Autism, Ayurveda & Alternate Therapies
Updated: Apr 2
According to WHO, 1 in 100 children has autism. In 2021- CDC reported that approximately 1 in 44 children in the U.S. is diagnosed with an Autism Spectrum Disorder, according to 2018 data – ASD in more common among boys (1 in 27) than among girls (1 in 116). Unfortunately, due to lack of knowledge, parents start treatment late and it gets tough for the child to overcome the complexities. Early interventions are very important to help a child to reach his or her potential and also can prevent disabilities in infants as well as toddlers. On this day of World Autism Day, the 2nd April, we are putting our efforts to share the insights about Autism with an intent to have an insight from both Ayurveda and Modern Medicine point of view.
In Modern Medicinal System, Autism or autism spectrum disorder was first described by Dr. Leo Kanner in 1943 in classic paper entitled ― “Autistic disturbance of affectile contact” Nervous child 1943,2,217-250. Term Autism was used by psychiatrist Eugen Biculer in 1908. Autism means Morbid self-admiration and withdrawal within self (Journal of pharmaceutical and medical research).
Autism is neuro-behavioral and neuro-developmental ailment. Autism is known as a ―SPECTRUM disorder because there is wide variation in the type and severity of symptoms people experience. ASD can be diagnosed at any age but symptoms generallya appear in early childhood (often within the first two years of life). Doctors diagnose ASD by looking at a person's behavior and development.
The patient has lack of social skills and an inability to reciprocate to social interactions. The patient may also have intellectual and cognitive deficits and problems in communication (verbal as well as non-verbal).
ASD affects every person differently; some may have only a few symptoms and signs while others have many. Some children and adults with ASD are fully able to perform all activities of daily living and may have gifted learning and cognitive abilities while others require substantial support to perform basic activities
Symptoms
Some children show signs of autism spectrum disorder in early infancy, such as reduced eye contact, lack of response to their name or indifference to caregivers. Other children may develop normally for the first few months or years of life, but then suddenly become withdrawn or aggressive or lose language skills they've already acquired. Signs usually are seen by age 2 years.
Each child with autism spectrum disorder is likely to have a unique pattern of behavior and level of severity — from low functioning to high functioning.
Some children with autism spectrum disorder have difficulty learning, and some have signs of lower-than-normal intelligence. Other children with the disorder have normal to high intelligence — they learn quickly, yet have trouble communicating and applying what they know in everyday life and adjusting to social situations.
Because of the unique mixture of symptoms in each child, severity can sometimes be difficult to determine. It's generally based on the level of impairments and how they impact the ability to function.
Below are some common signs shown by people who have autism spectrum disorder.
Social behaviors:
Literal and precise language; extensive vocabulary
Making little or no eye contact while talking to another person
Difficulty with the back and forth of conversation and when to speak or listen
Talking at length without noticing others are not interested
Facial expressions or gestures that don’t match what is being said
An unusual tone of voice that may sound flat and robot-like
Difficulty understanding people’s tone of voice, facial expressions or body language
Difficulty developing and maintaining relationships
Restrictive/repetitive behaviors:
Repeating or mimicking peoples’ behaviors
Repeating words or talking out loud to themselves
Ability to focus on one subject for extended periods of time and become an expert on the chosen subject
Ability to see developing patterns with numbers, details or facts
Thrown emotionally/mentally off balance with changes in routine
Sensory challenges:
Hypersensitivity to bright lights, multiple sounds, strong odors, certain textures and temperature changes
Insomnia is common because sleep is easily disturbed
Hyperflexible joints and uncoordinated movements
Unable to speak, or delayed speech
People with ASD have many strengths and excel in areas of technical learning:
Ability to learn and remember information in great detail for long periods of time
Remarkable focus and persistence on one topic
Aptitude for recognizing patterns within complex problems
Strong visual and/or auditory learning skills
Excelling in math, science, music or art
Autism and Ayurveda Perspective
According to Ayurveda, the tridosa (vata-pitta-kapha) is responsible for controlling and monitoring all of the bodily functions. Vata energy is responsible for movement, activity, cellular exchange, circulation, conduction, intellectual and memory processing, speech and sensory and motor action. Vata also controls the thought process like thinking, planning and decision-making. Pitta dosa is responsible for metabolism and digestion kapha dosa is responsible for nourishment and grounding.
