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High-Functioning Autism and Genetics

Is There a Link Between GI Problems and High-Functioning Autism?

“Is there a link between GI problems and high-functioning autism? Our son has frequent constipation, and we’re wondering if this has something to do with the disorder.”

Gastrointestinal (GI) disorders do occur in some children with High-Functioning Autism (HFA) and Asperger’s (e.g., chronic constipation, diarrhea, irritable and inflammatory bowel conditions). However, the link between GI issues and autism is up for debate.

One study from the Mayo Clinic found no apparent overall link between the two, although the researchers did find that some individual GI problems are more common in kids on the autism spectrum as compared to their “typical” (i.e., non-autistic) peers.

The Centers for Disease Control and Prevention (CDC) reports that kids on the autism spectrum are 3.5 times more likely to experience chronic diarrhea or constipation than their typical peers. Some researchers propose that toxins produced by abnormal gut bacteria may trigger or worsen the symptoms associated with the disorder.

Furthermore, researchers report that the GI activity of some young people on the spectrum differs from that of typical children in two major ways: 1) their intestines are home to abnormal amounts of certain digestive bacteria, and 2) their intestinal cells show abnormalities in how they break down and transport carbohydrates. In addition, it has been suggested that some of these children have abnormal levels of certain bacteria. Bacteria play an important role in normal digestion, and abnormal levels have been associated with intestinal inflammation and digestive problems.

==> Preventing Meltdowns and Tantrums in Asperger's and HFA Children

We also know that alterations in how intestinal cells break down carbohydrates can affect the amount and type of nutrients that these cells offer to intestinal bacteria. Such alterations may negatively impact the makeup of the intestine’s normal community of digestive bacteria. These findings may explain why some parents of kids on the autism spectrum report that special diets and probiotics improve both their child’s digestion and his or her behavior.

Treating GI Disorders in Kids on the Autism Spectrum—

1. Gastroesophageal reflux disease (GERD): Behavioral modifications include avoiding food near bedtime, eating smaller meals, avoiding foods that tend to trigger symptoms, and elevating the head during sleep. Also, medications can be implemented (e.g., antacids, Pepcid, Zantac, Nexium, Priolosec).

2. Chronic diarrhea: Treatment will depend on the cause. For example, if diarrhea is due to food allergies, lactose intolerance or celiac disease, it’s usually treated with dietary restrictions. Also, medications may be warranted in certain circumstances.

3. Chronic constipation: This condition is often addressed using behavioral management, which includes dietary changes (e.g., increasing fiber, eliminating constipating foods), and management of toileting behaviors (e.g., teaching a child to sit on the toilet after meals). In addition, supplements can be used to alleviate constipation (e.g., soluble fiber, laxatives such as mineral oil, magnesium hydroxide or sorbitol).

4. Casein- and gluten-free diets: Many moms and dads of kids on the spectrum report that behavior improves when their youngster eats a diet free of the proteins gluten (found mostly in wheat, barley and rye) and casein (found in dairy products).

5. Probiotics: In addition to eliminating casein and gluten from their child’s diet, many parents have reported that probiotics (i.e., the "good" bacteria) help lessen gastrointestinal distress.



How Parents Can Help—

You may want to consider consulting with a dietary counselor (e.g., a nutritionist or dietician). If so, bring the counselor a 3 - 5 day “dietary history” by writing down what was eaten and how much. The counselor will review the history to determine whether there is a risk for nutritional deficiency. He or she can then work with you to add foods or supplements that address potential gaps in nutrition.

==> Preventing Meltdowns and Tantrums in Asperger's and HFA Children

In addition to providing a history of what was eaten and how much, create a list of the specific symptoms and behaviors that you would like to work on (e.g., your child’s tantrums, meltdowns, shutdowns, inability to sit quietly during class, problems sleeping at night, etc.).

Recruit the assistance of teachers, babysitters, and others outside the family to help you accurately monitor targeted symptoms and behaviors – and verify your awareness of changes. If a consensus is reached that improvements are indeed occurring, then continuing the dietary changes will be worth the cost and effort.

Note that improvements may be due to the removal of just one of the aforementioned proteins (i.e., gluten or casein) from the diet. Some parents report improvement with a gluten-free diet alone, while others report improvements with just a casein-free diet. In addition, improvement may be due to dietary changes other than the removal of casein or gluten (e.g., the new diet replaces processed foods high in sugar and fat with healthier foods like fruits and vegetables).

