ASD is a complex multi factorial condition and requires an approach that looks at the whole system holistically. Symptoms are the expression of underlying problem and therefore testing and treatment is the key. My approach involves addressing all the 7 steps in a systematic way.
1. Gut Dysfunction / Digestion :
Prevalence of GI Symptoms like abdominal pain, distension, flatulence, diarrhea, constipation has been well demonstrated in studies and from parental reports. Symptoms such as GERD and constipation may be causing pain, irritability and oppositional defiant behaviors.
Bacteria such as Clostridia and candida are hugely implicated in ASD kids that influence their behavior. Gluten/ casein elimination has shown to improve a subset of children with ASD.
Testing and treating the cause is the key. There are different testing methods we use based on the need. A urine Organic Acid test, stool tests, a food sensitivity and/or intolerance testing all help identify the triggers.
ASD children tend to hold on to toxins. These can be associated with some of the Genetic Snps that prevent an efficient detox. Heavy metals, mold toxins, pesticides, herbicides etc. Heavy metal testing, Toxic profile or mycotoxin testing are some of them we use heavily to gauge the toxicity.
3. Immune/ Autoimmunity: If your child is sick frequently with cold, flus or has eczema, the immunity piece may need to be addressed. Majority of children that I see who are on the severe end of the spectrum do not get the regular colds and flus. But instead, develop autoimmunity triggered by infections or a noninfectious trigger such as mold, or other environmental toxin leading to a flare up called PANS or PANDAS. These involve sudden onset of behavioral change with OCD aggression etc. Routine labs that check for infections, strep, whole blood count, viral panel such as EBV are essential to rule out in these kids.
4. Nutrient deficiencies: Deficiencies in nutrients are common seen in ASD. They tend to burn up most nutrients due to the requirements for other metabolic reactions in the body. Secondly, these children often have very restrictive diets. Sensory related issues make them picky eaters and thereby creating a vicious cycle of further lowering the intake of broader foods. All that could further exacerbate behavioral problems.
5. Hormones: Assessing hormones such as cortisol, DHEA, insulin etc are crucial in improving mood and aggression. Low cholesterol (<150) has shown to cause temper tantrums and fatigue.
6. Genetics : Science has made considerable progress in demonstrating our environments and how they play a role in expression of certain Snps. Some of these inherited genetic snps can be modified to prevent disease from expressing in life through proper nutrition, supplements and life style factors. I usually recommend parents get this evaluated through 23&me.com. We choose and pick what is treatable. This can greatly help with mood and behavior along with rest of the above.
7. Mitochondria : Kids on spectrum that have constipation, low muscle tone, lack of gross motor skills have lower mitochondrial function. Mitoswab, OAT testing provide clues to metabolic reactions that can further throw light on nutrient interventions.