Autism is on the rise. The developmental disability, which influences how people perceive the world around them, affected 1 in 75 North American children less than ten years ago (2010). But just four years later, it had risen ominously to 1 in 59.
In the UK the picture is a little different, though there remain approximately 700,000 Brits classed as autistic: more than one in 100. Believed to affect more men than women, the stigma around autism has thankfully begun to be replaced by empathy in recent years. Many of us now feel that we have a better sense of the challenges autistic people face day after day.
Given that public appreciation for the difficulties of autism is at an all-time high, it is understandable that mothers – wishing to give their child the best possible care – pay close attention to their offspring’s development, and are keen to assure an early diagnosis of autism, which initially occurs during early childhood.
Evaluating autism isn’t always easy, and in this article we shall take a closer look at what autism evaluation entails while also identifying symptoms to watch out for. We shall also take a closer look at the best forms of treatment: from behavioural therapy and medicines to food and supplements.
Identifying Autism: Early Signs and Symptoms
Early diagnosis of autism is vital, not least so children can be treated when the brain benefits from exceptional plasticity in early life.
It is not out of the ordinary to identify autism within eighteen months, or within six months of symptoms occurring. However, nor is it easy, because red flags can vary greatly from person to person. The common warning signs of autism in toddlers and infants include:
• Difficulty with communication (verbal and non-verbal)
• Repetitive patterns of behaviour
• Refusal to make eye contact, smile or respond to affection
• Mental flexibility
• Developmental delays
• Selective eating
• Regression of communication ability (typically occurs from 12-24 months)
Of course, it can be difficult to recognise some of these in an infant. However, you may notice that your child is refusing to engage in a typical manner, whether when you are trying to play with them or get their attention. You may struggle to elicit eye contact despite repeated attempts, which is a common sign to watch out for.
Although you may be anxious for your child to talk or walk, late development is not a sure sign of autism: it may simply be a coincidence, as children develop very much at different rates. Naturally, you should speak to your healthcare practitioner if you are at all concerned.
Traditional Therapies for Autism
Of course, autism symptoms develop as an infant becomes a toddler, a toddler a child, a child a teenager, and right into adulthood.
Difficulties with social communication tend to be the most recognisable symptom, with autistic people struggling to read or interpret other people’s feelings or emotions, cues like facial expressions and tone of voice that we all take for granted.
Symptoms, meanwhile, can evolve to encompass highly specific interests, habitual behaviours and approaches, a sensitivity to sensory stimulation and so on. Autism Spectrum Disorder (ASD) is a broad term conceived to define these various behaviours.
Traditional therapies for autism, as mentioned in the introduction, include behavioural therapy and medicines: there is no “cure”, as such. However, autism treatments can include Applied Behaviour Analysis (ABA), Occupational Therapy and Speech Therapy. These structured therapies can serve to improve attention span, learning function and other assorted behaviours under the ASD umbrella.
In terms of medication, it is generally prescribed to help the individual function better, whether it is intended to address inability to focus, stress and anxiety or other medical conditions linked with ASD (epilepsy, depression, OCD etc.)
According to many enlightened doctors, including the director of Massachusetts General Hospital’s Lurie Center for Autism, Christopher McDougle, MD, “There are a whole lot of things you want to do before you even think about using medicines to treat behavioural problems.”
Can Diet Affect Autism Symptoms?
Nutrition can play an important role in supporting the management of autism symptoms.
There is a growing body of evidence highlighting the efficacy of nutritional therapy, as it can help in several key areas. For example, by identifying and reducing possible intake of brain-polluting heavy metals; by eliminating food additives; by addressing undiagnosed food allergies; by correcting gut dysbiosis (and thereby nurturing the gut-brain connection); and by remedying possible nutritional deficiencies.
As noted in a 2013 Polish research paper, “adapting an appropriate diet could help alleviate the disease severity, as well as the psychological and gastrointestinal symptoms…
“Many studies demonstrate the need to supplement the nutritional deficiencies of autistic patients with fatty acids omega-3, probiotics, vitamins and minerals in combination with medical and psychological interventions.”
There have been many reported cases of gluten- and casein-free diets improving symptoms of autism, including positive clinical studies (Knivsberg et al., 2002, Pennesi and Klein, 2012). What’s more, ketogenic (high-fat, low-carb) diets have resulted in increased sociability, decreased repetitive behaviours and improved social communications in an animal model (Ruskin et al., 2013; Castro et al., 2016). In addition to gluten and casein, many autism-friendly diets exclude sugar, food colouring and soy.
Omega-3 fish oil appears to be one of the most beneficial nutrients for autism. Omega-3 deficiency has been repeatedly linked to both autism and ADHD, and there is some evidence to suggest that continued high-quality supplementation can cause a regression of symptoms.
Autistic children tend to exhibit high levels of pro-inflammatory cytokines, associated with excess inflammation. One of the benefits of omega-3s is their production of anti-inflammatory cytokines and their ability to impair the production of pro-inflammatory cytokines.
Other nutrients which have shown to be beneficial include vitamin B6, vitamin C and magnesium. Since autistic children tend to exhibit vitamin D deficiency, and because vitamin D is essential for brain function, it may be worthwhile supplementing year-round.
If you’re interested in using nutritional therapy to address your child’s autism, careful planning is required. It is advisable to work alongside an experienced dietitian or nutritionist to structure a tailored plan.
Probiotics and Autism
Antibiotics destroy good as well as bad gut bacteria, and this may partly explain the commonly-cited bowel irregularities of autistic people who have undergone antibiotic therapy in early life. Probiotics (‘good bacteria’) have been suggested as a remedy.
Novel treatments that regulate the ecosystem of the gut have result in dramatic improvements in ASD symptoms in recent years. Most recently, children given fecal transplants benefited from a reduction in autism symptoms of up to 50% after two years.
The fact that Microbiota Transfer Therapy – a method of transplanting beneficial microbes into people with an imbalanced microbiome – engendered improvements in autism symptoms which persisted long after the treatment may shock many people. But it provides yet more evidence showing the benefits of bacterial diversity in the gut.
Restoring bacterial equilibrium via probiotics may be a sensible action for those looking to treat autism symptoms. Preliminary studies on mice appear to show that probiotics improve autistic behaviours.
Of course, not all probiotics are equal. Some contain absurdly low, completely ineffective dosages of bacteria which cannot hope to compete in the gut, a fiercely competitive environment teeming with trillions of resident microbes. Your best bet, particularly in light of the fecal transplant study, is to use high-strength, human-derived probiotics.
Progurt is the strongest such supplement currently available, boasting a one trillion megadose of probiotic bacteria per sachet. If you do not notice an improvement within a few weeks, you may have to address certain factors which are hindering probiotic colonisation. These can include nutrient flow, oxygenation, hydration, fitness level, body pH, vitamin D status and core temperature.
Clearly autism is a highly challenging condition and there are no easy answers. However, important work is being done in this area and awareness is spreading about the best ways to manage and treat ASD and associated behaviours.
Regarding autism in infants specifically, the evidence shows that spotting signs early is vitally important; parental observation is naturally the best tool for detecting behaviours which may pinpoint autism and achieve an early diagnosis. Don’t hesitate in arranging to see your doctor for an assessment.
As mentioned, there are steps you can take to manage symptoms and favouring a joined-up approach is surely the best course of action.
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“There are a whole lot of things you want to do before you even think about using medicines to treat behavioural problems.” – Christopher McDougle, M.D.