Autistic Spectrum Disorders (ASD) Including Aspergers Syndrome
Autism, or more correctly, Autistic Spectrum Disorders (ASD), are a series of neurodevelopmental disorders characterised by repetitive behaviours, social withdrawal and communication deficits. Patients with ASD display a wide range of cognitive ability, ranging from mental retardation to high functioning adults with an above average IQ. There are three main categories of ASD:
- Autistic disorder – The diagnosis of autistic disorder is given to individuals with significant impairments in social interaction and communication as well as restricted and repetitive interests, activities and behaviours which are generally evident prior to three years of age. There are subtypes of autism:
- Regressive Autism: When a child appears to develop normally but then starts to lose speech and social skills, typically between the ages of 15 and 30 months.
- Infantile Autism: When a child does not achieve developmental milestones and if effectively determined to have had autism from infancy.
- Asperger’s disorder – Individuals with Asperger’s disorder have some difficulties with social interaction and social communication as well as restricted and repetitive interests, activities and behaviours. However, those with Asperger’s disorder do not have a significant delay in early language acquisition, cognitive abilities or self-help skills. The condition is often detected later than autism as speech usually develops at the expected age.
- Pervasive Developmental Disorder – Not Otherwise Specified (PDD-NOS) – This diagnosis is made when an individual has a marked social impairment but fails to meet the full criteria for either autistic disorder or Asperger’s disorder. These individuals may also have some communication impairments and/or restricted or repetitive interests, activities and behaviours.
The diagnosis of ASD is based exclusively on a particular developmental pattern in the child and has historically been considered a psychiatric disorder. Whilst a diagnosis is made on observation (see signs and symptoms below), and there are no quantitative biochemical tests to confirm diagnosis, there is evidence that indicates numerous biochemical abnormalities in these children, including oxidative stress, decreased methylation capacity, mitochondrial dysfunction, heavy metal accumulation, intestinal dysbiosis, inflammatory bowel disease, immune dysregulation and cerebral hypofusion.
Causes/ Risk factors
Some possibilities include:
- Heritable genetic polymorphisms influencing detoxification, methylation and dopamine signalling.
- Gender bias, with a 4:1 ratio (males to females)
- Heavy metal exposure – especially mercury, but others may be implicated.
- Immune dysfunction – Severe maternal inflammation, infections, allergy and autoimmunity during pregnancy may lead to a ‘cytokine storm’ causing microglial activation and CNS inflammation, influencing neurodevelopment.
Immune dysfunction – mild acute or chronic gut mucosal inflammation with ileo-colonic lymphoid nodular hyperplasia (LNH) leading to “autistic colitis”. Maybe a cause or consequence of systemic oxidative stress and inflammation associated with autism.
Signs and Symptoms (Including diagnostic criteria)
Qualitative impairment in social interaction, as manifested by at least 2 of the following:
- Marked impairment in the use of multiple nonverbal behaviours such as eye-to-eye gaze, facial expression, body postures, and gestures to regulate social interaction
- Failure to develop peer relationships appropriate to developmental level
- A lack of spontaneous seeking to share enjoyment, interests, or achievements with other people (e.g., by a lack of showing, bringing, or pointing out objects of interests)
- Lack of social or emotional reciprocity
Qualitative impairments in communication, as manifested by at least 1 of the following:
- Delay in, or total lack of, development of spoken language (not accompanied by an attempt to compensate through alternative modes of communication such as gestures or mime)
- In individuals with adequate speech, marked impairment in the ability to initiate or sustain conversation with others
- Stereotyped and repetitive use of language or idiosyncratic language
- Lack of varied, spontaneous make-believe play or social imitative play appropriate to developmental level
Restricted repetitive and stereotyped patterns of behaviour, interests, and activities, as manifested by at least one of the following:
- Encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or in focus
- Apparently inflexible adherence to specific, nonfunctional routines or rituals
- Stereotyped and repetitive motor mannerisms (e.g., hand or finger flapping or twisting, or complex whole body movements)
- Persistent preoccupation with parts of objects
- Characteristic deviant communication features in autism include a lack of social chat, pragmatic deficits, pronoun reversal, delayed echolalia, neologisms, lack of emotion in speech, phrase repetitions, and idiosyncratic use of language. Behavioural manifestations frequently involve repetitive, self-stimulatory behaviour, especially in more severely affected individuals. This behaviour can be self-injurious in some, as with arm biting, head slapping, and skin picking.
In order to obtain optimal results, the patient might consider a holistic approach that integrates several treatments to address biochemical, physiological, energetic, emotional and/or spiritual imbalances.
Biomedical Treatment for Autism
Biomedical or Nutritional and Environmental Treatments include Diet, Nutrient Therapy, Detoxification and treatment of infections.
