While waiting in line at the store recently, I found myself charmed by a cute 17-month-old boy with a head full of blond curls. As his mother held him, I made some funny faces and he laughed. He quickly lost interest in me, however, as he spotted a display of small stuffed animals by the register. He began talking and I found myself rather amazed at this expressive (“that’s a monkey”) and receptive (able to point to the animals his mom named out loud) language abilities.

“He’s quite the talker,” I said to mom.

“He is!” she chirped, obviously very proud of her son.

I immediately thought of all the children I know with language delays and disorders (including my son) and how their lives would be easier if these issues did not create such an obstacle to clear communication. Many moms struggle with whether their child’s language is developing in a typical way.

One close friend struggled for months wondering if her daughter had language delays or was just a late-bloomer when it came to talking. The pediatrician assured her the child’s development was normal. My friend’s “mother’s gut feeling” told her otherwise and took her daughter to a specialist who discovered a mild to moderate language delay. With some intervention and speech therapy, my friend’s daughter is on target with her language development.

Not all development issues are solved that easily, but most caring and aware moms have that gut feeling that something is amiss. And talking (or making sounds and baby words like da-da and ma-ma) is one of the first skills that parents look to for confirmation that everything is okay.

Given that moms are always comparing their children with other kids (come on, we all do it), it’s even more difficult to determine whether your own child has a problem or whether the other kid is just uber-brilliant. The blond-haired boy I flirted with in the store seemed to be very advanced in his language development, but placed in a population of 100 boys his same age, he could very well be behind many of his peers.

What’s my point?

That as a mom you know your child better than anyone. If you suspect something is wrong, then check it out. If the pediatrician poo-poos your worries and you feel unheard, then ask someone else. Many schools have professionals who can guide you and help you find the answer (or the person that can provide the answer) you need to find peace and know that you are doing everything you can for your kids. If your child does have an issue, then the earlier he or she gets help the better.

And oh yeah, here’s a belated Happy Mother’s Day!!

Post from: Kids Enabled

%%POSTLINK%%

Moms Know Their Kids!

by Heidi S. Liefer, MS, MS, CCC-SLP, BRS-S, CLC

Although most people think of speech pathologists as teachers who help others articulate letter sounds and speak smoothly (fluency), there are actually many processes and tasks that fall within the realm of speech pathology. KE asked speech therapist Heidi S. Liefer (MS, MS, CCC-SLP, BRS-S, CLC) to explain what it means to be a speech-language pathologist (SLP).

The Basics

• SLPs must earn a master’s degree from an accredited program. In order to graduate and to obtain a certificate of clinical competence (CCC-SLP), they are required to complete a requisite number of hours gaining experience in a variety of areas.
• IIn terms of required training and coursework, there is no difference between the terms “speech therapist” and “speech-language pathologist.”
• Speech aides or SLP assistants may have specialized coursework in communication disorders, but typically have not received a master’s degree. The most common place for an SLP to work is in the school system. About 50% of SLPs are employed or contracted by the schools. Pediatric therapists may also be found in private practice or in hospitals. Therapists who work with adults may work in rehabilitation facilities, hospitals, the VA system, and home health.

Areas of Expertise

• Articulation encompasses the letter sounds of language and how they are formed by the mouth. Because talking involves motor movements, learning to pronounce a sound correctly is similar to learning how to swing a baseball bat or type on a keyboard. The more times it is executed correctly, the more quickly the new movement or pattern can be executed correctly.
• Language involves the content of the utterances. This is an extremely broad area, which progresses and changes as we age. It is also changes with different situations and demands. Language intervention may begin “pre-linguistically,” or before the time we would expect children to be producing words. Even as infants, human beings are very social and communicate a desire for interaction well before we are mature enough to use our mouths to communicate. We make connections with eye contact and imitation of sounds and expressions as young infants. We also respond to familiar names and words with recognition, like looking at daddy when the word “daddy” is spoken.
• Fluency involves the smoothness in which a person is able to express thoughts and ideas. This is a complicated process, which often encompasses both speech and language. Children may go through a period of stuttering in early pre-school years as language demands change, and their mouth struggles to “keep up” with their thoughts. This typically passes relatively quickly, and does not always need direct intervention. If there is a family history of stuttering, if the child is frustrated, or if it continues longer than 6 months, it is important to seek intervention from someone who is competent in treating fluency.
• Auditory processing is related to the way in which the brain receives and makes sense of information from the ear. It typically involves sorting out more complex tasks of the meaning of sounds. It may involve tasks such as responding to important sounds vs. unimportant sounds, such as ignoring the refrigerator noise and attending to a speaker. It may also involve hearing the differences between closely related letter sounds (d vs. t). Sometimes therapists will address tasks such as taking in complicated directions, processing them, and producing a response.
• With the increase in autism spectrum diagnoses, more focus is being placed on the pragmatic area of language, as it is one of the key areas impacted by autism. Deficits in this area of language are not limited to people on the autism spectrum, and although it is difficult to explain, it is clearly apparent to a listener when there are deficits. It involves the application of language to a situation. Therapy addresses interpersonal interactions, turn-taking, appropriate comments for specific situations, and making or maintaining conversation. These language skills are the basis of making and maintaining friendships, making personal connections, and having productive work interactions.
• Speech and language may both be affected as a result of a traumatic brain injury or stroke. This may be seen at any age, and typically those people will be seen in the hospital, and then sent to a rehabilitation facility. They may eventually receive services in community locations or school systems. Because the brain controls all areas of speech and language, deficits will be related specifically to the area in which the damage occurred.
• Feeding and swallowing disorders can be caused by the same deficits that cause disruptions in speech. Because SLPs are experts at the nerves and muscles of the mouth and throat, they are also knowledgeable in the process of biting, chewing and swallowing safely Dysphagia, or swallow dysfunction, may result from many causes. Children who are born prematurely may have significant difficulty with coordinating the suck:swallow:breathe process. Toddlers may have a difficult time learning to coordinate chewing movements. Brain damage at any age may cause weakness or deficits in the actual swallowing of liquids or chewed foods.
• Hearing impairment may create speech deficits as well. Auditory verbal therapy is one specific type of treatment for hearing impairment, which follows specific protocols for teaching the brain to recognize and give meaning to the sounds being received by the ear. Children and adults may both benefit from amplification (hearing aids), but still need assistance in making sense of the information their ear is relaying to the brain.
• Children or adults who have significant impairments to spoken communication may rely on specialized devices to provide a way to communicate with those around them Augmentative communication may include simple low-tech devices, such as spelling boards or pictures, or more complex electronic devices, such as computer-based systems. These may be useful for teaching language to children with impairments, as well as providing a way to communicate. Because the usefulness of the devices is dependent upon how usable it is to the patient and family, it should be chosen after a careful assessment of the patient’s abilities and limitations. Therapists who specialize in Alternative and Augmentative Communication (AAC) may be helpful because of their familiarity with the broad range of devices available.

