There are several reasons why parents should consider a gluten-free, casein-free diet for their child with autism. In this article, we will discuss some of the science behind why this diet is important.

1. Safe and Effective

This is the most important reason of all. If you can do something at home that is safe and may help your child, it is always worth a try.

2. Probable Improvements in Skills and Health

Parents report improvements in these areas:

• Better cognition (described as the “fog lifting”)
• Improvement in receptive language
• Improvement in expressive language
• Better sleep
• Reduction in disruptive behaviors
• Less hyperactivity
• Better bowel movements
• Reduction in ear infections and other illnesses
• Pain tolerance normalizing
• Eczema clearing

3. Gluten and Casein Cause a Functional Folate Deficiency

Folate is CRITICAL for proper brain development. Cerebral Folate Deficiency has been shown to be a problem in many kids with autism.

Folate is important because it supports the metabolism of purines and pyrimidines, which are the building blocks of RNA and DNA. They are needed to make energy properly.

Folate is utilized by the body for cognitive development.

Casein (The Protein In Dairy):

• Studies show that dairy blocks folate receptors. This is extremely important information because recent studies show that the majority of kids with autism have folate receptor autoantibodies that block folate from entering the cerebral spinal fluid.
• Most kids with autism are already low in folate. Dairy can make that problem worse.

Gluten (The Protein In Wheat):

• Most processed wheat products (cereal, pasta, bread, cake and cookie mixes) have added folic acid. Folic acid is the synthetic, oxidized form of folate.
• Most kids with autism have genetic polymorphisms that make it difficult to utilize folic acid. If this is the case, folic acid floats around in the blood, unable to be used, and can actually block folate receptors.

4. Gluten Contains Zonulin Which Contributes to Leaky Gut

Gluten is high in a component called zonulin which can cause intestinal permeability, also known as “leaky gut”. Increased gut permeability contributes to heightened reactions to food components in the intestinal tract of children with ASD. As a result, the child becomes sensitive to any food that they eat often. The reactions can vary from child to child but often include difficulty concentrating, constipation and/or diarrhea, and widespread inflammation. A 2017 review suggests that leaky gut may also contribute to anxiety and depression.

• Zonulin is a protein that modulates the permeability of the GI tract. The higher the zonulin, the greater chance of gut permeability (AKA leaky gut).
• In 2012, the American Academy of Pediatrics began to acknowledge the problem of leaky gut in autism. “The protein zonulin is a component of intercellular tight junctions that is involved in regulating gut permeability. Small-intestinal exposure to bacteria and gluten are two of the more powerful triggers for zonulin-induced tight junction disassembly.”
• Interestingly, individuals with ASD on gluten and casein free diets have significantly lower intestinal permeability than those on unrestricted diets.

5. Gluten and Casein Bind to Opioid Receptors in the Brain

An opioid reaction to long chain peptides (gluten and casein) creates a high pain threshold and a foggy, disconnected feeling, similar to the feeling of being drunk. Many parents report that “the fog lifted” after starting a gluten and casein free diet and this may be the reason.

• This study found abnormally high intestinal permeability in nearly 40% of autistic patients and in 21% of their first-degree relatives compared to less than 5% of normal control subjects.
• See this study that shows β-casomorphin-7, one of the most biologically active milk-derived peptides, (BCM7) is significantly higher (1.6x) in the blood of kids with autism.
• Gluten and casein are very long chain peptides (small versions of proteins) and are very similar in structure to natural opioid-binding peptides.
  • They are difficult to break down, especially if the child has insufficient digestive enzymes.
  • If the child’s digestive system is not properly breaking down gluten and casein, undigested peptides from these foods can access the bloodstream via a permeable gut lining (AKA Leaky Gut).
  • Once in the bloodstream, they are carried to the brain where they attach to the brain’s opiate receptors.
  • This opiate reaction causes an addiction to the food, much like an opiate drug would.
  • An opioid reaction is also the reason many kids go through withdrawal when gluten and casein are removed from the diet.
• In this analysis, it is explained how exomorphins (produced outside the body) pose as endomorphins (made inside the body) and, if they reach the brain, can have addictive effects. They can also cause the symptoms of autism and other disorders such as schizophrenia.
  • “Foods that contain exorphins, such as wheat and dairy products, have indeed a reputation for being rewarding and people find it extremely hard to give them up.”
  • They are called “comfort foods” because of the dopamine release.

