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This area will introduce selected resources to help you improve the lives of children with disabilities. Please help us spread this information by suggesting resources and web sites you've found to be helpful. Send us
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This section provides an update of news about TelAbility. Bookmark
this page to keep up with our progress. To see a list of news stories in
our archive, click here.
| Featured News |
| Title: | Eating for Autism Book Review |
| Date: | 01/26/2010 |
| Summary: | Eating for Autism by Elizabeth Strickland, MS, RD, LD outlines a 10-step treatment plan to improve nutrition for children with autism spectrum disorders, Asperger’s Syndrome, and/or ADHD. The premise of this book is that nutritional deficiencies contribute to atypical brain functioning; therefore, if nutrition is made a larger focus with children with autism, improvements will be seen across the presentation of the disorder. This book is an easy ready for families and professionals working with children with autism. Strickland suggests that due to the neurological differences of children with autism, diet is essential to improve brain functioning by ensuring that all nutrients are in balance. As a result of many children with autism limiting their diets, their brains may not have access to all the vitamins and nutrients needed for peak functioning. The book provides a detailed description of how to implement each of the 10 steps along with 75 gluten-free, casein-free recipes for families that decide to place their children on some of these special diets. Strickland emphasizes throughout the book how essential it is for families to have a strong, knowledgeable team (including a dietitian, speech/language pathologist, pediatrician, occupational therapist, behavioral specialist, etc.) involved with the child to ensure that the program is safe and effective. Strickland also notes that there is limited research available on the efficacy of these diets. She suggests implementing these special diets only until you determine if your child is a “positive responder.” A positive responder will showed a reduction or elimination of undesired behaviors (i.e. stimming, tantrums) and may show an increase in desired behaviors (i.e. speech/language, eye contact). A major limitation of these controversial diets is that many children with autism are so rigid about their eating that it may be difficult to implement special diets as the diets may put kids at risk for malnutrition if they result in an even more limited repertoire of foods. If you are interested in trying one of the special diets, be sure to stay objective about the results by completing pre-diet and post-diet rating scales, and always remember that a team approach is essential to the success of your child and the program.
Step 1: The first piece of the 10-step plan involves ensuring that all artificial colors, flavors, preservatives, sweeteners, refined sugars, and bad fats are removed from the diet. This helps to rid the body of synthesized compounds and ensure that more natural foods are offered. Eating fresher, home cooked meals will help to detoxify the system.
Steps 2-4: After ensuring that food is made more natural, Strickland recommends analyzing basic nutrition to ensure that children are getting the appropriate amounts of protein, carbohydrates, healthy fats, vitamins, minerals, and water. Due to highly restrictive diets, many children with autism are deficient in many of these key areas. Based upon this analysis, vitamins and supplements, especially Omega 3 fatty acids, are recommended to ensure that the body and brain have all the building blocks for functioning. Strickland acknowledges the difficulties that can come with getting picky eaters to take nutrition supplements and provides suggestions on how to work around those limitations.
Step 5: Now that the system should be more balanced, it is time to determine if there are other contributing factors impacting your child. Those can include GI issues, food allergies/sensitivities/intolerances, side effects from medications, dental problems, deficiencies with swallowing coordination, sensory integration issues, environmental elements, and behavioral concerns.
Step 6-7: Children with autism are thought to have a higher prevalence of GI involvement and food allergies/intolerances/sensitivities that can cause stomach pain, bloating, gas, constipation, reflux, vomiting, and diarrhea. These conditions can cause children, especially those that are non-verbal or language delayed, to act out to express discomfort by refusing food, eating selectively, throwing tantrums, engaging in self injurious behavior, and being irritable. These behaviors are often dismissed as typical autistic behaviors; however, identification and treatment may reduce frequency and/or severity. If allergies are suspected, elimination diets are recommended for at least two weeks to determine symptoms diminish.
Step 8: The Gluten Free Casein Free (GFCF) diet is the most popular diet in the autism community. It is considered highly controversial, and many medical professionals do not support its use due to the lack of evidenced-based research. The elimination of wheat, rye, barley, and milk protein is implemented to attempt to relieve behavioral and GI concerns. This diet is highly restrictive; therefore, families must work with the feeding team to ensure that nutrition is not compromised. Due to the prevalence of food selectivity among children with autism, this diet is not always an immediate option as many children with autism will only eat foods that contain gluten and casein.
