Physical & Medical Issues Related to Autism Spectrum Disorders
Seizures occur in up to 39% of people with autism. They are more common in children who also have cognitive deficits. Seizures usually start early in childhood or during adolescence, but may occur at any time. There are different types and subtypes of seizures and a child with autism may experience more than one type. The easiest to recognize are large “grand mal” (or tonic-clonic) seizures. Others include “petit mal” (or absence) seizures and subclinical seizures, which may only be apparent in an Electroencephalogram or EEG. It is not clear whether subclinical seizures have effects on language, cognition, and behavior. If you think your child may be having seizures, you should seek a referral to a neurologist who may order tests such as an EEG, an MRI (Magnetic Resonance Imaging), a CT (Computed Axial Tomography) and a CBC (Complete Blood Count).
A small number of children with autism also have a neurogenetic condition such as Fragile X Syndrome, Angelman's Syndrome, Tuberous Sclerosis, Chromosome 15 Duplication Syndrome or another chromosomal abnormality. If a child has a family history or physical symptoms that are characteristic of one of these disorders, a pediatrician may order tests or may refer the family to a developmental pediatrician, a geneticist and/or a pediatric neurologist for testing. The chance of having one of these abnormalities is a little higher if the child also has cognitive deficits or mental retardation. It is also higher if the child has certain physical features that are characteristic of a given syndrome. While none of these conditions is curable, it is important to know if a child has one of these syndromes because there may be other medical issues that go along with some of them. Having a known genetic cause for autism may also change your risk of having another child with autism.
Surveys have suggested that between 46 and 85% of children with autism have problems such as chronic constipation or diarrhea. If a child has symptoms such as chronic or recurrent abdominal pain, vomiting, diarrhea, or constipation, we urge you to see a gastroenterologist (preferably one that works with people with autism). Pain caused by GI issues is sometimes recognized because of a change in the child's behavior. Look for an increase in self soothing, behaviors such as rocking or outbursts of aggression or self-injury. Bear in mind that a child may not have the language skills to communicate pain caused by GI issues. Treating GI problems may result in improvement in a child's behavior and his ability to learn.
A popular dietary intervention for GI issues includes the elimination of dairy and gluten containing foods. As with any treatment it is best to consult the child's physician to develop a comprehensive plan. There are very knowledgeable parents and groups in Delaware who can provide you with more information about used the Gluten and Casein free diet.
Sleep problems are common in children and adolescents with autism. Sometimes they may be caused by medical issues such as obstructive sleep apnea or gastro-esophageal reflux. Addressing the medical issues may solve the problem. In other cases, when there is no medical cause, sleep issues may be managed with behavioral interventions including “sleep-hygiene” measures such as limiting the amount of sleep during the day, and establishing regular bedtime routines. Many families have tried natural remedies, such as Melatonin or medication prescribed by a physician. This is a topic often discussed on the online support group.
Sensory Integration Dysfunction
Many children with autism have unusual responses to sight, sound, touch, smell, taste and movement (sensory stimuli, or input). These responses are due to difficulty in processing and integrating sensory information. This means that while information is sensed normally, it may be perceived much differently. Sometimes stimuli that seem “normal” to others can be painful, unpleasant or confusing by the child with Sensory Integration Dysfunction (SID). SID may also be called Sensory Processing Disorder or Sensory Integration Disorder.) Many children have difficulties processing two senses at one time. For example, it may be difficult to look and listen at the same time.
An example of a child who is hypersensitive would be the inability to tolerate wearing clothing, being touched, hearing sounds like fire alarms or vacuum cleaners, or being in a room with normal lighting. In contrast, a child who is hyposensitive might have an increased tolerance of pain or a constant need for sensory stimulation. Treatment for Sensory Integration Dysfunction is usually addressed with occupational therapy and/or sensory integration therapy.
Pica is a condition which involves eating things that are not food. Children between 18 and 24 months old often eat non food items, but this is typically a normal part of development. Some children with autism and other developmental disabilities persist beyond the developmentally typical time frame and continue to eat items such as dirt, clay, chalk or paint chips. Children showing signs of persistent mouthing of fingers or objects, including toys, should be tested for elevated blood levels of lead, especially if there is a known potential for environmental exposure to lead.
Source: Autism Speaks website and http://www.aspergersyndrome.org/Forums.aspx.
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