As the definition of autism expands, are we losing sight of those with the greatest needs?
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Thinking about autism has evolved.
Just three decades ago, autism was a relatively rare and clearly defined condition, diagnosed in people with limited verbal language and highly repetitive behaviour.
Today, autism is diagnosed along a spectrum of a wide range of abilities, from people who may require 24-hour care to those able to live independently.
Around 290,900 Australians are diagnosed with autism, a 42% increase from an estimated 205,200 in 2018.
For many people and their families, this has been an overwhelmingly positive change that has meant recognition of difference, and access to support they previously didn’t have.
But expanding the diagnostic boundaries of autism has also had unintended consequences. Are we leaving those with the most profound disability behind?
An expanding definition
Few diagnoses have broadened their diagnostic boundaries as much or as quickly as autism. In the space of a generation, autism went from a narrowly defined clinical condition to one of the most expansive categories in medicine. We now understand someone can be autistic without having an intellectual disability or significant language difficulties.
Today, autism is diagnosed based on differences in social communication and restricted or repetitive behaviours that are significant enough to affect everyday functioning.
At one end of the spectrum are people who may live independently but experience difficulties with social interaction, managing changes and sensory sensitivities.
At the other end are those with profound disability. They may have minimal spoken language, intellectual disability and require lifelong, around-the-clock support.
While there is broad international agreement about the core features of autism, the boundaries of the diagnosis continue to evolve. This means more people meet the threshold for diagnosis.
For example, there is evidence that some children in the 1990s who may have been described as “socially awkward” – but had autism specifically ruled out as a diagnosis – would now meet modern diagnostic criteria.
Autism can be a difference – and a disability
For many people, this expanded definition of autism has been positive.
In addition to better access to support, diagnosis can give some people a way of thinking about and understanding their experiences of the world – and their interactions with others – which previously may have been confusing or misunderstood.
This is part of a broader shift towards viewing autism through a neurodiversity lens. Autism is seen by many not as a clinical condition, but as a natural variation in human thinking, communication and behaviour.
However, for other autistic people what they live with is more than difference – it is a profound disability that affects their capacity to live independently.
So, what are the downsides?
There is a worry from some parents, researchers and some autistic people themselves that increased focus on autistic people with milder presentations might have inadvertently impacted how we recognise and understand the needs of those with profound disability.
Visibility
Increasingly, autism is portrayed in traditional media – and particularly social media – through milder and more relatable experiences. This risks making those with more profound disability less visible in public consciousness.
Some parents have described their experiences of caring for autistic children with profound disability and the isolation they feel within a culture that increasingly views autism in a starkly different way to their lived reality.
Over-medicalisation
Broadening diagnostic boundaries also risks medicalising what are in fact broadly typical differences among developing children, meaning more children are viewed through a clinical lens.
Medicalisation can have unintended consequences. These include reducing expectations of the child and their development, and providing them therapeutic supports that may be unnecessary, inappropriate or harmful.
Resources
Historically, access to support in schools and disability systems such as the National Disabilty Insurance Scheme (NDIS) has been closely tied to whether someone has a diagnosis. As more people meet criteria for autism, it places more pressure on finite funding and clinical capacity.
When resources are stretched, it can be harder for those with the most complex needs to access the level of support they require for day-to-day life.
The government’s recently announced reforms for the NDIS recognise and respond to some of these tensions. Focus will shift towards providing funding support based on functional need, rather than diagnosis.
Research
With broader definitions, research has moved towards focusing almost exclusively on more cognitively able autistic individuals. While around 40% of autistic children have an intellectual disability, they make up only about 6% of research participants.
This means those who may stand to benefit the most from research that can improve quality of life are, often, the least represented in it.
Finding a balance between inclusion and precision
In many ways, the expansion of autism has been a story of progress. More people feel recognised. More individuals and their families have access to supports. And there is far greater community acceptance of difference.