More information can be found in this article titled “Peptides’ Role in Autism with Emphasis on Exorphins”.

6. Mast Cells that are Triggered by Food Allergies or Sensitivities Contribute to Leaky Gut

Eating foods that we are sensitive to, stimulates mast cells and thereby can create a permeable gut lining. Continuing to eat these foods makes the problem worse. When we stop eating foods that we are sensitive to, it calms the mast cells.

• Mast cells are mainly thought of when we are allergic to something, but they do a lot more. Mast cells in the body are connected to the immune response and they release histamine, interleukins, proteoglycans and other enzymes.
• When mast cells living in the connective tissue that line the GI tract are stimulated by a food sensitivity or food allergen, like wheat or dairy, they release the contents of their granules which has been shown to cause a permeable gut lining (AKA “Leaky gut”).
• This is one reason prescription oral mast cell stabilizers can be helpful for some kids with autism.
• Dairy and wheat are two of the top eight allergens. However, you don’t have to have a food allergy to have a mast cell reaction, which is why a regular allergy test cannot test for mast cell reactions. The best test is fully removing these foods from your diet, in addition to any other foods that you may be sensitive to, based on your physical and emotional reactions to the foods. An elimination diet is the best test.

7. Gluten and Casein Increase Glutamate

Elevated Glutamate and low GABA in the brain contribute to high anxiety, perseverating on topics, restlessness, tics, migraines, and Complex Motor Stereotypies which looks like flapping or stimming.

• Elevated glutamate is tied to Autism in recent studies.
• Glutamate (which is an excitatory neurotransmitter) and GABA (which is a calming neurotransmitter) need to balance. Studies show that in autism, glutamate needs to be decreased and GABA needs to be increased.
• Gluten and casein contain about 25% glutamic acid. When these proteins are degraded, pasteurized, or processed, they become free glutamate, which is problematic because it creates inflammation.
• Reducing glutamate can also help with seizure activity.
• More on the positive effect of removing free glutamate from the diet here.

8. Gluten and Casein Fuel Inflammation

When the gastrointestinal barrier function is disrupted (as is described in “Leaky Gut” above), there is an increased passage of dietary and microbial antigens interacting with cells of the immune system, which causes inflammation.

• This article focuses on the many issues with gluten that can cause inflammation.
• We can see that the role of diet has a huge impact on neuroinflammation in this article published in Frontiers in Immunology.
• Pasteurized milk is acid-forming because it contains lactic acid. It makes the stomach produce more acid, which may increase symptoms of reflux (GERD). In order to reduce inflammation, you want to consume an alkaline (not acidic) diet.

9. Milk is Very High in Hormones

Dairy is naturally very high in anabolic hormones.

• Anabolic hormones stimulate growth. These hormones are not always good for a growing child; and, theoretically, may lead to precocious puberty or even cause cancer cells to grow.
• Dairy farmers inject cows with a genetically engineered bovine growth hormone called rBGH to increase milk production.
• Even cows that are raised on an organic diet are often milked while pregnant, producing milk that is full of hormones.
• Research shows that steroid hormones in dairy products can be counted as an important risk factor for various cancers in humans.
• Dairy accounts for almost 70% of the estrogens in the human diet.

10. The Science Supports a Gluten and Casein Free Diet for Autism

There are hundreds of studies that provide proof that implementing a gluten, casein, and soy free diet is beneficial for people with autism. Here are a few of our favorites:

A. Effect of Gluten Free Diet on Gastrointestinal and Behavioral Indices for Children with Autism Spectrum Disorders: A Randomized Clinical Trial.

