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PRIORITIZING THERAPIES FOR CHILDREN WITH AUTISM SPECTRUM DISORDERS

PRIORITIZING THERAPIES FOR CHILDREN WITH AUTISM SPECTRUM DISORDERS. NAA- NY Metro Chapter November, 2008 Patricia S. Lemer, M.Ed., N CC Executive Director Developmental Delay Resources (DDR) www.devdelay.org devdelay@mindspring.com 800- 497- 0944. AUTISM SPECTRUM DISORDERS (ASD).

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PRIORITIZING THERAPIES FOR CHILDREN WITH AUTISM SPECTRUM DISORDERS

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  1. PRIORITIZING THERAPIES FOR CHILDREN WITH AUTISM SPECTRUM DISORDERS NAA- NY Metro Chapter November, 2008 Patricia S. Lemer, M.Ed., NCC Executive Director Developmental Delay Resources (DDR) www.devdelay.org devdelay@mindspring.com 800- 497- 0944

  2. AUTISM SPECTRUM DISORDERS (ASD) AD(H)D LD ASPERGER’S PDD AUTISM ………………………..………………………….. Least severe More severe Most severe

  3. ALPHABET SOUP • AUTISM LD • ASPERGER’S NLD • PDD GTLD • PDD-NOS SPD • ADD OCD • ADHD

  4. WHAT A DIAGNOSIS SAYS • A diagnosis describes a cluster symptoms. • People with the same diagnosis display the same symptoms, but do not necessarily require the same treatments. • Determining appropriate treatments requires knowing cause of symptoms. • Determining cause requires taking a complete history. • History must be pre-natal, natal, environmental, developmental and medical.

  5. TOTAL LOAD THEORY • The body is like a bridge, and can handle only a limited number of stressors. • Cumulative effect of stress factors overloads it. • Body’s top priority is staying well. • Sensory, language, social-emot. development must take a back seat to biological issues. • Degree of overload determines diagnosis. • Specific load factors determine treatment.

  6. GENETIC LOAD FACTORS • Parents with immune system dysfunction • Chronic fatigue, fibromyalgia, familial allergies • Nutritional/endocrine deficiencies, including thyroid and EFA • Environmental toxic exposure prenatally

  7. ENVIRONMENTAL INSULTS • Pregnancy complications - birth trauma • Smaller incidence of breast-feeding • Allergy-prone foods, including milk/wheat • Insufficient sensory stimulation • Aggressive use of medications • Immunizations containing toxic metals • Toxic metal exposure through other sources: Kuwait, Rh negative

  8. Group Exercise on “Total Load” • List possible genetic load factors in your family • List possible environmental insults your child(ren) may have had

  9. EVERY CHILD IS UNIQUE • Restoring health is like restoring a fine painting: you must know its history; • It takes at least as long to get well as it did to get sick; • Need for a prioritized model of therapies; don’t take therapies “off the shelf.” • Look at “total load” factors • Genetics loads the gun, environment pulls the trigger

  10. TAKE A DEVELOPMENTAL APPROACH • Lay the foundation for motor, sensory-motor, language and cognitive development, all of which must wait until health improves. • Development follows a predictable hierarchy. • Skipped developmental steps can cause later problems. • Uneven and spotty development increases over time without intervention.

  11. STEP 1 Lay the Foundations • STRUCTURAL • BIOLOGICAL • Dietary • Nutritional • DETOXIFICATION

  12. STRUCTURAL SYSTEM • WHAT GOES WRONG Organs, fluids, bones and connective tissues are out of balance due to birth or other trauma • SIGNS TO LOOK FOR • Long labor, forceps delivery, C-Section • Delay in sucking, reflux, vomiting or spitting • Strabismus, nystagmus, reduced acuity • Missing stages in motor development

  13. STRUCTURAL THERAPIES • Chiropractic • Osteopathy • Cranio – Sacral therapy • Massage • Other “Bodyworks” therapies

  14. Structural Checklist • What, it any, structural “load factors” does your child(ren) have? • What interventions have you already done? • Which interventions might you consider?