What to expect from an appointment

• Evaluation Typically an evaluation is conducted to assess areas of strength and weakness. The evaluation may consist of standardized tests in addition to clinical assessment and parent interview. he need for treatment will be determined and specific intervention goals will be developed.
• Treatment often involves weekly visits, but frequency may be either more or less frequent, based on the findings in the assessment. The progress in treatment is also impacted by the ability of the child and family to practice or implement strategies at home.

Resources for Parents

The web site for the American Speech Language Hearing Association (http://www.asha.org/) provides further information and resources in all of these areas. Because SLPs are trained in all of these areas, they are also excellent resources to help provide direction and resources of appropriate assessment and treatment. Check out these web sites below for more information:

• KidsHealth.org — A good overview of speech disorders and available strategies and treatments.
• Speech-Language-Development.com — An informative question and answer segment by an SLP.
• SpeechTherapyWeb.com — A good general web site about speech therapy with tips and great information for parents.

Heidi is a Speech Language Pathologist at Children’s Healthcare of Atlanta, where she has worked for 13 years. She is a Board Recognized Specialist in Swallowing and Swallowing Disorders, and a Certified Lactation Counselor. She treats a variety of pediatric communication disorders, but specializes in infants and children with feeding and swallowing disorders. Prior to her current position at Children’s, Heidi worked with adults at a hospital in North Carolina, and was a teacher in the school system. She also teaches Introduction to Communication Disorders at Georgia State University to aspiring speech language pathologists in the Department of Communications

Post from: Kids Enabled

%%POSTLINK%%

May is Better Speech and Hearing Month

Atlanta-based Wynsum Arts has developed a tool, the i.AM Search app, to help filter through these apps for children with autism. Some features of this app are below:

• Users create a profile based on a child’s age, ability level, and symptoms.
• Based on this profile, i.AM Search creates a customized list of Apple apps, making it easier to find apps that improve the life of that child.
• i.AM Search works for all levels of functioning and it supports kids from kindergarten to college.
• It is designed to filter based on the same medical terms used by a child’s teachers, doctors, therapists and psychologists.
• Besides communication skills, parents and teachers can also filter based on specific skills related to executive function, repetitive behavior, self-assessment, self-determination and social skills.
• i.AM Search includes a database of 2,200 apps, which have been profiled by the Wynsum team. The team, which researches and adds more apps to the database weekly, gives each app a Wynsum score; this four-star scoring system evaluates apps for relevancy, adaptability, quality and whether the content is evidence-based.

Here is an example of how the i.AM app can be used: a teacher wants to search for apps to suit a 10-year-old with high-functioning autism who struggles with communication skills. A Google search returns 532,000 results. A search in the Apple App Store returns two results. Using advanced search in i.AM Search, the teacher can filter the initial results by more than 40 different communication skills, such as figurative language, interpreting social cues, and phonemic awareness. An advanced search for apps that help with all communication skills returns 25 results.

This app will help many parents save time and energy by focusing on those apps that are most appropriate for their child’s needs, and in turn move more kids with autism toward success. The i.AM Search app free to download and use and is available for the iPad, iPhone and iPod on the App Store via iTunes (http://itunes.apple.com/us/app/i.am-search/id459557470?mt=8).

Post from: Kids Enabled

%%POSTLINK%%

There’s an App for That!

