Natural Therapies for Autism
There are over 200 clinical trials that have been completed on natural therapies for autism and more research is released every year. At our clinic, we take a comprehensive approach and address a wide range of aspects. For example, research has found that those with autism may be deficient in certain nutrients, regardless of diet, due to various changes in metabolism. Studies have found that by addressing these deficiencies behavioral and cognitive symptoms can sometimes improve. Other goals to treatment include:
Treat underlying factors: Target factors that can contribute to progression or worsening of autism
Treat symptoms: associated behavioral and cognitive changes
Digestion: screen and treat common gastrointestinal symptoms, such as chronic constipation, diarrhea, reflux, bowel disease, and nausea. Some children with increased digestive complaints are also found to have increased behavioral disturbances (2022 study).[1]
Sleep: disturbances in sleep are common in autism, and research has found improvements in daytime behavior in those who have improved sleep duration (2011 study).[2]
Diet: A 2022 study found that diet can improve cognition and behavior[3] - however supervision under a health professional is important to avoid nutritional deficiencies
Nutrition: ensuring adequate intake of essential nutrients, testing for common deficiencies
Exercise: Maintaining regular exercise, adequate sleep, management of stress, and social support - A 2017 study found exercise improved functioning as well as self-regulation and awareness of behaviors.[4]
Environmental: Avoidance of common neurotoxins found to be associated with autism
Allergies: Screen for allergies that may be contributing to worsening of symptoms
Blood Testing For Autism
Dr. Baker (ND) will usually complete a set of blood work that consists of around 20 different tests that look at factors that can contribute to autism. These tests are aimed at uncovering underlying factors that are found in research to be associated with autism or its complications, as well as factors that can aggravate and worsen symptoms. This panel of blood testing checks for metabolic, nutritional, hormonal, immunological and inflammatory changes. Some examples of these tests include:
Magnesium testing: A 2020 study found that magnesium is lower in those with autism.[5] Low magnesium is a risk factor for increased hyperactivity in some behavioral disabilities.
Zinc testing: A 2014 study found that a lower level of zinc is associated with greater ASD symptoms, and those with higher zinc had improved symptoms.[6]
Thyroid hormone testing: hypothyroidism can affect intellect and development; A 2020 study found worsening ASD symptoms in those with hypothyroidism compared to those with normal thyroid levels.[7] A 2017 study found that those with lower levels of thyroid hormone were at increased risk of autism.[8]
Lead testing: A 2020 study found that those with higher blood lead were at increased risk of autism.[9]
One common question is: why look at risk factors for autism if it has already been diagnosed? This is because for many conditions, research suggests that risk factors can also increase progression of the condition and lead to further deterioration.
Symptoms of Autism
Autism is a developmental condition that manifests with two main categories of symptoms:
Social: Impaired social communication and interaction (see first section below)
Behavioral: Restricted and repetitive behavior, interests, and activities (see second section below)
Impaired Social Communication and Interaction
Social communication refers to the verbal and nonverbal skills needed for communication between two people. Those with autism may often have impaired language development as well as a lower level of nonverbal skills, which is needed to give deeper meaning to spoken words. Social communication includes sharing thoughts, intentions, and feelings. Atypical, infrequent, or limited duration of social behaviors:
Limited or no interest in social interaction with other children and only interacting to get personal needs met.
Lack of social play behaviors, such as copying the play of peers and vocational actions of adults.
Inappropriate response to another's attempt at communicating (eg, failure to make eye contact when called by name)
Difficulty observing and watching others, imitating others, sharing emotions (empathizing), smiling or standing near to someone to show social interest, calling a peer by name
Getting too close to the social partner and not noticing that this makes the social partner uncomfortable; indifference or aversion to socially motivated physical contact and affection.
Atypical or poorly coordinated social attention behaviors (despite social motivation) – Atypical social behaviors can manifest as speaking without concomitant nonverbal communication behaviors such as making eye contact. Alternatively, a child with ASD may push a peer to gain social attention without also initiating a conversation or making other, more appropriate attempts at socializing.
Difficulties With Nonverbal Communication:
Difficulty using or paying attention to nonverbal behaviors such as shared eye gaze, facial expressions, intonation, gestures, body posture, and head and body orientation
May avoid eye contact, gaze too intently, or gaze at areas of the clinician's face or body other than the person’s eyes
They may not change their facial expressions or may make exaggerated or "scripted" facial expressions
May exhibit awkward or absent gestural communication (movement of the hands, face, or other parts of the body)
May speak in a monotone voice that lacks emotional expressiveness.
