The fact that my daughter's autism was not diagnosed on time still gets me upset. I firmly believe our lives would have been different had I known earlier. I have come across plenty of studies saying that when treatment — including plenty of behavioural therapy — is given early, the child goes on to do considerably better.
And if I had also known that some conditions arrive in pairs for children with autism, I could have handled them without panicking the way I did. When my daughter developed a sleeping disorder and constipation at the same time, I thought it was the end of everything. I honestly did not believe she would come out of it alive.
And then, just as we overcame that, the eating and sleeping problems began. Most nights I would go to bed with her beside me, knowing full well I would probably not sleep — because if she was awake, I needed to be awake too, keeping my eyes on her. And I don't think any mother can be at ease watching her child go through most of the day without eating.
Paired Health Conditions in Autism Have Been Proven Scientifically
My relief came when I began reading about autism and its accompanying conditions. I found a study that analysed autistic children between the ages of 17 months and 17 years who visited autism clinics across the United States. The study, which spanned a whole network of autism clinics, ran from 2010 to 2016.
Some of these pairings are easy to explain; others resist explanation entirely. Anxiety, for instance, is one of the most common health challenges in children with autism — and anxiety often follows from insomnia, which is another common challenge. That link is simple to draw. But the overlap between other conditions — gastrointestinal issues, speech problems, and attention deficit hyperactivity disorder (ADHD), which also occur in pairs — is far harder to account for scientifically.
Anxiety is one of the most common health challenges of children with autism.
Facing the behavioural challenges alone is difficult enough for a parent or caregiver — these accompanying health issues make it harder still. Researchers have also shown that such health challenges can mask the early diagnosis of autism, and vice versa.
One habit I recommend to every parent
Keep detailed notes of every behavioural or health change you observe. Those notes become invaluable during diagnosis and treatment — and they give you the best possible shot at getting ahead of these paired conditions.
Scientists Are Tracing the Relationships Between These Challenges
As I mentioned, some relationships are easy to establish. In children younger than five, for example, feeding difficulty and speech problems have been found to occur together 23% more often — and in children older than five, that figure rises to 27%. For the pairings that are harder to explain, Beth Malow, professor of neurology and pediatrics at Vanderbilt University in Nashville, has suggested that some underlying mechanism may be leaving these children's systems dysregulated or over-aroused.
In children under five, feeding difficulty and speech problems occur together 23% more often.
Once I understood my daughter's condition better, I began to observe her far more keenly. If there was the slightest change in the way she walked, you could trust me to spot it. It was during this period that I noticed her speech difficulty persisted — in other words, it appeared in association with almost every other condition she faced.
As much as the research emphasises paired conditions, I would advise you to prepare for more than pairs. There were times my daughter had as many as four conditions at once — constipation, speech difficulty, sleeping problems and anxiety, all at the same time.
My daughter may look fragile, but when I look back at the health challenges she has overcome, I know she is a strong girl. My advice: make your pediatrician your friend and pay them regular visits. You will need their reassuring words to carry you through the pressure.
