subject: Ayurveda for Autism Spectrum Disorder [print this page] AYURVEDA FOR AUTISM SPECTRUM DISORDERS AYURVEDA FOR AUTISM SPECTRUM DISORDERS
The incidence and prevalence of autism spectrum disorders (ASD) are increasing worldwide. As per the latest accounts released by the Maternal & Child Health Bureau of Health Resources and Services Administration (HRSA), US Department of Health and Human Services, 1 out of 97 children of the age between 3 and 17 years is diagnosed with some or other of the ASD. This is an alarming figure. It is observed that boys are affected more often than girls, with an incidence ratio of 4:1. Various researches and trials are going on worldwide to find some or other method of intervention which can reverse, partially if not completely, the symptoms of autism.
In India, the exact details of the disease-statistics are not available. Anyway, the cases reported are increasing. Of course the increase awareness about the disease also may be helping an early diagnosis. But it should be accepted that there is an upsurge in the rate of incidence of the disease.
Diagnosis of ASD: indicators*
Does not babble, point, or make meaningful gestures by 1 year of age
Does not speak one word by 16 months
Does not combine two words by 2 years
Does not respond to name
Loses language or social skills
Poor eye contact
Doesn't seem to know how to play with toys
Excessively lines up toys or other objects
Is attached to one particular toy or object
Doesn't smile
At times seems to be hearing impaired
Some Other Indicators
*taken from www.nimh.nih.gov/publicat/autism.cfm
Scope of Ayurveda
Trials with Ayurvedic medicines and treatments for their efficacy in ASD are going on at various centres in India and abroad. In our personal experience for the last eight years, ayurvedic treatments have promising results in the management of ASD. The main advantage of ayurvedic medicine is that it has got a magazine of safe therapeutic preparations of various forms which are developed by continuous trials and rectifications over thousands of years. There are many preparations like decoctions,herbalpowders, self-fermented beverages called aritas, different sorts ofpills, preparations ofmedicated ghee(clarified butter) and vegetable fats etc. In recent times, many of the herbs used in Ayurveda are proven to have excellent detoxifying effect as well as free radical- scavenging potential. The therapeutic preparations like herbal decoctions are combinations of many herbs. These combinations are originally developed on the basis of ayurvedic principles. Till recent times these formulations were not given due consideration by the western scientists. But now the picture has changed. More and more ayurvedic preparations are under their evaluation. In Ayurveda, the compounds as well as single herbs are used for different purposes of health care like pacifying vitiated functional units called doas, eliminating excessive toxic accumulations, providing targeted nutrients to tissues, tuning the mind-body coordination, sharpening the efficacy of sense-organs, and so on. These prescriptions are based on personalised evaluation of different aspects like body constitution, doik (means related to doa) status, power of digestion and assimilation, status of bowel evacuation, physical strength, mental constitution, and etc which is done by experienced physicians. Mind is an important factor in the healing of any ailment. It is assumed that mind is like ghee which is held inside a pot called body. If the ghee is hot the pot also gets warmed and if the pot is hot definitely the ghee also will be hot. You can not expect warm ghee in a cool pot and wise versa. Similarly, food is given the supreme role in the healing process as well as in the maintenance of health. It is a basic concept in Ayurveda that there is no use for any medicine if one stick on to a healthy and wholesome eating habits as it brings about health spontaneously and there is no use for any medicine if one does not stick on to such a eating habits as there is no scope for proper functioning of the medicine. The former one is known as patya and the latter apatya. In the context of autism, these assumptions are extremely important and we have seen it exceptionally beneficial.
We care autistic kids with a protocol of a three-step intervention.
detoxifying and stabilizing the gut (viz. AGNI in ayurveda)
detoxyfying the tissues and balancing the mind-body interaction,
Enhancing the mental abilities like comprehension
Again, though the stages are generalised in appearance, the execution is highly personalised.
The first stage is based on medicines, almost completely. Medicinal preparations like purgatives, specific formulations for de-worming, for enhancing the functions of the liver and pancreas, for enhancing the digestive fire (called Agni), and for regulating the intestinal motility are used in this stage. Certain preparations meant for squeezing out heavy metals from the tissues are also used. To name a few, turmeric, garlic, curry leaves, etc are having this advantage. They are used either alons or in combination with other herbs in compounded form.
