Author: Melissa A. Rightor, M.A., CCC-SLP
Eating for Autism by Elizabeth Strickland, MS, RD, LD outlines a 10-step treatment plan to improve nutrition for children with autism spectrum disorders, Asperger?s Syndrome, and/or ADHD. The premise of this book is that nutritional deficiencies contribute to atypical brain functioning; therefore, if nutrition is made a larger focus with children with autism, improvements will be seen across the presentation of the disorder. This book is an easy ready for families and professionals working with children with autism. Strickland suggests that due to the neurological differences of children with autism, diet is essential to improve brain functioning by ensuring that all nutrients are in balance. As a result of many children with autism limiting their diets, their brains may not have access to all the vitamins and nutrients needed for peak functioning. The book provides a detailed description of how to implement each of the 10 steps along with 75 gluten-free, casein-free recipes for families that decide to place their children on some of these special diets. Strickland emphasizes throughout the book how essential it is for families to have a strong, knowledgeable team (including a dietitian, speech/language pathologist, pediatrician, occupational therapist, behavioral specialist, etc.) involved with the child to ensure that the program is safe and effective. Strickland also notes that there is limited research available on the efficacy of these diets. She suggests implementing these special diets only until you determine if your child is a ?positive responder.? A positive responder will showed a reduction or elimination of undesired behaviors (i.e. stimming, tantrums) and may show an increase in desired behaviors (i.e. speech/language, eye contact). A major limitation of these controversial diets is that many children with autism are so rigid about their eating that it may be difficult to implement special diets as the diets may put kids at risk for malnutrition if they result in an even more limited repertoire of foods. If you are interested in trying one of the special diets, be sure to stay objective about the results by completing pre-diet and post-diet rating scales, and always remember that a team approach is essential to the success of your child and the program.
Step 1: The first piece of the 10-step plan involves ensuring that all artificial colors, flavors, preservatives, sweeteners, refined sugars, and bad fats are removed from the diet. This helps to rid the body of synthesized compounds and ensure that more natural foods are offered. Eating fresher, home cooked meals will help to detoxify the system.
Steps 2-4: After ensuring that food is made more natural, Strickland recommends analyzing basic nutrition to ensure that children are getting the appropriate amounts of protein, carbohydrates, healthy fats, vitamins, minerals, and water. Due to highly restrictive diets, many children with autism are deficient in many of these key areas. Based upon this analysis, vitamins and supplements, especially Omega 3 fatty acids, are recommended to ensure that the body and brain have all the building blocks for functioning. Strickland acknowledges the difficulties that can come with getting picky eaters to take nutrition supplements and provides suggestions on how to work around those limitations.
Step 5: Now that the system should be more balanced, it is time to determine if there are other contributing factors impacting your child. Those can include GI issues, food allergies/sensitivities/intolerances, side effects from medications, dental problems, deficiencies with swallowing coordination, sensory integration issues, environmental elements, and behavioral concerns.
Step 6-7: Children with autism are thought to have a higher prevalence of GI involvement and food allergies/intolerances/sensitivities that can cause stomach pain, bloating, gas, constipation, reflux, vomiting, and diarrhea. These conditions can cause children, especially those that are non-verbal or language delayed, to act out to express discomfort by refusing food, eating selectively, throwing tantrums, engaging in self injurious behavior, and being irritable. These behaviors are often dismissed as typical autistic behaviors; however, identification and treatment may reduce frequency and/or severity. If allergies are suspected, elimination diets are recommended for at least two weeks to determine symptoms diminish.
Step 8: The Gluten Free Casein Free (GFCF) diet is the most popular diet in the autism community. It is considered highly controversial, and many medical professionals do not support its use due to the lack of evidenced-based research. The elimination of wheat, rye, barley, and milk protein is implemented to attempt to relieve behavioral and GI concerns. This diet is highly restrictive; therefore, families must work with the feeding team to ensure that nutrition is not compromised. Due to the prevalence of food selectivity among children with autism, this diet is not always an immediate option as many children with autism will only eat foods that contain gluten and casein.
Step 9-10: Megavitamin therapy involves ingesting high doses of specific vitamins and supplements, the most popular being vitamin B6 in conjunction with magnesium. Some families report improvements in behavior and gains in the areas of social skills including eye contact and speech while also experiencing a reduction in aggression, tantrums, and stimming. Vitamin B6 is essential for brain function as it is key to the synthesis of serotonin and dopamine. Serotonin and dopamine regulate mood, anger, aggression, sleep, appetite, motor activity, and behavior. This treatment is also highly controversial due to the lack of research available and potential safety concerns. Excessively high doses of vitamin B6 can result in problems such as shaking of the hands, increased stimming, wrenching of the hands, and toe walking. As a result it would only be safe to implement this treatment under the close watch and supervision of the feeding team, and if the child is a non-responder, high dose B6 treatment should be discontinued after the two week trial.
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