Prairie Life: Unplugged

While at my son’s neurologist appointment recently, I spoke at length about my son’s seizure issues while the doctor diligently typed notes into the computer, which contained all my son’s lab results, MRI findings, medication lists, and doctor’s notes from previous visits.

“Isn’t it great to be able to do that?” I asked him.

“Yes!” he replied enthusiastically, “How did I get through medical school without the Internet?!”

I didn’t say it out loud, but my thought was, “I think they call it a library.”

How did we get through anything before we had technology? How did Laura Ingalls Wilder survive on the prairie with no GPS, no Words With Friends, no way to find the cheapest gas in her area, no way to Pin her favorite pictures of the latest prairie designs, and no way to use her Groupons?

When I went to the car wash last weekend, I handed the cashier my debit card. Instead of sliding it through the card reader on the register, she reached under the counter and lugged out a heavy unwieldy metal object, across which she laid my card, laid a blank carbon receipt on top of that, and then struggled to drag the engraver across to make an imprint of my card. When she noticed me standing there with my mouth open, she offered, “The computer’s down.”

So when technology isn’t working, we go back to the way we accomplished tasks before our lives were so saturated with electronics. When your phone is dead and you can’t play Draw Something, I guess you drag the Pictionary game out of the closet and play with people that are actually in the same room with you.

The problem is that young children today don’t have the reference of “what we did before technology.” They’ve always had the buttons to push. So when the lights go out and the computer goes down and the smart phone is dead, do they know what to do? Do they know that all those apps imitate a life activity that came before?

One of my fondest memories of my daughter is of our Pioneer Day. She was 4 years old, and we went about our ordinary daily activities, but we completed the tasks as if we were “pioneers.” We hung wet laundry outside to dry, we walked to the store, we made candles, we boiled onion skins to make yellow dye (for paint), and we wrote letters to far-away family. We kept the technology of the day (landline, microwave, VHS player, television, and cassette player) off and created our own entertainment.

I encourage every family to have a “pioneer day,” (you really only need to go back to the late 80s, right?) and pretend the distractions of technology don’t exist. Play board games, read books, tell stories, write (or dictate) letters, make crafts, catch bugs outside, walk to the park, engage in lively debate, put on a play, cook over a backyard fire, explore the neighborhood creek, and/or start a leaf/flower/rock collection. Here’s a pioneer challenge: if possible, walk to the nearest stores (or strip mall) and 1) see if you can even find a pay phone and 2) teach your kids how to use it.

Post from: Kids Enabled

%%POSTLINK%%

Life Imitating Apps

Many parents know what questions to ask when looking into camps for their children. For the special needs child, there are special questions that need to follow the basic Q and A. In the following blog, Aerie Experiences Director Matthew Weneta lets us in on a few questions we may not know to ask.

A low camper-to-staff ratio is important when assessing what program is the right fit for a child with special needs. When asking this question, also ask how that ratio is accounted for. Do administrative, kitchen and maintenance staff count? What you really need to know is how many qualified adults are with your child’s group at all times and how large is the group.

Our exceptional children need exceptional staff. Is a well meaning, energetic college student going to be able to meet your child’s social and emotional needs? Do they have the knowledge to keep your child physically and emotionally safe in a 24/7 environment? Find out the educational and practical experience of the direct care staff at a camp and what the ages of the staff are.

Camps all have an advertised cost. Some camps’ actual costs are more than expected. Find out if your camp has admissions, activity or gear fees. Also, find out what gear that you likely do not already own is required; this is especially important with travel and adventure camps.

How they serve food matters. Camps committed to creating a sense of community and family will serve meals family style. It is more expensive for the camp than cafeteria style but allows for more social interaction and growth, sharing, fairness, group conversation and working together to clean up.

These days all camps are equipped to dispense medications. Find out the procedure for this. Camps that take the time and effort to bring your child’s medications to them during meal and bed times are making more efforts to accommodate your child’s experience than the camps that bring your child to line up at the nurses office and wait while meds are distributed.

If you have a chance to visit the camp, ask to see the medical and gear storage. A camp’s attention to these details shows how seriously they take safety issues. Poorly organized nursing facilities or improperly functioning gear will lead to increased risk for your child.

Camp is an opportunity for fun and adventure. For some kids, camp is also an opportunity for social and emotional growth and to meet developmental milestones. Does the camp administration work to accommodate the child’s goals? Do they effectively communicate with the family and any involved practitioners?

If your child is camping or playing in the woods without swift EMS or vehicle access, there should be a Wilderness First Responder with the group at all times. Ask if this is the case.

Statistically speaking, the most dangerous thing your child will do at camp is ride in a van. Find out who is driving.

How does the camp handle transitions and down-time between activities or while waiting for meals? This is when some kids will struggle the most.

How much time off does the staff get during the summer? A well-rested counselor is better at their job.

Will your child be a match for the camp? Don’t ask about behavior management philosophy; ask about specific occurrences of behaviors and how the camp has handled them in the past. Has the camp sent children home in the past? Why? Camps that specialize in specific learning differences are more likely to better handle specific situations versus a camp that tries to meet everyone’s needs.