• This 2016 study suggested that a gluten-free diet may be effective in controlling gastrointestinal symptoms and ASD behaviors.
• 80 children of which 54% had GI abnormalities
  • Half (40 children) put on a gluten-free diet
  • Half (40 children) remained on a regular diet
  • Length was 6 weeks
• In the gluten-free group, the prevalence of gastrointestinal symptoms decreased significantly and the gluten-free diet resulted in a significant decrease in behavioral disorders as well.

B. Comprehensive Nutritional and Dietary Intervention for Autism Spectrum Disorder – A Randomized, Controlled 12-Month Trial.

• This 2018 12-month trial explains how nutritional interventions (healthy gluten, casein, soy free diet) and supplements can improve the quality of life for people with autism.
• Nonverbal IQ increased significantly in the treatment group. In addition, interpersonal skills, coping skills, and communication were also significantly improved.
• “Parents reported that the vitamin/mineral supplements, essential fatty acids, and GFCFSF diet were the most beneficial.”
• Over 12 months, the treatment group gained 18 months of development, verses 4 months in the non-treatment group.

C. A Modified Ketogenic Gluten-Free Diet with MCT Improves Behavior in Children with Autism Spectrum Disorder.

• This 2018 study suggested that a modified gluten-free ketogenic diet with supplemental MCT is a potentially beneficial treatment option to improve the core features of autism.
• This study tells us that, for some kids, we need to go further than just gluten and casein free to see excellent results. The carbohydrates in gluten-free foods may still be problematic.

D. Biological Explanation for Wheat Sensitivity Found.

• This new research is very pertinent to our kids who may not have celiac disease but react to gluten nonetheless.
• “People with non-celiac wheat sensitivity have a weakened intestinal barrier, which leads to a systemic immune response after ingesting wheat and related cereals, new research confirms.”
  • This tells us that you can react to gluten without having celiac disease.

E. Ketogenic Diet Versus Gluten Free Casein Free Diet in Autistic Children: A Case-Control Study.

• Patients (aged 3-8) were equally divided into 3 groups:
  • Ketogenic diet as modified Atkins diet (MAD)
  • Gluten-free, casein-free (GFCF) diet
  • Balanced nutrition which served as a control group
• Both diet groups showed significant improvement in ATEC and CARS scores in comparison to control group, yet ketogenic scored better results in cognition and sociability compared to GFCF diet group.
• The reason this study was important is because it emphasized the idea that sometimes diet change is bigger than just removing gluten and casein. It is also about including nutrient dense, nourishing foods.

F. Dietary Considerations in Autism Spectrum Disorders: The Potential Role of Protein Digestion and Microbial Putrefaction in the Gut-Brain Axis (an analysis).

• “Indeed, strict implementation of the diet has resulted in substantially greater improvement ASD behaviors, physiological symptoms, and social behaviors. In addition, there are likely other dietary proteins that are similarly difficult to digest that have not been considered and need to be minimized in cases of a fragile gut.”
• Regarding conflicting studies:
  • “Overall, dietary intervention studies in these children have not been able to address the multiple, integrated consequences of inappropriate proteins in the diets of individuals with ASD, including dietary protein digestion, gut-associated immune responses, and potential perturbations to the intestinal microbiota, much less provide the diagnostics to build tailored solutions.”

The post Top Reasons to Implement a GFCF Diet appeared first on The Autism Community in Action.

This article will give you information about the screening and assessment processes, including:

• How to prepare for your appointment(s)
• What to do during your appointment(s)
• Answers to frequently asked questions, such as what to do if you are told to “wait and see”

Screening vs Assessment

Developmental Screenings

Developmental screenings are brief, informal evaluations to identify children who are at risk for developmental delays and need further evaluation. Doctors, nurses, or other professionals in healthcare, community, or school settings can perform developmental screenings.

During the screening process, your child will be given a brief test and you’ll be asked to complete a questionnaire. The results will help determine if your child needs to be referred for further evaluation.

Developmental Assessments

If areas of concern are identified in the screening process, an in-depth, formal developmental assessment is needed. Developmental assessments need to be conducted by a trained specialist or a team of trained specialists (developmental pediatricians, child psychologists, occupational therapists, speech-language pathologists, etc.).

