July 24, 2015

Seven Underlooked, Underlying Medical Conditions that Could Cause Extreme Behaviors in Severe Autism

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         1.  Chronic constipation causing intermittent abdominal pain

         2.   Reflex esophagitis  (you will see increased behavioral outburts during or shortly after ingesting food or drink).

       3.  Glutamate storm in brain. Elevated levels of glutamate can occur suddenly and spark a behavioral meltdown. You must work quickly to reduce the glutamate. Sometimes, glutamate spikes when the autistic person hasn't eaten, and blood sugar drops, so make sure they get snacks throughout the day. Natural ways to remedy a glutamate storm in brain: Take recommended dosages of Taurine, Magnesium, Zinc. However, during a behavioral crisis it's not so simple to say, "No sweat dear, let's give you some vitamins to calm your brain...." Uh, no. It often does not work so easily, as you find yourself on the floor trying to prevent your autistic child from biting himself or punching his head. That's why I
 wish every damn pill for autistic patients was a quick-dissolving- fast melt.

   4. Exaggerated cortisol (neurobiological stress hormone) response rooted in dysfunctional hypothalamic pituitary-adrenocortical (HPA system). What does this mean? It means the entire world, which is NOT autism friendly, is an antecedent to behavioral spikes in autism. For example, imagine you are out in public, and a screeching car alarm goes off and startles your autistic child triggering him to punch himself in the head. In a severely-autistic person with dysfunctional HPA system, the behavioral meltdown is more likely to have prolonged duration of elevated cortisol and slower recovery. The best way to immediately handle exaggerated cortisol is to let the autistic person walk or run fast (with 1:1 or 2:1 assist!) Do not continue to restrain them or start doping them up with more drugs that are going to further cloud their thinking and disrupt their homeostasis. Okay, somebody is reading this now going, "Well gosh, how can we do that in a hospital setting?" "Or school setting?" "Or when we're riding in a car?" Answer: It is difficult, but you find creative ways with the right level of support and staff, to do it. It would also be great to have fast melt B vitamins or Vitamin C at that point to help calm the system. Again, it can take a lot of staff during a behavioral crisis to keep the autistic person safe, especially when you are dealing with a 5'9 or 6'2' autistic adult who is twisting and turning, trying to hit or bite themselves. In order for them to receive PROMPT MEDICAL care they need adequate staffing and support.

5. Sleep Disorder rooted in a deviated septum or vibration or collapse of soft palate during sleep. In this case an autistic patient may wake up self-abusing due to the untreated medical condition.

6. Oxidative Stress causing abnormal methione metabolism and elevated levels of homocysteine. Elevated homocysteine works against NMDA receptors in the brain, which causes an imbalance of neuronal excitatory and inhibitory synapes which then causes psychosis. Can you imagine how terrifying this would be to an autistic person who can't communicate this is happening to them? No wonder we see such a desperate cry for help--- by self-abusing-- in some people with autism who may experience this.

7. Headaches or stomachaches caused by seizure or psych medications. This is a tricky one, given if you give, for example, an Alleve for SUSPECTED headache, but it turns out there is a tiny ulcer in the stomach causing pain, well, then you will see an increase in behavior because Alleve will not mitigate the stomach pain.



July 15, 2015

Treating Extreme Behaviors in Adults with Autism

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It's not everyday that you come across an article that makes you cry. Specifically, "Yes! Yes! Yes!" "So TRUE!" "Thank God someone gets it!"

I found the following article on the Interactive Autism Network at Kennedy Krieger Institute. Though it's written about autistic children, you can apply everything said here to adults with autism.

This is a must read for nurses, doctors and other medical personnel who do and will come into contact with non-verbal autistic patients exhibiting extreme behaviors:

Title of article: Diagnosing and Treating Extreme Behavior in Children with Autism.

Best article I've read in a very long time.

Every hospital should have an on call doctor who specializes in treating autistic patients. Sadly, few if any hospitals have a doctor on call who is trained in diagnosing non-verbal autistic patients. Even worse, few if any registered nurses or certified nurse assistants are given any training in how to handle non-verbal autistic patients with extreme behaviors. As a result, many autistic patients are ignored, overmedicated and sent home, everything blamed on their "autism." This is a serious mistake, as quoted from the below article....I agree. You can't just throw a bandaid on extreme behavior that is rooted in underlying medical issues causing pain. Giving pain medicine may temporarily help, but it's not treating the etiology of the pain.

Naturally, the big question remains HOW do you discern between behavioral self-injury and self-injury rooted in medical pain? As a mother who has lived with this behavior for over 20 years, the answer is ironically simple.

You know behavior is rooted in pain when the self-injury or aggression does NOT respond to what normally would quell the behavior. And you see an increase in duration and intensity that is OFF baseline behavior. You  may also see a look in the autistic person's eyes as if they are screaming silently, "Help me, help me, I'm in pain."

 Listen to what they are showing you with the increased extreme behavior. Don't blame increased extreme behavior on autism alone. Oversimplification of extreme increases in behavior do not equal proper treatment.