Has the camp had a critical incident (drowning, fire, big fall, etc.) in the past? How was it handled and what was learned? Having a critical incident in the past should not disqualify a program; in fact, the opposite may be true. Having dealt with unfortunate circumstances often makes a camp more vigilant in mitigating risks. What really matters is how they handled it and did they learn from their mistakes. Chuck Yeager didn’t hire the mechanic responsible for his first test flight crash for no reason; he knew that mechanic would not let it happen again.

Does the camp offer choice in activities, meals and participation? Offering choice often takes more time for the camp and staff. But it also increases internal motivation for the children and creates opportunity to practice self-regulation and decision making.

Be forthcoming about your child’s needs. It is the only way for a camp to ask the right questions about your child.

Some of these questions may seem superfluous but asking the right questions now can save you from major headaches (and possibly heartaches) later on.

Post from: Kids Enabled

%%POSTLINK%%

What You Really Need to Know…

I am not a speech (or occupational or physical) therapist.

I am a mother.

This was the predominant feeling I had when handed “home programs” by (childless) therapists and heard the words, “try to work on this at least 15 minutes each day.”

Fifteen minutes is really no time at all, right?

Hah! Mothers of young children know in 15 (uninterrupted) minutes the dishwasher can be unloaded (which opens the way for getting the sink full of dirty dishes cleared), laundry can be switched from the washer to the dryer (which means you can now throw that smelly pile of wet towels into the washer), a family-sized frozen macaroni and cheese dinner can get started in the microwave, and you can listen to voicemail messages while hauling backpacks, lunchboxes, important school papers and groceries out of the car.

I can’t be any kind of therapist. I have a household to run!

That said, the therapists who felt sorry for me would help me find ways to incorporate therapy activities into normal household chores and tasks like the ones mentioned above. And I would try, truly I would, to get my son to sort silverware, fold dishtowels, carry items around the house, and put groceries away. This worked a little bit, but mostly it didn’t because, although my son has cognitive and developmental disabilities, he is smart enough to know that sorting silverware and folding dishtowels is not fun. Duh.

Generally speaking and given all ranges of abilities, children know innately when they are being had. They have hidden radar that inwardly beeps and buzzes when grown-ups are passing off lessons/therapy/learning as “fun.” Some children don’t care. To them learning is fun. But to my son, learning is learning, meeting therapy goals is meeting therapy goals, and having fun is having fun.

Recently I ran into a mom friend with young twins who are both receiving various therapies. This friend happens to be a very seasoned and experienced occupational therapist. Our conversation went something like this:

Me: What’s wrong?
Mom-Friend: How much time did you spend with Jack doing therapy at home?
Me: Oh, hours and hours.
MF: Really?
Me: No. I did what I could, when I could, but I can for sure say that I was a mom first and a therapist second. So I should say I spent minutes and minutes on Jack’s therapy.
MF: I’ve just been handed a “home program” by the twins’ therapist. What am I supposed to do?
Me: Oh, I would take it seriously and do the best you can. But also take it realistically and be your kids’ mom when they need a mom. They might actually like doing “therapy” at home.
She seemed encouraged and relieved.

For me, the most important goal of being a mom is being able, at the end of the day, to say that I did the very best I could for my kids today. Sometimes that means we did therapy stuff and sometimes that means we did not do much of anything.

Post from: Kids Enabled

%%POSTLINK%%

Am I a Mom or a Therapist?

by Montie Stone, KE Director

Hold on and let me finish off my bacon cheeseburger and Diet Coke so I can write a blog about optimal nutrition for the brain… I think I will begin by saying, “Do as I say, not as I do.” In my defense, the cheeseburger in question was prepared at home which means I had control over ingredients (low fat cheese and meat, whole wheat bun) and portion size (less than a quarter pounder) – OK, lame defense.

So, I may not be the best example for those wanting to give their family a nutritional makeover but I do know the facts. Following are easy to follow steps to a healthier lifestyle.

Breakfast really is the most important meal of the day.
Do not skip breakfast! You have heard this mantra your whole life: breakfast is the most important meal of the day. If kids skip breakfast, or skimp on a quality breakfast, they are apt to get brain fatigue by midmorning. A quality breakfast for kids (and you) could be an egg, fruit, whole grain toast, low fat milk and a variation of the protein and fiber choices above. What is not quality would be sugary cereal, white flour products (biscuits, pancakes), fruit flavored juices or skipping breakfast altogether. While it is not always possible, a midmorning snack has also been shown to improve memory.

You need to “show up” physically and mentally to learn.
If kids miss class, they miss out. If they make it to class but are not paying attention, they miss out. Kids who have a healthy diet are more likely to be present and participating in school. Proper nutrition gives the brain the power necessary to learn. It also affects mood and alertness. This just makes sense – bad foods leave you feeling bad, good foods make you feel good. If you don’t feel good, you will check out physically, mentally or both.

Water is good for you!
Drink your water daily substituting it for juice or soft drinks whenever possible. The website fitness.com tells us that “Water is by far the most important nutrient for the human body.” Water aids in digestion, circulation and overall body function. Other research from www.about.com tells us that because “…your brain is about 80 percent water, the first rule of brain nutrition is adequate water to hydrate your brain. Even slight dehydration can raise stress hormones which can damage your brain over time.”