In ayurveda, Autism is correlated with Unmada. Unmada is characterized by various types of inappropriate behavior shown by the person as a result of the distortion of the normal mind, intellect, conscious awareness, memory, desire, manner, and behavior.
The long list of general symptoms points toward a vata dominant disorder. Both vata dosa and majja dhatu (bone marrow tissue) are factors in ASD.
Autism Spectrum Disorder(ASD) or Unmeda involve impairments of:
Manas – mind-total or partial loss of sensory perception
Buddhi—intellect—partially affected—could be irregular as shown in savant skill.
Samjna Jnana – an aware presence – seen to be lost in their own environment, barring one or more sensory stimuli.
Bhakti – ability – inherent willingness to connect with others
Seela – manners – socially inappropriate outbursts and adherence to strict rigid routines.
Cheshta – Activities – Motor stereotypes that are improper and compulsive
Achara – learned skills – poor socialization skills, failure to obey orders, loss of healthy habits, etc.
Jnanotpathi – Knowledge of acquisition , one of Manas; essential roles, is disrupted in Unmada. Jnanotpathi occurs only when Manas is in tune with Atma (soul), Indriya (sense organ), and Indriyartha (objects).
Clinical features of Autism/ Unmeda & their relation with Dosha
When to see a doctor
Babies develop at their own pace, and many don't follow exact timelines found in some parenting books. But children with autism spectrum disorder usually show some signs of delayed development before age 2 years.
If you're concerned about your child's development or you suspect that your child may have autism spectrum disorder, discuss your concerns with your doctor. The symptoms associated with the disorder can also be linked with other developmental disorders.
Signs of autism spectrum disorder often appear early in development when there are obvious delays in language skills and social interactions. Your doctor may recommend developmental tests to identify if your child has delays in cognitive, language and social skills, if your child:
Doesn't respond with a smile or happy expression by 6 months
Doesn't mimic sounds or facial expressions by 9 months
Doesn't babble or coo by 12 months
Doesn't gesture — such as point or wave — by 14 months
Doesn't say single words by 16 months
Doesn't play "make-believe" or pretend by 18 months
Doesn't say two-word phrases by 24 months
Loses language skills or social skills at any age
Diagnosis of autism
Physician may recommend a following tests for diagnosis of autism, that include:
DNA testing for genetic diseases
Behavioral evaluation of child
Visual and audio tests
Occupational therapy screening
Reasons of Autism
In the etiopathology of Unmada and ASD in Ayurveda, genetic deficiencies (Beeja dushti) may be caused due to genetic predisposition or defects and therefore, is a lifelong condition. Acharya Sushruta mentioned in his text the state of health and disease are determined by the relative presence of tridosha since the formation of embryo in the womb. Kapha is Tamobhuyistam so that the predominance of kapha and tamo guna can contribute development of vishada, nastikam, adharmasheela, budhinirodha, ajnanam in child, likewise predominance of vata and rajas guna contribute development of dukhabahutwam, tadansheelata dambham and krodha in children. In case of panchamahabhuta akasha is satvabhuyitam, vayu is raja guna predominant and prithvi is tamoguna predominant so that their predominance contributes their qualities in the child. The genetic material is deranged as it leads to beeja dusti which is responsible for basic genetic susceptibility to develop the disease.
Researchers have also found that specific gene variants contribute to autism risk. A gene variant is a permanent change in the DNA sequence that makes up a gene. The probable etiopathogenesis is based on faulty organogenesis, brain damage, trauma, obstructed labour, metabolic changes in intra-uterine life. Fragile X syndrome or genetic mutations increases Prevalence of Autism by four times more in boys than in girls because of presence of single X chromosome. Whereas, in girls there are two X chromosomes coming from different parent and chances of domineering mutation gets reduced.