Difficulty understanding other’s interests or focus of attention.
Misinterpret gestures (eg, pointing, waving, nodding or shaking of the head) and facial expressions
Difficulty with Pragmatic language (selecting the appropriate words for the situation):
Not using language for communicating (eg, simply repeating words)
Difficulty initiating or sustaining a conversation (eg, lack of turn-taking or because of an over-focus on personal interests)
Difficulty producing a relevant response and maintaining the topic of conversation; this is sometimes associated with a lack of shared eye gaze and failure to interpret the conversation successfully.
Failing to consider the interests, preference, or level of understanding of the listener; failing to explain a topic about which the listener may know nothing.
Difficulty choosing the appropriate words or topics given the social context (eg, speaking too bluntly, not respecting the differences between familiar and nonfamiliar listeners, formal and informal contexts)
Difficulty understanding the meaning of what is said (eg, providing responses that are unrelated to the topic of conversation)
Not understanding how context or nonverbal communication may alter the meaning of words; this makes it difficult for persons with ASD to appreciate dual or ambiguous meanings, such as metaphors, humor, sarcasm, teasing, jokes, or deception (skills that are present in typically developing children by six to seven years of age).
Difficulties with Social Cognition:
Difficulty understanding social situations, including understanding beliefs, desires, intentions, and emotions of others and the ability to guess at the actions that others are likely to take
Misunderstanding the emotional responses of others (eg, believing that someone is scared when they are happy, not understanding that someone is experiencing pain)
Responding inappropriately to another's distress (eg, by laughing), which also may occur in children with other disabilities
Not noticing that the other person is not interested in their preferred topic of conversation
Inability to understand the difference between acquaintances, friends, and intimate relationships
Difficulty inferring the intentions, beliefs, attitudes, or likely behaviors of others
Social interaction and relationships:
Difficulty developing and sustaining friendships
Little interest in developing relationships
Preference for solitary play over social play and may involve others only as "mechanical" aids (ie, using the hand of a caregiver to obtain a desired object without making eye contact)
Delayed development of attachment to primary caregivers (although few children with ASD are so socially isolated that they fail to interact with loved family members)
Social interactions with peers are usually limited in frequency and breadth (sometimes due to limited motivation or interest in socializing)
Socializing may occur but without the expected joy typically seen
Limited social success can be a significant source of distress for the child or adolescent with ASD, who is motivated to socialize but is not able to change social behaviors to get social needs met more successfully. Socially motivated children who fail to achieve satisfying peer relationships may develop depression.
Restricted and Repetitive Behavior, Interests, and Activities
The second core symptom of ASD is a pattern of restricted and repetitive behaviors, activities, and interests and hypersensitivity or hyposensitivity to sensory input (sounds, visual stimulus, etc). These symptoms may continue throughout life and are especially obvious when they persist into school age. Motor mannerisms:
Hand or finger flapping
Twisting, rocking, swaying, dipping, walking on tip-toe [toe walking]
May line up an exact number of playthings in the same manner each time, without apparent awareness of what the toys represent
Echolalia (repeating scripts or phrases heard on video clips or from television programs or elsewhere)
Reported in 37 to 95 percent of individuals with ASD
Mannerisms often manifest during the preschool years
Self-injurious: head-banging, face or body slapping, self-biting, or self-pinching
Self-injurious behaviors are more common in those with severe intellectual disability
Triggers for motor mannerisms:
Frustration
Anxiety
Excitement
Self-injurious behavior may be a way of communication (for attention, to escape, to avoid), or they can be internally driven without obvious reason. However, if a new self-injurious behavior develops, they child should be evaluated for other underlying causes, such as pain, discomfort or infections. Nonfunctional routines or rituals:
Insistence on carrying out the same routine or ritual each time
Temper tantrums or anxiety when routines are changed
Always eating particular foods in a specific order
Always following the same route from one place to another
Always talking about the same things or repetitive questioning about a particular topic
"Scripted" play activities (eg, mimicking verbatim what has been seen on television or in other types of media [eg, videos, websites])
Not tolerating deviations from "normal" or "expected" rules of conduct
Some of these behaviors are similar to those in children with obsessive-compulsive disorder (OCD). However, unlike children with ASD, children with OCD typically have normal social communication and interaction. In addition, children with OCD who show rigid or obsessive behaviors commonly find them distressing, whereas those with ASD typically are unaware of their perseverations. Children with ASD may show more perseverative behaviors when they are anxious. The perseverative behaviors may give them a feeling of comfort or control, making it difficult to differentiate them from the child with OCD. Restricted interests:
Complete preoccupation with one or more interests with great intensity or focus
Interests may seem very specific, unusual, and intense compared to others
Difficulty shifting attention away from their preferred topic, even when provided with multiple cues, prompts, or requests → this may cause difficulty when completing chores, schoolwork, or daily tasks.
