Many years ago, a child with autism taught me everything I needed to know about autism and Gastroesophageal Reflux Disease (GERD). Joey had GERD from infancy and his family struggled like so many families I know to help him to eat, sleep and grow. A special diet and medication eventually calmed the reflux and his digestive system was greatly improved by the time he was one year of age. On occasion, his mother would note some burping, picky eating and backwashing but Joey was weaned off his medication and seemed to be thriving. We talked on a regular basis during that first year and then I did not hear from his mom for a while.
During the toddler years, there were new worries. Joey had terrible tantrums that came out of no where and seemed to go on forever. He had difficulty communicating and preferred to spend time alone rather than interacting with his loving family. Eventually Joey was diagnosed with Autism Spectrum Disorder or autism. Speech therapy and early intervention services filled their days. In addition to the daily tantrums, Joey was becoming a very selective eater and would only eat about five foods and only took liquids from a bottle. Then Joey started waking up at night and crying and carrying on for an hour or more before he would calm down and go back to sleep. In desperation, Joey was taken to a neurologist who told his mom to throw away the bottles and prescribed anxiety medication to help with the tantrums and night waking.
Joey's mom called and we talked about all of the symptoms and worries she had-the tantrums, the poor sleep, his picky eating and inability to communicate his wants and needs or tell her what was wrong. During the conversation, she told me that she had not followed up with the gastroenterologist in a long time since treating the autism became the focus of their energy. I suggested that she return to the gastroenterologist for advice on his symptoms and to decide on a course of action.
A few weeks later, I heard from Joey's mom again. The gastroenterologist put Joey on a two week trial of reflux medication and Joey's tantrums had decreased in intensity and he was sleeping through the night 4 out of 5 nights. And best of all, he had learned three new words. Needless to say, Joey's mom was thrilled that they had gotten to the root of his problem and the treatment had helped him in so many ways. He was still a picky eater and it would be months before the bottle was exchanged for a cup. Joey still had autism. However, now his doctors and therapists had vital information that would help them to understand his behavior and provide the treatments he needed.
Joey taught me:
· GERD does not cause autism.
· Digestive discomfort may cause behavioral changes in a child with autism.
· Digestive conditions such as GERD may cause a worsening of the symptoms associated with autism such as tantrums, poor self regulation, sleep and picky eating.
· GERD and other digestive conditions may be misdiagnosed or under diagnosed in a child with autism. Doctors and parents must engage in some challenging detective work to sort through layers of behavior and symptoms.
· A child with autism has communication limitations that may impact his/her ability to identify the source of pain and discomfort such as heartburn, throat pain or a stomach ache.
· Children with Autism Spectrum Disorders need to have GERD and digestive issues diagnosed and treated whether or not the treatment improves behavior, learning or communication skills.
· GERD treatment may improve sleep, self regulation, communication, behavior and decrease anxiety and tantrums.