ADHD, Autism Spectrum & Anxiety In Our Kids; Why Is This A Growing Concern?
By Dr. Nicole Roberts, ND
How we can help our kids
build healthy brains and bodies with a Biomedical Approach to Neurodevelopmental Health.
I see a lot of kids in my office, each one of which I find to be an incredibly fascinating person with an interesting, individual medical case. From 4-year-olds with attention issues that are extremely bright and social but cannot sit still, to teenagers with a huge amount of insight into their mental health but are feeling stuck after having combed the internet for solutions to try (and of course the tireless, supportive parents that come in with them); each is a unique story about mental health in modern day society.
If you ask me what I think is the reason behind the epidemic of young people struggling with brain-body function across the developed world is, I would say the answer is of course multifactorial, but also relatively simple. In my opinion, it comes down to the following;
Kids have less time to be physical, tactile explorers because they are asked to become intellectual & rational long before they are ready. We are pushing kids to go inside their minds at a time when what they may need is to explore existing in their bodies at their own pace and build a mind they can live within as they age.
We’re stressing kids out. Isolation (increasingly less close-knit communities), homework, competitive academic pressure, playing on an adult-level as opposed to a child’s-level, less time for wonder & creativity and the tense energy given off by parents (who are super stressed out too), all contribute to a heightened stress response in children through signalling of the Hypothalamic-Pituitary-Axis. Chronically elevated levels of stress hormones can influence the way the brain models itself, increasing the likelihood of anxiety as the child grows.
Many kids aren’t building healthy gastrointestinal systems anymore. Their formative gut experiences such as a flora exposure during birth, early childhood diet and developing in a low stress environment, are becoming harder to offer to our kids without compromise. Increased exposure to microbiome-killing agents from cleaning supplies, pollution, pesticides and soaps, coupled with a decreased exposure to healthy soils, dirts, germs and foods that build good microflora, are changing what lives inside the digestive tracts of children and dramatically affecting their gut-brain axis. Read more about this HERE.
Kids’ diets are increasingly processed. This is often due to the convenience factor. Most foods are coming from jars and plastic packaging, even if they are plastic packages of food from the health food aisle. Diet changes the microbiome and the nutrients the body needs to build healthy neurotransmitters, immune function and more.
We may be passing on genes to our kids that simply don’t work as well. Research has found that the actions of many generations back can influence the genetic SNPs of a current generation. For example, if your great grandmother chain-smoked and never ate vegetables, the epigenetic changes she sustained during her child bearing years may have been passed on to you and then to your children. Many children on the spectrum or those struggling with anxiety have changes to the function of their MTHFR genes which regulate methylation processes throughout the metabolism. This is one of the most identified genetic SNPs out there, but is by no means the only one. Untreated SNPs along the COMT pathway and MTHFR pathway in mom and dad, particularly mom, have been linked to higher rates of offspring with autism or ADHD.
Heavy metal exposures are exceeding the detoxification capacity of the body, allowing for accumulation within the body’s tissue which leads to changes in brain and immune function. MTHFR and other genetic pathways are the rate limiting step to the production of glutathione, a potent cellular antioxidant and redox participant that allows us to have effective detoxification capacity.
Kids aren’t as active as they used to be and spend more time inside (lots of exposure to allergen-ridden indoor air). This is often why parents sign their kids up for a number of after-school-activities which can increase exposure to exercise, but may contribute to heightened stress states a child’s schedule becomes overly busy. Which brings me to my next point.
Communities aren’t supporting kids the way our villages used to. A community could provide a safe place for a child to explore with others and spend time outside interacting with nature, all without meeting undue danger. This, along with shared food collection, meal preparation and social interactions, didn’t place every single responsibility of a child’s upbringing at the feet of the parents, but rather at the feet of the collective communities’.
As we can see, even without discussing adverse childhood events (highly stressful incidents in an individual’s early childhood that predispose to a range of health concerns in adulthood), the average mental and physical health of our children is increasingly being put in jeopardy. According to Children’s Mental Health Ontario, about 1/2 of all Ontario parents are worried about their kids’ levels of anxiety. Additionally CMH Ontario’s stats indicated that 1 out of 5 kids will experience mental health problems in some form, and up to 85% of those kids won’t receive the kind of treatment they need. This is a growing concern because mental health symptoms that are not addressed in young children or teens, can feed forward, creating a worsening mental health profile as the child ages and transitions into adulthood. For example, anxiety and depression is a common comorbidity of ASD children as they age.
What is the kind of treatment a child might need?
This is a fantastic question and one that is not discussed enough. Parents are facing a huge array of options for having their kids assessed, many of which come with LONG wait times, and some that come with empty promises.
Within the conventional medical system, long wait times to see professionals, the cost of medication and medical care in an era with an expensive cost of living and a lack of time spent understanding the unique situation of each child is a big barrier to creating healthy solutions for children struggling with anxiety, ADHD and autism spectrum disorder.
While Naturopathic Doctors may not be seen by all as part of the conventional network of care for children with mental health concerns, those who take a special interest in treating neurodevelopment are carving out an important niche that many families are gravitating towards; biomedical care models. A biomedical approach involves natural medical treatment plans created to address the biochemical and metabolic hurdles an individual child faces as the root cause of their neurological symptoms.
There is a growing percentage of families that are finding good quality Naturopathic Care at the onset of their children’s diagnosis as they recognize the massive role diet, nutrition, gastrointestinal health play in the pathogenesis of neurodevelopmental symptoms. A 2 week wait time as opposed to a 12 month wait time allows families to begin addressing neurodevelopmental treatment sooner rather than later. As these NDs provide excellent medical care to their paediatric population, they are building trust with parents and co-managing medical professionals.