Persistent preoccupation with unusual objects (eg, ceiling fans, vacuum cleaners)
In younger children, preoccupations may center on peculiar sensory or perceptual arousal
Preoccupations of older children may include weather, dates, schedules, phone numbers, license plates, Thomas the Tank Engine, Pokémon, or subtypes of any classification (eg, dinosaurs, dogs, planes)
Atypical responses to sensory stimuli:
Refusal to eat foods with certain tastes or textures or eating only foods with certain tastes and textures.
Preoccupation with sniffing or licking nonfood objects.
Tactile defensiveness or resistance to being touched or increased sensitivity to certain kinds of touch; light touch may be experienced as painful, whereas deep pressure may provide a sense of calm. This may include resistance to the feel of certain clothing textures or colors next to the skin.
Apparent indifference to pain.
Strong preferences for and/or perseverative touching of certain textures and strong aversions to others.
Hypersensitivity to certain frequencies or types of sound (eg, distant fire engines) with lack of response to sounds close-by or sounds that would startle other children.
Visual inspection of objects out of the corner of the eyes.
Preoccupation with edges, spinning objects, or shiny surfaces, lights, or odors.
Children may be overresponsive, underresponsive, or have a paradoxical response to environmental stimuli (eg, noises, touch, odors, tastes, visual stimuli)
There is often heighten responses, causing inattention, anxiety, and/or problems with anger management
These behaviors may be associated with gastrointestinal symptoms (eg, weight changes, diarrhea, constipation), which appear to be more prevalent in children with ASD than without ASD. They also may be associated with nutritional deficiencies and selective eating.
Three Levels of Autism
There are three levels of autism based on the severity of symptoms. This allows for more effective targeted treatment plans and helps caretakers better understand individuals' symptoms and needs.
Social Communication & Interaction
Level 1 - (Requiring support)
Characterized by noticeable impairment without support
Difficulty initiating social interactions (starting conversations and engaging with others)
Atypical or unsuccessful responses to social overtures (non-verbal or subtle verbal cues that signal a desire for social engagement - smiling, eye contact, etc)
Decreased interest in social interactions
Failure of turn-taking in conversation
Failure to generate responses or topics appropriate to the context
Unsuccessful or odd attempts to make friends
A child with ASD and level 1 social communication/interaction may be able to successfully communicate basic intentions and needs using words but may do so in a scripted manner and that is missing nonverbal communication behaviors (eg, changes in facial expression, use of eye contact, use of gestures)
Level 2 (Requiring substantial support)
Marked deficits in communication
Impairments apparent even with supports
Limited initiation of social interactions
Reduced/abnormal response to social overtures.
Level 3 (Requiring very substantial support)
Severe impairments in functioning; very limited initiation of social interactions; minimal response to social overtures from others.
Examples of social communication/interaction that requires very substantial support include:
Nonexistent communication (the child makes no attempts to share thoughts or interests or to make requests)
Communication that consists only of physical gestures (eg, takes an adult by the hand to lead them to a desired object or activity without accompanying eye contact or spoken language)
Communication that consists of words that are repeated from other contexts and have no relevance to the current context (eg, echolalia)
Repetitive and Restricted Behavior
Level 1 (Requiring support)
Behaviors significantly interfere with function
Difficulty switching between activities
Independence limited by problems with organization and planning.
The repetitive behavior may manifest as a specific interest (eg, trains, vacuum cleaners), a general topic (eg, dinosaurs, natural disasters), or an age-appropriate interest (eg, collecting cards). However, the ongoing interest takes up the majority of the child's recreational time and interferes with other activities. In addition, the child often experiences distress or frustration when not allowed to pursue the interest.