Step 9-10: Megavitamin therapy involves ingesting high doses of specific vitamins and supplements, the most popular being vitamin B6 in conjunction with magnesium. Some families report improvements in behavior and gains in the areas of social skills including eye contact and speech while also experiencing a reduction in aggression, tantrums, and stimming. Vitamin B6 is essential for brain function as it is key to the synthesis of serotonin and dopamine. Serotonin and dopamine regulate mood, anger, aggression, sleep, appetite, motor activity, and behavior. This treatment is also highly controversial due to the lack of research available and potential safety concerns. Excessively high doses of vitamin B6 can result in problems such as shaking of the hands, increased stimming, wrenching of the hands, and toe walking. As a result it would only be safe to implement this treatment under the close watch and supervision of the feeding team, and if the child is a non-responder, high dose B6 treatment should be discontinued after the two week trial.
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| Author: | Melissa A. Rightor, M.A., CCC-SLP |
| URL: | http://www.amazon.com/Eating-Autism-10-Step-Nutrition-Asperger/dp/0738212431 |
Click here to see a list of archived news stories.
This area highlights an internet site we feel are of special interest to the
TelAbility community. For a comprehensive listing of
sites please check our links page. To see a list of sites that were
previously featured, click here.
| Featured Site |
| 2008 Summer Camp Directory |
| http://www.fsnnc.org/camps/start.asp |
| An online directory from the Family Support Network of North Carolina that lists summer camps, both day and residential, serving children who have special needs. |
Click here to see a list of archived featured sites.
This area highlights a case
concerning a child with disabilities. As new cases are made available
previous cases will be archived for future reference.
To view all archived cases, click
here.
| Featured Case |
| Title: | WATCH Case Study-CHARGE Syndrome |
| Reviewer: | Joshua Alexander, MD |
| Summary: | Emma is a beautiful 3 year old girl with long dark hair, big blue eyes and a winning smile. She has many of the features of CHARGE syndrome (Coloboma of the eye, Heart defects, Atresia of the choanae, Retardation of growth and/or development, Genital and/or urinary abnormalities, and Ear abnormalities and deafness) although testing for this syndrome was negative. Emma has visual impairment affecting her right eye more than her left, choaneal astresia, genitourinary abnormalities, and global developmental delays. She had a tracheotomy from birth until March of this year. Emma sustained a grade III intraventicular hemorrhage as a newborn and she has a VP (Ventriculo-Peritoneal) shunt. She has had surgery to open her nasal passages and recently had tubes put in her ears. Emma’s muscle tone is mildly low, mostly at her feet and ankles. She has severe hind foot eversion and forefoot abduction in weight bearing and wears supramalleolar AFO’s during the day (#4 DAFO’s). Emma also has a progressive scoliosis convex to the right which is at 30 degrees. She wears a body jacket at night.
Emma’s motor development has been slow, but sequential. She learned to sit independently and roll prone to and from supine at about 15 months of age. At 24-26 months she learned to transition sit to and from quadruped and started creeping several months after that. She started cruising this past summer, but only cruises to the left. She does not like moving to the right probably because of her visual impairment. Emma still requires minimal assistance to pull to stand, but will lower herself to sit with both hands holding onto furniture. She will take steps with hands held and we are looking at gait trainers.
Emma does not have much interest in feeding herself. When handed a spoon with food on it she will put it in her mouth and then throw down the spoon. She will not attempt to pick the spoon back up nor will she attempt to pick up food from the tray. She will, however, take small pieces of food that are handed to her and put them in her mouth. Emma is able to chew small soft pieces of food, but has a tendency to pocket food behind her front bottom teeth. Emma does enjoy flavorful food and especially likes guacamole, Thai noodles, and banana pudding.
Communication skills are another area of concern. Since Emma had her tracheotomy removed in March we do get to hear her laugh and cry. Unfortunately she does not yet make any consonant sounds and is generally quite. Emma does recognize and use a few signs. She also uses a Tech/Talk Augmentative Communication Device (http://www.turningpointtechnology.com/Communication/AM/TechTalk.htm) and makes choices from 4 different pictures.
Emma is in her second year at Governor Morehead School’s Preschool program where she spends 4 mornings a week. She started at one morning last year and increased to 3 mornings over the school year. Her preschool teacher is working hard to integrate all areas of development into Emma’s preschool program. Emma has been receiving physical therapy since 4 months of age, occupational therapy since 12 months of age and speech therapy since 18 months of age.