Also note that a strict casein-gluten free diet requires hard work and can be costly (e.g., parents will be faced with the task of sending or bringing special meals and treats whenever their child eats away from home, it may be difficult to eat from the menus in a restaurant or school cafeteria, birthday parties may present a challenge, etc.).

==> More information on diet and children with ASD can be found here...

Marriage Difficulties and Raising Children on the Autism Spectrum

5 Ways to Help Reduce Anxiety in Children with Aspergers

Many advancements have been made in recent years in order to help children with Asperger's Syndrome better manage emotional strife. Because the effects of Asperger’s can range from emotional hypersensitivity to difficulty expressing emotional affect, children diagnosed with Asperger's often require additional support.

Anxiety for children with Aspergers can present a particularly challenging struggle for both the children and their families. Below are some carefully researched suggestions in order to reduce anxiety in children with Asperger’s Syndrome.

First, children with Aspergers often function well with routines and struggle when routines are broken or something unexpected suddenly springs up. Predictable daily schedules will help reduce and prevent anxiety in a child with Asperger's because he or she can understand what to expect on a daily basis out of any situation.



Nonetheless, changes in our routines are inevitable. When changes are anticipated to the child’s routine, it is important to verbalize to him or her what to expect from the situation. If the child is meeting a new person, explain the relationship of this person to the family. If going on vacation or visiting a new place, preview with the child some of the sights, sounds, and experiences he or she can anticipate from the change of scenery.

Allow for the child to begin to process and interpret the new situation beforehand in order to help him or her cope better with the change in routine.

Often, when a child with Asperger's is struggling with anxiety, one of the best solutions to offer include items that help to stimulate the child’s senses. Weighted blankets are a useful tool to include in a child’s bedding.

These blankets are carefully designed to place additional pressure upon the person using them. The intention is for the child to feel an extra tight snuggle. Medical experts support that the added pressure can even simulate the experience and safety and security of the womb.

Much like weighted blankets, pressurized clothing and fabrics are available. Pressurized clothing stimulates the senses. In many cases, these are items like undergarment vests or leggings that allow for the child to actively connect with his or her body and use sensorial coping strategies in order to alleviate tension.

In addition, parents can purchase full body socks that function much like a sleeping bag or cocoon. These items allow for the child to stretch out but to feel secure with added sensorial pressure. These materials help the child to develop motor skills, promote sensory awareness, and help alleviate anxiety when a child is feeling tense.

Apart from fabrics and materials, there are also manual items and toys that can help a child with Asperger's handle his or her anxiety. Children with Asperger's can benefit from both tactile and visual stimulation. Many hand-held items including toys, fidget spinners, and even putties exist to alleviate anxiety.

Fidget toys and spinners are often multifaceted toys that allow for the child to spin, pull, press, twist, or squeeze a small item manually to help to promote sensory awareness and alleviate immediate tension. Similarly, stress putty, much like silly putty or molding clay, can be used to relieve anxiety, offering the child something small and stimulating to squeeze when he or she is feeling anxious.

The final recommendation is a popular solution in modern alternative medicine. Pure essential oils logically help Asperger's children with anxiety because they stimulate the olfactory senses. According to Mental Health Matters, common fragrances selected for anxiety include lavender, chamomile, eucalyptus, frankincense, and peppermint extracts.

Pure essential oils can be used aromatically using an essential oil diffuser to produce a light scented mist, or they can be used in sprays and lotions to apply to fabric or even directly onto the body. The effects of pure essential oils can be extremely calming and soothing, especially combined with other relaxation techniques. If curious about essential oils, please follow this link for more information and to purchase: Pure Path Essential Oils

The struggles for children with Asperger's Syndrome are unique in many situations. However, taking these suggestions in mind, it is important for children with Asperger's to be able to process their environment and to feel secure. With the assistance of these techniques, parents of children with Asperger's can best assist their children in any anxiety-provoking situation.

Anxiety Management in High-Functioning Autism: 25 Tips for Parents

Anxiety can't be measured or observed except through its behavioral manifestation, either verbal or nonverbal (e.g., crying, complaining of a stomachache or headache, crawling under the table, becoming argumentative, etc.).

