For this article featured in the Issaquah Press Parent’s Guide this month, I was asked to summarize treatments for autism spectrum disorders that apply to every patient. This was a really challenging thing to do, because naturopathic medicine is based on the principle of individualized treatment. Five kids or teens struggling with attention issues or anxiety will likely receive five very different treatments in my office. This is true because I am focusing on the cause rather than the symptoms of illness, and because I choose treatments based on the whole person rather than the individual systems involved in their complaints. The reality is that, while a colorful diet and sleep hygiene can be hugely effective for all children and those on the autism spectrum or with attention issues, much of my job is meeting kids and parents where they are at and helping to make diet and sleep changes more achievable over time.
Healthy Eats: Supporting Parents and Kids through Healthy Food Choices
Food choices, especially in sensory disorders, can be a challenging aspect of daily life for parents, caregivers and kids. I work a lot in my office with kids, teens and parents (both on and off the autism spectrum) to get healthy foods into the diet in creative ways. Sometimes I will refer to my friends at Mosaic Children’s Therapy for further support with feeding; they have an amazing food experimentation room in which they hold classes to address sensory-related issues with kids on the spectrum. While sensory issues can definitely be a component of dietary choices, our physiology can also direct food choice to some extent.
Sometimes making healthy food choices comes down to having a healthy nervous system and digestive system. For example, if kids aren’t producing the right amount of stomach acid or digestive enzymes, appetite may be affected and digestive symptoms (like reflux, gas, bloating, constipation and diarrhea) can result. Many of these kids will either have low appetite in general or will only eat easy-to-digest foods (mainly carbohydrates and bread-like foods).
On the contrary, sometimes the issue can be too much appetite, usually for one item or food group while rejecting anything else. Many children crave a lot of carbohydrate, as previously mentioned. Carbohydrate cravings at certain times of development can be completely normal. But when these cravings start to affect behavior – either through growing nutrient deficiencies or because of an undiscovered immunological response – we need to take action. I may give digestive health supplements like probiotics or digestive enzymes for a period of time with these kids while we are working on taste and texture introductions. Furthermore, if children experience anxiety around food or stooling, appetite can be affected and digestive issues can again result. For parents, I also recommend cookbooks like The Sneaky Chef and Deceptively Delicious to help navigate the world of sensitive eating.
Healthy Sleep: The Importance of Individualized Assessment and Treatment
Issues with sleep can also be important to address. Without good sleep, kids (and parents) are never functioning well. Sleep is our time to restore and regenerate; adequate sleep boosts immune function, helps with adaptation to stress, reduces catecholamine production, and helps regulate blood sugar throughout the day. There are many problems that can arise with sleep, but two kids with the same sleep issues may need completely different interventions.
Generally, there are kids who 1) who have trouble getting to sleep, 2) trouble staying asleep, 3) a shift in the normal circadian rhythm (usually going to bed late and sleeping late or going to bed early and waking early), and 4) all of the above. In order to accurately improve sleep issues we need to rule out and/or address physiologic issues like urination issues (bedwetting), blood sugar dips and troughs, excess allergic response & histamine (excites the brain and nervous system), shifts in cortisol production over the course of a day, and nutrient deficiencies. If none of the above are issues for a child, sleep hygiene can be an important part of treatment.
Sleep hygiene is a term used to encompass many behavioral and lifestyle modifications that are known to improve sleep. For example, making sure a bedroom is cool when kids are sleeping actually improves sleep and is associated with less night waking. Keeping a room very dark is also important, as darkness is the trigger for the brain to make melatonin. Melatonin is a hormone produced by the pineal gland in the absence of light, in particular blue light. Many children fall asleep next to a TV, computer or iPad, which emit a lot of blue light and prevent melatonin release. For some kids, this behavior can be changed easily; for others, blue light filtering glasses and light bulbs can be used to increase melatonin production and regulate sleep cycles. Eliminating or filtering blue light an hour before bed and using a full spectrum daylight lamp or alarm clock in the morning can help normalize the circadian rhythm.
Depending on other symptoms (like muscle cramps, constipation, or anxiety), magnesium can be a great supplement to help calm the nervous system and relax muscles before bedtime. If children or parents are averse to supplementation, Epsom salt baths – composed of magnesium sulfate crystals – are a great way to improve sleep. Melatonin and other supplements may be indicated, as well as genetic testing to determine if an excess of catecholamines are contributing to sleep disturbances.
To access the full Parent’s Guide for this month by Issaquah Press, click here.
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