Healthy kid = healthy adult
Set a good example for a lifetime of healthy habits. Like it or not, “monkey see, monkey do.” Or, in our case, kids imitate what they see. Not only do we need to set the example, we need to teach the concepts of a healthy lifestyle. If kids grow up eating for optimal brain health, the chances are much higher that they will continue this lifestyle into their adult life.

As I go eat an afternoon snack of yogurt with fresh fruit before I go on a walk with my water bottle, I leave with the wise words:

“We do children an enormous disservice when we assume that they cannot appreciate anything beyond drive through fare and nutritionally marginal, kid-targeted convenience foods. Our children are capable of consuming something that grew in a garden or on a tree and never saw a deep fryer. They are capable of making it through dinner at a sit-down restaurant with tablecloths and no climbing equipment. Children deserve quality nourishment.”

― Victoria Moran, Lit from Within: Tending Your Soul for Lifelong Beauty

Post from: Kids Enabled

%%POSTLINK%%

Do As I Say, Not As I Do

First, some autism facts from the National Autism Association:

• Autism now affects 1 in 88 children.
• Boys are four times more likely to have autism than girls.
• About 40% of children with autism do not speak. About 25% to 30% of children with autism have some words at 12 to 18 months of age and then lose them. Others might speak, but not until later in childhood.
• Autism greatly varies from person to person (no two people with autism are alike).
• The rate of autism has steadily grown over the last twenty years.
• Autism is the fastest growing developmental disorder, yet most underfunded.
• Children with autism do progress – early intervention is key.
• Autism is treatable; it is not a hopeless condition.

What does “on the spectrum” mean?

Autism Speaks: Autism spectrum disorder (ASD) and autism are both general terms for a group of complex disorders of brain development. These disorders are characterized, in varying degrees, by difficulties in social interaction, verbal and nonverbal communication and repetitive behaviors. They include autistic disorder, Rett syndrome, childhood disintegrative disorder, pervasive developmental disorder-not otherwise specified (PDD-NOS) and Asperger syndrome. ASD can be associated with intellectual disability, difficulties in motor coordination and attention and physical health issues such as sleep and gastrointestinal disturbances. Some persons with ASD excel in visual skills, music, math and art.

American Academy of Pediatrics: Autism spectrum disorders (ASDs) are a group of related brain-based disorders that affect a child’s behavior, social, and communication skills. They include 3 of 5 disorders known as pervasive developmental disorders (PDDs). These are autistic disorder, Asperger syndrome, and PDD-not otherwise specified (PDD-NOS).

What are the warning signs of autism?

Autism Speaks (and First Signs, Inc., firstsigns.org):

In clinical terms, there are a few “absolute indicators,” often referred to as “red flags,” that indicate that a child should be evaluated. For a parent, these are the “red flags” that indicate your child should be screened to ensure that he is on the right developmental path. If your baby shows any of these signs, please ask your pediatrician or family practitioner for an immediate evaluation:

• No big smiles or other warm, joyful expressions by six months or thereafter
• No back-and-forth sharing of sounds, smiles, or other facial expressions by nine months or thereafter
• No babbling by 12 months
• No back-and-forth gestures, such as pointing, showing, reaching, or waving by 12 months
• No words by 16 months
• No two-word meaningful phrases (without imitating or repeating) by 24 months
• Any loss of speech or babbling or social skills at any age

*This information has been provided byFirst Signs, Inc. ©2001-2005. Reprinted with permission. For more information about recognizing the early signs of developmental and behavioral disorders, please visit firstsigns.org or the Centers for Disease Control at cdc.gov/actearly.

American Academy of Pediatrics:
Autism is a neurodevelopmental disorder characterized by social impairments, cognitive impairments, communication difficulties, and repetitive behaviors. It can range from very mild to very severe and occur in all ethnic, socioeconomic and age groups. Some children with autism appear normal before age 1 or 2 and then suddenly “regress” and lose language or social skills they had previously gained. This is called the regressive type of autism.

Early signs of autism:

• Doesn’t make eye contact (e.g. look at you when being fed)
• Doesn’t smile when smiled at
• Doesn’t respond to his or her name or to the sound of a familiar voice
• Doesn’t follow objects visually
• Doesn’t point or wave goodbye or use other gestures to communicate
• Doesn’t follow the gesture when you point things out
• Doesn’t make noises to get your attention
• Doesn’t initiate or respond to cuddling
• Doesn’t imitate movements and facial expressions
• Doesn’t reach out to be picked up
• Doesn’t play with other people or share interest and enjoyment
• Doesn’t ask for help or make other basic requests

     Even if I’m not seeing signs of autism, should I have my child screened?

National Autism Association:
Developmental screening is a short test to tell if children are learning basic skills when they should, or if they might have delays. During developmental screening the doctor might ask the parent some questions or talk and play with the child during an exam to see how he learns, speaks, behaves, and moves. A delay in any of these areas could be a sign of a problem.

All children should be screened for developmental delays and disabilities during regular well-child doctor visits at:

• 9 months
• 18 months
• 24 or 30 months

Additional screening might be needed if a child is at high risk for developmental problems due to preterm birth, low birth weight or other reasons.

