Autism and Asthma

Greetings Earthlings! 😀

Having just been officially diagnosed with asthma this week (after 23 years of uming and ahing about whether to diagnose as it’s been mild thusfar), I decided to do some investigating to see if there are any links between ASD’s and asthma.

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Did you know, that autists are 35% more likely to suffer from asthma than the general population?

Seemingly random, but true!

So what exactly is happening in the lungs of asthmatics?

Asthma is a chronic inflammatory disease of the airways in the lungs. Inflammation in the airways in response to triggers (such as allergens, cold air, tobacco smoke etc.) causes the airways to narrow and spasm, resulting in bouts of wheezing and shortness of breath- which I’m ironically experiencing as I write this *drags deeply on inhaler*.

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But how exactly are asthma and ASD’s intertwined? 

The exact cause of asthma, like autism remains unknown, however, it’s inflammatory nature may reveal it’s links to autism. A recent study suggests that there is a connection between inflammation and ASD’s. Post mortem examination of the brains of autists show that there are increased levels of the pro-inflammatory cytokine (a substance secreted by the immune system) IL-18 in the amygdala and the dorsolateral prefrontal cortex of the brain- areas where alterations are often linked to autism. Perhaps these increased inflammatory markers may predispose autists to the development of asthma. Moreover, research has shown that there is genetic overlap between asthma genes and multiple mental health disorders such as anxiety, ADHD and major depressive disorder (MDD) that are often co-morbid with autism, which could suggest a common genetic pathway for both asthma and autism.

In addition to the link between asthma and autism, recent research suggests that having a parent with an asthma diagnosis may slightly increase the risk of autism development. However, there are conflicting studies as to whether or not the use of asthma medications during pregnancy may increase this risk (although the most recent of these studies supports their use).

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Hope you enjoyed this post dear Earthlings! 😀

Have a lovely weekend!

Aoife

 

Autism and Trust

Greetings Earthlings! 🙂

This week I’d like to briefly talk about the issue of trust and autism.

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Trust is something that we all struggle with from time to time. In an increasingly disingenuous world, it can be tough to tell friend from foe. This is even more problematic for the autistic community.

Studies have shown that autists struggle to read facial cues for signs of trustworthiness in others. As an autist is so often transparent in their words and actions with their black and white thinking, it’s a struggle to comprehend that others may not be. For example, if an adult tells an autistic child a lie, they will usually believe them without question- after all, why would a grown up lie to you? Isn’t lying supposed to be bad? This is particularly worrying for an autist coming up against potential bullies and predators.

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I found this to be a problem during my school days. On the surface, my peers seemed nice to me. I thought many were friends, but I was unable to tell from their tones that they were mocking me and my eccentricities. It was only after the damage was done that I saw through the facade, which made it hard to trust my peers for a long time. When you see everything in black and white, it can be hard to discern that a smiling face may be a sarcastic sneer.

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But is there a biological reason for our trust issues?

Studies have shown that changes in the structure of the autistic brain can cause issues with trust. Changes in the ventral medial prefrontal cortex (the area that assesses social rewards) in people that tended to be more trusting of others, and changes in the amygdala (an area associated with memory and emotional responses) in both those who were more and less trusting of others appear to be linked to trust issues.

Moreover, as I’ve discussed in previous posts, oxytocin is a hormone that is thought to be associated with social behaviour, emotional attachment and trust. Multiple studies suggest that oxytocin levels are dysregulated in autists, which could explain our struggles when it comes to trusting others.

Hope you enjoyed this post dear Earthlings! 😀

Have a lovely weekend!

Aoife

Autism and Food

Greetings Earthlings! 😀

Following a recent report about a teenager who has been left blind from a restrictive diet of roughly 4 nutritionally lacking food items, this week I’d like to discuss the topic of food and autism.

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Did you know that feeding difficulties are estimated to occur in as many as 70 to 90% of children with autism?