  15. IMMUNE SYSTEM • WHAT GOES WRONG • System becomes exhausted from constant assaults from too many load factors • SIGNS TO LOOK FOR • Allergies, asthma, leaky gut, skin problems • Chronic ear/sinus/strep infections • Heavy use of antibiotics • Dark circles, red ears and cheeks

  16. LOOK AT DIET • ROTATE • Grains, fruits, nuts, protein sources • ELIMINATE WHITE FOODS • Dairy, wheat flour, salt, sugars • SUBSTITUTE • Organic, natural sweeteners • EXPERIMENT with new products • COOK good quality, simple foods

  17. DIETARY MODIFICATION • Diet free of artificial colors, flavors, additives and salicylates • Diet free of gluten and casein • Diet free of yeasts, molds & sugar • Drink good quality & ample water • Special diets – GF/CF, SCD, etc.

  18. TRACK DOWN HIDDEN FOOD SENSITIVITIES • Artificial colors, flavors and preservatives • Dairy products • Corn • Wheat • Eggs

  19. LOOK AT SPECIAL DIETS • Feingold • Yeast-free • GF/CF • Specific Carbohydrate Diet (SCD) • Body Ecology Diet (BED) • Minimze use of “prepared” foods • Rediscover your kitchen • Take cooking classes; buy books

  20. BODY ECOLOGY DIET • 7 Principles - acid/alkaline, 80/20, food combining, contraction/expansion • Fermented Foods • Coconut oil, kefir and pudding • Celtic sea salt • Only nutritionally dense foods

  21. Diet Exercise • What foods are missing in your families diet? • What foods does your family eat too much of? • What can you do to improve the quality of your families diet? • Which “special diets” have you tried? • Why did it work or not? • Which “special diet” might be best for your family?

  22. NUTRITIONAL SUPPLEMENTATION • Closes the gap between what is eaten and what the body needs • Helps with poor absorption • Detoxifies environmental chemicals • Heals the leaky gut • Repairs the nutritional deficiencies • Boosts the immune system

  23. BIOLOGICAL STATISTICS • 99% - Omega 3 Fatty Acid Deficiencies • 90% - Zinc Deficiencies - Copper Excess - Immune Disregulation • 80% - Chronic Diarrhea / Constipation • 80% - > 5 Ear or strep infections • 50-70% - Mercury (Hg) Toxic

  24. CLEAN UP ENVIRONMENT • Use non-toxic cleaners • Use natural fiber clothing and household items • Eliminate pesticides • Drink filtered water • Watch art materials • Eliminate passive smoking

  25. VITAMINS & MINERALS • Zinc, chromium, selenium for detoxification of heavy metals • Calcium – balance with magnesium • DMG/B6/magnesium • Folic acid • Vitamins C, E, B-complex

  26. TESTING FOR TOXICITY • Urine, hair and blood tests for recent exposure • Immune system testing and observation for past exposures • “Challenge”tests • Stop all ongoing exposures

  27. DETOXIFY • Reduce exposures • Amalgams, some fish, new construction • Homeopathic detox • Assists the body to heal itself from inside • Chelation • Promising; changing protocols • Nutrients • Sauna • All require strict medical supervision

  28. HOMEOPATHY • 200 year old approach that helps the body’s ability to heal itself • Based on the concept that like cures like • Addressess whole body, not just physical body • People get sick from the outside in; they get well from the inside out • Homotoxicology – a safe way to detox slowly from the deepest cellular level

  29. STEP 2 • Lifestyle changes to include exercise • Reflex integration • Sensory integration/OT • Brain Gym • Vision therapy • Use of lenses and prisms • Auditory Integration

  30. ASSURE ADEQUATE PHYSICAL EXERCISE • Helps elimination, sleep, executive function and concentration • Boosts serotonin levels • Vestibular stimulation • Walking • Relaxation and meditation, yoga

  31. REFLEXES • Over 100 involuntary movements that are controlled by the brain stem • In infancy protect and assist with survival • Lead to the development of movements • As they integrate person gains volitional control over body • Result is skilled, intentional behavior • If unintegrated, interfere with behavior

  32. Reflex Timetable

  33. CONSEQUENCES OF REFLEX ABNORMALITIES • Aberrant motor development • Poor lateralization • Hyper- or hypotonic muscles • Vestibular dysfunction • Poor binocularity • Eye motor difficulties • Perceptual problems

  34. SENSORY INTEGRATION Near senses • Touch • Movement • Muscles and joints (proprioception) Far senses • Vision • Audition All must work together!!

