Medical Red Flags of Autism

Sheri Marino MA, CCC-SLP

Sheri Marino MA, CCC-SLP

Former Director, Pediatric Health Initiatives | BIO

autism information Experts are identifying common comorbid medical conditions (conditions that are often seen in children with autism) that increase the complexity of autism. Many of these disorders can be identified well before the developmental markers of autism become obvious. Therefore, if early signs of the common comorbid medical conditions coexist with developmental markers in infancy or young childhood, perhaps these children should be identified as a vulnerable population or at-risk for autism.

Autism information included in this article, click one to skip ahead. . .


Seizures

According to The National Institute for Neurological Disorders and Stroke, about 20-30% of individuals with autism will develop epilepsy by adulthood. Frequently, young children with autism have subclinical seizures which have no symptoms. Symptoms of simple-partial seizures may be mild, such as eye-gaze, auras, a brief increase or decrease in muscle tone, or unusual sensations effecting the 5 senses. It is easy then to understand how these symptoms may be overlooked in a young child by both parents and physicians. If you have concerns that your child may exhibit any of theses signs or other signs of seizures, it is best to speak to your pediatrician and ask for a referral to a pediatric neurologist.

Gastrointestinal Disorders

GI disorders are the most common comorbid medical condition of autism. Studies show that 70% of children with ASD have some type of gastrointestinal disorders that can include:
  • GERD (gastroesophogeal reflux disease)
  • Constipation
  • Irritable bowel
  • Motility issues
  • Gastritis
GI disorders in children with ASD are difficult to recognize and treat due to communication impairments. Infants, still unable to communicate, are particularly difficult to diagnose. Early signs of gastrointestinal distress can be observed in irregularity of bowel movements, diarrhea, or constipation. Infant reflux or “spitting up” is very common however sometimes this condition can actually be gastroesophogeal reflux (GERD). GERD is a more serious and painful condition that can cause damage to the lining of the esophagus due to high acidity in stomach contents. It is important to note that GERD can be present without “spitting up” and therefore irritability from the pain may be a more obvious symptom. For individuals of all ages, reflux is also exacerbated when lying down. Therefore individuals who have trouble sleeping can be showing signs of pain from GERD. Signs of GERD include, frequent spiting up (can be yellow or green fluid), vomiting, blood in the stool, difficulty gaining weight, sleep disturbances and others that can include behavioral reactions to the pain. Watch your child for an increase in behaviors that can include applying pressure on abdomen, leaning over furniture to press on belly, and hitting sides, chest or chin. Often these behaviors are misinterpreted as self-injurious behaviors when actually they are an indication of GI pain or reflux.
  • GI Issues

    Common GI Disorders in Autism

    Gastrointestinal disorders are often overlooked by parents and professionals because of communication impairments and may lead to aggressive and self-injurious behaviors.

    read more about GI disorders in Autism

Watch your child for an increase in behaviors that can include applying pressure on abdomen, leaning over furniture to press on belly, and hitting sides, chest or chin. Often these behaviors are misinterpreted as self-injurious behaviors when actually they are an indication of GI pain or reflux. Talk to your pediatrician about symptoms, however, if GI symptoms persist, ask for a referral to a pediatric gastroenterologist.

Food Allergies and Sensitivities

Research suggests that 36% of children with ASD have food allergies. Allergies are an inflammatory response of the immune system to defend the body against irritants. Allergies can be genetic, especially in families that tend to have a history of eczema, asthma and seasonal allergies. Food allergies can cause gastrointestinal issues as well as irritability and pain which could exacerbate behavioral responses.
“Early signs of food allergies in infants can be bloody stools, vomiting, diarrhea, fussy or erratic behavior, and arching of the back. After one year of age, swelling and hives can develop.” Dr. Raffi Tachdjian, Allergy/Immunologist of The Autism Think Tank
Other signs of potential allergies or food sensitivities include dark circles under the eyes and red ears. Children with ASD are commonly reactive to cow’s milk (casein) and wheat, nuts, eggs, and soy, however, allergy testing should be considered across a broad spectrum of allergenic foods if allergy or sensitivity is suspected. A consultation with a board certified allergy/immunologist is recommended if you suspect food allergies.
  • GI Issues

    Autism, Allergies and the Immune System

    Individuals with ASD are often medically complex, and being aware of early allergy signs and symptoms, as well available treatment options, can help to provide relief and promote overall wellness.

    read more about allergies in Autism

Eczema, an atopic dermatitis, most often has an allergy basis and is very common in children with ASD. Children with eczema frequently have food allergies, and food triggers can cause flare-ups. Dr. Tachdjian says, “Much like a nickel or make-up allergy, eczema can have an immediate or delayed response and throw a parent off by not correlating in time with a possible food trigger.” Eczema causes itching and discomfort, so it is important to consult your pediatrician if you notice eczema patches on your child. If eczema spreads or flare-ups are noted in response to certain food triggers, it is best to consult with a pediatric allergy/immunologist.

Ear Infections

While research shows only a slightly higher risk, parents frequently report their child with ASD had frequent bouts of ear infections. Ear infections can be a weakness of the immune system referred to as immunodeficiency. Frequent ear infections can cause speech and language delays as speech sound frequencies cannot be perceived normally. Signs of ear infections in infants can include irritability, poor appetite and sleeplessness. It can also cause physical symptoms such as red ears, vomiting and diarrhea. Children with ASD may not perceive pain the same way as neurotypical children and may not show behavioral signs such as irritability or crying from pain. Therefore, it is important to recognize the physical signs. If your infant or young child has frequent ear infections, ask your pediatrician for a referral to an immunologist and ear, nose and throat specialist.

