The wide range of symptoms and behaviors associated with Autism Spectrum Disorder (ASD) are complicated enough to deal with on their own, but add in the vast array of other issues that often accompany it and it becomes a minefield to navigate.
If your child has been diagnosed with autism you already face special behavioral challenges. What makes ASD even more difficult are the many other medical health issues that often arise in conjunction with it. Sometimes these symptoms even mask ASD or vice versa.
Many of the issues outlined here can overlap each other. This makes it even more difficult for researchers to clearly determine how and why children with ASD are more likely to experience one or more of them. It is important that as a parent you keep very detailed notes on any areas of concern. This can aid in diagnosis and treatment options, giving you the best shot possible at reducing or eliminating these issues.
Seizures and epilepsy are one of the most common medical conditions associated with ASD. Statistics show that the rate of epilepsy in children with ASD can vary from 5% to 38% in contrast to 1-2% of the rest of the population. Another source shows that statistic even higher at 10% to 30%.
Seizures can begin at any point in the lifetime of someone with ASD but typically signs will show up by adolescence. One study shows the majority of seizure activity occurs in children with ASD after 10 years of age with the average age being 13.3. While there are still not enough studies to conclusively determine why seizures are so common, scientists have found some evidence to support various scenarios. For instance, the risk for seizures or epilepsy appears to be higher in those children who experienced a regression of language skills before the age of three. The largest group at risk for seizure disorders appears to be those individuals diagnosed with intellectual disability in addition to ASD. Additionally, seizures appear to be more common in children who have used antipsychotic medications as part of their ASD treatment.
Though diet has not been shown as a factor causing seizures, some doctors have used a ketogenic diet to significantly reduce and even eliminate seizures. This diet consists of increasing fat intake to four times the intake of carbs and proteins. Doctors still aren’t sure why this works but according to the Epilepsy Foundation, up to two-thirds of patients have found some success with the diet.
Children with ASD have a significantly high rate of sleep disorders. It has been reported that up to 80% have some issue with sleep. The two most common problems are difficulty falling asleep and waking up repeatedly. Some children with ASD seem programmed to wake up early regardless of what time they go to sleep.
Many things can impact your child’s ability to sleep. One common thread is that children with ASD often have greater anxiety and/or depression than other children. These feelings can cause your child to lay awake worrying, making it difficult for them to turn off their brain and fall asleep. If your child has a gastrointestinal disorder in addition to ASD, this can also factor into their ability to stay asleep throughout the night.
Some sleeping problems can be attributed to behavioral problems in which the child hasn’t adjusted to limits being set. Lastly, any medications that your child may be taking can affect how they sleep.
Sleep disorders can affect the entire family but can be especially disruptive to the child, causing additional behavioral issues. Parents can establish routines to promote optimal sleeping conditions. Some common practices include:
- Keep the bedroom dark and cool
- Keep the wake and sleep schedule consistent – even on weekends
- Do not allow your child to have caffeine
- Establish a bedtime routine and stick to it
- Make sure your child gets exercise each day
Another common ailment in children with ASD is gastrointestinal disorder which can include chronic diarrhea and constipation. It has been estimated that 46% to 85% of autistic children suffer from these GI issues. Common symptoms include vomiting, constipation, abdominal pain, acid reflux and diarrhea. When a child is experiencing these problems, it can further contribute to behavioral problems, limit learning and interrupt sleep.
Researchers have still not been able to clearly define why these children are more susceptible to GI problems but some studies suggest dietary allergies may play a role in some cases. Some children have been found to fare better when removing dairy and gluten from their diets. Others do better when processed foods with dyes are eliminated. Still others have added probiotics to their diet to offset symptoms.
Some studies have pointed to a possible connection between immunity issues in ASD patients and GI disorders. Research is still underway to drill down the exact relationship between autism and gastrointestinal issues.