But progress brings new challenges. As a concept for guiding research, evidence-based clinical practice and policy, the broadened definition of autism has been stretched to the point of breaking.
In response, some clinical and research experts have advocated for a separate diagnostic category of “profound autism” in order to better highlight the needs of these individuals. Others have warned this could undermine the social advances made, and force those with milder levels of disability back to the margins.
The challenge is to retain the gains of broader recognition while ensuring those with the most complex needs remain clearly in view. A spectrum can accommodate diversity. But it must have enough precision to guide action for those who need it the most.
Andrew Whitehouse, Deputy Director, The Kids Research Institute Australia, Professor of Autism Research, The University of Western Australia; David Trembath, Head of Autism Research and Senior Principal Research Fellow, The Kids Research Institute Australia, and Mirko Uljarevic, Professor/Senior Principal Research Fellow, The Kids Research Institute
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Chickpeas vs Peas – Which is Healthier?
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Our Verdict
When comparing chickpeas to peas, we picked the chickpeas.
Why?
Both are great! But…
In terms of macros, chickpeas have more protein, fiber, and carbs, the ratio of which latter two also gives them the lower glycemic index. It’s worth noting that peas are not far behind chickpeas here, but by the numbers, it’s a win for chickpeas in this category.
In the category of vitamins, chickpeas have more of vitamins B9, E, and choline, while peas have more of vitamins A, B1, B2, B3, B5, B6, C, and K. So, a win for peas this time!
When it comes to minerals, however, chickpeas have more calcium, copper, iron, magnesium, manganese, phosphorus, potassium, selenium, and zinc, while peas are not higher in any minerals.
Adding up the sections gives a 2:1 victory for chickpeas, but by all means enjoy either or both; diversity is good!
Want to learn more?
You might like:
Plant vs Animal Protein: Head to Head
Enjoy!
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How I Cured My Silent Reflux – by Don Daniels
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Acid reflux, in its various forms (not all of which include heartburn as a symptom!), affects around 1 in 8 people. Often it takes the form of coughing or excess mucus after eating, and it can trigger ostensibly random sweats, for example.
Don Daniels does an excellent job of demystifying the various kinds of acid reflux, explaining clearly and simply the mechanics of what is going on for each of them and why.
Further, he talks about the medications that can make things worse (and how and why), and supplements that can make it better (and supplements that can make it worse, too!), and a multiphase plan (diet on, meds weaned off, supplements on, supplements weaned off when asymptomatic, diet adjust to a new normal) to get free from acid reflux.
The writing style is simple, clear, and jargon-free, while referencing plenty of scientific literature, often quoting from it and providing sources, much like we often do at 10almonds. There are 50+ such references in all, for a 105-page book.
So, do also note that yes, it’s quite a short book for the price, but the content is of value and wouldn’t have benefitted from padding of the kind that many authors do just to make the book longer.
Bottom line: if you have, or suspect you may have, an acid reflux condition of any kind, then this book can guide you through fixing that.
Click here to check out How I Cured My Silent Reflux, and put up with it no longer!
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Why can’t I keep still after intense exercise?
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Do you ever feel like you can’t stop moving after you’ve pushed yourself exercising? Maybe you find yourself walking around in circles when you come off the pitch, or squatting and standing and squatting again when you finish a run.
Sometimes the body knows what’s best for us, even if we’re not aware of the science.
Moving around after intense exercise actually helps the body recover faster. Here’s how it works – plus a tip for if you feel exactly the opposite (and just want to lie down).
Drazen Zigic/Shutterstock What is ‘intense’ exercise?
There are different ways to measure exercise intensity. One is simply how hard it feels to you, known as the “rating of perceived exertion”.
This takes into account how fast you’re breathing, how much you’re sweating and how tired your muscles are. It also considers heart rate.
The average resting heart rate when you’re not exerting yourself is around 60–80 beats per minute, although this can vary between people.