Many specialists have wait lists, so you will want to call and schedule an appointment for a developmental assessment immediately following your referral.

How To Get An Appointment For A Screening And/Or Assessment

There are a number of ways to get the evaluation process started. One way is through your child’s pediatrician. Another way is through your state’s Early Childhood Intervention Program (ECI).

Your Child’s Pediatrician

Contact your child’s pediatrician, tell them you are concerned about your child’s development, and request a developmental screening for your child.

If your child’s pediatrician identifies areas of concern during the screening process, they should refer you to a trained specialist (developmental pediatrician, child neurologist, child psychiatrist, or child psychologist) for further evaluation in an autism assessment.

Your State’s Early Childhood Intervention Program (ECI)

Another option is contacting your state’s Early Childhood Intervention Program (ECI) to have your child screened and evaluated for autism. Screenings and evaluations through ECI are almost always free of charge.

Your child’s age will determine how you go about scheduling an appointment to have your child screened and assessed through ECI.

Children Under 3:

• Find your state’s ECI contact information here

Children Over 3

• Contact your local public elementary school to receive ECI services through them

Before Your Appointment

Preparing for your appointment paves the way for effective advocacy for your child and helps ensure they receive a thorough evaluation. You can prepare for your appointment by:

• Compiling a list of questions and concerns to discuss with your doctor or the person who will be evaluating your child
• Collect video data of your child doing any concerning behaviors that you feel your child may not engage in during an assessment
• Completing a milestones checklist. Some free options include:
  • The CDC’s “Learn the Signs. Act Early.” website has printable and digital trackers
  • Modified Checklist for Autism in Toddlers (M-CHAT)
  • Autism Treatment Evaluation Checklist (ATEC)
• Complete any surveys or questionnaires given to you by your child’s doctor or ECI office
  • Be sure to do this 3-5 days before your appointment to allow for ample time for completion
• Call your insurance company to discuss coverage and any out-of-pocket expenses that you might incur
  • Screenings and assessments through state’s ECI program should be free of charge (see above)

During Your Appointment

During the screening and assessment processes, your child may be asked to perform some simple tests that may look like play. As the parent, you will be asked questions about your child’s development and behaviors.

Go over your completed milestone checklists and/or M-CHAT with your doctor. Point out all of the missed or delayed milestones. Do not be embarrassed to accurately describe concerns and issues. Do not “sugar coat” or downplay any delays. Minimizing or downplaying answers will not help your child in the long run. Don’t be afraid to speak up. Your input is invaluable throughout this process!

Remember, screenings are brief, informal, and may look like a well-child visit. However, their informal nature doesn’t excuse the person conducting the screening from taking this process seriously. Your concerns should never be dismissed. If the person screening your child tells you to “wait and see” or suggests this a “just a stage” your child will grow out of, go and get a second opinion! Always listen to your intuition.

Developmental assessments, are more comprehensive and in-depth than screenings. Assessments can take a long time to complete, so they may be broken up into several appointments. They might also be conducted by several different specialists who are trained in specific areas (speech-language pathologist, occupational therapist, physical therapist, child psychologist, etc.).

In order to ensure your child receives a comprehensive assessment, your child should be observed in a number of different settings to obtain an understanding of how they behave in various environments. Depending on your child’s comfort level, you may be asked to be in the room with your child, view the from an observation room, or remain in the waiting room.

Frequently Asked Questions

Related Articles

I Think My Child May Have Autism

Diagnostic Criteria for ASD

The post I Think My Child May Have Autism appeared first on The Autism Community in Action.

** Important Reminder**

Not every therapy or therapist will be a good fit for your child. There are good and bad professionals in every field. Talk to other families in your community for their recommendations. Interview the therapist. Request to observe sessions. Watch your child for warning signs of abuse or neglect. If you feel apprehensive, stop the therapy and re-evaluate. Read TACA’s article on Risk Reduction Strategies for Physical and Sexual Abuse to learn more.