It’s a shocking statistic!

People with autism are often described as selective or picky eaters, often favouring carbohydrates and highly processed foods while rejecting fruits and vegetables- but why is that?

Research has found that food issues in autism overlap with sensory sensitivities to taste, texture, colour  and smell. As such, autists will often actively avoid these foods to avoid adverse sensory reactions. In the animal kingdom, many species develop conditioned aversions to certain unpleasant tastes, associating them with danger and illness. As the autistic tongue is so sensitive, it’s thought that autists can also develop aversions to foods in this manner.

In my case, although my autistic traits are extremely mild, food continues to be an issue for me. Certain smells, tastes and textures in particular will make me want to throw up. Fruit and veg in particular have been troublesome on a sensory level- for example I love the taste of strawberry, but I can’t tolerate physically eating one due to the texture.

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It’s made things quite difficult at times when I’ve been out eating with friends to try to maintain a neutral expression when a foodstuff disagrees with my brain to avoid hurting someone’s feeling. A lot of the time it’s just easier to pretend that I’m not hungry to avoid an awkward social/sensory situation- pro tip, always keep snacks in your car/handbag.

Selective eating habits are commonplace for autists, however, serious food aversions can can be diagnosed clinically as avoidant/restrictive food intake disorder (ARFID), previously known as selective eating disorder (SED).

But is there any getting around these sensory issues?

CBT as with many other aspects of autism, cognitive behavioural therapy can help to change behaviours surrounding food over time.

Persistence- keep trying to build up your tolerance to certain textures/tastes. When I was younger, I could not stand to drink a glass of water as it felt so weird compared with other soft drinks. It was not easy to adjust to this texture at first  (I even had to swap shots of water for shots of orange juice to get it down! 😂), but I stuck with it, and now I drink several litres a day willingly 🙂

Prepare food in different ways- this has perhaps been the most helpful for me. Changing the way some foodstuffs are prepared/cooked can really impact the textural outcome. Smoothies have been particularly useful to help me achieve my 5 a day. I may not be able to eat the fruit itself, but throw it in a blender and bye-bye textural issues. Similarly, with apple tart, if the apples are too chewy, I find it extremely difficult to stomach, but if you bake the tart until the apples are soft and mushy I can’t get enough of it!

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Hope you enjoyed this post dear Earthlings! 😀

Have a good weekend!

Aoife

 

Autism and Stress

Greetings Earthlings! 🙂

Stress- it’s hard to escape it in the modern world; even more so for an autist.

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Ordinary day to day life can be very stressful to navigate. Such simple things as responding to an email, dealing with crowds, sensory triggers and social interactions can be completely overwhelming. The thought alone of these seemingly innocuous situations can be incredibly stressful for an autist.

In my case, just the mere idea of driving in Dublin city centre for example majorly stresses me out- I have genuinely told my friend that if his directions landed us there I would get my car towed and grab a taxi 😛 Any unexpected scenarios, detours or maneuvers in my car will leave me hot under the collar, praying out loud for help to keep from freaking out!

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But are there any scientific reasons why autists are more predisposed to stress?

Interestingly, autists show signs of greater biological stress than their neurotypical peers. In particular, studies have indicated that autists have higher levels of stress hormones than neurotypicals. As I’ve previously discussed, stress hormones such as cortisol and adrenaline are released in response to stressful situations from the hypothalamic–pituitary–adrenal axis or HPA axis. This is a complex interconnecting network that comprises the hypothalamus, the pituitary gland and the adrenal gland (i.e. HPA) to control our response to stress- a network that is hyperactive in autists.

Following exposure to a stressful situation, stress hormone levels should return to normal, however, research has shown that stress hormone levels tend to persist in autists, which can make us more susceptible to stress related outbursts and meltdowns. In other words, we’re constantly living in a state of fight or flight.