The maximum healthy heart rate is based on subtracting your age from 220. So, if you’re 20 years old, that’s 200 beats per minute when you’re exercising as hard as you can.
This decreases as you age. If you’re 50 years old, your maximum heart rate would be around 170 beats per minute.
An increased heart rate helps pump blood faster to deliver fuel and oxygen to the muscles that are working hard. Once you stop exercising your body will begin its recovery, to return to resting levels.
Let’s look at how continuing to move after intense exercise helps do this.
Removing waste from the muscles
Whenever the body converts fuel into energy it also produces leftover substances, known as metabolic byproducts. This includes lactate (sometimes called lactic acid).
During intense exercise we need to burn more fuel (oxygen and glucose) and this can make the body produce lactate much more quickly than it can clear it. When lactate accumulates in the muscles it may delay their recovery.
We can reuse lactate to provide energy to the heart and brain and modulate the immune system. But to do this, lactate must be cleared from the muscles into the bloodstream.
After intense exercise, continuing to move your body – but less intensely – can help do this. This kind of active recovery has been shown to be more efficient than passive recovery (meaning you don’t move).
Intense exercise can mean your muscles produce more metabolic byproducts. Tom Wang/Shutterstock Returning blood to the heart
Intense exercise also makes our heart pump more blood into the body. The volume pumped to the muscles increases dramatically, while blood flow to other tissues – especially the abdominal organs such as the kidneys – is reduced.
Moving after intense exercise can help redistribute the blood flow and speed up recovery of the respiratory and cardiovascular systems. This will also clear metabolic byproducts faster.
After a long run, for example, there will be much more blood in your leg muscles. If you stand still for a long time, you may feel dizzy or faint, thanks to lowered blood pressure and less blood flow to the brain.
Moving your legs, whether through stretching or walking, will help pump blood back to the heart.
In fact around 90% of the blood returning from the legs via veins relies on the foot, calf and thigh muscles moving and pumping. The calf muscle plays the largest role (about 65%). Moving your heels up and down after exercising can help activate this motion.
What if you don’t feel like moving?
Maybe after exercise you just want to sit down in a heap. Should you?
If you’re too tired to do light movement such as stretching or walking, you may still benefit from elevating your legs.
You can lie down – research has shown blood from the veins returns more easily to the heart after exercise when you’re lying down, compared to sitting up, even if you’re still. Elevating your legs has an added benefit, as it reverses the effect of gravity and helps circulation.
Ken Nosaka, Professor of Exercise and Sports Science, Edith Cowan University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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10 Ways To Naturally Boost Dopamine
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Dopamine is the “reward” hormone, and is responsible for motivation, as well as various oft-forgotten functions (such as spatial skills, motor functions, task processing, planning, and language). Sometimes, our relationship with dopamine isn’t what it could be, so here’s how to fix that:
Let’s get hormone-hacking…
Here are the 10 ways:
- The seesaw effect: reduce overstimulation by taking tolerance breaks from high-dopamine activities that aren’t particularly useful (like social media or phone games), allowing for natural enjoyment of daily activities that you’d normally find enjoyable. Think: if you died and negotiated to be sent back to life on the condition you’d appreciate it properly this time, what things would you then spend your time doing? It’s probably not Kingdom Crush Saga Farm 2, is it?
- Conscious state meditation: practise conscious state meditation, focusing inward to reduce anxiety and release dopamine. Even a few minutes a day can significantly enhance dopamine levels.
- Hack your REM cycles: optimize sleep, especially REM cycles, which produce the most dopamine. Aim to wake up after your final REM cycle to feel energized and happy.
- The runner’s high: engage in regular exercise, which boosts dopamine through physical exertion and can lead to feelings of relaxation and euphoria, often known as the “runner’s high.”
- Mood-enhancing music: listen to music that makes you feel good. Favorite songs can stimulate dopamine production, improving your mood and well-being.
