AUTISM- FIND THE THRUST AREAS OF AYURVEDIC MANAGEMENT
Dr Dinesh.K.S;MD(Ay.);Asst.Professor,V.P.S.V.Ayurveda
College, Kottakkal, drayurksd@gmail.com,
+919447698085
I
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ntroduction
Man is a social animal; because he transfers
emotions, uses language and communicate each other. He has several other skills
to make fit himself in to the society. This is attained by proper neuronal formation
and maturation which starts from the intra uterine environment and completes with
the help of the environment proper outside the womb. This is the essence of
pervasive development, and the disorder of the above said physiology is called
pervasive developmental disorder [PDD]. The best known PDD is Autism. This may be the reason why the doctors are
speculating their role in the autism management as it has a physical basis. Autism
was previously a symptom in adult schizophrenia1. In this condition there is marked and sustained
impairment in social interaction, deviance in communication, and restricted or
stereotyped patterns of behavior and interest. Abnormalities in functioning in
each of these areas must be present by age 3 years. Approximately 70 percent of
individuals with autistic disorder function at the mentally retarded level, and
mental retardation is the most common comorbid diagnosis2. Humanity is now astonishing with the rising scene of
autism features among the children. Obviously the disease is a stroke to the
family as well as to the society. The
curative management of the condition is still a mirage because the cause of the
disease is still unknown. However the management teams like religious persons,
traditional healers and ayurvedic hospitals are mushrooming with golden blind
offers to exploit the helplessness and hopes of the suffering family members. Even
the visual media is now a day identifying this trend and trying to highlight
Ayurveda as a ridicule method to treat autism. So it is the responsibility of scientific
Ayurveda people to publish and highlight the real thrust areas of Ayurveda in
autism management. Following are some of the areas where Ayurveda has a
pronounced role in the autism management according to the limited experience of
author.
Neuronal
Migration problems and autism
Neuronal migration disorder refers to a heterogenous group of disorders that, it is
supposed, share the same etiopathological mechanism: a variable degree of
disruption in the migration of neuroblasts during neurogenesis3. The recent autopsy
studies are revealing the the children with PDD has migrational defects4.
So the PDD has to be
considered as the garbha vikritis
caused by the deficient quality of gametes[sukla and artava], defective uterine environment, time of conception,
diet and activities of mother5.
The features of PDD will be expressed as, defective pravritti of vayu[sanga] in the areas of budhi and mana[praana and udaana]. Language
developemental problems, sterotypies, defective socializations are example of
it6. Sometimes in PDD the
vata vitiated[vriddhi] lakshanas in
the pakwasaya, siraa and snaayu will be expressed as walking difficulties,
microcephaly, loss of bladder control etc7.
This clearly indicates the srotorodha is in the brain itself so as to produce a
bipolar feature of vayu viz atipravritti
and sanga. So the medhya with ushna teekshna drugs and budhi prabodhaka procedures
[gomutra preperations and pradhamana ] along with tiktapaachana drugs mainly
with guloochee is showing some hopes to alleviate the symptoms. Here we have to
exploit the neuronal plasticity, the wonderful capacity of neurons to mould and
rewire according to the inputs from the sensory organs and proprioceptive
stimulus. Ayurveda is a science with good treasure of procedures which promotes
the neuronal growth by the mechanism of neuronal plasticity. Udwarthana,
abhyanga, some vastis are such examples. These procedures can be effectively
implemented aiming the management of migration issues.
Gut problems in autism
&deficiencies
Usual gut problems of autistic children are
some specific allergies especially to gluten and casein. Frequent spells of
either diarrhea or constipation is usual among these children. All these issues are invariably featuring
similarity to either aama/ajeerna or doosheevisha concept in ayurveda. The
amaasayastha or pakwasayastha dosheevisha lakshanas are more prominent in this
context. The kaalasaakadi kashaya, villwadi gulika, hinguvachaadi churnam,
doosheevisharigulika are the chief agents which acts powerfully to manage these
problems. But interesting point is that management of food allergies is finally
reaching to the good management of hyperactive symptoms associated with
autistic children. This is due to the fact that both faculties [gut and mind]
are the functions of rasadhatu. The references
of enterocolonic encephalopathy theory have to be read in connection with this
similarity.
The management of deficiencies has been started since 1960
for the autism treatment plan. Vitamin B6, magnesium,zinc are the usual
supplements of foods which gives positive results in
speech,attention,irritability and learning skills8. These are all indicative of an inherent agnimandya of
autistic babies either at the level of koshta or at the level of dhatuparinaama.
Toxins in autism
Several endotoxins and exotoxins are
hypothesized to have a prominent role in the etiogenesis of autism diseases.
