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Sleep, diet and exercise
Looking after the physical health of children with autism is important for their overall growth and development.
Autistic individuals often face several challenges when it comes to maintaining their physical health. Below, we will explore three common challenges that they encounter: eating, sleep, and exercise.
Eating and autism
Eating disorders and unusual eating habits are fairly common in autistic people, and around 70% of autistic children might struggle with these issues. Autistic individuals often experience the world differently, especially when it comes to their senses. Food, textures, smells, and how food looks can be overwhelming or unappealing, and this can make mealtime challenging and sometimes leads to limited diets, known as selective eating.
Sensory sensitivities
One of the biggest issues for autistic individuals is sensory sensitivity. For example, some might find the texture of certain foods too hard to handle or too soft in their mouth. This isn't just being picky; it's a genuine reaction to the sensory input that can make eating certain foods uncomfortable and very difficult.
The social side of eating
Eating isn't just about food—it's a social activity. This can be tricky for autistic individuals who might find the social norms around eating, like sitting at a table with others or waiting to eat until everyone is served, stressful and anxiety-inducing.
Common eating disorders
There are many eating disorders that are common among autistic individuals. These include:
There is a significant link between autism and anorexia nervosa. Unlike the general population, where body image concerns typically lead to anorexia, individuals with autism may use food restrictions as a way to cope with anxiety or to maintain a sense of control through routines. up to 35% of people with anorexia may also be on the autism spectrum.
ARFID, also known as avoidant/restrictive food intake disorder, is a condition that differs from anorexia. Unlike anorexia, it does not involve concerns about weight or body image. Instead, it is about avoiding certain foods that don't feel right due to their texture, smell, or other sensory attributes. This can lead to nutritional deficiencies since it might mean missing out on important foods. Additionally, it can make it very difficult to manage socially or even at family dinner times, where the options a person will eat are so limited.
Pica is a condition characterised by an uncontrollable urge to consume non-food items such as ice, clay, soil, paint chips, paper, and hair, all lacking nutritional value. Unlike the exploratory behaviour seen in toddlers, pica persists beyond early childhood and can continue into adulthood.
The management of pica typically involves consulting with mental health professionals such as psychologists or psychiatrists, who may prescribe medications to help manage the impulses. Support from family and friends is also crucial; they can help by ensuring that items commonly craved are kept out of reach or securely locked away.
Addressing pica is crucial not only to stop harmful eating behaviour but also to prevent associated health risks. These risks include dental damage, iron deficiency anemia, digestive disturbances such as constipation or diarrhea, intestinal infections and obstructions, and lead poisoning. Effective management and supportive care are essential to improving the health and well-being of individuals with pica.
Overeating in autistic children and teenagers can have various causes, and understanding these can help effectively manage their eating behaviours. Some may experience increased appetite due to medications, so consulting a gp or pediatrician is advisable to check if this is a factor. Others might overeat due to habits such as snacking during screen time or boredom, which can be addressed by keeping a food diary to identify patterns. Compulsive behaviours, irregular meal times, sensory sensitivities, and emotional triggers can also contribute to overeating.
Different strategies are needed depending on the underlying reasons for these behaviours. Restricting access to snack foods and maintaining structured meal times can help. Engaging the child in preferred activities or physical exercise to distract from snacking can also be effective. For sensory-driven overeating, substituting food with non-food sensory activities like playing with playdough may be beneficial. Emotional overeating requires teaching the child healthier emotional management strategies.
If a child shows signs of pica, which involves eating non-food items, this should be addressed with professional help. Keeping a close watch on the child’s diet and involving healthcare professionals is crucial, especially if there are concerns about overweight and obesity, which can affect the child's overall health and development.
Individualised treatment
Treating eating disorders in individuals with autism requires a thoughtful approach that takes into account their unique needs. Standard treatments focused on weight management or group therapy may not be the best option. Instead, it's important to focus on personalised plans that respect their need for routine and predictability and directly address sensory issues.
The importance of early help
Identifying these issues early can make a big difference. education for parents/carers, and medical professionals can help them spot the signs of eating disorders quickly and get the right help.
Sleep and autism
Sleep is essential for children, just like a healthy diet and regular exercise. It is particularly important for their growth, development, and learning. However, autistic children often struggle to get restful and sufficient sleep. These challenges can significantly impact many aspects of a child's life, including their mood, ability to concentrate, and overall health.
