Looking for Links in Autism

As if dealing with autism were not difficult enough, most children with autism also have at least two other medical conditions. A recent article, “Some conditions tend to accompany autism in pairs,” written by Hannah Furfaro and published online on the Spectrum website on September 12, 2018, describes research regarding this phenomenon. [To read this article, please click here.] This article summarizes research published on July 24, 2018, in the journal Academic Pediatrics under the title “Identifying Associations among Co-occurring Medical Conditions in Children with Autism Spectrum Disorders.”

Under the leadership of neurologist Ann Neumeyer, the medical director at the Lurie Center for Autism at MassGen Hospital for Children in Boston, this study examined data from a network of autism clinics between 2010 and 2016. The research focused upon 3335 children with autism: 2114 who were seventeen months to five years old and 1221 who were six to seventeen years old.

For this study, researchers identified twelve medical conditions that commonly affect people with autism. These conditions included anxiety, ADHD (attention deficit hyperactivity disorder), developmental delay, and seizures. In addition, issues related to eating and digestion often found in autism, such as feeding difficulties, pica (eating nonfood substances), and constipation, were also included. Rounding out the list were various conditions: eczema, hypotonia (low muscle tone), disruptive behavior, sleep difficulties, and speech issues.

As they examined the data, researchers looked for conditions that were often found together and calculated the prevalence of these pairs in the two age groups of children with autism. In the group of children under six years old, the most commonly linked conditions were speech issues and developmental delay, occurring in 18.54% of the children. Next, 16.46% of the children had both speech issues and sleep difficulties. The third most common pair of conditions was speech issues and feeding difficulties (9.74%), followed by speech issues and constipation in 8.09% of the children. Closely following at 7.99% was the pair of sleep difficulties and developmental delay, then speech and hyponia at 7.28%, and finally, sleep difficulties and constipation, with 6.24% of children affected by both conditions.

In the group of children with autism who were six to seventeen years old, some of the same pairs of conditions occurred, but other new ones also arose in this data. The most commonly observed pair was sleep difficulties and ADHD seen in 11.22% of the older children. In approximately one tenth of those children, speech issues and sleep difficulties (10.89%) and speech issues and ADHD (10.65%) were paired. In addition, 8.68% of these children had speech issues with developmental delay. Also, these children suffered from constipation: 6.39% of the children with speech issues had constipation, and 5.65% of the children with sleep problems had constipation. Finally, 5.16% of the children had both speech issues and hypotonia.

Obviously, the common denominator in many of these paired conditions is speech issues, which occur in the vast majority of these pairings. Dr. Neumeyer notes that speech issues are linked with other conditions because speech difficulties are common in autism. She also notes that the link between some conditions proves more obvious. For example, children who have oral motor issues may likely have problems with speech and feeding. By examining the linked conditions, researchers hope to discover possible genetic origins and potential treatments for these conditions.

Clearly, the overall prevalence of speech issues highlights the importance of speech therapy for children with autism. However, finding a speech therapist is not always easy, especially with the increasing numbers of children with autism, which often means being on waiting lists before speech therapy can begin. Speech therapists in school districts are often overwhelmed by ridiculously large caseloads of children and cannot always provide the individual therapy time needed to help children with autism.

Another issue repeatedly found in this research is the problem of sleep difficulties. Many children with autism struggle with sleeping, which impacts their families, as well. To keep their children with autism and insomnia safe, many parents stay awake with their children all night. For some children with autism, the supplement melatonin offers a natural way to increase drowsiness, helping them fall asleep and stay asleep so that everyone in the home can get a good night’s sleep.

In addition, doctors need to find the cause of constipation in children with autism so that they don’t have to suffer needlessly. Children with speech issues may not be able to communicate abdominal distress associated with constipation, and abdominal pain may be responsible for sleep problems linked to constipation. Since many children with autism also have food allergies and digestive issues, perhaps identifying and addressing these conditions could prevent constipation and any related issues.

Most importantly, this research demonstrates the wide range of medical conditions associated with autism. Parents must advocate to make sure their children get the best medical care possible, and doctors must recognize that these problems go beyond the scope of autism and need to be addressed. After these common conditions found in autism are diagnosed, proper treatment must begin to help children overcome issues that affect their health and well-being. Awareness of the links between autism and various conditions is just the beginning; seeking the true connections and finding ways to make children with autism happier and healthier should be the ultimate goal.

“Keep on asking, and you will receive what you ask for. Keep on seeking, and you will find. Keep on knocking, and the door will be opened to you.” Matthew 7:7