Using Diet Therapy in the Treatment of Children Diagnosed with Autism

Your Questions and Answers

What is diet therapy?

It is using diet and nutrition as therapeutic tools. When done correctly, it makes other interventions more effective, has no side effects, and may diminish the need for drug treatments.

What benefits could I expect?

It depends on your child's age, degree of impairment at the outset, and compliance with all pieces of an intervention. The diet is not a magic cure; it requires full commitment, but benefits are worth it for many families. Typically improvements emerge across several areas: Bowel function, potty training, eating behavior, self-care, sleep, hyperactivity, eye contact, aggressive or injurious behavior, perseverance/rigidity, language skills, and social skills. Sensory sensitivities may diminish as well.

How do I know if my child needs this?

Aside from Autism Spectrum Disorder diagnosis, typical signs that diet intervention would help are: pallor, gray circles under eyes, excessive drooling, eczema, diffuse rash on the shoulders or limbs, white dots on nails, cracked or peeling nails, gray coated tongue, bright pink/red tip of tongue, red ears, cracks or red rash around lips, anal itching, frequent ear infections or colds, chronic constipation and/or unformed wet stools, stools that are foamy, mucousy, stringy, glossy, gold, green, or foul smelling; bloating, reflux, hiccups, and rigid eating pattern.

I keeping hearing and about "gluten" and "casein". What are those?

These are proteins in wheat and milk. Research suggests they are not digested normally in most persons with autism, but are broken down into compounds, which act like opiates, which are addictive and destructive to developing brain tissue. Many people with autism show some improvement when these two dietary proteins are omitted.

It didn't work for us. Why not?

Removing gluten and casein alone is rarely sufficient to get an excellent result. In autism, there can be many complex nutrition issues that need correcting. Professional assessment and treatment of these will increase your child's odds for success. There may also have been gluten or casein in medications, chewable vitamins, or some foods you gave your child. Even trace amounts of these can impede progress.

What other things need correcting, usually?

Many of these kids also have multiple food allergies and/or malabsorptive syndromes that have never been properly diagnosed. A skin prick test (RAST) for food allergy will not completely reveal a child's true reactivity to foods. A good delayed food allergy test will uncover the child's real food allergies. Antigenic foods will impede progress towards wellness. A tailored diet based on elimination allergic foods helps immensely the autistic child. Though delayed food allergies are common in kids with autism, each child is different as well as the foods, and the diet intervention must be tuned to individual child.

If changing the diet works, why aren't my child's doctors telling me to do it?

No parent takes a child to a nutritionist for a brain scan or to a neurologist for chronic constipation. The neurologist, pediatricians, psychologist, occupational therapists, and behavior therapists, have no nutrition care training. It is professionally delinquent of them to instruct you in a therapeutic diet. It is also a relatively new approach and very little has been published about it in the journals they trust. For expertise, approach a DAN physician who understands the impact of diet on autism.

How long does it take to work?

A 6-month trial is advisable before giving up. This means six months of strict adherence to all pieces of the intervention designed for your child, which may include gluten and casein restriction, medications for intestinal disease, supplements or supplemental formulas, or avoidance of identified antigens. Expect slower progress for kids over age four, when eating known antigens, when he eats "a little" gluten or casein, or where gut function remains unassessed.

What are the safety concerns with this diet?

If your child is on medications for seizures, mood, depression, sleep or behavior, professional guidance is a must. Though this new diet can ultimately diminish the need for medications, transitioning onto it can be tough. Spikes in seizure activity can occur when gluten or casein are first withdrawn. An initial hard withdrawal period usually bodes well for success - but careful monitoring is necessary though this "withdrawal" period. Children on gluten and casein restrictions also need supplementation, and safe doses of supplements must be laid out for your child's weight.

How do I know if it is working?

Good signs include a change in stools for the better (formed brown stools 1-2/day); increased calmness and eye contact; diminished hyperactivity; loss of bloating/reflux/hiccups and picky eating behaviors; transient regression into tantrums or autistic features; headache or a spike in seizure activity. Once this withdrawal phase is passes, new developmental milestones usually emerge in a progression, though not as quickly as one sees in a typical infant.

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