- Low IQ: Research studies have frequently used inappropriate IQ tests, such as verbal tests with nonverbal children and, in some cases, estimating the child’s intelligence level without any objective evidence. Tests that do not require language skills, such as the Test for Nonverbal Intelligence (TONI), can offer more accurate information about the person.
- Seizures: It is estimated that 11-39 percent (Jepson, Changing the Course of Autism, 2007) of autistic individuals also develop seizures, some in early childhood and others as they go through puberty as changes in hormone levels may trigger seizures. Suspected seizures should be confirmed by electroencephalogram (EEG) and treated with anticonvulsant medications.
- Chronic Constipation and/or Diarrhea: Recent medical literature cites that 70-80 percent of autistic children have gastrointestinal symptoms. Diarrhea is most common, abdominal pain is cited next most frequently, and constipation is reported slightly less. Constipation in autism is usually not hard, impacted stools, but the slow passage of stools with long gaps in between, and loose stools when they do come.
- Sleep Problems: Many individuals with autism have sleep problems. Night waking may be due to gastrointestinal issues, food/environmental allergies or intolerances, seizures or the effects of medications. Other potential causes might include: sleep apnea (pauses in breathing when the airway becomes obstructed during sleep), sleep terrors and confusional arousals. Children with sensory processing difficulties may have more problems falling asleep and increased periods of night waking.
- Pica: About 30 percent of children with autism have moderate to severe pica. Pica refers to eating non-food items such as paint, sand, dirt, paper, etc. Pica can be dangerous as ingesting these inedible substances can cause choking, digestive problems, parasitic infections and illness.
- Low Muscle Tone: About 30 percent of children with autism have moderate to severe loss of muscle tone, which can limit their gross and fine motor skills.
- Sensory Integration Disorder: Many children with autism have unusual sensitivities to sounds, sights, touch, taste and smells. High-pitched intermittent sounds, such as fire alarms or school bells, may be painful to these children. Scratchy fabrics and clothing tags may also be intolerable, and some children have visual sensitivities, such as to the flickering of fluorescent lights.
- Allergies/ Immune System: Many children with autism also suffer immune system deficiencies or immune dysregulation. Within the autism spectrum population, there are groups that will experience rashes, allergic sensitivities, gastrointestinal, ear and other infections as a result. Immune deficiencies and/or immune dysregulation make a person with autism more vulnerable to infection, chronic inflammation and autoimmune reactions in body systems. These are most frequently observed in the brain and GI tract (Jepson, 2007, p.58).
- Pain: Some children with autism have very high pain thresholds (i.e., insensitivity to pain), whereas others have very low pain thresholds. There are interventions designed to help normalize their senses, such as sensory integration therapy.
- Hearing and Visual Impairments: Children with a dual diagnosis of autism and a sensory impairment and their families travel many different paths at almost the same time. Some of these are determined by which disorder is identified first. Children born deaf/hard of hearing or blind/visually impaired are usually identified early and receive intervention to support their communication and interaction with their families. Sometimes, children have progressive hearing and visual impairments or a traumatic loss of sensory input. In these cases, sometimes behavioral issues are overlooked or seen as a reaction to blindness or deafness. In other cases, a child’s atypical behaviors are seen as part of their autism and not as compensation or adaptation to the increasing sensory loss. This can complicate the dual diagnoses occurring with a gap of 2 to 8 years. For more information, visit www.ncecbvi.org or http://deafness.about.com/cs/multipledisab/a/autism.htm.
About 30 percent of children receiving education related to deafness/hard of hearing and blindness/visual impairment are also identified as having autism. Every child should be able to enter his or her education program in the best aural and visual health, and should be monitored and tested to see that continues. For more in-depth information on hearing and vision screenings for people with autism, see the following article from the Autism Advocate, Second Edition, 2006.
Families can be overwhelmed and isolated while searching for information. The Autism Society’s subgroup, the Autism Network for Individuals with Hearing and Visual Impairments, holds its annual meeting at the Society’s National Conference every July. The Network, with worldwide family and professional membership, provides links to other families and researchers at www.autism.com (click on Hearing/Visually Impaired under Support/Resources).