By Deborah Jeanne Sergeant
If you have a child on the autism spectrum, it’s only natural to wonder why. Or wonder if something you do could help mitigate your child’s behavioral issues that are caused by autism.
Many parents scrutinize their children’s diet.
If the right foods can promote good health and prevent disease, could it also affect autism?
“ASD [autism spectrum disorder] is an increasingly common disorder with considerable variability,” said physician Prateek D. Wali, division director at Karjoo Family Center for Pediatric and Gastroenterology, Hepatology and Nutrition and director of the Pediatric IBD Program at Upstate Golisano Children’s Hospital. “Gastrointestinal issues are commonly encountered and may be secondary to selective diet while also playing a role in exhibited behavioral symptoms.
“Therefore, nutritional interventions are often used in ASD both with and without clinical supervision to improve gastrointestinal symptoms. Unfortunately, there is no consensus regarding optimal nutritional therapy including empiric trials of gluten-free and casein-free diets, as well as probiotics, and dietary supplements.”
Despite the lack of studies, the pull of anecdotal evidence still draws families to try nutritional interventions to improve their children’s behavioral challenges.
“We suggest families have a personalized discussion with their primary care providers and gastroenterologist including a pediatric dietitian if possible, to optimize nutrition while minimizing symptoms safely,” Wali said.
Many families with children on the autism spectrum look at diet because they hope to find a natural intervention that can help their children’s challenging behaviors. The anecdotal findings appear convincing. But “research has not found a causal relationship between gut health and autism,” said Andy Shih, chief science officer at Autism Speaks in New York City. “However, ensuring a healthy and balanced diet is a key part of health and wellbeing in all children, including those with autism.”
He added that gastrointestinal issues are commonplace among those with autism, including constipation, diarrhea, irregular bowel movements, acid reflux and others, which can be caused by food sensitivities. The resulting stomach pain and discomfort can contribute to behavioral issues.
“We encourage families to consult with their child’s medical professionals to determine any food allergies and intolerances which might be contributing to GI distress,” Shih said. “A care team can help parents identify and implement treatment plans to relieve GI issues and reduce resulting behavioral symptoms.”
Anecdotally, some families choose to restrict gluten and casein (milk protein) intake and find it helps symptoms improve. However, Shih said that “rigorous clinical research to date does not support the effectiveness of gluten and casein-free diets as an evidence-based treatment for autism.
“While implementing a healthy diet in autistic children is important, some children may have food aversions and sensitivities that can make mealtime challenging for parents. Some children have sensory issues related to food, limiting the taste, texture and smells of foods they are willing to eat, which can lead to concerns about weight gain or malnutrition, and may require the implementation of strategies to help children become comfortable with a variety of new foods.”
Food & Autism
Autism Speaks in New York City offers resources and guidance to address concerns around nutrition, including these:
• Tips for picky eaters: www.autismspeaks.org/blog/autism-picky-eating-tips
• Parent’s Guide to Feeding Behavior in Autism: www.autismspeaks.org/sites/default/files/2018-08/Exploring%20Feeding%20Behavior.pdf
• Parent’s Guide to Managing Constipation in Children with Autism: www.autismspeaks.org/sites/default/files/2018-08/Constipation%20Guide.pdf