In addition, all children should be screened specifically for ASDs during regular well-child doctor visits at:

• 18 months
• 24 months

Additional screening might be needed if a child is at high risk for ASDs (e.g., having a sister, brother or other family member with an ASD) or if behaviors sometimes associated with ASDs are present.

It is important for doctors to screen all children for developmental delays, but especially to monitor those who are at a higher risk for developmental problems due to preterm birth, low birth weight, or having a brother or sister with an ASD. If your child’s doctor does not routinely check your child with this type of developmental screening test, ask that it be done.

If the doctor sees any signs of a problem, a comprehensive diagnostic evaluation is needed.

American Academy of Pediatrics:
Because autism is a genetic disorder, there is no single treatment or medication that can “cure” it. However, early identification and intervention, through medication and therapy, can limit symptoms and help the child enjoy a better quality of life. “The focus in the past was on identifying children when language problems became clear, around the age of three,” says Paul Lipkin, M.D., FAAP, director for the Center of Development and Learning at the Kennedy Krieger Institute and immediate past chair of the American Academy of Pediatrics’ Council on Children with Disabilities. “But now there’s research to suggest that you can identify key issues at an earlier age.”

As a result, the AAP now recommends that pediatricians screen children for autism at 18 months of age. But if you notice that your child is delayed at an earlier age, or if you are concerned that he is not meeting developmental milestones at any age, talk to his doctor.

“We know that when parents voice concern about a child’s development, more often than not they are correct that there is a developmental concern,” says Dr. Lipkin, who also serves as an assistant professor of pediatrics at The Johns Hopkins University School of Medicine. “We are now making active efforts to get pediatricians to recognize these concerns earlier, so that they don’t give that old advice ‘let’s wait’ or ‘boys will be boys.’”

     What are some of the common treatments for autism?

Autism Speaks:
Each child or adult with autism in unique and, so, each autism intervention plan should be tailored to address specific needs. Intervention can involve behavioral treatments, medicines or both. Many persons with autism have additional medical conditions such as sleep disturbance, seizures and gastrointestinal (GI) distress. Addressing these conditions can improve attention, learning and related behaviors. Early intensive behavioral intervention involves a child’s entire family, working closely with a team of professionals. In some early intervention programs, therapists come into the home to deliver services. This can include parent training with the parent leading therapy sessions under the supervision of the therapist. Other programs deliver therapy in a specialized center, classroom or preschool. (Learn more about Early Intervention).Typically, different interventions and supports become appropriate as a child develops and acquires social and learning skills. As children with autism enter school, for example, they may benefit from targeted social skills training and specialized approaches to teaching.

National Autism Association:
Many professionals feel that early intervention is key in treating autism, and that behavior modification techniques are crucial in a child’s early years. There are several types of behavior modification techniques, including the following (see the end of the article for links to web sites that explain these techniques and programs):

• Applied Behavioral Analysis
• Verbal Behavior
• Floor time
• Son-Rise
• Relationship Development Intervention
• SCERTS (Social Communication, Emotional Regulation, and Transactional Support)

There are also possible dietary treatments. One is the gluten-free, casein-free diet (the removal of all wheat protein [gluten] and milk protein [casein] from the diet). Many parents and physicians have found that implementing this diet relieves many of the symptoms associated with autism spectrum disorders.

Medical treatment of autism is sometimes necessary if a child has an underlying medical issue that can cause or exacerbate symptoms of autism. These medical conditions include Fragile X, allergies, asthma, epilepsy, bowel disease, gastrointestinal/digestive disorders, vitamin and mineral deficiencies, food sensitivities, persistent viral and fungal infections, PANDAS, feeding disorders, anxiety disorder, bipolar disorder, ADHD, Tourette Syndrome, obsessive-compulsive disorder, sensory integration dysfunction, sleeping disorders, immune disorders, autoimmune disorders, heavy metal toxicity and neuroinflammation. Treating these underlying medical issues can greatly improve some of the behaviors and symptoms associated with autism.

Treatment options may include:

• vitamin and mineral supplementation
• immune system support
• anti-inflammatories
• neurofeedback
• chelation/detoxification therapy
• hyperbaric oxygen therapy
• anti-fungal and anti-viral therapies
• dietary intervention
• methyl B-12 therapy

The National Autism Association recommends finding a physician who will not ignore underlying medical conditions that may be contributing to the symptoms and severity of autism. There are a number of physicians in the U.S. who specialize in treating children and adults with autism. Until recently, the Autism Research Institute (ARI) maintained a list of clinicians who attended DAN! (Defeat Autism Now!) physician training seminars.

Although the amount of information about autism can be overwhelming, the good news is that awareness and research is at an all-time high, which means treatments, interventions and family resources are more available than ever. Unlike 50 years ago, parents do not have to struggle alone to find the answers to their questions about autism. Children today have a great chance of getting help and succeeding!