To manage the anxiety in Aspergers and High-Functioning Autistic (HFA) kids, moms and dads are encouraged to do any – or all – of the following:

1. Avoid over-scheduling. Soccer, karate, baseball, music lessons, play-dates the list of extracurricular activities children can take on is endless. But too many activities can easily lead to stress and anxiety in kids. Just as grownups need some downtime after work and on weekends, kids also need some quiet time alone to decompress.

2. Be flexible and try to maintain a normal routine.

3. Consult a counselor or your pediatrician. If you suspect that a change in the family such as a new sibling, a move, divorce, or a death of a family member is behind your youngster's stress and anxiety, seek advice from an expert such as your youngster's school counselor, your pediatrician, or a child therapist.

4. Create an anxiety hierarchy, and put the events in order from easy to hard.

5. Develop, practice, and rehearse new behaviors prior to exposure to the real anxiety-producing situation.

==> Preventing Meltdowns and Tantrums in HFA Children

6. Don’t dismiss his feelings. Telling your youngster “not to worry about his fears” may only make him feel like he’s doing something wrong by feeling anxious. Let him know that it’s okay to feel bad about something, and encourage him to share his emotions and thoughts.

7. Don’t punish mistakes or lack of progress.

8. Get him/her outside. Exercise can boost mood, so get him moving. Even if it’s just for a walk around the block, fresh air and physical activity may be just what he needs to lift his spirits and give him a new perspective on things.

9. Gradually shift “anxiety control” to your youngster by preparing him for anxiety-producing situations by discussing antecedents, settings, triggers, and actions to take.

10. Help your youngster identify the source of the anxiety if he is old enough to understand this concept.

11. If he is old enough, teach your youngster increasing independence in anticipating and coping with anxiety in a variety of situations.



12. Implement new behaviors in the actual situations where anxiety occurs.

13. Keep your youngster healthy. Make sure he’s eating right and getting enough sleep. Not getting enough rest or eating nutritious meals at regular intervals can contribute to your youngster’s stress. If he feels good, he’ll be better equipped to work through whatever is bothering him.

14. Limit your youngster's exposure to upsetting news or stories. If she sees or hears upsetting images or accounts of natural disasters such as earthquakes or tsunamis or sees disturbing accounts of violence or terrorism on the news, talk to her about what's going on. Reassure her that she and the people she loves are not in danger. Talk about the aide that people who are victims of disasters or violence receive from humanitarian groups, and discuss ways that she may help, such as by working with her school to raise money for the victims.

15. Listen carefully to your youngster. You know how enormously comforting it can be just to have someone listen when something’s bothering you. Do the same thing for your youngster. If he doesn’t feel like talking, let him know you are there for him. Just be by his side and remind him that you love him and support him.

16. Make a list of numerous anxiety-producing situations, from easy ones to those that are more difficult (this is called “anxiety mapping”).

17. Modify expectations during stressful periods.

18. Offer comfort and distraction. Try to do something she enjoys, like playing a favorite game or cuddling in your lap and having you read to her, just as you did when she was younger. When the chips are down, even a 10-year-old will appreciate a good dose of parent TLC.

19. Plan for transitions (e.g., allow extra time in the morning if getting to school is difficult).

20. Prevent anxiety by “external control” (i.e., structuring the environment to make it predictable, consistent, and safe).

==> Discipline for Defiant Asperger's and HFA Teens

21. Use psychological, environmental and psychopharmacological treatments as needed (see below).

22. Recognize and praise small accomplishments.

23. Set a calm example. You can set the tone for how stress and anxiety in kids is handled in your house. It's virtually impossible to block out stress from our lives in today's high-tech, 24-hour-news-cycle world, but you can do something about how you handle your own stress. And the more you are able to keep things calm and peaceful at home, the less likely it is that anxiety in kids will be a problem in your household.

24. Stay calm when your youngster becomes anxious about a situation or event.

25. Stick to routines. Balance any changes by trying to maintain as much of her regular routine as possible. Try to stick to her regular bedtime and mealtimes, if possible.

