Autism Spectrum Disorder
If you have joined the Nourishing Autism Collective, it’s likely that your child or loved one is on the autism spectrum. This article will help you learn more about autism, common signs & symptoms, dual diagnoses, and nutrition/lifestyle implications to consider.
What is Autism?
Autism, or autism spectrum disorder (ASD), refers to a broad range of conditions characterized by challenges with:
Social skills
Repetitive behavior
Verbal & non-verbal communication
See the full diagnostic criteria for Autism Spectrum Disorder in the DSM-5. [1]
Autism affects about 1 in 36 children according to the CDC’s Autism and Developmental Disabilities Monitoring (ADDM) Network [2]. Autism statistics have changed drastically over the past 20 years - up from 1 in 150 children in the year 2000. This CDC says that this change is thought to be due to a change in the diagnosis criteria, awareness of autism, and an increase in the disorder itself. [2]
The CDC has an Autism Visualization Tool that lets you view autism prevalence by geographic location, over time, by sex, and by ethnicity.
Autism is usually diagnosed around 2-4 years of age, and even as young as 18 months.
Autism affects boys 4-5x more than girls [2]. It is unclear whether autism is actually less prevalent in girls or if the established diagnosis criteria only accounts for autism presentation in boys.
The rate for ASD is about 1 in 34 among boys (or 2.97%) and 1 in 145 among girls (or 0.69%).
In 2013, the American Psychiatric Association merged 4 distinct diagnoses under one umbrella term of Autism Spectrum Disorder. [1] The previous diagnoses were:
Autistic Disorder
Childhood Disintegrative Disorder
Pervasive Developmental Disorder - Not Otherwise Specified (PDD-NOS)
Asperger Syndrome
Autism is a spectrum as indicated by its name. Adults and children with autism may present with completely different symptoms, severity levels, or skill sets.
Signs/Symptoms
Signs of autism usually appear by age 2-3, but some developmental delays may appear earlier. In some cases, autism can be diagnosed as early as 18 months. Not all children with autism will show all of the signs, and even children who don’t have autism may show signs. Because of this, it is crucial to get a professional evaluation if you suspect your child has autism. [2]
There are no medical tests (i.e. a blood or DNA test) that can diagnose ASD. Doctors must look at a child’s behavior and development and determine the diagnosis. However, there are roughly 100 discovered genes which have been found to have ties to autism, the most prevalent being Fragile X Syndrome.
The following are possible “Red Flags” as defined by the CDC: [3]
A child with ASD might:
Not respond to their name by 12 months of age
Not point at objects to show interest (point at an airplane flying over) by 14 months
Not play “pretend” games (pretend to “feed” a doll) by 18 months
Avoid eye contact and want to be alone
Have trouble understanding other people’s feelings or talking about their own feelings
Have delayed speech and language skills
Repeat words or phrases over and over (echolalia)
Give unrelated answers to questions
Get upset by minor changes
Have obsessive interests
Flap their hands, rock their body, or spin in circles
Have unusual reactions to the way things sound, smell, taste, look, or feel
Common Dual Diagnoses
Some children with autism may have more than one diagnosis. Common dual diagnoses include:
Feeding & eating challenges (see: Picky Eating)
Seizures/Epilepsy
Depression
Down Syndrome
Autoimmune Disorders
Tourette Syndrome
Next Steps
A quick note from Brittyn: If your child was just diagnosed on the autism spectrum and you’re feeling isolated and anxious, you’re not alone in this ❤️ It’s so normal to have a variety of feelings when receiving a diagnosis. Some parents feel relief to finally have answers, some grieve the life they expected or imagined for their child, and some experience heartbreak and shock. However you’re feeling, let yourself feel it! Your child is so amazing whether or not they have an autism diagnosis, and they are SO lucky to have you as their parent. The fact that you are here and looking for ways to support your child in feeling their best shows that you were made to be their parent. If you’re feeling alone in this, please come post in the Inner Circle - I would love to meet you and I know there are a ton of other parents feeling the very same feelings you are that would love to connect with you. We are all in this together.
Diet
Picky eating is very common in autism due to sensory sensitivity. If you are struggling with selective eating, check out our picky eating guide!
Gut issues such as constipation, diarrhea, bloating, or gas are common.
The Gut-Brain Axis is a study of the bi-directional connection between the gut and the brain. Essentially, a happy gut = a happy brain! Gut health should be a big focus for individuals with autism.
Probiotics (from Fermented Foods and probiotic supplements) and prebiotics (from dietary fiber and fiber supplements) can be great gut supports!
Some children with autism are sensitive to certain foods and may require a special diet. There is no one food that is reactive to all children with autism, though some of the most common reactive foods include wheat (and other gluten-containing grains), dairy, soy, and corn.
The body can react to foods in many different ways including allergies, sensitivities, and intolerances. See the note on Food Reactions for more information.