Traditional Therapeutic Interventions

Speech Therapy

Speech Therapy focuses on improving communication and feeding skills. This includes oral motor development, verbal language skills, augmentative and alternative communication modalities, social communication and feeding therapy. A speech language pathologist evaluates your child’s understanding of language, ability to communicate through non-verbal and verbal gestures, and your child’s ability to chew and swallow food and liquids to develop a treatment plan. Learn more about speech therapy here.

Occupational Therapy (OT)

Occupational Therapy (OT) assists your child to perform activities of daily living (ADL), such as manipulating toys in play, handwriting, dressing, feeding, bathing, and working. An occupational therapist will evaluate your child’s trunk and upper body strength, joint range of motion, muscle tone, skin integrity, fine motor milestones, hand-eye coordination, manipulation of objects within their hands, sensory (sight, smell, hearing, touch, taste) awareness, and activities of daily living. The therapist, along with your input, will develop goals for your child and a plan of how to achieve these goals. Therapy sessions are typically geared towards functional activities that your child should be performing, such as playing, dressing, self-feeding, bathing, coloring, writing, craft projects, and work activities. Learn more about Occupational Therapy here.

Physical Therapy (PT)

Physical Therapy (PT) focuses on gross motor development including coordination, movement and balance, gait, motor imitation and play skills. Physical therapists work with adaptive equipment like braces, seating devices, wheelchairs, and specialized car seats. Learn more about Physical Therapy here.

Behavioral Therapies

There are a number of different behavioral therapies available, which can leave parents feeling confused about which approach to take. Below, you will find a brief overview of the most common behavior intervention programs for use as a starting point in determining whether or not behavior therapy is a good fit for your child and, if so, which approach best meets their individual learning style and needs.

Applied Behavior Analysis (ABA)

Based on B.F. Skinner’s theory of Behaviorism, ABA therapy aims to improve adaptive learning skills, communication, and behavior through breaking down tasks into small steps, repetition, and reinforcement. ABA therapists train Register Behavior Technicians (RBTs) to implement your child’s treatment plan. Research-based evidence shows benefit from therapy when a child receives 20-40 hours of ABA therapy per week. ABA is the only therapeutic treatment for autism approved by the FDA.

Complimentary Therapeutic Options

Below is a brief description of some other types of therapeutic interventions that are available. When considering which options may be a good fit for your child, it is important to remember that play and therapy are the work of a child with autism. A life with balance includes rest. Be sure your child’s schedule has plenty of free time to relax and participate in activities of their choice.

(Options are listed in alphabetical order for convenience)

Aquatic Therapy

Physical therapy that takes place in a pool. Additional benefits to physical therapy performed in water include sensory stimulation from hydrostatic pressure, water resistance for strength training, and body awareness. 

Chiropractic Therapy

Misalignments of the spine, called subluxations, are manually corrected. This alleviates pressure on nerves and improves nervous system functioning. Specially trained chiropractors can evaluate for primitive reflex integration and provide nutritional guidance.

Cognitive Behavioral Therapy (CBT)

Cognitive Behavioral Therapists work with individuals and families to strengthen mental health, develop coping strategies, and improve emotional regulation. Common issues addressed are anxiety, depression, anger, eating disorders, and difficulty handling stress.

Feeding Therapy

Evaluates and implements a treatment plan for feeding issues including; sucking, chewing, swallowing, gagging, and sensory defensiveness with food textures. A nutritionist or dietician may be consulted for nutritional advice.

Hippotherapy

Utilizes horses as a therapy tool for improved sensory, neuromotor, and cognitive development.

Masgutova Neurosensorimotor Reflex Integration (MNRI)

Specially trained professionals assess and create a treatment plan for primary motor reflex patterns and integration.

Music Therapy

Uses music therapeutically to address behavior, communication, sensory, motor, self-regulation, and cognitive functioning.

Neurofeedback

Also referred to as EEG biofeedback; utilizes computer-based brain training to analyze and retrain the client’s brainwave activity to a more controlled pattern.

Primitive Reflex Integration

Professionals assess and develop treatment plans for retained primitive reflexes. Primitive reflexes are naturally present in infancy and disappear through normal development. Reflexes that do not integrate may contribute to developmental delay and sensory issues.