  35. VESTIBULAR SYSTEM • Balance system • Located in the inner ear • Key to well-integrated sensory function • Connected to: • Language center of the brain • Digestive tract • Eye muscles • Requires suspended equipment

  36. BRAIN GYM • Learning is not all in your head • Educational kinesiology • Integrates top with bottom, left with right and front with back • Can benefit everyone • Takes only a few minutes each hour • KIDS LOVE IT !!

  37. Movement Exercise • What movement activities is your family participating in on a regular basis? • What are some opportunities to turn daily activities (such as going to and from school) into movement? • How can you integrate tools like Brain Gym and Reflex integration into your day?

  38. VISION • Different from eyesight • Eye movements • Binocularity • Focus, convergence • Visual-motor integration • Visual perception • Visualization

  39. VISUAL SYMPTOMS IN AUTISM • Poor eye contact • Staring at lights and/or spinning objects • Looking askance • Side viewing • Stimming • Inflexible behavior

  40. WHO EVALUATES & TREATS VISION PROBLEMS • Ophthalmologist – MD - looks at pathology, disease, structure • Optometrist – OD – looks at function • Occupational Therapist –OT • Psychologist – Ph. D. • Educator – M. Ed. All look at end-product skills

  41. VISION THERAPY • Delivered by behavioral optometrist • Always done in the context of movement • Uses lenses therapeutically • Facilitates using the 2 eyes effectively • Teaches eyes to move, align, fixate and focus as a team • Coordinates messages from eyes with brain for perception and cognition

  42. EFFECTS OF LENSES & PRISMS • Research shows those with autism benefit greatly from yoked prism lenses • Send different messages to the brain • Brain interprets new information and integrates it • Magnify or make thing smaller • Make objects appear closer or further away • Change spatial perception • Give the brain a preview of what is possible

  43. Organization & Attention • A well-organized body is like a well-rehearsed orchestra: it is in tune. • Organize the body from large motor to the smallest parts: • Lower body, trunk, shoulder, arm, wrist, hand. • Lower body, trunk, neck, head, eyes. • Organize yourself before another person. • Take your own view before another’s. • Organize on the body before on the paper.

  44. Vision Exercise • What visual symptoms does your child(ren) manifest? • Are they frequent or infrequent? • How are they related to your child(ren)’s Total Load? • Who has evaluated your child(ren)’s vision? • Is it time to (re)evaluate vision?

  45. STEP 3 • Focus on LANGUAGE • Assumes that all sensory systems are GO • ACADEMICS - May need VISION THERAPY before READING, WRITING & MATHEMATICS emerge • SOCIAL SKILLS

  46. SPEECH-LANGUAGE THERAPY • Often the first place families turn • Oral-motor issues related to prematurity • Interaction with feeding/eating problems • Co-treatment with OT • Consider missing links to talking • Role of movement and vision • Moves from general to specific • Relationships between receptive, expressive language, reading and writing

  47. ACADEMICS • Use strengths to improve weaknesses • Look at process, not end product • Encourage thinking not memorization • Use child’s meaningful life experiences • Understand the role of VISION in reading, writing, mathematics

  48. SOCIAL SKILLS • The most complex outcome of sensory integration • Touch (tactile defensiveness) • Vestibular or Balance • Where am I, where are you? • Vestibular relationship to vision + language • VISION • Focus • Giving meaning to body language • Depth perception

  49. STEP 4 • TRANSITION & ESTATE PLANNING • REVISIT NUTRITIONAL NEEDS with hormonal changes • VISION THERAPY moves from binocular to visual thinking • VOCATIONAL TRAINING • LEISURE TIME ACTIVITIES & HOBBIES

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