- Bright light therapy: spend time in natural sunlight to stimulate dopamine production and elevate your mood, countering the negative effects of extended indoor time. If natural sunlight is not very available where you are (e.g. this writer who lives next to an ancient bog surrounded by fog and the days are getting short, at time of writing), then artificial daylight lamps are respectable supplement—but just that, a supplement, not a replacement. Despite how it looks/feels, natural sunlight (especially in the morning, to cue the circadian rhythm to do its thing) is beneficial even through cloud cover.
- Relieve stress for good: actively reduce stress, as it inhibits dopamine. Simplify daily routines and eliminate stressors to naturally boost dopamine and feel more relaxed. Of course, you cannot remove all stress from your life, so get good at managing the stress created by the stressors that do remain.
- Tap into your flow state: enter a “flow state” by focusing deeply on an engaging task, which can elevate dopamine levels and boost motivation and happiness.
- The hormesis effect: embrace mild physical challenges, like cold showers. The temporary discomfort will paradoxically increase dopamine (it’s the body’s way of saying “congratulations, you survived the hard thing, here’s a little treat, so that you’ll be motivated to survive the next hard thing, too”)
- Activate your inner artist: engage in creative activities that you find fun. The process of creating boosts dopamine and provides motivation, enhancing mood and enjoyment in life.
For more on all of these, enjoy:
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Want to learn more?
You might also like to read:
Rebalancing Dopamine (Without “Dopamine Fasting”)
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Successful Aging – by Dr. Daniel Levitin
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We all know about age-related cognitive decline. What if there’s a flipside, though?
Neuroscientist Dr. Daniel Levitin explores the changes that the brain undergoes with age, and notes that it’s not all downhill.
From cumulative improvements in the hippocampi to a dialling-down of the (often overfunctioning) amygdalae, there are benefits too.
The book examines the things that shape our brains from childhood into our eighties and beyond. Many milestones may be behind us, but neuroplasticity means there’s always time for rewiring. Yes, it also covers the “how”.
We learn also about the neurogenesis promoted by such simple acts as taking a different route and/or going somewhere new, and what other things improve the brain’s healthspan.
The writing style is very accessible “pop-science”, and is focused on being of practical use to the reader.
Bottom line: if you want to get the most out of your aging wizening brain, this book is a great how-to manual.
Click here to check out Successful Aging and level up your later years!
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What is ‘breathwork’? And do I need to do it?
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From “breathwork recipes” to breathing techniques, many social media and health websites are recommending breathwork to reduce stress.
But breathwork is not new. Rather it is the latest in a long history of breathing techniques such as Pranayama from India and qigong from China. Such practices have been used for thousands of years to promote a healthy mind and body.
The benefits can be immediate and obvious. Try taking a deep breath in through your nose and exhaling slowly. Do you feel a little calmer?
So, what’s the difference between the breathing we do to keep us alive and breathwork?
Taras Grebinets/Shutterstock Breathwork is about control
Breathwork is not the same as other mindfulness practices. While the latter focus on observing the breath, breathwork is about controlling inhalation and exhalation.
Normally, breathing happens automatically via messages from the brain, outside our conscious control. But we can control our breath, by directing the movement of our diaphragm and mouth.
The diaphragm is a large muscle that separates our thoracic (chest) and abdominal (belly) cavities. When the diaphragm contracts, it expands the thoracic cavity and pulls air into the lungs.
Controlling how deep, how often, how fast and through what (nose or mouth) we inhale is the crux of breathwork, from fire breathing to the humming bee breath.
Breathwork can calm or excite
Even small bits of breathwork can have physical and mental health benefits and complete the stress cycle to avoid burnout.
Calming breathwork includes diaphragmatic (belly) breathing, slow breathing, pausing between breaths, and specifically slowing down the exhale.
In diaphragmatic breathing, you consciously contract your diaphragm down into your abdomen to inhale. This pushes your belly outwards and makes your breathing deeper and slower.