Sensory Integration Therapy

Specially trained occupational therapists expose people that have sensory processing issues to a variety of sensory stimuli and play-based activities in a structured, thoughtful way.

Social Skills Programs

Teaches social skills through direct instruction and repetition. Professionals use a variety of techniques including role playing, Social Stories, social scripts, typical peers, or a standardized curriculum to promote social skill generation.

Verbal Behavior (VB)

Based on the principles of ABA, Verbal Behavior teaches communication through connecting words to their function. Words are divided into four functions: echoics, mands, tacts, and intraverbals.

The post Therapeutic Interventions appeared first on The Autism Community in Action.

In this article, we will discuss causes of selective eating and measures to correct it. Then, we will offer tips to get your child to try more foods.

What Causes Picky Eating?

If we understand what causes picky eating, then we can begin to address these issues and start to reverse the problem.

Sensory Problems

Many of our kids only like a certain texture, color or temperature food. However, once the following medical issues are addressed, this problem often resolves. A full work-up by a functional medicine doctor can help you identify what is causing the sensory problems.

Delayed Oral Motor Function

This can present as an aversion to textures or even gagging on foods. Kids with this problem may have difficulty moving food around their mouth causing them to be fearful about trying new foods. At least one in three children with autism has significant movement difficulties according to a 2019 study.

When there is difficulty with oral motor function, kids tend to want to drink their meals instead of chew them because it is easier. This is the child that wants to drink milk for every meal.

Feeding therapy and occupational therapy are both helpful in this instance.

Problems Swallowing

When this is the case, kids will gag on foods. This may be due to many things including:

• A developmental delay in swallowing
• Mitochondrial Dysfunction
  • It is well established that kids with autism have much higher prevalence of mitochondria that is not working at optimum levels. This affects many aspects of the body, including chewing properly, swallowing and digestion.
• Eosinophilic Esophagitis (EoE)
  • This is an autoimmune disorder where white blood cells attack the esophagus causing inflammation and sometimes pain. There is a strong correlation between picky eating and GI disease including EoE. Kids that have EoE may have problems with eating, swallowing, food getting stuck, abdominal pain or gaining weight. Or they may be completely asymptomatic.
  • See this article titled, Kids with EoE often mislabeled Picky Eaters. Since immune dysfunction is common in autism, EoE is found many kids with autism.
  • The only way to diagnose EoE is with an endoscopy and biopsies. Make sure that the gastroenterologist you chose is an expert in eosinophilic esophagitis and that he/she uses TIGERS/AGREE protocol for diagnosis and treatment. You can find a list of qualified doctors here.
• Problems swallowing can also be due to other medical issues. Be sure to see a qualified gastroenterologist.

Pain

Picky eating can be a self-taught behavior in response to pain. Kids learn to be wary of food very quickly if eating food is associated with pain. According to this study, children with diseases of the upper gastrointestinal tract are more likely to develop feeding problems.

Sources of pain can include:

• Gastroesophageal Reflux Disease (GERD)
  • See this paper titled: Dietary Habits and Gastroesophageal reflux disease in preschool children.
  • An endoscopy can tell you if GERD is a factor in your child’s picky eating. This link is a good overview of what to expect from the scope.
• Constipation
  • When the child is constipated, he or she feels full and doesn’t want to eat. In addition, constipation is extremely painful.
  • A child may be having bowel movements every day and still be constipated so the only way to rule constipation in or out, is with an abdominal x-ray.
  • More information on constipation in autism found here.
• Tooth pain
  • A child may be having tooth pain. If they cannot communicate pain, they will have no way to tell you.
  • Get a pediatric dentist on board that knows how to help special needs children. Patience and practice with brushing, flossing and regular dental visits is a good way to make sure your child does not have tooth pain.

Mineral Deficiency

Mineral deficiency is a problem in many kids with autism and will only continue to get worse with continued selective eating. See this paper titled Macro- and MicroNutrient intakes in picky eaters: A Cause for Concern which tells us that intake of zinc and iron are below recommended levels in picky eaters.

