place to think it through, you're in the right spot. You don't need to have decided anything to reach out.

Who I work with

Most of the families I work with have a child with a PDA profile (Pathological Demand Avoidance, often reframed as a Persistent Drive for Autonomy). Many have already tried the standard advice and found that it backfires.

What parents often describe when they first come to me:

Meltdowns, shutdowns or aggression that seem to come out of nowhere
A child whose anxiety spikes at even gentle requests
Sleep that's broken for the whole household
Exhaustion, and the feeling that nothing they try is working
Curiosity about cannabis after hearing other parents' stories, alongside real worry about safety

Where cannabis fits

Cannabis is one possible tool inside a bigger picture, never the whole plan. My core work is helping families lower demands, rebuild trust and create a home where everyone's nervous system can settle. That work comes first, and it matters whether or not cannabis is ever part of it.

When a family wants to explore cannabis, my role is to help them do it thoughtfully:

Understand what the research actually shows, including where it's thin
Know the difference between CBD-dominant, balanced and THC-dominant products
Learn what a quality product looks like, including how to read a lab Certificate of Analysis (COA)
Prepare good questions for their child's doctor
Track changes carefully so decisions are based on what they observe, not hope

Many families decide cannabis isn't right for them. That's a good outcome too.

What working together looks like

A first conversation. We talk about your child, your family and what's hardest right now. No pressure, and no assumption that cannabis is the answer.
The foundations. We look at demands, environment, sleep and family stress. These shifts often make the biggest difference on their own.
Exploring cannabis, if you want to. I walk you through the research, product types and quality standards, and help you choose a quality product. I encourage you to keep your child's physician informed from the start.
Gentle titration. Together we build a gradual 12-week protocol, starting low and adjusting slowly. I give you simple tools to log sleep, mood, meltdowns and anything else that matters, and we fine-tune based on what you observe.
Ongoing support. Regular check-ins while you find what works for your family.

What I do and don't do

I'm a certified cannabis coach and family coach, not a doctor. I guide families through a gradual protocol, and I encourage every family to keep their child's physician informed.

I do:

Share research and explain what it does and doesn't show
Help you understand product types and lab testing
Guide a gradual, start-low protocol over 12 weeks and help you fine-tune it
Point you to cannabis-informed clinicians and parent communities
Support your family through the whole process

I don't:

Diagnose or treat any condition
Prescribe medication
Replace your child's medical care or advise stopping any medication
Promise outcomes or claim cannabis cures autism
Pressure anyone toward or away from cannabis

The science: the endocannabinoid system

The reason cannabis is studied for autism at all is the endocannabinoid system (ECS), a signalling network every human body makes for itself. Several studies suggest it may work differently in some autistic children, and a few clinicians and researchers are exploring whether plant cannabinoids can help bring it back toward balance. That idea is promising but still unproven.

What the ECS is

The ECS is one of the body's main balancing systems. It helps regulate stress responses, mood, sleep, appetite, pain, immune activity and how nerve cells talk to each other. It works "on demand": the body makes endocannabinoids when they're needed, they act briefly, and then they're broken down.

Endocannabinoids (made by the body), such as anandamide (AEA) and 2-AG: messenger molecules that calm overactive signalling and help restore balance.
Receptors: CB1 (mostly brain and nerves) and CB2 (mostly immune system), the "locks" endocannabinoids fit into to deliver their message.
Enzymes: FAAH (breaks down anandamide) and MAGL (breaks down 2-AG) clear endocannabinoids away once their job is done.
Related molecules: PEA and OEA, cousins of anandamide involved in inflammation and appetite.

Where plant cannabinoids come in

THC fits directly into CB1 receptors, much like anandamide does. That's why it can have strong effects, including the "high", and why dose matters so much in children.
CBD barely binds to CB1 or CB2. One proposed way it works is by slowing FAAH, which may let the body's own anandamide stay active longer. It also acts on serotonin and other receptors.
Other compounds such as CBG and plant terpenes are being studied for how they work alongside THC and CBD. This is the idea behind "whole-plant" products.

Signs of ECS dysregulation in autism

Several blood studies have found lower endocannabinoid levels in autistic children than in their non-autistic peers:

Stanford, 2018: In 112 children, those with lower anandamide were more likely to be autistic, and average anandamide was significantly lower in the autistic group (Karhson et al., Molecular Autism). The authors called the finding preliminary.
Jerusalem, 2019: Comparing 93 autistic children with 93 matched peers, Dr. Adi Aran's team found lower levels of anandamide, PEA and OEA in the autistic group (Aran et al., Molecular Autism). They noted more work is needed to know whether blood levels reflect what's happening in the brain.
The bigger idea: Neurologist Dr. Ethan Russo proposed "clinical endocannabinoid deficiency", the theory that some conditions involve an under-active ECS. It's a useful framework, but still a hypothesis.

These studies show an association, not a cause. Lower endocannabinoid levels don't mean every autistic child has an ECS problem, or that cannabis will help.