Level 2 (Requiring substantial support)
Behaviors sufficiently frequent to be obvious to a casual observer
Behaviors interfere with function in a variety of settings
Distress or difficulty when changing focus to something else or changing activities or actions
Level 3 (Requiring very substantial support)
Behaviors markedly interfere with function in all aspects
Extreme difficulty coping with change
Extreme distress and difficulty shifting one’s attention and focus, thoughts, or behaviors from one thing to another
Examples of repetitive/restricted behavior that requires very substantial support include:
Rocking or spinning the body
Spinning objects
Flapping the hands while rocking
Visual self-stimulatory behaviors associated with spinning or rocking objects or the self
Engaging in unusual sensory exploration such as regarding hands or objects closely, sniffing or mouthing objects
Rigid adherence to routines during play or adaptive tasks that interferes with functional activities (eg, socializing)
Concluding Remarks
The field of natural medicines has witnessed substantial growth with over 200 completed clinical trials and ongoing research efforts. At our clinic, we adopt a comprehensive approach to address various facets of autism, drawing on the insights gained from these studies. Notably, research highlights the importance of addressing nutrient deficiencies, as these deficiencies can impact behavioral and cognitive symptoms. Our treatment goals encompass managing autism-associated symptoms, optimizing digestion, improving sleep patterns, fine-tuning dietary choices with professional guidance, ensuring proper nutrition, promoting regular exercise, minimizing exposure to environmental neurotoxins, and screening for allergies that may exacerbate symptoms. These holistic strategies aim to enhance the well-being and quality of life for individuals with autism.
Dr. Baker (ND) uses a comprehensive panel of blood tests consisting of approximately 20 different assessments designed to identify factors associated with autism and its complications, as well as those that can exacerbate symptoms. These assessments help in uncovering critical insights for a more targeted and effective approach to autism management.
References
[1] Patel M, Atluri LM, Gonzalez NA, Sakhamuri N, Athiyaman S, Randhi B, Gutlapalli SD, Pu J, Zaidi MF, Khan S. A Systematic Review of Mixed Studies Exploring the Effects of Probiotics on Gut-Microbiome to Modulate Therapy in Children With Autism Spectrum Disorder. Cureus. 2022 Dec 8;14(12):e32313. doi: 10.7759/cureus.32313. PMID: 36632246; PMCID: PMC9828007.
[2] Rossignol DA, Frye RE. Melatonin in autism spectrum disorders: a systematic review and meta-analysis. Dev Med Child Neurol. 2011 Sep;53(9):783-792. doi: 10.1111/j.1469-8749.2011.03980.x. Epub 2011 Apr 19. PMID: 21518346.
[3] Quan L, Xu X, Cui Y, Han H, Hendren RL, Zhao L, You X. A systematic review and meta-analysis of the benefits of a gluten-free diet and/or casein-free diet for children with autism spectrum disorder. Nutr Rev. 2022 Apr 8;80(5):1237-1246. doi: 10.1093/nutrit/nuab073. PMID: 34617108; PMCID: PMC8990762.
[4] Bowling A, Slavet J, Miller DP, Haneuse S, Beardslee W, Davison K. Cybercycling Effects on Classroom Behavior in Children With Behavioral Health Disorders: An RCT. Pediatrics. 2017 Feb;139(2):e20161985. doi: 10.1542/peds.2016-1985. Epub 2017 Jan 9. PMID: 28069663.
[5] Guo M, Li L, Zhang Q, Chen L, Dai Y, Liu L, Feng J, Cai X, Cheng Q, Chen J, Wei H, Li T. Vitamin and mineral status of children with autism spectrum disorder in Hainan Province of China: associations with symptoms. Nutr Neurosci. 2020 Oct;23(10):803-810. doi: 10.1080/1028415X.2018.1558762. Epub 2018 Dec 20. PMID: 30570388.
[6] Li SO, Wang JL, Bjørklund G, Zhao WN, Yin CH. Serum copper and zinc levels in individuals with autism spectrum disorders. Neuroreport. 2014 Oct 22;25(15):1216-20. doi: 10.1097/WNR.0000000000000251. PMID: 25162784.
[7] Ames JL, Windham GC, Lyall K, Pearl M, Kharrazi M, Yoshida CK, Van de Water J, Ashwood P, Croen LA. Neonatal Thyroid Stimulating Hormone and Subsequent Diagnosis of Autism Spectrum Disorders and Intellectual Disability. Autism Res. 2020 Mar;13(3):444-455. doi: 10.1002/aur.2247. Epub 2019 Dec 10. PMID: 31823519.
[8] Lyall K, Anderson M, Kharrazi M, Windham GC. Neonatal thyroid hormone levels in association with autism spectrum disorder. Autism Res. 2017 Apr;10(4):585-592. doi: 10.1002/aur.1708. Epub 2016 Oct 14. PMID: 27739255.
[9] Jafari Mohammadabadi H, Rahmatian A, Sayehmiri F, Rafiei M. The Relationship Between the Level of Copper, Lead, Mercury and Autism Disorders: A Meta-Analysis. Pediatric Health Med Ther. 2020 Sep 21;11:369-378. doi: 10.2147/PHMT.S210042. PMID: 33061742; PMCID: PMC7519826.