AUTISM - Integration of Ayurveda and Medical Nutrition Therapy
Autism Spectrum Disorder or ASD is a complex developmental and neurological condition that typically appears during the first 3 years of life. This disorder is characterized, in varying degrees, by communication difficulties, social and behavioral challenges, and repetitive behaviors. https://www.autismspeaks.org/news/news-item/cdc-update-autism-shows-gap-between-early-concerns-and-evaluation. It is classified as a disorder because the challenges in these areas makes it difficult for the child or adult to cope in a society with rules and expectations. Some children are non-verbal and that makes it more difficult for the parents and caregivers. From the perspective of the person with ASD, social norms are confusing and conflicting in many ways and the sensory overload is very stressful and causes anxiety. The technological advances today have given a voice to these children and adults to communicate more effectively.
History of Autism
According to the American Psychological Association, the term autism was first coined by Swiss psychiatrist, Paul Eugen Bleuler in 1908. It comes from root word “autos” which means “Self”, combined with Greek suffix “ismos” which means “action or state of being”. Absorbed in oneself or withdrawn within oneself. In the 1940s upon further research, Hans Asperger found a set of children different from the ones studied by Leo Kanner, who exhibited a slightly different pattern. The pattern included "a lack of empathy, little ability to form friendships, one-sided conversation, intense absorption in a special interest, and clumsy movements." Asperger called children with AS "little professors" because of their ability to talk about their favorite subject in great detail. This was then called Aspergers Syndrome in 1960s. DSM-IV in 2013 was revised to include Asperger's Syndrome under the same umbrella the same umbrella.
Prevalance
About 1 percent of the world population has autism spectrum disorder. (CDC, 2014). Prevalence in the United States is estimated at 1 in 59 births. (CDC, 2018) versus 1 in 2500 about 40 years ago. Comparing boys versus girls it is estimated to be 1 in 42 in boys versus 1 in 189 in girls. However, Dr. Tony Attwood, a clinical psychologist has done a lot of work with Autism/Asperger’s syndrome and claims from his experience that the ratio of boys to girls is not 4:1 but more like 2:1. Girls fall under the invisible end of the spectrum because they fly under the radar for diagnosis and have learned to cope on their own by several techniques. They tend to camouflage themselves in any group to fit in. With this increase in diagnosis there is also an increase in awareness for accommodating those with special needs and this gives an opportunity for caregivers to show more patience and compassion.
There is a lot of speculation about the causes such as genetics, advanced age of the mother, exposure to certain drugs or chemicals during pregnancy or vaccines but there is no significant evidence to support these claims.
Characteristics of Austim
The characteristics are very similar in both Autism and Aspergers syndrome with a few significant differences which puts Aspergers on the high functioning end as shown in the picture below.
Ayurvedic perspective of Autism
Ayurveda would classify Autism under Unmada or Insanity, which is defined as wandering about of mind, intellect, consciousness, knowledge, memory, inclination, manners, activities and conduct. (Charaka Samhita – Ni 7.5). The figure below illustrates some possible causes and weakness manifested in the Mano Vaha Strotas or the mental pathways.
Nutritional Challenges
GI disorders and immune disorders common
Food allergies and intolerances
Picky eaters so fewer foods within food groups
Repetitive diets with a preference for crispy, crunchy foods
These influence inflammation, intestinal biota and GI permeability (leaky gut), malabsorption of nutrients leading to nutrient deficiency
Children with GI symptoms tend to have higher rate of sleep problems (70% as compared to 30% without), higher measures of irritation, anger and social withdrawal, more disruptive and less attentive behavior and overall lower quality of life.
Most common symptoms are constipation, bloating, sometimes diarrhea.
Popular Diets prescribed for Autism
Gluten-free and Casein-Free Diet (GFCF) (“do diet”)
A gluten-free/casein-free diet is also known as the GFCF diet. It is one of several alternative treatments for children with autism. When following this strict elimination diet, all foods containing gluten ( found in wheat, barley and rye) and casein ( found in milk and dairy products) are removed from the child's daily food intake. https://www.webmd.com/brain/autism/gluten-free-casein-free-diets-for-autism#1
Specific Carbohydrate Diet (SCD)
The Specific Carbohydrate Diet (SCD) is a very restrictive, unconventional diet plan that severely limits most carbs. It is based on the theory that by eliminating most carbs (primarily grains, starches, dairy, and sugars) and allowing only specific carbs that require minimal digestion, it can reduce inflammation and make eating enjoyable for people with gastrointestinal (GI) disorders. https://www.webmd.com/digestive-disorders/features/specific-carbohydrate-diet-review#1
Ayurvedic Approach to Autism
Ayurvedic approach is always holistic in nature and focuses on identifying dosha imbalance and prescribing a diet and lifestyle regimen that would help to balance the doshas. ASD being a neurological condition with a different brain wiring, the focus is on equipping the patient or client with tools to cope in social situations which cause a sensory overload. There are specific dietary interventions and lifestyle modifications that would go a long way in helping in that direction.
Some general guidelines are as follow:
1. Improving Agni with dosha balancing to facilitate the following:
Proper operation of Strotas
Detoxification of toxins
Facilitates proper nutrition of Dhatus
Proper functioning of Manovaha Strotas
Formation of Ojas
2. Purification or rejuvenation of dhatus
3. Administrating Medhya Rasayana
4. Sensible Ayurvedic diet and Yogic support (asanas and pranayama)
Dietary intervention
Some general suggestions are as follows. But intervention in Ayurveda is always based on every individual and it starts with identifying their body type (Prakruti), imbalance (Vikruti) and their Agni (strength of their digestive fire).
Vata Pacifying Diet in general
No cold foods or drinks
Cooked foods only
Tastes sweet, salty and sour
Avoid refined processed foods like white sugar, chips, chocolates, caffeine, white flour, soft drinks, leftovers, nightshades, legumes other than mung, old cheeses, microwavable foods and soy products
Buttermilk is good: ¼ cup of yogurt, ¾ cup of water blended with cumin, coriander and ginger prepared fresh.
Juices like Mango, apple, grape, carrot, pineapple, litchi and apple are recommended 1-2 glasses daily for detoxification. (Ref: www.panchakarma.com)
Diluted Pomegranate juice is recommended daily.
Lifestyle management
Massage with Vata oil warmed or mix of 50% Vata oil and 50% cold pressed sesame oilwarmed.
Almond oil could be applied to the head and feet daily
Mantras are good for balancing the mind.
Mahamrtyunja mantra for example.
Om tryambakaṃ yajāmahe sugandhiṃ puṣṭivardhanam
urvārukamiva bandhanānmṛtyormukṣīya mā'mṛtāt
Yoga asanas like grounding poses and Pranayama.
Panchakarma or detoxifying treatments
In conclusion both systems have their strengths and can be integrated to provide an optimum treatment plan for someone with ASD. These are some guidelines to consider if you have or know someone with Autism but this cannot replace sound nutrition advice from a dietitian or Ayurvedic practitioner.
A quote to ponder about is:
“Everyone is a genius. But if you judge a fish by its ability to climb a tree, it will live its whole life believing that it is stupid.”