     SOURCES

Atlanta/Georgia web sites
Autism Society of America-Georgia chapter
Emory Autism Center
Marcus Autism Center

General web sites
Autism Speaks
American Academy of Pediatrics
National Autism Association
Defeat Autism Now
Autism Society of America
The Autism Education Network

Informative articles about the new statistics
HuffingtonPost.com

AutismSpeaks.org

These articles explain in detail the different available autism interventions:
Explains several common treatment programs
The Son Rise Program
The SCERTS model
Floor time

Post from: Kids Enabled

%%POSTLINK%%

The Changing Pieces of the Autism Puzzle:
  Making Sense of the Statistics and the Debate

There is an African proverb that speaks to dealing with a major change: “You must eat an elephant one bite at a time.” Obviously, this is not to be taken literally, but it is rich in wisdom and simplicity, i.e., when faced with a major challenge, the best approach is to break it down into small, manageable (bite-size) tasks.

Is it possible for families to have a healthy diet in our fast-food culture? The interview below offers some practical strategies employed by one real-life family of four: father, mother, and two adorable, high-energy elementary school-aged boys with learning differences including autism and ADHD.

Question: How would you describe your family’s health, energy, mood, interaction with food BEFORE your family’s nutrition makeover?

Answer: Before I had kids I swore I would not be a “short order cook.” Naively, I thought, “My kids will eat what we eat.” I have two boys (7 and 5 ½ years of age) that have distinct and different food preferences. Their diet had little variety, was extremely high in refined carbohydrate-heavy foods, low in fiber, void of color since they were only white or beige colored foods, and the foods they ate were uniform in texture. The standard meal consisted of macaroni and cheese, string cheese, cheerios, and apple sauce. Whatever the boys wanted to eat, if it helped keep the peace, was dinner.

Sweets and kid-friendly processed foods were rewards for good behavior and almost like “bribes” to “quiet the boys down” in stores and restaurants. Food was not an issue, as long as I served them exactly what they wanted, when they wanted it.

My oldest son was diagnosed with autism at age 2 ½ years. My “mother’s intuition” told me that improving the nutritional quality of his diet would help, but the thought of “over-hauling” our family’s diet seemed too overwhelming. My son’s doctors discouraged any diet changes; I followed their advice. My sons liked to eat, but their diets were extremely limited.

After years of potty training nightmares, painful gastrointestinal issues, and an obesity diagnosis at 4 years old, I finally called a nutritionist. I was scared about making changes, but I knew things could not stay the same.

Q: How would you describe the nutritional quality/variety of your family’s meals BEFORE and AFTER your nutrition makeover?

A: My husband and I ate balanced meals (lean protein, veggies, and “light” or whole grain carbohydrates). In contrast, refined processed carbohydrate foods (crackers, cereals, pasta, breads, cookies, etc.) were dietary staples for my sons. Their diets were lacking in texture, color, and flavor. They loved salty, sweet, and repetition.

But now everyone eats the same meal! The kids learned, in a fun way, how to create balanced meals. They became food “detectives” and “scientists.” They discovered lots of new foods that they like. Our nutritionist gave us practical tips/suggestions that really worked for us. We turned trying new foods into games; this helped considerably.

My boys, now 6 and 4 years old, have learned about protein and it helps build strong muscles and bodies. They know to include it every meal. Together my boys and I plan meals, shop, and have fun cooking. The kitchen is the hub of our house! My boys have also learned to manage their own snacks & sweet treats. They make much healthier choices, because they help create the plan. We still have our challenges here and there, but revamping our diet has changed our lives (and meals) considerably for the better.

Q: What were some of the first and/or easiest changes that you made in regards to your family’s diet?

A: First, we examined and evaluated each food choice and meal individually. We developed a list of healthier food options to replace our “not-so-healthy” food choices. For example, before our “nutrition intervention,” breakfast was a waffle (not whole grain) with syrup. Our nutritionist encouraged me to consider eliminating gluten from my oldest son’s diet because she suspected that gluten, the protein in wheat, rye, barley, and most oats, might be a trigger and culprit in his gastrointestinal discomfort. Our “new” breakfast included a gluten-free waffle with sunflower butter for protein and “just fruit/no added sugar” jelly. We opted for sunflower butter because my son has a peanut allergy. By taking our diet meal by meal, it did not seem so overwhelming. We ultimately learned that our boys were healthier after omitting dairy, gluten and nuts from their diet.

Yes, this was VERY DAUNTING at first. However, making small changes meal by meal and snack by snack and breaking down our meals and snacks into “time of day” categories, I eventually found healthy alternatives. Feeling overwhelmed gave way to feeling empowered!

Q: What were some of the more challenging changes to make?

A: The hardest changes were planning ahead for events and activities that involved food. Going to restaurants, birthday parties, and play dates was a little tough at first. Yet, it did not take long to work systems into our schedule that made things much easier. Also, after adopting and living with our “new and improved” diet, healthy choices became much easier to find. Healthy food choices, even gluten-free, dairy-free, and nut-free foods are out there and available (and delicious); I just didn’t always know where to look.

Q: Can you describe your family’s health, energy, mood, interaction with food AFTER working with a dietitian/nutritionist?