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Long term activation of the stress system can lead to a number of health problems such as poor mental health, weight gain, sleep issues, digestive and cardiovascular problems to name but a few- many of which are regularly comorbid with autism.

In addition to this, studies have shown that autists have higher levels of oxidative stress in the body. Oxidative stress occurs when there is an imbalance between anitoxidants and free radicals (unstable oxygen atoms that can damage cells causing illness and aging – not so fun fact, free radicals are thought to contribute to hair greying) in our bodies. Several studies have indicated that antioxidant enzyme levels that regulate free radicals in the body may be altered in autists. As such, oxidative stress has been linked to the appearance of autistic symptoms such as language delay in previous studies.

In addition, as with prolonged exposure to stress hormones, oxidative stress may also contribute to the development of cardiovascular disease and mental health problems such as depression. Worryingly, heart disease and suicide are among the leading causes of mortality for autists, with studies indicating that the average autist lives 16 years less than their neurotypical peers! 😲  In addition to this, research suggests that psychological stress may worsen the symptoms of ASDs.

Therefore, as for everyone, it’s very important for an autist to find ways to manage their stress levels for both their long term physical and mental health.

Hope you enjoyed this post dear Earthlings! 🙂

Have a lovely weekend!

Aoife

Auitsm and Echopraxia

Greetings Earthlings! 🙂

Leading on from my previous post on echolalia, this week I’d like to briefly discuss the phenomenon echopraxia.

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Yes I know, it’s another mouthful, but what exactly is echopraxia?

Echopraxia (also known as echomotism or echokinesis) is a type of tic disorder characterized by involuntary imitation of another persons actions e.g. waving a hand, touching your nose, kicking something, even facial expressions. Echopraxia is one of the core features of Tourette’s syndrome, however it has also been found to occur in ASD’s. It is often paired with echolalia, but it has been known to occur independently in autists.

I know what you’re thinking- imitation of actions is critical to early development in childhood and perfectly “normal” behaviour, so it seems like echopraxia might be reading into things too much. However, when this behaviour persists and becomes reactionary rather than a learning tool, then it can be viewed from a pathophysiological  perspective. As such, it can be very difficult to diagnose this behaviour in children. 

So what does the science have to say about echopraxia and autism?

There’s very limited research in this area, however experts believe that echopraxia is related to damage or dysfunction within the frontal lobe known as the action cortex of the brain- an area that is often implicated in autistic behaviours. Other’s have theorized that abnormalities in the mirror neurons located here may be responsible.

Nope, I’m afraid mirror neurons are not quite this exiting- mirror neurons are in fact a particular type of nerve cell that fires when a person or an animal acts and witnesses another person complete the same action. This type of behaviour has been particularly observed in primates, giving new meaning to the phrase ‘monkey see, monkey do’.

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In general, echopraxia is considered harmless, however if it starts to interfere with social functioning, then behavioural modifications, medications and psychotherapy are possible treatment options 🙂

Hope you enjoyed this post dear Earthlings! 😀

Have a lovely weekend!

Aoife

 

Autism and Eating Disorders

Greetings Earthlings! 🙂

This week I’d like to talk about a very common issue, particularly for women with autism- eating disorders.

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As discussed previously, mental health issues are quite prevalent among the autistic population. Because of this, many autists can go un-diagnosed as co-morbid mental health issues often mask the root autism diagnosis. This is particularly true of eating disorders for female autists where doctors will diagnose an eating disorder, but due to social masking tendencies will often overlook their autistic traits.

In fact this should really be one of the first things that doctors should assess when patients present with eating disorders as numerous studies have shown that there is a higher prevalence rate of autism in patients diagnosed with eating disorders (up to 20%). Evidence indicates that patients presenting with anorexia nervosa, bulimia nervosa and binge eating disorder (BED) have greater numbers of autistic traits than the general population.

Autists will often not benefit from conventional treatment for disordered eating so it is critical that it is identified early.