Supplementing zinc can be particularly helpful. The major zinc protein in saliva is called gustin. Gustin influences your sense of taste. Because of this relationship between zinc and taste, and because taste and smell are so closely linked in human physiology, impaired sense of taste and smell are common symptoms of zinc deficiency.

Juicing fresh vegetables and fruits may be a solution to get active enzymes, vitamins and minerals into your child. You can start by syringing the juice into their mouth little by little.

Cerebral Folate Deficiency

Recent science has shown that some kids with autism may have a disorder called Cerebral Folate Deficiency which occurs when the folate in the blood is normal, but the folate in the brain is too low. This can cause many developmental problems including picky eating.

Properly treating CFD can make a difference in eating habits.

Find more information on CFD here.

Candida (Fungal) Overgrowth

When there is a fungal overgrowth in the GI tract, it can cause the child to crave grains, carbohydrates and sweets. These foods feed the pathogens and make the child less likely to want other types of foods.

The kid that craves bread, crackers, cookies, and sweets is probably dealing with fungal overgrowth in the gut.

See our article on yeast for more information on how to deal with it.

Food Sensitivities and Food Addiction

Yes! Our kids can actually be addicted to certain foods.

Sadly, most of the time, kids tend to crave the foods that they should not be eating.

Gluten and casein are very long chain peptides that are difficult to break down. If the child has intestinal permeability, also known as leaky gut, these large proteins are passing into the bloodstream where they react with opiate receptors. This makes the child want more of the food they are addicted to.

Addiction to particular foods may also happen because the child is eating foods that has highly addictive ingredients such as glutamic acid in the form of monosodium salt (MSG). This is why Doritos are so addictive. The brain is craving the MSG in them like a drug. Other top foods that have MSG are Ramen Noodles, Pringles, many seasonings and even deli meats.

PANS/PANDAS

PANS/PANDAS occurs when strep or other triggers such as Lyme or viruses trigger a misdirected immune response which results in inflammation in the brain. Two of the biggest symptoms are OCD and/or selective eating.

More information on PANS/PANDAS can be found here.

Take-Aways

Related Articles

Top Reasons to Implement a GFCF Diet

The post Picky Eating and Autism appeared first on The Autism Community in Action.

Only well-qualified, trained professionals can issue an autism diagnosis. The American Psychiatric Association has outlined diagnostic criteria for autism in its Diagnostic and Statistical Manual of Mental Disorders (DSM).

In the most recent version of the DSM, the DSM-5, autistic disorder, pervasive developmental disorder-not otherwise specified (PDD-NOS), and Asperger syndrome were consolidated under one diagnosis of “autism spectrum disorder.” In addition, the DSM-5 now requires healthcare providers to categorize individuals into “severity levels” to help identify their support needs.

Below you will find the diagnostic criteria for autism spectrum disorder under both DSM-5 and the DSM-IV.

