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Biomedical interventions for autism can get a little overwhelming

Recently I held a “Biomedical Troubleshooting” session at the Imagine! Colorado offices, sponsored by Autism Society of Boulder County.  Both veteran and newbie parents showed up – parents who had done everything from heavy metals chelation and special diets, to nothing but behavioral interventions – but across the board, the same questions were asked:  Which diet does my kid need for an autism diagnosis?  What lab tests? Special food, weird meal routines, hours in the kitchen making bone broths and nut milks – is it worth it?

Well, there is no “diet for autism”. Every child with autism in my practice is unique. There are several nutrition and GI problems that come up often with an autism diagnosis, and these are treatable. I map those for families, using clinical standards for nutrition assessment as well as functional nutrition lab tests that look deeper for problems. Find the trouble, make a plan to fix it, and children feel, function, learn, grow and behave better. Nutrition perfectly supports and complements all your child’s other interventions. All are important. But none unravel underlying physiological barriers to progress the way a targeted nutrition program can.

It comes down to being a nutrition detective, and finding that nutrition understory that is meaningful in your child’s case. Whether you have placed your child on Gut and Psychology Syndrome diet (GAPS), Specific Carbohydrate diet (SCD), gluten – casein free (GFCF), low oxalate (LOD), Body Ecology diet, yeast free diet, Paleo, Feingold, or no diet at all – you first need to know if it’s the right measure for your child. I meet families week after week who implement special diets without expert help.  Sometimes it works wonders… and sometimes it just drives a family nuts.

This didn’t emerge anew in the last few years, just for kids with autism. I’ve been a registered dietitian since 1989. In both my graduate and undergraduate training, much emphasis was placed on infant and child health, and how nutrition impacts these.  Since about the mid 1990s, “biomedical treatment for autism” tools have tapped tenets in pediatric nutrition, and expanded on that evidence base with an integrative medical approach. This works for kids with any chronic condition – from autism, to ADHD, epilepsy, growth or feeding problems, Down’s syndrome, or severe behavior and mood problems. And, good news, pieces of this may be accessible within insurance networks you already have.

For instance, before you leap into provoked urine toxic metals tests, spaghetti squash fries, and methylcobalamin injections (all of which their place when indicated), knock off the simple stuff first with your mainstream physician.  These are things that can also profoundly impact a child’s behavior, sleep, growth, learning, appetite, immune function, or development – and may prevent progress with more novel therapies if left unaddressed:

1 – Is your child underweight, below 5th percentile for age for body mass index (check here), eating enough  most the time?  A shortage of just one or two hundred calories a day over the long term is enough to derail a child. In fact, low body mass index is linked to more frequent, more severe infections in kids, as well as more difficulty with sleep, behavior, focus, and attention.

2 – Does your child hold it together through the school day, then blow up or show rage and reactivity once home?  Does this shift abruptly with a hefty snack? Check usual calorie needs for kids here, to see if your child is coming up short.  Check usual protein needs here.  You can also work with your provider to screen for bowel infections, and rule out inflammation from foods with food allergy and food sensitivity testing – both of these can drive mood swings, anxiety, and appetite in kids. If your in network provider isn’t familiar with thorough testing, this is my niche – schedule a free ten minute chat to talk to me!

3 – Got iron? Iron is key for learning, focus, attention, mood, behavior, sleep, and immune function.  Some children with autism don’t absorb or metabolize this typically; anemia and poor iron status are common problems for children with or without autism, across the US.  Balancing iron metabolism is crucial for kids. Ask your pediatrician to check ferritin, serum iron, and transferrin to get a sense of whether diet or supplements can help. Ferritin levels below 30 – though considered “in reference range” – usually correlate with lesser ability for focus, attention, and behavior – plus more frequent infections – in my experience. Since iron can become toxic if used incorrectly, don’t use iron supplements for a child without your provider’s input.

4 – Got pica? If your child puts non-food items in his mouth often, eats non food items, has oral tactile sensitivity for certain food textures, or has difficulty swallowing or tolerating food textures in his mouth, then a review of mineral intakes from foods or supplements is in order. These symptoms can signal problems like poor status for iron or zinc, or heavy metals exposures. Eating non-food is called pica, and is a classic flag for mineral imbalances. Learn more about pica here. Correcting mineral balance can dramatically improve behavior, mood, self regulation, anxiety, rageful reactions, and more.

5 – Gut biome – the bacteria populating your intestines – is crucial for digestion, absorption, and even immune function. Is your child dependent on Miralax or reflux medication? Needed antibiotics? These can disrupt that biome, and change how foods and nutrients are digested and absorbed. If your child isn’t able to pass comfortable stool daily without prescription medications, then screen for bowel infections or inflammation from foods. Many functional nutrition lab tests can define the biome in enough detail to direct treatments, so chronic constipation or diarrhea can be resolved. Normal passage of stools means optimal uptake of nutrients, and this means the brain gets what it needs to function every day.

6 – If you feel you’ve done it all and just want to throw in the towel, two thoughts: One, call me and let’s see if you really un-turned all the possible stones. Two, call me, and let’s discuss how to explore immune dysregulation (autoimmune reactions, immune deficiency) as an underlying piece of an autism presentation. Promising treatments are becoming more and more available and I am happy to pass these resources on to my patient families.

There are many other nutrition-detective steps I take in practice to bring children through assessment. We create a sequence that fits your family. In fact, nutrition intervention may be one of the least expensive and most beneficial tools you engage. I offer new patient families a six month, six visit Nutrition Transition package for at $1200 that maps the journey, from lab tests to supplements, foods, recipes, and meal plans. We move at a good clip and get results. I find discounted supplements and lab test fees where possible for my patient families, and throw in free copies of my books too.

Jumping out of sequence can backfire, which is why many families have mixed results when using nutrition care, biomedical tools, and special diets for autism. But working a methodical, professionally monitored nutrition plan may afford your child a few nice leaps, before you order up a $3500 battery of tests with an out-of-network doctor and pay thousands for six hours of his face time. For more info on sequencing, troubleshooting, and using nutrition-focused tools for autism, see Special Needs Kids Eat Right and Special Needs Kids Go Pharm-Free. And, call me!

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