ADHD, Autism, Behavioural Issues and Anxiety are not limited to the function of the brain in isolation; they are a whole body metabolic condition that requires assessment and metabolic treatment, which may be in addition to prescribed medication as per the families’ and co-managing professionals’ preferences. A biomedical approach to neurodevelopment and mental health is what Naturopathic Doctors with training in this area are using to heal the systems that affect neurological function with great success. The biomedical approach is based on research literature that has been conducted by doctors and institutions across the globe, bringing the best and brightest protocols to neurodevelopmental care.
As insurance companies continue to expand their offer of Naturopathic Coverage to working parents that apply to their families, adding a Naturopathic Doctor to the team of professionals (including a child’s Family Doctor, Psychologist and or Psychiatrist, Speech Therapist, Neurologist, Physiotherapist, and more) that work with children adds an element of wholism to the medical management of mental health. Logically, mental health is not simply a product of brain health or lack thereof; it is truly a symptom of whole body and lifestyle health.
Are We Having Trouble Identifying Mental Health Concerns In Our Kids?
I would say that the answer to this is collectively, yes. Yes we are. And I think we come by this honestly. As the cost of living rises and parents are required to spend more time working to support their families, kids are increasingly spending time on their own, at school or in programs. This diversifies the number of people kids interact with over a range of different settings. While this isn’t overall a bad thing, it can create a challenge when it comes to identifying what is going on behaviourally for children. For example, teachers, especially those who have been doing their job for some time, may be able to first identify recurring mental health concerns for children, but this can be compromised by large class sizes and excessive work loads faced by teachers in our school systems. Relaying their concerns to parents who then are faced with seeking out the right medical professionals on their own, both for diagnosis and then treatment, is a chain of events that is not very streamlined or easy in a stressed out, busy system.
This article’s content is not appropriate for a definitive diagnosis of your child as that is done in the presence of health care professionals who can take a full history, conduct physical exams and observe your child’s behaviour, sometimes over the span of multiple visits. This is simply a discussion of common symptoms that you can be on the look out for, make note of and consider making an appointment to discuss for your child if they arise frequently.
Identifying signs of Anxiety In Your Child:
Clingy behaviour
Unable to sleep on their own bed by themselves, having a hard time falling asleep
Tantrums and crying; Meltdowns that begin to occur as a pattern; i.e. every Monday before school or while putting on shoes to leave the house, etc
Having a hard time with change and transitions; Situational anxiety can arise or be exacerbated with switching schools, changing routines, a new sibling, etc
Worrying about the future; from grades to future tests to performance measures in school or sports
Having very high expectations of themselves and being hard on themselves in instances of “less than perfect” performance
Obsessions and or compulsions (also a part of OCD which has a big anxiety picture and may be concurrently present to some degree along with anxiety)
Stomach pain and a change in appetite
Appearing shut down, sullen or fearful in situations where they used to be bright and outgoing
Outbursts of anger or the expression of feeling overwhelmed (may appear as sudden episodes of crying)
Isolating themselves
Changes to friendships and relationships with other family members
Repetitive behaviours that seem to soothe; picking at hair or skin, etc
Weight changes and food binges or food restriction
Identifying signs of Autism Spectrum Disorder in Your Child:
Constipation; children on the spectrum may break down the protein of wheat and dairy differently, causing a build up of opiate like substances that slow bowel function
Rashes on the skin; can be significant of changes at the level of the gastrointestinal tract (balances of yeast and bacteria) that commonly occur in children on the spectrum
Unusual motions in the hands, feet, mouth or face that occur regularly
Restlessness; unable to sit or lie still for 2 minutes
Stereotypies; repetitive motions, patterns or sounds that don’t appear to serve a specific purpose, i.e. hand flapping
Poor progression of fine motor skills
Difference in gaze monitoring; when a child is less likely to establish a shared attention with you to an object you have pointed out
Clumsiness, awkward gait, rolling of body on the floor or couches
Self injurious behaviours (may overlap with repetitive behaviours that appear when the child is more distressed / anxious): slapping or punching self, picking at or pinching skin, hair pulling / tugging, head (or other body part) banging, lip chewing, etc
and more as ASD in a single child tends to be individual in it’s presentation
To conclude, I want to reach out to parents specifically: labelling our children (or having our child labelled) with one mental health concern or another can be tough for us as parents. It might even prevent us from recognizing what is going on with our kids if they don’t perfectly fit the criteria of a single mental health “illness”. Firstly, it should be said that it is not a personal failing on either a nature or nurture level if our child is struggling, and that needs to be reinforced over and over again with families. The rising levels of mental health concerns in children is, in my mind at least, more of a sign of our social structures failing to provide what families need and our health increasingly being influenced by the food industry and other capitalistic influences. Additionally, medical diagnoses can be very helpful when it comes to getting our children the help & support they need, but in some circumstances they can hinder this process by masking something else that is going on or by placing our child’s experiences into a box.
It is my wish (and mission) for all parents that are seeking a supportive medical team for their children’s mental health that the process be supportive and streamlined for each of you, with plenty of time and space for you and your child to have your questions answered (for in the end education and passing on of knowledge is the key to healing) and treatment monitored with many a helping hand along the way.
Dr. Nicole Roberts
Is a Naturopathic Doctor practicing in Richmond Hill & Toronto ON who has a clinic focus on mental health concerns, concussion recovery and autism spectrum disorder in kids and adults. Her goal is to build an institute dedicated to the research & treatment of Brain and Immune Health while working with Medical Doctors and other medical specialists to advance the health of our children. Dr. Roberts continues to be an advocate for community health as basis of individual health.