Second phase is mainly comprised of massages. Traditional methods of hot-oil massages (abhyanga), dry powder massages (udwartana), a list of fomenting procedures like pindaswda, pizhicil, special types of head-packs like talapoticil etc are used here. These manoeuvres improve the muscle tone, reduce hyperactivity, create better motor coordination, and normalize most of the obsessive repetitive movements. Child sleeps well. The bowels become more regular at this stage. He/she will be more receptive to commands or suggestions. The demand for sensory stimulation slows down considerably and the symptoms like increased sensitivity to certain sounds (hyperacusis) slowly disappear. There will be oral medications parallel to the therapies and a few of these medications will be carried over to the next phase as well.
The third stage is very specific and is meant for enhancing the higher mental functions. This stage of intervention is not started before the proper completion of the first two. It should be kept in mind that, nourishing the brain is possible only with an otherwise-clean body. There is no meaning in pouring in the kid with brain stimulants and memory-boosters indiscriminately. The major therapies in this stage are irrigating the head with specific medicated fats (irodhra) holding similar fats on the head within specially designed leather-rims (sirovasti), wetting the scalp with oil bandages (siropicu), fumigation with specific medicines(dhpanam) etc, along with certain specific oral medications. This follow-up medication is continued for prolonged periods. This third stage of the regimen is repeated later periodically, say, once in six months or so.
Food for ASD
Digestive system of autistic kids often swings to extremes. The three major components of the system viz. digestion, assimilation and excretion, are never in order. This makes the kid a fuzzy eater. Watchful parents report that the behavioural problems of the kids are closely related to the status of their gut. And this observation is perfectly correct.
These kids generally have odd eating habits. They may not eat many of the ordinary stuffs and show cravings to certain other things. They may crave for toothpastes, soaps, paints, plastic, perfumes, creams etc. Stuffs made out of refined starch and sugars may be their favourites. Some kids crave for spicy chips and salted nuts. It is a common observation that the stuffs which they crave for make their behaviour worse and uncontrollable.
Bowels show irregular rhythms. Diarrhoea and constipation may come alternatively. Stools may be bulky, frothy, with lots of undigested food-particles, and with atypical odour. Diarrhoea is a cause of concern because it deprives the child of vital nutrients. Constipation makes him/her upset, hyperactive and with poor attention span. Those with recurrent seizures may show an increase in number as well as intensity of the attacks when they are constipated.
All these observations make it a point that kids with ASD needs a special diet.
As mentioned earlier, food is an integral part of ayurvedic treatment. Ayurvedic authors have specifically depicted that the purity of food is the foundation for the purity of mind (hrasudhdhau satwasudhi : ). So food becomes very important in ASD. We should make sure that the kids get the right stuff, given in right form, get digested properly, assimilation is perfect, no toxin get into the system, and there is proper excretion. Any stuff which is difficult to digest should be avoided. The tool here should be keen observation, not the textbooks. The cravings of the kid should not decide the menu. Many of the protein-rich foods are not tolerated by the system and should be very selective about them. Same is the case with fermented foods. They have certain advantages. But as it hinders proper digestion, it should not be a part of the regular menu. In South India dishes like idli and doa are (obsessively!) included in the breakfast menu almost daily. These are made out of fermented flour of rice and black gram. No doubt, idli and doa are very rich in their nutritive value. But in autistic kids, they weaken the digestive fire and thus promote the growth of unhealthy gut flora. So they are better avoided from the menu. Similarly items like breads, which contain yeast, are to be used with care. This is more so when refined starch is used for its making. They provide excellent culture-medium for the pathological fungi when under-digested. This will create a lot of cravings and hyperactivity.
Fruits, fully ripened, are good options. They provide sufficient amounts of nutrients. Organically cultivated sources are the best. But this never means expensive ones. Locally available less-expensive fruits should be preferred. Bananas, guava, mango, pear, berries, apple, etc can be selected based on availability. Ripened fruits are easy to digest, and provide excellent nutrition. As consumed raw, the chance of allergic responses is very low. When less ripened, they contain more starch and this is not beneficial. When purchased from the market, the potential threat of pesticides, polishing substances like wax, chemical preservatives, and many other toxic accumulations are to be taken care of.