Ayurveda claims that along with external factors like radiation, pollution, Dushivishasevan (food with toxic elements), improper use of food & medicines, the activities of the pregnant woman, her mental state plays a significant role in the development of wellbeing and disease – both mentally and physically in the child. Majja is a matrruj bhav important for development of brain (mastullunga). In autism it is says the role of deranged brain so that the vitiation occurring in matruj bhav leads to referred problem likewise atmaj bhav contribute chetana, buddhi, dhriti, smiriti, atmaj bhava vaigunya (vitiation) can cause impairment of function of mind . Majja dhatu has an impact on the nerve cells in the brain. The goal of Ayurvedic treatment is to balance vata dosa as well as nourish majja dhatu to enhance or maintain chemical balance within the nerve cells.
Environmental triggers like stress during ANC, perinatal and postnatal insults, Vega Dharna (suppression of natural urges)and other known or unknown reasons may provoke the disorder. It is a Tridoshajvyadhi with variation in their single or mix dominance, also vitiates Mansik Doshas. They together affect Buddhi-intellect (Dhee-short time memory Dhruti-act with dedication, Smruti-memory) and create various clinical features especially abnormal pervasive movements, screaming suggesting ASD. Maternal obesity or diabetes, older parental age at the time of conception and extremely preterm birth and low birth weight may also trigger Autism.
TREATMENT OF AUTISM SPECTRUM DISORDER IN AYURVEDA
The Preventive Protocols
Preventative considerations before conception: Consanguineous marriages were prohibited in Ayurveda not only by Charaka and Sushruta but by biologists. Acharya Bhela made clear that consanguineous marriages should be avoided to prevent psychological disorders. Ayurveda gives primary importance to periconceptional practices followed by father and mother, the time of conception, role of parents during coitus, bad aharvihara contributes to mental illness. Preconception counseling should be given.
Preventing during pregnancy: In the sense of Garbhopghatkarbhavas, Acharya Charaka Majja bhava and atmaj bhava may cause autism as a disorder, it has also been recommended to avoid various defective dietary regimens, otherwise, they may lead to absorption of childbirth and various psychological disorders, e.g. Excessive sleep, over-consumption of alcohol by a pregnant woman can result in low IQ, poor memory, or hyperactivity. In the fourth month of pregnancy, the fetal heart, which is the seat of consciousness, becomes active, thus expressing its desires through the mother, which is called Daurhruda. The wishes and wishes of Daurhrudini, if not honored and satisfied, can lead to autism.
Prevention during delivery: Mostly during the second stage of labor, Sushruta pointed out that instruction to relieve the pain of women with Assanaprasava can result in psychological abnormality.
Prevention during the neonatal phase of the child: In this regard, in Ayurveda Neonatology, the ultimate first-line treatment of the neonatal baby is to support respiration called Pranpratyagamana (resuscitation) the method in the mode of cleaning Mukhasleshma and physical stimuli along with Pranvayu (oxygen) with the aid of the hollow tube of Krishnakapalikasupa in order to avoid the birth of Asphyxia which causes autism.
Therapeutic Streams In Ayurveda to treat Autism (Unmeda)
Ayurvedic treatment for autism includes natural ayurvedic medicine and Panchakarma therapies that boost the energy level of the body and mind. Ayurvedic treatment of Autism is nourished the brain to the desired extent. Our natural ayurvedic medicine for autism is most successful as it is geared to word the physical and mental needs of an autistic child.
A perfect hasmony of all the three is required for intellectual capabilities. Our natural ayurvedic remedies for autism balanced nutritional diet plan, natural ayurvedic medicine physical activities and Panchakarma therapies boosts the energy level of cells on the basis of several case studies.
· Basti
· Nasya
· Shirodhara
· Siropichu
· Abhyangam
· Lepam
· Udvartana aur Ubtan
· Pottali
· Yoga and Pranayam
· Meditation
· Ahar (pathya – A pathya diet)
Panchakarma Therapy
Nasya (nasal instillation)- the therapy cleanses and opens the channels of the head, thereby improving the process of oxygenation (prana), which has a direct influence on the functioning of the brain. Kshirabala oil, 2 drops in each nostril at the morning and evening daily for a minimum of three months is given. The therapy is beneficial if done on regular basis.