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So why are eating disorders so prevalent for those on the spectrum?

The reasons are varied, but tend to be either psychological or sensory related:

Psychological:

Some people on the spectrum develop eating disorders as a means to fit in, to attain the kind of figures that they see in magazines and perceive to be “perfect” or “normal”. Others develop eating disorders as a means of control, where the routine and rigidity can be a source of comfort to an anxious mind running on overdrive (interestingly this may have a scientific basis as starvation decreases levels of serotonin, which is heavily involved in anxiety and is often elevated in autism). Moreover, if exercise or particular foods become specialist interests, an autist may obsess and inadvertently develop a disorder as a result.

In some cases an eating disorder may be a simple matter of mind blindness where an autist simply does not understand that their eating behaviours are abnormal or dangerous.

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Sensory:

Sensory issues are commonplace for autists both with and without an eating disorder. An autist may be sensitive to different tastes, textures and smells which can make for a very restrictive diet depending on the severity. In some cases, eating may be so stressful that they may not eat very much at all to avoid an unpleasant sensory event.

For further information about autism and eating disorders you can check out the link below for advice and support:

https://www.bodywhys.ie/understanding-eating-disorders/key-issues/autism-eating-disorders/

Hope you enjoyed this post dear Earthlings! 🙂

Enjoy the weekend!

Aoife

Autism and Gait

Greetings Earthlings! 😀

This week I’d like to discuss another lesser known aspect of the spectrum- autism and gait.

As I’ve discussed previously, coordination issues are part and parcel with autism, however, what you may not know is that these coordination issues tie in with an autists gait- particularly for those with Asperger’s syndrome. In fact one of the lesser known diagnostic criteria in the DSM-V is that of an odd or unusual gait.

New technologies are even using gait analysis as an early means of detecting autism:

I know it seems an unusual trait, (let’s face it, we rarely notice a person’s walk) but researchers have observed that autists can have greater or even reduced step and stride length, increased step width, have unusual posturing, tend to walk on their toes, and are lacking in “motor smoothness” when compared with their neurotypical peers.

So why is an autists gait so unusual? What does the science have to say?

Thus far only a few studies have investigated the underpinnings of gait and autism (although the association has been known for decades), but as usual, the evidence points back to the brain. There has been a lot of debate as to which region is responsible for gait differences, however there is evidence to suggest that neurological alterations in the cerebellum (regulates motor movement) and the basal ganglia (a group of nerves involved in voluntary control of motor movements) in autists are the likely culprits.

Furthermore, those autists who tend to toe walk can develop a leg length discrepancy which can also contribute to their odd gait. Gait issues such as this can have a negative impact on the body as this can shorten your Achilles tendon.  Research shows that children with ASD’s tend to have a reduced range of motion in the knee and ankle when walking which may imply weakness around these joints.

It’s not all bad news however, as special orthotics can be used to help improve some of these issues.

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Hope you enjoyed this post dear Earthlings! 🙂

Have a lovely weekend!

Aoife

Pica and Autism

Greetings Earthlings! 🙂

This week I’d like to briefly talk about an aspect of the autistic spectrum which you may not be familiar with- pica.

So what exactly is pica?

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No not that guy! 😛

Pica is a type of eating disorder where a person has an appetite for things that are not considered to be food such as dirt, dust, chalk, hair etc.

It’s often seen in pregnancy however, almost 25% of autists display signs of this behaviour.

Thankfully I’ve never really had any weird cravings like that, however as I child I did like to eat toothpaste on occasion…what can I say Aquafresh just looked too much like sweets!! 😛

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Those red, white and blue stripes were just too tempting! I even think I used to recreate this Werther’s Original ad in the mirror pretending the toothpaste was the sweet! 😂

Anyway less of my weirdness, back to pica!

Joking aside, pica can be very serious if the substance that is ingested is toxic such as lead or if the item can cause an intestinal obstruction like hair ingestion.

