Sunday, April 15, 2007

Co-occuring conditions in Autism


• Mental Retardation: Although it has been estimated that up to 75% of people with autism have mental retardation, research studies have frequently used inappropriate IQ tests, such as verbal tests with nonverbal children and, in some cases, estimating the child’s intelligence level without any objective evidence. Parents should request non-verbal intelligence tests that do not require language skills, such as the Test for Nonverbal Intelligence (TONI). Furthermore, regardless of the result, realize that autistic children will develop more skills as they grow older, and that appropriate therapies and education can help them reach their true potential.

• Seizures: It is estimated that 25% of autistic individuals also develop seizures, some in early childhood and others as they go through puberty (changes in hormone levels may trigger seizures). These seizures can range from mild (e.g., gazing into space for a few seconds) to severe, grand mal seizures.

Many autistic individuals have subclinical seizures which are not easily noticeable but can significantly affect mental function. A short one- or two-hour EEG may not be able to detect any abnormal activity, so a 24-hour EEG may be necessary. Although drugs can be used to reduce seizure activity, the child’s health must be checked regularly because these drugs can be harmful.

There is substantial evidence that certain nutritional supplements, especially vitamin B6 and dimethylglycine (DMG), can provide a safer and more effective alterative to drugs, for many individuals

• Chronic Constipation and/or Diarrhea: An analysis of the ARI’s autism database of thousands of cases show over 50% of autistic children have chronic constipation and/or diarrhea. Diarrhea may actually be due to constipation—i.e., only liquid is able to leak past a constipated stool mass in the intestine. Manual probing often fails to find an impaction. An endoscopy may be the only way to check for this problem. Consultation with a pediatric gastroenterologist is required.

• Sleep Problems: Many autistic individuals have sleep problems. Night waking may be due to reflux of stomach acid into the esophagus. Placing bricks under the head of the bed may help keep stomach acid from rising and provide better sleep. Melatonin has been very useful in helping many autistic individuals fall asleep. Other popular interventions include using 5-HTP and implementing a behavior modification program designed to induce sleep. Vigorous exercise will help a child sleep, and other sleep aids are a weighted blanket or tight fitting mummy-type sleeping bag.

• Pica: 30% of children with autism have moderate to severe pica. Pica refers to eating non-food items such as paint, sand, dirt, paper, etc. Pica can expose the child to heavy metal poisoning, especially if there is lead in the paint or in the soil.

• Low Muscle Tone: A study conducted by the first author found that 30% of autistic children have moderate to severe loss of muscle tone, and this can limit their gross and fine motor skills. That study found that these children tend to have low potassium levels. Increased consumption of fruit may be helpful.

• Sensory Sensitivities: Many autistic children have unusual sensitivities to sounds, sights, touch, taste, and smells. High-pitched intermittent sounds, such as fire alarms or school bells, may be painful to autistic children. Scratchy fabrics may also be intolerable, and some children have visual sensitivities. They are troubled by the flickering of fluorescent lights. If the child often has tantrums in large supermarkets, it is possible that he/she has severe sensory oversensitivity. Sensory sensitivities are highly variable in autism, from mild to severe. In some children, the sensitivities are mostly auditory, and in others, mostly visual. It is likely that many individuals who remain non-verbal have both auditory and visual processing problems, and sensory input may be scrambled. Even though a pure tone hearing test may imply normal hearing, the child may have difficulty hearing auditory details and hard consonant sounds.

Some children have very high pain thresholds (i.e., be insensitive to pain), whereas others have
very low pain thresholds.Interventions designed to help normalize their senses, such as sensory
integration, Auditory Integration Training (AIT), and Irlen lenses.

Note from writer

I have seen my students sensitiveness to light,whether its the light inside the classroom or the sun.One of them was playing up for the whole school year after outdoor play and would not participate anymore in any school work or activity.When I came in as his shadow teacher,I observed this so I suggested to the regular teachers that he should stay inside the room and do something to occupy the time his classmates were outside.I explained to them that it might be the sun hurting him thats why he was misbehaving after outdoor plays.They agreed.After that,he was able to join the class after their outdoor and he did not show any excitement or tantrums anymore.I knew its the sun hurting him here.

There is also one student i had that when he comes inside the classroom first thing he do is close the light.Then another would turn it on.Autistic children are so much different from each other.That is what makes teaching them a challenge.

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