At the Magaziner Center for Wellness we have long talked about the need to set up individualized programs for the child with Autism Spectrum Disorder aimed at diagnosing and treating hidden problems that may be impeding his or her development.
Doctors at Boston Children’s Hospital, Harvard Medical School, published a case history in the Journal of developmental and behavioral pediatrics about a 4-year-old girl with autism spectrum disorder diagnosed with feeding problems.
- Feeding concerns date to infancy, when she was diagnosed with Gastroesophageal Reflux Disease (GERD) associated with persistent bottle refusal and the acceptance of few pureed foods.
- At 13 months, milk and peanut allergies were diagnosed. Following a feeding clinic evaluation at 24 months, she was prescribed a soy milk supplement and an H2 blocker (a stomach acid reducer).
- There was no concern for oral-motor dysfunction. She was referred to early intervention for feeding therapy. However, her parents terminated participation after 6 months because she became anxious and had tantrum prior to treatment groups.
- She was seen in another feeding program at 3 years; zinc, folate, thyroid, and a celiac panel were normal, and an endoscopy was negative for eosinophilic esophagitis.
- She began individual feeding therapy, where concerns for rigidity, difficulty transitioning, and limited peer interactions led to a neuropsychological evaluation.
- The child was diagnosed with an ASD and avoidant/restrictive food intake disorder (ARFID).
- Her cognitive skills were average, and expressive and receptive language skills were low average.
- Her diet consisted of French fries, Ritz crackers, pretzels, and 32 ounces of soy formula daily. She had stopped accepting Cheerios and saltines 2 months prior.
- She controlled other aspects of feeding, insisting on a specific parking spot at a fast food restaurant and drinking from a particular sippy cup. Her parents accepted these demands with concern about her caloric intake, which they tracked daily.
- Following diagnosis with ARFID, she resumed feeding therapy using a systematic desensitization approach with rewards. At the first session, she kissed and licked 2 new foods without gagging. Her mother appeared receptive to recommendations that included continuing the “food game” at home, replacing 1 ounce of soy formula by offering water each day, limiting between-meal grazing, and refusing specific feeding demands.
- Currently, her parents plan to discontinue feeding therapy with concerns that the treatment was “too harsh.” Her father produces logs of her caloric and micronutrient intake as evidence that she did not replace missed formula with other foods and reports that she subsequently became more difficult to manage behaviorally.
- Her father now demands to see randomized controlled trials of feeding therapy approaches. Her weight is stable, but she has now limited her pretzel intake to a specific brand.1
The doctors ask each other – How would you approach her continued care?
- Doctors in Japan speculate that many children “grow out,” of this problem if stress and anxiety are managed. 2
- Doctors at the National University of Singapore suggest that controlling inflammation with natural phenol foods (grapes, blackberries, etc) would provide a good therapy, It should be noted that natural phenols are supported as anxiety and stress reducers.3
- Doctors at the Villa Santa Maria Institute, Neuropsychiatric Rehabilitation Center in Italy suggest that long-term probiotic use reduced the severity of abdominal symptoms as expected and improved Autistic core symptoms. 4
- Doctors at the Department of Health Psychology and Thompson Center for Autism and Neurodevelopmental Disorders, University of Missouri suggest that: “sensory over-responsivity and anxiety were highly associated, and each provided unique contributions to the prediction of chronic GI problems. The results indicate that anxiety, sensory over-responsivity and GI problems are possibly interrelated phenomenon for children with ASD, and may have common underlying mechanisms.5
Children with Autism Spectrum Disorder are often express eating challenges which can lead parents to suspect that their children might not be getting adequate amounts of vitamins and minerals. This sometimes leads these parents to try nutritional supplements and dietary regimens such as gluten-free and casein-free (GFCF) diets without professional supervision. In the largest study of its kind, published in the Journal of the Academy of Nutrition and Dietetics researchers report that these well-intentioned efforts can result in both insufficient nutrients and excessive nutrients.
This research was supported by a new study which compared nutritional intake in children with autism spectrum disorder, 20 on a gluten-free casein-free (GFCF) diet and 85 on a regular diet using 3-days food diaries.
- Those on the GFCF diet had a lower weight, body mass index, and total energy, pantothenic acid, calcium, phosphorus and sodium intake, but a higher intake of fiber, legumes, and vegetables.
- Further, the GFCF diet group had a better quality of fat intake, but needed supplementation with vitamin D.6
- Doctors at the Children’s Hospital Oakland Research Institute (CHORI) suggest that dietary intervention with vitamin D, tryptophan and omega 3 fatty acids would boost brain serotonin concentrations and help prevent and possibly ameliorate some of the symptoms associated with ASD without side effects (such as eating disorders).7
At the Magaziner Center, we approach autism from a holistic standpoint. We believe that covering up the symptoms is not good enough, and instead strive to find their causes and metabolic and biochemical factors that may be imbalanced. We utilize a series of extremely thorough and unique tests to determine exactly which factors are adding to the condition in each individual case. No two patients are the same and there is no ‘one-size-fits-all’ treatment. We each have unique biochemistry and contributing factors; environmental toxins, lifestyle and nutrition.
Do you have questions about diet and autism?
Call US 856-424-8222
OR email us at: info@DrMagaziner.com
1 Lucarelli J, Pappas D, Welchons L, Augustyn M. Autism Spectrum Disorder and Avoidant/Restrictive Food Intake Disorder. J Dev Behav Pediatr. 2016 Nov 4.
2 Tanoue K, Takamasu T, Matsui K. ood repertoire histories of children with autism spectrum disorder in Japan. Pediatr Int. 2016 Sep 7. doi: 10.1111/ped.13160.
3 Rangarajan P, Karthikeyan A, Dheen ST. Role of dietary phenols in mitigating microglia-mediated neuroinflammation. Neuromolecular Med. 2016 Sep;18(3):453-64. doi: 10.1007/s12017-016-8430-x. Epub 2016 Jul 27.
4. Grossi E, Melli S, Dunca D, Terruzzi V. Unexpected improvement in core autism spectrum disorder symptoms after long-term treatment with probiotics. SAGE Open Medical Case Reports. 2016;4:2050313X16666231.
5 Mazurek MO, Vasa RA, Kalb LG, et al. Anxiety, sensory over-responsivity, and gastrointestinal problems in children with autism spectrum disorders.
6. Patrick RP, Ames BN. Vitamin D hormone regulates serotonin synthesis. Part 1: relevance for autism. FASEB J. 2014 Jun;28(6):2398-413. doi: 10.1096/fj.13-246546. Epub 2014 Feb 20.
7 Vitamin D and the Omega-3 Fatty Acids Control Serotonin Synthesis and Action Part 2: Relevance for ADHD, Bipolar, Schizophrenia, and Impulsive Behavior. FASEB Journal