Autism and Vitamin D

Reading LifeExtension magazine (January 2014- www.lef.org) I learned that there might be a connection between vitamin D deficiency and Autism. Research indicates that vitamin D stimulates factors in the body than could have a beneficial effect on the disorder:

-        Vitamin D has significant anti-inflammatory actions, which are high in autism. For example, it inhibits the actions of pro-inflammatory prostaglandins, elevated in autism.  Some believe that autism is a disease of neuro-inflammation. The article speculates that vitamin D could help autistic children by reducing inflammation.

-        Autoantibodies to the brain have been identified in autistic children. The severity of autism are associated with levels of those antibodies. The article speculates that vitamin D could help autistic children by reducing levels of antibodies.

-        Some proteins induce the survival, development and function of nerve and brain cells. Vitamin D regulates those proteins and thus, it could help autistic children by increasing those proteins and help the brain to develop properly.

Too many coulds, mights, maybes. The author of the article, John Cannell, MD, advises parents to understand that “no evidence, other than theoretical, exists for such effects.” And yet he states “even though there are no studies proving the benefits of the vitamin in autism specifically, the proven benefits on the mechanism underlying autism make vitamin D a smart option for children with autism.”

And goes on to explain complicated procedures of calculating the dosage per pounds ratio, other vitamin and nutrients the child should take, and blood tests that should be obtained every specific amount of months. Something that the lay person would have a hard time to understand, in my opinion.
And he goes further to provide his contact information “for parents who want me to participate in the diagnosis and treatment of their child.”

I can imagine desperate parents raising their hopes and being ready to invest (waste?) efforts, time and money on unproven treatments.

I think making non-scientifically proven claims and raise the expectations of people is a very delicate matter. We should raise our voices against it and explain the danger involved. I understand parents who will do anything to improve their situation. We the professionals in the field ought to safeguard them.

I usually recommend to share with the general public only proven effective treatments based on scientific research. On behalf of distressed and confused parents, I think it is the right thing to do.

 

Daniel Adatto, MA, BCBA
cadatto@tesidea.com

Raising Your Child with Special Needs

A child with special needs requires special care due to emotional, health, intellectual, developmental or physical reasons. It might be challenging, but it is also rewarding.

Research and clinical practice has repeatedly demonstrated that early intervention is linked with positive treatment outcomes. In seeking effective and research-based treatment for autism, you are on the right path.

Parents with kids with special needs often feel alone, as if they were the only ones facing these problems. It is important to know that you are not alone. We the professionals devote our lives to assist you. It is what we do for a living. Obtaining appropriate education and information will lead you to success. The school, the state health department, support groups and other parents are resources for you to learn more.  

Spend quality time with your child and don’t forget to have fun. Above all, a child with special needs is like any other child because all children have essential needs: acceptance, care, support and more than anything, love. The difference is that the child with special needs experiences delays in development which limit him/her from positive life experiences: learning from the environment and from school, enjoying outings, playing, making friends. This leads to frustration which in turn trigger behavior challenges.

Therefore, these children might be exposed to a state of permanent punishment. Although challenging behaviors produce an immediate desired outcome for the child (e.g. not participate in non-preferred activities, obtaining attention, escaping aversive stimuli, obtaining sensory stimulation) those behaviors also produce anger and frustration in the adults who deal with that child, avoidance by others, poor relationships and low self-esteem, loss of learning opportunities, or restraint.

It’s our job as parents, educators and therapist to rescue this child.

In the spirit of the Holidays, make helping your child a priority for the coming year. That would be the best gift.

 

Daniel Adatto, BCBA
cadatto@tesidea.com

Five Parenting Tips to Survive the Holidays

Holiday season is upon us, again. It feels that time flies, right?

A couple of years ago we posted a blog on the topic of helping your special needs child during the holidays:  

http://totaleducationsolutions.blogspot.com/2011/12/holidays-and-autism.html  

For families with a member who has special needs, the holidays can present unique challenges: lack of predictable and familiar routines, overstimulation, being away from home, and the caregiver himself being stressed, to name a few.    

Let’s review our top tips on how to navigate these troubled waters.

1. Keeping routines in place is the best ways to avoid holiday havoc: sleep/meals times, play/outing activities, etc.

2. When changes in routines are foreseeable, prepare your kids in advance. The use of visual aids, such as pictures, timers, schedule boards, can be very helpful when dealing with children with special needs.

3.   Avoid long trips whenever possible. Airports, planes and long car rides can be very stressful.

4.   At family gatherings prepare a quiet space for your child to retreat to when stimulus gets too intense and he/she needs a break.

5.   Don’t force your child to do anything unless it involves a safety concern or an emergency. Motivation by offering a preferred item/activity in exchange for doing something is always a better solution.

As I said in my previous blog, it’s important for you to relax and stay as calm as possible. Your child absorbs your mood and your stress can rub off. Have fun. You are your child’s barometer and if you are stressed out, he/she will be too.