Children suffering from GI problems may not exhibit typical symptoms so in some cases parents may not even know there is a problem. Some behaviors that can indicate a problem may include:
- Coughing excessively
- Refusing to swallow food or difficulty swallowing
- Hitting self in jaw or fisting the jaw
- Chewing excessively
- Chewing on clothes
- Chin tapping
- Sleep problems
- Eating to relieve symptoms
- Unexplained changes in behavior
Researchers from Columbia University believe that early treatment of GI symptoms can result in the reduction of behavioral problems.
One of the less common ASD symptoms is headaches. One reason may be because ASD can be associated with pain insensitivity. This means that the child may just not feel the pain of a typical headache the same way a child without ASD would. Research has however indicated a link between migraines and ASD. A 2014 study found that children with sensory hyperactivity were more likely to experience migraines. Additionally those children with higher levels of anxiety are more likely to have migraines or cluster headaches than others.
Children with ASD may also suffer from headaches if they are head bangers. Children who bang their heads may be doing so in an attempt to limit the pain signals that are being delivered to their brains. Inflammation caused by GI disorders can also cause headaches in your child.
Nutritional changes, behavioral therapies and other treatments to reduce anxiety can play a significant role in reducing these symptoms.
It may be no coincidence that in the 1990’s not only was there a huge uptick in reported autism diagnoses but a vast increase in food allergies in children as well. Food allergies, like autism, have an underlying link to the immune system, which is why it’s possible that they may go hand in hand. In most cases the food allergies are not life-threatening for children with ASD however certain foods may cause worsening of autistic symptoms.
Inflammation caused by a reaction to certain foods can cause the brain of an autistic child to be even more overactive than usual. Toxins in other foods may decrease the brain activity in other children who have under-active brain activity. Research has shown that there are five foods that tend to increase ASD symptoms:
- Artificial ingredients like dye, preservatives and artificial sweetening agents
To understand which, if any of these foods affect your child, an elimination process is suggested. A journal can be particularly helpful when recording changes that result from eliminating foods. Parents should not eliminate all foods at once, but systematically to better understand which foods affect their child and how. It is also important to note that behavior changes may take time so be ready to wait a few weeks or more to see any differences.
It is still unclear how much ASD is related to asthma because asthma is such a common respiratory disorder. The association between the two however, is increasingly being acknowledged as research reveals some correlation. Asthma is considered an immune-mediated disorder that inflames the lungs. Individuals with ASD are considered to have an imbalance of the immune and inflammatory processes. The connection of both disorders to the immune system may suggest that they are related in some instances.
Eczema and Other Skin Issues
Children with autism are 1.6 times more likely to have skin conditions like eczema. Studies have shown a possible link between autism and autoimmune disorders. More research needs to be done but one study suggests that parents with autoimmune disorders may be more likely to have children with autism.
When autism is accompanied by a skin condition, it may be the result of an autoimmune disorder passed on by a parent or an existing food allergy that is causing dry skin, rashes or other skin issues.
Due to the connection between the immune system and autism as described in other conditions, autism is often accompanied by another immune disorder. Current research points to a family history of immune disorders when autism is present in a child.
Other research suggests that expectant mothers who experience infections or inflammation during pregnancy may be more likely to have a child with autism or other disorders of brain development. This again falls back to the connection of the immune system and its link to autism.
Tuberous Sclerosis (TSC) is defined as a rare genetic disease that causes noncancerous tumors to grow all over the body. It is estimated that 25% – 50% of children diagnosed with TSC will develop ASD compared to only 1% of the general population. This connection suggests that TSC symptoms show before ASD symptoms. Often times ASD is not diagnosed until a child with TSC is older because of the other developmental disabilities that accompany TSC. As of 2017 more studies need to be done to narrow the risk factors for TSC among those with ASD.
Children with sensory issues due to autism may be at risk for feeding disorders including difficulty eating or swallowing food based on the smell, texture or color. These children tend to be picky eaters and may even throw tantrums when asked to eat certain foods. Up to 70% of children with ASD may present symptoms of feeding disorders.
Parents dealing with these picky eaters are encouraged to offer choices while still having their child stick to the rules. For instance, let them know they have to eat one vegetable at dinner, but allow them to choose which one. It is also important to ensure that your child isn’t avoiding a food because of an allergy.