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have associated the likelihood of being overweight or obese with the number of psychoactive behavioral medicines these children take.3 Treatment usually takes into considerations dietary and behavioral measures. Dietary approach to treatment entails introducing healthier food choices while reducing each serving size for breakfast, lunch and supper. At times, if required high-calorie foods are removed from the child’s diet while daily exercises in the form of walking and/or riding bicycles is encouraged.34 SLEEP PROBLEMS Chronic sleep problems frequently occur in children with autism (more than half of children with autism have trouble sleeping). Most persons with autism experience disrupted sleep that is, they have issues with normal sleep patterns.35 For instance, many adults with autism have problems going to sleep while others wake frequently at night, still some may wake up very early and stay awake throughout the day. Lacking sufficient sleep may actually result in a sleep disorder, which can aggravate abnormal behaviors during the day. Sleep disturbances may also pose difficulty in communicating, increase aggressive and repetitive behaviors, as well as inattention, hyperactivity and irritability. Generally, these reduce the quality of life and hamper learning. According to research, possible biological causes of sleep problems in persons with autism include mutations in genes that control the body’s sleep-wake cycle called the circadian rhythm. In addition, sleep problems may be worsened by undetected seizures occurring at night disrupting sleep brain patterns.36 Again, anxiety may affect the ability to fall asleep and remain asleep for long hours at night. In addition to biological causes of sleep problems, reduced levels of melatonin may cause autism-related sleep problems.37 Some strategies to help improve sleep for persons with autism and get them back to sleep after waking up at night have been suggested. These strategies include integrating daytime exercises and outdoor activities in a manner that will lead to evening routines that limit screen time before bed. In addition, parents are taught how to create visual schedules that help to establish regular bedtime routines. These strategies have been proven to increased sleep time for individuals with autism as well as reduced anxiety, inattention and challenging behaviors during the day.38 MENTAL HEALTH DISORDERS Mental health conditions such as ADHD, anxiety and depression among others frequently affect children with autism. Averagely 62% of persons with autism suffer from one or more mental health disorders14 which can greatly worsen autism’s behavioral challenges if not identified and treated. Usually, autism and ADHD have similar symptoms39 as such an evaluation by a specialist is required to differentiate between the two disorders and develop a suitable treatment plan for the individual. Generally, treatment may entail ADHD medication as well as behavioral strategies such as the Applied Behavior Analysis (ABA). ABA is a remarkable treatment therapy for individuals with autism,40 which is widely used by healthcare professionals as well as in many schools, autism centers and clinics. Anxiety Anxiety disorders are mostly diagnosed among persons with autism; about 42% of children and teenagers with autism are affected with one or more anxiety disorders41 compared to about 3% of children and 15% of adults who develop normally. Persons with autism are particularly affected by social anxiety, which is excessive fear of strangers, crowds and social circumstances. Anxiety can be elicited at different points in time and caused by various activities including past enjoyable events. For many children with autism anxiety may be triggered by difficulty participating in social activities and significant sensory sensitivities to lights, tastes, smells and loud noises. Depression It is estimated that about seven percent of children and 26% of adults with autism are affected by depression whereas only about two and seven percent of children and adults respectively in the general population are affected. It is worth noting that the rates of depression among individuals with autism increase with age and Review | Volume 8 | Number 1| 7
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