Behavioral Manifestations of Anxiety in Kids on the Autism Spectrum:



==> Parenting Children and Teens with High-Functioning Autism

Summary of Anxiety Treatments for Children on the Autism Spectrum—

1. Psychological Treatments:
  • Behavioral Therapies: Focus on using techniques such as guided imagery, relaxation training, progressive desensitization, flooding as means to reduce anxiety responses or eliminate specific phobias.
  • Cognitive-Behavioral Therapy: Addresses underlying “automatic” thoughts and feelings that result from thoughts, as well as specific techniques to reduce or replace maladaptive behavior patterns.
  • Psychotherapy: Centers on resolution of conflicts and stresses, as well as the developmental aspects of an anxiety disorders solely through talk therapy.
2. Environmental Treatments:
  • Reduction of stressors. Identify and remove or reduce stressful tasks or situations at home, school and work.
  • Good sleep habits. Getting adequate, restful sleep improves response to interventions to treat anxiety disorders.
  • Avoidance or minimization of stimulants. No caffeine, minimize use of asthma medications if possible (bronchodilators, theophylline), avoid use of nasal decongestants, some cough medications, and diet pills.
3. Psychopharmacological Treatments (used as a last resort only):
  • Antihistamines: Older medications used for mild to moderate anxiety for many years. These, like the benzodiazepines, work fairly quickly (Atarax, Vistaril).
  • Benzodiazepines: Long-acting are best (Klonopin, Ativan, Valium, Librium, Serax) to quickly reduce the symptoms of an anxiety disorder. However, if used long term the result may be that tolerance develops.
  • Buspirone (BuSpar): A new serotonergic combination agonist/antagonist. Is nonaddicting, but may take 2 to 4 weeks for full effect.
  • Combination Serotonin/Norepinephrine Agents: New medications such as Effexor, Serzone, and Remeron, also with excellent tolerability and effectiveness. Takes 4 to 6 weeks for full response.
  • Major Tranquilizers (also called neuroleptics): Medications that act on a variety of neurotransmitter systems (acetylcholine, dopamine, histamine, adrenergic). Most are somewhat sedating, and have been used in situations where anxiety is severe enough to cause disorganization of thoughts and abnormal physical and mental sensations, such as the sense that things around you aren't real (derealization) or that you are disconnected with your body (derealization). Commonly used neuroleptics include: Zyprexa, Risperdal, Seroquel, Mellaril, Thorazine, Stelazine, Moban, Navane, Prolixin, and Haldol.
  • Serotonergic Agents: Newer antidepressants act as antianxiety agents as well, with excellent tolerability and effectiveness. Takes 4 to 6 weeks for full response (Luvox, Prozac, Zoloft, Paxil).
  • Tricyclic Antidepressants (TCAs): Older antidepressants with more side effects typically than the serotonergic agents, but also effective. Takes 4 to 6 weeks for full response (Tofranil, Elavil, Pamelor, Sinequan) 

Resources for parents of children and teens on the autism spectrum:
 
 
 
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Meltdowns are not a pretty sight. They are somewhat like overblown temper tantrums, but unlike tantrums, meltdowns can last anywhere from ten minutes to over an hour. When it starts, the Asperger's or HFA child is totally out-of-control. When it ends, both you and your child are totally exhausted. But... don’t breathe a sigh of relief yet. At the least provocation, for the remainder of that day -- and sometimes into the next - the meltdown can return in full force.

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Although Aspergers [high-functioning autism] is at the milder end of the autism spectrum, the challenges parents face when disciplining a teenager on the spectrum are more difficult than they would be with an average teen. Complicated by defiant behavior, the teen is at risk for even greater difficulties on multiple levels – unless the parents’ disciplinary techniques are tailored to their child's special needs.

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Your older teenager or young “adult child” isn’t sure what to do, and he is asking you for money every few days. How do you cut the purse strings and teach him to be independent? Parents of teens with ASD face many problems that other parents do not. Time is running out for teaching their adolescent how to become an independent adult. As one mother put it, "There's so little time, yet so much left to do."

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Two traits often found in kids with High-Functioning Autism are “mind-blindness” (i.e., the inability to predict the beliefs and intentions of others) and “alexithymia” (i.e., the inability to identify and interpret emotional signals in others). These two traits reduce the youngster’s ability to empathize with peers. As a result, he or she may be perceived by adults and other children as selfish, insensitive and uncaring.

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Become an expert in helping your child cope with his or her “out-of-control” emotions, inability to make and keep friends, stress, anger, thinking errors, and resistance to change.

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