Hidden
Medical Problems Can Cause Behavior Problems
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Dr.
Margaret Bauman and Dr. Timothy Buie at Massachusetts General Hospital have
worked with many autistic children. They both warn doctors, parents, and
teachers that hidden, painful, or distressful medical problems must be ruled
out before child is put on psychiatric medicines such as Risperdal. Some
doctors may not even bother to look for problems that would have been diagnosed
in a NORMAL child. They just assume that all behavior problems are caused by
autism. Dr. Buie, a pediatric gastroenterologist, explained that 24% of normal
children have distressful GI (gastrointestinal) problems. The rate in children
with autism is often much higher.
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At
the Autism 2008 Geneva Center Conference in Toronto, Dr. Buie we showed videos
of three young nonverbal autistic children with terrible behaviors that were
caused by non-obvious stomach distress. In the first video, a little girl
refused to sit still to do a task. She was in constant motion and would not
settle. She also had weird postures, and strangely, she did not hold her
stomach. In a second video, a child was refusing to lie flat and kept flinging
and flailing about. In the third video, there was severe self-injury and a
weird "saluting" posture.
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All
three children suffered from acid reflux (heartburn), the most common GI
problem. Although none of them expressed overt signs of GI distress, such as
constipation, vomiting, diarrhea, or touching/rubbing their stomach or chest,
their behaviors were a direct result of their severe discomfort. Being nonverbal,
their behaviors were their only means of communicating their discomfort. Some
of their body movements were, undoubtedly, their attempts to alleviate the pain
they felt. All three children greatly improved after they were treated for acid
reflux.
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Acid
reflux can be easily treated with over-the-counter medications such as Pepcid
(famotidine) or Prevacid (lansoprazole). Not allowing a child to lie down
immediately after eating, and raising the head of the bed to keep acid in the stomach
and prevent it from burning the esophagus, are other common remedies. If brown
stains are seen on the child's pillow, that usually is a sign of acid reflux.
Other signs include chewing clothing or other objects, or tapping the chest.
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Other Hidden Medical Problems
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Obviously
acid reflux is only one of the many physical issues that can cause behavior
problems, Other GI problems such as constipation or H pylori can also cause
pain. H pylori is the bug that causes stomach ulcers and it can be diagnosed
with a simple stool test and treated by your local doctor. I have also talked
to teachers and parents who reported that their child's behavior greatly
improved after an ear infection or a toothache was treated. A severe yeast
infection can also make? a child feel
terrible, and should be treated.
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Dr.
Bauman described other useful observations from her clinical practice with
hundreds of children with autism. She has observed that girls' behaviors are
often more likely to get worse at puberty than boys'.? I can really relate to this. When puberty
started, my anxiety and panic attacks exploded. Dr. Bauman has found that some
girls with autism have an imbalance between the hormones of estrogen and progesterone.
Treating the hormone imbalance improved behavior. This problem can be diagnosed
and treated by either a very good gynecologist or an endocrinologist.
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Temple
Grandin "The Way I See It: A Personal Look at Autism &
Asperger's" (2011)