Return to:

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Other Autism Red Flags:

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Sheri Marino MA, CCC-SLP

Former Director, Pediatric Health Initiatives

Sheri is a pediatric speech and language pathologist with over 25 years of clinical experience specializing in autism. As the former Director of Pediatric Health Initiatives for the Focus for Health Foundation, Sheri contributed her clinical expertise authoring articles on autism and other chronic health issues and also managed the pediatric health grantees. Sheri’s professional experiences helped guide the Foundation’s mission addressing chronic health issues related to environmental causes from 2014 through 2019. Sheri also serves as the Executive Director of The Autism Think Tank, NJ, a non-profit organization which offers medical videoconferences with a team of renowned medical experts who collaborate on medically complex cases of autism around the globe. She is the founder of Rocking Horse Rehab, a pediatric rehabilitation and family wellness center specializing in therapy services for children with various disabilities including, autism, cerebral palsy, spinal muscular atrophy, brain tumors, and rare syndromes, neuromuscular and psychiatric disorders. Sheri has been featured on CBS News, NBC News, NJN and multiple cable networks.

8 Comments

Mark Logan

I’ be been dating this woman for the past 3 years off and on; only because we can’t make the final connection necessary to execute cohabitation. It was recently brought to my attention that she may be an adult victim of autism.

Her granddaughter seems to be touched by this disease and the hereditary line stops with my girlfriend. She has often told me of her shy youth; where she couldn’t hear presumably due to ear infections as a youth where she was not monitored very closely. She says she didn’t speak until the age of 11yrs and not complete sentences until 15. Her selfishness and intolerance of activity were signs but until her recent bout with an connective tissue autoimmune diagnosis did I start to piece things together. My question is this: if she were to take the blood test and be a carrier, is there any medications that are available to help her cope? Truth be told I love this woman with all my heart; and even though she may need to chase life’s dreams without me, I want her happiness above all else. Any direction is appreciated.

Reply
Jayden

Many people who are autistic, have a harder time detoxing things like mercury containing thimerosal (which deletes a very important antioxidant glutathione) & aluminum. You can do a test thru a company online, 23 & me, to check for any MTHFR gene mutations, which will help determine what kind of specialist she needs to do to. Unfortunately, it seems not just any doctor is qualified to help with autism & as I don’t have anyone close to me with it, I can’t tell you much more. However, there is a Facebook group called “Healthy Mothers Questioning Vaccines” (not just for women) and many have children on the autistic spectrum & could point you to someone in your area that could help. They are an amazingly compassionate group of caring people with a wealth of resources & the desire to help! Even if you don’t have a Facebook, it’d be worth it to create one to get in touch. Through detoxing & working with qualified naturopathic & holistic doctors, many have helped reverse & almost eliminate the symptoms in their kids.

Reply
Rebecca Graham

I am very concerned about my Grandson, age 7 not being able to complete simple tasks requested of him. He says he is confused. He also is hyper-sensitive to noises and covers his ears allot, plus cannot make eye contact and lots of repeating. His parents say these symptoms have been presented to his MD and he was prescribed a med for ADD which is NOT working. It hurts my heart to see him struggle with almost everything. Can someone help me convince my son (his Dad) to get a 2nd opinion?

Reply
Jayden

Many people who are autistic, have a harder time detoxing things like mercury containing thimerosal (which deletes a very important antioxidant glutathione) & aluminum. You can do a test thru a company online, 23 & me, to check for any MTHFR gene mutations, which will help determine what kind of specialist she needs to do to. Unfortunately, it seems not just any doctor is qualified to help with autism & as I don’t have anyone close to me with it, I can’t tell you much more. However, there is a Facebook group called “Healthy Mothers Questioning Vaccines” (not just for women) and many have children on the autistic spectrum & could point you to someone in your area that could help. They are an amazingly compassionate group of caring people with a wealth of resources & the desire to help! Even if you don’t have a Facebook, it’d be worth it to create one to get in touch. Through detoxing & working with qualified naturopathic & holistic doctors, many have helped reverse & almost eliminate the symptoms in their kids.

Reply
len

I am a general education preschool teacher and have a 5-year-old student I have concerned about. I have read the signs and symptoms of autism , and this child doesn’t seem to demonstrate them. However, I notice that he always needs to be holding something specifically a toy when coming to class and cannot part from it. He is also having difficulty on self-regulation. Transition is hard for him. He usually runs off when the rest of the group are already gathering together for the next activity or transition from outdoor to indoor. He is putting me in a difficult situation of being with the group and just waiting for him to come which takes forever , or leaving the group and getting him. Do you think he has autism, slightly might be?

Reply
Focus For Health Team

It’s difficult to assess whether or not this child is on the autism spectrum, however your observations are excellent. Self-regulation is a broad topic but generally has a root in sensory integration issues which are common in ASD. Attachments to inanimate objects in the way you describe can be a red flag as can the tendency to play in isolation. These can all look like red flags but can also be completely normal which is why autism is tough to diagnose at too young of an age and also underdiagnosed in high functioning kids. I don’t know the protocol for reporting concerns in your school but I would check with your administration so he can get help if he needs it.

Reply
MK Austin, PA, MPH

Hello … please review your information in the section on “ear Infections”: the sentence “It can also cause physical symptoms such as RED EARS”(paraphrased) needs editing.
As a pediatric physician assistant in General Pediatrics, Duke University Medical Center, red ears is not a sign of otitis media. The symptoms you listed “irratibility, poor appetite, and sleeplessness” are correct for infants. I’m not aware that autistic children have an increased incidence of otitis media, but that can be checked. Thank you for your work. Sincerely – MK Austin, PA, MPH

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