School-age Autistic Patients

Are we putting students on the autism spectrum into therapies when they aren't feeling their best?

Posted in Chiropractor on Tuesday, April 12, 2022

By Dr. Janet Lintala

"The fog is like a cage without a key." - Elizabeth Wurtzel

IEPs, aides, modifications, tutoring, special classrooms, and well-trained, dedicated teachers are useful resources to help students on the autism spectrum. But are we putting them into school and therapies when they aren’t feeling their best? New research indicates they may not be as ready to learn as we thought.

A Look Inside the Brain of Your Autistic Patient

Take the example of two students sitting side by side in a classroom. The one on the left is a typically developing student, and the one on the right is on the autism spectrum. They may be similar in appearance since autism doesn’t have a “look,” but the student on the right is struggling through a crushing daily burden of invisible medical issues that cannot be seen with the casual eye.

• Have you noticed a bleary, tired, foggy look on the faces of some of your patients with ASD?
• Are they restless and impulsive, or even have difficult behaviors? 
• Do you think this is simply what autism looks like?

Schools might even suggest to parents that this child would benefit from a stimulant medication to help him or her have better focus, or a prescription antipsychotic to control some of their difficult behaviors.

Silent Struggles This Student May Face

1. Fatigue and grogginess due to the disrupted sleep patterns of ASD

2. Poorly integrated sensory information

• This is a child that needs to move and have a sensory diet to be able to pay attention.
• A busy classroom is like having 10 radios on, all tuned to different stations.
• He may be seeing double, in which case all the skilled teaching in the world will not help this child read or learn better. When an overwhelmed brain doesn’t integrate the sensory input from both eyes, it can be very hard to read, do math or catch a ball at recess. Such a student will benefit from a developmental optometry exam and prism lenses. Learning will have a better chance of success with a child who can actually see correctly to begin with. A referral from you for a developmental optometry evaluation could be life-changing.

3. ASD children with immune dysfunction often don’t feel well

• More frequent colds and allergies lead to missed days and gaps in learning
• Autoimmune attack on various brain tissues
• Chronic inflammation, including brain inflammation
• Oxidative stress

4. Gastrointestinal dysfunction is very common on the autism spectrum

• Acid reflux is painful and often expressed as irritability and disrupted sleep
• Constipation and diarrhea
• Gassiness
• Stomach aches
• Insufficient digestive enzymes in 50% of ASD children
• More prone to gastrointestinal infections
• Opioid peptides may form in the gut from the digestion of gluten and casein, enter the circulation and affect cognition, language, mood, and behavior

5. Anxiety and other mood disorders

6. ADHD

7. Food sensitivities

• Children with ASD are prone to more food sensitivities, which can affect attention, hyperactivity, handwriting and learning.
• Here is an eye-opening example of a common sensitivity to salicylates

Figure 1: This is Peter's brain ... 

Figure 2: This is Peter's brain on ketchup ... 

It is shocking what a few specific dietary changes can do for the brains of these children (see www.feingold.org). The brain in Figure 1 is ready to learn, play and have a good day. The brain in Figure 2 is not. At the very least, Peter likely would have been placed on ADHD medication and given some occupational therapy had these common food sensitivities not been discovered. And yet, the brain in Figure 2 is what is most likely to be sitting in the classroom each day, and teachers are tasked with teaching through this mess of brain fog and agitation.

Polypharmacy and “Side Effect Hell”

These invisible health issues can cause a great deal of irritability and even aggression, and the child ends up getting medicated for the difficult behaviors, without the original health issues being resolved. The most common side effects of medications, such as constipation and acid reflux, enhance or worsen the health issues that are already causing the problems in the first place! It becomes a merry-go-round of side effects that I call “side effect hell.”

Who could possibly do their best while experiencing even half of the things on this list? Both sides of the desk, students and teachers alike, are working through this fog of medical issues:

What Can Be Done?

What is the key that unlocks the cage of fog? We need a seismic shift in the conventional medical approach to ASD.

Don't Abuse Medications

Medications are useful, but only if they are aimed at the right problem. In the clinical report from the American Academy of Pediatrics, Management of Children with Autism Spectrum Disorders, it is stated, “Medications have not been proven to address the core deficits of ASDs, and are not the primary treatment.” When medications are used for irritability and difficult behaviors, as they are now, it may be like washing the car instead of changing the oil. We need to address underlying medical issues first, and stop targeting just the irritability or brain fog that results from them.

Support Health in Other Ways

Once health has been supported with digestive enzymes with DPP-IV, probiotics, herbal antifungals, natural anti-inflammatories, and basic nutritional support, many of these health challenges will fall out of the picture, and there is usually less need for medications. I have seen some of my patients go from a classroom placement based on difficult behaviors to a mainstream classroom where they are more appropriately academically challenged. Nothing cures, treats, prevents or “fixes” ASD, but the correct health approach can greatly enhance function and cognition.

I understand why teachers might strongly suggest a student will benefit from various medications. And I also understand why teachers would like for a student to be able to sit still and quiet down. But now that you understand why autistic children (and adults!) might not be able to sit still or learn at their best, or why they may be irritable, you can suggest appropriate gastrointestinal, neurological, and nutritional support.

About Janet Lintala, DC

Janet Lintala, DC, founded and heads Autism Health, Pllc., which serves children and adults in 20 states. Her advice integrates the clinical expertise of a nonprescription autism practice with the firsthand experience only an autism parent can deliver.  She is author of The Un-Prescription for Autism: A Natural Approach for a Calmer, Happier, and More Focused Child.

Learn more about Dr. Lintala or book her as a speaker.

All opinions expressed by guest writers are their own and do not reflect the opinions of NCMIC.