Consult a Biomedical Doctor, Naturopath or Nutritional Practitioner to investigate the needs of the individual to:
- Improve gastro-intestinal health
- Screen for food sensitivities and allergies
- Address nutritional deficiencies
- Determine impact of environmental toxins
- Balance hormone levels (e.g. reducing oestrogen)
- Balance blood sugar levels
- Restore healthy sleeping patterns
Diet and Lifestyle Considerations for Autism Spectrum Disorder
- Eliminate all food allergens from the diet. The most common allergenic foods are dairy, soy, citrus, peanuts, wheat, fish, eggs, corn, food colourings, and additives. An elimination/challenge trial may be helpful in uncovering sensitivities, or an IgG ELISA food allergy test may be used. Remove suspected allergens from the diet for at least two weeks. Re-introduce foods at the rate of one food every three days. Watch for reactions which may include gastrointestinal upset, mood changes, headaches, and exacerbation of asthma. Warning: Do not challenge peanuts, or any other food, if there is history of anaphylaxis.
- Reduce pro-inflammatory foods in the diet including saturated fats (meats, especially poultry, and dairy), refined foods, and sugar. Patients sensitive to antibiotics should eat only organic meats to avoid antibiotic residues.
- A small percentage of people respond dramatically to a diet free of nightshades. They include peppers, eggplant, tomatoes, and white potatoes. A month-long trial is recommended.
- Emphasise foods high in essential fatty acids such as oily fish and nuts / seeds
- Eat a minimally processed diet rich in antioxidants, phytonutrients and bioflavonoids
- Protein is essential for connective tissue support, and should be consumed regularly
- Nutrients to support digestive health including fibre and yoghurt should be consumed if tolerated to enhance beneficial bacterial levels
- Stress management techniques should be implemented
Integrative Treatments Overview
In order to obtain optimal results, the patient might consider a holistic approach that integrates several treatments to address biochemical, physiological, energetic, emotional and/or spiritual imbalances. These treatments can include Allopathic Medicine, Complementary Medicine, Biomedicine, Nutritional & Environmental Medicine, Functional Medicine, Orthomolecular Medicine, Energy Medicine, Traditional Chinese Medicine, Naturopathy, Ayurvedic, muscular-skeletal support, Psychology and more. It’s important that treatments are overseen by experienced and certified practitioners who are able to work in teams (see below for where to find one).
For Treatment options see Treatments menu at mindd.org
Nutritional & Environmental Medicine Overview
Nutritional & Environmental practitioners focus on cellular health by optimising nutrient uptake while minimising toxic exposure. Biomedicine, Functional Medicine and Orthomolecular Medicine are all subsets. The overall goal is to reduce inflammation and oxidative stress which are key drivers in chronic modern disease (e.g. asthma is inflammation of the lungs, arthritis is inflammation of the joints, eczema is inflammation of the skin, IBS involves inflammation of the gut and ADHD and Autism include inflammation of the brain). A combined approach of diet, lifestyle and natural therapies supports the body’s innate ability to heal and prevent disease by maintaining homeostasis (balance).
It is recommended that a patient consult a certified practitioner to assess their symptoms and case history and explore their individual need to:
- Screen for food sensitivities and allergies
- Implement dietary intervention geared to the individual (e.g. GAPS, Gluten-Free, Dairy-Free, Soy-Free, FodMAPS, Evolutionary, low oxalate/salicylate, Ketogenic)
- Supplement with vitamins, minerals, amino acids and probiotics
- Improve gastro-intestinal health to support the vagus nerve and brain and immune function
- Support neurotransmitter function
- Supply fat soluble nutrients for brain structure and function
- Reduce toxicity and heavy metal accumulation
- Minimise infections (e.g. bacteria, yeast, virus, parasites) to reduce immune response and nutritional deficiencies that can impact on mental and physical health
- Regulate blood glucose and establish healthy eating habits
- Use energy healing (acupuncture, homeopathy, kinesiology, Emotional Freedom Technique)
Where can I find a certified practitioner?
Finding a well-trained Integrative practitioner requires research. You can reference the lists below for one in your area and should consider checking references and interviewing several before you select one.
The World Anti-Aging Academy of Medicine can help you find Integrative practitioners throughout the world.
Generation Rescue has a list of Integrative practitioners who specialise in childhood neurobiological disorders (Autism, ADHD, allergies). If they do not treat adults or your condition, they might be able to refer you to someone in your area who can.
Australia & New Zealand
Mindd Foundation trains Integrative practitioners in Australia and New Zealand and is partnered with the Medical Academy of Paediatric Special Needs (MAPS).
The British Society for Ecological Medicine has a list of practitioners in the UK
Mindd Foundation gratefully acknowledges the contribution of Metagenics in supplying the Definition, Causes and Diet & Lifestyle Considerations for this page.