A: I honestly believe that changing our diet has had the most dramatic impact on our overall health and behavior than any of our previous interventions. Before changing our diet, my oldest son had no emotional language. He spoke, but could not articulate when and how he felt pain or fear, even his gastrointestinal (GI) discomfort. He would cry, but could not give me any details about his feelings. He was also unable to “go BM (bowel movement) in the potty.” After taking him off of dairy, he immediately was able to explain how painful it was to go to the bathroom and that he was afraid due to the pain. He also was able to tell us that the way certain foods smelled made him nervous. After taking him off of gluten, he had no more chronic GI pain and immediately potty trained himself.

Our new diet has significantly decreased anxiety, and behavior issues are significantly improved. We all have much more energy and are considerably more active than we were before. The most rewarding gift of improving our diet was being able to stop a wide variety of medications.

Having the support of a good nutritionist made all the difference in the world for us. There are so many factors to consider when looking at meals, food intolerances and vitamin/mineral and omega-3 fatty acid supplements. On my own, I was overwhelmed and felt that changing our diet was too difficult. I did not know where to start, so I did not. After working with a supportive nutritionist, I realized that EVERYTHING did not have to change at once. She helped me prioritize our issues and supported me step by step, which made the process manageable. I learned how to plan meals and prepare food in a way that worked for me and my family.

Parents need not feel overwhelmed or helpless when it comes to their child’s diet and feeding/eating habits. You can makeover your family’s diet one food at a time, then one meal or snack at a time. Seeking assistance or coaching from a Registered Dietitian (RD) can be a worthwhile investment as healthy eating is a learned skill that you and your child will have for life. For families with extremely picky eaters, seek out an RD specially trained in the Sequential Oral Sensory (SOS) approach to feeding. The SOS feeding strategies provide parents with a “better nutrition game plan” and empower parents and children with the necessary skills needed to expand their diets. To locate an RD in your area, go to the Find a Dietitian section at EatRight.org. For more information about the SOS approach to feeding visit StarCenter.us

Carol Ann Brannon, MS, RD/LD, is an experienced Registered and Licensed Dietitian in private practice in the northeast metro-Atlanta area. She has a BS degree in Dietetics from Carson-Newman College and a MS degree in Nutrition Education from Georgia State University. Carol Ann holds a Certificate in Childhood and Adolescent Weight Management, as well as the Sequential Oral Sensory Approach to Feeding, and Food Chaining©; both specialized certificates for the treatment of pediatric sensory food aversions and feeding/eating disorders. In her private practice she guides individuals and families, particularly those with developmental and learning differences including autism and ADHD, food allergies or intolerances, diabetes, obesity, and GI conditions. Carol Ann enjoys speaking to groups and free-lance writing. On a personal note, being mom to four active teenagers is her most fulfilling role. She is fully able to understand the family dynamics of busy families. Her passion is helping individuals and families improvetheir health with practical and personalized nutrition guidance.

Post from: Kids Enabled

%%POSTLINK%%

Yes, You Can! Practical Strategies for a Family Nutrition Make-Over

Recently I saw a commercial for chicken pot pies. The super-catchy music caught my attention, and I watched as two very happy young men drove up to the pick-up window of a well-known fast food restaurant. The commercial hailed the chicken pot pie as a “classic.”

A classic indeed. I ate many chicken pot pies (and cans of “potato sticks” and skillets of Hamburger Helper) as a child. Taken frozen from the box (I was raised by a single mom who worked full time) and popped into the oven, my pie dinner was ready a quick 45 minutes later. Funny how our perception of “quick” has changed.

I think the women of my mom’s generation were so excited to have “quick” and easy dinners that would go from shelf to oven; they really didn’t care what was in it. So you have to inject hydrogen atoms into food to make it a solid, prolong its shelf life, and increase its resistance to heat. How harmful can that be? Very harmful, as it turns out.

Food is inherently simple, but we’ve made it complicated. The more we try to make it quick and easy, the more packed with additives, preservatives, and chemical-laden ingredients it becomes. Processed food may save us time, but it’s not enriching or nurturing our lives, and it just positively reinforces our own false sense of needing to do things faster.

To help people return to a simpler and healthier way of eating, Michael Pollan wrote a little book celebrating the simplicity of food, Food Rules. It’s a book of food wisdom in which he directs readers to “eat all the junk food you want as long as you cook it yourself.” Since I love to make sugar cookies from my family’s 60-year-old recipe, this is a food rule I can follow! Here are a few more rules from the book:

“Don’t eat breakfast cereals that change the color of the milk.”
“If it came from a plant, eat it; it if was made in a plant, don’t.”
“It’s not food if it’s served through the window of your car.”
“It’s not food if it’s called by the same name in every language.”

You get the picture. The simpler the food, the healthier the food. No matter what the labels try to tell you.

I like that we are so much more educated about our food. I like that we (mostly) recognize the connection between our food and our brains. I appreciate that better food (organic, free-range, wild-caught) is more available. I like that we are working harder to hold the big food manufacturers accountable for the ingredients they use. But mostly I like that I don’t need a frozen chicken pot pie to make me happy, as the commercial would have me believe, when a fresh berry smoothie or a homemade batch of sweet potato fries would make me even happier.

Post from: Kids Enabled

%%POSTLINK%%

Classic Foods