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Sunday, April 17, 2011

Seasonal Allergies and Autism

Autism and allergies go together like spring and running noses. Many ASD individuals that I have worked with have allergies of one sort or another - with some of the allergic reactions showing up in unusual forms. There are traditional reactions like itchy eyes, runny noses, congestion, rashes and asthma - but I have also met people who lose mental acuity, suffer temporary inability to process and use language, experience emotional lability (high giddiness, irritability, anger/aggression, depression), show heightened sensory reactions, and generally become a different person in their overall behaviour and interaction with the world.

I first observed this type of "seasonal disintegration" in my early work with Adam. When he was a very young boy, he was so generally disorganized (in his language, sensations and interaction with others), that any changes in behaviour and reactivity during certain seasons of the year were not noticeable. That changed as he began to learn to communicate and interact with the larger world. Suddenly, without any apparent warning, he seemed to go backwards in his skills. He was hand-flapping and toe-walking, going back and forth in front of the heater grid lost in the visual pattern, unable to use or understand words that he had been learning - he retreated entirely into his own world again. Understandably, all of the adults around him were very distressed, and we began to frantically change up his program, trying to bring back his earlier success. In a couple of months, he did seem to be back on track, and we moved on. But it kept recurring - every once in a while, he would apparently lose all of his hard-won skills.

At the same time, I was trying to unravel the more traditional allergy symptoms of my oldest son. A friend asked me to accompany her to a talk given by Dr. Doris Rapp, an allergy specialist who had expanded her traditional training to explore more unusual allergic responses and potential treatments. The talk was a revelation. She not only described the symptoms that my son had been experiencing since he was a baby, she also showed us videos of children who were showing the same types of temporary disintegration of mental and language abilities that we had been observing in Adam. I looked back through my notes, and discovered that Adam's "disintegrations" matched the same timeline as my eldest son's difficulty with congestion and breathing - and both patterns matched the population of people who are allergic to molds and mildew.

Over all the years since then, we have seasonally adjusted Adam's program each spring, and to a lesser extent in the fall. As he has gotten older, Adam himself is more aware of the days when he is suffering from his allergies. Here is a sequence of pictures that he drew this past fall on the topic, on a day that he was definitely not feeling well (this is the picture he is drawing in the photograph on the home page of our website):

As soon as the snow starts to melt, a type of mold is released and Adam begins to show signs of the seasonal change - he becomes a bit giddy, he laughs for no reason, it becomes difficult for him to follow verbal language. As the spring progresses, he has a harder time, especially on wet melting days - he becomes irritable and his sensory reactions increase - traditional allergy symptoms like running nose and congestion appear. On these days, we have found that we have to reduce the amount of verbal language we use with him, and he is less able to give us any type of verbal response. On the better days, written language is still usable, but it takes him much longer to process and formulate a response. Drawing, math and other sorts of visual activities seem to be much less affected, and during the wettest part of the spring, we go totally visual and subtract almost all language. Once the ground dries out in the sunshine, he is more himself again, although as the years have gone by, he has also shown reactivity to some other seasonal substances like certain pollens, so some parts of summer are also difficult. Winter is his most stable season, and he does the bulk of his new learning over the frozen months.

Allergies that are expressed in a behavioural way can be very difficult to diagnose. Traditional allergy testing involves a "scratch test" where substances are put below the skin, and the doctor looks to see which ones cause skin irritation. But what if the allergic response is not a skin irritation? My eldest son (who was eventually diagnosed with asthma) went through the scratch test, and nothing showed up as a skin bump - but during the airflow test that followed the scratch test (that exposed him to his allergens) he was barely able to breath. Similarly, I know of multiple ASD individuals who go through the skin testing, show no decisive bumps, but leave the allergy office spinning, flapping and melting down. So, a negative scratch test doesn't necessarily mean no allergies.

If you think that allergies are playing a possible role in your child's profile, I would highly recommend the book by Dr. Doris Rapp called "Is this your child?". She offers practical information that you can apply in the home environment to figure out what possible allergens may be giving your child difficulty. It's not an easy or quick process, but definitely worth the time and energy.


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