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 student:
Take the example of two students sitting side by side in your 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 you cannot see.
Have you noticed a bleary, tired, foggy look on some of your ASD students’ faces? Think that’s autism you’re seeing? Is your first thought this child may need a stimulant medication to help him or her have better focus and attention, or a prescription to control some of their difficult behaviors?
Let’s see what global research is revealing about the silent struggles this student may face each day in your class:
- Fatigue and grogginess due to the poor sleep patterns of ASD
- Poorly integrated sensory information
- This is a child that needs to move and have a sensory diet throughout the day to be able to pay attention
- A busy classroom is like having 10 radios on, all tuned to different stations. They do not “get used to” noise and movement, and cannot tune it out.
- He/She 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 much better chance of success with a child who can actually see correctly to begin with.
- 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 is well-documented in the scientific research
- Chronic inflammation, including brain inflammation is common
- Oxidative stress
- Gastrointestinal dysfunction:
- Acid reflux is painful and often expressed as irritability
- Constipation and diarrhea
- Gassiness
- Stomach aches
- More prone to gastrointestinal infections
- Insufficient digestive enzymes in FIFTY percent of autistic children
- Opioid peptides may form in the gut during digestion due to insufficient digestive enzymes, enter the circulation and affect cognition, language, mood and behavior. It’s like they are on drugs while you are trying to teach them!
- Anxiety and other mood disorders are more common on the spectrum
- ADHD is very common
- Food sensitivities
- Children with ASD are prone to more food sensitivities, which can affect attention, hyperactivity, handwriting and learning. Many are very sensitive to foods high in salicylates, and these foods are common childhood favorites such as apples, tomatoes, grapes, etc. Here is an eye-opening example:
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. I’m sure Peter would have been placed on ADHD medication, and given some occupational therapy at the very least had these common food sensitivities not been discovered. And yet, the brain in Figure 2 is what is most likely to be sitting in your classroom each day, and you 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 used for ASD children and adults, such as constipation, 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.
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.
Once health has been supported with digestive enzymes, probiotics 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 more on difficult behaviors than their academic abilities, 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 thoughtfully 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 might not be able to sit still or learn at their best, or why they may be irritable, you can suggest they see a physician who understands their unique health challenges (www.medmaps.org), or look into the suggestions I share in my book, The Un-Prescription for Autism.