Refined sugars are better substituted by raw sugars like jaggery (row brown sugar-cakes). Cane sugar is not a healthy habit even to non-autistic individuals. Palm jaggery is the best alternative. Beverages like coffee and tea are better avoided. But some kids get easily habituated to these items and the parents find it difficult to withdraw. In such cases black tea/coffee with jaggery as sweetener can be tried. Organic tea/coffee is available freely these days. Green tea is another option. Tinned health mixes which contain wheat/soya and milk invariably, should strictly be avoided. Fresh fruit juices are the best drinks. Honey can be used to sweeten them. Good honey of reliable quality is a good source of glucose and energy. But honey should not be mixed with hot items. Cola and similar bottled synthetic drinks should be strictly avoided. Home-made sweets (with jaggery) may be tried and included in the menu on a rotation arrangement. Traditional should be preferred over the new-age continental dishes. Food from restaurants which contain a lot of vegetable oils and colours should not be entertained. Artificial flavouring agents like monosodium glutamate (MSG) are very toxic to developing brains. MSG is seen to do a lot of harm on kids with ASD. Refined vegetable oils are not good for cooking. Try to get oils in their natural form. Refining involves heating and this destabilises the stuff. It is reported that most of the vegetable oils create dangerous trans-fatty acids on heating. Coconut oil is an exemption. Indian cookery which uses oil liberally should take this point seriously. Coconut oil which is plenty in India is propagated as an unhealthy option and is getting replaced by other vegetable oils. This is a big mistake. Home-made ghee (clarified butter) is another good option for cooking. Ghee is really tasty, healthy and has tremendous influence on brain tissue. When properly (or traditionally' is the right word!) prepared, it contains no casein and so does not create any problem. Milk is boiled over slow fire, allowed to cool and then added with little quantity of souring agent like lemon. This mix is kept overnight for proper curdling and the fermented product is called curd. Fully formed curd, not yogurt, is churned to separate the butter and buttermilk. Butter is thoroughly washed in fresh water to remove traces of buttermilk and can be stored in water or can be refrigerated. If stored in water, the water should be changed everyday. Butter is boiled to procure ghee. This was a routine of our village-life. Ghee is a wonderful product. It is used extensively in Ayurveda. It is observed by the ancient authors of Ayurveda that ghee has excellent potential to nourish the brain. It improves the cognitive skill, enhances memory, and improves the power of digestion. It can promote the functions of all sensory organs like eyes. It detoxifies the tissues and rejuvenates them. It is described as a rasyana which means having the capacity to revitalise the entire tissues and systems of the body. A number of medicinal preparations used to treat mental disorders in Ayurveda are prepared with ghee. Kallynakaghrtam, mahakallynakaghrtam, brhmighrtam, sraswataghrtam, mahpaisacikaghrtam etc are a few examples.
Hurdles
In Ayurvedic management system scope of generalisation is very little if not absent. Though the concepts accept generalisation, the applications in terms of medicines and therapies do not. A method or medicine which worked well with one child may not give the same response when tried on another child with the same symptoms.
Many medicinal preparations are not so pleasant to eat/consume.
The therapies need hospitalization of 3-4 weeks and some of the methods generate temporary fatigue. So the child is to be resting totally. So all other programs of special education and training may be stopped temporarily.
The treatments need periodic follow ups. Sometimes repetitions are needed once in six months or so.
The methods are yet to be assessed thoroughly. As of now, the methods practised are not recognized by any accrediting agencies or research organizations.
Strict adherence to diet is a must for predictable outputs. But most of the parents, especially working couples, find this point extremely difficult.
Children with ASD show increased susceptibility towards certain infections. Skin infections and middle ear infections are the most common to name. These infections are to be handled strategically. At times, parents, out of panic, resort to conventional antibiotic therapies. Some other times, the infection may run a very severe course that nothing other than antibiotics work. In any case, antibiotics bring about drastic setbacks in the progress achieved; and sometimes everything will be back to square one.
Some kids may be on long term medications like anti-epileptics (e.g. Carbamazepine) or anti-psychotics (e.g. risperidone). Anti-epileptic drugs are often prescribed to autistic kids indiscriminately. These cases respond much feebly to ayurvedic medications and withdrawing them is quite difficult.
Conclusion
It is seen that the classical ayurvedic treatment done systematically give promising results in kids diagnosed with ASD. But it should be emphasised that the level of improvements is different from child to child. Another important point is that these interventions are made in a corrective manner. The child gets relieved of a lot of physical problems and tantrums. But this will not make him/her a normal child. Intensive training and special education are needed to put him on track and to catch up the peers. This requires the dedicated involvement of parents, special educators, and skilled professional like occupational therapists.