So what does the science have to say? Why is this behaviour found in autism?

There does not seem to be one uniform cause of pica, however, pica has been associated with nutrient deficiencies (such as iron) and is thought to be the body’s subconscious way of replenishing the missing nutrients, which would be consistent with the often restrictive nature of an autists’ diet.

It’s also thought that pica may be a sensory response to stimuli in autists to relieve stress, anxiety, pain and discomfort or the item simply has a pleasurable texture. Pica may equally be interpreted psychologically as a means of seeking attention.

Science aside, experts say that the cause of pica may simply be that the autist is unaware that they are eating an item that is unconventional/unsafe.

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That’s all for this week Earthlings, hope you enjoyed this post! 😀

Have a great weekend! 🙂

Aoife

Autism and Change

Greetings Earthlings! 🙂

David Bowie: “Ch-ch-ch-anges-”

Autism: NOOOOOOOO!

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Yes, this week we’re going to talk about autism and change! 😂It’s a well known fact that autists do NOT like change. We like routine, structure, predictability- we like to be in control.

Historically, I’ve never been the greatest with change. As a child I went into a full-scale meltdown when the school banned chocolate (it’s pretty hilarious when I picture my 11 year old self wailing “I’m a chocoholic!” at the teacher!😂), I couldn’t sleep for 2 weeks after my sister changed the angle of her bed; worse still when we sold my family home, it took years to get my head round the loss. Sure, it may have only been 4 miles up the road, and I still went to the same school, but this one simple shift was as if a ton weight had been dropped on my fragile, pubescent head.

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New things can be a lot more complicated for an autist than the average person. You have to consider the sensory implications- how might a new smell affect you; will the taste of this new food make you sick; will this new top make you want to rip off your own skin? Last year I tried paint-balling for the first time without pausing to think of any potential sensory issues. The noise of the guns, the overpowering smell of the mask, the pain when I got hit- I was completely overwhelmed! I had to be removed within 10 mins after having a meltdown behind a tree! At least I drove myself there so I could make a quick escape to the PS4 to shoot things from the safety of my couch instead 😉

It’s not that an autist is not capable of change, it’s just oftentimes it can be a lot easier to stick with the status quo for fear of the unknown.

If it ain’t broke, don’t fix it! I know I like a particular dish at a restaurant, so why would I rock the boat and risk an adverse sensory reaction?

That being said, here are some tips to cope with change:

Take baby steps- you’ve got to learn to crawl before you can walk. Make small changes in your life and you’ll gradually learn to cope with bigger ones.

Challenge yourself- Setting goals to change something in your life can be a great motivator. Choosing to make a change on your terms can help to prepare you for the unexpected changes that life likes to throw at us.

Do the research– for any impending changes, take the time to educate yourself. If moving to a new place, familiarize yourself with the area- check out the amenities, the bus routes, use google street view to digitally walk around etc. The more you know about it, the sooner it becomes familiar which ultimately feels like less of a change.

Rewards and bribery– not always the best plan but it can help to incentivise behaviour change! As I’ve discussed previously, bribery worked to help me change my study habits as a teenager by trading hours of study for hours of gaming!

You can read more tips for coping with change in the link below:

https://www.autism.org.uk/about/behaviour/preparing-for-change.aspx

But might there be a scientific explanation for our struggles with change?

In 2017, researchers discovered that the posterior cingulate cortex of the brain is associated with changes in routine behaviour. As of yet this area has not been extensively studied, however the research would suggest that there is some level of dysfunction taking place in this cortex in the autistic brain. Current evidence indicates that there is poor connectivity, reduced metabolic activity and structural changes at the cellular level in the neurons within this region.

No wonder change is difficult if your brain is actively fighting against you! Perhaps the real change that is needed is our attitude towards an autists struggles with change; maybe then change won’t be so scary after all 🙂

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Have a good weekend Earthlings! 🙂

Aoife

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