Autism Awareness is rising worldwide. Autism figures on articles, documentaries and a series of researches, vastly shared by the media. However, the most discussed subthemes seem to be the ones related to social skills and communication, rather than sensorial issues. Those can influence the identification of physical problems – by parents or even physicians – on people with autism that might bring undesirable consequences to their well-being.
Many people with autism present a different sensorial process than people without autism. Following this thought, some signs could go unperceived:
– Pain, infection, and absence of fever
– Less sensibility to anesthesia
– Abnormal sensation of hunger and thirst
– Dietary allergies
– Unbalanced diet and less physical resistance
People with autism may not always express when they are feeling pain. Often when the pain is strong, they can react in the opposite way, seemingly indifferent to pain. At the contrary, there are people with autism who may overreact to pain due to anxiety. They can cry effusively which may let their parents or physician overestimate their pain.
Many children, teenagers and adults on the spectrum experience pain in a distinctive way than other people. Sometimes they don’t even have fever. The absence of fever can compromise the identification of an infection and other physical problems.
E.g.: Sarah, a five years old autistic girl, says she can’t hear well with one of her ears. The ENT specialist then discards an eventual ear infection. When the specialist ear washes her, he realizes there was an old infection that was not taken care of. Unfortunately, it is too late to help the tympanum, and Sarah ends up deaf from that ear.
Less sensibility to anesthesia
In some cases, people with autism can react less to anesthesia. They need a higher dose to obtain the results. It’s very important that the anesthesiologist knows that. A thorough analyze before the surgery is recommended.
If during surgery when partial anesthesia is given, the patient says he is in pain, he should be taken seriously. Even when the surgeon is used to a certain amount of anesthesia for that kind of procedure.
Some other patients with autism may want no anesthesia at all because anesthesia can have a big sensorial impact on them.
E.g.: Martha, 44 years old, autistic: ” I had a panic attack during an epidural. I had chosen this type of anesthesia because I’m such a control freak; I wanted to follow everything that was going on my knee (meniscus). But exactly that, losing control on my legs, made me nervous. At last they gave me a tranquilizer, and I finally relaxed.”
The mother of an autistic boy of 11 says: “Our son has been operated twice with general anesthesia. Once at 4 (amygdala) and the second time recently (he needed to extract four teeth). On both times, he woke up in panic, kicking everything and everybody. He was so uncontrollable that we needed a couple of people to calm him down.”
Abnormal sensation of hunger and thirst
Some people with autism may not realize they are hungry or thirsty. Other ones, instead, feel hungry and thirsty all the time. In both cases, that could generate a weight disorder. Parents may not notice if they are sick because they keep eating, in spite of being nauseous.
E.g.: Daniel, autistic, 25 years old, never feel hungry. His friends taught him that whenever his stomach hurts, it’s maybe time to eat something.
Thirst may be a symptom of a couple of illnesses. However, when someone has autism, it may not be a signal. In this case, the autistic child, teenager or adult may not feel thirsty at all, when they are ill.
There are dietary allergies linked to autistic people even when those aren’t obvious, like the onset of skin allergies, stomach or intestinal pains.
Some of them may present progress on their behavior after a gluten-free diet, even when there aren’t a celiac disease. To avoid dairy products can also contribute for them to improve their behaviors.
In Holland, the Dutch Autism Foundation (Nederlandse Vereniging voor Autism, NVA) together with the health and wellness ministry’s secretariat published a document. In this document, there is an indication for dietary intervention with autism patients. This information is given to all physicians. While waiting for new research, Dutch doctors are expected to recommend those diets to parents and patients with autism.
Unbalanced diet and lack of physical resistance
Many people with autism have an unbalanced diet as a result of their sensorial disorder. Their high sensibility to certain food may compromise the absorption of essential proteins, vitamines, and minerals. Those elements are unmissable to build their physical strength and resistance to illnesses.
People with autism who keep an unbalanced diet should consult their physicians or nutritionists frequently. It’s recommended periodic check-ups so that they are assured of taking in enough vitamines and supplementation to help them stay healthy.
Autism is a challenge to for the autistic person and for many parents. A lot of them aren’t able to explain what they feel nor the gravity of what they feel. Both the parents and physicians should be alert to that.
They should not be fooled by the absence of emotions someone with autism may show. He or she could be feeling more pain than the (apparent) lack of emotion they might show.
What parents can do:
If you suspect your child is in pain or ill, ask him or her closed questions, never open, as to avoid a long, not clear answer. The child with autism may get caught on details and not to answer accordingly. He may say the first thing that comes to his mind or answer according to “here and now,” unable to generalize situations when they might feel pain.
– Be aware of anything your child does which he usually doesn’t do like any discomfort, a big change in behavior, aggression, sudden introversion (or extroversion)
– If it is the case to consult a doctor, prepare the autistic person in advance. Tell him the doctor will probably examine him (touch him) to know what is going on.
– If it’s the case, tell the doctor your child has autism and, therefore, may present difficulties for the examination. Tell the doctor that he may have difficulties answering his questions objectively. Also, ask the doctor to make brief, objective questions (closed questions).
– During the consult, make use of you knowledge about the individual (autism) characteristics of the patient to promote good communication between him and his physician.
If needed, write down a document and hand it over to the physician:
– Name of the patient
– Date of birth
– Type of autism and his or her characteristics
– Additional information for the medical staff with the peculiarities of the patient like, for instance that he doesn’t seem to feel pain; he rarely or never has a fever; he doesn’t like to be touched etc.
What physicians can do:
If the physicians hear the patient has autism, ask him closed questions, not open ones, as to avoid a long, not clear answer. The child with autism may get caught on details and not to answer accordingly. He may say the first thing that comes to his mind or answer according to “here and now,” unable to generalize situations when they might feel pain.
– Although you need the information of the autistic’s companion, include the patient into the evaluation as m, much as you can
– Take into consideration that the lack of pain or fever may disguise a more serious picture. Don’t discard anything based upon your experience with non-autistic people.
– Ask permission to touch the person with autism before you do it
– Name each procedure to the patient with autism (even the nonverbal ones), explaining what you are doing in a simple way.
– Avoid figure of speech
– Respect the patient’s decisions in case he doesn’t follow a balanced diet (in consequence of his autism). Make suggestions or try to find a solution if this is the origin of the patient’s sickness.
– Ask for additional tests even though it seems irrelevant considering the absence of pain, fever or emotion of the patient.
Autism is a condition not yet totally understood by many people.
It’s imperative that parents and family of people with autism observe them thoroughly whenever they suspect of an illness or another physical discomfort. Remember that they may – and probably will – react differently than neurotypical people.
Source consulted: www.delachendepanda.nl
By Fatima de Kwant