Abhyanga- Abhyanga is defined as an Ayurvedic procedure of application of Sneha dravyas (medicated oils) over the body with a certain amount of pressure in a specific direction. Abhyanga with Bala oil is to be done daily morning and evening on regular basis. It helps in combating anxiety, enhances the performance of alertness, and also reduces subclinical depression. Massage has been used in an effort of improving symptoms, disease progression, and quality of life.
Sirodhara- It could be said that by irrigating the roots, trees get furnished; similarly during sirodhara entire body is benefitted. However, to prevent Vata dosha vitiation sirodhara is applied. Sirodhara induces sleep and stabilizes the mind effectively reducing the condition of hyperactivity in children by reducing the chemical transactions inside the brain. Shirodhara should be done with Til (seasum) oil- 1 litre+ Brahmi oil- 100ml, oil changed after every 15 days. The practice is to be done Daily for a minimum of 40 minutes, for 40 days. If Shirodhara is not possible then make oil using Til oil, and add Bhahmi, Shankhpushpi, Jatamansi, Lavender, and Amalaki; do regular massage in the head.
Bastichikitsa- Autism is vata predominant disease and basti chikitsa with 30 ml of Brahmighrita as suggested and administered by the ayurvedic physician is considered as the most suitable treatment for vata predominant disease and designated as ‘ArdhaChikitsa’ for all diseases.
Herbs/ Ayurvedic Medicine for Autistim in Child
Brahmi is an important herb and is known for its, anti-anxiety, neuroprotection and antioxidant properties can help considerably. It delays the process of forgetting and improves memory. Not only does Brahmi improve memory, but also increases the grasping power, intellect, and speech and also corrects the abnormality of emotions, personality, and mood of an autistic individual. This ayurvedic medicine helps in performing complex tasks such as comprehension, reasoning, and learning.
Ashwagandha has a high affinity for gamma-aminobutyric acid (GABA) receptors. Low GABA activity is related to cognitive impairment.
Shankhapushpi is a very effective ayurvedic remedy in improving learning and memory and is highly effective in treating insanity and epilepsy.
Mandukaparni is used as a medication for insanity, speech disorders, and epilepsy, making it a very useful drug for treating autism.
Yashtimadhu is a nerve tonic, that calms down the nervous system and improves the intellect.
Vacha possesses intellect-promoting, anti-depressant properties. It has memory-enhancing and behavior-modifying properties. It is used as a sedative, anxiolytic, tranquilizer, and rejuvenator. Vacha is also used to reduce fatigue and improve memory. It is used as a sedative, anxiolytic, tranquilizer, and rejuvenator.
Jyotishmati is a brain tonic with a wide range of neurological benefits. It helps in tackling repetitive and social behavior. It also helps to manage the delayed milestones thus responsible for the growth and development of the child.
Satavari has been found to possess neuroprotective, nootropic, antidepressant, and antianxiety activities.
Pippali is having deepana (stomachic) and paachana (digestant) properties which improve drug absorption and bioavailability.
Other medicines described for the treatment of autism & various manasikarogas are-
BrahmiGritham
Sarasvatharishtam
Panchagavyagritham
Mahakalyanakamgritham
Brahma rasayanam
Ashwagandharishtam
RudrakshaChuranam
Satvavajaya (Mind or Self-Management Techniques) or Applied Therapies to deal with Autism:
APPLIED BEHAVIOR ANALYSIS (ABA): In ABA, an instructor at first tries to understand the behavior of the patient suffering from Autism. The instructor also tries to understand the effects of the environment on their behavior, and how the patient learns from the same. By analyzing the patient’s current behavior and teaching them new actions step-by-step, an instructor can provide both the patient and the people around them with tools for support.
EARLY START DENVER MODEL (ESDM): This type of behavioral therapy is conducted during play, & helps children between the ages of 1 and 4 years old. A psychologist, behavioral specialist, or occupational therapist helps a child with autism build positive relationships with other children with a sense of fun. Parents can then continue the therapy at home.
FLOORTIME: This involves parents joining their children in the play area which helps in building stronger relationships with their child. Parents let their children lead the game, allowing the child's strengths to develop. Through this therapy, a child with autism learns two-way and complex communication, emotional thought, and intimacy.
