May 30, 2023

Autism

Dr. Jennifer Yee shares some insight into autism:

What is autism?

The way autism is defined is constantly evolving as our understanding and acceptance of neurological differences and traits continue to expand. The current consensus is that autism is a neurodevelopmental condition that impacts brain development but is not a disease. It is important to note that not all individuals on the autism spectrum have identical experiences or challenges; however, many will experience communication difficulties (verbal and non-verbal) and challenges with social interactions. They may also have a very restricted range of preferences, activities and interests, as well as a tendency to repeat specific patterns of behaviour. 

In Canada, as well as many other countries, we utilize the DSM-V (Diagnostic and Statistical Manual of Mental Disorders, fifth edition) for diagnosis which was developed by the American Psychiatric Association. In the most recent edition, published in 2013, autism is now referred to as autism spectrum disorder (ASD) and includes Asperger’s syndrome as well as what was previously called autism disorder.

What are the possible signs of autism? How is autism diagnosed?

Parents and other caregivers are often the first to suspect that a child might be on the autism spectrum. For example, a caregiver may notice that their child has speech delays, challenges interacting with other children or difficulty initiating and maintaining eye contact. Another scenario is that a child was reaching all standard developmental milestones but then regressed – in this case, it would be important to be assessed by a medical professional as soon as possible for autism or other health concern causing regression. 

Before discussing possible signs of autism, it is important to note that cultural differences, language, age, gender, ability level, and social environment can affect how someone may interact with the world. For example, in Canada, eye contact is commonly used when communicating with others; however, in other places (and within Canada, with people of different cultural backgrounds), it may be uncommon to make direct eye contact with someone as it is considered rude or is just not a standard learned communication pattern, at which point lack of eye contact would likely not be a reliable sign of autism.

Early signs of autism (ages 12-24 months) may include the symptoms such as:

-lack of language abilities or a child begins to develop language but then loses it

-responds unevenly or not at all to their name or sounds (also important in this case to assess for hearing impairment)

-avoids eye contact

-does not “point and look” and seems disinterested in interactive games (e.g. Peek-a-boo)

-difficult to console when upset

-resistance to physical affection (e.g. being held, hugged or kissed)

-repetitive behaviours (e.g. rocking, flicking fingers, spinning, flapping, picking, etc.)

-severely restricted diet beyond being a “fussy eater”

-aggression and/or self-injury

In older children and adults, we may also see some of these possible indicators:

-impaired communication and social skills (e.g. not responding when spoken to, inability to display appropriate facial expressions, avoidance of eye contact, challenges seeing things from another person’s perspective, etc.)

-difficulty coping with changes in environment or routine & prefers highly structured situations with predictable routines

-a narrow range of interests (e.g. hobbies, food, conversation topics, etc.)

-unconventional reactions to sensory stimulation. This can include being hypersensitive to things such as touch, noise, taste, texture, odours and sound or hyposensitive (e.g. high pain tolerance, not responding to loud noises or when being spoken to, etc.)

-behavioural challenges such as emotional outbursts, aggression or self-injury. This may also present as mental health challenges such as depression or anxiety

-challenges with sleep (difficulty falling asleep and/or waking at night)

If a person or a caregiver of a child suspects they may be on the autism spectrum, they will typically consult with a family doctor or other medical professional. Screening assessments can then be initiated which may involve the integration of a specialized diagnostic team. As previously discussed, in Canada, we use The DSM (Diagnostic and Statistical Manual of Mental Disorders) as the guidelines for diagnosis with a variety of screening tools (tests, questionnaires, observational studies) that are used to assess children and adults. Early diagnosis can result in more effective treatments and supports, but autism can be diagnosed at any age, including older adults such as seniors. 

How can Naturopathic Medicine support people with autism?

Individuals on the autism spectrum will have varying combinations of experiences and symptoms, and they can vary in severity and level of disruption to daily quality of life. Therefore, it is integral that treatments be specific to the individual and their goals, needs, skills, and abilities. People with autism typically have co-occurring medical conditions such as sleep disorders, digestive abnormalities, immune dysregulation, and mental health challenges such as anxiety and depression.

The objectives when helping and supporting people on the autism spectrum is to treat any related or co-existing health issues in order to increase the quality of life, happiness, and well-being. If these challenges are impacting others in the family or other caregivers, then it is also important to also make sure they are being supported appropriately as well.

From a naturopathic perspective, some of the primary areas of focus are the digestive system, the neurological system (brain, nervous system), and the immune system. It is common for people on the autism spectrum to experience a greater incidence of digestive upset which could include diarrhea, constipation, gassiness, bloating, and abdominal discomfort. Some individuals may also have sensory issues that negatively impact their dietary or toileting habits. Assessment for food intolerances and the balance of the microbiome may be helpful. This includes supporting optimal levels of beneficial bacteria such as probiotics as well as limiting/reducing harmful overgrowth of undesirable bacteria, parasites or yeast.

The neurological system can be supported through diet and optimal nutrition, as the digestive system has a substantial influence on our neurological health as well as mental health. If stress, depression, anxiety, sleep disruption or behavioural challenges are impacting the quality of life, there are a number of different targeted treatments (dietary adjustments, vitamins, supplements, herbal medicines, detoxification support, etc.) that may be helpful.

Individuals on the autism spectrum also experience a greater likelihood of immune dysregulation. This can include a weakened immune system where the person is more vulnerable to becoming sick (e.g. cold and flus) or an overreactive immune system (e.g. overreactive allergy response, autoimmunity, inflammation, etc.). Much of naturopathic medicine is focused on re-balancing the responses of various systems in the body, and the immune system is one of the key areas of focus.

Although autism can be challenging and complex to diagnose and treat, there are numerous naturopathic treatment options that may be helpful to improve symptoms, quality of life, and behavioural challenges and address co-existing health issues. From childhood to adulthood, naturopathic medicine can be utilized to support the entirety of a person as a unique individual.

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