Endotoxins are chiefly by several infections9, intermediary metabolic substances like ammonia,
lactate, pyruvate, endomorphin10
etc. Exotoxins are chiefly by heavy metals, food addictives, drugs, pesticides
etc11. Here the
endotoxins are to be treated as dhatugata aama and doosheevisha and should be treated
accordingly. Exotoxins are the real vishaas and heavy metals and all vishahara
chikitsas are inevitable in most of the cases. Heavy metals such as mercury
from several vaccines and fishes have been chiefly blamed in the causation of
autism disorders12. Current
chelation therapy in biomedicine is one such an effort in this regard. The
patoladi ganam, aragwadhadi ganam are the chief agents which we are utilizing
for this aspect in autism management.
Hyperactivity and
autism
Poor
affect modulation and the display of emotions inappropriate to a given social
situation are common. Some individuals may show sudden mood changes, and laugh,
cry, or giggle to themselves for no apparent reason. The controlling and stimulating power of the
vayu on mind is getting totally underdeveloped here to produce almost similar
features of vata paittika unmada. Interestingly all those children are showing other
paittika symptoms like diarrhea, self injurious behavior, head banging
etc..Maximum other co morbidities like fragile X syndrome[FRAXA],tuberous
sclerosis are mostly seen with this prominent symptom of hyperactivity in
autism. So the management protocol
should be directed towards these co morbidities. Snehapaana with kaaraskara
ghrita[Indicated in vatasonita chikitsa by sahasrayoga] usually alleviate
hyperactivity in tuberous sclerosis and FRAXA. The typical vatapittika unmaada hara chikitsas like seka
with himasagaram tailam, yashti madhu+gudoochee kwatha, rajanyaadi churna,
sirolepam etc..is giving positive changes. Sleep issues are also getting relieved by this
management scheme.
Autism spectrum
disorders(ASDs)
Rett’s syndrome, Asperger
syndrome, childhood disintegrative disorder(CDD) and pervasive developmental
disorder not otherwise specified are the ASDs. Of these exposure to asperger
syndrome is less to the author where as PDD –NOS is the mostly encountered
case. Rett’s syndrome and CDD are the diseases in which the doshas in the rasadhatu
makes its manifestation both in somatic and psychic areas prominently. The
samprapti finally progress to the further dhatus and upadhatus to create the
symptoms like, vasti vikaras, dourbalyam, kampam, akshepakam, apasmaaram etc.
General informations
and conclusions13
Research based acceptable methods,
principles, techniques and rationale are the only applicable interventions
allowed ethically in autistic children. Ayurveda is not one among them at
present. The accepted interventions are Applied Behaviour Analysis(ABA), the
TEACCH approach[Treatment and Education of Autism and related Communication
Handicapped Children], Lovaas and discrete trial teaching, augmentative and
alternative communication,Higaashi daily life therapy, sensory integration therapy are few of them. A multidisciplinary team and transdisciplinary
team is inevitable to manage those children and that team should inevitably consist
of an experienced Ayurveda specialist. If it is a classical case of autism best
approach is multidisciplinary and if it is co morbidity along with other
multiple problems transdisciplinary approach is best.
A transdisciplinary team should have one or
two persons as primary facilitators of the services and other team members acts
as consultants.
References
1.
Kuhn R; tr. Cahn CH.
Eugen Bleuler's concepts of psychopathology. Hist
Psychiatry. 2004;15(3):361–6.
2.
Benjamin
J Sadock; Virginia Alcott Sadock; Pedro Ruiz; Kaplan and Sadock’s comprehensive
text book of psychiatry.
3.
Sarnat, Harvey (1992). Cerebral dysgenesis, embryology and
clinical expression. New York, US: Oxford University Press. ISBN 0-19-506442-9
4.
Schmitz C, Rezaie P.
The neuropathology of autism: where do we stand? Neuropathol Appl Neurobiol.
2008;34(1):4–11.
5.
Charakasamhita,sareerasthaana,atulyagotreeyam
sareeram.
6.
Ashtanga
samgraha,sutrastaana,doshabhedeeya.
7.
Ashtangahridaya,
Nidanastaana,vatavyaadhi.
8.
DSE(ASD)Therapeutics;
rehabilitation council of india;Kanishka publishers.
9.
.Libbey JE,
Sweeten TL, McMahon WM, Fujinami RS. Autistic disorder and viral infections. J Neurovirol.
2005;11(1):1–10.
10.
Ng F, Berk M, Dean O, Bush AI. Oxidative
stress in psychiatric disorders: evidence base and therapeutic implications. Int J Neuropsychopharmacol.
2008;11(6):851–76.
11.
Rutter M. Incidence of autism spectrum
disorders: changes over time and their meaning. Acta Paediatr. 2005;94(1):2–15.
12.
Austin
D. An epidemiological analysis of the 'autism as mercury poisoning' hypothesis. Int J Risk Saf Med.
2008;20(3):135–42
13.
DSE(ASD)Therapeutics;
rehabilitation council of india;Kanishka publishers.
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