You can also slow the breath by doing:
- box breathing (count to four for each of four steps: breathe in, hold, breathe out, hold), or
- coherent breathing (controlled slow breathing of five or six breaths per minute), or
- alternate nostril breathing (close the left nostril and breathe in slowly through the right nostril, then close the right nostril and breathe out slowly through the left nostril, then repeat the opposite way).
You can slow down the exhalation specifically by counting, humming or pursing your lips as you breathe out.
In contrast to these calming breathing practices, energising fast-paced breathwork increases arousal. For example, fire breathing (breathe in and out quickly, but not deeply, through your nose in a consistent rhythm) and Lion’s breath (breathe out through your mouth, stick your tongue out and make a strong “haa” sound).
What is happening in the body?
Deep and slow breathing, especially with a long exhale, is the best way to stimulate the vagus nerves. The vagus nerves pass through the diaphragm and are the main nerves of the parasympathetic nervous system.
Simulating the vagus nerves calms our sympathetic nervous system (fight or flight) stress response. This improves mood, lowers the stress hormone cortisol and helps to regulate emotions and responses. It also promotes more coordinated brain activity, improves immune function and reduces inflammation.
Taking deep, diaphragmatic breaths also has physical benefits. This improves blood flow, lung function and exercise performance, increases oxygen in the body, and strengthens the diaphragm.
Slow breathing reduces heart rate and blood pressure and increases heart rate variability (normal variation in time between heart beats). These are linked to better heart health.
Taking shallow, quick, rhythmic breaths in and out through your nose stimulates the sympathetic nervous system. Short-term, controlled activation of the stress response is healthy and develops resilience to stress.
Breathing in through the nose
We are designed to inhale through our nose, not our mouth. Inside our nose are lots of blood vessels, mucous glands and tiny hairs called cilia. These warm and humidify the air we breathe and filter out germs and toxins.
We want the air that reaches our airways and lungs to be clean and moist. Cold and dry air is irritating to our nose and throat, and we don’t want germs to get into the body.
Nasal breathing increases parasympathetic activity and releases nitric oxide, which improves airway dilation and lowers blood pressure.
Consistently breathing through our mouth is not healthy. It can lead to pollutants and infections reaching the lungs, snoring, sleep apnoea, and dental issues including cavities and jaw joint problems.
Breathing can be high and shallow when we are stressed. mi_viri/Shutterstock A free workout
Slow breathing – even short sessions at home – can reduce stress, anxiety and depression in the general population and among those with clinical depression or anxiety. Research on breathwork in helping post-traumatic stress disorder (PTSD) is also promising.
Diaphragmatic breathing to improve lung function and strengthen the diaphragm can improve breathing and exercise intolerance in chronic heart failure, chronic obstructive pulmonary disease and asthma. It can also improve exercise performance and reduce oxidative stress (an imbalance of more free radicals and/or less antioxidants, which can damage cells) after exercise.
Waiting at the lights? This could be your signal to do some breathwork. doublelee/Shutterstock A mind-body connection you can access any time
If you feel stressed or anxious, you might subconsciously take shallow, quick breaths, but this can make you feel more anxious. Deep diaphragmatic breaths through your nose and focusing on strong exhalations can help break this cycle and bring calm and mental clarity.
Just a few minutes a day of breathwork can improve your physical and mental health and wellbeing. Daily deep breathing exercises in the workplace reduce blood pressure and stress, which is important since burnout rates are high.
Bottom line: any conscious control of your breath throughout the day is positive.
So, next time you are waiting in a line, at traffic lights or for the kettle to boil, take a moment to focus on your breath. Breathe deeply into your belly through your nose, exhale slowly, and enjoy the benefits.
Theresa Larkin, Associate professor of Medical Sciences, University of Wollongong and Judy Pickard, Senior Lecturer, Clinical Psychology, University of Wollongong
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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