•Low IQ: Research studies have frequently used inappropriate IQ tests, such as verbal tests with nonverbal children, and in some cases have estimated children’s intelligence level without any objective evidence. Tests that do not require language skills, such as the Test of Nonverbal Intelligence (TONI), can offer more accurate information about the person.
•Seizures: It is estimated that around 30 percent of people with autism develop epilepsy, some in early childhood and others as they go through hormone level changes in puberty. Suspected seizures should be confirmed by electroencephalogram (EEG) and treated with prescribed anticonvulsant medications.
•Chronic Constipation and/or Diarrhea: Medical literature states that about 45 percent of children with autism and 47 percent of adults on the spectrum 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, allergies, environmental intolerances, seizures or the effects of medications. Other potential causes are sleep apnea (pauses in breathing when the airway becomes obstructed during sleep), sleep terrors or confusional arousals. Children with sensory processing difficulties may have more problems falling asleep and increased periods of night waking. The Autism Society offers a guide on sleep problems and strategies for solving them.
•Pica: About 30 percent of children with autism have moderate to severe pica, which means they eat 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 other illnesses.
•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 Processing Disorder: Many people with autism have sensory processing disorder (formerly known as sensory integration disorder), which involves 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, most frequently in the brain and gastrointestinal tract (Jepson, 2007).
•Pain: Some people with autism have very high pain thresholds (insensitivity to pain), while others have very low pain thresholds. There are interventions, such as sensory integration therapy, designed to help normalize their senses.
Hearing and Visual Impairments
Children with a dual diagnosis of autism and a sensory impairment face many possible paths. If the child is born deaf/hard of hearing or blind/visually impaired, that diagnosis is usually made early on, and autism behaviors may be mistaken for a reaction to the sensory loss. Conversely, if a child with autism has progressive hearing and visual impairments, his or her adaptation to the sensory loss may be misunderstood as a behavior of autism. For more information, visit the Nebraska Center for the Education of Children who are Blind or Visually Impaired or this article about autism and deafness.
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/her education program in the best aural and visual health possible, and should be monitored and tested to ensure continued health and care. For more in-depth information on hearing and vision screenings for people with autism, see this article from the Autism Advocate.
Families can feel overwhelmed and isolated while searching for information. An Autism Society subgroup, the Autism Network For Individuals Deaf/Hard Of Hearing and Blind/Visually Impaired, holds its annual meeting at the Autism Society’s National Conference every July. The network, which has worldwide family and professional membership, provides links to other families and researchers through the Autism Research Institute.