Due to severe picky eating, restricted diets, gastrointestinal issues, or certain medications, children with autism may be at higher risk for nutrient deficiencies.
Certain nutrients such as folate, vitamin B12, vitamin D, and omega-3s may be especially important for children with autism. It’s recommended to consume foods high in these nutrients to prevent deficiency.
For more information on each nutrient, visit the Nutrients section.
Increase foods rich in antioxidants such as berries, leafy greens, and dark chocolates. Antioxidant supplements include glutathione, vitamin E, and CoQ10, among others.
Genetic Mutations
Certain genetic mutations, such as the MTHFR Gene Mutation, can alter our body’s ability to absorb nutrients, detox, or perform other vital processes in the body.
Certain chromosomal mutations, such as Fragile X Syndrome, can cause autism-like symptoms.
Supplements
Just like diet, there’s no one-size-fits-all supplement regimen for everyone on the spectrum. Some of the most common supplements include multivitamins, fish oil, prebiotics, probiotics, and protein supplements (if the diet is limited in protein). You can browse all supplements here.
Lifestyle
Routines
Routines can be especially helpful for those with autism. Routines can be helpful for eating, sleeping, or just day-to-day tasks. Consider having dietary changes and/or supplements built into a routine that your child can expect.
Low Toxin Lifestyle
There are many things we cannot change (our genetics, for example) - but many things in our environment can be in our control! Children with autism may have a decreased ability to detox from their environment, therefore limiting toxin exposure can be extremely beneficial (for your whole family!)
You can check out the Toxic Load note for more on this!
For lifestyle considerations associated with sensory processing, see Sensory Processing Disorder.
Building Your Autism Care Team
Children across the spectrum have different needs, therefore require different services and therapies. While nutrition lays the groundwork, it’s not the only approach to consider. The Library is only intended to cover nutrition-based approaches, but we wanted to mention some vital members of an autism care team to help your child thrive!
Source: Autism Dietitian Instagram Page
Most autism care teams include a combination of several of the following:
Registered Dietitian
Integrative & Functional Nutrition Approach preferred!
Clinical Psychologist
Developmental Pediatrician
Integrative & Functional Nutrition Approach preferred!
Speech-Language Pathologist
If working on communication, consider an AAC Specialist
Occupational Therapist
Consider an OT that is SIPT certified
SOS Feeding Therapist
Functional Dentist
Pediatric Chiropractor
Board Certified Behavioral Analyst (BCBA)
PLEASE NOTE: Every child with autism is different and requires individualized care. Please consult your pediatrician and Registered Dietitian before modifying medications, supplements, or diet.
Autism & Nutrition in the Research
Nutrition & Supplements Benefit in Autism
In one study measuring parent ratings and biomedical interventions, biomedical treatments showed to be the most effective. The supplements that proved to be the most helpful for autism included fish oil/omega-3s, digestive enzymes, vitamin B12, folate, vitamin A, vitamin C, and zinc. [4]
In this same study, the special diets that were shown to be the most effective were the dairy-free diet, gluten-free diet, the gluten-free casein-free diet, and removing sugar. Food allergy treatment was also shown to be effective. [4]
Individualized Diets Are Needed
One of the concerns about a “one-size-fits-all” diet and supplement approach for children with autism is their lack of individualization. Because of this, they may not be effective for all individuals with ASD [5]
For example, not all children with ASD show immune reactivity to dietary proteins in wheat and milk, and wheat and milk may not be the only foods to which a child is sensitive. [5]
This research study suggested to personalize dietary treatment for autism with a three step process: [5]
Step 1: Screen for food reactions, perform a gut bacterial profile, and do additional biomedical testing (such as testing for environmental toxins, nutrient deficiencies, etc.) [NOTE: We hope to have a “Testing” section in the Library soon! Until then, you can ask your questions in the Q&A Archive or learn more about testing via Biomedical Beginnings]
Step 2: Implement individualized dietary restrictions and targeted supplements
Step 3: Observe changes in the gut microbiome and inflammation responses and track changes in autism symptoms.
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[1] Diagnostic Criteria: Autism Spectrum Disorder. Centers for Disease Control and Prevention (CDC) Website. Accessed 5 Sept 2020. Link.
[2] Data & Statistics on Autism Spectrum Disorder. Centers for Disease Control and Prevention (CDC) Website. Accessed 5 Sept 2020. Link.
[3] Signs and Symptoms of Autism Spectrum Disorders. Centers for Disease Control and Prevention (CDC) Website. Accessed 5 Sept 2020. Link.
[4] Parent Rating of Behavioral Effects of Biomedical Interventions. Autism Research Institute. ARI Publ. 34. March 2009. https://www.autism.org/treatment-ratings-for-autism/
[5] Doenyas C. Novel Personalized Dietary Treatment for Autism Based on the Gut-Immune-Endocrine-Brain Axis. Front Endocrinol (Lausanne). 2019;10:508.