OCCUPATIONAL THERAPY (OT): This helps the patient to develop the skills for everyday living and learn to be independent. These skills include- dressing without assistance, grooming, and hygiene, and fine motor skills. Patients with autism then practice these skills outside of the therapy sessions, which are usually between 30 and 60 minutes long.
PIVOTAL RESPONSE TREATMENT (PRT): This therapy aims to support motivation and the ability to respond to motivational cues in children with ASD. It is a play-based therapy that focuses on natural reinforcement. For example, if a child wants a toy car and asks in an appropriate way, they get the toy car, not an unrelated reward, such as candy. This also encourages children with autism to start social interactions, as well as merely responding to them.
SPEECH THERAPY: helps to address the challenges in communication that patients with autism might experience. A speech therapist teaches the nuances of vocal tone and helps the individual strengthen their speech and clarity
TEACHC (TREATMENT AND EDUCATION OF AUTISTIC AND COMMUNICATION OF HANDICAPPED CHILDREN): This program helps to integrate the needs of children with autism into a classroom environment, with an emphasis on visual learning and support for the attention and communication difficulties that might arise
DIET FOR AUTISTIC KIDS
It is very important to know the nutrient requirement of autistic kids to have a healthy diet plan. The dietary needs of kids with autism spectrum disorder are met and associated complications are decreased by consuming foods high in vitamins B6, C, D, magnesium, and other nutrients. The following is the list of nutrients and some food examples than might help to build a healthy diet plan.
PROBIOTICS: Children with autism frequently experience digestive issues. Since probiotics contain beneficial bacteria that influence gut microbiota, including them in the diet can help with these issues. Regular consumption of probiotics will assist the child to pass stool easily. Some examples of probiotics include fermented foods (idli, dosa, dhokla), buttermilk etc.
MAGNESIUM AND VITAMIN B6: It is found that foods high in magnesium and vitamin B6 help to improve speech and language in kids with ASD. Some of the foods that are rich in vitamin B6 are fish, peanuts, soybeans, oats, and bananas. Almonds, spinach, cashews, pumpkin seeds, black beans, dark chocolate (60–69%), bread, potato, and brown rice are all promising sources of magnesium.
ZINC AND VITAMIN C: Mothers who are low in zinc and vitamin C have been linked to an increased risk of autism in the foetus. Furthermore, if the autistic child lacks these two nutrients in their diet then they may experience worsening symptoms. Certain foods that are rich in zinc and Vitamin C are oranges, lemons, seeds (pumpkin seeds, almonds, sunflower seeds), papayas, broccoli, eggs, and legumes.
VITAMIN D AND OMEGA- 3 FATTY ACID: There is a strong link between a healthy diet plan and autism. It was suggested that a diet rich in vitamin D, PUFA (Omega- 3 fatty acid) and DHA have the potential to significantly improve the symptoms of autism spectrum disorder as per a study in the journal Trials. Some foods rich in these nutrients are walnuts, seeds (chia seeds, flaxseeds), soybeans, and fatty fishes like salmon, mackerel and cod liver oil.
Here are some of the foods on this list help with vitamin deficiencies, such as zinc and vitamin D, and others help with things like fiber intake.
• Beans
• Nuts, especially walnuts.
• Seeds, such as chia seeds, hemp seeds, and flax seeds.
• Fortified (filled with Omega-3 fatty acids) eggs.
• Fish high in Omega-3 fatty acids, such as salmon.
• Alternative milk, like soy or almond.
• Leafy greens, such as spinach or kale.
• Variety of fresh fruits and vegetables.
• If you must eat grains, make sure they’re whole grains.
Autism is a manifestation having its deep root in beejadosha activated by favourable environment. The condition requires a long-term intervention and the improvements soon after each course of management. Ayurveda opens a large door in the management of autism and similar conditions and help those suffering from this disorder.
Refences:
Harris J. Leo Kanner and autism: a 75-year perspective. Int Rev Psychiatry, Feb, 2018; 30(1): 3-17. doi: 10.1080/09540261.2018.1455646. Epub 2018 Apr 18. PMID: 29667863
Kliegman et al. Nelson Textbook of Pediatrics. Chapter 30th Autism spectrum disorder. Philadelphia: ELSEVIER Company, Asian edition, 20th edition 2015, p.177