 

Daniel Adatto, BCBA.
cadatto@tesidea.com 

It should be more than reacting

“Billy, stop”; “Billy, quiet mouth”; “Billy, no hitting”; “Billy, sit down”; “Billy, stand in line”; Billy, quiet hands.”
Although this reacting mode (intervening after the behavior to stop it) is part of our repertoire of tools as behavior intervention professionals, it shouldn’t be the only part, or even the larger. As “experts” on behavior management, our larger repertoire of strategies should be teaching appropriate, functional equivalent (serving the same purpose as the challenging behaviors) behavior repertoires. We should be behavior teachers.
Behaviors have a communicative function. The individual is conveying needs and wants. For example, when the student engages in dysfunctional self-stimulatory behaviors (tapping, self-talking, flapping hands, giggling and laughing with no reason, jumping, moving around constantly, getting out of seat, touching others, body rocking, etc.) in the absence of demands, he is telling us that he needs sensory stimulation. Thus, the recommended treatment in this case is (a) Increase/Provide Access to Alternative Sources of Stimulation: Sensory Diet: various sensory-based activities visually scheduled into the child’s daily routines; (b) Teach replacement behaviors: acceptable methods for gaining the same type of stimulation; (c) Interrupt and Redirect Behavior; and (d) Reward the replacement behaviors: use rewards that provide preferred sensations.
Sitting/standing next to student or behind him and telling/modeling him "stop", "quiet hands", "quiet mouth", etc. is not enough and should not be the only intervention.

Different treatments would be recommended if the child engages in the behaviors to escape non-preferred activities, or to obtain attention.

To summarize, the intervention should focus on teaching appropriate, functional replacement behaviors to communicate desired objectives, thus eliminating the need to engage in the problematic behaviors.
As stated in the textbook Applied Behavior Analysis, by John Cooper, Timothy Heron and William Heward, chapter 3, page 60, “A practitioner should never plan to reduce or eliminate a behavior… without (a) determining and adaptive behavior that will take its place and (b) designing the intervention plan to ensure that the replacement behavior is learned. Teachers and other human services professionals should be in the business of building positive, adaptive repertoires, not merely reacting to and eliminating behaviors they find troublesome (Snell & Brown, 2006).”

And this applies also to teachers, parents and every adult who interacts with that child.

For more information and tips, check out our blog “Responding vs. Reacting” at http://totaleducationsolutions.blogspot.com/2013/08/responding-vs-reacting.html 

Be a teacher, a behavior teacher and you will be not only eliminating/reducing problematic behaviors, but you will give that child the tools to be independent in life.

Daniel Adatto, BCBA.
cadatto@tesidea.com

 

It touched a nerve!

I always tell my team that it is important to stay professional, not let the things that people do get to us, not to get upset, and to continue offering our help to the best of our ability. Well, against my own advice this week I got upset.

I entered a session and the mother of our client said “I hope he’s OK today, he didn’t sleep from 1 am to 4:30 am.”

“What did he do from 1 to 4:30?” I asked.

“He played,” she replied with a smile on her face. I guess she thought it was funny.

In my head I was shouting “This is not funny. How is it possible that you let him stay awake that whole time?” It’s a good thing she could not hear my thoughts.

It is simply not OK to let a child stay awake in the middle of the night. If he cries and screams, as difficult as it is, you wait until he’s done and take him back to bed. It may seem easier to avoid the power struggle, but in fact it is not.

Yes I recognize that it was 1:00 AM and the mother did not have the energy to fight with the child. But, in allowing him to get away with this, is she really making things easier? For one, she ended up sleep deprived because she was not able to fall asleep again. Second, her son was now sleep deprived too, which in turn leads to behavior problems, difficulty learning, disrupting the classroom, etc. Lastly, it taught him one more time he can get his way. No wonder this child throws tantrums at school, including aggression, when he doesn’t get what he wants. “Why they don’t let me, at home I get everything I want when I want. Perhaps I have to be more assertive,” is what he is probably thinking.

I’ve been working with this family for over two years, educating this mom on behavior management and best practices when it comes to helping children with special needs. So I guess I must be the worst behaviorist ever. I quit! (Just joking, TES).

Children need to learn that there are rules, routines, laws they have to obey, the same way that you and I do on a daily basis. Letting them play instead of sleeping at night is simply not good parenting. Good parenting is setting rules and limits, and teaching children that they can’t always get their way. They are children so they will always try, and always test the limits. You might think it is “easier” now to give in, because you’re tired and don’t want to fight. But it is not. You are just making your life harder.

If the goal is to avoid tantrums and you want to take what you think is the easy route, then I suggest you let your kids stay home, eat junk and play video games when they don’t want to go to school; do not take them to the dentist when they cry; and allow them to skip the daily shower. Would you describe that as good parenting? I didn’t think so.

We discussed all this in previous blogs:

1. “The Power of Structure and Routines” (http://totaleducationsolutions.blogspot.com/2013/04/the-power-of-structure-and-routines.html ): “Routines: A predictable and consistent daily schedule (time-space-people in charge). Lack of predictability increases anxiety, which leads to problematic behaviors.”