DSM-5 Diagnostic Criteria for ASD

1. Persistent deficits in social communication and social interaction across multiple contexts, as manifested by the following, currently or by history (examples are illustrative, not exhaustive; see text):
   1. Deficits in social-emotional reciprocity, ranging, for example, from abnormal social approach and failure of normal back-and-forth conversation; to reduced sharing of interests, emotions, or affect; to failure to initiate or respond to social interactions.
   2. Deficits in nonverbal communicative behaviors used for social interaction, ranging, for example, from poorly integrated verbal and nonverbal communication; to abnormalities in eye contact and body language or deficits in understanding and use of gestures; to a total lack of facial expressions and nonverbal communication.
   3. Deficits in developing, maintaining, and understanding relationships, ranging, for example, from difficulties adjusting behavior to suit various social contexts; to difficulties in sharing imaginative play or in making friends; to absence of interest in peers.
2. Restricted, repetitive patterns of behavior, interests, or activities, as manifested by at least two of the following, currently or by history (examples are illustrative, not exhaustive; see text):
   1. Stereotyped or repetitive motor movements, use of objects, or speech (e.g., simple motor stereotypes, lining up toys or flipping objects, echolalia, idiosyncratic phrases).
   2. Insistence on sameness, inflexible adherence to routines, or ritualized patterns of verbal or nonverbal behavior (e.g., extreme distress at small changes, difficulties with transitions, rigid thinking patterns, greeting rituals, need to take same route or eat same food every day).
   3. Highly restricted, fixated interests that are abnormal in intensity or focus (e.g., strong attachment to or preoccupation with unusual objects, excessively circumscribed or perseverative interests).
   4. Hyper- or hypo-reactivity to sensory input or unusual interest in sensory aspects of the environment (e.g., apparent indifference to pain/temperature, adverse response to specific sounds or textures, excessive smelling or touching of objects, visual fascination with lights or movement).
3. Symptoms must be present in the early developmental period (but may not become fully manifest until social demands exceed limited capacities, or may be masked by learned strategies in later life).
4. Symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning.
5. These disturbances are not better explained by intellectual disability (intellectual developmental disorder) or global developmental delay. Intellectual disability and autism spectrum disorder frequently co-occur; to make comorbid diagnoses of autism spectrum disorder and intellectual disability, social communication should be below that expected for general developmental level.

• Note: Individuals with a well-established DSM-IV diagnosis of autistic disorder, Asperger’s disorder, or pervasive developmental disorder not otherwise specified should be given the diagnosis of autism spectrum disorder. Individuals who have marked deficits in social communication, but whose symptoms do not otherwise meet criteria for autism spectrum disorder, should be evaluated for social (pragmatic) communication disorder.
• Specify if:
  • With or without accompanying intellectual impairment
  • With or without accompanying language impairment
  • Associated with a known medical or genetic condition or environmental factor.
    Coding note: Use additional code to identify the associated medical or genetic condition.
  • Associated with another neurodevelopmental, mental, or behavioral disorder.
    Coding note: Use additional code[s] to identify the associated neurodevelopmental, mental, or behavioral disorder[s].
  • With catatonia (refer to the criteria for catatonia associated with another mental disorder for definition).
    Coding note: Use additional code 293.89 [F06.1] catatonia associated with autism spectrum disorder to indicate the presence of the comorbid catatonia.

Severity Levels for Autism Spectrum Disorder

LEVEL 3: Requiring very substantial support

• Social Communication:
  Severe deficits in verbal and nonverbal social communication skills cause severe impairments in functioning, very limited initiation of social interactions, and minimal response to social overtures from others. For example, a person with few words of intelligible speech who rarely initiates interaction and, when he or she does, makes unusual approaches to meet needs only and responds to only very direct social approaches.
• Restricted, Repetitive Behaviors:
  Inflexibility of behavior, extreme difficulty coping with change, or other restricted/repetitive behaviors markedly interfere with functioning in all spheres. Great distress/difficulty changing focus or action.

LEVEL 2: Requiring substantial support

• Social Communication:
  Marked deficits in verbal and nonverbal social communication skills; social impairments apparent even with supports in place; limited initiation of social interactions; and reduced or abnormal responses to social overtures from others. For example, a person who speaks simple sentences, whose interaction is limited to narrow special interests, and who has markedly odd nonverbal communication.
• Restricted, Repetitive Behaviors:
  Inflexibility of behavior, difficulty coping with change, or other restricted/repetitive behaviors appear frequently enough to be obvious to the casual observer and interfere with functioning in a variety of contexts. Distress and/or difficulty changing focus or action.

LEVEL 1: Requiring support

• Social Communication:
  Without supports in place, deficits in social communication cause noticeable impairments. Difficulty initiating social interactions, and clear examples of atypical or unsuccessful responses to social overtures of others. May appear to have decreased interest in social interactions. For example, a person who is able to speak in full sentences and engages in communication but whose to-and-fro conversation with others fails, and whose attempts to make friends are odd and typically unsuccessful.
• Restricted, Repetitive Behaviors:
  Inflexibility of behavior causes significant interference with functioning in one or more contexts. Difficulty switching between activities. Problems of organization and planning hamper independence.

The DSM-5 was published in May 2013.

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