Any comments, insights, or suggestions would be appreciated in the big three; walking, communicating and eating. The worsening scoliosis is also a big concern. Any thoughts on scoliosis management would be greatly appreciated.
Response by Darlene Sekerak, PhD, TelAbility Team Physical Theapist:
Emma sounds like a delightful child who presents us with many interesting challenges. It's hard to get a complete picture of a child in such a short description. I’m sure that her teachers and therapists have attempted many creative approaches to encourage her development. That being said, I'm happy to add a few comments that might apply to any child with some of the characteristic you describe. These suggestions may or may not be appropriate in this case.
1) I often worry about strengthening and endurance in young children with disabilities. Typically they do not have the same level of activity as their peers. Activity is really important for overall health as well as development. Sometimes we get too focused on facilitating the next developmental step and don’t encourage enough movement in general.
2) It is important to consider what excites a child. Does he/she respond to music? What kinds? What makes a child want to “dance”? Is a child prone to imitation – maybe of another child or an older child? A child with low tone, especially, may need a bit more stimulation for movement.
3) Scoliosis is always a concern but is not usually ameliorated by exercise alone. However, exercise targeted at improving respiratory function is important with or without a body jacket or orthotic.
4)A thorough assessment of sensory processing and integration can be very helpful in trying to understand and help a child in the areas of feeding, fine motor activities, and movement planning.
5) Family members are also important to consider. Family members (siblings and grandparents, included) have great insights.
6) The coordination of activities at home and at school can be helpful if possible. Sometimes its not possible, and sometimes the child benefits from different expectations in different situations.
Thanks for starting the discussion. What do others have to add to these comments?
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Click here to see a list of archived cases.
This area highlights medications we feel are of interest to the TelAbility
community. As new medication reviews are made available previous medication reviews
will be archived for future reference. To view the archived medications, click
here.
| Featured Meds |
| Name: | Nizatidine (Axid ®) |
| Reviewer: | Joshua Alexander, MD |
| Summary: | COMMON USES:
Relieves the heartburn associated with acid reflex.
HOW IT'S SUPPLIED:
150- and 300-milligram tablets.
15 milligram per milliliter solution.
HOW IT WORKS:
Decreases the acid made by the stomach that can cause pain when there is an ulcer or when it comes back up the esophagus (food pipe) in reflux.
THINGS TO DISCUSS WITH YOUR DOCTOR:
* For use in children ages 6 months and older.
* Side effects include diarrhea, vomiting, irritability, stuffy nose, cough and fever.
* May also cause headache and dizziness.
* Use with caution in children who have kidney and/or liver disease.
* Liquid is bubble gum flavored. |
Click here to see a list of archived meds reviews.
This area highlights recent articles of interest to the TelAbility
community. As
new article reviews are made available previous article reviews will be
archived for future reference. To
view all archived articles, click
here.
| Featured Article |
| Title: | The Effects of Maternal Depression on Young Children |
| Author: | Geraldine Dawson, Profession University of Washington |
| Summary: | Many studies have indicated that maternal depression is correlated with infant irritability, delayed development, and later behavior problems. Dr. Dawson’s research indicates that the interaction between depressed moms and their babies is actually related to those children’s brain functioning.
Activity in the left frontal lobe of the brain’s cortex is associated with outwardly-directed emotion such as joy, interest, and curiosity. The right lobe is associated with withdrawal emotion such as distress and sadness. Dr. Dawson found that babies of depressed mothers showed less activity in the left frontal lobe and more activity in the right frontal lobe (compared to babies of non-depressed mothers). For those children whose mother’s depression improved, brain activity returned to normal. At age three, children whose mothers remained depressed continued to show differences in brain functioning, as well as problems with emotional regulation, aggressiveness, sleep patterns, and higher levels of stress hormone (cortisol).
Dawson says, “What we are learning is that very early in life there are these periods when certain parts of the brain are being wired and that later in life these patterns will be very difficult to change. We believe that by experiencing different emotions you’re stimulating different parts of the brain and that this leads to connections between the synapses.”
In other words, children who experience smiles and happy emotions from caregivers may have brains that are “prepared” for experiencing those emotions, while children who experience apathy, irritability, or sadness may develop brains that are predisposed to experiencing those negative emotions.
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Click here to see a list of archived articles.
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