1. “Limits and Consequences” (http://totaleducationsolutions.blogspot.com/2013/02/limits-and-consequences.html ):  “Limits are set to help your child to understand respect for himself and the world around him.”    

Deal with that tantrum now, even if you are tired. Think that it is an emergency, your child got hurt and you have to help him no matter how tired you are.

Good parenting; that is the easier way.

 

Daniel Adatto, BCBA
cadatto@tesidea.com

Autism, there is an app for that!

Developers dive in to create a wealth of autism apps

Parents, therapists and developers are eager to tap into what they view as a powerful tool to reach people with autism (http://articles.latimes.com/2013/apr/30/business/la-fi-apple-autism-20130430).

Andy Shih, senior vice president for scientific affairs at Autism Speaks, a national advocacy organization based in New York, helped organize a "hacking autism" event in San Francisco that drew 135 apps developers. Over the course of 24 hours, teams built prototypes for more than a dozen apps.

Nearly 1,500 autism apps are available in Apple's App Store.

Even as researchers just begin the process of trying to determine how effective such technologies are, parents, therapists and developers are racing ahead in their attempts to tap into what they view as a powerful tool to reach people with autism.

The range of these apps has expanded well beyond the initial focus of helping people with autism communicate and improve social skills to learning about emotions and delivering basic educational lessons in a format that's better suited to autistic learners, Shih said.

Howard Shane, director of the Center for Communication Enhancement and the Autism Language Program at Children's Hospital Boston, said while he's eager to see more studies, his experience with the iPad and autistic children has been so overwhelmingly positive that he's content to push forward with finding new and better ways to use it.

"The clinical evidence is still emerging," Shane said. "But the excitement and interest in these technologies exists because they are working."

Bill Thompson, a school psychologist at the Orange County Department of Education, who wrote some of the first autism apps, said he's trying to find ways to make their use more effective. Many educators and parents, for instance, like the iPad and other mobile gadgets simply because they can be used as a powerful reward to reinforce a desired behavior. Complete a task, get some iPad time.

That's understandable considering that it often can be hard to find rewards that motivate some autistic children. But Thompson said he'd like more of the iPad time used for educational purposes, rather than just getting bonus Angry Birds time. For instance, Thompson has created a system in which a classroom with many kids on the autistic spectrum use iPads that can be beamed onto a large-screen TV using an Apple TV unit to enable them to communicate with each other in ways they might not otherwise.

Finding rewards that motivate autistic children, that’s the challenge, that’s the key. You cannot teach if you cannot motivate. Think about yourself sitting in a boring class, listening to a boring teacher talking about a topic you couldn’t care less about. Your mind will be focused on anything but the class. And you won’t remember anything later. That’s what happens to our kids, in particular those with special needs. And we know that all kind of challenging behaviors emerge when the kids are bored, or worse, when we force them to work on non-preferred activities. That is the challenge and that is the meaning of “special” in “Special Education.”

And it is not only the rewards that motivate. We must find and use powerful tools to reach people with autism. The activity has to be stimulating enough to motivate them. If we know that they can focus and concentrate when they are watching TV or playing video games, we must use the same technology to teach.

There is no time to waste. Every awaking moment in the lives of these kids is precious. They are so behind that it is immoral, I believe, to waste time with ineffective instructional strategies.

Motivate and you’ll get the response you want. McDonalds knows that. Kids TV channels know that. Video games builders know that. When are we, parents, therapists, “special educators” going to know that?

 

Daniel Adatto, BCBA
cadatto@tesidea.com

Healthy Dining

On Friday September 13, 2013, the LA Times published the following article:

“Public Health Dept., restaurants team up for healthier dining

http://www.latimes.com/local/la-health-restaurants-20130913,0,3105477.story

L.A. County restaurants are joining the Public Health Department's campaign to offer patrons smaller portions and healthier children's meals. The Los Angeles County Department of Public Health launched a partnership Thursday with restaurants throughout the region to promote healthier options for customers. To be part of the Choose Health LA Restaurants program, places must offer smaller portion sizes and healthier children's meals with less fried food and more fruits and vegetables.

The program is the latest effort to attack the obesity epidemic in Los Angeles County, where about 23% of residents are obese. The county has also been encouraging residents to eat less and to give up soda and other sugar-sweetened beverages. "Small changes in what we eat every day, at every meal can make a huge difference in terms of not only our weight but our overall health,"

Kudos to the Los Angeles County Department of Public Health officials. I believe these kind of initiatives put us in the right path to a better quality of live. Although far from reaching a critical mass, I think, every little effort counts. The obesity problem, and child obesity in particular, is that serious.

As we discuss in previous blog (See “Overweight Children” and “Obesity II”, May 2012), “…it is about your behavior, mom, dad, not your child’s. You change the child’s behaviors by changing the behaviors of the adults that take care of that child. Plain and simple. No kid starves if there is food available. So it is about what is available.”

We are responsible for our health. But more so for our children’s health. And that is good parenting.

 

Daniel Adatto, BCBA

cadatto@tesidea.com