The work of Dr. Bonni Goldstein

Dr. Bonni Goldstein is a pediatrician who trained at Children's Hospital Los Angeles and worked in pediatric emergency medicine for 14 years. Since 2008 she has focused on cannabis medicine, and as Medical Director of Canna-Centers Wellness & Education in California she has evaluated thousands of patients, with a special interest in children with autism and intractable epilepsy (profile). She is the author of Cannabis Revealed and Cannabis Is Medicine (2020).

Her recent research tries to answer a practical question: can we measure whether cannabis is actually helping a child, rather than relying only on how things look at home?

2023, cannabis-responsive biomarkers: In a small pilot study, her team analysed saliva from autistic children before and after medical cannabis treatment and compared it with typically developing children. They identified 65 molecules that shifted toward typical levels after treatment, including anti-inflammatory markers, neurotransmitters and endocannabinoids (Siani-Rose, Goldstein et al., Cannabis and Cannabinoid Research).
2023, machine learning follow-up: Using the same kind of data, the team found that THC and CBD appear to affect two distinct groups of biomarkers, with CBG overlapping both, and that some non-cannabinoid plant compounds may contribute to the effect (Quillet, Goldstein et al., Scientific Reports).

If this approach holds up in larger studies, it could one day help clinicians choose products and track progress more objectively. For now, these are small pilot studies without placebo groups.

Dr. Goldstein also makes an important point about who this is for: in most healthy children the ECS is working fine, and she has cautioned that adding cannabis to a developing brain that doesn't need it may interfere with development (Project CBD interview). Her approach centres on CBD-rich, low-THC preparations for children with serious needs, under medical supervision.

Other researchers to know

Dr. Adi Aran (Shaare Zedek Medical Center, Jerusalem) led both the 2019 endocannabinoid-levels study and the 2021 placebo-controlled trial described below.
Dr. Itzhak Kurek (Cannformatics) co-leads the saliva biomarker work with Dr. Goldstein.
Dr. Debra Karhson and Dr. Karen Parker (Stanford) produced the first human data linking lower anandamide to autism.

What this means for your family

The ECS gives a real biological reason to study cannabis for autism, and researchers like Dr. Goldstein and Dr. Aran are doing serious work. But the science can't yet tell us which children will benefit, which product or ratio to use, or what dose is right. That's why I treat cannabis as something to explore carefully, with a physician, and with close observation at home.

What the research says

The research on cannabis for autism is promising in places but still early, and I'll always tell you both sides.

The strongest study so far is a 2021 placebo-controlled trial in Israel of 150 young people aged 5 to 21 (Aran et al., Molecular Autism). On one main measure, disruptive behaviour was much or very much improved in 49% of those on a CBD-rich whole-plant extract versus 21% on placebo. On the other main measure, there was no difference. No treatment-related serious side effects were reported.
A follow-up analysis of the same trial found no sleep benefit over placebo (summary).
The lead researcher's own 2024 review describes results across placebo-controlled studies as mixed, and recommends waiting for larger trials before treating cannabis as an established option.
There is no research specific to PDA. What I share with PDA families is drawn from autism, anxiety and family-stress research, and I'll always tell you when we're extrapolating.

Much of what's out there comes from parent reports and open-label studies, which can't separate a real effect from hope or chance. That's why careful observation in your own home matters so much.

My safety commitments

Your child's doctor stays in the loop. I encourage every family to involve a physician, especially if your child takes other medications, since cannabinoids can interact with some of them.
Lab-tested products only. I'll help you check a Certificate of Analysis for cannabinoid content and contaminants like pesticides, heavy metals and mould.
Caution with THC. Children's brains are still developing, and THC carries more risk than CBD. I treat that seriously and say so plainly.
Know your local law. Cannabis laws differ by state and country, and many products that are legal for adults aren't legal for children. I'll point you to what applies where you live.
Safe storage. Edibles and tinctures can look like treats. Keep them locked away from children and pets.

Common questions

Do I have to use cannabis to work with you? No. Most of my work is about the family system, and plenty of families never use cannabis at all.

Do you help with dosing? Yes, as part of coaching. We start low and adjust slowly over about 12 weeks, based on what you see at home. I'm not a doctor, so I encourage you to keep your child's physician informed, especially if your child takes other medications.

Is CBD the same as marijuana? Not quite. CBD is one compound in the cannabis plant and doesn't cause a high. Products range from CBD-only to THC-dominant, and those differences matter a lot for children.

Can cannabis cure autism? No, and autism isn't something to cure. Some families find cannabis helps with specific struggles like anxiety, sleep or meltdowns. Others see no change.

Where do your resources come from? Published studies, parent communities such as Whole Plant Access For Autism, and research bibliographies like Granny Storm Crow's List. I'll always tell you how strong a source is.

Let's talk

If you're curious whether this could help your family, book a free discovery call. We'll talk about where you are and whether working together makes sense, with no pressure either way.

Important information

The information on this page is for education only and is not medical or legal advice. I am not a physician, and nothing here is intended to diagnose, treat, cure or prevent any disease. Statements about cannabis and CBD have not been evaluated by the U.S. Food and Drug Administration or Health Canada. Always consult a qualified healthcare provider before starting, stopping or changing any treatment for your child, and follow the laws where you live.