How Gut Health, the "Second Brain," Affects ABA Therapy

As a BCBA, I have been involved in the treatment process for 10 years, and I have felt that various research related to children's health is being conducted, and that such new research has a great influence on the direction of treatment.

Among these, I've been continuously following research on children's digestive health, which has been published in prominent papers. Today, I'd like to discuss how children's digestive health and brain development impact the Applied Behavioral Analysis (ABA) therapy I practice.

 

Second Brain: The Link Between Gut Health and Autism Symptoms

Reference paper: Hung, LY, Margolis, KG Autism spectrum disorders and the gastrointestinal tract: insights into mechanisms and clinical relevance. Nat Rev Gastroenterol Hepatol 21, 142–163 (2024).

You might wonder, "What does ABA therapy have to do with digestive health?" But understanding the causes of changes in children's bodies clearly impacts the day-to-day ABA lessons they receive.

A study by Hung and Margolis, published in Nature Reviews Gastroenterology & Hepatology, a top-ranked medical journal in the field of gastroenterology and hepatology, confirms a strong link between autism spectrum disorder and gastrointestinal health.

1) People with autism spectrum disorder are said to have a much higher risk of experiencing gastrointestinal problems than the general population. Constipation, diarrhea, and abdominal pain are particularly common.

2) What's even more surprising is that these gastrointestinal problems are associated with the severity of core autism symptoms. In other words, poorer gastrointestinal health may be associated with more severe autism symptoms.

3) The researchers suggest that gut microbiome and its metabolites may play an important role in the pathological mechanisms of autism.

These study results suggest that a holistic approach is necessary when treating ASD. Rather than simply focusing on the behavior itself, attention should also be paid to overall physical health, including gastrointestinal health.

 

Learning about children's physical health during ABA therapy

Let me share some of my personal experiences from the past...

I had a child who was receiving treatment at the center for about three years, and his parents were constantly concerned that as he got older, his aggression was increasing, he was having difficulty concentrating during therapy sessions, and his stereotyped behaviors were getting worse.

Although the child's challenging behavior patterns were observed, no clear cause was found, and the parents, frustrated, started various new treatments, hoping that the child would get better, but the irritability and aggressive episodes continued.

Then one day, out of the blue, my child was taken to the emergency room with abdominal pain. At that time, I realized that my child was suffering from persistent abdominal pain and severe constipation, and that he had language problems making it difficult for him to properly express his pain.

After this incident, I was able to change the direction of my ABA treatment as I began to suspect a connection between my child's digestive health and his overall concentration, aggression, and repetitive behaviors.

- Record eating habits, bowel patterns, abdominal pain, and other symptoms more systematically.

- Consider the child's GI (gastrointestinal) health when analyzing problem behavior functions.

- Strengthening communication training - Training in skills to express symptoms through photos or drawings

- Establish an intervention plan related to your child's picky eating.

Fortunately, as my child's aggressive episodes began to decrease by about 40% and his participation in sessions improved significantly, I realized even more strongly that ABA also needed a comprehensive approach.

 

The Role of Parents: Gut-Brain Health Management

Parents also seem to have a very important role to play. It's crucial to understand and share information about your child's overall physical health and eating habits in advance, as they can impact the various treatments they undergo.

Keep a food-mood journal : Record your child's diet, behavior, and mood. There may be a connection between what they eat, their stomach condition, and their mood.

- Open communication : If your child has abdominal pain, diarrhea, or constipation, please let your care team know and discuss it together.

Explore gut-healthy foods : Talk to a nutritionist or doctor to find out how you can improve your child's diet. Small changes can make a big difference!

- Introduce stress-reduction techniques : Stress clearly affects gut health. Introducing calming activities, such as gentle massage or emotional regulation training, can also help.

 

What do you think about the connection between gastrointestinal health and a child's development? Have you ever noticed any connection between your child's GI health and behavior?

If you have had a similar experience, or a completely different one, please let me know in the comments :)

I will continue to seek out more excellent research to ensure our children's healthy lives! Thank you!