Sleep challenges for autistic children
Autistic children may face several obstacles that can disrupt their sleep. Some common sleep issues include difficulty falling asleep, waking up frequently throughout the night, and irregular sleeping and waking patterns—like staying awake very late or waking unusually early. these problems can stem from a mix of behavioural, physiological, and environmental factors:
Behavioural factors
Inconsistent bedtime routines can leave children feeling unsettled when it's time to sleep. Without a regular signal that it's bedtime, their bodies don't learn to wind down.
Physiological factors
Many autistic children experience heightened anxiety, which can make relaxing difficult. Additionally, they may have different sensory sensitivities, such as an aversion to certain textures or sounds, making the sleep environment feel uncomfortable.
Environmental factors
The bedroom environment plays a huge role. Too much light, noise, distractions, or an uncomfortable bed can prevent a good night's sleep.
Practical tips for better sleep
Improving sleep for autistic children often involves a combination of strategies designed to address their specific needs. Here are some examples of strategies that can help.
- Establishing a consistent bedtime routine: Creating a predictable and calming bedtime routine can greatly improve sleep quality.
- Dimming the lights: Bright lights can reduce the production of melatonin, the hormone that signals our brain it's time to sleep.
- Limiting screen time: Screens emit blue light which can disrupt natural sleep cycles. Turning off electronic devices at least an hour before bed can help.
- Relaxing activities: Incorporating activities like reading a book, listening to soft music, or gentle stretches can signal to the body that it’s time to wind down.
- Create a comfortable bedroom: The right environment can significantly enhance sleep quality:
- Control sensory inputs: If noise is an issue, consider soundproofing the room or using a white noise machine. Blackout curtains can be very effective for light sensitivity.
- Adjusting the room temperature: The ideal temperature for sleeping is typically between 18-22 degrees celsius. Keeping the room at a comfortable temperature can help.
- Comfortable bedding: Ensure the bedding is comfortable for your child, which may mean special materials that are non-irritating, and layers of bedding to adjust to body temperature
Diet and physical activity
What children eat and how active they are can really affect their sleep. To help them wind down at night, it's best to avoid caffeine and sugary snacks before bed since those can give them a burst of energy right when you want them to relax. Dinner should be healthy but not too heavy, so they don’t go to bed feeling too full. Regular physical activity is also great for getting them into a good sleep routine. Just make sure the activities are fun, age-appropriate, and not too exciting right before bedtime, so they can settle down more easily.
Monitoring sleep patterns
Monitoring sleep patterns can be an effective way to identify what’s helping or hindering a good night’s sleep. Keeping a sleep diary is a simple but valuable tool for this.
In your diary, note down sleep and wake times to spot any patterns or issues in the sleep cycle. Also, record evening activities and behaviours leading up to bedtime, as these can impact how easily sleep comes. Additionally, tracking diet and exercise is important since both can significantly affect sleep quality. This information can provide helpful insights into improving sleep habits.
Seeking professional guidance
Sometimes, despite our best efforts, sleep issues can persist, and this is when seeking professional advice can be crucial.
Consulting healthcare providers, such as a paediatrician or sleep specialist, can help determine if underlying medical issues are affecting sleep. Additionally, professionals like psychologists or occupational therapists can provide effective strategies to manage anxiety or sensory issues that might be interfering with sleep.
Exercise and autism
Engaging in regular physical activity offers many benefits, including improved muscle and bone health, enhanced mental wellbeing, and overall fitness. However, autistic individuals often experience challenges that can make regular exercise difficult. These challenges may include busy schedules filled with various appointments and therapies and a lack of local sports facilities and teams that can accommodate their sensory and behavioural needs. Understanding and addressing these barriers is crucial to helping autistic individuals find and participate in suitable physical activities.
Why is exercise so important?
Exercise is particularly important for children with autism, especially in those early intervention years. regular physical activity, particularly in the form of specific and targeted exercises, can see improvements in:
- Gross and fine motor skills
- Muscle strength
- Coordination
- Motor planning
- Balance
- Mood and behaviour
- Verbal and non-verbal social and communication skills
- Social skills and interaction
Practical tips for encouraging exercise
- Start small: Begin with achievable goals and gradually increase the amount and intensity of physical activity. Short, frequent sessions can be more manageable than longer, infrequent ones.
- Build motor skills: Use fun, home-based activities to build fundamental motor skills, which can help your child play games and interact in the playground
- Try new things: Explore various activities and try different activities to find the ones that are most enjoyable. This could include individual or group activities. Incorporate a child’s special interests where possible to keep them engaged.
- Role modelling: Parents/carers play a huge role in influencing their child’s approach to exercise. By being a positive role model you can encourage your child to enjoy exercise.
Starting exercise early in life can help children develop a lasting positive attitude towards physical activity. Exercising together can be a good way for parents and children to spend quality time together.