It seems like common sense that a well nourished child is a happier child. Many parents have noticed moody or cranky behavior in their young children before meal time or after school when they arrive home hungry. For an Autistic child, however, who may not be able to accurately communicate his or her needs, this hunger may go unnoticed. Or they may not want to eat and may have many food aversions. For these reasons, integrating nutrition therapy into treatment for children with autism is critical.
In many cases, nutrition is not an integral part of overall therapy at diagnosis. Yet many parents who eventually seek out this information on their own, are getting nutrition information from questionable sources. Some parents may not take nutrition therapy into consideration at all.
Autism is complex and involves a spectrum of challenging behaviors, so it is natural for both parents and caregivers to initially focus directly on controlling those behaviors. In many cases, the health care team includes a physician, occupational therapist, speech therapist and behavior therapist; but does not include a registered dietitian to provide nutrition therapy. What is interesting is that almost all autistic children have nutritional deficiencies, food intolerance, or gastrointestinal disorders that often are not thoroughly addressed. While studies involving the significance of the effect nutrition status has in the management of autism are preliminary, there is good reason to consider filling this gap in treatment.
The goal of nutrition therapy in autism is to support the structure and function of the child's brain and body to perform at their optimal level and to maximize the child's brain function so that the response to other treatment is enhanced. Proper nutrition therapy should include a comprehensive nutrition assessment and also address feeding problems, any gastrointestinal problems, or need for vitamin and mineral supplementation.
Imagine a child who has difficulty communicating his or her needs, feeling uncomfortable every time he eats due to unknown food sensitivities or intolerance. This sends a negative message to avoid those foods or avoid eating all together. Children with food allergies are at higher risk for nutrition-related problems and decreased growth, but children with autism are more negatively affected due to their problems with sensory integration dysfunction.
Allergy symptoms may include hives, coughing, eczema, nausea, diarrhea, constipation, gastrointestinal reflux, watery eyes, nasal congestion or sneezing. To determine which foods are problematic, an "Elimination/Challenge Diet" is applied. Once problem foods are removed from the diet, the discomfort is resolved, and the child becomes more open to mealtime. A well-nourished child is a better-behaved child. In many cases, children who undergo nutrition assessment and treatment, have a formed bowel movement for the first time in his or her life. Imagine how eliminating this discomfort helps a child!
Many autistic children may also have a subclinical nutrition deficiency. This is a deficiency of a particular vitamin, mineral, or essential fatty acid that is not severe enough to produce a classic deficiency symptom, but rather has more global, subtle effects that result in loss of optimal health and impairment of body processes. These subclinical deficiencies can cause irritability, poor concentration, depression, anxiety, sleep disturbances or loss of appetite. While it is best to determine which vitamin or mineral the child may be deficient in, minimally a standard multi-vitamin and mineral supplement is recommended. Look for supplements that have the USP label on them, and those that are free of colors, allergens or artificial flavors to eliminate any possible food intolerance issues. Using liquid forms that can be mixed into favorite foods (such as applesauce, yogurt, juices, or sherbet) is one strategy for children who have difficulty chewing or swallowing vitamins. Asking a pharmacist to compound a multivitamin and mineral supplement that is age appropriate is another option.
In addition to the multivitamin/mineral, omego-3 fatty acids have been shown to be helpful as well. Numerous studies indicate that Omega-3 fatty acids are deficient in those who have ADHD, Dyslexia and Dyspraxia. Abnormalities in fatty acid metabolism may account for many features common in these conditions. There is some preliminary evidence that it is also deficient in children with autism. For children ages seven and older, 650 milligrams per day of an Omega-3 that provides both EPA and DHA is recommended. For children four to six years of age, 540 milligrams per day is recommended, and for children aged one to three, 390 milligrams per day is needed.
Much more research is needed in the area of nutrition and autism, but clearly nutrition is a key piece of the treatment puzzle that is often missing. Speak with your health care team about a thorough nutrition assessment for your autistic child.
Rosanne Rust, MS, RD, LDN
Registered Dietitian
Nutrition Consulting, Writing, Lectures
http://www.rustnutrition.com
Licensed Provider for Real Living Nutrition Services®
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